In Makerere Kivulu, an informal settlement below Makerere University, the waste trucks often don’t come. Local leaders say collection providers pass the settlement by serving wealthier neighbouring areas. Collection for low-income settlements is meant to be free. In practice, residents often pay informal fees or bribes to have their rubbish taken away.

Kivulu’s parish chairman has stopped waiting. When waste sits uncollected for more than two weeks, he asks residents to photograph it and post the pictures to community WhatsApp groups and municipal portals. He also sees value in what residents throw away. Young people who have left school now earn a living sorting waste and selling plastics and food scraps such as banana and potato peels.

Neglect and opportunity, side by side, ran through a multi-sector policy dialogue on flooding and waste management, held in Kampala on 22 July 2026. It built on two previous CASCADE City Learning Labs (first, second), where flooding and poor waste management emerged as Kampala’s most critical public health threats, and brought together residents of informal settlements, the Kampala Capital City Authority (KCCA), national government, researchers, civil society and the media.

875 tonnes with nowhere to go

Kampala generates about 2,500 tonnes of solid waste a day. KCCA collects around 65%. The remaining 875 tonnes, more than a third of everything the city throws away, stays in communities every day, much of it in drainage channels. In Bwaise, home to more than 20,000 households, collection can take three to four weeks. With nowhere else to put it, residents dump waste in the channels, and the next rains carry it through the settlement.

Plastic bags lodge in drain pipes, sediment settles behind them, and channels that were already too small overflow. Across the city, flooding now affects more than 153 villages and puts over 170,000 residents at direct risk, with losses from property damage and business disruption estimated at US$50 million.

When the water comes in

Dr Stephen Okoboi, who leads CASCADE in Kampala, described it as a cycle: waste blocks the drains, the drains flood, and floodwater contaminates the water people depend on. Sewage-contaminated floodwater spreads cholera, typhoid and dysentery, and standing water breeds mosquitoes, raising the risk of malaria.* The Ministry of Health linked flooding in informal settlements to outbreaks of diarrhoeal disease and measles. In Kivulu, which takes runoff from the higher ground around the university, some residents drink harvested rainwater without boiling it because fuel is costly. In some areas, open drainage channels without barriers have led to drownings that often go unreported.

A Bwaise community leader described how women and single mothers there sleep in waterlogged homes, live with persistent cold-related illness, and face infections when pit latrines flood. Health facilities are not spared. Unplanned development and road construction have altered drainage around a health centre in Bukoto, which now floods in heavy rain, cutting patients off from care and destroying supplies and records.

The obvious fixes, clearing floodplains and building bigger drains, carry their own costs. KCCA acknowledged that they can displace the very residents those works are meant to protect.

Finding gold in the rubbish

Other answers start with the waste itself. Back in Kivulu, the chairman argues that teaching households to sort their waste early could turn the young people’s trade into something much bigger. More than 70% of what Kampala throws away is organic, mostly food and garden waste. The National Water and Sewerage Corporation sees energy, poultry feed and fertiliser in it. Dr Henry Semakula of Makerere University agreed with the chairman, calling for community education that shows households how to earn from waste, not just raises awareness.

None of this works unless waste is sorted at home. Once food scraps are mixed with everything else, they rot on the way to the disposal site and lose their value. Many households already put plastic bottles aside, but with nowhere to drop them off, the bags simply pile up.

Those who already sort Kampala’s waste by hand do so without protection. Some private clinics and drug stores put used needles and syringes in with ordinary rubbish, and waste pickers at disposal sites are injured handling it. If waste is to become a livelihood, that work has to be made safe.

Sharing the load

Participants agreed on three priorities. The first echoed the chairman: waste is not KCCA’s problem alone, and everyone’s responsibilities need to be clear. Local councils, parishes and residents need a say, including in where disposal sites go. Second, sorting at home should pay, through buy-back centres and buyers for recovered materials. Third, waste collection should be an essential public service, funded nationally, matched to how much waste each area produces, and designed with women, young people and informal waste pickers in mind.

Promises in the pipeline

Following the deadly collapse of the Kiteezi landfill in 2024, the Government of Uganda has released funding for an Integrated Waste Management Facility at Buyala, with dedicated sorting zones. KCCA is revising its 2000 Solid Waste Ordinance to make household sorting mandatory, with surcharges on unsorted waste. It is also mapping buyers of recovered materials and will register and accredit informal bottle and metal collectors, a step that could bring workers like Kivulu’s young people into formal recognition. A plastic recycling facility has opened at Wankoko.

KCCA has designed a City Disaster Early Warning System, though only US53,000 of the US800,000 it needs has been secured. The Ministry of Health has issued updated healthcare waste procedures for public and private facilities and is linking private clinics to centralised incinerators.

Will it reach Kivulu?

Kampala already has workable solutions, Dr Okoboi said in closing. What it needs is coordinated action across institutions, well-documented evidence, and investment in flood prediction and early warning. Participants’ recommendations are being compiled into a policy report for KCCA’s Executive Director, and KCCA has committed to reviewing it across its directorates.

The test will be whether those commitments reach places like Kivulu, where residents are still photographing uncollected waste and paying to have it removed.

* Malaria is a national concern: Uganda is one of five countries that together account for more than half of the world’s malaria cases, according to the World Health Organization.

This piece draws on the internal report of the Multi-Sector Policy Dialogue on Flooding and Waste Management, held in Kampala on 22 July 2026 and organised by the CASCADE Kampala team at the Infectious Diseases Institute and Makerere University, led by Principal Investigator Dr Stephen Okoboi with Co-Principal Investigator Dr Paul Mukwaya.

Co-authored by Hugo De Lemos and Alacia Armstrong.