Waste management has been a challenge in the Freetown municipality of Sierra Leone for a long time, underpinned by the limited capacity of institutions responsible for waste collection and depositing. These challenges come with a huge cost to human health. The situation is even worse for people living in informal settlements within and on the fringes on the city. The lack of a well-planned and regulated waste management system in the informal settlements is a key driver of indiscriminate waste dumping. Waste dumping by communities, mostly in waterways, drainages and under footbridges, are invariably linked to health challenges for informal communities and built-up settlements located alongside those communities.