NOVEMBER 2018

2.3 Billion People Have No Place to Go: Taking Action to Address the Global Sanitation Crisis



“It is easy to take a toilet for granted – lock the door, do your business, flush when finished, and forget all about it. But for 2.3 billion people worldwide – almost one in three – such a normal part of daily life is out of reach.”

– Out of Order: State of the World’s Toilets 2017, WaterAid

Rahab, 20, lives in a camp for internally displaced people in Abuja, where there are no decent toilets. For her this daily necessity is a dangerous outing: “We go to the toilet in the bush. It is risky as there are snakes and I have also experienced some attacks from boys. It is not safe early in the morning or in the night as you can meet anyone.” (Inter Press Service)

Rahab is not alone. She’s one of more than a billion women and girls in the developing world who do not have access to a toilet. Like Rahab, many of these women and girls are forced to defecate in fields or alleys – often under the cloak of darkness to preserve some dignity – putting themselves at the peril of violence or sexual assault and making this every-day necessity a daunting challenge.

Globally, 2.3 billion people – almost one in three – lack access to adequate sanitation and 892 million people still practice open defecation. To draw attention to the global sanitation crisis – and to inspire action, the UN has named November 19th, “World Toilet Day”. That is because even beyond the inconvenience or potential peril faced by women like Rahab, the lack of adequate sanitation globally has devastating consequences.

Here are some of the harsh health implications, with statistics drawn from leading international WASH NGO WaterAid, as well as data from UNICEF and WHO.

  • Every minute a new-born dies from an infection caused by lack of safe water and unclean environments
  • Diarrhoea caused by inadequate sanitation kills 289,000 children every year
  • Children who survive are more susceptible to malnutrition and stunting. Stunting causes physical and intellectual challenges that last a lifetime. Malnutrition is the underlying cause of 45% of child deaths
  • Poor sanitation increases the risk of infection in childbirth; sepsis accounts for 11% of maternal deaths
  • 1.8 billion people use an unimproved source of drinking water with no protection against contamination from faeces.

As the UN has reported, ‘toilets save lives, because human waste spreads killer diseases’. Lack of sanitation also undermines personal and economic potential – especially for women and girls.

No toilets in schools: a proxy for ‘lost potential’

Imagine a 13-year-old girl living in Mali or Bangladesh or Kenya. Like girls everywhere she has dreams. But her school, like one in three schools globally, doesn’t have a toilet. For girls, the lack of a toilet, let alone a separate toilet, has proven to be a significant barrier to staying in school. Without a safe clean place, girls are more likely to miss classes if they are menstruating or to stop attending school all together once they hit puberty. Newly released data from WHO and UNICEF report that 31% of schools globally do not have a basic drinking water service, 34% do not have basic sanitation and 47% don’t have a basic hygiene service.

On the flip side, having a safe clean toilet for girls in schools increases student attendance, contributes to dignity, respect and gender equality and significantly reduces hygiene-related disease. For example, in Bangladesh, girls’ attendance increased by 11% when sanitation facilities were made available.

Progress is possible – but it isn’t happening fast enough

The world, through the Sustainable Development Goals (SDGs), specifically SDG 6, has made a commitment to ensure availability and sustainable management of sanitation and water for all by 2030. This includes a commitment to ending open defecation and achieving access to adequate sanitation.

We have seen some progress. However, this progress is uneven. In 10 countries in sub-Saharan Africa with the most severe sanitation challenges, 7 of 10 people still lack access to even basic toilets. At this rate, we will never meet the SDG for sanitation. In part that’s because sanitation still lacks the political will and resources commensurate to the need. For example, according to the Statistical Report on International Assistance, Canada spent only $37 million in 2016-217 on aid for basic or large-system sanitation. This is less than 1% of our aid budget.

And, since WASH is critical to so many of the SDGs, if we miss the target on WASH, the implications for progress in other areas, from health to education to gender equality, will also be harder to achieve.

It’s time to raise awareness and to take action on sanitation. The lack of access to sanitation not only undermines human dignity – it has serious implications for health, education, income, and women’s empowerment and security. By working together, we can reach everyone, everywhere within a generation – and transform millions more lives for good.

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