Tomorrow, November 19, is World Toilet Day and to celebrate I thought I‘d tell you how I fooled God when I was about four. I was playing outside and needed to go to the toilet, urgently, but realised I wouldn’t make it home in time and guessed that peeing outside was probably a sin. But in my personal theology, God was like a geostationary satellite observing the Earth from high in the sky, so I figured that if I hid under the overhang of a roof while I did the dastardly deed, I’d be OK. My relief was short-lived though as I saw with horror that I would be betrayed by the trickle seeping out into the open and He’d see me as soon as I quit my hiding place. So I edged round the building, back to the wall, then casually strolled away on the other side, whistling innocently, and leaving the Almighty to solve the mystery of the phantom pee.
It’s amusing now, but for hundreds of millions of people the world over, not being able to go to a toilet still has far more immediate consequences than divine retribution. 2.5 billion people don’t have access to a clean and safe toilet, so they improvise. For 1.1 billion people, the solution is open defecation, a practice that poses a major threat to human health, but also to economic and social development, as well as being an affront to human dignity.
As the 2010 Millennium Development Goals Report points out, indiscriminate defecation is the root cause of faecal-oral transmission of disease, which can have lethal consequences for young children. In this article, we gave the figures for what that means: in any given week, around 30,000 children under the age of five will die from water-related diseases, that’s one every 20 seconds. Unsafe water now kills more people than all forms of violence, including war, with diarrheal diseases claiming 1.8 million victims a year and causing more deaths in children under 15 than the combined impact of HIV/AIDS, malaria, and tuberculosis.
Sanitation is also a gender issue. Women and girls have a greater need for privacy than men and boys when using toilets and when bathing. Inaccessible toilets and bathrooms make them more vulnerable to rape and other forms of sexual violence, especially if they have to walk long distances at night.
If they live in rural areas of developing countries, they also face a greater risk of being attacked by animals in the bush because women and girls tend to move quietly in order to be discreet. Snakes and other animals are then not scared away and are more likely to be surprised by the women’s presence and bite them. The solution is often to use “flying toilets” – human waste disposed of in plastic bags thrown into the open, a double source of pollution from both the wastes and the plastic bags.
Women and girls also have a much greater need for privacy and dignity when menstruating, and the taboos surrounding this in many cultures make the problems worse. Separate toilets for girls in school, for example, mean more girls are likely to attend classes in the first place, and more girls are likely to stay after puberty to complete their education. The World Toilet Day website puts it like this: “In many countries, girls stay home during their menstruation days because the absence of a safe place to change and clean themselves makes them feel unsecure … Besides the emotional stress, poor menstrual hygiene often leads to health problems such as abdominal pains, urinal infections and other diseases.”
Catarina de Albuquerque, UN expert on the right to safe drinking water and sanitation agrees: “Women and girls place higher value on the need for a private toilet than men, and thus are often willing to devote household resources to gaining such access. However, women are rarely in control of the household budget, and access to sanitation remains a low priority in many parts of the world.”
Unless policies and practices change significantly, the number of people without access to basic sanitation is expected to grow to 2.7 billion by 2015 and the world will miss the MDG target of halving the proportion of people without access. Almost 1.5 billion will still not have access to improved sanitation in 2050. The consequences for water quality are severe and made worse by the fact that progress in treating wastewater does not always keep pace with progress in collecting it, resulting in new sources of nutrients and pathogens being dumped untreated.
Issues related to water and sanitation are a priority for the OECD and you can find information here on our World Toilet Day webpage on a range of topics, including health impacts. A number of people working at the OECD are also involved through our War on Hunger Group. For example, last year the Group funded a project in Mozambique to reduce diarrhoea by at least 25% in children under the age of five by training in hygiene and changing current practices. The project also improves access to drinking water and to sanitation through the construction of protected water points and 60 family latrines. It contributes to the sustainability of the protected water points by establishing local maintenance services.
Colleagues from the War on Hunger Group told me that you need to accompany the building programme with education. Their experience suggests that, in some countries, the toilets are used as a much appreciated shed or store room, and people continue to go to the fields. The problem is the cleaning, which in some places can only be done by certain (often stigmatised) groups, such as untouchables in India.
If you’re wondering what you can do, Matt Damon has an idea:
The War on Hunger Group helps people tackle a number of problems that we in the developed countries never have to worry about, for example the fact that air pollution from cooking will soon kill more people in developing countries than malaria, tuberculosis or HIV/AIDS. This article from the OECD Observer describes how WHG contributing to a solution
* Insert your own joke about making a splash, flushed with success, etc