Over 2.6 billion people do not have adequate toilets, sewers, or latrines. This is also bad news for other development goals, including education, gender equality, and public health.
 | A girl brushes her teeth in a refugee camp in East Timor. Refugees are among the 2.6 billion people who do not have regular access to adequate sanitation (Photo: Reuters) |
Most people in Europe and North America don't worry much about finding a clean toilet. But if French novelist Victor Hugo was correct in saying that sewers reflect "the history of men," ours is one of neglect and ignorance.
A century and a half after the first campaigns to introduce sanitation in Victorian London, a third of humanity still lives without adequate toilets and sewers. Some countries like China are making steady progress toward improving access to clean water, but the other half of the global water crisis - lack of sanitation - remains elusive.
Around 86 percent India's 1.1 billion people, for example, have access to clean water - up from 70 percent in 1990. But only 33 percent have sanitation that the UN considers adequate: a toilet connected to a public sewer, a septic system, or an improved pit or pour-flush latrine. Many of the 700 million people in India without any of the above defecate in the bushes, on roadsides, or into the streams and rivers that others bathe in and drink from.
This situation is not only undignified, it is also a central cause of diarrhea and other water-borne diseases that kill over five million people each year. The United Nations declared 2008 the International Year of Sanitation, and used high-profile meetings with experts, celebrities, and even European royalty to draw public attention to this problem.
When girls in developing countries reach puberty, for example, many drop out of school entirely because the sanitary facilities at schools are not welcoming to the onset of the menstrual cycle. And when girls and women must venture far to use the toilet, sometimes at night, going to the bathroom can be a safety risk.
Toilet talk
A key to any sanitation awareness campaign will be overcoming the prevailing taboos and sensitivities that prevent frank discussion of the topic.
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"We've managed to talk about sex when it comes to HIV and AIDS, but we still can't talk about pee and poo, and how it affects people's everyday lives and social and economic development," says Cecilia Martinsen of the Stockholm International Water Institute (SIWI), a policy institute that hosts the World Water Week each summer in the Swedish capital.
Another big hurdle to improving sanitation is changing behavior at the local level. Martinsen says efforts to simply introduce latrines in communities where there were none before usually fail. Building capacity must go hand-in-hand with social marketing initiatives that communicate the connections between disease, polluted water, and sanitation.
"We need to start looking at it as not only a matter of technology," says Martinsen. "It's a different approach then we've done in recent years, when we've focused on bringing latrines and infrastructure. People come back five years after one of those infrastructural projects, and find that people were using these latrine for rice storage."
"If they aren't used, then we haven't really got rid of the problem," says Martinsen. "We might have access to latrines, but there will still be 5,000 kids that die every day from unsafe water and sanitation-related diseases."
Others want to mobilize market forces to fill the sanitation gap. Jack Sim, founder of the World Toilet Organization, a Singapore-based non-profit, says that creating demand for better toilets is the only way to make any sanitation improvement campaign sustainable.
"Right now, if you look at sanitation, it is a dysfunctional market," says Sim. "It does not have a demand, does not have supply, and does not have efficient price mechanism or profit motive. It relies on donations that are few and far between, and the projects come only one at a time."
Sim says that local entrepreneurs could meet this demand. In one recent project in tsunami-devastated Banda Aceh, Indonesia, Sim's organization built public toilets designed to convert human waste into methane gas that can be sold for cooking. Entrepreneurs willing to operate and maintain the toilets would be "paid in gas."
The UN International Year of Sanitation highlights solutions that could speed up progress on sanitation. According to Jack Sim, the year is necessary to create a structural change in the mindset of people in the way we address this issue this year, because next year will be the international year of something else."
editor: Valdis Wish
Latest update: May 4, March 2009
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