Improving sanitation

Four out of ten people in the world, 2.6 billion, do not have somewhere safe and clean to go to the toilet. The majority of these people live in Asia where just over half the population (52%) do not have adequate sanitation.

Poor sanitation means bad health. Bacteria, viruses and parasites found in human waste are responsible for the transmission of cholera, typhoid and other infectious diseases that kill millions of people every year. 

Yet, basic latrines alongside knowledge and understanding about the connection between hygiene and diseases can save lives, so much so, that Mahatma Gandhi once said, "Sanitation is more important than independence."

What is sanitation?

Sanitation can be defined as access to excreta disposal facilities. In the developing world, this often means access to an 'improved' latrine like those that WaterAid and its partners promote.

In addition adequate sanitation means a clean, private environment, as well as knowledge and understanding about the connection between hygiene and disease.

The problem

It is often women and children who suffer the most from poor sanitation.

Credit: Brent Stirton

It is often women and children who suffer the most from poor sanitation, especially in the world's poorest communities where malnourished children are more vulnerable to disease.

Diarrhoea is the second biggest killer of children under five worldwide (after pneumonia) but in most cases it can be prevented through safe water, sanitation and hygiene education.

The lack of adequate sanitation facilities prevents girls from attending school, particularly when they are menstruating.

Of the 104 million children currently not enrolled in school worldwide, 62% are girls. Yet girls' attendance at school is increased through improved sanitation.

For example, in Bangladesh, a school sanitation programme has increased the enrolment of girls by 11% per year since it began in 1990.

In many cultures, women who have no access to a latrine must wait until it is dark to go to the toilet or they have to walk long distances to find an isolated spot.

This exposes them to the danger of sexual harassment, assault and animal attacks, never mind discomfort and sometimes illness.

These problems can all be prevented by having a safe, clean toilet close to home. Enabling women's voices and problems to be heard in the decision-making process is not easy, but a crucial part of the solution.

Pollution and urbanisation

Sewage can contaminate wide areas, posing a serious public health hazard.

Credit: WaterAid / Caroline Penn

Sewage pollution is the largest and most common type of pollution. For example every minute 1.1 million litres of raw sewage are dumped in to the Ganges River in India.

The pollution of surface water, rivers and groundwater by sewage spreads disease and causes environmental degradation.

The problems are exacerbated by rapid urbanisation as every day 160,000 people move to cities from the country.

At least 600 million urban dwellers in Africa, Asia and Latin America live in squatter settlements. The number of people living in these settlements is expanding so rapidly that governments are unable to keep up with the necessary infrastructure development.

Because of the increasing problem in urban settlements, we are now expanding our work in these areas to help address this growing need.

Economics
Poor health resulting from inadequate sanitation has a knock-on effect on family economy. This results in a severe drop in income and a negative effect on the whole family's nutrition.

A study in Karachi found that people living in areas without adequate sanitation who had no hygiene education spent six times more on medical treatments than those with sanitation facilities.

Poor sanitation also affects the national economy: significant funds are spent on health care and medicines to combat disease, while many school and working days are lost to ill-health resulting from poor sanitation.

Water-related diseases (the consequence of a combination of lack of clean water supply and inadequate sanitation) costs the Indian economy 73 million working days a year.

Sanitation - a dirty word?
Sanitation can be an embarrassing subject. It can be a taboo, regarded with horror or ignored.

It takes time to create an environment of trust where people will speak with complete strangers about such intimate matters as going to the toilet.

This is why hygiene education is so important in WaterAid projects. While it is often a lack of privacy that makes people initially want a latrine, once they understand the links between diseases and the lack of sanitation people are more likely to ensure that all family members use them hygienically.