India has the most women waiting for a toilet – reveals WaterAid’s report, calls for urgent action

16 September 2017
India has the most women waiting
Image: Poulomi Basu

India remains the nation with the most people without toilets, reveals WaterAid’s State of the World’s Toilets 2017 report. Despite immense progress through the Swachh Bharat Mission, more than 732 million people still suffer fear and indignity of relieving themselves in the open or in unsafe or unhygienic toilets – a situation that is worse for women and girls.

‘Out of Order,’ WaterAid’s third-annual analysis of the world’s toilets released ahead of World Toilet Day, reveals that globally, one in three people still have nowhere decent to go to the toilet, and demonstrates how women and girls bear the brunt of this global crisis. For more than 1.1 billion women and girls, this injustice results in an increased risk of poor health, limited education, lost opportunities, vulnerability and embarrassment of having to go out in the open.

Maheshwari, 25, from Raichur, Karnataka, experienced difficulties defecating in the open during her pregnancy. “When I got pregnant, it was hard to walk to the field to defecate, as the path was not safe. My mother-in-law used to accompany me because I needed help sitting down and getting up,” said Maheshwari.

With more than 355 million women and girls still waiting for access to basic sanitation, India tops the list for the longest queue for the toilet. In fact, it would stretch around the Earth more than four times!

Reaching everyone with basic services is a huge challenge, but change is happening. Strong political will and sanitation financing has helped put India in the top 10 for reducing open defecation and improving access to basic sanitation. According to Government data, 52 million household toilets have been built between October 2014 and November 2017.

VK Madhavan, Chief Executive for WaterAid India, said:

 “While India is making rapid progress in improving sanitation under the ongoing Swachh Bharat Mission, we need to ensure inclusion, recognizing the importance of safe and accessible toilets specific to the needs of the differently abled, the elderly, the poorest, as well as women and adolescent girls. The lack of toilets affects women and girls disproportionately at every stage in their life, increasing their health risks manifold, while adversely impacting on their safety and dignity. We need to recognise that ending open defecation is but one step towards ensuring safely managed and sustainable sanitation.”

Among the other findings in the ‘Out of Order’ report:

  • All 10 of the world’s worst countries for access to basic sanitation by percentage are in sub-Saharan Africa, where only 28% of people have a decent toilet, and children are 14 times more likely to die before the age of five than in developed regions.
  • Ethiopia is top of the list of countries with the greatest percentage of people living without decent toilets, leaving more than 46 million women and girls have nowhere safe to go to the toilet. Conversely, Ethiopia has also made the most progress in reducing open defecation, largely by investing in rudimentary community latrines.
  • Djibouti, a major route for refugees from the Yemen war, has the worst figures for open defecation, with a 7.2% increase since 2000.
  • Madagascar – known as an ‘aid orphan’ due to its reputation for political instability – features in the top three for the most people without decent toilets as well as for failing to address open defecation.
  • Between 2000 and 2015, the number of people in the world defecating in the open dropped from 1.2 billion (20% of the global population) to 892 million (12%). Despite this progress, it is still a huge problem, resulting in enough faeces to fill seven bathtubs every second going into the environment untreated.
  • Cambodia has emerged from decades of conflict to become one of the fastest growing economies in Asia. It comes second for progress in reducing open defecation as well as improving access to basic sanitation.

This World Toilet Day, WaterAid is calling for governments to:

  • Invest more money and spend it transparently and efficiently, paying particular ntion to the needs of women and girls.
  • Promote the value of sanitation for gender equality and female empowerment, and involve women as leaders to ensure solutions address the challenges women and girls face.
  • Improve coordination to create gender-friendly toilets in all schools, healthcare facilities, work environments and public spaces.
  • Combine plans to improve access to sanitation with efforts to redistribute water and hygiene work, which is predominantly the responsibility of women and girls.


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