Out of Order: WaterAid reveals where in the world is hardest for women to find a toilet

Posted by
Laura Crowley
16 November 2017
A child walks through the road, which has no drainage facility and all wastes from hanging toilet go directly to the road, Gojariapara, Gazipur, Bangladesh, April 2017 WaterAid/H&M Foundation/GMB Akash/Panos

Ethiopia is now worst in the world for the highest percentage of its population without toilets, while India remains the nation with the most people without toilets, reveals WaterAid’s State of the World’s Toilets 2017 report.

While both have made progress, millions still suffer the fear and indignity of relieving themselves in the open or in unsafe or unhygienic toilets – a situation which is most dangerous for girls and women.

‘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, harassment and even attack.

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! However, there has been immense progress in improving access to sanitation through the Swachh Bharat (Clean India) Mission, helping put India in the top 10 for reducing open defecation and improving access to basic sanitation. As WaterAid’s report shows, there is still a long way to go to reach everyone.

A staggering 93% of Ethiopia’s population still have no access to a basic toilet, the highest percentage of people living without decent toilets of anywhere in the world. Conversely Ethiopia has also made the most progress in reducing open defecation, reducing the proportion of people defecating in the open from nearly 80% in 2000 to 27% in 2015, largely by investing in rudimentary community latrines.

Among the other findings:

  • All 10 of the world’s worst countries for access to basic sanitation 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.
  • 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.

Tim Wainwright, WaterAid’s Chief Executive, said:

“It is unacceptable that one in three of the world’s population have nowhere safe to go to the toilet. This is a denial of their basic human rights and contributes to the appalling death toll from diarrhoeal disease of one child every two minutes. A community without toilets is particularly hard for women and girls who are exposed to an increased risk of harassment and attack when finding somewhere to do their business, find it more difficult to cope during their periods, and spend more time both ill themselves and caring for those who are sick.

“The world has promised that by 2030 everyone will have a safe toilet but, whilst there has been considerable progress made over the last couple of decades, this target will not be met unless there is a step change in ambition and action.”

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

  • Invest more money and spend it transparently and efficiently, paying particular attention 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.

Alongside the report, WaterAid is working with a group of female artists, illustrators and singers, from the UK and Sierra Leone, to create a multi-media exhibition exploring the impact a lack of decent toilets has on women across the globe. The ‘Out of Order’ exhibition, will open at London’s Old Truman Brewery on Thursday 16 November, culminating on World Toilet Day on Sunday 19 November.


Read the ‘Out of Order’ report: http://www.wateraid.org/wtd2017

Download photos: https://wateraid.assetbank-server.com/assetbank-wateraid/images/assetbox/e3653d0d-0a3c-4eee-a70a-5fdfe1e8e506/assetbox.html

Download film footage: https://wateraid.assetbank-server.com/assetbank-wateraid/images/assetbox/43123b8d-8067-4619-a0cb-d408cf71fd9b/assetbox.html

See what happened when WaterAid and Andrex gave commuters at Kings Cross station a chance to visit Bangladesh to experience what it feels like when there’s no toilet at all: https://youtu.be/LjldFko5fR8

For interviews or more information, please contact: Laura Crowley, Senior Media Officer, [email protected] or +44 (0)207 793 4965; or Carolynne Wheeler, News Manager, [email protected] or +44 (0)207 793 4485. Or call our after-hours press line on +44 (0)7887 521 552 or email [email protected].

Notes to Editors:


WaterAid is working to make clean water, decent toilets and good hygiene normal for everyone, everywhere within a generation. The international not-for-profit organisation works in 34 countries to change the lives of the poorest and most marginalised people. Since 1981, WaterAid has reached 25.8 million people with clean water and 25.1 million people with decent toilets. For more information, visit www.wateraid.org, follow @WaterAidUK or @WaterAidPress on Twitter, or find WaterAid UK on Facebook at www.facebook.com/wateraid.

  • 844 million people in the world – one in nine – do not have clean water close to home.[1]
  • 2.3 billion people in the world – almost one in three – do not have a decent toilet of their own.[2]
  • Around 289,000 children under five die every year from diarrhoeal diseases caused by poor water and sanitation. That's almost 800 children a day, or one child every two minutes.[3]
  • Every £1 invested in water and toilets returns an average of £4 in increased productivity.[4]
  • Just £24 can provide one person with clean water.[5]
  • To find out if countries are keeping their promises on water and sanitation, see the online database www.WASHwatch.org

[3] washwatch.org

[4] World Health organization (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage

[5] www.wateraid.org