From Taboo to Action: Addressing the Global Sanitation Crisis

As the sun rises over a quiet rural community in sub-Saharan Africa, a mother steps outside her home, scanning the horizon for privacy. She balances the need to relieve herself quickly with the need to avoid prying eyes or lurking dangers. With no toilet nearby, she makes her way to a nearby bush, well aware that it offers little safety or dignity.

The risks of using the bush are unpredictable: she might encounter dangerous wildlife, face harassment, or step into an unsanitary area already contaminated with human waste. The same place where she crouches today might be where her children play, exposing them to preventable but deadly diseases. This mother might not even know that the way she relieves herself could cause her children significant health problems tomorrow.

November 19th was World Toilet Day, inaugurated in 2001 to help address the world’s ongoing sanitation crisis. For 1.5 billion people worldwide, lacking a safe place to go to the bathroom threatens lives. Poor sanitation contaminates local water sources, fuels disease outbreaks, and perpetuates cycles of poverty. 

Sanitation is a cornerstone of public health, yet it often remains taboo, hidden behind closed doors, or avoided in discussions. It’s time to bring this issue to light and take meaningful action to address the global sanitation crisis.

Breaking the Taboo

Conversations about toilets, waste management, and sanitation are often met with discomfort or silence. Reluctance to talk about the issue perpetuates the crisis, leaving billions without access to basic facilities and support. Sanitation is more than just a personal matter — it is a public health priority.

Organizations like The Water Project work to normalize discussions about sanitation by integrating education and advocacy into our community programs. By addressing sanitation openly, we demonstrate that these are not just personal or cultural issues, but global challenges with far-reaching consequences.

Our trainers have witnessed the discomfort around open defecation countless times when they first enter a community to talk about water, hygiene, and sanitation — three topics that are inextricably linked to preventing diarrheal disease. Community members are often shy when discussing their open-defecation practices. 

One recent example was at a primary school. 

Field Officer Jonathan Mutai explained: “Teaching aids were distributed among learners, some [of whom] had gotten pictures [that] depicted bad practices like peeing in the open or open defecation practiced next to the water points. Most of them were shying off from explaining the bad practices seen in the photos. The facilitator asked if such cases had not been witnessed in that community. The teachers confirmed that those were common practices in that area, and they were asked to stop engaging in such behaviors.”

When we break this taboo, we pave the way for awareness and solutions. Open dialogue about sanitation can change lives, ensuring that no one feels ashamed or unsafe when addressing a basic human need.

The Scope of the Crisis

Despite its importance, sanitation remains out of reach for far too many. 

• 419 million people still practice open defecation, leading to the spread of disease, environmental pollution, and severe health risks.
• Poor sanitation is linked to approximately 564,000 deaths annually due to diarrhea, largely caused by contaminated water sources.

These figures highlight the vast and interconnected challenges tied to inadequate sanitation. 

For women and girls, the absence of private, secure facilities often means risking violence or harassment while searching for a safe place to relieve themselves or check menstrual materials. Children are particularly vulnerable, as exposure to contaminated environments contributes to diseases like cholera, typhoid, and dysentery — illnesses that claim young lives at an alarming rate.

These challenges vary by global location. In rural areas of sub-Saharan Africa, where sanitation infrastructure is often nonexistent, people are left with no choice but to defecate in open spaces, further polluting nearby water sources. Meanwhile, urban slums deal with overcrowded communal latrines that are unhygienic and unsafe, compounding the risks for those who use them.

The environmental impact of poor sanitation is equally devastating. Open defecation and untreated waste contaminate rivers, lakes, and groundwater, harming ecosystems and perpetuating the spread of waterborne illnesses. Polluted water sources then cycle back into human consumption, creating a relentless feedback loop of illness and suffering.

The sanitation crisis goes beyond statistics. Each number represents a life interrupted by preventable disease, missed opportunities, and a daily struggle for dignity. Addressing this crisis is essential for building healthier, safer, and more equitable communities worldwide.

Why Sanitation Matters

Addressing the sanitation crisis unlocks new opportunities for healthier, more equitable communities. Improved sanitation directly impacts several critical areas:

1. Health and Hygiene: Poor sanitation contributes to water contamination, leading to diseases like cholera and dysentery and exacerbating stunting and malnutrition.
2. Education: Schools without proper facilities see higher absenteeism, particularly among girls of menstruating age. Safe, private toilets ensure students can focus on learning.
3. Economic Growth: Lost productivity from sanitation-related illnesses and time spent searching for facilities costs billions annually, perpetuating poverty.
4. Environmental Sustainability: Open defecation and untreated waste harm ecosystems. Sanitation solutions help protect water sources and soil.

Community-Centered Solutions

Effective sanitation initiatives are not one-size-fits-all; they must reflect the unique needs and cultural contexts of each community. 

Below are some successful strategies employed worldwide:

1. Community-Led Total Sanitation (CLTS):

CLTS mobilizes communities to take ownership of sanitation challenges, encouraging behavioral change over subsidies. The Community-Led Total Sanitation approach is used to improve the sanitation and hygiene practices and behaviors of a village. CLTS facilitates a process in which community members realize the negative consequences of their current water, sanitation, and hygiene behaviors and are inspired to take action. 

This is the approach The Water Project uses while working with communities in Sierra Leone, Southeast Kenya, and Uganda. 

2. Eco-Sanitation:

Ecological sanitation, or eco-san, turns human waste into a resource. Composting toilets, for example, safely process waste into fertilizer, benefiting agriculture while addressing sanitation needs. This approach not only improves sanitation but also addresses food security by supporting local farming efforts. 

Eco-sanitation systems are especially useful in regions with limited water access, as they often require little to no water for operation, making them a sustainable solution for rural and arid communities. By turning waste into a resource, eco-sanitation promotes both environmental conservation and community resilience.

3. School-Based Programs:

Every day, our teams encounter schools that do not have enough latrines for students, and in some cases, no latrines at all. Students complain of waiting in long lines because there are not enough toilets. We also hear stories of latrines in such terrible shape – including no doors for privacy – that students go to the bathroom elsewhere. In those cases, that often means in the nearest bushes or walking all the way home.

In Western Kenya, The Water project installs latrines alongside each school water project to provide safe, private places for students to relieve themselves. Gender-segregated toilets and menstrual hygiene education ensure that all students, especially girls, can attend school without fear or embarrassment.

How You Can Help

The global sanitation crisis requires urgent attention, collaboration, and investment. At The Water Project, sanitation is an integral part of our mission. By breaking the taboo and working directly with communities, we help turn this crisis into a story of resilience and progress. While the sanitation crisis can sometimes feel overwhelming, everyone can play a part in addressing it. 

Here’s how you can help:

1. Support Organizations: Donate to groups that provide sanitation infrastructure and hygiene education in underserved regions.
2. Advocate for Change: Use your voice to raise awareness. Share articles, engage on social media, and encourage policymakers to prioritize sanitation in global development agendas.
3. Educate Yourself and Others: Learn about sanitation challenges and spread awareness within your community.
4. Reduce Stigma: Encourage open conversations about sanitation to break down taboos and foster understanding.

Together, we can ensure that access to safe sanitation is not a privilege, but a universal right.

Let’s turn action into impact, one toilet at a time.

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