NEW YORK/Addis Ababa, 19 November 2014 – Slow progress on sanitation and the entrenched practice of open defecation among millions around the world continue to put children and their communities at risk, UNICEF warned on World Toilet Day.
Some 2.5 billion people worldwide do not have adequate toilets and among them 1 billion defecate in the open – in fields, bushes, or bodies of water – putting them, and especially children, in danger of deadly faecal-oral diseases like diarrhoea.
In 2013 more than 340,000 children under five died from diarrhoeal diseases due to a lack of safe water, sanitation and basic hygiene – an average of almost 1,000 deaths per day.
“Lack of sanitation is a reliable marker of how the poorest in a country are faring,” said Sanjay Wijesekera, head of UNICEF’s global water, sanitation and hygiene (WASH) programmes. “But although it is the poor who overwhelmingly do not have toilets, everyone suffers from the contaminating effects of open defecation, so everyone should have a sense of urgency about addressing this problem.”
The call to end the practice of open defecation is being made with growing insistence as the links with childhood stunting become clearer. India, with 597 million (half the population) practising open defecation, also has high levels of stunting. Last week, UNICEF convened a conference in New Delhi called ‘Stop Stunting’ to call attention to the effect of open defecation on the entire population, particularly children. UNICEF’s ‘Take Poo to the Loo’ campaign in India also works to raise awareness of the dangers associated with open defecation.

Asfaw Legesse a model in his community washes his hand after using a latrine. ©UNICEF Ethiopia/2014/Sewunet
“The challenge of open defecation is one of both equity and dignity, and very often of safety as well, particularly for women and girls,” Wijesekera noted. “They have to wait until dark to relieve themselves, putting them in danger of attack, and worse, as we have seen recently.”
Compared to other African countries, Ethiopia has made huge progress in reducing open defecation rates from 92 per cent in 1990 to 37 per cent in 2012. The Joint Monitoring Programme (JMP) 2014 report from UNICEF/WHO confirms that Ethiopia is leading the charge in Africa in reducing open defecation.The community total sanitation and hygiene approach, supported by UNICEF and utilizing the 38,000 Health Extension Workers in the country, has greatly contributed to this success.
“The challenge of improving sanitation levels to ensure that the minimum standards of toilet construction remains in many rural areas across Ethiopia. With the rapid urbanisation of the country there is also a need to “reinvent the toilet” to make it affordable, durable and appropriate for high density urban dwellings. UNICEF is advocating for these, and greater focus on toilets in schools and health centres nationwide, to ensure greater access to improved sanitation,” said Patrizia DiGiovanni, Acting Representative of UNICEF Ethiopia.
UNICEF’s Community Approaches to Total Sanitation addresses the problem at the local level by involving communities in devising solutions, and has led to some 26 million people across more than 50 countries abandoning the practice of open defecation since 2008.
Eighty-two per cent of the 1 billion people practising open defecation live in just 10 countries: India, Indonesia, Pakistan, Nigeria, Ethiopia, Sudan, Niger, Nepal, China, and Mozambique. The numbers of people practising open defecation are still rising in 26 countries in sub-Saharan Africa, though they have declined in Asia, Latin America and the Caribbean. In Nigeria, numbers of open defecators increased from 23 million in 1990 to 39 million in 2012.
Globally, some 1.9 billion people have gained access to improved sanitation since 1990. However, progress has not kept up with population growth and the Millennium Development Goal target on sanitation is unlikely to be reached by 2015 at current rates of progress.
The inter-governmental Open Working Group on the post-2015 Sustainable Development Goals have recommended that the new goals include a target of achieving adequate and equitable sanitation and hygiene for all and ending open defecation by 2030.
