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Water, Sanitation & Hygiene

It’s a Sh*tty Situation

By Caitlin Gruer
World Toilet Day

Everyone poops. This is a well-known fact—there is even a children’s book about it.  But did you also know that poop is (literally) everywhere?

In studies conducted in the U.S. and the U.K., fecal matter was found all over airplanes, subways and movie theaters, and even on 72 percent of shopping carts.  It’s not just public spaces either.  Studies have also shown that 16 percent of cell phones, 20 percent of office coffee mugs, and 60 percent of toothbrushes have traces of fecal matter.

And that is just the sh*t situation in high income countries, where the vast majority of the population has access to a toilet.  For many people around the world, the situation is much worse. 

There are 2.4 billion people in the world without access to an improved sanitation facility, and the standards for what qualifies as “improved” are not that high; a pit latrine qualifies as long as it has a cover and a washable floor. Even worse, 1.1 billion people don’t use a latrine or a toilet at all, and are instead forced to poop outside in fields or the woods (this practice is called open defecation).  To put that in perspective, that’s equivalent to the entire population of North America, Central America, and South America combined defecating outside.

If poop is everywhere in our environment despite access to toilets, imagine how crappy things are without them. 

Now, while poop can be gross and smelly, it is not, in and of itself, dangerous; however, it frequently carries pathogens like e.coli, cholera, rotavirus, and giardia, which are dangerous.   When the environment is contaminated with feces, it becomes really easy to unintentionally ingest these pathogens through something as simple as a fly landing on your food, or not washing your hands before eating.  When these pathogens are ingested, they can cause serious illnesses like diarrhea and intestinal parasites.

Diarrhea might not seem like a big deal—who hasn’t had an upset stomach—but it can be.  It can lead to severe dehydration, and increase susceptibility to other illnesses. Diarrhea kills more children worldwide than HIV and AIDS, tuberculosis and malaria combined. It kills more children under five than any other cause besides acute respiratory infections. 

Intestinal parasites cause their own problems.  They can lead to diarrhea, or lack of appetite, or they can stop their hosts from absorbing nutrients from the food that they eat. 

Repeated bouts of these types of infection can also lead to a condition called environmental enteropathy, which is damage to the intestines that can permanently impede nutrient absorption.   

These conditions can have long lasting effects.  Fifty percent of undernutrition worldwide is associated with infections like these that are related to water, sanitation and hygiene (WASH).  Undernutrition is an underlying cause of 50 percent of all child deaths.  It increases susceptibility to illness, and increases the severity and length of illness.  Chronic undernutrition also impacts children’s cognitive and physical development, and can decrease their future earning potential by almost 10%. 

These conditions have far reaching ramifications. Each year, children miss an estimated 443 million days of school due to illnesses caused by WASH-related diseases like diarrhea and intestinal parasites.  Educated girls and boys tend to be healthier, participate more productively in the formal labor market, earn a higher income, and raise healthier, more educated children.  

It also has far reaching economic consequences:  Each year, the global economy loses $260 billion in healthcare costs and lost productivity as a result of lack of sanitation. That’s more than the total annual GDP of more than 128 countries around the world, including New Zealand, Finland, Kenya and Vietnam.  

Have I convinced you yet?  Living in a world completely contaminated by feces is hazardous.  Luckily, there are two simple actions that can significantly improve the problem: toilets and handwashing.

Toilets (or any other form of improved sanitation) are critical. Improved sanitation facilities ensure that our excreta is safely contained, away from us and out of our surrounding environment.  It can reduce the number of cases of diarrhea by almost 40 percent.  This is why child-centered development organization Plan International is working around the world to increase sustainable access to sanitation.  In 2015 alone, Plan helped 4.8 million people gain access to sanitation.

Handwashing is another clear way to reduce the transmission of all pathogens, including those carried in poop.  In fact, handwashing is the single most cost-effective health intervention because it is so inexpensive and so effective at reducing rates of illness. Unfortunately, many people, including in the U.S., don’t wash their hands nearly as frequently as they should, which is why Plan conducts behavior change initiatives around the world to improve handwashing behaviors. 

Plan– alongside communities, local government and similar nongovernmental organizations – is addressing the fact that “everyone poops” by supporting behavior change, building facilities, and working with entrepreneurs to make sure that households have everything they need to build their own sanitation solutions.  Through this work, and the work of many others, the global community has made significant progress; since 1990, 2.1 billion people have gained access to an improved sanitation facility, and the prevalence of diarrhea has decreased significantly.

So, this World Toilet Day, be grateful for your toilet and your tap, because without them, your life would be a whole lot sh*ttier.  

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