World Toilet Day: 13.2m Pakistanis have no toilet facility

ISLAMABAD: Like the whole world, Pakistan also marked November 19 as the World Toilet Day with toilet facility available to 94 percent across the country.

By 2017-18, in Pakistan, only 6 percent population lacked the facility to have access to toilets. And in urban areas, 99 percent people had the toilet facility and only 1 percent didn’t possess the said facility. However, in rural areas, 91 percent people had access to toilet facility, whereas 9 percent had no access.

In Pakistan, average toilets per household stood at 1.3. However, in urban areas of the country, the average toilets per household were at 1.4 and in rural areas of Pakistan, the average toilets per household stood at 1.2. About 13.2 million individuals and two million households had no access to toilet facility in Pakistan.

According to the UnitedNations report on World Toilet Day with focus on water, sanitation and hygiene around the world, approximately 2.2 billion people worldwide lack access to safe drinking water, 4.2 billion have to go without safe sanitation services and 3 billion lack basic hand washing facilities. By 2015, close to a billion people were still defecating outdoors, resulting in widespread diseases and millions of deaths. That drove the UN to call for an end to the practice and some parts of the world have proven hugely successful in eradicating it.

Access to sanitation is a fundamental human right that guarantees bright future and safeguards health and human dignity, especially for women and children. Unicef joined the world and the government of Pakistan to commemorate the World Toilet Day (WTD) on the Tuesday.

This year, WTD’s theme of “Leaving no-one behind” reminds that access to sanitation should be made universal regardless of race, colour or socio-economic status. The theme resonates well with Prime Minister Imran Khan’s Clean and Green Pakistan initiative.

According to the Human Rights Watch, lack of access to sanitation can undermine the rights of others, including the right to education, health, decent work and gender equality. The Alma-Ata declaration of 1978 recognised safe sanitation as an indispensable element of disease prevention and of primary healthcare programmes. It isolates faeces from the environment thereby breaking the faecal-oral transmission pathways associated with open defecation (OD) that would otherwise lead to significant disease burdens. Availing sanitation facilities leads to time saving, comfort, increased productivity, greater safety and a higher social status.

However, according to the Unicef/WHO Joint Monitoring Programme for Water Supply, Sanitation and Hygiene (Joint Monitoring Programme) Report 2017, close to 40 million people use makeshift latrines which lack dignity and protection raising safety issues for children and women. Nearly 200 million people lack access to safely managed sanitation. Effluent from the sanitation systems is discharged into the environment or non-functional centralised sewer systems. This means the effluent contaminates environment including natural water courses. For example, in Lahore, the sewage/effluent is discharged into River Ravi. Instances like this can be found across country. Besides, poor and old sewerage system mixes with drinkable water causing diseases

Lack of access to safe sanitation increases the risk of diarrheal diseases, especially for children. These include serious infections such as polio and cholera. According to Val Curtis, Director of the London School of Hygiene and Tropical Medicine, every year more than 750,000 children die of gastrointestinal infections in the world due to lack of toilets.

In Pakistan, 22.5 percent of infant deaths are due to diarrhoea. According to the 2018 Demographic Health Survey, diarrhoea is more prevalent among children whose households lack basic sanitation. The same survey reported that 37.6 percent of children in Pakistan are stunted while 23.1 percent are underweight. All these are associated with a lack of safe sanitation facilities for all in the country.

Women and girls are the hardest hit by this. They usually wait until after dark to defecate making them vulnerable to harassment and assault. Girls also commonly miss out on education if school sanitation including menstruation and hygiene management facilities are inadequate. The sick and the elderly face special difficulty and a loss of dignity due to the lack of sanitation facilities. This loss of dignity is especially acute for elders, for whom honour and respect are important.

Poor sanitation has an economic cost too. The World Bank estimates that poor sanitation costs Pakistan 3.94 percent of its GDP, which is about $5.7 billion (Rs886 billion) per annum. Poor sanitation causes diseases ending up in debility and death impacting output and productivity of the working class.

As we commemorate the World Toilet Day this year, I am encouraged by the Government of Pakistan’s efforts in ensuring access to basic sanitation for all through the Clean and Green Pakistan initiative. However, the government and partners need to increase funding for sanitation. The 2017 JMP report estimates that almost 820 latrines need to be constructed per day to achieve an open defecation free Pakistan by 2030.

According to UN report, in 2000 the rate of open defecation was even worse with 21 percent of the global population — 1.3 billion people — practicing it. The impact of the UN's call to action has been telling and by 2017, the global share of people practicing open defecation had fallen to just 9 percent - 673 million people. Ethiopia saw the largest fall during that period, -57 percent. Cambodia and India also experienced declines of -53 and -47 percent respectively. The India has been particularly ambitious in installing proper toilets.

Under the Swachh Bharat Abhiyan ("Clean India") campaign which kicked off in October 2014. India's Ministry of Drinking Water and Sanitation states that toilet coverage today stands at an impressive 99.22 percent. It is about public toilets

Altogether, 91 countries reduced open defecation by a combined total of 696 million people between 2000 and 2017 with Central and Southern Asia accounting for three quarters of that figure. The news isn't positive everywhere though and 39 countries experienced increases during the same period, totalling 49 million people.

Under the "Clean India" campaign which kicked off in October 2014, India's Ministry of Drinking Water and Sanitation states, toilet coverage today stands at 99.22 percent.

According to Al Jazeera, the Research Institute for Compassionate Economics (RICE) surveyed 3,235 households in four north Indian states in 2014 and 2018. Their research, released in January this year, found that open defecation had reduced by 26 percent since Clean India was launched and access to household toilets increased from 37 percent in 2014 to 71 percent in 2018.