UN’s Challenge: The 638 Million in India Who Go Outdoors

Photographer: Sanjay Kanojia/AFP via Getty Images

An eight-month-old Indian child suffering from diarrhea lies on a bed at a government hospital in Allahabad. According to the UN, open defecation is the riskiest sanitation practice, one of the main causes of diarrhea. Close

An eight-month-old Indian child suffering from diarrhea lies on a bed at a government... Read More

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Photographer: Sanjay Kanojia/AFP via Getty Images

An eight-month-old Indian child suffering from diarrhea lies on a bed at a government hospital in Allahabad. According to the UN, open defecation is the riskiest sanitation practice, one of the main causes of diarrhea.

About 638 million people in India, or more than half of those residing in the second-most populous nation on Earth, defecate in the open.

Remedying the dearth of toilets, its toll on children from diarrhea and other diseases related to dirty water and sanitation, and the lack of a safe clean place to go is the challenge facing India and others on the first World Toilet Day.

On a planet where one in three don’t have access to proper sanitation, toilets are out of reach for 53 percent of India’s 1.2 billion residents left with little choice but to go outdoors, according to UNICEF.

“Having access to a toilet is still an alien concept in India,” said Subramanya Kusnur, chairman and chief executive officer of Aquakraft Projects Ltd., a company that’s setting up water vending machines in rural India.

The good news is that the figure for those lacking a toilet in India is an improvement from 63.6 percent in 2001. According to the United Nations, 1.8 billion people in a world of 7 billion have gained access to sanitation since 1990 though 15 percent of the globe still practices open defecation.

Twenty countries, most in South Asia and sub-Saharan Africa, account for 80 percent of the 1.1 billion that practice open defecation. About 526 million women have nowhere safe to go to the toilet except in the open, the WaterAid agency says.

‘Basic Service’

“At the turn of the millennium, world leaders promised to halve the proportion of people living without access to a basic toilet by 2015,” Barbara Frost, chief executive of WaterAid, said in a statement. “At current rates of progress, around half a billion people will have to wait another decade before they get this basic service they were promised.”

According to the UN, open defecation is the riskiest sanitation practice, one of the main causes of diarrhea. Each day about 3,000 children age 4 and younger die from it, most before their second birthday.

“The biggest public health impact on the rural population is because of lack of access to proper sanitation,” Kusnur said today in a phone interview. “Education access depends on availability of clean drinking water, especially for the girl child. And this has been a big problem in this country.”

Use of simple pit toilets helped 6-year-old Indian children study better because of improved physical and mental health, according to a World Bank study based on a government-run sanitation program.

India’s Total Sanitation Program, which started in 2001, helped cut open defecation in the Asian nation by more than 10 percent in as many years, according to the study released by the World Bank.

Latrines Help

Children living in villages in which more latrines had been constructed by their first year of life were more likely to recognize letters and numbers when they are 6, the World Bank paper showed.

Open defecation remains a threat to India’s labor force. Waterborne diseases deprive India of 73 million working days each year and along with the health impact affects economic gains, according to a report by the WaterAid group.

While more than half of India’s people go to the toilet outdoors, in Bangladesh and Brazil only 7 percent do. That figure is 4 percent in China, Unicef data shows.

Let’s “break the taboos and make sanitation for all a global development priority,” UN Secretary-General Ban Ki-Moon said in declaring today the inaugural World Toilet Day.

To contact the reporter on this story: Archana Chaudhary in New Delhi at achaudhary2@bloomberg.net

To contact the editors responsible for this story: Sam Nagarajan at samnagarajan@bloomberg.net; Randall Hackley at rhackley@bloomberg.net

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