New York — On World Toilet Day, UNICEF says that trends in the past five years allow for cautious optimism that significant progress will be made in decreasing the number of people globally who practice open defecation.
A lack of toilets remains one of the leading causes of illness and death among children. UNICEF estimates that around 2 million children die each year from pneumonia and diarrhoea, illnesses which are largely preventable with improvements in water, sanitation and hygiene.
Community Approaches to Total Sanitation (CATS), now being supported by UNICEF in 50 countries around the world, including crucial ones in sub-Saharan Africa and South Asia, have already led to more than 39,000 communities, with a total population of over 24 million people, being declared free of open defecation within the last five years.
UNICEF estimates that with support from governments and other partners, an additional 88 million people now live in communities free of open defecation.
"The beauty of this approach is that solutions are not imposed from the outside," says Therese Dooley, UNICEF's senior advisor on sanitation, "Communities themselves take the lead and identify their own measures to end open defecation. Only then can it work."
In South Sudan, which in 2011 became the world's newest country, already five communities have achieved 'open defecation free' status, showing that poverty is not an insurmountable barrier to ending open defecation. The World Bank estimates the poverty rate in the country at 50.9 per cent. While South Sudan does not yet have a ranking on UNDP's Human Development Index, all indications are that it will be close to the bottom.
In Pakistan, through UNICEF-supported CATS programmes, almost 5,000 villages with a total of 5.8 million people have been declared free of open defecation. Rapid and notable improvements have also been made in Mozambique, Zambia, Mali, Sierra Leone, Malawi and Ethiopia.
CATS aim to make all communities free of open defecation by focusing on social and behaviour change and the use of affordable, appropriate technologies.
The emphasis is on the sustainable use of sanitation facilities rather than the construction of infrastructure, and the approach depends on the engagement of members of the community ranging from individuals, to schools, to traditional leaders. Communities use their own capacities to attain their objectives and take a central role in planning and implementing improved sanitation.
According to a joint UNICEF and World Health Organization report this year, more than 1.1 billion people in the world practice open defecation. The largest number of these people are in India (626 million), followed by Indonesia (63 million), Pakistan (40 million), Ethiopia (38 million), and Nigeria (34 million).
"No aid operation in the world can provide toilets for1.1 billion people," says Dooley. "They have to do it for themselves - with support. And we've found, in fact, that it is only when they do it for themselves that the changes are achievable and sustainable."