because of diarrhoea and other infectious diseases that are linked to poor sanitation. Others develop a chronic infection of the gut, a condition which shows no acute symptoms, but over a long period of time hinders the intake of important nutrients.
These children become chronically malnourished and if nothing is done against it before their second year of age, it becomes too late. They become stunted; their physical and mental development is irreversibly damaged. Stunting is not only a problem for the child itself, it affects the community as well. If almost half of the future workforce suffers from this condition, as is the case in Pakistan, it will be a problem for the development of the country as a whole.
If we want to tackle stunting we need to stop open defecation. Current statistics show that over a third of the population in South Asia practices open defecation. There is also a very high rate of stunting. In Pakistan alone 41 million people do not have access to a household toilet. This is both a challenge and an enormous opportunity for improvement.
We know from other countries in South Asia like Bangladesh that reducing levels of open defecation is possible, by following the right policies and by investment in the right programmes. Policies and programmes that are built on the recognition that access to adequate sanitation is essential for human dignity. Policies and programmes that focus on community engagement and behaviour change. Policies and programmes that capture innovations, not just in the design of new products, such as toilets, but also innovations in processes that foster social change, citizen-led accountability and community education.
Such policies and programmes are also the key to improving gender equality and thereby directly affecting stunting. By giving women and girls, particularly during the adolescent years, more access to suitable sanitation facilities, we are improving the likelihood that they will be healthier and that they will have healthier children, who are not stunted.
Access to sanitation facilities could also reduce violence against girls and women, violence that is more likely when they have to walk far from home to defecate privately. Access to sanitation facilities in schools, that takes account of menstruation, will give adolescent girls less reason to miss class or drop out of school. And all of this – the improved nutrition, less violence, more schooling – we know empowers girls and women, promotes gender equality and has a ripple effect that is immeasurably good for their families, communities and national economies.
Improved sanitation is not a magic bullet, but we will not see real change without it. Investing in sanitation and hygiene will allow us to achieve healthier, more productive communities who live in dignity and are part of a stronger economy.
The writer is the deputy executive director of Unicef.