Some of the most basic aspects of life for many of us are something we rarely think about. The world, and Pakistan, marked November 19 as World Toilet Day. Although Pakistan has achieved significant improvement in access to clean water, decent toilets and good hygiene, around 40 percent of the population does not have access to decent toilets. And more than 20 million people defecate openly. We do not often think about the wider implications of this. According to the UN, globally 4.2 billion people have no access to safe sanitation. This results in millions of deaths and a huge burden of disease. The UN holds that providing toilets to people is not only a sanitary requirement but also one that is fundamental to human rights and dignity. Encouragingly, over the last decade or so Pakistan has developed relatively progressive legislative and policy frameworks on various subsets of WASH rights. However, much is left to be done.
In addition to the fact that some people still lack toilets, there is also the issue of public facilities especially for women. These are rarely available even in major cities, causing considerable hardship in some situations. The lack of toilets at schools also holds back girls from acquiring an education and from meeting their basic needs. An associated problem is the entry of faecal material in drinking water which is responsible for millions of cases of stomach disease and gastroenteritis. When sewerage affluents mix with drinking water it creates diarrhoeal disease especially for children. The burden of such disease, which includes cholera and typhoid as well as polio, also carried by water, is extremely high in Pakistan. More than twenty-two percent of infant deaths in the country are caused by diarrhoea. The problem is more common in households which lack basic sanitation. Apart from all this, extreme weather events are also causing irreparable damage to weak sanitation systems. Other countries have launched major initiatives to reduce open defecation by teaching communities how to build toilets. In Pakistan, we have seen initiatives like the Salman Sufi Foundation’s Saaf Bath that aim at providing safe public toilets in major urban areas in the country. A long-term financial project needs to be planned out to further such initiatives and, more importantly, to build toilet facilities for those living in the rural areas.