Get off the pot and celebrate World Toilet Day

Dr. Bob Dickson, Ashley Raeside and Blaise Salmon, Special to The Windsor Star
Published: Wednesday, November 19, 2008

Popular it is not, but today, Nov. 19, is a day of major significance -- 2.6 billion people do not have access to even the most basic of sanitary services and this humanitarian deficiency is responsible for over 3/4 of all diseases in the poorest corners of our earth. Whatever odorous connotations you might conjure, World Toilet Day gives us an opportunity to learn about a subject that for too long has been taboo.

Last year, the British Medical Journal ranked sanitation as the most important medical advance since 1840, ahead of even antibiotics and anesthesia in its impact on human well being. Yet today, five times more children die every day from poor sanitation than from the effects of HIV/AIDS.

Sanitation is the world's most neglected public health crisis. To address this tragedy, the United Nations has declared 2008 the International Year of Sanitation.

Here are some facts outlining the human toll of poor sanitation:

» 40 per cent of the world's population do not have access to a basic latrine.
» Up to 80 per cent of illnesses and five million deaths every year in the developing world are related to sanitation and water.
» 4,500 children die every day from diarrheal diseases.
» 443 million school days are lost each year due to sanitation and water-related illnesses.
» Up to 50 per cent of all girls drop out of school due to absence of latrines.
» Less than a century ago in North America, life expectancy was not even 50 years. Today, it is close to 80, largely because of adequate sanitary services.

Hygiene is a major element of sanitation programs. Every year, more than 3.5 million children do not live to celebrate their fifth birthday because of diarrhea and pneumonia. Hand washing with soap can cut these deaths in half. Hand washing also helps prevent skin and eye infections, intestinal worms, SARS and Avian flu. It benefits the health of people with HIV/AIDS. Even in highly contaminated slums, hand washing helps prevent the spread of many diseases.

Hand washing with soap is the single most cost-effective health intervention in the world. A $3 investment in hand washing promotion brings the same health benefits as an $11 investment in latrine construction or a $200 investment in household water supply. It helps maximize the health benefits of investment in water and sanitation, and can reduce health risks even when families do not have access to sanitation and water. The cost of soap is often not a barrier to hand washing as most households already have soap, though it is commonly used for other things rather than for hands.

Unfortunately, sanitation and hygiene have been ignored by the Canadian International Development Agency. In 2004, the Auditor General criticized CIDA for the absence of a water and sanitation plan. Yet, as of 2008, CIDA still has not produced an action plan.

CIDA spending on water and sanitation has averaged about $70 million a year over the past three years, according to Minister Bev Oda. This is less than two per cent of the CIDA budget and includes all spending on water-related programs such as water resource management, water and sewage infrastructure.

Only a fraction of CIDA's spending is directed at basic sanitation, such as encouraging the use of covered latrines and promoting hygiene education. CIDA does not even keep a record of its spending on sanitation and hygiene.

Sanitation and hygiene are different from water. Water is primarily technical and engineering work. Sanitation is more about behavioural change and understanding people and their priorities and motivations. This work requires in-depth involvement in communities over a longer period of time, work which many donors, including Canada, have shied away from.

World Toilet Day is a good opportunity to draw attention to the global need for improved hygiene and sanitation. Progress is being made with water in many parts of the world, and the water targets for the Millennium Development Goals are likely to be reached. However, sanitation remains the most lagging of all the goals.

So far, CIDA has not acknowledged the International Year of Sanitation. Despite ongoing pressures, or indicated it is considering boosting funding for sanitation and hygiene, such as contributing to the new Global Sanitation Fund based at the World Health Organization. As well, Canadian organizations like our own Centre for Affordable Water and Sanitation Technology (CAWST), WaterCan in Ontario and the Sanitation & Water Action Network (SWAN) are all putting renewed efforts into the sanitation side of the equation and are worthy of major funding and support from both government and the private sector.

Given the overwhelming importance of hygiene and sanitation and its top ranking in cost-effectiveness, Canada's government must act now and mark the International Year of Sanitation with new efforts to boost sanitation and hygiene for the world's poorest people.

What better day to get off the pot than World Toilet Day.

Dr Bob Dickson is a partner with RESULTS CANADA. Blaise Salmon from Victoria is the national president. Ashley Raeside is a RESULTS volunteer from Windsor, working on water, sanitation, and hygiene promotion with Engineers Without Borders in Zambia