It can be tough to talk about that thing we all do, but a startling 2.5 billion people around the world still don't have access to adequate sanitation.

Welcome to Waterloo

Every day, thousands of people gather, shop, and work in Sierra Leone's Waterloo market — and when open defecation was the only option, it caused some serious problems.

Beyond the social discomfort, open defecation poses serious health risks, particularly to children. In fact, diarrhea-related illnesses are responsible for more deaths among children than HIV, malaria, and tuberculosis combined. For this reason, water and sanitation programs are a key component of our emergency response and development work. Across the world, we're working to ensure that communities have access to simple sanitation — such as Veronica Buckets —  and facilities like the ones we built in Waterloo market.

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Proper toilets prevent disease and danger

Issues of sanitation and gender are often intertwined. A lack of privacy for women and girls increases the risk of sexual violence. Many toilets do not have any facilities to help women and girls manage their menstrual hygiene. If toilet blocks are not lit properly, women will not use them as they fear for their safety.

Like so many development issues, we still need the political will and financial support to make sanitation for all a reality.

Equality and dignity is what we aimed for when constructing latrine blocks in Waterloo market. On the entrance we label women-only toilets with large pictures of women, so they are kept separate for men and women. This affords women greater safety and privacy, along with simple locks that can be fastened to the doors using nail and string.

People walk through a flooded area
Women walk through contaminated flood waters in the displacement camp on the UN base in Bentiu, the capital of oil-producing Unity State in South Sudan. Photo: Crystal Wells

Of course, toilets are not the entire solution. People need information on how they can protect themselves from life-threatening diarrhea. For example, a survey we conducted in South Sudan last year about the causes of diarrhea revealed that people associated the disease with eating cold food, and they didn't think people could get sick from hot meals. This is logical, considering that heat kills off bacteria, while a cold meal indicates that the food was cooked some time ago. But those surveyed did not make the connection between uncovered food (exposed to flies) and contamination.

We must prioritize sanitation as an important global issue and encourage open dialogue instead of open defecation.

Moreover, no one mentioned the importance of using the lid of the toilet. In a latrine without a lid, flies go in and out and subsequently contaminate food, causing diarrhea. On top of all that, unclean hands used to prepare food were not recognized as a cause of food contamination. Gathering this sort of knowledge helps Concern build a shared understanding of what should be done to prevent diseases in the communities where we work, and how we can provide targeted messages to improve behavior.

Taboo talk of human waste

Many cultures are reluctant to talk about feces. While this is understandable, it's something we are continually working on with families and communities to promote good hygiene and health practices. It's also encouraging to see new and innovative solutions becoming readily available.

In South Sudan, where flooding has rendered hundreds of latrines unusable, we've successfully piloted the use of PeePoo bags. These self-sanitizing and fully biodegradable toilets are designed for single use. Given the current constraints on latrine construction caused by a lack of dry land, the PeePoo bags offer a means of addressing the sanitation gap until more permanent measures can be put in place.

A Syrian child standing alone in an informal settlement
A Syrian child living in an informal settlement near the city of Halba, Lebanon, where Concern works with Syrian refugees in education, protection, shelter, hygiene promotion, and the provision of water and sanitation services.

Another innovative way to improve hygiene is the Glo Germ. This "makes visible the invisible" by using UV light to show that hands can be dirty even if they look clean to the naked eye. This helps demonstrate that the only way to thoroughly clean your hands is by washing with soap. An entire kit, which is sufficient for up to 100 washes, costs just over $100.

Like so many development issues, we still need the political will and financial support to make sanitation for all a reality. We must prioritize sanitation as an important global issue and encourage open dialogue instead of open defecation.