Sanitation
Sanitation is in crisis. Roughly 2.5 billion people – nearly 35 percent of the world’s population – dispose of their excreta unsafely, usually in public spaces. The results are widespread diarrheal disease, environmental pollution and crippling effects on developing countries’ economies. The situation is a major affront on the dignity of poor people, especially poor women. Yet it is a crisis that is entirely avoidable: simple, effective latrines can cost less than $5 each.

In Muganzi Lumanza, Uganda, poor sanitation and inadequate drainage turn neighborhood lanes into open sewers.
Credit: WaterAid / Caroline Irby
Sanitation’s impact on health
More than 200 million tonnes of human waste are uncollected and untreated every year. This leads to water supplies, food and people’s hands being contaminated with the pathogens contained in excreta, which can transmit cholera, typhoid, dysentery and potentially fatal diseases.
Every day 2,000 children die from from diarrhea caused by
unsafe water and poor sanitation. Millions more adults and children are too sick to work or attend school.
Sanitation’s impact on the economy
In the developing world infant deaths, lost work days, and missed school due to poor water and sanitation are estimated to have an economic cost of at least $38 billion per year, with sanitation accounting for 92% of this value. In sub-Saharan Africa diseases and productivity losses linked to water and sanitation amount to 5% of GDP, dwarfing what the region receives in aid.

Poorly constructed latrines discharge human waste straight into the surrounding area in Dhaka, Bangladesh.
Credit: WaterAid / Abir Abdullah
Sanitation’s environmental impact
Untreated human excreta pollute urban and rural environments, contaminate drinking water supplies with deadly diarrheal diseases, reduce oxygen levels in rivers so that plant and animal life dies and cause sewage to build up along coastal fringes.
As populations grow, so does the amount of sewage. Levels of suspended solids in Asia’s rivers have almost quadrupled since the late 1970’s, and indicators show sewage levels in Asia’s rivers are 50 times higher than the WHO guidelines.
Tackling the crisis
WaterAid works to find solutions to dismantling the barriers in the way to expanding sustainable sanitation. We implement the solutions ourselves in our fieldwork delivering sanitation, clean water and hygiene education to poor communities in 27 of the world’s poorest countries.
Find out about some of the different types of latrines WaterAid helps communities to build We also advocate for others to adopt pro-poor policies that prioritize sanitation. For example, we have assisted the governments of Nepal, Madagascar and Ghana in developing national sanitation policies.
Our approach emphasizes building awareness of the impact poor sanitation has on health, education and livelihoods. This knowledge is crucial in building motivation amongst communities, donors and government to give sanitation the priority it so desperately needs.
Download WaterAid's report Tackling the silent killer: The case for sanitation
(PDF 1MB)
Download WaterAid's Sanitation information sheet
(PDF 1MB)
Back to top
Women and sanitation
Sanitation for dignity

The sensitive, personal nature of sanitation renders it a taboo subject, a topic that many women in developing countries are uncomfortable discussing in public.
The sanitation taboo mutes women’s descriptions of their experiences and inhibits discussion of the topic by those with the financial and political power to improve the situation – predominantly men.
Access to a safe, private toilet is essential for female dignity, especially in cultures that demand high standards of modesty. But the lack of discussion of women’s personal matters means that the provision of private toilets is given very low priority.
This paradox results in women living in a constant state of anxiety as they strive to meet their sanitation needs without losing their dignity. While men and boys are found squatting by roadsides in broad daylight, similar behavior for women and girls is unthinkable.
Women’s options include leaving their children unattended and risking animal attacks and insect stings while they venture into dense vegetation to seek privacy, or enduring discomfort while they wait until nightfall to relieve themselves under the cover of darkness.
Those who wait until night – often referred to as ‘prisoners of daylight’ – face increased chances of urinary tract infection and chronic constipation. The psychological stress and pain associated with having to wait is also considerable, particularly for vulnerable groups such as pregnant, elderly or disabled women.
By day or night women venturing outside to go to the toilet are exposed to intimidation by men and possible sexual harassment.
Jannuta Buniya (pictured above), a 30 year old mother of four from Alhazai, Nigeria described the dilemma: “It is difficult for women. During the day we must walk so far into the bush if we do not want to be seen. At night there is a danger from snakes and scorpions. Sometimes the men follow us and that also makes us afraid.”
Photo: WaterAid / Suzanne Porter