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It’s World Toilet Day: How can we achieve adequate sanitation for all?

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Navesh Chitrakar/Reuters/File

(Read caption) A domestic toilet is seen inside a house in Lalitpur, Nepal, October 8, 2015. The UN says 2.4 billion people around the world don't have access to decent sanitation and more than a billion are forced to defecate in the open, risking disease and other dangers.

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Today is World Toilet Day, and the United Nations is bringing awareness to the loo, because one billion people can’t find one.

About one in three people in the world don’t have access to sanitation facilities, and some 946 million are defecating in the open, say experts.

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And it’s not just about finding relief: inadequate sanitation facilities can contaminate waterways and soil, contribute to malnutrition, and even stifle girls’ education.

A joint report released this summer by the World Health Organization and UNICEF shows that, while progress has been made on sanitary conditions worldwide, there is still a tremendous amount of work to be done.

According to the United Nations, 15 years ago, 2,000 children under five years of age died each day from diarrhea caused by insufficient water, hygiene, or sanitation. That number has since been halved, the UN says.

But while more than two billion people have seen sanitary conditions improve since 1990, the UN target for 2015 has been missed by almost 700 million people.

What’s getting in the way?

"The progress on sanitation has been hampered by inadequate investments in behavior change campaigns, lack of affordable products for the poor, and social norms which accept or even encourage open defecation," the UN press release said.

As The Christian Science Monitor reported in July, poor sanitation habits are culturally ingrained in some parts of the developing world. So while governments and NGOs can build toilets, that doesn’t mean people will use them.  

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These social norms are a major barrier to remediating the global crisis of sanitation, and some experts point to market-based solutions as the key to shifting behavior.  

"The rules and regulations, the system, blocks the practical, pragmatic, adept solutions," Jack Sim, founder of World Toilet Organization (WTO), told the Monitor in an interview.  

The WTO, an international non-profit dedicated to improving sanitation conditions, first started World Toilet Day in 2000.   

Mr. Sim argues that while governments can build toilets, they can’t necessarily make citizens want to use them.

"The toilet must … be like a spa. You go there to have your shower, you go there to have your relief, and you come out very happy. To do that you have to create a toilet that is clean, ventilated, no smell, and is maintained well. When a toilet is colorful it is nice, people want to take ownership of it. When it is dirty and smelly, who wants to go there? They will continue to openly defecate," he said.  

For the communities that initially reject new sanitary practices, Kim wants to cast toilets as a status symbol – a "rich man’s toilet," so that individuals will feel more social pressure to use them.

Dr. Francis De Los Reyes III, a professor of Environmental Engineering and University Faculty Scholar at North Carolina State University, endorses Sim’s approach.

"Reliance on continuous external funding (local governments or foreign aid) is not sustainable," he told the Monitor in an email interview. But he also acknowledges the potential gap between a sustainable, privatized operation and one that can provide sanitation for all regardless of income level.

"Initially, funding for start-up (infrastructure, initial capital costs) can be from governments and foreign aid, but in the long run, profitable businesses should be able to operate long-term, plowing back profits to more investments, reaching out to underserved areas, etc. This is going to be difficult, as the 'consumer' market will have limited resources. So there is a balance there – how much can local businesses really make versus making sure the poor can afford it."

Professor De Los Reyes also emphasizes that the whole sanitation chain must be examined to determine how private businesses can efficiently collect, reuse, and dispose of waste.

In South Africa, he says, some local officials are trying to build a "sanitation economy" by providing training, capital, and supplies. "They have tried a franchising model, and it seems to work. This is an example where local government can help create the long-term market-based solution for sanitation," he says.