World Toilet Day 2020: The Serious Issue of Global Sanitation Crisis

World Toilet Day is a United Nations Observance that celebrates toilets and raises awareness of the 4.2 billion people living without access to safely managed sanitation. It is about taking action to tackle the global sanitation crisis and achieve Sustainable Development Goal 6: water and sanitation for all by 2030.

The implementation of the United Nations (UN) Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) has resulted in an increased focus on developing innovative, sustainable sanitation techniques to address the demand for adequate and equitable sanitation in low-income areas.

Sanitation is a comprehensive field connected with multiple categories, and the increasing number of publications reflects a strong interest in this research area. Most of the research took place in developed countries, especially the USA, although sanitation problems are more serious in developing countries. Innovations in sanitation techniques may keep susceptible populations from contracting diseases caused by various kinds of contaminants and microorganisms. Hence, the sanitisation of human excreta, resource recovery, and removal of micro-pollutants from excreta can serve as effective sustainable solutions.

Commercialized technologies, like composting, anaerobic digestion, and storage, are reliable but still face challenges in addressing the links between the political, social, institutional, cultural, and educational aspects of sanitation. Innovative technologies, such as Microbial Fuel Cells (MFCs), Microbial Electrolysis Cells (MECs), and struvite precipitation, are at the TRL (Technology readiness levels) 8 level, meaning that they qualify as “actual systems completed and qualified through test and demonstration.” Solutions that take into consideration economic feasibility and all the different aspects of sanitation are required.

There is an urgent demand for holistic solutions considering government support, social acceptability, as well as technological reliability that can be effectively adapted to local conditions.

The United Nations (UN), many local governments, and international organizations have launched programs to deal with the negative impact on human health and the environment caused by the lack of access to adequate sanitation. In the 1990s, 192 UN member states and at least 23 international organizations agreed to the Millennium Development Goals at the World Summits.

In September 2015, the 2030 Agenda for Sustainable Development Goals (SDGs) was adopted by world leaders at the UN, which calls on countries to begin new efforts to achieve 17 SDGs over the next 15 years, including the goal to ‘ensure the availability and sustainable management of water and sanitation for all’.

To inspire action to tackle the global sanitation crisis, “World Toilet Day”, which was established by the World Toilet Organization in 2001, was declared an official UN holiday in 2013. Every November 19th since then, UN-Water, local civil society organizations, and volunteers have planned events all over the world with themes such as “Toilets and Nutrition”, “Toilets and Jobs”, and “Wastewater”.

Narendra Modi, the prime minister of India who launched projects like the Swachh Bharat Mission (Clean India Mission) in 2014, forged ahead to eliminate open defecation with the goal of constructing toilets in every household in the country by 2019. India is making impressive headway with its comprehensive planning for achieving this goal (Liangyu, 2017).

President Xi Jinping proposed a “toilet revolution” in China's rural areas in 2015. Thereafter, the China National Tourism Administration (CNTA) quickly started a “toilet revolution in tourism”, and great efforts have been undertaken to promote better sanitation (Cheng et al., 2018). More than 68,000 public toilets have been refurbished in China (Wong, 2017). Global sanitation efforts have been undertaken by governments as well as non-governmental organizations, where there are additional resources and manpower.

In 2011, the Bill and Melinda Gates Foundation (BMGF) launched a research program named “Reinvent the Toilet Challenge (RTTC)”, which aimed to build sustainable and financially-profitable sanitation services and businesses that operate in poor, urban settings in both developed and developing nations. The new toilet system that won the challenge is a truly aspirational next-generation product that operates “off the grid” without connections to centralized water, sewers, or electrical supplies, removes harmful organisms from human waste, and recovers valuable resources such as energy, clean water, and nutrients.

The toilet also costs (consists of both fundamental investment and operation cost) <5 cents (US) per user per day. In 2013, after the successful implementation of worldwide activity in 2011 and 2012, the BMGF expanded the project by supporting for regional programs, including “Reinvent the Toilet Challenge- India (RTTC-India)” and “Reinvent the Toilet Challenge- China (RTTC-China)”, encourages researchers and institutions to innovate and design new-generation toilets in the China and India locally, but the RTTC-China also accepted the proposal which was proposed by Chinese leading team cooperated with the foreign partners.

However, although the percentage of people gaining access to improved sanitation increased from 54% to 68% and the percentage for open defecation has fallen from 24% to 13%, the world still missed the MDG target (WHO, 2015).

Currently, there are still 4.5 billion people lacking safely managed sanitation, and among them, 2.3 billion still do not have basic sanitation services. This number includes 600 million people who share a toilet or latrine with other households and 892 million people- primarily in rural areas who defecate in the open, as reported by the World Health Organization (WHO) and the UN International Children's Emergency Fund (UNICEF) on July 12th, 2017 (Osseiran et al., 2017). WHO defines sanitation as the provision of facilities or services that separates people from urine and faeces. Safe access to sanitary toilets and the management of excreta are the basic targets for global sanitation, and these targets are important to realizing effective resource recycling.

Resource recycling, generally called “sustainable sanitation”, should be economically viable, socially acceptable, and technically and institutionally appropriate. It should protect the environment and conserve natural resources. Developing economical, acceptable, technically flexible, and environmentally-friendly sanitation technology for the next generation requires research into sanitation technologies development.

Not long ago, Bollywood churned out a movie that tackles the subject of open defecation- ‘Toilet: A Love Story’. The film depicts the story of Jaya, a newly married woman who leaves her husband because his home has no toilet, is flushed with success.

Jaya, who grew up with a toilet in her house, becomes outraged when she learns there is no toilet in her new marital home. The women go to a field at night to relieve themselves carrying their "lota" or water vessels to clean themselves afterwards. "Shed all your inhibitions and get down to business," one woman urges an unwilling Jaya. It is not only the matter of sanitisation but safety too! In India, women defecating in the open faces a high possibility of rape.

Movie critic Tanul Thakur, among those who termed "Toilet" propaganda, admits he was surprised by the film's topic, "A film like that hasn't really been made in India. It's very classic Bollywood in some ways, one man trying to restore right in his world. But definitely the topic is different."

Sociologist Bindeshwar Pathak has spent decades championing the cause of sanitation in India and knows toilets aren't an easy sell. In rural areas, many consider defecating in an open space healthier and having a toilet in the home violates its purity.

Pathak thinks the movie's success will have a positive impact and motivate women in particular.

"All women deserve and must have toilets inside the house," Pathak says, "The film's lead actress says to her father-in-law, "Why should I hide myself [in modesty] from you, when I have to go outside for open defecation, exposing myself to others while relieving myself?"

Under the Swachh Bharat Abhiyan (SBA) programme, people living below and above poverty line in India- can avail reimbursement for constructing toilets at household level. The programme has given a huge impetus to nationwide toilet building exercise.

The SBA, currently, operates under a reimbursement model, where the households are expected to build the toilets from their own funds and then, upon producing the required documents, they are reimbursed Rs 12,000- Rs 15,000.

Despite the SBA subsidies easing the process of household toilet construction, BPL households are faced with significant barriers:

Raising Capital

One of the most important barriers is a household’s ability to raise the initial funds needed to build the toilets. Based on our initial visits in rural Karnataka, it emerged that the real cost of building a toilet is highly variable and can often be more than Rs 20,000.

The average agriculture household income was Rs 8,931 per month in 2016-17, according to the Nabard's All India Rural Financial Inclusion Survey. Combining the income data with the cost of constructing the toilet indicates that households find it challenging to raise the initial funds.

While informal methods of raising the funds exist (borrowing from relatives or dipping into personal savings), these are not accessible to all households.

Moreover, the reimbursement from the SBA is delayed by at least six months. Until then, people continue to pay interest to moneylenders. This makes households reluctant in building toilets.

Limited Space

Urban slums are characterised as congested lanes with poor light and ventilation and having wall- to-wall houses with single room per household.

According to census 2011, 45 per cent of households in urban slums are having single room.  It becomes clear that the spare space available to a household to build a toilet may not exist or maybe too less.

Households that can raise the funds may be challenged by the lack of space to build a toilet. Moreover, it becomes difficult for people living in rented homes, as the decision to build a toilet lies with the house owner. Community toilet is suggested as a solution in such settlements.

However, its construction and long-term use depends on finding suitable site close to the slum and proper use and maintenance. 

Lack of Information

The success of any government programme lays in its design, implementation and participation of community members.

SBA is only focussed on toilet construction, not on IEC (Information, Education and Communication) activities. In the earlier programme Nirmal Bharat Abhiyan, 15 per cent of the fund in the budget was spent on IEC activities, but it has been brought down to 8 per cent under SBA.

Lack of proper information about sanitation programme can impact the most marginalised people. For example, women-headed households may lack access to the information about the process of applying for subsidies to build toilets.

In rural areas, many women did not know who to approach or what paperwork is needed to apply for the construction of the toilet under the SBA.

For example, when we asked women from Jayanagar slum in Nelamangala, Bengaluru, to describe the process of applying for toilet construction under the SBA, they were unable to describe who to approach and what documents were needed.

Improving the information dissemination about the processes through which the most marginalised people can access the programme subsidies can extend the benefit of SBA to these households.

Even with the impetus to build toilets under the national level SBA, households in urban slums continue to struggle to build toilets.

While some of the barriers are relatively easier to fix (such as improving information dissemination), space constraints can be the most challenging. Removing these initial barriers can improve household level access to sanitation.

Working with priority areas can be a step in ensuring sustainable sanitation solutions for all. Lixil presents three such key points of solution:

Innovation

Often, existing sanitation products are unsuited to the contexts of those living without access to a toilet. For instance, the typical 'western-style' flush toilet uses around 13 litres of water for each flush. With around 1/5 of the world's population living in areas of water scarcity often coinciding with areas that also suffer poor sanitation coverage such technology is not appropriate for the circumstances. Sanitation solutions that meet the specific needs of underserved communities must be developed.

Political Prioritisation

The social and economic impacts of improving sanitation are irrefutable. Politicians at international, national and local levels must put sanitation firmly at the top of their agenda, and reflect this in national planning and budgeting. The economic boost from improving sanitation would have a multiplier effect across themes as diverse as gender equality and education, nutrition and healthcare.

Ensuring the sustainability of new and existing services is critical to achieving universal access, and this requires national governments to establish and support the monitoring, operations and maintenance systems needed to ensure service failures are quickly and efficiently fixed, and provision is extended equitably and affordably.

Collaboration and Coordination

Addressing the sanitation crisis is a complex issue that no single person or institution could hope to solve alone. Collaboration among diverse players with different skill sets will drive disruption and encourage the innovation the situation needs. Coordinated efforts led by national governments working alongside intergovernmental organisations, NGOs, academia and the private sector will ensure brainpower and funding is put behind the most promising solutions. This approach enables each stakeholder to efficiently leverage their core skills, thereby ensuring that effective programmes can be taken to scale with the necessary speed.

Addressing the global sanitation crisis is a complex issue. Only with all sectors of society working together can we tackle the myriad of issues relating to poor sanitation and begin to drive change.

Everyone must have sustainable sanitation, alongside clean water and handwashing facilities, to help protect and maintain our health security and stop the spread of deadly infectious diseases such as COVID-19, cholera and typhoid.

Sustainable sanitation systems also reuse waste to safely boost agriculture and reduce and capture emissions for greener energy.

Sustainable sanitation begins with a toilet that effectively captures human waste in a safe, accessible and dignified setting. The next stage is treatment and safe disposal. Safe reuse of human waste helps save water, reduces and captures greenhouse gas emissions for energy production, and can provide agriculture with a reliable source of water and nutrients.

Due to COVID-19, although it may be difficult to participate in a physical event, you can still take action by using online tools. Contribute by raising awareness within your networks: whether big or small, every action counts!