No longer a laughing matter – 2.5 billion people do not have toilets!

By Edmund Smith-Asante

No household latrines
No household latrines

For the first time in 12 years since the World Toilet Organisation declared November 19 as World Toilet Day in 2001, this year’s observation of the day would be with the blessing of the United Nations with the theme: The Rural Meet the Urban Sanitation“.

Selection of the theme is informed by the need to improve sanitation to alleviate poverty, promote health and hygiene in both rural and urban communities and Ghana marked the day with a national forum at the Holy Spirit Cathedral in Accra. The theme for Ghana’s commemoration was “An open defecation free Ghana in my lifetime”.

The 139-member United Nations (UN)  at its 67th General Assembly and 92nd plenary meeting on July 24 this year, endorsed November 19, 2013 as World Toilet Day, by adopting a draft resolution without voting.

Tabling the draft resolution on “Sanitation for All”, one of four adopted by consensus at the meeting, Singapore’s charge d’affaires Mark Neo said; “The amusement and laughter likely to follow the designation of 19 November as ‘World Toilet Day’ would all be worthwhile if people’s attention was drawn to the fact that 2.5 billion people lacked proper sanitation and 1.1 billion were forced to defecate in the open.”

“I am sure there will be laughter among the press and the public when it is reported that the UN is declaring a World Toilet Day. Their laughter is welcome, especially if they recognise the prevailing and unhealthy taboo that prevents an open and serious discussion of the problems of sanitation and toilets globally,” Neo told the assembly before their unanimous vote in favour of the measure.

“Sanitation for All” is one of eight Millennium Development Goals (MDGs) adopted by the U.N. and is a blueprint of global aims agreed by all member nations.

Currently 23 per cent (over 5.7 million) of Ghana’s population practice open defecation because they do not have access to toilets, while only about 15 persons out of every 100 have access to improved sanitation.

No laughing matter

Open drains used daily by millions daily
Open drains used daily by millions daily

Nana Yaw, who used to live at Tetegu, a community of over 3,000 people in the western part of Accra, said there were very few household latrines (80 per cent of the population did not have) and no public toilets in the entire community.

“As a result of that residents defecated in the bushes, in uncompleted buildings and behind people’s houses and when it rained, the faeces were washed into people’s homes.”

“I also did it behind uncompleted buildings especially at night but always made sure I covered the faeces with some soil after I had defecated.  I was almost caught one day by a young lady who had come to dispose of some refuse,” Nana Yaw narrated.

Recounting his experience, Paa Kwesi, who from 1998 to 2000 lived at Bubuashie, a suburb of Accra, said “because there was no toilet at my rented apartment I had to most times resort to the bushes around ‘Cable and Wireless’ as the public toilet was not neat.”

Fortunately for him he now has his own apartment which has a water closet toilet. “I built a toilet before we moved to our house – my wife is very particular about it,” he said.

Ajara Issah, a young of about 25 years is however not as fortunate as Paa Kwesi. She lives in Maamobi, a densely populated community in Accra with over 5,000 residents but which has only four public toilets to serve them and a negligible number of household latrines.

“People get up at dawn to queue just to use the public facility and to prevent them from doing so, looking at the time and everything, some decide to do it in their own washrooms, and wash it down the drain. So you might be passing by somebody’s house and you can see the faeces pouring down the drain like that.

“Others too would like to do it in their polyethylene bags at home and then come and throw it away so the community itself is not properly structured. So you might be walking in an area and if you step on any polyethylene bag you see you have to be very careful about it because you might step into something that is not good,” she said.

“Considering the economic situation now and looking at the people we are dealing with – the people of Maamobi a suburb, a zongo community, not everyone is working, not everyone can afford 20 pesewas or 30 pesewas a day. Assuming I am having a running stomach it means I have to budget for about GH¢2 to go to toilet and it’s not going to be possible,” she surmised.

Ajara said many in the community cannot build their own toilets because they do not have space to do so in view of how the community has been structured.

She however says “My house has a pan latrine. My mum has issues with sanitation. For her she doesn’t play with her bathroom and toilet so it’s just for family use and by relatives when we have a gathering or anyone visits us and wants to use the toilet.”

Although pan latrines have been banned by the Accra Metropolitan Assembly (AMA) since January 2011 because they are considered unhygienic, Ajara said a project embarked on by the AMA to assist households with their own toilets hadn’t yet gotten to their area. She disclosed that it took about a week or two for their pan to be filled and emptied by a night soil carrier.

Confirming that emptying of the bowels is a natural and healthy practice, Dr Frederick Arhin of the Korle-Bu Teaching Hospital, Accra, said a normal human being can only stay without using the toilet for a short time depending on the quantity of food eaten. “If a person stays without going to toilet for three days it means there is a problem,” he said.

Access to mobile phones higher than access to toilets

The U.N. says that while six billion people in the world (out of a total population of 7 billion) have access to a mobile phone, only 4.5 billion people have access to toilets or latrines. If everyone in the world had access to a toilet, it’s estimated that the lives of 200,000 children could be saved each year.

According to U.N. Deputy Secretary-General Jan Eliasson, “Despite progress toward the Millennium Development Goals, one in three people do not have a basic toilet,” while “Almost 2,000 children die every day from preventable diarrhoeal diseases. Poor sanitation and water supply result in economic losses estimated at $260 billion annually in developing countries.”

Safe toilet facilities keep girls in school

Proper sanitation facilities are also considered as very instrumental for women and girls who on the average menstruate for 3000 days in their lifetime, and therefore need space for washing and somewhere to dispose of sanitary pads.

Especially for adolescent girls, research has shown that a clean and private toilet strongly impacts their school performance and increases the chance for them to complete their education.

In many countries, girls stay home during their menstruation days because the absence of a safe place to change and clean themselves makes them feel unsecure. In India, a recent research showed that 23 per cent of girls dropped out of school when they reached puberty.

Health experts say besides the emotional stress, poor menstrual hygiene often leads to health problems such as abdominal pains, urinal infections and other diseases and girls facing health problems are less able to concentrate and perform during their education.

WASH programmes for schools provide a major opportunity to address girls’ needs, by focusing on the practical dimensions such as appropriate girl friendly latrine facilities as well as on hygiene education and general awareness of menstruation challenges.

According to Ms Ellen Gyekye, Programmes Manager, Schools Health and Education Programme (SHEP), sanitation coverage for schools in Ghana is about 56 per cent, while coverage for water is around 43 per cent.


Families and nations would save a lot of income, time and energy if they did not have to deal on a regular basis with sick members as a result of poor sanitation.

Although toilets are a symbol of better health, higher income, more education, higher social status and a cleaner living environment, they are an unglamorous topic in many parts of the world and talking about open defecation and its consequences is considered taboo.

However, bringing clean toilets to those who are lacking them is not a matter of breakthroughs in science but an issue of political leadership, plain speaking champions, a change in attitudes, raising awareness and hard work.



November 19 to promote toilets
November 19 to promote toilets
  • The purpose of World Toilet Day is to raise awareness about the lack of sanitation in parts of the world and to encourage the policies that increase sanitation access among the poor.
  • According to the World Health Organisation (WHO), if everyone had access to safe sanitation and water, the world’s health sectors would save around $12 billion per year.
  • In 2010, the UN General Assembly recognised sanitation and water as a human right, essential to the full enjoyment of life and all other human rights.

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