Of the world’s seven billion people, a staggering six billion have cell phones. Mobile technology has soared in the developing world, creating networks for the distribution of health information in rural communities, and even generating mobile banking systems for people who previously lacked opportunities to save money electronically.
But the mobile revolution has been no match for the problem of ensuring adequate sanitation for the planet’s inhabitants. According to the United Nations, more people have mobile phones than access to toilets or latrines. Thirty-seven percent of the world’s population, or 2.5 billion people, live without basic sanitation.
One in seven individuals across the globe is forced to defecate in the open, putting them at risk for disease when untreated waste enters waterways. Open defecation also contributes to environmental degradation when sewage is not adequately disposed.
Last week, the United Nations intervened, using its considerable clout to launch an initiative to end the practice of open defecation by 2025.
Open defecation brings with it a host of health and social justice challenges. Countries where open defecation is an everyday reality often have high levels of poverty, poor nutrition, and soaring percentages of death for children under the age of five.
“Let’s face it—this is a problem that people do not like to talk about. But it goes to the heart of ensuring good health, a clean environment and fundamental human dignity for billions of people—and achieving the Millennium Development Goals,” U.N. Deputy Secretary-General Jan Ellison said in a press release.
Despite the U.N.’s commitment, the new program “will not set up any new structures or funding mechanisms, but focus on generating action at the community level—one community at a time,” according to the organization’s website.
What does ending open defecation at the community level look like?
Kris Ansin, who runs the Mali Health Organizing Project, says that while community education programs can’t buy toilets or build latrines, they can transmit valuable knowledge about sanitation from trusted sources like community leaders and advocates.
The Mali Health Organizing Project runs a number of community-focused health programs in Mali, West Africa, that aim to improve sanitation and bolster public health.
One of their initiatives involves a child-to-child health education campaign, which trains high school-aged kids to run workshops for elementary school students about sanitation issues like hand-washing, cleaning food before eating it, and separating areas where clothes are washed from areas used as a bathroom.
“These kids are becoming the champions in their families, taking ownership of those best health practices and learning how to avoid preventable conditions like diarrhea,” Ansin told TakePart. “Although some of our programs in Mali are really diffused, our community health workers plant a seed, or start a ripple, and information spreads.”
Mali Health has shown that community education is one critical part of improving health outcomes. The organization has 2,000 Malian children enrolled in a health services program that provides health education and medical care. Last year, the mortality rates for the children they serve were less than one percent for the third year in a row, compared to the nationwide average of 19 percent.
These are striking results, particularly as the challenges of diarrheal disease looms large. Two million people die each year of diarrheal disease, most of them children under five years of age. The U.N. estimates that ending open defecation will reduce cases of diarrhea in children under five by one-third.
But ending open defecation on a community-by-community basis might take a while, particularly if the U.N. plans to put an end to the practice without coughing up additional funding for the construction of clean, safe bathroom facilities.
“What we do on the community level is really important and is part of the answer. But you can’t really stop there. If there’s no toilet, a family or a child is at a serious disadvantage,” Ansin said. “One in six people doesn’t have access to a toilet. So I think the U.N. is right to address that situation specifically. But I hope they will put enough resources behind it, not just press and good words.”