World Toilet Day: Importance of Preventing Sanitation-Associated Infectious Diseases

One-third of the global population does not have access to basic sanitation and about 40% of the world’s populace is living without access to a clean and safe toilet.

That is almost half of the global population.

The Centers for Disease Control and Prevention (CDC) report that this equates to about 2.5 billion individuals around the world lacking “improved sanitation facilities,” which they define as “separating human waste from human contact in a hygienic way.”

To promote awareness of this issue, the CDC recognizes World Toilet Day, on November 19th each year. According to the CDC, the hope is that through innovation and education “the gap between safe toilets and unhealthy living conditions can be bridged.”

Unsanitary living conditions are one of the main factors that contribute to several harmful infectious diseases, which, in turn, can result in severe outbreaks, making lack of access to proper toileting facilities an enormous issue. In fact, according to the CDC, unsafe water and poor sanitation are linked with a staggering 80% of diseases in developing countries.

Some of the primary water- or sanitation-related diseases are:

• Diarrhea. The World Health Organization (WHO) reports that inadequate sanitation causes about 280,000 diarrhea-related deaths each year. In fact, a lack of sanitation is a key player when it comes to several neglected tropical diseases, including intestinal worms, trachoma, and schistosomiasis—a snail-borne parasitic disease that is endemic in tropical and subtropical countries. In early 2016, WHO teamed up with other government authorities to work with communities in Cambodia and the Lao People’s Democratic Republic to take action against the disease. The initiative included the creation of a task force to assess the situation through surveys. One survey found that 67% of households in one village lacked latrines, and, furthermore, in 60% of households the residents openly defecated—both factors contribute to transmission of the disease. Officials offered education on preventing transmission of the disease, and helped the task force design a plan to help residents engage in better hygiene practices, and build/use latrines in the areas.
• Cholera. WHO defines cholera as an “acute enteric infection” which is often caused by ingesting the bacterium Vibrio cholera via infected water or food. Poor sanitation and the lack of access to safe, clean water are key contributors to the disease. Cholera is often found in underdeveloped countries where environmental infrastructures have been weakened or completely broken down due to political conflicts or natural disasters. One such example of how a lack of access to clean water can lead to mass infections is the outbreak that sprung up in the Central African Republic (CAR)—what the United Nations Children's Fund (UNICEF) identified as “the first cholera outbreak in CAR since 2011.” According to UNICEF, the outbreak’s origin was in Djoukou, located within the Kemo district. In this area, many individuals are without access to safe water; in fact, for many of them, their main water source is the Oubangui River. Because of intensive efforts to improve sanitation conditions and promote education on the disease, the outbreak came to an end in December 2016.

• Hepatitis A. Although, these sanitary-related diseases are known to cause the most damage in underdeveloped countries, a handful of hepatitis A outbreaks occurring in California can remind those of us in developed countries that these diseases can spring up anywhere. The cases associated with the San Diego Hepatitis A outbreak consist mainly of homeless individuals who do not have access to safe, clean toilets, and who practice open defecation because of the lack of options. Efforts are being made by officials and nonprofits alike to clean up some of the homeless encampments along the San Diego River, but to date, the outbreak is ongoing, with 546 individuals infected thus far and 20 lives lost.

The theme for this year’s World Toilet Day focuses on wastewater. According to the United Nations (UN), the main question to ask is “Where does our poo go?” Here are the 4 steps that everyone’s waste needs to take to tackle the global sanitation crisis, according to the UN:

• Containment via hygienic toilet, sealed pit/tank—away from human contact
• Transport via pipes or toilet emptying services to move it on to the next stage
• Treatment, or processing waste into treated wastewater to be returned to the environment safely
• Disposal or reuse, where waste can be used for something else, such as fertilizer in food production

Feature Picture Source: UN Water.