Awareness raising and the consequent widespread adaptation of toilets and latrines has significantly reduced the number of people relieving themselves outdoors in Pakistan, according to a 15 March World Health Organization (WHO) report.
The Progress on Sanitation and Drinking Water – 2010 report says that as a result of awareness campaigns the prevalence of open defecation in Pakistan fell from 51 per cent in 1990, to 38 per cent in 2000 and 27 per cent in 2008.
People have begun building basic pit latrines in outhouses or other toilet facilities attached to their homes, rather than going outdoors. “I built a pit latrine at my home and it cost very little,” villager Irshad Masih told IRIN. “It’s much easier now for all of us, especially the women.”
Sanam Gul, 30, a teacher at a government primary school for girls just outside Islamabad, said that since reading a leaflet by a local NGO on the dangers of open defecation, she has been passing the message on to her students. “After I spoke to them, some of my pupils motivated their parents to build pit latrines rather than use streams as toilets,” she said.
Although modern toilets are plentiful across urban parts of Pakistan, basic latrines are less common in rural areas where about 65 percent of the country’s 169 million inhabitants live.
|It is only recently that I learned that using a stream as a toilet could be dangerous. Villagers who live upstream also do the same and we get sick as a result.|
“It is only recently that I learned that using a stream as a toilet could be dangerous. Villagers who live upstream also do the same and we get sick as a result,” said Uzma Bibi, 40, who uses the stream running through her village to collect drinking water, bathe and relieve herself. “For women, the water and the bushes around it also provide privacy.”
The World Bank Strategic Environmental Assessment for Pakistan estimates the total health care cost of diarrhoea and typhoid, both water and sanitation related diseases, to be Rs112 billion (US$1.33 billion), or 1.8 percent of the country’s gross domestic product (GDP).
“The main issue for the rural population is waterborne diseases. Cholera and gastroenteritis is common. And open defecation is a key factor in this because the waterways are polluted,” said Dr Uzair Muhammad, who works at a community clinic in Islamabad. He said “Even in urban areas there is a problem with this practice.
According to the WHO report, open defecation decreased globally from 25 percent in 1990 to 17 percent in 2008, representing a decrease of 168 million people practicing open defecation since 1990.
“It's simple measures, like not going to the bathroom outdoors, which can be very effective in preventing sickness. We need to do more to promote these ideas and overcome the awkwardness people feel in talking freely about them,” said Sanam Gul. “The girls I teach were shocked when I first brought up the topic, but now they are happy it was discussed.”