Although we are more open about erstwhile taboo subjects than we were a generation ago, it is still easier to talk about a subject such as water, its usage and scarcity than to openly discuss sanitation — yet the latter cannot be enjoyed without the former.
We use euphemisms for the toilet — the “restroom”, “washroom”, “bathroom”, “gents” or “ladies” but never anything that could describe in detail what happens in there lest we make people uncomfortable.
Sanitation is seen as a repugnant issue yet it is an unavoidable part of daily life.
Nobody can do without toilets, and nobody should have to. World Toilet Day, celebrated on November 19 every year, is not just to celebrate an oft-overlooked, underappreciated utility, but more than four billion people are without access to proper sanitation.
It is a day to reflect on Sustainable Development Goal (SDG) 6.2, whose aspiration is to achieve universal access to adequate and equitable sanitation and hygiene for all and to bring an end to open defecation by 2030.
The SDG also pays special attention to the needs of women, girls and all those in vulnerable situations and calls on stakeholders to address the global sanitation crisis.
The demographic most affected by lack of toilets is poor people; those living on the fringes of society.
They are easily excluded from public discourse, not because they have nothing valuable to contribute but poverty often robs one of everything — from the right to speak to the right to relieve oneself in a dignified manner.
Access to sanitation is not just a public health issue but a human right and, certainly, not a subject to be ignored because it makes people uncomfortable.
With just over a decade to 2030, it is a shame that 14 per cent of Kenyans still practise open defecation.
It is not by choice; 96 per cent of them are too poor to afford a basic latrine. Globally, 90 per cent of the people without access to proper sanitation live in rural areas.
Of this demographic, girls and women suffer more from lack of toilets.
During their menses, girls without access to appropriate sanitation facilities miss school for up to a week every month.
Women deal with shame and stigma over a natural body function, besides fearing the call of nature, especially if they must venture out of their homes to use the bathroom at night at the risk of being raped.
Beside the social injustice, there is the economic cost of poor sanitation. Open defecation leads to negative health outcomes caused by diseases such as cholera, diarrhoea, dysentery, hepatitis A, typhoid and polio.
It is also a major factor in several neglected tropical diseases like intestinal worms, trachoma and bilharzia.
BREAK THE CYCLE
By exposing low-income earners to such diseases, society makes it very hard for them to break out of the poverty cycle.
But with a community-first approach, we can resolve the global sanitation crisis and transform the lives of the world’s most vulnerable people.
We can ensure that the poor will not sink deeper into poverty simply because they cannot afford proper sanitation, or health services when they fall ill.
But we can only do so if we understand that universal health coverage also means leaving no one without sanitation.
Mr Waka is the programme director for water, sanitation and hygiene at Amref Health Africa.