In this Saturday, May 31, 2014 file photograph, members of the All India Democratic Women's Association (AIDWA) shout slogans during a protest against the gang rape of two teenage girls, in New Delhi, India. Beyond highlighting the rampant sexual violence in India, the horrific crime is drawing attention to a glaring and fundamental problem across the country that threatens women’s safety: the lack of toilets. The placards read: "Arrest all accused in the gang rape." (Altaf Qadri/AP)

In May, two young women in rural India left their modest homes in the middle of the night to relieve themselves outside. Like millions in India, their homes had no bathrooms. The next morning, their bodies were found hanging from a mango tree. They had been attacked, gang-raped and strung up by their own scarves. Eighteen months after a gang-rape on a Delhi bus, this incident and others since have galvanized nationwide protests to end violence against women and highlighted caste-related discrimination. The tragic story also underscores the need to talk about another taboo topic: open defecation.

Access to clean, safe and private toilets is a women’s issue. An estimated 2.5 billion people globally lack access to proper sanitation, with the largest number living in India. Women are disproportionately affected by lack of adequate sanitation. Many poor women living in rural villages or urban slums wait until nightfall, reducing their food and drink intake so as to minimize the need for elimination. Girls often do not attend school if there are no private toilets, and this is especially true after the onset of menstruation. Approximately 2,200 children die every day as a result of diarrheal diseases linked to poor sanitation and hygiene, which impacts women as mothers and caregivers. Finally, waiting until nighttime to urinate or defecate is not only dehumanizing, it makes women vulnerable to sexual assault, as vividly illustrated by the appalling events in India.

…waiting until nighttime to urinate or defecate is not only dehumanizing, it makes women vulnerable to sexual assault, as vividly illustrated by the appalling events in India.

The world is slowly acknowledging the need to talk about toilets, but we need to do more. In 2010, the United Nations General Assembly and Human Rights Council recognized a human right to safe drinking water and sanitation. Through the Millennium Development Goals (MDG), the global community committed to a series of targets designed to address development challenges, including a 2015 goal of reducing by half the number of people without access to sanitation. However, the targets for sanitation are dismally behind. With the MDG targets set to expire soon, sanitation — and its role as a women’s issue — must be given high priority in forthcoming Sustainable Development Goals.

India has launched several large government programs to expand access to sanitation, but success has been elusive. India’s Total Sanitation Campaign, which has recently been re-branded as Nirmal Bharat Abhiyan, or Clean India Campaign, initially reported that close to 80 percent of India’s rural households had access to sanitation facilities. But the more reliable 2011 Census put the figure at only 31 percent.

Why is it that more people around the world have access to cellphones than to toilets? The evidence from India suggests that simply building toilets is not enough — there also needs to be demand. Open defecation is a traditional practice in rural India, and cultural biases can impede actual toilet usage. Even after a toilet is constructed, a family may use it for storing, bathing and washing purposes, but not for defecation.

People may stop using toilets once the waste chamber fills. Technical solutions are complicated by the legacy of India’s caste system. Historically, lower-caste individuals, usually women, manually removed human waste from dry latrines in a process known as “manual scavenging.” While the practice is now outlawed, it still exists in various forms, and it remains, in the words of Mahatma Gandhi, a national shame.

Why is it that more people around the world have access to cellphones than to toilets?

Improving access to sanitation requires change across several scales of power. India needs to tap into its long-tradition of women’s self-help groups to promote critical peer-to-peer education, highlighting toilets as an issue not only of public health, but as one of safety and dignity. Because women are not necessarily household decision-makers, village-level approaches are needed. India has a complicated federal system, and the rural local bodies tasked with implementing central government projects require better skills and resources. Finally, technical solutions to the sanitation problem must never reinforce old caste-based and gender-based hierarchies.

The solution to this problem, while not easy, cannot wait, given the disproportionate impact that poor access to sanitation has on women around the world. If the promise of a human right to sanitation is to have any meaning, then the idea of human dignity that is at the core of human rights must apply to all people and transcend all aspects of daily life, even the parts that are taboo.


Tags: Women's Health

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  • Mark Lai

    The people would gladly use working toilets if they had them. What does the caste system or suppression of women have to do with it?

    Toilets require water and sewer systems. Building these is not rocket science. The only reason these are not built is that Indian governments, both at local and central levels, are incompetent and unaccountable.

    We heard Modi say during election season that he plans to build toilets for every Indian. What is the status of this plan? And if he gets re-elected five years from now, whose fault will that be?

    • AC

      ….’not rocket science’?
      you have obviously never been involved in infrastructure design and planning….

    • Allison

      As somebody who has worked in Uganda on spreading access to toilets and sanitation, it is VERY difficult to build these. Pit latrines, while they are a simple design, require that there is no water below the ground so that feces don’t contaminate any nearby freshwater. Once you’ve found an okay spot for that, you need capable workers to start digging the latrine; when families are worrying about where they are getting their next meal and preparing freshwater (which can be very far away) for their families, they may not have the strength to dig a latrine. Hire someone? That would cost money, money they likely don’t have. Maintenance is also a big problem, so once these are built there needs to be somebody knowledgeable about the system around (but they’re likely working another job on top of that). “Because women are not likely household decision makers, village-level approaches are needed.” This was a big obstacle and continues to be, in a lot of countries like Uganda and India. Women aren’t raised to feel empowered or like they have any authority. When things aren’t just, they are taught to accept these injustices. Preventable illnesses like diarrhea become the norm, and of course they realize how unfair this is, and are now having their voices be heard. Tapping into the self-help groups is key: Then such movements for change can eventually become self-promoting and self-sustaining, but it takes a lot of educating and empowering to get these groups off the ground.

  • Mark Lai

    Obviously, the lack of toilets hits women harder. I just don’t buy the author’s contention that Indians don’t demand toilets or that they would not use them if working toilets were built. The problem is poor government. The rest are excuses.

  • Aaron

    This is happening now in Detroit also. Thousands every week are having their water cut off for overdue accounts. There are groups now, inspired by a Canadian town, that are taking it to the U.N.
    It’s heartbreaking really. If 2,200 children dying every day doesn’t qualify as a human right in the eyes of the U.N., I don’t know what would. In “The Whistleblower”, a true story, Rachel Weisz portrayed the corruption at the U.N. level, nothing is worse than when an organization that’s supposed to help people ends up being the bad guys. Certainly, there’s no shortage of good engineers and bright folks with the know-how to get it done, and India’s economy has been growing for a long time, so the money is there to create the necessary infrastructure, if it can be pried from the corrupt, greedy politicians.

  • John Doe

    It’s sad that these women have to go through that – though a few more public toilets won’t get to the heart of the issue, which is that women are treated like garbage in that country and shoulder the burden sexual morality even in the context of rape.

    Unless the culture changes, nothing will change for those women. There was an Indian governor (??), male of course, who recently took the Clayton Williams “rape is like weather” approach to sexual violence and said men rape women because boys will be boys. When will it stop? Where is the voice of Indian men who are disgusted by this level of misogyny? Where is the voice of Indian men who have a problem with other Indian men treating women this way?