673 Million People Still Practice Open Defecation

Discover the shocking reality of open defecation as 673 million people worldwide continue to face this sanitation crisis

Written by Rika Andini

Can you imagine not having access to a toilet, let alone one with a flushing mechanism? Unfortunately, this is the reality for 673 million people worldwide.1[1] Open defecation not only poses a significant risk to public health, but it also restricts individual and societal growth.

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Introduction to open defecation

Open defecation is a global issue that affects millions of people around the world. It refers to the practice of people relieving themselves in open spaces, such as fields, forests, or bodies of water, instead of using proper sanitation facilities like toilets. This widespread practice is a major concern as it not only poses serious health risks but also has detrimental effects on the environment.


Open defecation, the practice of relieving oneself in public spaces such as fields, bushes, and rivers, is a public health concern that primarily affects low and middle-income countries. Shockingly, India alone accounts for half of the global burden, with 344 million individuals practicing open defecation.2[1] The situation is compounded by the lack of access to clean water and proper sanitation facilities. The United Nations (UN) estimates that more than 2.3 billion people do not have access to basic sanitation services such as toilets.3[2]


The consequences of open defecation

The consequences of open defecation are dire. The World Health Organization (WHO) reports that the practice contributes to over 829,000 deaths globally every year resulting from diarrheal diseases, including cholera and typhoid.4[1] Access to clean water and proper sanitation would significantly reduce these deaths. Additionally, open defecation makes girls and women vulnerable to sexual assault and harassment when they have to venture out in search of a secluded place to relieve themselves.

In Indonesia, a heartbreaking reality persists as nearly 1 in every 30 children tragically loses their life before reaching the age of five. This statistic becomes even more alarming in certain districts, where the figures soar to an alarming 1 in 10 children. These deaths are largely caused by preventable diseases, such as diarrhea, which are further exacerbated by the absence of safe water and adequate sanitation.


Similarly, in the city of Kenya, approximately 80 percent of households lack access to sewer lines, depriving them of proper sanitation and wastewater management. This lack of infrastructure poses significant health risks and contributes to environmental degradation within the community.


The gravity of these issues calls for urgent action and comprehensive solutions. In this blog, we will explore the causes and consequences of open defecation, delve into ongoing efforts to combat this practice globally, and discuss potential solutions to eradicate it.

Impacts of open defecation on health and environment

Open defecation is a widespread practice in many parts of the world. This practice involves the release of human waste into open spaces such as fields, water bodies, or on the side of roads. Sadly, open defecation has severe implications not only for the environment but for human health.


Spread of Diseases: One of the significant impacts of open defecation on health is its contribution to the spread of deadly diseases. Human waste contains a wide range of pathogens such as bacteria, parasites, and viruses that can contaminate water sources, leading to the spread of diseases such as diarrhea, cholera, and typhoid. Millions of people, especially young children, die annually from diseases caused by these pathogens. Moreover, open defecation also provides breeding grounds for disease-carrying vectors such as flies and mosquitoes, further exacerbating the spread of diseases.


Environmental Pollution: Open defecation also has severe implications on the environment. Human waste contains harmful chemicals, such as phosphorus and nitrogen, that can pollute soil and water, making it unsafe for agricultural purposes. This pollution can also harm aquatic ecosystems and create dead zones in the oceans where marine life cannot thrive. Moreover, the unpleasant smell and unsightly sight of human waste in open spaces can negatively affect tourism, leading to economic loss for communities that rely on tourism revenue.


Gender-Based Violence: Open defecation can also expose individuals, especially women and girls, to gender-based violence. The lack of proper sanitation facilities means that women and girls have to wait until dusk or early morning to relieve themselves, putting them at risk of sexual assault or harassment. Additionally, women and girls often have to walk long distances to reach the nearest toilet, making them vulnerable to attacks by animals or physical harm by criminals.


Economic Impact: The adverse effects of open defecation on health and the environment can also have severe economic implications for communities. The treatment of diseases caused by poor sanitation consumes a significant portion of household income, which could have been used for other purposes such as education and investment. The unsafe environment resulting from open defecation can also discourage tourists from visiting, leading to a reduction in revenue for businesses that rely on tourism.

Disease Caused by Open Defecation

Open defecation leads to the spread of diseases through fecal-oral transmission. When human waste is left in open spaces, it attracts flies and other insects, which carry disease-causing pathogens on their bodies. These pathogens then contaminate water sources, food, and other surfaces that come into contact with them. The most common diseases caused by open defecation are diarrhea, cholera, typhoid fever, and hepatitis A. These diseases can cause dehydration, severe gastrointestinal distress, and can be fatal if not treated promptly.


Diarrhea is one of the most common diseases caused by open defecation. It is estimated that over 484,000 children under the age of 5 die from diarrhea every year globally.5[1] Diarrhea occurs when the fecal matter contaminates food or water consumed by humans, leading to the infection of the digestive tract. The symptoms of diarrhea include abdominal pain, watery stools, and fever. It can be treated with oral rehydration therapy, antibiotics, and probiotics.


Cholera is another dangerous disease caused by open defecation. It is caused by the bacterium Vibrio cholerae, which is transmitted through contaminated water or food. Cholera causes severe diarrhea and vomiting, leading to dehydration and electrolyte imbalances. It is estimated that cholera causes 1.3 to 4 million cases and 21,000 to 143,000 deaths annually worldwide.6[2] Cholera can be treated with oral rehydration therapy and antibiotics.


Typhoid fever is a bacterial infection caused by Salmonella typhi, which is transmitted through contaminated water or food. The symptoms of typhoid fever include high fever, headache, abdominal pain, and diarrhea. It can cause severe complications if not treated promptly, such as intestinal perforation or bleeding. It is estimated that there are about 9 million cases of typhoid fever globally, leading to 110,000 deaths each year.7[3]


Hepatitis A is a viral infection caused by the hepatitis A virus, which is transmitted through contaminated water or food. The symptoms of hepatitis A include fever, nausea, vomiting, and abdominal pain. It can cause severe liver damage if left untreated, leading to liver failure, cirrhosis, or even death. It is estimated that hepatitis A is responsible for approximately 7,134 deaths, accounting for 0.5% of the mortality attributed to viral hepatitis.8[4]

The Crucial Role of Safe and Clean Water in Ending Open Defecation

Safe Water Enhances Personal Hygiene: Access to safe water makes it possible for individuals to maintain proper personal hygiene, such as washing hands, showering, or bathing. With improved hygiene, people can prevent the spread of communicable diseases such as diarrhea, cholera, and typhoid, which are often associated with open defecation.


Water also plays a critical role in cleaning toilets and other sanitation facilities. In a place where water is scarce, people may be forced to use unsafe water sources to clean their toilets, thereby exacerbating the sanitation crisis.

Safe Water Facilitates Effective Sanitation Practices

Providing safe water is also crucial for ensuring effective sanitation practices. Good sanitation practices require access to water for the cleaning and maintenance of sanitation facilities, such as toilets and showers. Without adequate water, it's challenging to maintain a clean and hygienic environment. This lack of sanitation practices promotes spread of diseases, leading to ill health, resulting in missing days at school or work, low productivity and an overall lack of progress in developing countries.

Safe Water is Essential for Infrastructure Development

Maintaining robust infrastructure for waste management and sanitation is essential for reducing open defecation. However, constructions of basic infrastructure for sanitation services require water. For example, the sewage system needs to be flushed with water to prevent blockages and avoid the outbreak of various diseases. As such, a safe water supply is critical in the construction and maintenance of sanitation facilities making access to clean water a necessity.

Safe Water Is Key to Sustainable Development

Access to clean and safe water should be considered a basic human right, and a priority for every government. Safe water supply is not only critical for sanitation but also serves as a fundamental driving force of progress and development. Ensuring access to clean water, particularly in poor and developing nations, fosters economic growth by reducing the burden of communicable diseases, improving public health, and increasing productivity.

Efforts to Tackle Open Defecation

Efforts to eradicate open defecation and ensure universal access to sanitation have seen remarkable collaboration between development partners. Notably, the Indian government launched a massive campaign known as the Swachh Bharat Abhiyan, aimed at eliminating open defecation across the country.


The program encompasses a range of strategies, including the construction of public toilets, financial support for sanitation projects, awareness campaigns, monitoring, and the introduction of innovative technologies to enhance sanitation practices. Thanks to the efforts of the Swachh Bharat Abhiyan, over 100 million households have received access to sanitation facilities, and 30 states have been declared open defecation-free.9[1]


Building sanitation infrastructure is an essential and effective approach to tackling open defecation. Many households without access to proper facilities are left with no choice but to defecate in open spaces, which leads to the spread of diseases and environmental contamination.


Air Minum Bersih has joined forces with KITA BISA to address this issue by providing sanitation facilities in remote schools that lack proper sanitation. By extending access to clean and hygienic facilities in these areas, this collaborative effort aims to combat open defecation and enhance the overall health and well-being of students and communities. Through such initiatives, development partners are working together to create sustainable solutions and foster a hygienic environment for all.


Information and communication technology (ICT) also plays a vital role in addressing the challenge of open defecation. Mobile technology, in particular, has been instrumental in disseminating information on sanitation and hygiene practices. Governments and NGOs have leveraged mobile applications like SMS, WhatsApp, and social media to educate people about the importance of sanitation and adopting open defecation-free living.

Innovative solutions for safe and clean water

In the ongoing battle against open defecation, innovative solutions for safe and clean water have emerged as crucial allies. Access to clean water serves as a fundamental necessity that can significantly reduce the practice of open defecation by eliminating the need for unhygienic alternatives. Among these innovative solutions, water purification systems, particularly solar-powered ones, have proven to be game-changers. By harnessing cutting-edge technology, these systems effectively eliminate harmful bacteria and contaminants, providing communities with a reliable and sustainable source of clean water.


In this pursuit, Air Minum Bersih has partnered with Carocell Solar Water, combining efforts to implement water purification systems that contribute to a healthier environment and combat open defecation. Carocell Solar Water’s advanced purification technology allows for the production of safe, high-quality drinkable water from various sources, including seawater, groundwater, contaminated or polluted water, and rainwater harvesting. With this collaboration, communities gain access to clean water, promoting better hygiene practices and reducing the reliance on unsafe water sources. Ultimately, such innovative solutions play a pivotal role in improving public health, fostering sustainable development, and working towards the eradication of open defecation.


The reality of 673 million people still practicing open defecation worldwide is a stark reminder of the urgent need for action. Open defecation poses severe risks to public health, leading to the spread of waterborne diseases and environmental contamination. The devastating impacts on communities, particularly vulnerable children, underscore the critical importance of finding solutions.


Development partners and governments are working together to eliminate open defecation and ensure universal access to sanitation. Initiatives like the Swachh Bharat Abhiyan in India have made significant progress in providing sanitation facilities to millions of households. Behavior change, communication strategies, improved sanitation infrastructure, and leveraging information and communication technology are also vital components of the efforts to tackle open defecation.


Furthermore, innovative solutions for safe and clean water, such as solar-powered water purification systems, play a pivotal role in creating sustainable improvements. Collaborative efforts like Air Minum Bersih’s partnership with Carocell Solar Water exemplify how access to clean water can be a stepping stone towards eradicating open defecation and promoting better hygiene practices.


The road to ending open defecation is challenging, but with concerted efforts, education, and implementation of innovative solutions, we can create a world where safe and proper sanitation is accessible to all. By working together, we can protect public health, preserve the environment, and build healthier, more sustainable communities for the future.

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AHU-0020799.AH.01.04 Tahun 2022

Berita Negara No 080 Tahun 2022

Akta Notaris
no 09, 30 September 2022

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