IT is a tragedy that basic human rights are often absent from national priorities. While weaving the fates of citizens, policymakers often neglect the most obvious of necessities. The right to water and sanitation is one of those needs. On World Toilet Day, it is worth considering the cost of failing to ensure it.

As unappealing a topic as public toilets might seem, there’s no use pretending that we can progress without them. Pakistan ranks 152 out of 189 countries on the UN’s Human Development Index. This is hardly surprising given its place among the top five countries where open defecation is most prevalent, as well as among the top 10 countries with the lowest access to clean water. This ought to ring alarm bells.

A significant deterrent to solving this problem is that policymaking is mostly occupied by individuals for whom access has never been an issue. For those who have faced such issues before joining public service, a combination of dampened political will and bureaucratic labyrinths renders them unable to effect change. As a result, despite being signatory to almost every international accord on sanitation, around 10 per cent of the population still practises open defecation, most entirely unaware of its perils.

The issue resides within a highly inequitable paradigm. The majority of Pakistan’s infrastructure development has focused around urban centres, which has come at a steep cost to rural areas. Communities lacking proper sanitation facilities are thus forced to build makeshift latrines, lacking in dignity and personal safety. Waste is disposed either into the environment or non-functional sewerage systems, contaminating water sources and increasing exposure to life-threatening diseases.

Access to water and sanitation is a human right.

Women are particularly at risk. In India, studies show that a lack of access to safe toilets significantly increases women’s vulnerability to sexual violence. Besides contracting diseases like dysentery, typhoid fever and hepatitis A, they are also at increased risk of vaginal or urinary infections and pregnancy complications. Poor sanitation also contributes to anaemia, which affects over half of Pakistani women of reproductive age.

Then there are children, who are especially susceptible to related diseases (such as poliovirus), which, coupled with mobility constraints curtailing access to healthcare, impacts health and quality of life outcomes. Unsafe waste management contributes towards diarrhoea, a leading cause of infant deaths, as well as malnutrition and stunting. The cycle of ill health and poverty caused by this deprivation is unending.

In 2006, Pakistan hosted the second South Asian Conference for Sanitation and formulated the National Sanitation Policy. In 2011, the Pakistan Approach to Total Sanitation programme was initiated in collaboration with development partners. Under PATS, the government made significant gains in improving sanitation access and countering open defecation through community-led and school-led total sanitation approaches, nationwide awareness campaigns and disaster-response strategies. Pakistan successfully met the MDG target for sanitation in 2015.

This achievement, however, was short-lived. With the 2030 SDGs deadline only a decade away, the massive effort required has been found wanting. The current government announced the Clean Green Pakistan Movement in 2018 — focusing on plantation, solid waste management, liquid waste management/hygiene, total sanitation and safe drinking water — yet progress has so far been lacklustre. In a Senate briefing earlier this year, the committee on environment took notice of the pressing need for sanitation facilities and promised that public toilets would be set up across the country.

With renewed focus on proper hygiene and sanitation as a result of Covid-19, the government must revaluate its strategy and focus on innovative methods to improve access, starting with better data collection. With the cooperation of a number of local and international organisations working on sanitation, the government only needs the will to establish and support public toilet networks across Pakistan. Redirecting even a small fraction of the amount spent on seminars to resolving the issue instead would significantly improve conditions. Private enterprises should face penalties for not providing clean and secure toilet facilities. Toilets in government offices must be redesigned to accommodate people of all genders and abilities. And a goal to establish 50,000 toilets in public spaces across the country should be announced, with a budget for implementation and maintenance, partially funded by the public by way of a small usage fee.

The status quo can and must change. Development that isn’t inclusive and doesn’t address citizens’ basic needs is repressive, and repression invariably nudges any country’s hopes for a better future down the drain.

The writer is founder of SaafBath, a public toilets initiative.

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Published in Dawn, November 19th, 2020