Everyone needs access to a toilet. How can we ensure that?

1.6 million people die every year around the world because of poor hygiene and sanitation. Bangladesh has made remarkable progress in ensuring safe sanitation – open defecation is nearly zero percent. Here are five initiatives that supported improvements to sanitation, in both big and small ways:

Toilets. Do you have one?

If you have access to a well-equipped toilet in your home, office, or neighbourhood, you are luckier than half of the world. Almost 4.5 billion people still do not have access to a safe toilet. This has a price – poor sanitation costs the world USD 260 billion every year.

Bangladesh is a role model for safe sanitation. There are toilets everywhere, of every possible kind. Open defecation has reduced from 34% to almost zero over the past two decades, and having a toilet has become a status symbol in remote areas. Here are five factors, both large-scale and small pilots, that have played some part in improving access to safe sanitation:

Changing behaviour across the nation

Let’s start with the biggest initiative: Bangladesh’s nationwide sanitation programme, which started in 2003, led by the government, and supported by non-government organisations and international agencies. This programme kickstarted a holistic, community-driven sanitation approach to improving sanitation.

Hygiene sessions supported communities to adopt good hygiene practices. People often brought family members, which helped to spread information.

The knowledge gained from these sessions motivated people to build self-financed hygiene models for their own neighbourhoods. BRAC’s water, sanitation and hygiene programme then worked with communities to materialise these models. Over 32.8 million people were supported with hygienic latrines, across 289 sub-districts out of 492 sub-districts – covering more than 50% of the country.

A key insight was that changing attitudes at the community-level is as important as changing infrastructure.

Promoting sanitation entrepreneurship

Ring slabs are a critical component in building hygienic latrines, so the people who build slabs are a crucial link between people and toilets. BRAC trained these builders as sanitation entrepreneurs, and equipped them with financial and technical support.

The entrepreneurs played two key roles. Firstly, they were trained in hygiene, and served as advocates of hygiene in their communities, stimulating demand for sanitary latrines across communities, schools and households. Secondly, they made sure that demand could be met, by ensuring people had access to the high-quality raw materials in both urban and rural markets needed to build sanitary latrines. The key insight from this was that market linkage is key in creating an effective, lasting ecosystem.

Read more: 4 ways to change the world of water, sanitation and hygiene

Ensuring safe sanitation in schools, particularly for girl students

Students are often the strongest ambassadors for change. When students understand good hygiene and have access to clean water and toilets, they thrive – not only in school, but in  creating a positive ripple effect by sharing their knowledge across their families and communities.

By working with schools in Bangladesh, BRAC identified gaps in healthy sanitation practices for students. Non-functioning toilets were repaired. It was found that girls often drop out of school once they hit puberty due to lack of segregated toilet facilities, so separate latrines were constructed for girls in secondary schools. In addition, they often do not have access to menstrual hygiene facilities – so girls toilets were equipped with menstrual hygiene management facilities. To date, over 6,000 schools have been supported with newly-constructed and repaired toilets.

Read more: Waste to welfare: A tale of Jamalpur and its people

Disability-inclusive latrines

Most toilets are not designed to accommodate the needs of people with disabilities, which can result in pain, discomfort – and contamination.

BRAC worked with communities across Bangladesh to identify appropriate schools for gender-segregated, disability-inclusive latrines, equipped with ramps and handles.

Double pit latrines with running water prioritise the safety and convenience of users living with disabilities – and adolescent girls and women. Wash basins with mirrors and soap trays enable handwashing with soap, and tiled floors and walls ensure easy cleaning. To date, 1,186 schools have new toilets, with girls toilets equipped with menstrual hygiene facilities.

Read more: Breaking the taboo: managing menstrual hygiene at school 

Avoiding a crisis within a crisis

Lack of sanitation facilities during emergencies can lead to the spread of diseases, which can make any crisis go from bad to worse very quickly.

Faecal sludge management keeps latrines functional and protects the environment from contamination by faecal bacteria in the densely populated Rohingya camps in Cox’s Bazar. BRAC constructed thousands of twin-pit and communal latrines in the camps, as well as 48 faecal sludge treatment plants, which can treat up to 13,000 litres of sludge every day.

What are the take-aways?

• Changing attitudes at the community-level is as important as changing infrastructure
• Market linkage is key in creating an effective, lasting ecosystem
• Students are some of the strongest ambassadors of change, through the ripple effect they create by spreading knowledge to friends and family.
• Sanitation cannot stop during a crisis – it is just as important, if not more, in an emergency.
• Sanitation must be inclusive. Community engagement and thoughtful design can lead to long-term use of facilities by all.

On World Toilet Day, with half the globe still lacking access to a safe toilet, Bangladesh’s progress has some insights for the world.

The BRAC Water, Sanitation and Hygiene (WASH) programme has made a critical contribution to sanitation in Bangladesh, reaching half the country with services. It has helped over 41.62 million people gain access to hygienic latrines, reached 13.9 million people with hygiene education, and 2.3 million people with access to safe drinking water. Targeted water and sanitation financing, entrepreneur development and financing, loans for people living in poverty, grants and water subsidy for the people living in ultra-poverty, along with motivation for self-financing has ensured equal access for all wealth categories.

To learn more about BRAC’s approach, visit the WASH Programme’s website. Find more blogs on what BRAC is doing in WASH on The Good Feed.

MD Yazdani is a Communications Specialist at BRAC Communications, and Fahmida A Chowdhury is a Deputy Manager, Communications at BRAC Communicable Diseases (TB & Malaria)  & Water, Sanitation and Hygiene (WASH) Programme.