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Millions dying for want of a decent toilet

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The AMA has joined health leaders from around the world in urging a dramatic increase in the number of people who have easy access to safe drinking water and proper sanitation.

AMA Vice President Dr Stephen Parnis said that 2.5 billion people, around a third of the world’s population, did not have access to a safe and clean toilet, putting their health at risk.

“Access to basic sanitation is fundamental to human health, yet inadequate sanitation continues to leave billions around the world prone to illness, poverty and death,” Dr Parnis said.

One of the biggest killers is diarrhoea, particularly among children. It is estimated that around 4000 children die every day from diarrhoea as a result of drinking unsafe water, and inadequate sanitation and hygiene.

“At any one time, more than half the hospital beds in the developing world are occupied by patients suffering from diarrhoea,” Dr Parnis said. “Each year, around four million people die from diseases linked to a lack of safe drinking water, inadequate sanitation, or poor hygiene.”

It is estimated that about a billion people defecate in the open – about 600 million of them in India alone. According to the World Health Organisation and UNICEF, in all there are 19 countries where more than half the rural population defecates in the open.

In a promising initiative, the Indian Government has embarked on a program to build millions of toilets, at the rate of about one every second.

Dr Parnis said having access to a toilet and adequate sanitation was not only important to help ward off disease, but also helped prevent sexual violence and assaults.

“Having no home toilet means that women and girls in some countries must relieve themselves in open fields and public areas, which exposes them to an increased risk of assault,” Dr Parnis said.

 “And the failure to provide safe female sanitation in schools contributes to lower educational attendance for girls.”

Inadequate sanitation is not only a problem in south Asia, sub-Saharan Africa and south-east Asia.

Dr Parnis said Papua New Guinea had one of the lowest rates of access to safe and clean toilets of anywhere in the world – just one in five people had access to improved sanitation.

“Dramatic improvements must be made to water, sanitation, and hygiene access if we are to sustainably raise living standards and build prosperity in our region,” he said, adding that it was also a problem in parts of Australia.

“There are also many Australians who suffer from poor sanitation,” he said. “The Productivity Commission report, Overcoming Indigenous Disadvantage 2014, shows that a considerable number of Indigenous communities lack proper access to clean water and functioning sewerage services.”

The AMA has added its signature to a letter to UN Secretary-General Ban Ki-moon from leading health organisations including the World Medical Association urging that the Millennium Development Goals be renegotiated to ensure many more have access to adequate sanitation and safe drinking water.

The sanitation goal under the current MDG agreement, which aims to halve the proportion of the world’s population without access to basic sanitation by the end of next year, appears unlikely to be met.

Adrian Rollins