We rarely give the toilet a second thought. We use it when we need to, and we flush and forget. We are also able to conveniently wash our hands afterwards. But imagine if you are on a long hiking trip or a bus ride with no stops in sight and had no access to a toilet or running water. It’s a situation most people would dread.
In poorer parts of the world, this is the daily reality for many. The humble toilet—perhaps the most important contributor to improved human health in history—is a luxury item which relatively few people enjoy. Without a toilet, the poor have to go in the open, behind bushes, or next to streams. They cannot flush their waste away or wash their hands afterwards if they wanted to. In poorer countries, managing human waste remains a major challenge, and failure to meet that challenge exposes millions of children and adults to waste-borne diseases that can have deadly consequences.
In Nepal, a country of approximately 26 million people, nearly 40% of the population do not have toilets. In parts the Terai or lowland areas, this number climbs to a staggering 75%. To be sure, the Government of Nepal has achieved remarkable progress in improving sanitation coverage in the last two decades. In 1990, only 6% of Nepalis had access to a toilet. By 2011, 62% had access, with the sanitation Millennium Development Goal (MDG) achieved ahead of the 2015 target. However, that achievement still leaves a large population—more than nine million people—without toilets. So the Government decided to aim for a new and more ambitious target—universal access by 2017. And it may get there.
Last month, I visited Nangkhel, a Newari village near Bhaktapur in the eastern corner of the Kathmandu Valley, to see how one village succeeded in bringing the luxury of a toilet to all 181 households (or about 900 people).