If you lined up the number of people in India who don't have toilets in their homes, the queue would stretch from the Earth to the Moon and beyond. This is among the findings of the latest report on the state of the world’s toilets by the international organisation WaterAid.

The report finds that more than 650 million people in the world have no access to clean water and 2.3 billion don’t have access to private toilets. India has been making a push for better sanitation and building toilets has been a cornerstone of Prime Minister Narendra Modi’s pet project Swachch Bharat Abhiyaan. As a result, the government’s sanitation initiatives might have kept India off the WaterAid list of the ten worst places in the world to find a toilet. It is hardest to find a toilet of any kind in the newly formed South Sudan that is being rebuilt painfully slowly. In Niger, a decade of conflict has left 100,000 people internally displaced and the largely nomadic populations rarely build toilets when they halt.

India still has the dubious distinction of being the country with the longest queues for toilets and with the most number of people defecating in the open. On both counts, India beats all other countries by many miles or rather by many square kilometers.



It’s no secret that India’s many health crises are triggered or augmented by this severe lack of sanitation. According to World Health Organisation data, more than 140,000 children in India die from diarrhea each year before they reach the age of five. About 40% of children in the country are stunted. The stubbornly high maternal mortality rate is also linked to childbirths in environments contaminated by open defecation. Sepsis caused when the body cannot cope with severe infection occurs during childbirth when women have to deliver babies in unhygienic conditions and without access to clean water.




Between 1990 and 2015, India has managed a 23% change for the better in access to improved santitation, the WaterAid report says, while neighbouring Nepal has managed a 40% improvement. The Swachch Bharat campaign that has given the sanitation agenda some much-needed vigour, is still a mammoth task. The campaign's goal is to end open defecation in India by the year 2019. In order to do this, the government will have to build toilets in about 99 million rural households in the next four years.

In August, the government announced that it had accomplished the target of 100% access to separate toilets for girls and boys at schools. Subsequent analysis, however, revealed that the claim wasn’t entirely true. Fact Checker reported in September that many schools, whether in urban Delhi or backward Sedam district in north Karntaka, did not have toilets. Many toilets did not have water, were not cleaned or were not maintained and so were unusable. Many toilets were built without drainage and in other places students weren’t trained to use toilets. This leaves a large gap between the toilet building activity and the ambition of becoming an open defecation-free country.