Overflowing Cities: WaterAid Reveals the World’s Hardest Place to Find an Urban Toilet

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India, the world’s fastest growing economy, is also the worst country in the world for urban sanitation, WaterAid’s State of the World’s Toilets 2016 report reveals.

water, sanitation, toilets, menstrual hygiene, urban sanitation,

Children outside a WaterAid toilet in Pursat Province, Cambodia

Good sanitation is the bedrock of public health. Every town and city in the world needs to prioritize providing safe sanitation services to all the population in order to create a healthier, more sustainable future.

Despite the government’s campaign to make sanitation a priority, India’s towns and cities are growing at such breakneck speed that the number of urbanites living without sanitation is growing each year.

WaterAid’s second-annual report on the world’s toilets, ‘Overflowing Cities,’ examines the state of urban sanitation around the world, an issue that is becoming more pressing as two-thirds of the global population are expected to live in towns and cities by 2050.

To read the report: click here
To see a photo gallery: click here

India ranks top for having the greatest number of urbanites living without a safe, private toilet— 157 million—as well as the most urban dwellers practicing open defecation—41 million. The problem is so big that the daily waste produced on the streets of India’s towns and cities is enough to fill eight Olympic-sized swimming pools, or 16 jumbo jets, with poo, every day. As cities expand the numbers of urbanites living without basic sanitation has swelled by 26 million since the year 2000.

Other findings include:

  • War-ravaged South Sudan, the world’s newest nation, is the worst country in the world for urban sanitation in percentage terms. An estimated 84% of urbanites have no access to a toilet and every other urban-dweller there practises open defecation.
  • Africa’s biggest economy, Nigeria, is falling furthest behind in reaching its urban population with a toilet. For every urban dweller reached with sanitation since 2000, two were added to the number living without, an increase of 31 million people in the past 15 years.
  • Fast-growing China is making the most progress in reaching its urban population with sanitation. It’s managed to build toilets faster than the pace of new arrivals, reaching 329 million people since 2000, and outpacing population growth by 9 million.

The report examines the problems facing more than 700 million urban dwellers around the world living without decent sanitation. An estimated 100 million of these have no choice but to defecate in the open—using roadsides, railway tracks and even plastic bags dubbed ‘flying toilets’.

The high population density of urban areas means that diseases spread fast in the absence of good sanitation.

One child dies every two minutes from diarrheal diseases caused by dirty water, poor sanitation and hygiene. Globally 159 million children under five have their physical and cognitive development stunted; many of such cases are caused from repeated bouts of diarrhea attributed to dirty water, poor sanitation and lack of hygiene.

WaterAid’s Chief Executive Sarina Prabasi said:

“For millions of people, cities hold the promise of opportunity, innovation and ready convenience. But our cities boast an ugly secret, too: rapid growth, stretched infrastructure and overcrowded slums have left over 700 million people without access to a decent toilet. Beyond the humiliation and health risks this causes, the lack of sanitation in our cities threatens the health and security of all of us. The future is unfolding in towns and cities. That future must include access to sanitation and toilets for everyone.”

WaterAid’s senior policy analyst on sanitation, Andrés Hueso, said:

“WaterAid’s latest ‘State of World’s Toilets’ report has exposed several countries for failing to make progress in providing urban sanitation, despite their rapid economic growth. Often politicians prefer to invest in roads and other visible infrastructure and neglect the dirty issue of sanitation. But good sanitation is the bedrock of public health. Every town and city in the world needs to prioritise providing safe sanitation services to all the population in order to create a healthier, more sustainable future.”

This World Toilet Day, WaterAid is calling for:

  • Everyone living in urban areas, including slums, to be reached with a toilet to ensure public health is protected
  • More money, better spent from governments and donors on sanitation, clean water and hygiene for the urban poor
  • Coordination from all actors in the sanitation chain including governments, city planners, NGOs, the private sector, informal service providers and citizens
  • Sanitation workers to be given the respect they deserve with stable employment, safety and decent pay. Without them healthy communities and cities are impossible.


About WaterAid

WaterAid is the #1 ranked international non-profit dedicated to helping the people living in the world’s poorest communities gain access to safe water, toilets and hygiene. WaterAid has programs and influence in 37 countries across Africa, Asia, the Caribbean, Latin America and the Pacific region. Since 1981, WaterAid has reached 23 million people with safe water and, since 2004, 21 million people with toilets and sanitation.

Connect with WaterAid at Facebook.com/WaterAidAmerica and on Twitter @WaterAidAmerica, or find out more at WaterAid.org.

  • Around 315,000 children die each year from diarrhoeal diseases caused by dirty water and poor sanitation. That’s almost 900 children each day, or one child every two minutes.
  • Over 650 million people (around 1 in 10 people) are without safe water
  • Over 2.3 billion people (around 1 in 3 people) live without improved sanitation
  • For details on how individual countries are keeping their promises on water and sanitation, please see our online database, WASHWatch.org.

For more information or to arrange interviews please contact:

Alanna Imbach, Media Relations Manager: Aimbach(at)wateraidamerica(dot)org // +1 (212) 683-0430 or +1 (646) 267 8006

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