With holidays and recognition days as random as “Answer Your Cat’s Questions Day” (January 22nd) and “Stick Out Your Tongue Day” (July 19th), it would be understandable to assume that “World Toilet Day” (November 19th) is just another funny namesake. Yet with 3.5 billion people worldwide living without safe toilets and 419 million people practicing “open defecation”— meaning they have no choice but to defecate in streets, gutters, or bushes — this health crisis is anything but a joke.
United Nations Sustainable Development Goal 6 was established in 2015 with the target of ensuring the availability and sustainable management of water and sanitation for all by 2030. It states that the pace of progress will need to accelerate five times over to meet the 2030 goal.
According to United Nation Water’s World Toilet Day, disease related to lack of proper sanitation kills 1,000 children under the age of five every day. The World Health Organization reports 1,245,000 deaths per year in low- and middle-income countries. Many more are sickened by wastewater-borne diseases such as cholera, dysentery, typhoid, intestinal worms, polio, and malnutrition.
Before you write off this condition as one in far-off, developing lands, you need to know that it is happening here, in the United States. Rural areas rely on onsite wastewater treatment like septic tanks and leach fields. These systems frequently fail, and it is estimated that up to 65 percent of U.S. land is inconducive to septic systems due to clay and other geologic conditions.
This statistic was shared by Catherine Coleman Flowers in her 2019 testimony before the Congressional Subcommittee on Water Resources and the Environment. Named to Forbes’ 2023 50 Over 50 List and TIME’s 100 Most Influential People of 2023, Flowers returned to her childhood homeland of Lowndes County, Alabama following college, service in the Air Force, and years of work as a teacher. Lowndes County, population 11,000, is between Selma and Montgomery, the route along which the 1965 civil rights marches and Bloody Sunday took place. In her 2020 book Waste: One Woman’s Fight Against America’s Dirty Secret, Flowers illuminates Lowndes County conditions that include failing or inadequate water systems in an estimated 90 percent of households — 34.5 percent of those tested were positive for hookworm, a disease thought to have been eradicated in the U.S. — and the failing wastewater system at the National Park Service’s Selma Interpretive Center regularly results in raw sewage being discharged onto neighboring land.
Compounding the problem, those with failing systems are levied fines they cannot afford to pay due to having failing systems they cannot afford to upgrade in the first place. When they couldn’t pay, some were arrested and carted off to jail (arrests in Lowndes County were ended as a result of early advocacy by Flowers and others). Some residents with connections to public wastewater utility systems pay for these utilities yet these systems fail, resulting in wastewater backflowing into their homes and yards. Their yards fill with raw sewage, attracting insects and wastewater-borne disease where their children should be able to play. When sewage backs up through their toilets and tubs, they need to pay to restore their homes. These homes lose their value, leaving owners with diminished equity and unable to sell or get home equity loans to make repairs. And these conditions are common throughout rural America.
Flowers asserts that the areas impacted by inadequate wastewater are largely minority, and largely poor. Upon witnessing these conditions in her home county, Flowers founded the Center for Rural Enterprise and Environmental Justice, which influences policy, inspires innovation and research, and advocates for environmental justice in marginalized rural communities. Flowers urges people to care about World Toilet Day “because sanitation inequality is one of the most pressing climate justice issues that exists,” she said. “Clean and functional sanitation is a basic human right – inadequate sanitation can lead to the spread of harmful diseases, and no one deserves to live without adequate sanitation. The sanitation crisis is happening all over the U.S. – and all over the world – and disproportionally impacts poor and systemically oppressed communities,” she added.
So what can you do?
UN Water’s World Toilet Day is focused on three pillars: Learn, Share, Act, which Flowers believes are a great starting point for dealing with the issue of sanitation inequality. “Inadequate sanitation is more prevalent than people would expect – and the consequences of it are only worsening due to climate change,” Flowers said. To learn, Flowers encourages people to evaluate the situation in their own communities and see if the issue exists there. To share and act, “they should reach out to my organization, CREEJ, to report it. And finally, they should call their Congressmembers to make them aware that this issue – which is continuing to gain national attention every day – is happening in their area,” she said.
“To adequately address failing wastewater systems, we need long term, sustainable solutions. This includes changing sanitation designs for onsite and centralized treatment for sustainability and resilience to reflect the realities of climate change,” Flowers said. The problem of inadequate sanitation is complex, and the result of myriad contributing factors – technical, political, economic, social, and more. This complex problem will only be solved with a comprehensive approach.
The conversation has been edited and condensed for clarity. Check out my other columns here.