Most Americans take for granted that they can happily do their thing in the toilet every morning. Not the 2.5 billion people all over the world who don't have access to a toilet.

To raise awareness on this long suppressed global sanitation problem, the United Nations has designated Nov. 19 as World Toilet Day. This year's activities were spurred by the efforts of the Toilet Board Coalition, comprising business groups and non-government organizations pushing for sustainable sanitation solutions for the 35 percent of the global population who don't have toilets and the 14 percent, or around 1 billion, who defecate in open air.

"In many places, even talking about defecation and sanitation is perceived as taboo, or worse, as unimportant," U.N. Deputy Secretary-General Jan Eliasson says in an interview with Sanjay Wijesekera, UNICEF's chief of water, sanitation and hygiene. "To see progress on sanitation, communities worldwide will need to create the space to talk about the practice of open defecation. Only then will the issue gain more visibility in public discourse and motivate tangible actions -- from both private and public sectors -- to improve adequate sanitation access."

Approximately 10 million children have died because they had no access to basic sanitation facilities, according to a report published by WaterAid, one of the members of the Toilet Board.

The U.S. Centers for Disease Control and Prevention (CDC) says 2,200 children around the world die every day due to diarrhea, a disease strongly associated with poor sanitation. Around 88 percent of the number, the World Health Organization (WHO) says, are attributed to the absence of sanitation facilities, making them "preventable deaths."

The U.N. is taking the battle for sanitation into India as one of its focal points, where 60 percent of the 2.5 billion people without toilet access are found and 65 percent of the population, or around 818 million Indians, regularly practice open defecation.

The WHO says 600,000 Indians die from diarrhea every year. Other countries, such as China and Bangladesh, have succeeded in reducing their open defecation rates to three and one percent respectively.

Indian Prime Minister Narendra Modi has set 2019, Mahatma Gandhi's 150th birthday, as its target for "total sanitation." He also plans to clean up the sacred Ganges River, now polluted with 290,000 gallons of human waste every minute.

The problem, analysts say, is largely cultural rather than financial. Payal Hathi, associate director of the Research Institute for Compassionate Economics, cites a government-funded program that aims to distribute 111 million latrines in low-income households. Hathi says people who were given latrines did not completely understand the need for toilets.

"Our survey shows deep-seated beliefs in the ideas about pollution and impurity," Hathi says. Many think "having a toilet at home pollutes their home. Also, cleaning toilets and the pit dug for feces has been connected to certain castes. Many believe that walking out in the open in early mornings to defecate in the fields or open spaces is good for their health."

The Toilet Board plans to ease the situation by making a business out of selling toilets and latrines to low-income families. Neil Jeffrey, CEO of the Water and Sanitation for the Urban Poor (WSUP), says the trick is to intelligently market toilets to create consumer demand from people who don't have them. Jeffrey says the notion that low-income people are poor people who must always receive aid is not right. Selling toilets, he says, is not about "flashy adverts" but by recruiting people who live in the local areas "going door to door and talking to people about how this product could change their life."

WSUP, in fact, is already running four pilot projects that offer private, clean chemical toilets to 700 households in Kumasi, Ghana. Dubbed Clean Team, the service charges households every month in exchange for cleaning out the waste cartridges every few days. Workers also try to generate additional revenue by selling other hygiene products such as soaps and detergents.

Clean Team, which employs 35 workers, is currently funded by the Stone Family Foundation until the business is able to reach a point where it can finance itself. Clean Team also aims to launch similar projects in India, Bangladesh, Cambodia and the Philippines in the next two years.

"We want to assist low-income consumers to have access to buy as many services as possible that are suitable for them in terms of enhancing their sanitation and water needs," says Jeffrey. "If you bring the low-income consumer into the core activity of a regular business rather than as an add-on philanthropic program, it means that ultimately those [consumers] will be taken seriously and their needs responded to."

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