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Living in a Fragile World: The impact of climate change on the sanitation crisis

  • Living in Fragile World: The impact of climate change on the sanitation crisis

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SWM Bimonthly frontpage

About the blog

Rosie Wheen
WaterAid Australia Chief Executive.
Schneider Electric

Everyone everywhere has the right to safe and accessible sanitation. In fact, the United Nations Sustainable Development Goal 6 states that we must “ensure access to water and sanitation for all.” Much of WaterAid’s work focuses on providing access to clean water, however with World Toilet Day celebrated this month on November 19, 2020, I am going to talk about the often-under-acknowledged importance of sanitation. Right now, two billion people do not have access to a decent toilet at home.

Where decent toilets are lacking, human faeces can contaminate the groundwater or end up in rivers and lakes, polluting what is often the only supply of water for drinking, cooking, and cleaning. Children play on ground rife with pathogens and as a result of faecal contamination, whole communities can contract diarrhoeal diseases.

Further, inadequate sanitation in healthcare centres increases the risk of them becoming the epicentres of epidemics. One in 10 healthcare facilities have no sanitation at all and 1.8 billion people have no basic water services at their local facilities.

There is an answer. There are ways that sanitation systems can be adapted to become climate change-resilient and help to achieve SDG 6

Poor sanitation is linked to the transmission of deadly, preventable illnesses, such as cholera, diarrhoea and dysentery. Tragically, more than 310,000 children under five – that is one child every two minutes – die every year of diarrhoeal diseases as a result of lack of access to decent toilets and also clean water. Inadequate sanitation is also a main factor in the transmission of neglected tropical diseases, such as trachoma and intestinal worms.

The world’s sanitation crisis is nothing short of a global disgrace, and now climate change threatens to escalate it. Between 2030 and 2050, a quarter of a million additional deaths per year are predicted due to climate change – many of these deaths will be related to preventable diseases linked to poor sanitation. Frequent, extreme weather events – such as severe cyclones, heavy rainfall and rising sea levels – often cause damage to already weak sanitation infrastructure. Inadequate sanitation perpetuates a vicious cycle of disease and poverty because when communities do not have access to decent toilets and clean water, disease spreads fast. Good sanitation services are disaster-resilient.

The worldwide COVID-19 pandemic has highlighted the importance of working towards SDG (Sustainable Development Goal) 6 and ensuring everyone has access to basic resources, such as clean water, to wash hands and stop the spread of disease. Climate change is a growing global crisis that must be factored into the approaches we take to achieve SDG 6, and decent toilets are a vital resource that can help protect vulnerable people from its impact.

Safely managed and resilient sanitation is one of the first lines of defence against climate change and disease outbreaks, and we need to act now to save lives. Living without access to a decent toilet has a direct impact on the health, education and livelihoods of billions of people around the world, and certain groups – such as women and girls – are more affected by poor or non-existent sanitation facilities. Women and girls are disproportionately impacted by the sanitation crisis, and lack of access to decent toilets makes it extremely difficult for them to manage their periods with the dignity and privacy they deserve both at home and school.

The needs of disabled people and those with limited mobility are also often overlooked when it comes to providing sanitation services. People with disabilities face multiple barriers when using facilities, such as steps leading to toilets and narrow doorways. A lack of inclusive facilities means disabled people often have to perform dangerous and unhygienic practises, for example, wheelchair users are forced to crawl on the floor of latrines. If we are to achieve SDG 6, it means everyone, everywhere has to have access safely managed sanitation, but progress on achieving inclusivity in this goal is still very slow.

Despite commitments by governments and international donors to improve sanitation, little is being done to ensure this human right becomes a reality. As I write, 9% of the world’s population– that is a staggering 673 million people – have no choice but to defecate outside due to lack of access to a toilet. Women and girls, in particular, can be exposed to gender-based violence, including sexual assault, when open defecation is their only option. Human faeces contaminate water sources, exposing vulnerable communities to harmful bacteria and viruses that lead to fatal illnesses – such as cholera – placing more pressure on over-stretched healthcare services. At current rates of progress, everyone in sub-Saharan Africa will not have access to safely managed sanitation until 2403, well beyond the SDG 6 timeline, and in some countries, the proportion of the population without access to a decent toilet is increasing.

Governments need to roll out appropriate sanitation infrastructure to help communities become resilient to extreme weather events

But there is an answer. There are ways that sanitation systems can be adapted to become climate change-resilient and help to achieve SDG 6.

Appropriate technologies that ensure sanitation infrastructures are resilient to extreme weather episodes. For instance, building raised toilets with ramps for accessibility can prevent floods from damaging the structure and waste spilling into the environment.

Early warning systems that signal the arrival of extreme weather events can enable households and sanitation workers to take precautions to protect toilets and sanitation systems.

Investing in human resources to ensure that the delivery and running of sanitation services are uninterrupted by extreme weather. More sanitation workers and specialists are required to respond to this challenge and need to be offered training and decent working conditions.

Identifying areas vulnerable to climate-related weather episodes and prioritising those areas for climate-resilient sanitation investments. For instance, authorities should avoid setting up sewage treatment facilities in areas prone to flooding.

Strengthening services to complement appropriate technologies and robust infrastructures. Establishing effective sanitation services is critical to disaster preparedness; the running and maintaining of services need to be climate-resilient. For instance, regularly emptying pits and septic tanks to reduce the level of contamination triggered by heavy rainfall and flooding.

Identifying areas vulnerable to climate-related weather episodes and prioritising those areas for climate-resilient sanitation investments

Urgent action is needed to ensure everyone has access to decent toilets to help prevent the spread of diseases and protect communities from the impacts of climate change. To tackle this issue, we will need to see:


Lack of decent toilets contributes to the spread of deadly diseases, placing a strain on fragile healthcare services. Governments must commit more money to the sanitation sector, so everyone has access to decent sanitation services that are safe, reliable and inclusive.

Government action:

Governments need to factor sanitation services into national climate adaptation plans. Climate change has led to severe weather events destroying sanitation infrastructure. Governments need to plan and roll out appropriate sanitation infrastructure, to help communities become more resilient to extreme weather events.


Ensuring everyone, everywhere has access to a decent toilet and delivering climate- resilient sanitation infrastructure will require a considerable workforce – including more sanitation workers. Safely managed sanitation must accompany a safe and dignified working environment for sanitation workers. Governments need to ensure decent working conditions through legislation, monitoring and enforcement. Planning for sanitation services must include the participation and requirements of women, girls and disabled communities to ensure toilets are inclusive and safe. Climate change adaption must be holistic, ensuring that there is sufficient expertise and resource at every level of sanitation services planning.

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