Addressing Open Defecation around the World

by Vins
Published: Last Updated on

In 2017 photographer Andrea Bruce was given an assignment for National Geographic in which she traveled to India, Vietnam, and Haiti, to document the global issue of open defecation. As Bruce told National Geographic in October 2017, “It’s probably one of the most—if not the most—important topics for humans today.” One year later in 2018, Peter Beaumont, a journalist for the Guardian, published an article reflecting on Bruce’s photographs and the ongoing issue that affects 1.1 billion of the world’s poorest people. In countries where access to toilets is lacking, open defecation results in disease and even death.

Peter Beaumont cites a UNICEF statistic from India, one of the countries Bruce visited:  In India 524 million people lack proper sanitation, resulting in an estimated one million deaths of children under the age of five from diarrhea every year. Beaumont also reported, “More people die of health problems related to sanitation issues every day than do of malaria, HIV and the top five diseases combined.”

There are several ways that open defecation causes health problems. Open defecation can lead to contamination of water in villages in which, due to lack of proper sanitation, access to clean water is already so scarce. In countries that have undergone natural disasters, such as Haiti after Hurricane Maria, the spread of cholera can cause severe vomiting and diarrhea. According to the Centers for Disease Control, “inadequate availability of water for hygiene, and lack of access to sanitation together contribute to about 88% of deaths from diarrheal diseases.”

Beyond disease, open defecation also causes safety problems for women and girls, who are vulnerable to rape when they search for private places to defecate.

Compounding these problems is that open defecation is a deeply-rooted practice in many cultures. For example, UNICEF reported that, in India, open defecation is “a well-established traditional practice deeply ingrained from early childhood. Sanitation is not a socially acceptable topic, and as a result, people do not discuss it.” Approaching the issue of open defecation requires respecting it as cultural practice, while also educating people in cultures it results in disease and death in order to show how changes can positively impact the health of the society as a whole.

The topic of open defecation receives virtually no coverage by corporate news organizations in the United States. It is challenging to find any information on this issue that goes beyond cut and dry statistics from organizations like the Centers for Disease Control. The lack of news coverage by US news companies fails to give life to these statistics and to put human faces on the stories behind those facts and figures. More coverage of the health impacts of open defecation could lead to greater opportunities for individuals to partner with organizations like UNICEF that are working to eliminate the negative effects of open defecation. UNICEF India, for example, is working with governments policies that aim to “support and improve the efficiency of the roll-out of the government’s sanitation program,” which is known as SBM (Swatchh Bharat Mission). The photographer, Andrea Bruce, has seen the impact of her advocacy work. She told the Guardian, “Since the pictures came out the Indian government has been to the village and they have built a community toilet. Who knows? Maybe they were going to come anyway but the villagers are very happy”  (Beaumont, 2018). The more people become are aware of this issue, the more progress can be made to help those who are suffering.



Peter Beaumont, “Life without Toilets: The Photographer Tackling a Global Taboo,” The Guardian, March 19, 2018,

Mallory Benedict, “Inside the Hidden Dangers of Life Without Toilets: How a Photographer Showed Why We Need Toilets and Sanitation,” National Geographic, October 11, 2017,

Student Researcher: Laura Beth Akins (The University of Vermont)

Faculty Evaluator: Rob Williams (The University of Vermont)