Why do 25 million Pakistanis defecate openly?

Published: July 23, 2016

An Indian child defecates in an open near a railway track on. PHOTO: AFP

During moments of reflection it sometimes occurs to me that, as a nation, we have been conditioned to only react to tragedies on a large scale. In the greater scheme of things, this ability to suppress emotional reactions to the trauma that surrounds us serves as a defence mechanism of sorts; one that allows us to go about each day without being overwhelmed by paralysing depression.

With this filter in place, we are able to circumvent the accompanying responsibility, writing off what we deem minor and letting it drown under a sea of other (more) pressing issues. Failing to comprehend the enormity of the basic, we allow it to escalate in scale and impact. Whether it is education, health or everyday dishonesty the pattern repeats itself over and over again like an algorithm programmed into our collective consciousness.

Let’s take two “minor” diseases, for example: many of us are blissfully unaware that every single day children in Pakistan die due to pneumonia and diarrhoea. I refer to them as minor because for most of us these two diseases barely even fall under the radar as dangerous, let alone life-threatening.

Yet, diarrhoea takes the lives of 53,300 children in Pakistan every year. That amounts to 110 children every single day. I was shocked to discover that diarrhoea actually kills more children than AIDSmalaria and measles combined. What is sobering to know is the fact that simple and inexpensive interventions can help prevent and reduce the incidence of diarrhoea, saving lives of children and protecting them from malnutrition.

The question that remains is: what makes diarrhoea such a recurring and pervasive disease in countries like Pakistan? The answer is shocking in its simplicity: lack of hygiene. Twenty five million Pakistanis defecate openly. It is an act instilled as a tradition in rural areas and practiced for generations. The concept of treating water before drinking and washing hands with soap is novel for a large percentage of the population in rural areas and urban informal settlements (katchi abadis). A large number of diarrhoea-associated deaths can be attributed to unsafe water, inadequate sanitation, and insufficient hygiene.

Strides made over the last 20 years have shown that diarrhoea prevention focused on safe water and improved hygiene and sanitation is not only possible, but cost effective: every $1 invested yields an average return of $25.50. I don’t think it would be too far off the mark to assume that this is reflected in the time and money saved on hospital visits, the cost of medicines, the opportunity cost of a day’s work for a daily wage worker and the economic cost associated with the loss of life.

I recently came across the project Sehatmand Gharanay, Khushaal Pakistan (SGKP) – globally known as ‘Save a Child a Minute’ – which aims to sustainably reduce the incidence of diarrhoea and prevent child deaths due to diarrheal diseases. By enacting a behaviour change model it focuses on improving hygiene practices while simultaneously empowering women to become agents of social transformation and lead change within their families and communities. To test the behaviour change model, SGKP has been running a pilot project in Dhori, Sargodha.

The pilot project has put into action three main pillars: educating village residents on the causes of diarrhoea and how to prevent it; providing low-cost health and hygiene products at highly subsidised rates; empowering women through an inclusive business model. Within the last six months that the project has been operating, it has already yielded favourable results. Through awareness activities and weekly community engagement the messages of hygiene and cleanliness are constantly reinforced. The number of women in the village who treat water before drinking has increased from 4% to 100% – such basic changes to everyday habits are acting as deterrents to the occurrence of diarrhoea. A public toilet for women has also been inaugurated and women hygienists have been trained to visit households every week to ensure that lessons of hygiene are being put into practice.

The way I see it, as this project grows in scale, it has the potential to create a strong impact and truly reduce cases of diarrheal deaths within the country. However, as individuals, we can also take steps to initiate change within our own spheres of influence. Passing on basic messages of hygiene to the less privileged individuals we come into contact with everyday can have a multiplying effect that can accelerate the rate of change and help us become part of something meaningful.

It’s important to remember – change doesn’t always require monumental gestures; sometimes it’s the little things that make all the difference.

Rimsha Zahid

Rimsha Zahid

The author is a Communications Professional with a passion for social causes, travel and fantasy fiction. She tweets as @RimshaJZahid (twitter.com/RimshaJZahid)

The views expressed by the writer and the reader comments do not necessarily reflect the views and policies of The Express Tribune.

  • ajeet

    So at last someone took a statistics of this in Pakistan? I was telling the Pakistanis making fun of India regarding this to wait until it’s safe to coll this statistics in Pakistan and it will be worse.Recommend

  • Ravi Blr

    What, Pakistan lao have open defecation!!! From pakistani comments, I thought only India had open defecation issues!Recommend

  • vasan

    If 25 millions or more pakistanis defecate openly, why on the earth do u publish an Indian child’s photo. No gumption to face the paki trolls if u publish one of them?. They are as usual in their denial mode anywayRecommend

  • mazharuddin

    half of the population in Karachi defecate openly.Recommend

  • rationalist

    If 25 million Pakistanis are open-defacating, what is the point in showing an Indian child doing it?Recommend

  • Alann

    Nice article, but you are preaching to the wrong public.
    Also, why are you talking about things like these? You must be a zionist RAW/CIA/MOSSAD Indian agent trying to malign Pakistan.
    Everyone knows Pakistan is a nuclear country. Don’t even bother arguing with me, I have facts about India’s poverty figures! If all that I have said doesn’t make sense to you, don’t bother.. Indians can’t match the IQ of a common Pakistani.Recommend

  • maynotmatter

    All Pakistani will be absolutely mute on this.Recommend

  • HM

    i am quite disagree with you. i have visited many informal settlement in karachi and even their i have never seen any one defecating openly.Recommend

  • Humza

    The difference is that in India, half the population defecate openly whereas the number and percentage in Pakistan is much smaller. Regardless, authorities have to work and stop this problem.Recommend

  • Straight
  • HonkyTonk Man

    “Why do 25 million Pakistanis defecate openly?”

    Probably there is something exhilarating about the feel of cool air on their buttocks that makes them do it i suppose… Otherwise i am sure they all have access to health care and other facilities but do it anyway… why do you ask?Recommend

  • AA

    Well 25 million is around 14 percent of Pakistan’s population, which I believe is probably an under estimate by all means. Most of the mountainous rural areas of Pakistan and many rural areas of lower Sindh are still do not have infrastructure for indoor toilets, it is still small proportion compare to 55 percent of more than a billion people in India which is almost 600 million. Yet Pakistan has to go long way.Recommend

  • Sid

    This can be true of Mumbai as according to the reports on media, about 62% of Mumbai population lives in slums and they don’t have toilets, this is the reason it smells like sewers, with a pungent smell all over the city.

    Even non regularized colonies like Orangi Town has proper sewerage and other utilities, can be Goggle searched. Also for India it is an staggering 64% of the population which defecate in the open and India has a population of 1.3 billion, it makes more than 75 crore people.Recommend

  • whatever

    Poverty rapes and open defecation are Indian issues, these things can not happen in Pakistan. Pakistan is a pious land and every issue is created by foreigners who are Indian stooges.Recommend

  • SamSal

    What makes you think it’s an Indian child?Recommend

  • rationalist

    Read the caption under the picture.Recommend

  • rationalist

    How does one really know for sure what % are openly defecating unless you stand in every vacant field and spaces and count the defecators?

    How does it help the situation using “our beggars are better than yours” argument? 50$, 25% or 10%, they are all bad.Recommend

  • LS
  • liberal-lubna-fromLahore

    disgusting – glad i made the decision to move from karachi to Lahore. Love the cleanliness and development in Lahore!Recommend

  • Fsert

    Why do you have to drag India to make yourself feel better?
    Are you seriously comparing MUMBAI to karachi?Recommend

  • Avid

    Mazhar Sb..Please do not defame Karachi, Where did u see half of the pop.. defecating ?Recommend

  • oats

    Just because there is more poverty and there are more people without toilets is no reason not to improve things in Pakistan. Pakistan is not India thank goodness but there is a lot of room for improvement. Such articles should push civil society organizations to work to make sure we don’t see pictures of poor Pakistani children doing what children in India have to do.Recommend

  • jay

    what is also true of Mumbai is that , entire Mumbai stock exchange can buy Karachi stock exchange twice and still money will be left ! Dare to compete on that front ?Recommend

  • jay

    Why dont Pakistan for once compete with India on things that really matter ? Education , Economics, IT. Pharma etc etc Oh yeah world status also ? Recommend

  • Laeeq

    About one billion people, or 15 percent of the global population, practice open defecation. India has the highest number of people practicing open defecation around 490 million people, or nearly a third of the population. Most of it occurs in rural areas, where the prevalence is estimated at 52 percent of the population, as opposed to urban areas, where prevalence is estimated at 7.5 percent. The other countries with the highest number of people openly defecating are Indonesia (54 million people), followed by Pakistan (41 million people), Nigeria (39 million), Ethiopia (34 million), and Sudan (17 million). /these are the fact and figures … and the Picture Rimsha Zahid used is from india …. kindly use the actual contents …Recommend

  • Keith Cameron

    If your country has developed Nuclear weapons before they had mastered Sanitation, you’ve got the wrong leaders.Recommend

  • liberal-lubna-fromLahore

    not true. thats india for u, not pakistan

    please take your anti pakistan propaganda elsewhereRecommend

  • El Cid

    No, not really! You have wrong!! Way, way wrong!Recommend

  • Xclusive

    Mumbai has more money than entire Pakistan.And only 18% of Mumbai actually lives in slums.Recommend

  • Xclusive

    At least we have the guts to recognize a problem and attempt to solve it unlike the self delusioned Pakistanis. Feel sorry for the children of Pakistan.Recommend