• The practice of open defecation is a risk to public health and nutrition, and is related to the deaths of 1,000 children every day from diarrhea 
• Action Against Hunger has incorporated the goal of eliminating this practice in its main intervention programs, emphasizing its relation to child malnutrition

Today is World Toilet Day, and Action Against Hunger is calling attention to the critical role that ending open defecation can play in preventing children under age five from contracting dangerous and often deadly diseases.

"It is so important to build family and community latrines -- but changing people's behavior, getting people to use them, this is where the real challenge is," explained Pablo Alcalde, who heads the Water, Sanitation, and Hygiene efforts for our headquarter office in Madrid, Spain. Behavior change requires addressing many cultural, social, and even religiously-based misconceptions. "While access to water is perceived by the community as a basic and immediate need, sanitation and hygiene fall lower on the list for people, because their links to health and nutrition, despite being very important, are not visible at first sight," he continued.

Mauritania: Community leaders pave the way

Action Against Hunger has been working in Mauritania, with the support of UNICEF, on an innovative approach that is getting community leaders invested in their own sanitation projects. 

"It's about overcoming the old-fashioned approach in which engineers simply come in, build latrines, and start promoting behavior change," according to Carlos Suarez, who oversees the program for us in Mauritania. "Instead we work with leaders first to map where open defecation is practiced, to closely observe the means of disease transmission, and to decide on the best locations to build latrines. The community becomes fully accountable in the project."

Philippines: Women on the front line of change

Without the help of her husband, who works all day, Gregoria Canatoy recently dug a hole that was six feet deep. This 39-year-old mother of three did masonry work -- including mounting a wood and concrete floor and installing a ceramic toilet bowl in a new family latrine.

"After four days of work, I managed to build the bathroom," she said, satisfied. "It's pretty complicated, but I fought for it. My husband and my children are very happy with the result."

Gregoria is only one of the women from remote villages in Eastern Samar, one of the areas most affected by Typhoon Haiyan in 2013, participating in the program.

Action Against Hunger has built on our core recovery-focused programs in the wake of Typhoon Haiyan, building a vision of creating environments where there is zero open defecation, the safe disposal of waste, and the promotion of sanitary and hygienic practices based within a holistic approach that includes disaster risk reduction and adaptation to extreme weather events.

Esther Magdayo, Head of Water and Sanitation for us in Eastern Samar, underscores the role of women in achieving these goals. 

"They bear the brunt of dirty and inadequate practices related to water, hygiene, and sanitation. However, these issues have made them strong. They were the first to understand the devastating effects of unhygienic habits and the benefits of having bathrooms. Typhoon Haiyan has brought about women who can step up and go beyond their traditional roles," she said. "The process of change in behavior fosters community and promotes local solutions."

All of this progress aside, 15 percent of the world's population is still practicing open defecation. In 2013 the United Nations General Assembly adopted a resolution to designate November 19th as World Toilet Day, to highlight the need for further awareness and change. At Action Against Hunger, we're proud to be part of that movement in Mauritania, the Philippines, and the more than 45 countries where we work around the globe.