World Toilet Day is marked every year on 19 November, with this year's theme being ‘let's make the invisible visible’. Declared an official annual United Nations (UN) event in 2013, it aims to encourage action to challenge the global sanitation crisis and help attain Sustainable Development Goal 6, which pledges sanitation for all by 2030 (UN, 2022a) – only 8 years away.
Encouraging people to engage with this is important. World Toilet Day provides an opportunity to exchange ideas, and think about practices and approaches to address this significant global problem. Being able to access basic toilets has the potential to decrease disease by twice as much as accessing clean drinking water and, yet, it fails to attract a fraction of the funding. It seems that funds are available for clean water, but little for sanitation.
Florence Nightingale championed the provision of care and comfort, but she was also an advocate of sanitary reform in the mid-1860s – she believed there was a link between unsanitary conditions and disease. She wrote extensively, using her data to highlight the deadly toll of poor hygiene and sanitary conditions in British Army hospitals. There is a need to protect water, the source of life. Currently, it is estimated that around 3.6 billion people globally do not have a toilet that works properly and 3.6 billion people live without access to safely managed sanitation (UN Water, 2022).
When people in a community are unable to gain access to safe toilets, everybody's health and wellbeing are put at risk. Dysfunctional sanitation contaminates drinking-water sources, rivers and beaches, as well as food crops, resulting in the transmission of potentially lethal diseases among the wider population.
In many parts of the world sanitation systems remain dysfunctional, underfunded, poorly managed or neglected, with devastating consequences for health, economies and the environment, especially in the poorest and most marginalised communities. The advantages of investing in an adequate sanitation system are significant, saving health and medical costs, and increasing productivity. For women and girls, the provision of toilets at home, in school and at work will help them achieve their potential and play a full role in society at every stage of their lives.
World Toilet Day adopts a humorous approach to a serious issue that should be a concern for all nurses. Adequate sanitation, along with good hygiene and safe water, are absolute prerequisites to good health. Most diseases resulting from poor sanitation will have a direct relation to poverty. Nurses, past and present, have been and are in the vanguard in a range of social, economic and political arenas, including the eradication of transmissible infections, such as polio and HIV/AIDS. Nurses have contributed to breaking the taboos that were associated with these issues in the past. Nurses are not known to be shy about standing up and speaking out but, if we fail to speak about a problem, it will continue to grow.
Poor sanitation and toilet problems are things that we need to speak about locally, nationally and internationally, and come together to address them. Nurses are visionaries, they have an open mindset, they are creative and innovative, but we cannot tackle poor sanitation on our own – nor should we. It it vital for governments, organisations and communities to step up. Poor sanitation and a lack of safe toilets are concerns require collaborative involvement across all levels of all society. World Toilet Day is an annual event, but being unable to access safe sanitation for some is an everyday event, so we need to celebrate World Toilet Day and make it an everyday concern.
Providing nations with toilets and effective sanitation is key, so too is respectfully changing cultural traditions and practices. The provision of education programmes and awareness activities may go some way to beginning to raise the issue of sanitary toilets.