Open defecation

In ancient times, there were more open spaces and less population pressure on land, open defecation was a common practice which brought fewer health and hygiene problems. With development and urbanization, open defecating started becoming a challenge and thereby an important public health issue, and an issue of human dignity.{{Cite journal| vauthors = O'Reilly K |date=2016-01-01|title=From toilet insecurity to toilet security: creating safe sanitation for women and girls|journal=Wiley Interdisciplinary Reviews: Water|language=en|volume=3|issue=1|pages=19–24|doi=10.1002/wat2.1122|bibcode=2016WIRWa...3...19O |s2cid=109965522|issn=2049-1948}} With the increase in population in smaller areas, such as cities and towns, more attention was given to hygiene and health. As a result, there was an increase in global attention towards reducing the practice of open defecation.{{Cite news|url=http://www.nationalgeographic.com/magazine/2017/08/toilet-defecate-outdoors-stunting-sanitation/|title=Nearly a Billion People Still Defecate Outdoors. Here's Why.|date=2017-07-25|access-date=2017-10-04|archive-date=5 October 2017|archive-url=https://web.archive.org/web/20171005050709/http://www.nationalgeographic.com/magazine/2017/08/toilet-defecate-outdoors-stunting-sanitation/|url-status=dead}}

Open defecation perpetuates the vicious cycle of disease and poverty and is widely regarded as an affront to personal dignity. The countries where open defecation is most widely practiced have the highest numbers of deaths of children under the age of five, as well as high levels of undernutrition, high levels of poverty, and large disparities between people of means and the poor.

Waste dumping in a slum of Cap-Haitien.jpg|Indiscriminate waste dumping and open defecation (from animals), Shadda, Cap-Haitien, Haiti

Open defecation along the river bank (6908382463).jpg|Evidence of open defecation along a riverbank in Bujumbura, Burundi

Child in open sewer in Nigeria (3150664698).jpg|Child defecating in the open in a canal in the slum of Gege in the city of Ibadan, Nigeria

Open defecation in Tirin Kowt bazaar (4361881653).jpg|Open defecation, Tirin Kowt bazaar, Afghanistan

The term "open defecation" became widely used in the water, sanitation, and hygiene (WASH) sector from about 2008 onwards. This was due to the publications by the Joint Monitoring Programme for Water Supply and Sanitation (JMP) and the UN International Year of Sanitation. The JMP is a joint program by WHO and UNICEF that was earlier tasked to monitor the water and sanitation targets of the Millennium development goals (MDGs); it is now tasked to monitor Sustainable Development Goal Number 6.

For monitoring of the MDG Number 7, two categories were created: 1) improved sanitation and (2) unimproved sanitation. Open defecation falls into the category of unimproved sanitation. This means that people who practice open defecation do not have access to improved sanitation.{{citation needed|date=September 2024}}

In 2013, World Toilet Day was celebrated as an official UN day for the first time. The term "open defecation" was used in high-level speeches, that helped to draw global attention to this issue (for example, in the "call to action" on sanitation issued by the Deputy Secretary-General of the United Nations in March 2013).{{cite web|url=https://www.un.org/millenniumgoals/pdf/DSG%20sanitation%20two-pager%20FINAL.pdf|title=United Nations Deputy Secretary-General's Call to Action on Sanitation|date=2013|website=United Nations|access-date=19 October 2014|archive-date=1 June 2015|archive-url=https://web.archive.org/web/20150601174853/http://www.un.org/millenniumgoals/pdf/DSG%20sanitation%20two-pager%20FINAL.pdf|url-status=live}}

"Open defecation free" (ODF) is a phrase first used in community-led total sanitation (CLTS) programs. ODF has now entered use in other contexts. The original meaning of ODF stated that all community members are using sanitation facilities (such as toilets) instead of going to the open for defecation. This definition was improved and more criteria were added in some countries that have adopted the CLTS approach in their programs to stop the practice of open defecation.{{cite book|last1=Cavill|url=https://opendocs.ids.ac.uk/opendocs/bitstream/handle/20.500.12413/5859/Issue%204%20-%20sustainability.pdf?sequence=13&isAllowed=y|title=Sustainability and CLTS: Taking Stock Frontiers of CLTS: Innovations and Insights Issue 4|last2=Chambers|last3=Vernon|date=2015|publisher=Institute of Development Studies|isbn=978-1-78118-222-2|page=18|access-date=28 July 2015|archive-url=https://web.archive.org/web/20150703142843/http://www.communityledtotalsanitation.org/resource/frontiers-clts-issue-4-sustainability-and-clts-taking-stock|archive-date=3 July 2015|url-status=live}}

The Indian Ministry of Drinking Water and Sanitation in mid-2015 defined ODF as "the termination of fecal–oral transmission, defined by:

1. No visible feces found in the environment or village and
2. Every household as well as public/community institutions using safe technology option for disposal of feces".{{cite web|url=http://www.mdws.gov.in/sites/default/files/R_274_1441280478318.pdf|title=Guidelines for ODF Verification|date=2015|publisher=Indian Ministry of Drinking Water and Sanitation|access-date=3 May 2016|archive-date=11 April 2016|archive-url=https://web.archive.org/web/20160411101355/http://www.mdws.gov.in/sites/default/files/R_274_1441280478318.pdf|url-status=live}}

Here, a "safe technology option" means a toilet that contains feces so that there is no contamination of surface soil, groundwater or surface water; flies or animals do not come in contact with the open feces; no one handles excreta; there is no smell and there are no visible feces around in the environment.{{Cite news|url=http://forum.susana.org/71-behaviour-change-and-user-psychology-issues/13746-definition-of-odf-open-defecation-free-indian-government-publication|title=Definition of ODF – Open Defecation Free (Indian government publication)|date=2015-06-18|access-date=2017-10-05|language=en-gb|archive-date=6 October 2017|archive-url=https://web.archive.org/web/20171006012854/http://forum.susana.org/71-behaviour-change-and-user-psychology-issues/13746-definition-of-odf-open-defecation-free-indian-government-publication|url-status=live}} This definition is part of the Swachh Bharat Abhiyan (Clean India Campaign). https://ourworld.unu.edu/en/un-vows-to-eliminate-open-defecation-by-2025

The reasons for open defecation are varied. It can be a voluntary, semi-voluntary or involuntary choice. Most of the time, a lack of access to a toilet is the reason. However, in some places even people with toilets in their houses prefer to defecate in the open.

A few broad factors that result in the practice of open defecation are listed below.

Open defecation frequently occurs when people lack toilets in their houses, or in the areas where they live.{{cite journal|vauthors=Routray P, Schmidt WP, Boisson S, Clasen T, Jenkins MW|date=September 2015|title=Socio-cultural and behavioural factors constraining latrine adoption in rural coastal Odisha: an exploratory qualitative study|journal=BMC Public Health|volume=15|page=880|doi=10.1186/s12889-015-2206-3|pmc=4566293|pmid=26357958 |doi-access=free }} Lack of toilets in places away from people's houses, such as in schools or on farms, also leads people to defecate in the open. Another example is a lack of public toilets in cities, whether by a reluctance among businesses to allow patrons to use their toilets or limited hours (e.g. if there are no 24-hour businesses in town and someone needs to use the toilet after regular business hours), which can be a big problem for homeless people.{{cite web|title=Public Bathrooms Become Ground Zero in the Opioid Epidemic|url=http://www.wbur.org/commonhealth/2017/04/03/public-bathrooms-opioids|access-date=2018-10-16|website=Wbur.org|date=3 April 2017 |language=en|archive-date=23 June 2018|archive-url=https://web.archive.org/web/20180623141445/http://www.wbur.org/commonhealth/2017/04/03/public-bathrooms-opioids|url-status=live}}

In some rural communities, toilets are used for other purposes, such as storing household items, animals, or farm products or use as kitchens. In such cases, people go outside to defecate.{{Cite journal| vauthors = Bardosh K |date=2015-11-01|title=Achieving "Total Sanitation" in Rural African Geographies: Poverty, Participation and Pit Latrines in Eastern Zambia|journal=Geoforum|volume=66|issue=Supplement C|pages=53–63|doi=10.1016/j.geoforum.2015.09.004|s2cid=153649870 }}{{cite web|url=http://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2762|title=Understanding Gendered Sanitation Vulnerabilities: A Study in Uttar Pradesh - Resources|website=Susana.org|access-date=2017-10-23|archive-date=24 October 2017|archive-url=https://web.archive.org/web/20171024095611/http://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2762|url-status=live}}

File:Pit latrines in Zambia (3233256285).jpg with failing superstructure in Zambia.]]

Sometimes people have access to a toilet, but the toilet might be broken, or of poor quality – outdoor toilets (pit latrines in particular) typically are devoid of any type of cleaning and have strong unpleasant odors. Some toilets are not well lit at all times, especially in areas that lack electricity. Others lack doors or may not have water. Toilets with maggots or cockroaches are also disliked by people, so they go outside to defecate.{{cite web|url=http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf|title=What Influences Open Defecation and Latrine Ownership in Rural Households?: Findings from a Global Review| vauthors = O'Connell K |access-date=23 October 2017|archive-date=18 November 2017|archive-url=https://web.archive.org/web/20171118135242/http://www.wsp.org/sites/wsp.org/files/publications/WSP-What-Influences-Open-Defecation-Global-Sanitation-Review.pdf|url-status=live}}{{cite web|url=http://www.wateraid.org/se/~/media/Files/Sweden/nowhere-to-go.pdf|title=Nowhere to go How a lack of safe toilets threatens to increase violence against women in slums|archive-url=https://web.archive.org/web/20140611225519/http://www.wateraid.org/se/%7E/media/Files/Sweden/nowhere%2Dto%2Dgo.pdf|archive-date=2014-06-11}}{{cite journal | vauthors = Kwiringira J, Atekyereza P, Niwagaba C, Günther I | title = Descending the sanitation ladder in urban Uganda: evidence from Kampala Slums | journal = BMC Public Health | volume = 14 | page = 624 | date = June 2014 | pmid = 24948084 | pmc = 4071028 | doi = 10.1186/1471-2458-14-624 | doi-access = free }}

Some toilets are risky to access. There may be a risk to personal safety due to lack of lights at night, criminals around them, or the presence of animals such as snakes and dogs. Women and children who do not have toilets inside their houses are often found to be scared to access shared or public toilets, especially at night.{{cite web|url=https://www.amnesty.org/en/documents/AFR32/002/2010/en/|title=Document|website=Amnesty.org|language=en|access-date=2017-10-23|archive-date=24 October 2017|archive-url=https://web.archive.org/web/20171024043145/https://www.amnesty.org/en/documents/AFR32/002/2010/en/|url-status=live}} Accessing toilets that are not located in the house might be a problem for disabled people, especially at night.{{cite journal | vauthors = Tsinda A, Abbott P, Pedley S, Charles K, Adogo J, Okurut K, Chenoweth J | title = Challenges to achieving sustainable sanitation in informal settlements of Kigali, Rwanda | journal = International Journal of Environmental Research and Public Health | volume = 10 | issue = 12 | pages = 6939–54 | date = December 2013 | pmid = 24336021 | pmc = 3881150 | doi = 10.3390/ijerph10126939 | doi-access = free }} In some parts of the world, Zambia for example, very young children are discouraged from using pit latrines due to the risk of them falling through the open drop-hole. In such cases when there is no other available sanitation facility, children are encouraged to practice open defecation.{{Cite journal|last=Water and Sanitation Programme and the United Nations Children's Fund (UNICEF)|date=2015|title=Child Feces Disposal in Zambia|url=https://www.wsp.org/sites/wsp/files/publications/WSP-Zambia-CFD-Profile.pdf|journal=International Bank for Reconstruction and Development / The World Bank and UNICEF.|access-date=22 September 2020|archive-date=2 October 2020|archive-url=https://web.archive.org/web/20201002000020/https://www.wsp.org/sites/wsp/files/publications/WSP-Zambia-CFD-Profile.pdf|url-status=live}} Some toilets do not have a real door, but have a cloth hung as a door. In some communities, toilets are located in places where women are shy to access them due to the presence of men.{{Cite journal| vauthors = O'Reilly K |date=2006-11-01|title="Traditional" women, "modern" water: Linking gender and commodification in Rajasthan, India|journal=Geoforum|volume=37|issue=6|pages=958–972|doi=10.1016/j.geoforum.2006.05.008}}

Absence of supply of water inside or next to toilets cause people to get water from a distance before using the toilet. This is an additional task and needs extra time.

If too many people want to use a toilet at the same time, then some people may go outside to defecate instead of waiting. In some cases, people might not be able to wait due to diarrhea (or the result of an Inflammatory Bowel Disease emergency). In the case of home pit latrines, some people fear that their toilet pits will get filled very fast if all family members use them every day, so they continue to go outside to delay the toilet pit filling up.

Some communities have safe and accessible toilets, yet people prefer to defecate in the open. In some cases, these toilets are provided by the government or other organizations and people do not like them, do not value them, or do not know the benefits of using them.In 2016, Kunwar Bai Yadav, a woman claiming to be 105 years old, said she had never heard about a toilet until that year, and had always gone into the nearby woods to defecate. Only when she learned about them, did she have one built in her community. Source: BBC News (India): [https://www.bbc.com/news/world-asia-india-37799425 "How a 105-year-old ended open defecation in her village"] {{Webarchive|url=https://web.archive.org/web/20181221154407/https://www.bbc.com/news/world-asia-india-37799425 |date=21 December 2018 }}, 1 November 2016{{cite web|url=http://riceinstitute.org/research/revealed-preference-for-open-defecation-evidence-from-a-new-survey-in-rural-north-india-longer-working-paper/|title=Revealed Preference for Open Defecation: Evidence from a new survey in rural north India (longer working paper) {{!}} r.i.c.e.|website=riceinstitute.org|language=en-US|access-date=2017-10-23|archive-date=24 October 2017|archive-url=https://web.archive.org/web/20171024043235/http://riceinstitute.org/research/revealed-preference-for-open-defecation-evidence-from-a-new-survey-in-rural-north-india-longer-working-paper/|url-status=live}} They continue to defecate in the open. Older people are often found to defecate in the open and are hesitant to change their behavior and go inside a closed toilet.

Some people prefer being in nature while defecating, as opposed to an enclosed space. This happens mostly in less populated or rural areas, where people walk outside early in the morning and go to defecate in the fields or bushes. In some cases there may be a cultural or habitual preference for open defecation. Some consider it a social activity, especially women who like to take some time to go out of their homes. While on their way to the fields for open defecation they can talk to other women and take care of their animals.

Open defecation is a part of people's life and daily habits in some regions. For instance, a 2011 survey in rural East Java, Indonesia, found that many men considered the practice 'normal', and having distinct benefits such as social interaction and physical comfort. In some cultures, there may be social taboos, such as a father-in-law may not use the same toilet as a daughter-in-law in the same household.{{citation needed|date=March 2019}} Open defecation is a preferred practice in some parts of the world, with many respondents in a survey from 2015 stating that "open defecation was more pleasurable and desirable than latrine use". In some societies, open defecation is an intentional and widely used means of fertilization.

People with fecal incontinence can have abrupt 'emergencies' and not enough time to access a toilet, which can make open defecation their only option in such scenarios.

In developed countries, open defecation can be due to homelessness. Open defecation in developed areas is also considered to be a part of recreational outdoor activities such as camping in remote areas. It is difficult to estimate how many people practice open defecation in these communities.

File:People-practicing-open-defecation-of-population.png (2024) - [https://ourworldindata.org/grapher/people-practicing-open-defecation-of-population?time=latest "Sanitation". Published online at OurWorldInData.org] {{Webarchive|url=https://web.archive.org/web/20240816121425/https://ourworldindata.org/grapher/people-practicing-open-defecation-of-population?time=latest |date=16 August 2024 }}. Retrieved from: 'https://ourworldindata.org/sanitation' [Online Resource] The prevalence of open defecation in India has been significantly reduced since the launch of the Swachh Bharat Mission on October 2, 2014, according to government data.]]

The practice of open defecation is strongly related to poverty and exclusion particularly, in the case of rural areas and informal urban settlements in developing countries. The Joint Monitoring Programme for Water Supply and Sanitation (JMP) of UNICEF and WHO has been collecting data regarding open defecation prevalence worldwide. The figures are segregated by rural and urban areas and by levels of poverty. This program is tasked to monitor progress towards the Millennium Development Goal (MDG) relating to drinking water and sanitation. As open defecation is one example of unimproved sanitation, it is being monitored by JMP for each country, and results are published on a regular basis.{{cite web|url = http://www.wssinfo.org/data-estimates/|title = Data and estimates|access-date = 12 March 2015|website = JMP – WHO/UNICEF Joint Monitoring Programme (JMP) for Water Supply and Sanitation|publisher = WHO/UNICEF|archive-url = https://web.archive.org/web/20150219114756/http://www.wssinfo.org/data-estimates|archive-date = 19 February 2015}}WHO and UNICEF (2017) [https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2805 Progress on Drinking Water, Sanitation and Hygiene: 2017 Update and SDG Baselines] {{Webarchive|url=https://web.archive.org/web/20200227032419/https://www.susana.org/en/knowledge-hub/resources-and-publications/library/details/2805 |date=27 February 2020 }}. Geneva: World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) The figures on open defecation used to be lumped together with other figures on unimproved sanitation but are collected separately since 2010.

The number of people practicing open defecation fell from 20% in 2000 to 12% in 2015.{{rp|page=34}} In 2016, the estimate was for 892 million people with no sanitation facility whatsoever and therefore practicing open defecation (in gutters, behind bushes, in open water bodies, etc.). Most people (9 of 10) who practice open defecation live in rural areas, but the vast majority lives in two regions (Central Africa and South Asia). In 2016, 76% (678 million) of the 892 million people practicing open defecation in the world lived in just seven countries.

{{Further|Swachh Bharat Mission}}

File:People-practicing-open-defecation-of-population (1).png

A report published by WaterAid in 2017 stated that India had the highest number of people without access to basic sanitation despite efforts made by the Government of India under the Swachh Bharat Mission.{{cite web|date=7 November 2017|title=India has highest number of people without basic sanitation: Report|url=https://timesofindia.indiatimes.com/india/india-has-highest-number-of-people-without-basic-sanitation-report/articleshow/61694077.cms|work=Times of India|access-date=22 April 2024|archive-date=16 October 2023|archive-url=https://web.archive.org/web/20231016003537/https://timesofindia.indiatimes.com/india/india-has-highest-number-of-people-without-basic-sanitation-report/articleshow/61694077.cms|url-status=live}}{{cite web|date=7 November 2017|title=India Has Highest Number Of People Without Basic Sanitation: Report|url=https://www.ndtv.com/india-news/india-has-highest-number-of-people-without-basic-sanitation-wateraid-report-1776912|work=NDTV|access-date=13 June 2021|archive-date=3 January 2022|archive-url=https://web.archive.org/web/20220103010854/https://www.ndtv.com/india-news/india-has-highest-number-of-people-without-basic-sanitation-wateraid-report-1776912|url-status=live}} About 433 million people, or approximately 33.14% of the population, practiced open defecation in India in 2014, despite having access to a toilet.{{Cite web |last=If you are viewing it from a mobile device, it would be best to open the link in desktop mode for a complete and convenient experience. |title=JMP |url=https://washdata.org/data/household#!/ind |access-date=2024-09-01 |website=washdata.org |archive-date=11 January 2019 |archive-url=https://web.archive.org/web/20190111175434/https://washdata.org/data/household#!/ind |url-status=live }}{{Cite news| vauthors = Dinnoo S |date=17 June 2014|title=Why do millions of Indians defecate in the open?|language=en-GB|work=BBC News|url=https://www.bbc.com/news/world-asia-india-27775327|url-status=live|access-date=13 April 2020|archive-url=https://web.archive.org/web/20200306225737/https://www.bbc.com/news/world-asia-india-27775327|archive-date=6 March 2020}} Many factors contributed to this, ranging from poverty to government corruption.{{Cite book| vauthors = Coffey D |title=Where India goes: abandoned toilets, stunted development and the costs of caste|others=Spears, Dean E.|year=2017|isbn=978-93-5264-565-7|location=Noida, Uttar Pradesh|pages=7–11|oclc=994315306}}

File:Baina beach defecation zone.jpg

Since then, through Swachh Bharat, a two-phase program managed by the Indian government, India has constructed around 100 million additional household toilets which would benefit 500 million people in India according to the statistics provided by Indian government (Phase 1: 2014–2019, Phase 2: 2020 to 2025).{{cite web|title=An open defecation free India|url=https://www.unicef.org/india/what-we-do/ending-open-defecation|url-status=live|archive-url=https://web.archive.org/web/20200807020542/https://www.unicef.org/india/what-we-do/ending-open-defecation|archive-date=7 August 2020|access-date=29 July 2020|website=unicef.org|quote=According to the national statistics, over 100 million household toilets were constructed by the deadline benefiting 500 million people across 630,000 villages, but the government acknowledged that more had to be done.}} A campaign to build toilets in urban and rural areas achieved a significant reduction in open defecation between 2014 and 2019. In September 2019, the Bill & Melinda Gates Foundation honored Indian leader Narendra Modi for his efforts in improving sanitation in the country.{{cite news|date=25 September 2019|title=Gates Foundation award seen as boost to Swachh Bharat Abhiyan|work=Mint|url=https://www.livemint.com/news/india/gates-foundation-award-seen-as-boost-to-swachh-bharat-abhiyan-1569432677658.html|url-status=live|access-date=20 December 2020|archive-url=https://web.archive.org/web/20201130113601/https://www.livemint.com/news/india/gates-foundation-award-seen-as-boost-to-swachh-bharat-abhiyan-1569432677658.html|archive-date=30 November 2020}} According to UNICEF, the number of people without a toilet was reduced from 550 million to 50 million.{{cite web|title=A Clean (Sampoorna Swachh) India|url=https://www.unicef.org/india/what-we-do/ending-open-defecation|access-date=2021-07-07|website=Unicef.org|language=en|archive-date=7 August 2020|archive-url=https://web.archive.org/web/20200807020542/https://www.unicef.org/india/what-we-do/ending-open-defecation|url-status=live}}{{cite web|date=2019-03-05|title=93 Percent Households In Rural India Have Access To Toilets, Says Government Survey {{!}} News|url=https://swachhindia.ndtv.com/93-percent-households-rural-india-access-to-toilets-government-survey-31891/|access-date=2021-07-07|website=NDTV-Dettol Banega Swasth Swachh India|language=en-US|archive-date=9 July 2021|archive-url=https://web.archive.org/web/20210709183528/https://swachhindia.ndtv.com/93-percent-households-rural-india-access-to-toilets-government-survey-31891/|url-status=live}} There have also been reports of people not using the toilets despite having one, although according to the World Bank, 96% of Indians used the toilets they had.{{cite news|author=Helen Regan and Manveena Suri|date=2019-10-06|title=Half of India couldn't access a toilet 5 years ago. Modi built 110M latrines -- but will people use them?|url=https://www.cnn.com/2019/10/05/asia/india-modi-open-defecation-free-intl-hnk-scli/index.html|access-date=2021-07-07|website=CNN|language=en|archive-date=30 November 2021|archive-url=https://web.archive.org/web/20211130053416/https://www.cnn.com/2019/10/05/asia/india-modi-open-defecation-free-intl-hnk-scli/index.html|url-status=live}}{{Cite news|last=Sharma|first=Aman|title=96% usage of toilets under Swachh Bharat, shows a survey by an independent verification agency|work=The Economic Times|url=https://economictimes.indiatimes.com/news/politics-and-nation/96-usage-of-toilets-under-swachh-bharat-shows-survey-by-an-independent-verification-agency/articleshow/68265399.cms?from=mdr|access-date=2021-07-07|archive-date=10 July 2021|archive-url=https://web.archive.org/web/20210710000513/https://economictimes.indiatimes.com/news/politics-and-nation/96-usage-of-toilets-under-swachh-bharat-shows-survey-by-an-independent-verification-agency/articleshow/68265399.cms?from=mdr|url-status=live}} In October 2019, Modi declared India to be "open defecation free", though this announcement was met with skepticism by experts who cited slowly changing behaviors, maintenance issues, and water access issues as obstacles that continued to block India's goal of being 100% open defecation free.{{Cite news|author=Kuchay B|date=2 October 2019|title=Modi declares India open defecation free, claim questioned|work=Al Jazeera|url=https://www.aljazeera.com/news/2019/10/2/modi-declares-india-open-defecation-free-claim-questioned|access-date=6 April 2021|archive-date=18 August 2021|archive-url=https://web.archive.org/web/20210818075114/https://www.aljazeera.com/news/2019/10/2/modi-declares-india-open-defecation-free-claim-questioned|url-status=live}}{{cite web|last=Santosh Mehrotra|date=January 2019|title=Is India Really 96% Open Defecation Free?|url=https://thewire.in/government/is-india-really-96-open-defecation-free|website=The Wire (India)|access-date=24 March 2022|archive-date=3 January 2022|archive-url=https://web.archive.org/web/20220103010855/https://thewire.in/government/is-india-really-96-open-defecation-free|url-status=live}}

With the success of the Swachh Bharat Mission, Modi launched Phase 2 from 2020 to 2025.{{Cite news|agency=Press Trust of India|date=2020-03-04|title=Second phase of Swachh Bharat Mission (Grameen) launched|language=en-IN|work=The Hindu|url=https://www.thehindu.com/news/national/second-phase-of-swachh-bharat-mission-grameen-launched/article30981702.ece|access-date=2021-07-07|issn=0971-751X|archive-date=28 January 2022|archive-url=https://web.archive.org/web/20220128195604/https://www.thehindu.com/news/national/second-phase-of-swachh-bharat-mission-grameen-launched/article30981702.ece|url-status=live}} During Phase 2, the government is to focus on segregation of waste and further eliminating open defecation.{{cite web|date=2021-03-03|title=Phase 2 of Swachh Bharat Mission to focus on waste segregation at source|url=https://indianexpress.com/article/India/phase-2-of-swachh-bharat-mission-to-focus-on-waste-segregation-at-source-7210207/|access-date=2021-07-07|website=The Indian Express|language=en|archive-date=9 July 2021|archive-url=https://web.archive.org/web/20210709185247/https://indianexpress.com/article/india/phase-2-of-swachh-bharat-mission-to-focus-on-waste-segregation-at-source-7210207/|url-status=live}}

In Pakistan, sanitation facilities are available to only about 42% of the population, 65% in urban areas and 30% in rural settlements in 2009.https://www.researchgate.net/publication/256191560_Sustainability_of_Sanitation_Systems_in_Pakistan

In 2017, WaterAid reported that 79 million people in Pakistan lacked access to a decent toilet.{{cite web|date=2017-11-23|title=79m Pakistanis still lack a decent toilet: report|url=https://dailytimes.com.pk/145728/79m-pakistanis-still-lack-decent-toilet-report/|access-date=2021-06-23|website=Daily Times|language=en-US|archive-date=22 January 2021|archive-url=https://web.archive.org/web/20210122011353/https://dailytimes.com.pk/145728/79m-pakistanis-still-lack-decent-toilet-report/|url-status=live}}{{cite web|title=Pakistan {{!}} WaterAid Global|url=https://www.wateraid.org/where-we-work/pakistan|access-date=2021-06-23|website=Wateraid.org|language=en|archive-date=13 June 2021|archive-url=https://web.archive.org/web/20210613103834/https://www.wateraid.org/where-we-work/pakistan|url-status=live}} In 2018, 12% or 26 million people in Pakistan practiced open defecation, according to UNICEF.{{cite news|url=https://data.worldbank.org/indicator/SH.STA.ODFC.ZS?end=2018&locations=PK|title=People practicing open defecation (% of population) - Pakistan|newspaper=World Bank|access-date=29 November 2021|archive-date=29 November 2021|archive-url=https://web.archive.org/web/20211129221532/https://data.worldbank.org/indicator/SH.STA.ODFC.ZS?end=2018&locations=PK|url-status=live}}{{cite news|date=24 November 2018|title=Women in Pakistan fight for toilets, while men have 'other priorities'|url=https://www.thehindu.com/news/international/women-in-pakistan-fight-for-toilets-while-men-have-other-priorities/article25587275.ece|work=The Hindu|access-date=27 May 2021|archive-date=17 July 2021|archive-url=https://web.archive.org/web/20210717200628/https://www.thehindu.com/news/international/women-in-pakistan-fight-for-toilets-while-men-have-other-priorities/article25587275.ece|url-status=live}} As of 2022, 7% or 15.92 million people in Pakistan practice open defecation, UNICEF reported.{{Cite web |date=July 2023 |title=Sanitation statistics |url=https://data.unicef.org/topic/water-and-sanitation/sanitation/ |access-date=1 September 2024 |website=UNICEF |archive-date=22 May 2024 |archive-url=https://web.archive.org/web/20240522174203/https://data.unicef.org/topic/water-and-sanitation/sanitation/ |url-status=live }}

An increase in homelessness and the creation tent cities nationwide have led to an increase in open defecation because of a lack of public toilets.https://www.theatlantic.com/photo/2016/02/americas-tent-cities-for-the-homeless/462450/ Many cities since the 1970's have closed public toilets due to concerns that homeless people would vandalize or use drugs in them.{{Cite news |date=2021-11-05 |title=Where Did All the Public Bathrooms Go? |language=en |work=Bloomberg.com |url=https://www.bloomberg.com/news/features/2021-11-05/why-american-cities-lost-their-public-bathrooms |access-date=2023-09-25 |archive-date=4 February 2022 |archive-url=https://web.archive.org/web/20220204040645/https://www.bloomberg.com/news/features/2021-11-05/why-american-cities-lost-their-public-bathrooms |url-status=live }}

In San Francisco, open defecation complaints for street feces increased fivefold from 2011 to 2018, with 28,084 cases reported. This was mainly due to the rising amount of homelessness in the city. San Francisco formed the Poop Patrol to deal with the problem.{{cite web| vauthors = Moffitt M |date=3 December 2019|title=San Francisco plans to power-wash the poop out of the Tenderloin|url=https://www.sfgate.com/local/article/City-plans-to-power-wash-the-poop-out-of-the-14878629.php|url-status=live|archive-url=https://web.archive.org/web/20191206150800/https://www.sfgate.com/local/article/City-plans-to-power-wash-the-poop-out-of-the-14878629.php|archive-date=6 December 2019|publisher=SFGATE}} Similar problems were reported in Los Angeles{{cite web|last1=Grover|first1=Joel|last2=Corral|first2=Amy|date=February 19, 2020|title=Homeless People Are Without Toilets and Going in the Streets. We Asked the Mayor of LA Why|url=https://www.nbclosangeles.com/investigations/homeless-people-are-without-toilets-and-going-in-the-streets-we-asked-the-mayor-of-la-why/2311759/|website=NBC Los Angeles|language=en-US|access-date=28 September 2021|archive-date=1 December 2021|archive-url=https://web.archive.org/web/20211201190317/https://www.nbclosangeles.com/investigations/homeless-people-are-without-toilets-and-going-in-the-streets-we-asked-the-mayor-of-la-why/2311759/|url-status=live}} and Miami.{{Cite news|last=LINDA ROBERTSON|date=October 19, 2019|title=Poop and urine turn downtown streets into outdoor toilet|work=Miami Herald|url=https://www.miamiherald.com/news/local/community/miami-dade/downtown-miami/article236262158.html|access-date=28 September 2021|archive-date=8 September 2021|archive-url=https://web.archive.org/web/20210908122341/https://www.miamiherald.com/news/local/community/miami-dade/downtown-miami/article236262158.html|url-status=live}}

The Mad Pooper was the name given to an unidentified woman who regularly defecated in public places while jogging during summer 2017 in the U.S. city of Colorado Springs.{{cite news|date=19 September 2017|title=We Urge You 'Mad Pooper,' Stop Crapping in Your Neighbor's Yard|newspaper=Runner's World|url=https://www.runnersworld.com/poop/we-urge-you-mad-pooper-stop-crapping-in-your-neighbors-yard|url-status=live|access-date=3 November 2017|archive-url=https://web.archive.org/web/20171107025928/https://www.runnersworld.com/poop/we-urge-you-mad-pooper-stop-crapping-in-your-neighbors-yard|archive-date=7 November 2017}}

File:Dirty pit latrine in Mongolia in winter (5321157342).jpg

{{Further|WASH#Health aspects}}

The negative public health impacts of open defecation are the same as those described when there is no access to sanitation at all. Open defecation—and lack of sanitation and hygiene in general—is an important cause of various diseases. The most common are diarrhea and intestinal worm infections, also including typhoid, cholera, hepatitis, polio, trachoma, and others.{{cite web|title=Call to action on sanitation|url=http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|website=United Nations|access-date=15 August 2014|url-status=usurped|archive-url=https://web.archive.org/web/20140819084624/http://sanitationdrive2015.org/wp-content/uploads/2013/03/DSG_Sanitation_Fast-Facts_final.pdf|archive-date=19 August 2014}}{{cite journal | vauthors = Spears D, Ghosh A, Cumming O | title = Open defecation and childhood stunting in India: an ecological analysis of new data from 112 districts | journal = PLOS ONE | volume = 8 | issue = 9 | pages = e73784 | year = 2013 | pmid = 24066070 | pmc = 3774764 | doi = 10.1371/journal.pone.0073784 | bibcode = 2013PLoSO...873784S | doi-access = free }}

Adverse health effects of open defecation occur because open defecation results in fecal contamination of the local environment. Open defecators are repeatedly exposed to many kinds of fecal bacteria like gram-positive Staphylococcus aureus and other fecal pathogens. This is particularly serious for young children whose immune systems and brains are not yet fully developed.

Certain diseases are grouped together under the name of waterborne diseases, which are diseases transmitted via fecal pathogens in water. Open defecation can lead to water pollution when rain flushes feces that are dispersed in the environment into surface water or unprotected wells.

Open defecation was found by the WHO in 2014 to be a leading cause of diarrheal death. In 2013, about 2,000 children under the age of five died every day from diarrhea.{{cite web |url=https://www.who.int/mediacentre/factsheets/fs330/en/ |title=WHO | Diarrhoeal disease |publisher=World Health Organization |date=2013 |access-date=10 March 2014 |archive-date=1 April 2014 |archive-url=https://web.archive.org/web/20140401193648/http://www.who.int/mediacentre/factsheets/fs330/en/ |url-status=live }}

Young children are particularly vulnerable to ingesting feces of other people that are lying around after open defecation, because young children crawl on the ground, walk barefoot, and put things in their mouths without washing their hands. Feces of farm animals are equally a cause of concern when children are playing in the yard.

Those countries where open defecation is most widely practiced have the highest numbers of deaths of children under the age of five, as well as high levels of malnourishment (leading to stunted growth in children), high levels of poverty, and large disparities between rich and poor.

Research from India has shown that detrimental health impacts (particularly for early life health) are even more significant from open defecation when the population density is high: "The same amount of open defecation is twice as bad in a place with a high population density average like India versus a low population density average like sub-Saharan Africa."{{cite book|last1=Vyas|url=http://www.susana.org/_resources/documents/default/3-2089-16-1414062223.pdf|title=Population density and the effect of sanitation on early-life health], slide 19 (presentation at UNC conference in Oct. 2014)|date=2014|publisher=Research Institute for Compassionate Economics, project (r.i.c.e.)|access-date=12 March 2015|archive-url=https://web.archive.org/web/20150402092447/http://www.susana.org/_resources/documents/default/3-2089-16-1414062223.pdf|archive-date=2 April 2015|url-status=live|via=Sustainable Sanitation Alliance}}

Open defecation badly harms health of children and their quality of life, including psychological issues.{{cite web |url=https://www.unicef.org/media/media_86283.html |title=UNICEF: Without toilets, childhood is even riskier due to malnutrition | Press centre | UNICEF |access-date=6 April 2021 |archive-date=1 March 2021 |archive-url=https://web.archive.org/web/20210301000911/https://www.unicef.org/media/media_86283.html }}

There are strong gender impacts connected with a lack of adequate sanitation. In addition to the universal problems associated with open defecation, having to urinate in the open can also be problematic for females. The lack of safe, private toilets makes women and girls vulnerable to violence and is an impediment to girls' education. Women are at risk of sexual molestation and rape as they search for places to urinate or defecate that are secluded and private, often during hours of darkness.Lennon, S. (2011). [http://www.susana.org/en/resources/library/details/1758 Fear and anger: Perceptions of risks related to sexual violence against women linked to water and sanitation in Delhi, India] {{Webarchive|url=https://web.archive.org/web/20150924112250/http://www.susana.org/en/resources/library/details/1758 |date=24 September 2015 }} – Briefing Note. SHARE (Sanitation and Hygiene Applied Research for Equity) and WaterAid, UKHouse, Sarah, Suzanne Ferron, Marni Sommer and Sue Cavil (2014) [http://violence-wash.lboro.ac.uk/ Violence, Gender & WASH: A Practitioner's Toolkit  – Making water, sanitation and hygiene safer through improved programming and services] {{Webarchive|url=https://web.archive.org/web/20151004081037/http://violence-wash.lboro.ac.uk/ |date=4 October 2015 }}. London, UK: WaterAid/SHARE.

Lack of privacy has an especially large effect on the safety and sense of dignity of women and girls in developing countries. Facing the shame of having to urinate or defecate in public, they often wait until nightfall to relieve themselves. They risk being attacked after dark, meaning painfully holding their bladder and bowels all day.{{cite web| author = Cavil S |title=Violence, gender and WASH: A practitioner's toolkit: Making Water, Sanitation and hygiene safer through improved programming and services|url=http://violence-wash.lboro.ac.uk/|publisher=WaterAid, SHARE Research Consortium |access-date=7 October 2015|archive-date=4 October 2015|archive-url=https://web.archive.org/web/20151004081037/http://violence-wash.lboro.ac.uk/|url-status=live}}{{cite journal| author = Lennon S |title=Fear and anger: Perceptions of risks related to sexual violence against women linked to water and sanitation in Delhi, India |journal=SHARE (Sanitation and Hygiene Applied Research for Equity) and WaterAid, UK |date=November 2011|url=http://www.susana.org/en/resources/library/details/1758|access-date=7 October 2015|archive-date=24 September 2015|archive-url=https://web.archive.org/web/20150924112250/http://www.susana.org/en/resources/library/details/1758|url-status=live}} Women in developing countries increasingly express fear of assault or rape when having to leave the house after dark. Reports of attacks or harassment near or in toilet facilities, as well as near or in areas where women urinate or defecate openly, are common.

Strategies that can enable communities, both rural and peri-urban, to become completely open defecation free and remain so include: sanitation marketing, behavior change communication, and 'enhanced' community-led total sanitation ('CLTS + '), supplemented by "nudging".{{Cite journal|vauthors=Mara D|date=2017|title=The elimination of open defecation and its adverse health effects: a moral imperative for governments and development professionals|url=https://iwaponline.com/washdev/article/7/1/1/30446/The-elimination-of-open-defecation-and-its-adverse|url-status=live|journal=Journal of Water, Sanitation and Hygiene for Development|language=en|publication-place=University of Leeds|volume=7|issue=1|pages=1–12|doi=10.2166/washdev.2017.027|issn=2043-9083|archive-url=https://web.archive.org/web/20200517195652/https://iwaponline.com/washdev/article/7/1/1/30446/The-elimination-of-open-defecation-and-its-adverse|archive-date=17 May 2020|access-date=29 June 2020|doi-access=free}}

Several drivers are used to eradicate open defecation, one of which is behavior change. SaniFOAM (Focus on Opportunity, Ability, and Motivation) is a conceptual framework that was developed specifically to address issues of sanitation and hygiene. Using focus, opportunity, ability and motivation as categories of determinants, the SaniFOAM model identifies barriers to latrine adoption while simultaneously serving as a tool for designing, monitoring and evaluating sanitation interventions.{{Cite book|title=Introducing Sanifoam: A Framework to Analyze Sanitation Behaviors to Design Effective Sanitation Programs| vauthors = Devine J |publisher=World Bank|year=2009|location=Washington, DC, USA}}{{Cite journal| vauthors = Devine J |year=2010|title=Beyond tippt-taps: The role of enabling products in scaling up and sustaining handwashing|journal=Waterlines|volume=29|issue=4|pages=304–314|doi=10.3362/1756-3488.2010.033}} The following are some of the key drivers used to fight against open defecation in addition to behavior change:

• Political will
• Sanitation solutions that offer a better value than open defecation
• Stronger public sector local service delivery systems
• Creation of the right incentive structures

Efforts to reduce open defecation are more or less the same as those to achieve the MDG target on access to sanitation.{{cite web|url=https://apps.who.int/iris/bitstream/handle/10665/274939/9789241514705-eng.pdf|title=GUIDELINES ON SANITATION AND HEALTH|date=2018|website=Apps.who.int|access-date=4 April 2022|archive-date=3 April 2022|archive-url=https://web.archive.org/web/20220403213525/https://apps.who.int/iris/bitstream/handle/10665/274939/9789241514705-eng.pdf|url-status=live}} A key aspect is awareness-raising (for example via the UN World Toilet Day at a global level), behavior change campaigns, and increasing political will and demand for sanitation. Community-Led Total Sanitation (CLTS) campaigns have placed a particular focus on ending open defecation by "triggering" the communities themselves into action.{{cite web|title=Field Notes: UNICEF Policy and Programming in Practice|url=http://www.unicef.org/socialpolicy/files/Field_Note_-_Community_Approaches_to_Total_Sanitation.pdf|website=UNICEF|access-date=10 March 2015|archive-date=2 April 2015|archive-url=https://web.archive.org/web/20150402160413/http://www.unicef.org/socialpolicy/files/Field_Note_-_Community_Approaches_to_Total_Sanitation.pdf|url-status=live}}

File:Photo by Ashley Wheaton, May 2011 (6376606733).jpg, Bangladesh participate in a workshop to discover more about mobile sanitation options (MoSan) as an alternative to open defecation]]

Simple sanitation technology options are available to reduce open defecation prevalence if the behavior is due to not having toilets in the household and shared toilets being too far or too dangerous to reach, e.g., at night.

People might already use plastic bags (also called flying toilets) at night to contain their feces. However, a more advanced solution of the plastic toilet bag has been provided by the Swedish company People, which produces the "Peepoo bag", a "personal, single-use, self-sanitizing, fully biodegradable toilet that prevents feces from contaminating the immediate area as well as the surrounding ecosystem".Wheaton, A. (2009). [http://www.susana.org/en/resources/library/details/1125 Results of a medium-scale trial of single-use, self-sanitising toilet bags in poor urban settlements in Bangladesh] {{Webarchive|url=https://web.archive.org/web/20150427111520/http://www.susana.org/en/resources/library/details/1125 |date=27 April 2015 }}. Deutsche Gesellschaft für Technische Zusammenarbeit GmbH (GTZ), Dhaka, Bangladesh This bag is being used in humanitarian responses, schools, and urban slums in developing countries.Owako, E. (2012). [http://www.susana.org/en/resources/library/details/1612 Nyando peepoo trial project report] {{Webarchive|url=https://web.archive.org/web/20150407064759/http://www.susana.org/en/resources/library/details/1612 |date=7 April 2015 }}. Kenya Red Cross, KenyaNaeem, K., Berndtsson, M. (2011). [http://www.susana.org/en/resources/library/details/1611 Peepoo Try Pakistan – Sindh Floods] {{Webarchive|url=https://web.archive.org/web/20150407014736/http://www.susana.org/en/resources/library/details/1611 |date=7 April 2015 }}, November 2011. UN-HABITAT, Pakistan

Bucket toilets are a simple portable toilet option. They can be upgraded in various ways, one of them being urine diversion, which can make them similar to urine-diverting dry toilets. Urine diversion can significantly reduce odors from dry toilets. Examples of using this type of toilet to reduce open defecation are the "MoSan"Mijthab M., Woods E., Lokey H., Foote A., Rieck. C (2013). [http://www.susana.org/en/resources/library/details/2021 Sanivation and MoSan Toilet – 4 week Service Pilot in Karagita Naivasha, Kenya] {{Webarchive|url=https://web.archive.org/web/20141020111441/http://www.susana.org/en/resources/library/details/2021 |date=20 October 2014 }}. GIZ and Sanivation toilet (used in Kenya) or the urine-diverting dry toilet promoted by SOILRussel, K. (2013). [http://www.susana.org/en/resources/library/details/1753 Mobile sanitation services for dense urban slums – Various documents on results from research grant.] {{Webarchive|url=https://web.archive.org/web/20141018221935/http://www.susana.org/en/resources/library/details/1753 |date=18 October 2014 }} Stanford University, U.S. in Haiti.

The mainstream media in some affected countries, including India{{cite news |url=https://www.bbc.com/news/world-asia-india-29502603 |title=Why India's sanitation crisis needs more than toilets |publisher=BBC |date=2014-10-06 |access-date=10 March 2015 |work=BBC News |vauthors = Biswas S | archive-date=17 March 2015 |archive-url=https://web.archive.org/web/20150317202558/http://www.bbc.com/news/world-asia-india-29502603 |url-status=live }}{{cite web|url=http://www.dnaindia.com/india/report-india-has-highest-number-of-people-practicing-open-defecation-2036591|title=India has highest number of people practicing open defecation ||publisher=DNA India|date=19 November 2014|access-date=10 March 2015|archive-date=2 April 2015|archive-url=https://web.archive.org/web/20150402111413/http://www.dnaindia.com/india/report-india-has-highest-number-of-people-practicing-open-defecation-2036591|url-status=live}} and Pakistan,{{cite web |url=http://www.dawn.com/news/1168181 |title=More than 40m Pakistanis defecate openly: Unicef – Pakistan |publisher=Dawn |date=2015-03-08 |access-date=10 March 2015 |archive-date=10 March 2015 |archive-url=https://web.archive.org/web/20150310030633/http://www.dawn.com/news/1168181 |url-status=live }}{{cite web |url=http://tribune.com.pk/story/850024/lack-of-toilets-tied-to-stunted-growth-in-pakistan-unicef/ |title=Lack of toilets tied to stunted growth in Pakistan: UNICEF |publisher=The Express Tribune |date=13 March 2012 |access-date=10 March 2015 |archive-date=11 March 2015 |archive-url=https://web.archive.org/web/20150311155013/http://tribune.com.pk/story/850024/lack-of-toilets-tied-to-stunted-growth-in-pakistan-unicef/ |url-status=live }}{{cite web |url=http://www.thenews.com.pk/Todays-News-6-215001-Over-43-million-people-in-Pakistan-defecate-in-the-open |title=Over 43 million people in Pakistan defecate in the open |publisher=The News International |access-date=10 March 2015 |archive-date=2 April 2015 |archive-url=https://web.archive.org/web/20150402162853/http://www.thenews.com.pk/Todays-News-6-215001-Over-43-million-people-in-Pakistan-defecate-in-the-open |url-status=live }} have recently been publicizing the issue of open defecation.

In certain jurisdictions, open or public defecation is a criminal offense that can be punished with a fine or even imprisonment.{{cite web|url=https://library.municode.com/oh/columbus/codes/code_of_ordinances?nodeId=TIT23GEOFCO_CH2317PUCO_2317.14PUURDE|title=Municode Library|website=library.municode.com|language=en|access-date=2018-01-30|archive-date=16 January 2018|archive-url=https://web.archive.org/web/20180116135043/https://library.municode.com/oh/columbus/codes/code_of_ordinances?nodeId=TIT23GEOFCO_CH2317PUCO_2317.14PUURDE|url-status=live}}{{Cite news|url=http://wnep.com/2017/09/19/mad-pooper-jogger-wanted-for-repeatedly-defecating-in-colorado-front-yards/|title='Mad Pooper': Jogger Wanted for Defecating in Front Yards of Colorado Homes|date=2017-09-19|work=WNEP.com|access-date=2018-01-30|language=en-US|archive-date=16 January 2018|archive-url=https://web.archive.org/web/20180116004459/http://wnep.com/2017/09/19/mad-pooper-jogger-wanted-for-repeatedly-defecating-in-colorado-front-yards/|url-status=live}}{{Cite news|url=http://www.dispatch.com/content/stories/local/2014/12/01/the-world-is-not-your-toilet-police-note.html|title=The world is NOT your toilet, Columbus police note| vauthors = Manning A |work=The Columbus Dispatch|access-date=2018-01-30|language=en|archive-date=16 January 2018|archive-url=https://web.archive.org/web/20180116081232/http://www.dispatch.com/content/stories/local/2014/12/01/the-world-is-not-your-toilet-police-note.html|url-status=live}}

David Sedaris' essay "Adventures at Poo Corner" dealt with people who openly defecate in commercial businesses.{{cite web|url=https://www.thisamericanlife.org/303/david-and-goliath/act-three|title=Adventures at Poo Corner|date=2017-12-12|website=This American Life|access-date=2019-08-18|archive-date=18 August 2019|archive-url=https://web.archive.org/web/20190818192955/https://www.thisamericanlife.org/303/david-and-goliath/act-three|url-status=live}}

Some national parks prohibit open defecation in some areas.{{cite web |url=https://www.nps.gov/dena/planyourvisit/leavenotrace.htm |title=Leave No Trace |publisher=National Park Service |access-date=20 September 2020 |archive-date=26 September 2020 |archive-url=https://web.archive.org/web/20200926090555/https://www.nps.gov/dena/planyourvisit/leavenotrace.htm |url-status=live }}{{cite web| vauthors = Martineau C |date=5 June 2019|title=Nature is calling: Here's how to poop properly in the great outdoors|url=https://roadtrippers.com/magazine/pooping-properly-great-outdoors/|url-status=live|archive-url=https://web.archive.org/web/20201027072508/https://roadtrippers.com/magazine/pooping-properly-great-outdoors/|archive-date=27 October 2020|work=Roadtrippers}} If defecating openly, the general advice is to defecate into a dug hole, and cover with soil.

• EToilet
• Free bleeding
• Public urination
• Sanitation worker
• Spitting

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• [https://web.archive.org/web/20141020010145/http://opendefecation.org/news/ UN Call to action to end open defecation]
• [http://www.susana.org/en/knowledge-hub/resources-and-publications/library?search=open+defecation Documents about open defecation] in library of Sustainable Sanitation Alliance

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Category:Sanitation

Category:Defecation