The Dangers of Poor Sanitation in India

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The Dangers of Poor Sanitation in India


The sun is setting, and women are waiting until the darkness before they venture out into the fields to relieve themselves under the cover of darkness. For generations, most of the population of India has practiced open defecation. This people group have grown accustomed to holding their bowels and bladders. Women must keep an eye out for hyenas, wild boars, snakes and men lurking in the shadows.

In May 2014, two girls aged 14 and 15 were gang-raped and hanged after going under the cover of darkness to relieve themselves. Women throughout India are always concerned about who may be watching them and waiting to attack them in the darkness when they are trying to relieve themselves.

The World Health Organization (http://www.who.int/water_sanitation_health/monitoring/jmp2012/fast_facts/en/) reports that approximately 626 million citizens of India practice open defecation. India accounts for 59 percent of the people who continue to practice open defecation.  Approximately 97 million people in India continue to have no access to clean drinking water.

What Is Open Defecation?

Open defecation is the practice of using urinating and defecating in open fields, along roadsides and by train tracks. Imagine being a woman in India who must wait until darkness descends before relieving yourself. Millions of women and young girls must try to squat in their sari while they hold a cup of water for cleansing themselves while keeping an eye out for a would-be rapist.

Open defecation contributes to a plethora of problems in India, including water pollution and diseases that lead to malnutrition. Oftentimes open defecation is done near residential areas. The urine and feces mix in the soil and drinking water, resulting in catastrophic illnesses and death.

Open Defecation and Illness

There are a number of illnesses that are linked to sanitation issues and the lack of sanitary toilets.  Some of the most common diseases include:



  • Intestinal Worms

  • Hepatitis

  • Polio

  • Diarrhea

  • Typhoid

  • Trachoma

  • Cholera

  • Tuberculosis

Sanitation Issues and Health Problems

Polluted groundwater and water scarcity have left many of the residents in India without clean drinking water. Untreated sewage pollutes surface water, lakes, and rivers in India. This polluted groundwater increases the risk of diarrheal diseases that lead to malnutrition even when enough food is eaten.

Another common illness suffered by women in India is urinary tract infections. Medical News Today (https://www.medicalnewstoday.com/articles/321408.php) reports that women can experience five complications caused by holding urine. In order to understand what happens when urine is held too long, you must know the capacity of the bladder. The bladder is designed to hold approximately 2 cups of liquid. Although it can stretch and hold more, it can be dangerous.

First, when you do not urinate often, you can experience bladder and kidney pain. Furthermore, holding urine all day can cause the muscles in the pelvic region to remain partially clenched after urination, which can cause pelvic cramping.

Holding urine all day also allows bacteria to multiply in the urinary tract, which can lead to urinary tract infections. The infection can cause burning during urination, pelvic and abdominal pain, strong, cloudy urine and blood in the urine. If the urinary tract infection is left untreated, it can lead to permanent kidney damage, the narrowing of the urethra, premature birth, low birthweight, and sepsis.

Bladder-stretching can also occur. When a woman regularly holds their urine, their bladder can stretch and make it difficult for the bladder to release urine normally. A stretched bladder can also lead to the need for catheterization.

Pelvic floor muscles can become damaged. The pelvic floor muscles contract to keep the urethra closed. When these muscles are continuously contracted, they can become weak and allow urine to leak.

Finally, holding urine for long periods of time can lead to the formation of kidney stones. Urine contains calcium oxalate and uric acid which can cause stones to form in the urinary tract.

Occasionally holding your urine will normally not cause harm; however, doing so regularly can increase your risk of health complications, including infections, pelvic pain, bladder stretching, and kidney stones.


The World Health Organization states that approximately 4 percent of deaths and 5.7 percent of disabilities are due to unimproved sanitation practices, poor hygiene and no access to clean drinking water. (http://www.who.int/sustainable-development/cities/health-risks/water-sanitation/en/) Each year 500,000 people die because of diarrheal diseases like typhoid, polio, cholera, dysentery and waterborne illnesses, including worm infections and malaria.

To help reduce the risk of death and disease, we must work together to educate the citizens of India, provide clean drinking water and proper sanitation.

Rohan Hirani