Here’s a pop quiz. If nature calls and you need to relieve yourself right now, do you know where you would go to do so?

 If you are at home, you might choose the nearest bathroom in your house. If you are at work, you might have to go down the hall to a restroom. In public, say at a concert or a sporting event, women might have to wait longer than men, but ample facilities are available.
 
It’s an easy question isn’t it? Most of us have probably never given a second thought as to where we go, many times a day, to fulfill one of life’s most basic of biological functions. Not so in the poorest areas of the world.
 
In the sprawling townships outside of Cape Town, South Africa, hundreds of thousands of people live in informal settlements – communities made up of shacks constructed of whatever discarded items can be found to build a shelter. The rickety houses are hot in the summer, cold in the winter and wet in the rainy season when water comes in from holes in the tin roofs and through the dirt floors. It is disrespectful to call these informal settlements squatter camps, or township ghettos or slums, but if you have never been to one before, the term informal settlement doesn’t come close to adequately describing the horrendous living conditions.
 
In one township, Khayelitsha, there are over 700,000 people – twice the population of the city of Minneapolis. Unemployment is at 40%. More than 17% of adults are living with HIV/AIDS. Between 50 and 60 rapes are reported monthly with many more going unreported. For the children who go to school, there are 45 learners in a classroom and many schools lack books and libraries. This is the baseline for life in Khayelitsha. In the informal settlements, life is even harder.
 
It’s not just that these informal settlements often lack electricity and inadequate sources of clean drinking water; there are no toilets. To the estimated 500,000 people in the townships around Cape Town who do not have access to clean, safe, hygienic or private toilets, it is not easy to answer the question, “where do you go when nature calls?”
 
For the residents of one informal settlement called Taiwan, women, men and children must squeeze between the openings of a fence behind their shacks and use the grassy area that runs along the N2 highway as their very public toilet. It would be the equivalent of Minneapolitans using any open space along 35W – during all hours of the day and night – to relieve themselves. It’s more than just embarrassing; it’s a public health issue.
 
Human excrement and bits of dirty newspapers and plastic bags – the alternatives to toilet paper – dot the grounds that run parallel to the highway. The waste eventually makes its way into the swamp that abuts the shacks and where children sometimes play. Worms and gastroenteritis are rampant. Diarrhea is a leading cause of death for children under the age of five in places like Taiwan.
 
But the lack of adequate toilets is not just unhealthy; it is also dangerous. In fact, according to the Social Justice Coalition, (SJC) a nonprofit fighting for adequate sanitation in South Africa, this “simple and private bodily function is one of the most dangerous activities in the informal settlements.”
 
All of us, whether we have access to toilets or not, can understand feeling vulnerable when relieving ourselves. What we can’t understand is how responding to nature’s call puts us at risk for robbery and physical and sexual assault. But think about it, people who must use the side of a major freeway for their toilet usually go there by themselves and seek as private a spot as possible where they become targets for crime. At night, when women must go off by themselves, they become easy prey for rapists. The SJC has documented numerous cases of assaults, robberies and rape against people who were made vulnerable because they didn’t have access to safe toilets. They also report on the shacks that are burglarized when residents must leave them unattended to go and relieve themselves.
 
Access to toilets is not unique to South Africa. Worldwide, 2.5 billion people lack basic sanitation. What is unique is talking about the issue in a direct manner that gets people to comprehend the negative impact that lack of toilets has on public health, child mortality, crime and human dignity. The Social Justice Coalition in Khayelitsha is doing just that. To learn more, visit www.sjc.org.za.

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