Bangladesh stops open defecation in just over a decade

Through a dogged campaign to build toilets and educate Bangladeshis about the dangers of open defecation, the densely populated South Asian nation has managed to reduce the number of people who defecate in the open to just 1 percent of the 166 million population, according to the government — down from 42 percent in 2003.

Activists say small-scale surveys show that the campaign has improved public health, though there are not yet any government statistics to prove it more broadly.

Open defecation is considered a major public health menace, causing childhood diarrhea, parasitic worm infections and other scourges that contribute to childhood stunting, malnutrition and tens of billions of dollars in lost productivity every year.

Indian Prime Minister Narendra Modi has made public sanitation a hallmark of his "Clean India" drive, promising that every home would have a toilet by 2019 and setting aside hundreds of millions of dollars for the job.

Millions of dollars from the government and charities were spent, and campaign volunteers said they worked hard to change public attitudes and habits.

Many villagers — particularly men — preferred going outdoors, where they could think in private, survey their lands or just feel the evening breeze or gaze at the sky.

The drive has even sparked a new industry in household sanitation, with small businesses cropping up across the country to sell the components for making inexpensive latrines.

"People might be using a toilet or a latrine, but then where does the human waste go from there?" said John Sauer, senior technical adviser of the Washington-based Water, Sanitation and Hygiene Population Services International (PSI).