November 19th is World Toilet Day. It’s estimated that more than a billion women lack access to safe sanitation. The NGO WaterAid says a lack of adequate toilets puts women at risk of shame, disease, harassment and even violence.

WaterAid Chief Executive Barbara Frost said governments need to invest a lot more in sanitation to improve women’s health and livelihoods.

“On World Toilet Day, the message that WaterAid is putting out is that one in three women still don’t have a decent toilet. And what that means is that they have to wait until it’s after dark to go out and find a safe place to relieve themselves – a threat to their health, to their security, to their safety,” she said.

She said the problem is particularly bad in Africa, where seven out of ten women have no access to a safe toilet.

“Women and girls bear the brunt of poor sanitation and not having a decent toilet. And many girls drop out of school at puberty because there isn’t a safe place for them to wash when they’re menstruating. And also women spend so many hours looking after their children, who are sick as a result of diarrheal diseases,” she said.

WaterAid commissioned a survey in five slums in Lagos, Nigeria. It indicates that in the last year one in five women have experienced verbal harassment or intimidation, or were threatened physically, when going to the toilet. The NGO said studies in Uganda and Kenya have similar findings.

Frost added the lack of sanitation has other tragic consequences as well.

“Every day 2000 mothers lose a child as a result of waterborne diseases, which is a terrible trauma and tragedy. And many other women are having to stay at home looking after their children, who’ve got diarrheal diseases as a result of drinking unsafe water or using poor sanitation,” she said.

WaterAid has programs in 27 countries in Africa, Asia and the Pacific region.