More Than a Bathroom Break: Understanding the Global Sanitation Crisis

Written by: Mallory Elaine Rogers

I’m sure you’ve never given much thought on going to the bathroom. For the most part, as Americans, we just walk down the hallway of where we work, go to school, or pull into a fast-food restaurant. We walk inside, do our thing, wash our hands, and we’re done! Not much effort. What most people in first world countries do not realize, is the privilege of being able to have safe restroom and sanitation access. Globally, there are around 1.8 billion people without water supplies and access to sanitation (World Health Organization [WHO] & United Nations Children’s Fund [UNICEF], 2023). That is around a quarter of the world facing daily challenges that most of us have likely never noticed.

History and Current State of Sanitation

The use of modern water and sanitation services are not recent developments; they are outcomes of a long, unequal process. This development has been traced back to the mid-19th century being led by public health interventions and economic prosperity. The “sanitary revolution” is when large scale water and sewage systems were diffused on a wide level (Gallardo-Albarrán, 2025). However, these trends did not make it to all geographic locations across the world. Historians have evaluated the causes of why there are present inequalities with clean water access and sanitation services. 

It is found that the causes for poor access to sanitation are multidimensional and have many layers. One of these reasons being poor infrastructure and growth which appears as a lack of access to high quality sewage systems or unsafe pipelines which leads to unsafe water sources (Centers for Disease Control and Prevention [CDC], 2025). There are barriers outside of individuals' control, such as poor governance or environmental factors. Unsafe access and infrastructure has led to what is called: a sanitation gap.

The sanitation gap is not something of the past and is still relevant to today. It’s a vital issue because when water is not safe to drink, there are multiple biological and social impacts. “Today, around 1 in 4 people still lack safely managed drinking water at home and 2 in 5 people do not have safely managed sanitation. Around 1 in 4 people cannot wash their hands with soap and water at home” (World Health Organization [WHO], 2023). Biologically, contaminated water reduces diarrheal diseases or respiratory infections, breaks disease transmission cycles, and helps sustain human life (Centers for Disease Control and Prevention [CDC], 2025). As a result of the sanitation gap, 1.4 million lives are lost every year.

On a social level, the sanitation gap affects numerous populations on contrasting levels. Those who are impoverished, do not have the resources to invest, and have fragile infrastructure have the highest risk of unsafe sanitation. But within this inequality, women and girls face the brunt of it. Women and girls are given the responsibility to collect water for the household meaning they must walk long distances, usually in unsafe areas to find water (UNICEF WHO Report, 2023). They are at increased risk for harassment, violence, and assault just for trying to use the toilet or collect water.

Furthermore women and girls are given the domestic chores and are expected to take care of the sick. Tasks such as cleaning, making food, and tending to the ill are risk factors for catching diseases without having the protection of hand washing. 

What is Being Done and What we Can Do

Thankfully, there is good news which is that there are organizations working close to the sanitation gap and there are groups in Birmingham helping to solve this crisis. 

The non-profit group Outreach International focuses on long-term, community focused change. They collaborate with the community to identify needs, build capacity, and create solutions that last. Their development alongside the community is why they have remained sustainable. 

Global issues can feel overwhelming but local action is so important to solving health issues. In Birmingham, the UAB Sanitation Health Program researches sanitation challenges and their impact on public health. Their focus is on community education, practical improvements, and connecting at-risk areas with healthcare providers. Students can get involved with their water, sanitation, and hygiene (WASH) workshops and community outreach.  

Students can continue to be involved through applying to be a Health Policy Ambassador at UAB Lister Hill Library. Students have the opportunity to partner alongside communities to address a policy-related issue and to help provide students the opportunity to advocate in the Birmingham area. One of these partners even being Cahaba River Society (University of Alabama at Birmingham [UAB], 2025).

Next time you wash your hands, go to shower, or use the restroom think of the privilege it is to be able to have safe access to sanitation and the importance it is to advocate for those who do not have it. In Birmingham, we can start locally then make a global impact. 

References

Africans deserve access to clean water and sanitation as a public health priority. (2025, May 24). Dateline Health Africa. https://www.datelinehealthafrica.org/africans-deserve-access-to-clean-water-and-sanitation-as-a-public-health-priority

Burki, T. (2025). Inequalities in progress on water, sanitation, and hygiene. The Lancet Infectious Diseases. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(25)00557-2/fulltext

Centers for Disease Control and Prevention. (2025). Global sanitation: Global water, sanitation, and hygiene (WASH). https://www.cdc.gov/global-water-sanitation-hygiene/about/about-global-sanitation.html

Gallardo-Albarrán, D. (2025). The global sanitary revolution in historical perspective. Journal of Economic Surveys. https://doi.org/10.1111/joes.12607 

Generosity.org. (n.d.). Our impact. https://www.generosity.org

Outreach International. (2025). Our process. https://www.outreach-international.org/our-process 

Sanitation Health Program. (2025). Resources. University of Alabama at Birmingham. https://www.uab.edu/sanitationhealth/

World Health Organization. (2023, July 6). Women and girls bear brunt of water and sanitation crisis – new UNICEF–WHO report. https://www.who.int/news/item/06-07-2023-women-and-girls-bear-brunt-of-water-and-sanitation-crisis---new-unicef-who-report