Getting poor to use toilets 'a major health conundrum'

More than one billion people worldwide have no toilet and defecate outside, while some have to be shamed into changing their habits when presented with conveniences, a conference was told.

Humanitarian organizations have for decades tried various ways -- be it new systems, pumps or subsidies -- of getting people in developing countries to stop defecating outdoors due to the serious health risks concerned.

But despite their efforts, an estimated 1.2 billion people, primarily in Asia and Africa, still don't use toilets to defecate, a forum of experts meeting in Stockholm was told.

For many extremely poor people who are given toilets by aid groups, it becomes the most precious item they own and therefore they use it as a religious shrine or a dry place to store firewood, international development consultant Kamal Kar said.

"What's becoming quite apparent is that the way you actually have an impact on health, development and poverty alleviation is when people adopt certain behaviours," Clarissa Brocklehurst, the head of UNICEF's water, environment and sanitation programme, told AFP.

In recent years, experts have found that the best method has been to shame people into using some form of toilets, even the most primitive sort, to confine excreta.

"It's just a matter of getting them to understand that what is a long established habit is in fact harmful and that you can do something about it," said Brocklehurst, one of 2,500 experts meeting in Stockholm to discuss water and sanitation issues at World Water Week.

She cited the example of India, where 48 percent of the population, or some 665 million people, still practice "open defecation".