37-year-old Sunita and her five daughters fromdistrict Tando Allahyar, are among millions of other women who are forced to defecate out in the open due to a serious dearth of toilets in rural Sindh. Each morning before sunrise, and again as darkness falls in the evening, the six walk a few meters away from their house to a large bush to relieve themselves. As per WHO/UNICEF3 2019worldwide, more than half (4.2 billionpeople lack safe sanitation.Nine out of ten open defecators live in rural areas and nearly half live in the least developed countries. On a positive note, open defecation rates have been decreasing steadily. According to WHO/UNICEF Joint Monitoring Programme Report between 2000-2015, open defecation cases declined from 1,229 million to 892 million, an average decrease of 22 million people per year. Pakistan has also made significant progress in improving access to sanitation since 1990, and was among 95 countries to have met the Millennium Development Goal on sanitation. However, progress seems to have stagnated since then. According to Pakistan Social and Living Standards Meaurement Survey (PSLM) 2018-19, 18% of the rural population, and 1% of the urban population still do not have access to toilet facilities. For women and children, a lack of toilet facilities not only means poor hygiene, but also security concerns (in having to go out and relieve themselves, sometimes alone) and also serious health issues. Women often also reduce water intake during the day as compensation. “Normally I drink a only little amount of water to curb the frequency of urination”, says Shugni, aged 45, from union council Dad Khan Jarwar, Tando Allahyar. A deeper look into the reasons for a lack of toilet facilities in rural areas reveals interesting insights. Even when families have the means and can afford to buy motorcycles, mobile phones, television sets, dish antennas, and refrigerators, theychoose not to construct toilets. According to them, the absence of drainage and sewerage system in the area renders toilets not very useful. 41-year-old Sumera, a resident of union council MasooBozdar, is one such woman, for whom an awareness session was the final motivating factor in constructing a toilet facility To prevent people from coming into contact with human waste and to reduce the transmission of communicable diseases such as typhoid and cholera, the United Nations celebrates World Toilet Day on November 19th each year. The theme this year is “Sustainable sanitation and climate change.” According to the official website, “Sustainable sanitation begins with a toilet that effectively captures human waste in a safe, accessible, and dignified setting. The waste then gets stored in a tank, which can be emptied later by a collection service, or transported away by pipework.” Sustainable sanitation must also withstand climate change, and should also “reuse waste to safely boost agriculture and reduce and capture emissions for greener energy.” As evident, this approach involves anextensive set of criteria. Particularlyin thecontext of safe disposal and reuse of sanitation waste, this whole process involves proper planning and designing along the entire sanitation cycle for whichdifferent government departments and non-government actors have to work collectively.This is not an easy task for countries such as Pakistan, that have limited resources and are still struggling to eliminate open defecation in its simplest form. However, while bringing this level of ‘sustainability’ into sanitation use may remain a distant reality, achieving the SDG of eliminating open defecation by 2030 may still be possible if efforts are rightly and jointly directed by the government and development partners alike. One such example is that of the ongoing Sindh Union Council and Community Economic Strengthening Support (SUCCESS) Programme, funded by the European Union and implemented in eight districts of Sindh by local Rural Support Programme chapters. Working with local rural communities, one major component of this programme is to raise awareness on key issues, including health, hygiene, and sanitation.131,594women have thus far benefited from these awareness sessions. The effectiveness of awareness raising is seen by the fact that in only two union councils of district Tando Allahyar (UC Masoo Bozdar and Dad Khan Jarwar), 1035 Households have built low-cost toilets following these sessions. 41-year-old Sumera, a resident of union council Masoo Bozdar,is one such woman, for whom an awareness session was the final motivating factor in constructing a toilet facility. She narrates, “Construction of a toilet was not my priority but thinking of my daughter, I decided to construct one. Now I feel satisfied that my daughter will no longer face the risks related with open defecation.” With the COVID-19 pandemic overtaking government priorities world-over and stringent SOPs being enforced in Pakistan as well, efforts to reduce open defecation must also be at the forefront.If left unchecked, open defecation could contribute to the spread of corona-virus in rural areas, that thus far have fared relatively better in terms of disease spread. Sultana Ali Kori is a sociologist and working as Field Researcher at Rural Support Programmes Network. She can be reached atsultana.kori@rspn.org.pk Amna Ejaz is Team Leader Research at Rural Support Programmes Network. She can be reached at amna.ejaz@rspn.org.pk