More than 40 million people in Pakistan don’t have access to a toilet.

About three million Pakistanis suffer from waterborne diseases every year – and children are particularly vulnerable. Pakistan’s under five child mortality rate is high: 120 in 1,000 children die before they are five, primarily due to diarrhoea and pneumonia. Unicef has also linked stunting in Pakistan’s children to the widespread practice of open defecation.


Sindh province, southern Pakistan.

Who’s being helped

Each year, the project is extended to reach new villages in Sindh province. Several villages have already been declared ‘open defecation free’.

The project

The water and sanitation project run by Toilet Twinning’s partner supports communities in several ways. As well as providing bio-sand water filters, the local partner is involved in latrine-construction and hygiene education.

To complement this work, it is offering training to build villagers’ capacity and helping them set up village development groups and self-help groups. All this is helping villagers work together and grow in confidence. The project has a strong focus on including women who are encouraged to join savings groups and start small businesses. Women have also played an important role in constructing latrines.

Changing lives

Changing lives Narain, a father-of-four from Sindh province, explains the difference having a toilet has made to his home and his village:

‘Open defecation turned our village into a dirty place. People were getting ill regularly and the situation was out of control. Men could go out in the fields for defecation any time of the day but women had to wait till dark. It was very unsafe for them…’ But everything changed after Toilet Twinning’s partner taught villagers about hygiene and help them build low-cost latrines next to their homes. ‘They helped us understand the harmful effects of our unhygienic practices. Less people are getting sick in our village now and we have to spend less on doctors.’

Sources: Dawn newspaper; Unicef; WHO