The other day my husband stated in an exasperated voice: “So, you got an advanced degree and you work in schools in sub-Saharan Africa and South America yet all you talk about are toilets. Isn’t that a waste of your education? Shouldn’t you be spending your time figuring out how to improve student achievement?”
Well, it jolted me for a few seconds and then I responded—but that’s what I am doing! It’s taken me years to understand that, yes—high quality teaching and strong school leadership will lead to improved student learning outcomes—but the school’s physical learning environment—the conditions for learning come first. Sanitation and nutrition are the foundation for learning and that’s why I have taken hundreds of photos of bathrooms and kitchens in schools around the world– so I can focus on student learning. Maybe my understanding of the importance of good sanitation and healthy children –washrooms and kitchens– is a key reason I did get degrees in education.
Over the last few years of working in mostly low-fee private schools in low and middle-income nations, I’ve come to understand that you can’t have a school with students successfully learning, without having a school with clean toilets. Of course, the corollary is not necessarily true, clean toilets do not equal improved learning. But, I am sure that each child and adult in a school having access to toilets that are clean, and in sufficient number for enrollment, is a basic condition for improving student learning. And by clean, at a minimum I mean– they don’t smell, there isn’t exposed dirty paper and there are no flies.

According to UNICEF – In 60 countries in the developing world, more than half of primary schools have no adequate water facilities and nearly two thirds lack adequate sanitation. Unsafe water, inadequate sanitation and lack of hygiene not only affect the health, safety, and quality of life of children; they also claim the lives of an estimated 1.5 million children under the age of five who die each year from diarrhea.
The research is clear. Schools with better sanitation facilities report higher attendance and overall better health for children. We know that providing better water, sanitation and hygiene services in schools reduces hygiene-related diseases and can help curb absenteeism due to missing school because of diarrhea. We also know that girls are reluctant to continue their schooling when toilets and washing facilities are either unavailable or are not private, safe, and clean.
According to the United Nations and UNICEF, one in five girls of primary-school age are not in school, compared to one in six boys. One factor accounting for this difference is the lack of sanitation facilities for girls reaching puberty. The installation of toilets and latrines may enable school children, especially menstruating girls, to further their education by remaining in school (see our March 2018 blog). If girls at puberty do not feel safe by having access to a private toilet area and if we do not provide access for students with disabilities, then absenteeism increases.
I’ve visited many schools that are oases for children. In far too many cases schools

are surrounded by extreme poverty, thus all types of services such as good roads, adequate drainage, easily available clean
drinking water, etc. are missing. Schools and the adults working in them are role models for youth and sanitation is key because poor sanitary conditions can lead to disease and minimal learning.
So, what can school leaders do to ensure that children and adults in schools are learning and teaching in sanitary conditions?
Here are some of the strategies we discussed with school leaders and trainers during a recent workshop:
- Make the School Leadership Team (Head Teachers, Directors, Coordinators, Proprietors, and others) aware of the importance of water, sanitation and hygiene in schools. They have an important role to play through their work with teachers and other staff, schoolchildren, and families. Provide guidance and support so that they can promote the development and maintenance of a healthy school environment.
- Find out if your country has school facility standards (E.g., Ghana, Peru, and Rwanda have guidelines while Burkina Faso and Liberia do not.). Usually the standards are posted on the Ministry of Education’s website or ask your local district supervisor. If standards do not exist here is a great resource: Water, Sanitation and Hygiene Standards for Schools in Low-cost Settings http://www.who.int/water_sanitation_health/publications/wash_standards_school.pdf
- Create a School Improvement Plan that includes setting targets for water, sanitation and hygiene. If you can’t make all the changes immediately, prioritize the improvements and phase them in so that the most urgent problems are targeted immediately, and other changes can subsequently be phased in.
- Provide sanitation and hygiene training and supervision to all adults. Staff training is crucial and the goal is a healthy school environment. Since teachers and other staff are role models for students, be sure to give these topics a central place in in-service teacher training.
- Develop and enforce school sanitation rules and procedures. Once the washrooms and toilets are ready for use create a maintenance plan and be sure to regularly monitor the facilities. Assign someone (or a group) to be responsible for daily cleaning; include who is responsible when the sink or toilet are not working or if there are problems with the water.
- Support the provision of consumables, such as soap.
- Encourage parents to support these efforts. Work with the Parent-Teacher Association and provide parent education programs on hygiene, nutrition and sanitation.
- Partner with community groups or NGOs to build water and toilet facilities for the students and the surrounding community to use.

Separate toilets for boys and girls
Every child—and teacher— has a right to a school with clean water and sanitary toilets!

Once the basic conditions for learning are ensured, then we can focus on why we are at school—to optimize learning.