One billion people worldwide still practice “open defecation” and they need to be told that this leads to the spread of fatal diseases, U.N. experts said Thursday at the launch of a study on sanitation and drinking water.

” ‘Excreta,’ ‘feces,’ ‘poo’ — I could even say ‘s—t,’ maybe — this is the root cause of so many diseases,” said Bruce Gordon, acting coordinator for sanitation and health at the World Health Organization.

Societies that practice open defecation — putting them at risk from cholera, diarrhoea, dysentery, hepatitis A and typhoid — tend to have huge income disparities as well as the world’s highest death rates among children under age 5.

Attempts to improve sanitation among the poorest have long focused on building latrines, but the U.N. says those funds went down the toilet. Attitudes, not infrastructure, need to change, it cautioned.

“In all honesty, the results have been abysmal,” said Rolf Luyendijk, a statistician at UNICEF. “There are so many latrines that have been abandoned, or were not used, or got used as storage sheds.

“We may think it’s a good idea (to use latrines), but if people are not convinced that it’s a good idea . . . they (effectively) have an extra room (worth of space).”

Many countries have made great progress in tackling open defecation, with Vietnam and Bangladesh — where more than 1 in 3 people relieved themselves in the open in 1990, according to estimates — virtually stamping out the practice entirely by 2012.

The global number has fallen from 1.3 billion in 1990. Still, some 1 billion people — 90 percent of them living in rural areas — “continue to defecate in gutters, behind bushes or in open water bodies, with no dignity or privacy,” the U.N. study said.

The practice is still increasing in 26 countries in sub-Saharan Africa. Nigeria was the worst offender, with 39 million open defecators in 2012, up from only 23 million in 1990.

Among other data reported, 14 percent of the population in the Democratic Republic of Congo are open defecators, but when the head of the household is an Animist, the figure is twice as high, at 30 percent. As for households headed by Jehovah’s Witnesses, the rate is only 9 percent.

Although the prevalence of open defecation is in decline, it is often common in fast-growing populations, so the total number of people practicing it is not falling so fast, or is even on the rise, the study warned.

The country with the largest number of public defecators is India, at around 600 million practitioners. India’s relatively “hands off” approach has long been at odds with the more successful strategy of neighboring Bangladesh, which has put a big focus on fighting waterborne diseases since the 1970s, Luyendijk, the UNICEF statistician, said.

“The Indian government did provide tremendous amounts, billions of dollars, for sanitation for the poorest,” he said.

“But this was disbursed from the central level to the provinces and then all the provinces had their own mechanisms of implementing. And as their own data showed, those billions of dollars did not reach the poorest,” he explained.

India’s government has now woken up to the need to change attitudes to defecation, he said, having launched a “Take the poo to the loo” campaign that aims to make open defecation unacceptable.

The drive is helped by a catchy YouTube video, at www.youtube.com/watch?v=_peUxE_BKcU. As of Friday afternoon, the video had racked up nearly 288,000 views and over 1,800 “likes” on the website.

“What is shocking in India is this picture of someone practicing open defecation and in the other hand having a mobile phone,” said Maria Neira, director of public health at the WHO.

Making the practice unacceptable has worked in more than 80 countries, according to the United Nations. The goal is to eliminate the practice entirely by 2025.

And poverty is no excuse, the study said, noting the role of cultural differences.

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