TODAY, I weigh in on a most disgusting topic, a problem that stinks literally and metaphorically to high heavens for a definitive solution.

According to 2008 UN figures, roughly 19 million Filipinos defecate in the open, like unto a water body, behind bushes or into the hole in the ground of an outhouse. Recently in 2020, however, a news item bemoaned that an estimated 50 million Filipinos, to use a euphemism, do not have access to sanitary toilets.

It’s such a shameful figure to accept that my initial reaction was one of disbelief. But when I did the math, I easily realized that even if the figure errs on the plus side by 50 percent it still leaves 25 million Filipinos defecating in the open. It made me wonder what happened to the Zero Open Defecation Program the Department of Health (DOH) launched in 2010.

The program’s avowed objective is to eliminate open defecation by 2022. Its medium-term objective is for 60 percent of all barangays to have zero open defecation by 2016. But today in Cebu City alone, does it look like there’s even one barangay that has reduced open defecation to zero? Maybe more than one but definitely not 60 percent of all Cebu City barangays.

In October 2010, the DOH published a Guidebook for a Zero Open Defecation Program. It’s an expertly written document that makes for sophisticated reading. Unfortunately, it widely misses its mark.

Its two-pronged strategy consists of: 1) toilet bowl distribution and hygiene education; and 2) centralized sewerage systems. My question is: If you give a toilet bowl to a family living (or trying to eke a living) in a one-room shanty, where will they put the bowl? Even if, by a miracle of sorts, they find a place for it, how can it be sanitary without running water?

How can you talk of central sewerage systems when millions of households have no running water? What good will education do when poor families do not have the wherewithal to implement the best of intentions gained from hygiene education?

To achieve zero open defecation, the most basic prerequisite is for poor families to have decent housing and running water. Without these fundamentals, no sanitary toilet is feasible even with the best of hygiene education.

There is a lot of talk about a new normal in the country’s public health system. I hope our legislators and DOH realize that no vaccine can eliminate the vulnerabilities (to future pandemics) that lack of decent housing and running water causes among the poor.

And if we can spend billions for world-class superhighways, bridges and airports, not to mention weapons to protect the assets of the rich (the poor have no assets to protect), why can’t we spend billions for decent housing and running water and so eliminate open defecation?