The statistics are chilling: 53% of Madagascar’s 20.7 million people defecate openly every day while another 33% use dilapidated, unsafe toilets. The under-5 mortality rate of is one of the highest in the world, at 72 deaths per 1,000 children. One-fifth of these deaths are caused by diarrhoea, causing great personal anguish for families, straining health care systems, and stretching pocketbooks filled with a per capita income of just US$ 488 per year. In Madagascar, open air defecation leads to a loss of an estimated US$ 65 million per year.
