Romania: an Analysis of Health Challenges and Their Impact on Health and Education

Article text

Romania still ranks among the top in the European Union in terms of lack of access to adequate toilets and sanitation facilities, especially in rural areas. According to Eurostat data and other European reports, a significant percentage of Romania's population, especially in rural areas, does not have access to modern toilets connected to sewerage networks. This situation places Romania among the countries with the greatest deficiencies in this area in the European context.

In the context of the Sustainable Development Goals (SDGs) set by the United Nations (UN), Romania must intensify its efforts to ensure universal access to clean water and sanitation by 2030, a key commitment for the country's sustainable development. Investments in modernizing the sanitation infrastructure are not just a fad and not just an immediate necessity, but a foundation for a healthier and more equitable future for all Romanian citizens.

The UN has established World Toilet Day on November 19 to highlight the importance of universal access to safe and hygienic toilets. The day aims to raise awareness of the need for adequate sanitation for all people worldwide.

Almost half of Romanians have a toilet in their backyard

In 2023, Romania faced significant challenges in terms of access to modern sanitation infrastructure. Data published by the National Institute of Statistics (NIS) indicated that 11.4 million Romanians had their homes connected to sanitation systems in 2023, which represents only 60.1% of Romania's resident population. In terms of development regions, the highest share of the population connected to these systems was in the Bucharest-Ilfov region, with 95.4%, followed by the Centre region, with 72.7%, and the West region, with 71.9%. In contrast, the lowest levels of connection were in the North-East (40.3%), South-Muntenia (41.8%) and South-West Oltenia (51.7%) regions. This situation underlines the urgent need to improve health infrastructure, especially in rural areas.

Schools with toilets in the playground

According to an announcement made by the Minister of Education, Ligia Deca, in September this year, the number of schools in Romania that still use toilets in the schoolyard has been significantly reduced, from more than 220 in April to 70 in September 2024, Edupedu.ro reported. This reduction was made possible by the allocation of funds for modernization, with 50 schools to receive funding to improve the sanitary infrastructure. However, 20 schools remain that are on private land or already involved in other programs, which complicates the modernization process. The county of Vaslui is an emblematic case of Romania's sanitary infrastructure problems, reports Scoala9.ro. In this region, the lack of access to sanitation and modern sanitation facilities is particularly acute, affecting many schools.

Specifically, Romania in 2024 is still facing the challenge of schools using toilets located in the courtyard, especially in Vaslui county, where numerous such facilities have been identified, journalists report. This county has the highest number of ongoing projects to modernize toilets, with 43 initiatives in the works. The journalists' visit to schools in Vaslui revealed glaring discrepancies between modern facilities (such as smart boards) and inadequate basic facilities (such as latrines in the yard).

One of the schools visited, located in Valea Mare, does not even appear on Google Maps and illustrates the difficulties these communities face. Here, the opening festivities of the new school year underlined local optimism and pride, contrary to the precarious conditions.

Despite significant investments made through state budget funds, including allocations through the National Recovery and Resilience Plan (PNRR), modernization of health infrastructure remains a slow and complex process. In many communities, low birth rates and high out-migration are contributing to low enrolment, raising questions about the viability of long-term investments. Local mayors face difficulties in securing the necessary funding and complying with bureaucratic requirements, such as obtaining authorizations from the Directorate of Public Health (DSP) and the Inspectorate for Emergency Situations (ISU). In order to meet the required standards, some schools have resorted to temporary solutions, such as installing toilets in containers, although these do not always meet the requirements of being located inside the building. In other cases, attempts are being made to convert some classrooms into toilets, but funds remain insufficient to fully modernize the infrastructure.

The problem of substandard toilets is not just a logistical one, but directly affects the educational experience of students. In many cases, sanitary conditions in schools are better than at home for some pupils, highlighting persistent social inequalities. Although significant funds have been allocated to address these shortcomings, implementation remains a complicated process and local communities have to navigate between priorities and limited resources.

Impact on health and education

The lack of modern toilets in some of Romania's rural schools has a considerable negative impact on health and education.

Inadequate sanitary conditions, such as lack of access to running water and sanitation, increase the risk of spreading infectious diseases such as gastroenteritis, parasitic infections and skin diseases. Pupils are also exposed to unhygienic environments on a daily basis, which can lead to frequent illness and school absenteeism. These health problems affect not only pupils, but also their families and, consequently, the entire social fabric of the community.

The embarrassment and discomfort associated with using inadequate toilets can cause students to avoid school. This is particularly problematic for adolescent girls, who may miss school during menstruation due to lack of adequate sanitation facilities. Frequent absences may lead to gaps in education and lower academic performance, thus affecting students' chances of continuing their education and accessing better opportunities in the future.

Poor conditions can undermine pupils' motivation to learn and affect their self-esteem. When pupils do not have access to a school environment that provides basic comfort and security, it can lead to demoralization and disinterest in education. In addition, feeling neglected or marginalized can have long-term negative effects on their personal and professional development.

Efforts to provide quality education are severely undermined by a lack of adequate sanitation infrastructure, reports Scoala9.ro. Even in schools that benefit from modern educational technologies, such as smartboards, the impact of these investments is diminished if they are not accompanied by adequate sanitary conditions. A healthy and safe learning environment is essential to support students' academic performance and holistic development.

Comparison with other countries

Germany is a success story in terms of sanitation infrastructure, thanks to rigorous planning and consistent investment over decades. Sewerage connection rates of over 99% reflect a systematic and integrated approach to water and waste management. Public policies are geared towards ensuring universal access to modern facilities, and continued investment ensures that sanitation networks are maintained and expanded. This not only improves public health but also contributes to a high standard of living and a robust economy.

At the other extreme, in sub-Saharan regions such as Nigeria, access to health facilities remains extremely limited, with only a small fraction of the population benefiting from improved infrastructure. This shortfall contributes to serious public health problems, including the rapid spread of infectious diseases, and affects overall quality of life. International and national efforts are focused on expanding access to piped water and sanitation, but progress is often hampered by financial and infrastructure constraints.

November 19: World Toilet Day

World Toilet Day, marked on 19 November, was established by the United Nations to draw attention to the importance of access to safe and hygienic toilets for all people. This day emphasizes the connection between sanitation, public health and human dignity, and reminds us of the urgent need to address the global sanitation infrastructure challenges.

Access to adequate sanitation is important for preventing disease, improving health and quality of life. Without them, millions of people worldwide are at increased risk of infectious diseases, malnutrition and other health problems. This problem disproportionately affects women, children and people in poor and remote communities, where lack of adequate sanitation infrastructure contributes to perpetuating cycles of poverty and inequality.

This day aims (a) to raise awareness about the importance of toilets and sanitation for public health and sustainable development. It is an opportunity to educate the public about the impact the lack of safe toilets has on health, education and the economy; (b) to encourage governments, international organizations, NGOs and individuals to take concrete action to improve sanitation infrastructure. These actions are essential to ensure universal access to safe toilets and to meet UN Sustainable Development Goal 6 (SDG 6); (c) another important objective is to fight stigma and taboos related to discussions on toilets and sanitation. Open discussions and education are also essential to transform perceptions and encourage innovative and sustainable solutions; (d) to stimulate investment in sanitation infrastructure and innovative solutions. It is important to allocate significant financial resources for the development and maintenance of water and sanitation systems, especially in disadvantaged communities.

In other words, World Toilet Day reminds us how essential sanitation is to the health and well-being of all, and urges us to take action to make access to safe toilets a reality for all. In a world of increasingly rapid technological and economic progress, ensuring universal access to adequate sanitation is not only a matter of public health, but also of social justice and human dignity. This day calls us to join forces, innovate and invest in solutions to ensure that every person enjoys the fundamental right to safe and dignified sanitation.

SDG 6: Clean water and sanitation

The United Nations (UN) and UNESCO (United Nations Educational, Scientific and Cultural Organization) recognize access to adequate toilets and sanitation facilities as essential for human health, dignity and development. This issue is addressed in the Sustainable Development Goals (SDGs), adopted by the UN in 2015, which set a global agenda to eradicate poverty and ensure a life of dignity for all by 2030.

SDG 6 is dedicated to ensuring availability and sustainable management of water and sanitation for all. Some of the specific targets of this goal include ensuring universal and equitable access to safe and affordable drinking water for all and ensuring access to adequate and equitable sanitation and hygiene for all, with a particular focus on the needs of women and girls and those in vulnerable situations.

The UN also emphasizes that lack of access to adequate toilets and sanitation facilities can lead to serious health problems, loss of dignity, and can affect education and economic participation, particularly for women and girls. In many parts of the world, the lack of safe and private toilets contributes to public health problems, such as the spread of water-borne diseases and poor sanitation.

UNESCO, part of the UN, also emphasizes the importance of adequate sanitation facilities in schools, recognizing that they are essential to ensure a safe and healthy learning environment. Lack of access to decent toilets in schools can affect the attendance of students, especially girls, who may avoid school due to lack of privacy and unsanitary conditions. UNESCO supports initiatives that improve access to water and sanitation in schools as part of a broader effort to ensure quality education for all.

UN, through UNESCO, is promoting an integrated approach to address water and sanitation issues, recognizing the close link between access to safe drinking water, adequate sanitation and health, education, and economic development. Through the SDGs, these organizations aim to mobilize governments, the private sector and civil society to overcome water and sanitation challenges and to ensure that every person has access to these essential resources for well-being.

Solutions and recommendations

In order to remedy these problems, Romania, i.e. its leaders, should prioritize investments in health infrastructure, learning from the positive examples of Western countries:

• Increased funding for the development of sewerage networks and modernization of sanitation facilities in schools, with a focus on rural and disadvantaged areas;

• Implementing educational programs that emphasize the importance of hygiene and health for students, parents and community members;

• Public-private collaborations to finance and implement health infrastructure projects using innovative technologies and green solutions;

• Adopt modern solutions such as eco-friendly toilets and water filtration systems to ensure access to adequate facilities even in remote communities.

And the most important thing above all of the above is to have, at a collective level, real interest in such pressing issues.