What Is the Least Sanitary Country in the World?

Understanding "Sanitary": More Than Just Clean Streets

Sanitation isn’t just soap and water

When we talk about a country's sanitation, we’re talking about access to clean water, proper sewage systems, waste disposal, and hygiene practices. It's a whole system. A shiny airport bathroom doesn’t mean much if rural areas have no toilets at all.

Key global sanitation indicators

Organizations like WHO and UNICEF track sanitation through the Joint Monitoring Programme (JMP). They look at things like:

• Percentage of population with access to basic sanitation

• Open defecation rates

• Access to handwashing facilities

• Water quality and availability

Sounds dry? Sure. But this stuff literally decides whether kids live past age five in many parts of the world.

So... what’s the least sanitary country then?

The uncomfortable answer: South Sudan

According to data from the JMP, South Sudan often ranks at the bottom when it comes to sanitation. Only about 10% of the population has access to basic sanitation. That’s... shocking.
To put that in perspective, over 60% of people in South Sudan practice open defecation—which means no toilet at all. No pit latrine, nothing.

And it’s not just that. Many communities don’t have regular access to clean drinking water. Combine that with seasonal flooding and conflict, and you've got a recipe for cholera, dysentery, and waterborne disease outbreaks on the regular.

(Actually, I almost went with Chad or Central African Republic at first, because the stats there are pretty dire too—but South Sudan really stands out in most reports.)

Why is sanitation so poor in some countries?

Conflict and instability

You can’t build water infrastructure when there’s a civil war going on. South Sudan has been in and out of violent conflict since its independence in 2011. Governments change, aid stops and starts, roads get destroyed. Sanitation? Not a priority when survival’s at stake.

Poverty and funding gaps

Even when there’s peace, building toilets and treatment plants isn't cheap. Many governments rely heavily on NGOs and international donors to even get the basics in place. And maintenance? Yeah, that’s a whole other issue.

Cultural factors and education

In some communities, open defecation is not seen as a major problem. It’s what people have always done. Changing habits takes time, trust, and education — not just infrastructure. And some attempts to "fix" things by outsiders have failed precisely because they didn’t respect local traditions.

The real-world impact of poor sanitation

Health risks are just the beginning

Dirty water kills — no exaggeration. Diarrheal diseases are among the top killers of children under 5 in poorly sanitized regions. One small infection, if untreated, can snowball into fatal dehydration.

But poor sanitation doesn’t just make people sick. It keeps girls out of school (no toilets = no privacy during menstruation), reduces economic productivity, and honestly... it just kills hope. It traps communities in a vicious cycle.

Personal story: Visiting a village without toilets

A friend of mine, Ana, volunteered in a rural part of Sierra Leone (which also has pretty bad sanitation stats). She told me how every morning, kids would go off into the bush to relieve themselves. No toilets. No handwashing station. Just nature.

And yeah, they got sick — often. But what really struck her was how normal it felt to them. They weren’t lazy. They weren’t dirty. That’s just the system they were born into.

Can this be fixed? (Well, kinda.)

There are success stories

Countries like Bangladesh and Cambodia, which once had poor sanitation, have made big improvements through consistent public health campaigns and low-cost latrine projects. It takes time. But it’s doable.

But it won’t happen overnight

The least sanitary country today could look totally different in a decade — if peace holds, funding arrives, and people on the ground get support. But yeah, it’s a long, messy road.

And hey, maybe instead of just pointing fingers, we should think about how global inequality shows up in something as basic as a working toilet.

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