Indonesia has a massive problem of open defecation. The WHO/UNICEF JMP reports estimates that there are around 55 million people practicing open defecation in the country, or one quarter approximately of the population. This is the second highest country total, after India. Open defecation is mostly by the poorest populations and they bear the heaviest burden. Children – already vulnerable and marginalized - pay the highest price in respect of their survival and development. This well-established traditional behaviour is deeply ingrained through practice from early childhood. Other reasons, from local KAP work, include poverty, landlessness, tenants in housing without toilets (usually urban), and deep rooted cultural and social norms that have established open defecation as acceptable practice.

Every year between 136,000 and 190,000 children still die in Indonesia before they can celebrate their 5th birthday (from Levels & Trends in Child Mortality – 2014 Report.  Estimates developed by the UN Inter-agency Group for Child Mortality Estimation). This means that every hour between 15 and 22 children die in Indonesia – in most cases from preventable causes linked to diarrhoea and pneumonia which can be drastically reduced by good sanitation and hygiene. In addition, Indonesia has almost nine million children affected by stunting. Stunting has lifelong effects that manifest physically, economically, and socially. Many stunted children also show impaired cognitive ability and perform less well than their peers at school.

The Government of Indonesia’s STBM (Sanitasi Total Berbasis Masyarakat or Community-based Total Sanitation) program, with technical support from UNICEF, has focused on the need for stronger interpersonal approach to generating and sustaining demand in rural Indonesia around five key WASH issues: use of toilets, washing hands with soap, safely storing and handling drinking water and then solid and liquid waste management. Such initiatives, especially at the community level where the entire community together realizes the need can lead to rapid acceleration in sanitation and hygiene. But this needs intensive follow-up at ground level, as UNICEF has seen from our work in Papua, NTT, South Sulawesi. Progress is being made but we all need to do more to ensure that all children are born into an environment that will not contribute to them being stunted; where they will no longer suffer from repeated episodes of diarrhoea; and where girls will be free from harassment and embarrassment as they enter puberty. Using a clean, working toilet is about health and also about dignity.

UNICEF has organised a social media campaign aimed at raising the most powerful voice of the nation: the voice of youth.  The campaign is called Tinju Tinja in the local Bahasa language and means literally Punch-the-Poo. This was launched on World Toilet Day, November 19 2014, in both Bahasa and English, by Indonesian rock star Melanie Subono.  It was preceded by a teaser phase that introduced the ‘Ninja Tinja’ or Poo Ninja character who threatens the health of the children in Indonesia.  The idea is through the urban youth, the majority of whom will already use a toilet, to create an active layer of advocates who can speak out to stop open defecation, further disseminate the message and influence their communities, families and decision makers to do the same. Collectively this voice can stimulate the creation of a new social norm - an Indonesia where nobody accepts open defecation and everyone uses a toilet.

Thus, the task is to create noise that makes the nation sit up, take notice and join the efforts to make Indonesia Tinja-free. Ultimately it is about realizing that everyone is affected by open defecation - whether you use a toilet or not!  After two months the campaign videos have already been viewed over 30,000 times and Twitter impressions have reached over 450 million so the message is getting out there! To know more about the Tinju Tinja campaign, see the infographics and background stats and take action for sanitation, please visit www.tinjutinja.com.

Aidan Cronin is the Chief of UNICEF's WASH programme in Indonesia.