Of the 600,000 children under five years of age who die from diarrhea each year, 88% of these deaths are due to poor hygiene practices, according to Therese Dooley, senior advisor, UNICEF.

“We need to prevent disease, not treat it,” explained Dooley. “It starts with hand washing with soap and sanitizer. One dollar spent on sanitation has a $5-7 return.”

She explained that 768 million people don’t have access to water; 2.5 billion lack access to a proper toilet and one billion people defecate in the open, primarily in sub-Sahara Africa and Southeast Asia. Bangladesh, for example, loses 6% of its GDP every year due to poor hygiene.

“The poorest 40% of the population in Southeast Asia have barely benefited from any improvements in sanitation.”

To combat the problems, in 2008, UNICEF designated October 15 as International Handwashing Day. The event is now recognized in more than 70 countries and is supported by a wide range of companies and associations, including the American Cleaning Institute. Their efforts are working. In the Philippines, through the Fit for School program, absence has been reduced more than 27% and heavy worm infestation has declined nearly 50%. And much of the program’s success is due to straight talk about the importance of proper hygiene.

“We’ve stopped sanitizing sanitation,” she said. “Now, we talk shit!”