To find a person defecating in a river in Bali is not a difficult task. Many can be seen doing so, or washing their clothes, along the banks of the Tukad Badung River, which flows through the centre of Denpasar.
The same can be seen in relatively smaller rivers as well.
One of the main causes for this is people's proximity to the rivers. In north Denpasar, for example, people build houses along the riverbank, with many of them built over the water.
The Bali Health Agency recorded that to date, 12 per cent of the island's people has no access to toilets for sanitation. They rely on conduits, rivers or even gardens to defecate.
In Karangasem regency, only 61 per cent of people has access to toilets; the lowest number in Bali. Bangli follows with 76 per cent.
"Around 88 per cent of people has access to latrines," said Ni Wayan Yogianti, the agency's environmental restructuring head, on Tuesday. Yet, the provincial administration did not hold any programs during World Toilet Day, which fell on Tuesday.
Yogianti said that although Karangasem had the lowest incidence, the number was increasing from year to year. Last year, half of the regency's residents had no access to toilets, she said. "The highest number is in Kubu district."
According to Yogianti, a healthy toilet requires access to water and is located a minimum of 10 meters from a water source, with the availability of closets and septic tanks.
The agency revealed that a high number of diarrhoea cases were related to bad sanitation. By August, around 28,000 people had been affected. In 2012, more than 63,000 people were recorded as suffering from diarrhoea.
Most of these cases were apparently in the city. Denpasar had the highest number of diarrhoea cases, with 4,895 people. Gianyar and Karangasem followed.
Diarrhea is included in the 10 main diseases treated in the province's community health centers (Puskesmas) and hospitals. Others include acute respiratory tract infection, allergies and skin infections.
The agency holds that diseases caused through bad sanitation would increasingly threaten the island's citizens in the future as they were closely related to environmental quality.
Meanwhile, the agency's head, I Ketut Suarjaya, said that clean water supplies and groundwater quality were also important issues to be monitored. He said that many factors were degrading groundwater quality, such as seawater intrusion and household wastewater.
"Many households are still without proper wastewater management," Suarjaya said.
The agency recommended that septic tanks be covered with hard material and located as far as possible from the house to reduce the possibility of groundwater pollution. Around 18 per cent of households in Bali do not following this recommendation.
Citizens in Bali nowadays are relying more on packaged water. According to the province's environment agency's data in 2011, 35 per cent of people chose packaged water, followed by spring water (23 per cent), tap water (22 per cent), wells (15 per cent), rainwater (4 per cent) and rivers (2 per cent).
Reliance on packaged water was expected to rise in the near future.