For millions of women across Bangladesh, the simple act of drinking water before leaving home has become a daily calculation shaped not by health needs, but by the fear of not finding a safe toilet.
From university students and office workers to field-level health staff, women are routinely limiting water intake, delaying urination and restricting movement because of the chronic shortage of clean, secure and women-friendly public toilets -- a reality experts warn is creating a silent public health crisis while undermining women’s participation in education, employment and public life.
At 8am every day, University of Dhaka student Saima Alam leaves home carrying a water bottle. Yet she consciously avoids drinking too much.
“While I am outside, I intentionally drink less water because there is no guarantee that I will find a clean and safe toilet when needed,” she said.
Private-sector employee Shahana Alamgir described similar struggles during meetings, field visits and long commutes.
“Many times toilets are available, but they are not usable or safe. During menstruation, when access becomes even more urgent, suitable facilities are often unavailable,” she said.
The problem extends far beyond Dhaka.
In Jashore, community health worker Sheuli Sarker said women working in unions and upazilas often spend hours searching for usable toilets or relying on shops and offices for access.
“In many markets, bus terminals and public places there are either no toilets or they are poorly maintained,” she said.
The experiences reflect a broader sanitation gap affecting urban Bangladesh, where rapid urbanization has far outpaced investment in public sanitation infrastructure.
According to the latest census, nearly 40% of Bangladesh’s population now lives in urban areas.
Millions travel daily for work, education, healthcare and business, yet access to public toilets remains severely limited.
Data from WaterAid Bangladesh shows Dhaka, a city of nearly 20 million people, has only 137 public toilets.
Many are non-functional, poorly maintained or lack facilities suitable for women.
Even where facilities exist, concerns over safety, cleanliness, water supply, broken locks and inadequate menstrual hygiene facilities often discourage use.
A 2025 WaterAid study involving 865 urban women found that many deliberately reduce water intake outside the home because they are uncertain about toilet access.
The findings reveal the scale of the problem: 89% of marginalized urban women lack access to women-friendly sanitation facilities, while 93% lack adequate menstrual hygiene management facilities.
Health experts say the consequences are far more serious than temporary discomfort.
Associate Professor Dr Tanvir Al-Misbah, a urology specialist, warned that chronic dehydration and delayed urination can significantly increase the risk of urinary tract infections (UTIs), bladder complications and kidney problems.
“When a person does not drink enough water, urine becomes concentrated and the risk of infection rises,” he said.
“More than half of women experience at least one urinary tract infection during their lifetime.”
Gynecologist Dr Afroza Gani said the problem becomes even more severe during menstruation, when many women struggle to find places to change or safely dispose of sanitary products.
“Many women remain dehydrated for long periods because they are afraid they will not find a suitable toilet,” she said.
“We regularly see patients whose health problems are linked to insufficient water intake and delayed urination.”
The impact extends beyond health.
Experts say inadequate sanitation infrastructure effectively limits women’s mobility, affecting their ability to study, work, travel and participate fully in public life.
Professor Salma Akhtar of the Sociology Department at the University of Dhaka said simply increasing the number of toilets is not enough.
“Women-friendly infrastructure must include security, proper lighting, clean water, sanitary waste management, childcare support and female attendants,” she said.
She argued that such facilities should become standard at bus terminals, railway stations, markets, parks and major commercial centres.
Some progress has been made.
According to project data, around 48 modern public toilets have been established in six major cities and railway station areas through partnerships involving local authorities and development organizations.
One example is “Ananya,” a women-only public toilet at Mohakhali Bus Terminal that includes drinking water facilities, sanitary pad vending machines, breastfeeding corners, childcare support and disability-friendly access.
Government officials say more such projects are planned.
However, experts warn that until safe sanitation becomes a basic urban service rather than an exception, millions of women will continue paying a hidden price -- with their health, mobility and opportunities.
For many women, the country’s public sanitation crisis is no longer just an infrastructure problem.
It is a barrier to equal participation in everyday life.
