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.