With the vast majority of rural Cambodians still lacking access to a toilet, and suffering the incumbent health risks, Ministry of Rural Development officials on Monday renewed long-standing intentions to improve the country’s sanitation infrastructure.

Just days after World Toilet Day, the officials surveyed villages in Kampong Speu province to assess barriers to toilet installation.

“[Villagers] claimed that they prefer open defecation behind their house, in the wild or in the rice fields.… It is difficult to change their minds,” Chhorn Chhoeurn, a deputy at the department of rural health care, said.

Cambodia has the lowest toilet coverage in East Asia, according to UNICEF, with the official census showing that only 23 per cent of rural households have access to a latrine.

The cheapest latrines cost about $25 each, a large chunk of many rural households’ income. Yet latrines provide long-term savings: According to the World Bank, a rural Cambodian family loses nearly $70 annually because of diseases related to poor sanitation and hygiene.

“Essentially, [defecating] outside means eating it; it gets into the water and the food,” Cordell Jacks, co-director of International Development Enterprises’ (IDE) sanitation marketing program, said. “Diarrheal diseases … kill more children than malaria, measles and AIDS combined.”

IDE and other NGOs have partnered with Vision Fund to provide rural families with microfinance loans to offset the cost of installing toilets. The program has seen sanitation access rapidly increase.

“It’s starting to be more of a societal norm to have a latrine,” Jacks said.

To further Cambodia’s 2015 goal to halve the percentage of the population lacking access to sanitation, the Ministry of Rural Development plans to start educational programs in schools and pagodas next year.

“We do not demand they build modern latrines or spend much money, but only buy the cheapest dry latrine,” said Chhoeurn.