After the fall of the Roman Empire, Europeans despised all things Roman, including bathing. There was a widespread belief that getting wet caused illness. This contempt and fear of bathing persisted through the Dark Ages. Some Europeans defied local customs by bathing, but this was usually done over great protest. When Queen Elizabeth bathed, her servants panicked, fearing she would become ill and die.
This resistance to bathing was brought across the Atlantic to America, influencing habits all the way into the 1800s. In 1835, Philadelphia almost passed an ordinance forbidding wintertime bathing. Ten years later, Boston did outlaw bathing, except by medical directive. (Though this law was not widely enforced, it does illustrate the American resistance to bathing as late as the mid 1800s.)
Before plumbing was widely used, indoor facilities consisted of a washstand and a washbowl, a pitcher, and a chamber pot or commode. Human waste was thrown into the street or anywhere convenient.
This total lack of sanitation in urban areas filled with rats and other vermin provided the perfect environment to spread disease. The Black Plague alone killed 75 million – 200 million people – including 1/3 of Europe’s population. Though this disease is not entirely eradicated, human infection has become a rare occurrence. The last plague epidemic in America was in the early 1900’s.
Polio thrives in fecal matter and is easily transmitted through human waste. Plumbing and water sanitation in India is way behind the rest of the industrialized world. In areas where sanitation and hygiene are good, polio is rare. In areas where sanitation and hygiene are poor, the disease can spread rapidly.
Immunization efforts have received a lot of publicity and have garnered most of the credit for India being declared “polio free” by the World Health Organization. As recently as 2009, India reported 762 cases of polio, and at that time, these numbers made India the polio capital of the world. In 2014, there are currently no “official” documented cases of polio, but without proper sanitation there is no way this can last.
India is the second most populous nation in the world, with an estimated population of 1.2 billion. Currently, 780 million Indians do not have a toilet; 96 million Indians do not have access to clean drinking water. In rural areas, open defecation is still more common than attempting to dispose of human waste in a more sanitary fashion, such as burying it.
There have been some efforts to improve sanitation, but they pale in comparison to the extensive efforts to vaccinate Indians. Over 9 billion has been spent in this vaccination public health campaign.