Around the world, 2.3 billion people do not have access to a decent toilet – that’s 1 in 3 of us. The impact of this is huge. Almost 800 children die every day from diarrheal diseases linked to not having clean water or good sanitation. A new report from WaterAid, Out of Order, shows how a lack of sanitation has a disproportionate impact on girls and women.

In Sierra Leone, 6 out of 7 women don’t have a basic toilet; in Ethiopia, 46 million women and girls have nowhere safe to go. India has invested a huge amount into ending its sanitation crisis under the Swaach Bharat initiative, but the U.N. says around half the population is still without a toilet.

Women and girls who don’t have a toilet at home or nearby often have no choice but to relieve themselves the open, perhaps on wasteground or on a railway siding. One is Rahab, 20, who escaped from violence in Borno State, Nigeria, and now lives in a camp in Abuja. She has to go to the toilet in the bush where there are snakes, and where she might also encounter drunk men, putting her at risk of sexual assault.

Women who are too scared to go outside will often use a plastic bag, which they then throw outdoors into the night. The next day, they will pick their way through many other similar plastic bags, which will later split and pollute the areas where children play.

Things are often no better in the daytime. Perhaps they work in a factory where no one has thought to install toilets. Or they are at home caring for children who are often sick because of the many germs to be found in a community without sanitation.

Women have to think before they drink and pause before they eat to avoid having to go to the bathroom again after dark. Dehydrated and hungry, they don’t function as well as they could.

Women worry about how often their children get sick, knowing that, although they feed them as well as they can, their stomachs just aren’t absorbing enough nutrients to keep them healthy.

Those children risk growing up stunted, their physical and mental development below what it would have been if they hadn’t suffered from diarrhea so many times in their young lives.

The impact of stunting will follow them through their lives. Stunted girls grow into underdeveloped women, who are vulnerable to complications during childbirth, and malnourished women are more likely to give birth to smaller babies, starting the whole sorry cycle again.

The day-to-day is hard enough, but life gets harder when women and girls get their periods. Trying to change sanitary products without the comfort of a locking door can be difficult for women, and mortifying for young girls, many of whom decide they just can’t face going to school on those days.

Bringing toilets to a community helps liberate women. A toilet opens the door to better health, education and economic opportunities. Yet WaterAid’s report shows that too many women are still struggling without this basic human right.

The toilet is not a technically innovative solution to a previously unsolvable issue. It is a basic service to address a situation that has been understood for more than 150 years; namely, that water polluted by feces causes potentially fatal diseases.

But, in too many places, there is insufficient political will to invest the sums necessary and give the vital focus needed to solve the problem.

For anyone who argues that this issue is too costly to solve in a world where there are so many competing priorities, here’s a sobering thought. The $450 million price tag on the Leonardo da Vinci painting sold this week would provide toilets for everyone who needs them in Sierra Leone, Liberia and South Sudan.

We just need to value toilets enough to invest in them.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of News Deeply.