"Girls go to the hill behind the school, boys go behind the trash cans," a boy declares solemnly.
"Okay, fine," the girls reply after a brief discussion.
The boys add a warning: anyone entering the other group’s area will get beaten.
One time two years ago a girl had accidentally walked in on the boys while they were relieving themselves. Embarrassed, they chased and hit her until she cried and begged them to stop.
The school's 74 students had the discussion to clearly mark their territory at the beginning of this school year.
For them, this segregation is extremely important.
"We always tell each other not to let the girls catch us," Ho Van Sao, a fifth grader, says.
The World Toilet Organization estimates that every human spends about five years of their life going to the toilet - an average of 5-8 times a day or 2,500 times a year.
For most children at this school in Nuoc Nia village in Son Ha Commune that time is spent outdoors.
What is supposed to be a basic act has become a source of anxiety and embarrassment to the students here, due to the absense of toilets.
According to the Ministry of Education and Training, only 57% of toilets in the country’s schools met national standards in 2022.
Di Lang 2 falls into the group without adequate facilities.
In 2021 the government launched a School Health Program with a target of 100% toilet coverage by 2025.
At its launch, Prime Minister Pham Minh Chinh criticized the habit of labeling toilets as "ancillary works," stressing that sanitation is fundamental to education.
According to UNICEF, lack of sanitation makes children more susceptible to diarrhea, pneumonia and parasitic infections, leading to malnutrition.
Among ethnic minority children, one in three is malnourished and stunted. As a result, when they grow up, they are less likely to achieve high economic performance compared to children who have access to adequate sanitation.
Sao knows nothing about school sanitation, only that his eyesight is deteriorating. Diagnosed with cataract, often linked to hygiene when the afflicted person is not elderly, he needs surgery soon to avoid vision loss.
During recess at Nuoc Nia, girls often gather in groups of three or five behind the hill to watch out for each other and relieve themselves.
If they see a boy in the vicinity, they wait until he leaves before urinating, but sometimes hold it in altogether.
Boys behave similarly, reporting to teachers if girls approach their area. They are also shy with other boys.
Once Sao was accidentally seen by a friend while defecating. That afternoon, after school, the boy called out to the group: "Hey, Sao went... haha."
"Everyone laughed at me," Sao says. He wanted to rush toward his friend and hit him, but restrained himself.
Since then Sao only urinates at school, not wanting to be embarrassed in front of his friends.
He does as his teacher instructed him, going to the toilet at home before coming to school.
But conditions are scarcely better at home.
Sao's hamlet is at the top of a slope where people either climb and breathe heavily or have to twist the motorcycle throttle all the way.
On a small patch of level ground pressed against the mountainside, Sao’s family lives in a shack measuring less than 20 square meters.
The walls are made of flattened bamboo stalk, many already rotting. There are no windows. In the afternoon sunlight slips through the gaps and holes in the walls, lighting up everything inside.
The doorway is just wide enough for one person to pass through. Inside are a torn hammock, a bed, an old two-drawer iron cabinet for clothes, and a cooking area of less than four square meters. There are no toys, and little space to move.
Just behind it stands a makeshift bathroom, patched together from wooden planks and scraps of corrugated iron.
Sao’s father, Dinh Van Nhit, 33, recently bought 500 meters of plastic pipes on credit for bringing water down from a mountain stream.
The bathroom, just two square meters in size, is where the family bathes, brushes their teeth, washes clothes, and carries out personal hygiene chores.
It is also where chickens and fish are slaughtered. Nhit says he thought about building a proper toilet but never had the money.
"People just go into the mountains."
In front of the house the ground drops away sharply. Within a few steps the slope gives way to a deep ravine with a stream running between two mountains.
To defecate Sao carefully makes his way more than 10 meters down the hillside. There, on a small patch of earth just large enough for one person to sit, hidden behind a tree with hand-sized leaves, is the family’s toilet.
There is no water, toilet paper, partition, roof, or waste treatment.
Just beyond it is a sheer drop, meaning a single misstep could send someone tumbling into the boulder-filled stream below.
Human waste seeps into the soil and is carried by rainwater into nearby rivers and streams, whose waters are then used by villagers for bathing, washing and other daily needs.
According to a 2023 UNICEF report, access to safe drinking water and sanitation remains lowest in Vietnam’s rural and remote areas, particularly in the north-central coast and Central Highlands.
Regions with ethnic minority populations consistently record lower levels of access to these basic services.
The Vietnam Multidimensional Poverty Report for 2016-2020 from the Ministry of Labor, Invalids and Social Affairs said 60% of households in Quang Ngai Province lack hygienic latrines, one of the highest rates in the country, and 41% of households rely on unsafe water sources.
As a result, children here are more susceptible to eye diseases, parasites, digestive problems, gynecological diseases, and physical stunting.
While at the end of first grade Sao noticed his eyes were getting increasingly blurry. In class, he could not see the letters on the board, and had to hold the book close to his face.
His teacher alerted his parents, but it was not until third grade that Nhit managed to take his son on the 55-kilometer trip to Quang Ngai City to see a doctor.
Sao was diagnosed with cataract, a condition rarely seen in children. Without timely surgery his eyesight could not be saved, the doctor warned.
Sao’s parents, both laborers, earn around VND5 million (US$190) a month, and do not know when they will be able to afford the operation.
Despite his name—Sao means "star"—his vision continues to worsen.
Many times at night he stumbles as he feels his way down the mountainside to use the toilet. His plastic sandals, with torn straps and worn soles, slip on the wet ground, and his failing eyesight makes it hard to find something to steady himself in the weak beam of a headlamp.
"I don’t want to go to the toilet in the rain and sun anymore," he says quietly.
Dinh Van Nhit once saw a green snake in a tree near the toilet area, and since then, afraid his child would not be able to see critters, accompanies him every time he goes to relieve himself affter dark.
Each time students return to the classroom after relieving themselves, Le Thi Thu Hao, the homeroom teacher of Class 1C, instinctively looks down at their feet.
On several occasions she has seen children sitting at their desks with thin streams of blood running down their ankles. Nearby would be a leech lying curled on the floor, swollen from feeding.
Recently she noticed blood on a boy seated at the back of the room.
"You’ve been bitten by a leech," she told him, instructing another student to carry the leech outside while she applied crushed medicinal leaves to the wound.
The school is in a damp area dense with trees and vegetation close to the mountains, and infested with insects and other creatures.
Since the students relieve themselves in areas that are overgrown with grass and wild plants, leech bites are a frequent occurrence, Hao says.
"It doesn’t hurt much, but it’s itchy.
"The children tremble with fear, but they don’t really know how to express what they’re feeling."
Behind the school, an acacia-covered hill slopes upward, its ground thick with insects and small animals. Leeches, centipedes, scorpions, frogs, toads, and swarms of ants are common, and children risk brushing against snakes hiding in the trees.
Teachers warn of a particularly aggressive species of ant, known locally as the "chicken beak ant," which is about half the length of a finger and has powerful mandibles and a sting as painful as a bee’s.
Some students have been bitten by ants or stung by scorpions and required medical treatment.
Teachers keep insect spray in the classroom, and on one occasion, after noticing children constantly scratching and having swollen skin, staff discovered the class was infested with fleas.
"Every year there are children who cannot hold it in and end up relieving themselves inside the classroom," Hao says.
Some are too shy to ask for permission, particularly when Vietnamese is not their first language.
Hao says when such mishaps happen, the lack of toilets at school leaves teachers with few options, and she often has to dismiss the class temporarily, take the child to a nearby house to wash, and call parents to bring clean clothes.
"The children panic. Afterward they come back ashamed, with their heads down, afraid of being teased."
Over time teachers have learned to read the signs.
Restlessness, lack of concentration, tightly crossed legs, shrinking posture, faces flushed at first and then turning pale, or sudden tears signal distress linked to the need to use toilets.
A 2022 survey on school sanitation conducted by BrandScape WorldWide in partnership with Unilever Vietnam found that 41% of children using substandard toilets suffer physical health impacts, including eye disease, digestive problems, stunting, and gynecological conditions.
The study also found psychological effects in 46% of children, such as bedwetting and reduced self-esteem.
Le Thi Thu Hao, homeroom teacher of class 1C at Di Lang 2 Primary School campus in Nuoc Nia village, often checks the health and hygiene of her students by picking lice or checking for scabies.
Teachers at the Nuoc Nia campus say most of their students suffer from scabies.
Sao’s hands and feet, for instance, are covered with chronic itchy sores.
Intestinal problems, vomiting and eye diseases are also common. Sao and another child have severe cataract and face the risk of blindness without early surgical treatment.
The lack of basic sanitation support affects more than physical health.
Teachers say it also erodes children’s morale and self-esteem, leaving them withdrawn, anxious and afraid to speak up about their most basic needs.
Aware of the embarrassment surrounding toilet use, particularly defecation, teachers often advise parents to have their children do it at home before coming to school.
One teacher regularly buys toilet paper with her own money to share in class. But a few rolls are not enough for 74 students, and most children continue to rely on leaves, as they have been taught since early childhood.
For the teachers and students at the school, the hope of having a proper school toilet remains distant.
The Nuoc Nia campus has five primary classes serving children from some of the most disadvantaged hamlets in Son Ha Commune.
Without it, Hre children would be forced to travel seven to 15 kilometers along steep, dangerous roads, also often threatened by floods and landslides, to attend school.
The campus once had a two-room toilet for boys and girls built many years ago.
But over time the structure fell into disrepair, its doors broken, mold forming across its walls and dirty water from nearby cattle and pig pens pooling around it. There was no water, all its fixtures were destroyed and the path leading to it from the schoolyard deteriorated into a muddy trench.
It is now abandoned.
This year Principal Dinh Thi Dieu Chi submitted three formal requests for assistance to higher authorities—at the start of the school year, after flooding in October and again following a storm in November.
The most recent response was that the school is still waiting for provincial funds to be allocated, she says.
"We just have to wait. That’s all we know."
The situation is not unique.
Some 80 kilometers away, also in Son Ha Commune, Nguyen Huu Mai, principal of Son Nham II Primary and Secondary School, faces the same problem.
His school has 461 students across three campuses.
At the Go Da elementary branch, there is no toilet at all and so its 80 children have to relieve themselves on open ground behind the classrooms.
The school’s repeated requests to the education department for construction and repair funds has received no concrete response.
So its teachers turn to visiting charities, appealing for support whenever the opportunity arises.
According to 2023 data from UNICEF, only 68% of schools across the country have basic sanitation facilities.
The rate for primary schools is 77%, while for secondary schools it is just 61%.
The 2025 deadline for the School Health Program’s ambitious goal of all schools having toilets has come and gone, but thousands of children like Sao continue to relieve themselves outdoors, exposed to the elements.
Sao is his family’s only hope for a better future.
His father is illiterate, his mother studied only up to grade four, and both survive on casual work like peeling acacia bark, digging cassava, picking coffee, and carrying goods for others.
Sao, now in grade five, can read and write.
School is his greatest joy. There, he not only learns to read but also encounters foods he had never known before, such as beef noodle soup and french fries.
At home the meals are usually limited to rice with forest vegetables, instant noodles or a few pieces of tofu with fish sauce.
But that joy is looking increasingly at threat as his eyesight continues to deteriorate and pages become increasingly difficult to make out.
His dream of becoming a soldier has taken him through five grades.
The lucky money from the last two Lunar New Year holidays amounted to VND120,000 ($4.56), which he stuffed into a piggy bank and locked tightly behind the rusty iron cabinet.
That is the child’s sole hope to overcome a destiny of poverty and illiteracy.
He longs for eye treatment so he can continue to pursue his studies.
"I will save money to get my eyes cured," he says.
Story by Hong Phuc, Phung Tien
Photos by Phung Tien
VnExpress's Hope Foundation has launched a program to build new toilets at 15 schools for disadvantaged children in Quang Ngai Province during the current academic year. Its estimated budget is VND3 billion ($114,000), and is expected to benefit nearly 5,000 students and teachers. For further information on the program, click here. |
