"Jesus wants you to build a toilet for the women," I told Pastor Barry in my best broken Tok Pisin. Normally I feel a bit annoyed when people make Jesus the poster child for their personal cause. I remember, for example, the billboard in Atlanta a few years ago that showed a picture of a cherubic Jesus and stated "Jesus was a vegetarian." I laughed nearly every time I saw it.

But Pastor Barry wore a baseball cap that sported the phrase "Jesus is my boss", so I figured I had his attention.

We were sitting on a bamboo bench on Petats Island in Papua New Guinea. A refreshing sea breeze rustled the coconut palms and mango trees. The bright red hibiscus flowers danced in the wind. It was a beautiful Pacific morning. A perfect day for conducting an evaluation of the water and sanitation project that World Vision is implementing in the region.

I had just inspected one of the new ventilated improved pit toilets built near the church. It's a really well constructed toilet. And Pastor Barry keeps a lock on it. The women told me it's only used on Sundays or special occasions. Apparently Pastor Barry doesn't want people using it regularly. So most of the time people go in the bush or walk into the sea. But sometimes they get to use the nice new toilet.

I asked the women whether they liked it. They giggled, perhaps on account of my broken Tok Pisin, and perhaps because they were embarrassed that a white man with notebook, camera and funny GPS unit strung around his neck was asking them whether they like defecating in the lone toilet. After the initial embarrassment, the eyes of one of the women lit up. "Yes," she told me. "We feel safe with the toilet."

The United Nations has proclaimed 2008 the International Year of Sanitation. That may seem irrelevant for those of us who are able to flush and forget. But roughly one third of people on the planet don't have access to improved sanitation. That more or less means 2 billion people relieve themselves in the bush.

Lack of improved sanitation has all sorts of negative effects on public health. Like dead children - diarrhea is still the leading cause of death for children under five. Like the additional burden for mothers who regularly have to take care of a sick child. Like cholera outbreaks - ever hear of cholera occurring in a place with improved sanitation? Nope.

Sanitation is a basic human need. If you look at the data from New York, London, and Paris before those cities built sewers, you'll see their mortality rates were about the same as mortality rates today in Sub Saharan Africa.

Preventing rape

On my first year in an overseas posting as a water and sanitation engineer, my focus was on improving access to clean water and sanitation. Women in displacement camps in northern Uganda would often wait in line for two hours to pump water, while some 1500 schoolchildren would have to share two toilets. So we drilled more wells and built more toilets.

I spent my second year in Sri Lanka where thousands of houses had been destroyed by the tsunami. In addition to rebuilding schools, health clinics, and homes, we installed hundreds of wells and built hundreds of toilets.

In Papua New Guinea I've begun focusing more on improving hygiene practices than building infrastructure. We can build lots of toilets, but what if people don't actually use them? (Happens more often than you may think.) And if people don't wash their hands after using the toilet, it's likely there will be hardly any improvements in health.

So for the past year my focus has been on behavior change: improving hygiene practices that complement improvements in infrastructure. But while assessing this project, I've been particularly moved by something that isn't directly related to safe water or improved sanitation.

Before our project, the women walked an hour or more to get water. To relieve themselves, they walked far into the bush or the mangroves. The women told us they used to get sexually assaulted by men hiding in the bush. Now that there are water taps and toilets close to their homes, they no longer get attacked on trips to fetch water or go to the loo.

Domestic and sexual violence against women is prevalent in the Pacific. I reckon that women tend to get the short end of the stick all around the world but it seems to me to be particularly bad here. Given a choice, I reckon I'd prefer to be a woman in Afghanistan than a woman in PNG.

On Petats the women told me that they felt safe when they used the new toilet.

"You know the Bible and I know the Bible," I said to Pastor Barry. "You know that Jesus loved the mamas and he loved the weak and the vulnerable. I think Jesus wants you to build a toilet for the women."

I hope he will.

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