I think that the focus on ...

I think that the focus on rural WASH is partly due to the way that surveys are being conducted. The absence of a toilet is far easier to detect than the presence of a dysfunctional, inaccessible, or otherwise unused toilet. This biases the numbers quite a bit, making it seem like rural areas are in much more dire need of WASH interventions than urban areas. Due to the sheer density of urban housing, toilets are close by to households and assumed to be accessible to the urban poor even though their actual functioning and accessibility are far from acceptable. The MDG guidelines for improved/unimproved toilets remain too broad and too superficial to reflect the actual state of sanitation that people experience, and surveys based on the guidelines are devised for speed and quantity rather than accuracy. A lot more money and time needs to be invested into evaluation processes to begin to combat the rural bias. Another probable reason for the focus on rural WASH is the predominant belief that urbanization is an advanced stage of development. Urban conditions are held as the standard, while rural conditions are judged against them, and deemed inadequate and backwards. Rural areas may lack sanitation, but they also experience less risk of water-related/water washed/vector diseases than urban areas that similarly lack sanitation. Inadequate WASH in densely populated areas quickly escalates to fatal diseases and epidemics, whereas OD practitioners in rural settings can experience few adverse health effects. If WASH prioritizes its target audience based on the severity of health risks rather than the presence or absence of sanitation facilities, there would be much more effort exerted in urban areas. After all, the goal of WASH is to improve health and well-being. We need to evaluate morbidity rates when determining what audiences we serve, rather than relying upon misleading and distorting data on the number of toilets we see.