For people who lack access to sanitary toilets, open defecation also has an impact on personal dignity and safety, with women and girls facing particular challenges. As they move farther away from crowded areas in order to have privacy, they are more at risk for physical attacks and sexual violence. The lack of sanitary toilets in schools also impacts girls’ ability to receive education. Without a clean and private area to use, many girls are unable to attend school while menstruating.