By Nikhil Srivastav:
As an emerging economy, India needs to have a strong resource pool of human capital to push its development ahead, but in order to do so, we first need to improve the diseased environment of the country. One reason that it is so bad in India is because of open defecation, which causes disease and inhibits the physical and cognitive growth of kids. This stunted growth, in turn, lowers their economic potential as adults.
This is particularly important in India, as 60% of all people defecating in the open in the world live in India, and 70% of rural families in India defecate in the open. Even after longstanding efforts to address the challenge of open defecation, the situation in India stubbornly remains unchanged. Part of the reason for this is because many people in rural India actually prefer open defecation to using affordable latrines.
Many people think that the root cause of such widespread open defecation in the country is the fact that India is a developing economy with a per capita monthly income of just 1499 US$ (World Bank Development Indicators, 2013), making it difficult for people to afford a latrine. Surprisingly, open defecation has less to do with a country’s economic strength than with the choices, priorities and habits of its people.
Among our neighbors who are culturally similar to us, Nepal (40% of the Indian GDP per capita in 2011) and Bangladesh (50% of the Indian GDP per capita in 2011) had 36% and 4% open defecation respectively in 2011. On the other hand, if we look at the census data from the same year in India, we find a shocking 50% of people defecating in the open. The average Indian is richer than the average Bangladeshi and the average Nepali, and so can certainly afford a simple pit latrine similar to those that have been seen to lower mortality in other parts of South Asia.
The Government of India adopted a “demand driven” approach by the name “Total Sanitation Campaign” (TSC) in 1999, later renamed the Nirmal Bharat Abhiyan (NBA). A financial subsidy was provided to households for constructing latrines. To give a boost to the TSC, the government also launched the Nirmal Gram Puraskar (NGP), an incentive program that sought to recognise the achievements and efforts of Panchayati Raj Institution (PRIs) in encouraging full sanitation coverage in their Gram Panchayats.
Between 2001 and 2011, the Government of India spent over 8 Billion INR just for constructing latrines under the NBA. Though there was a 13 percentage point increase in the share of households that had a latrine in the same time period, a recent SQUAT (Sanitation, Quality, Use Access and Trends) study which happened in Haryana, Bihar, Rajasthan, Madhya Pradesh and Uttar Pradesh shows that 80% of the people participating in the survey have built their latrine from money out of their own pocket. Many people in India recognise open defecation as a national embarrassment, but if one accounts for the loss that it inflicts on the health and future productivity of India’s children, it’s clear that the sanitation crisis is truly an emergency.
Where did we go wrong? Why haven’t we been able to make more progress in reducing open defecation? How can we prevent the loss of human capital by keeping our kids healthy? To find the answers, we spent several months talking to folks living in rural north India. We asked them about their sanitation beliefs and behaviours. We talked to people who had built latrines in their homes in the past ten years and to those who do not have one yet.
When we asked people who did choose to construct a latrine why they did so, a majority said that “latrines are for the old and weak”, “they are for new bahus and growing girls”, and “one should have a latrine for emergencies (when someone is sick or when it’s raining outside)”. For those who haven’t built a latrine in their house yet, they often said that latrines are not a priority. From what we saw, people often invest in a latrine only after investing in other consumer goods like mobile phones, cycles, and TVs.
We’ve seen that some common notions about why people in rural India defecate in open are incorrect, and also that government programs have not made enough progress in securing the health and productivity of Indian kids. I would now like to introduce you to a few of the families we met, because without hearing their voices, it’s sometimes hard for those of us used to urban life to understand their beliefs and preferences.
People who have a latrine don’t use it
In a 13-member family of a retired army person in Haryana, no one except his three grandkids (all below 13 years of age) use their tiled latrine, which cost the family quite a lot of effort and money to build. Their family is very rich and well educated as three out of the four sons are working in the security forces and all four bahus have at least a senior secondary education.
While narrating the reason for making the latrine, the head of household said, “Jaise aadmi buzurg ho jaata hai chala nahi jaata hai… bachche hain chhote chhote wo bahar nahi jaa sakte hain…. ya raat ko kisi ko dysentery lag jaae yaa aur kuchh ho jaae to fat se apna ghar mein he ho le… apna bahar kahan jaae…. uske liye banwaya gaya hai.” (People who are old and cannot walk… the kids who are unable to go out… or if someone catches dysentery at night, one can use the latrine quickly in the house… How would one go out in the open in such situations? This is why we have got the latrine built). This statement, coming from a family which is both rich and educated, demonstrates that latrine use has a lot to do with a person’s mindset, and less than we might think with their educational status or wealth.
People see latrines as disgusting and prefer open defecation
Deep in many people’s hearts there exists a disgust towards latrines and, on the other hand, many people see benefits of open defecation. Most people who we talked to, both those who have latrines and those who do not, gave various reasons for defecating in the open. One reason that we heard quite often was the argument that open defecation has health benefits.
People argued that “one can get fresh air while defecating in open”, “one remains fit, as walking to get to the place to defecate is an exercise” and some of them claimed that “if one poops in a latrine, the bad smell enters one’s body and makes them sick.”
A man in Uttar Pradesh, who was a wood businessman and actually declined the governments help in making a latrine said, “Ye sala badboo karta hai. Hamko to mil bhi rahi thi (sarkar se) lekin ham nahi banwaae bhai… ye dalidri hai sasur.”(The latrines smell… I was getting one from the government but I declined… Latrines are disgusting.)
Another man in Gujarat told us that he used to search for places to defecate in the open, even when he was working in Muskat, a city, as a migrant and had easy access to a latrine. He said in Gujarati,“Bathroom karta bahar sandaas jawu bau best!….to su che ke apane gandagi lage… baki javu sari reete sandas besai che kai? … bathroom ma je jae e ghungret lage… jeev ne pelu thai… koi ne sandaas thai bhi nai…… khula maidan ma jae, ekdham khula sandaas thai dil khush thi…baar saaru” (Going out and defecating in the open is the best!…And I am able to ease nicely in the open… I find using a latrine disgusting, feel like vomiting… If one goes out in the fresh air one is able to ease to one’s satisfaction and feels happy in one’s heart).
Latrines should be seen as a necessity
We were surprised to learn how strong people’s positive feelings towards open defecation were. We learned from the villages we visited that building latrines is not the solution.What is needed is a focus on how to make people believe that latrine use is a need, not just for their own health but also for the health of the people living around them. If we want the human capital of the country to work at its optimum potential for India’s growth, we need to stand together and start a latrine use revolution.
For too long, open defecation has caught the attention of just a few NGOs and a select few people in the government. Now it’s time for the Indian youth to invest their energy in thinking of innovative ways to push the conversation against open defecation into different public fora, in the same enthusiastic way in which we have talked about the Indian Premier League, the FIFA World Cup, and The Great Indian Election. Let’s inspire everyone we know to help find the answer to the puzzle of how to motivate all Indians to use a latrine.
Take the UNICEF India pledge to end open defecation, and tell the President of India to act on it.Â