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India's trouble with toilets: Government sanitation drives fail to sway those who believe going outdoors is more wholesome India's trouble with toilets: Government sanitation drives fail to sway those who believe going outdoors is more wholesome
(1 day later)
In the lanes of Parvar Poorab, a peaceful North Indian village set amid monsoon-soaked fields, Savita stares suspiciously at the concrete lavatory outside her home. “The government employee who constructed it told me we had to use it now and we shouldn’t go in the open”, says the slight and sombre 22-year-old who goes by only one name.In the lanes of Parvar Poorab, a peaceful North Indian village set amid monsoon-soaked fields, Savita stares suspiciously at the concrete lavatory outside her home. “The government employee who constructed it told me we had to use it now and we shouldn’t go in the open”, says the slight and sombre 22-year-old who goes by only one name.
“But it’s better to go in the open. The pit is very small and will fill up very soon. We only use it in an emergency or at night. I like going outside.”“But it’s better to go in the open. The pit is very small and will fill up very soon. We only use it in an emergency or at night. I like going outside.”
Millions of Indians like Savita continue to defecate in the open despite having a household toilet, frustrating government hopes to wean more than 600 million of its citizens off the practice and questioning the assumptions behind its mass toilet-building programme.Millions of Indians like Savita continue to defecate in the open despite having a household toilet, frustrating government hopes to wean more than 600 million of its citizens off the practice and questioning the assumptions behind its mass toilet-building programme.
In rural India, a strong cultural resistance to the build-up and disposal of excrement, and the view that going outdoors is more wholesome, is leading to rejection of the new latrines.In rural India, a strong cultural resistance to the build-up and disposal of excrement, and the view that going outdoors is more wholesome, is leading to rejection of the new latrines.
The most pressing reason to banish the practice, as Prime Minister Narendra Modi has vowed to do by 2019, is its effect on public health – spreading infectious diseases and stunting children’s growth by circulating faecal bacteria in the environment.The most pressing reason to banish the practice, as Prime Minister Narendra Modi has vowed to do by 2019, is its effect on public health – spreading infectious diseases and stunting children’s growth by circulating faecal bacteria in the environment.
In this densely packed country, even people using toilets will still be exposed to germs unless everyone in the community abandons their routine of trudging to the nearest field, pond or railway track to relieve themselves.In this densely packed country, even people using toilets will still be exposed to germs unless everyone in the community abandons their routine of trudging to the nearest field, pond or railway track to relieve themselves.
Delhi has for decades tackled the problem by subsidising toilets for poor households, with the underlying assumption that poverty rather than attitude is the main reason that people are not building their own. This year the government is spending about £350m on the project, but poorer countries including neighbouring Bangladesh have made far greater strides in reducing open defecation without as much subsidy.Delhi has for decades tackled the problem by subsidising toilets for poor households, with the underlying assumption that poverty rather than attitude is the main reason that people are not building their own. This year the government is spending about £350m on the project, but poorer countries including neighbouring Bangladesh have made far greater strides in reducing open defecation without as much subsidy.
Even on the measure of toilet construction, India’s progress has been slow. Census figures show that between 2001 and 2011, the proportion of families without a latrine actually fell from 63 to 53 per cent. Research suggests that many households who acquired toilets during this time have not abandoned open defecation entirely. A recent survey of rural north India by the Delhi-based RICE Institute found more than 40 per cent of families with a working toilet have at least one member who still defecates in the open.Even on the measure of toilet construction, India’s progress has been slow. Census figures show that between 2001 and 2011, the proportion of families without a latrine actually fell from 63 to 53 per cent. Research suggests that many households who acquired toilets during this time have not abandoned open defecation entirely. A recent survey of rural north India by the Delhi-based RICE Institute found more than 40 per cent of families with a working toilet have at least one member who still defecates in the open.
Rubina, 38, has lived in Mollar Bosti slum in Dhaka for 3 years. She moved from the countryside when her husband got a job in Dhaka. The toilet she uses is known as a shared hanging toilet and is situated 20 metres from her house. She says that once, in middle of the night, she went to the toilet and someone knocked the toilet door so hard she thought they were going to break the door down. She got very scared and since then, she has been too scared to use the toilet after 9pm
Martine is 27 years old. She lives near a river in Cayimithe. "I don't have an enclosed toilet. My toilet is a hole in the ground by my house, which is now full and has become really dangerous. I only use it at night when I can have some privacy. In the day time, I use a community toilet which is about 15 minutes away from my house"
Rosalie, 9, goes to school in Brussels. "At my school we have separate toilets for girls and boys on every floor. My classroom is on the 3rd floor. We have 22 toilets, which are shared between 230 pupils and 20 adults. The teachers at school let us go to the toilet whenever we need to"
Saritadevi lives in Ittava village in Uttar Pradesh. She has no access to a toilet in her house and so uses a local field. She suffers from a lack of dignity and privacy when she visits the toilet. She says she is humiliated by men, enduring people throwing stones at her, shouting abuse, making vulgar gestures, and playing offensive songs
Renee is an artist who left her former home in the densely populated suburbs of Sydney to live a quieter life in bush surrounds, a one-hour drive north of the city. She has built a shed on ten acres of land and has included an outside toilet and bathroom. Ironically, Renee is able to enjoy total privacy out in the open as she is surrounded by wild bush and forest, far from other houses
Ima, 47, is a public toilet attendant in Kumasi, Ghana’s second largest city. She lives in a rented room with her husband and four children aged 14-22. She is a very dedicated worker and relies on the income from her job to fund her children's education. She does not have a toilet at home. During the day, she uses the public toilet where she works, but at night she is forced to use plastic bags as it is not safe to walk long distances in the dark
June is the Allotment Secretary at Gordon Road Allotments in Finchley, North London. "We used to have a portable toilet, which had to be emptied every so often. It was very smelly and not very nice. Now we have a waterless compost loo, which enables women to stay down at the allotment all day if they wish. It also makes a big difference when we have Open Days. This year, for the first time, we were in the National Gardens Scheme book and had an open day with 170 visitors. We wouldn’t have been allowed to host this event without the compost loo"
Sineha, 71, uses a public toilet which is inside the temple she visits. "They are convenient and cleaned daily by the maid. It is a safe place because we have security guards here 24 hours a day and separate toilets for men and women"
Assucena, 14, is a Grade 8 student who loves to study and play football. She lives with her mother, grandmother, sister and two cousins. Her grandmother sells beer to provide for her extended family. Assucena shares a toilet with more than 30 other people from different families. "When it rains, the toilet floods. It really smells bad"
Fabiola, 69, lives in Cumbayá, a valley near Quito. Between the ages of seven and 21, she shared a toilet with 20 other people, who lived in her condominium. Now she lives in a large apartment, which has five bathrooms. Her bathroom is the biggest one and she is very proud of it as her current situation contrasts vividly with her childhood
Lorena, 16, is a student. She has just moved into one of Rio de Janeiro's favelas. "I don’t have a toilet but I am working hard to try and build one. In the meantime, I have to use my mother's. We only get water on Thursdays and Sundays, when the taps are opened. One day I would like to have a bathroom with running water. I am very vain, I like to have my hair and nails done and use perfume. Some people around here have been in poor health, partly due to the poor sanitation situation in the area"
Mary is a writer who lives in New York City. "Living with two housemates, it is important to schedule our bathroom time and take turns cleaning it. I used to live in Beijing, where I had to use a public bathroom as my apartment didn't have a private toilet. While it was safe and relatively clean, I used to hate putting my coat on just to go to bathroom in the middle of night during winter. That experience made me really appreciate the privacy and comfort of having a clean toilet at home"
Meseret, a restaurant manager in Addis Ababa, shares a one bedroom government house with her two children, two sisters and mother. She was widowed nine years ago when her husband was shot during the aftermath of the 2005 elections. Her shared toilet is a long way away so at night, for safety, the family use the side yard next to their house
Eiko, 61, lives in Tokyo. "Since this department store is close to my home, I often come here for shopping. When I was a child, the public toilets were not clean and smelled bad, but every time I use the bathroom here, I feel so relaxed. I could spend many hours here!" The department store’s toilet, called the "switch room", is a special place where people can switch their mood and feel relaxed. The toilets are an extreme example of good sanitation and have features like surround sound music and heated seats. In the ‘powder room’ next to the toilets, Eiko can charge her mobile phone, watch TV and have a foot massage, turning a basic daily function that we all have to do into a pleasurable and multisensory experience
Nombini has two Porta Potties, which are used by the 12 people who live in her home. When she first moved to Khayelitsha in 2005, she did not have a toilet so she had to go in the bush, across a main road. "It was terrible in the bush, the cars hit you. When we were given a Porta Potty in 2009, it was much better than going in the bush. Flush toilets are first class compared to the Porta Potty though. My dream is to have a flush toilet"
Susan, 46, is the founder of a community school for children with physical and mental disabilities. "It makes me proud and happy to teach disabled children so that in the future they can have a better life and not just stay at home. I was attacked by Polio at the age of two. It’s not easy being disabled in Lusaka. Using the toilet is a challenge, especially in the rainy season, as I have to crawl to the toilets on my hands"
Eunice is the Co-Founder of Kasarani Academy in Naivasha. Previously, the school only had two toilets which were used by 250 pupils. Tenants living nearby used the toilets as well and left them in a poor condition. Because of this, Eunice found that the children preferred to practice open defecation in the grounds around the school, which quickly became a public health issue. Eunice and her husband Paul have now invested in child-friendly toilets. These tiny toilets have prevented adults using them as they cannot fit through the doors. "Parents will enrol their children here because of our child friendly toilets"
Ghita, 48, from Buzescu village, says she is the proud owner of one of the biggest bathrooms in the village. It is 20 square meters. 35% of the population of Buzescu village are Romas who are prosperous and proud to show it off. However, there is no running water or sewerage in the village so toilets are on-site
Vanessa, 17, is a student who lives in Antananarivo. She says she worries when she is on her period at school. "At home, I have a shower outside my house and I can keep clean but when I’m at school, I feel embarrassed during my periods as there is no space to change or wash. I worry that my sanitary napkin will leak if I keep it on for too long while I’m waiting to come back home to change it"
Ms Moeun Sothy is a secondary school student, who lives with her grandmother and her aunty. At home she is responsible for collecting water for the household from the local water source. At her school she is on the children’s rota for cleaning the school toilets once a week. She believes that handwashing with soap is really important, especially after using the toilet
In Uttar Pradesh, India’s most populous state and with an open defecation rate among the worst in the country, officials acknowledge that they are not making inroads, even in priority villages like Parvar Poorab.In Uttar Pradesh, India’s most populous state and with an open defecation rate among the worst in the country, officials acknowledge that they are not making inroads, even in priority villages like Parvar Poorab.
“We are not facing any problem in the case of construction, but the major issue of toilet usage is our challenge, and regarding this we are helpless,” says Santosh Kumar Singh, who oversees the sanitation drive in the state.“We are not facing any problem in the case of construction, but the major issue of toilet usage is our challenge, and regarding this we are helpless,” says Santosh Kumar Singh, who oversees the sanitation drive in the state.
Shopkeeper Puttan Lal paid for his own toilet, embellished with tiles and a curtain, three months ago for his wife and young children. But even shelling out Rs32,000 (£311) – more than 10 times the cost of simple but effective latrines used all over the developing world – has not persuaded him of its merits. “Everybody is using it except for me. I go [outside] every day when I go for my morning walk,” he says matter-of-factly.Shopkeeper Puttan Lal paid for his own toilet, embellished with tiles and a curtain, three months ago for his wife and young children. But even shelling out Rs32,000 (£311) – more than 10 times the cost of simple but effective latrines used all over the developing world – has not persuaded him of its merits. “Everybody is using it except for me. I go [outside] every day when I go for my morning walk,” he says matter-of-factly.
Like most of his neighbours, Mr Lal’s enthusiasm for having a toilet stemmed from convenience rather than any awareness of the health benefits.Like most of his neighbours, Mr Lal’s enthusiasm for having a toilet stemmed from convenience rather than any awareness of the health benefits.
His preference for a much more expensive model with a septic tank, instead of a basic offering with a pit that must be emptied manually, highlights what experts believe is a key reason why Indians persist in defecating in the open.His preference for a much more expensive model with a septic tank, instead of a basic offering with a pit that must be emptied manually, highlights what experts believe is a key reason why Indians persist in defecating in the open.
  
“Emptying a pit in any other developing country… doesn’t carry a social stigma in the same way as it does in India,” says RICE’s Sangita Vyas, referring to Hinduism’s rigid caste system which prescribes that dealing with human waste is the responsibility only of those at the very bottom of the social hierarchy.“Emptying a pit in any other developing country… doesn’t carry a social stigma in the same way as it does in India,” says RICE’s Sangita Vyas, referring to Hinduism’s rigid caste system which prescribes that dealing with human waste is the responsibility only of those at the very bottom of the social hierarchy.
“Anybody who is of a higher caste would find it unthinkable do it themselves, and at the same time… people from lower castes are trying to avoid doing this type of work because it’s associated with their past and oppression,” she says.“Anybody who is of a higher caste would find it unthinkable do it themselves, and at the same time… people from lower castes are trying to avoid doing this type of work because it’s associated with their past and oppression,” she says.
In Parvar Poorab, 30-year-old Ranjita, who has a satellite dish and a television in her small brick bungalow, will only build a toilet for her family once she can afford one with a pit big enough that it does not have to be emptied for decades. “I want a good quality one, not a government one. I will wait to get a better one,” she says.In Parvar Poorab, 30-year-old Ranjita, who has a satellite dish and a television in her small brick bungalow, will only build a toilet for her family once she can afford one with a pit big enough that it does not have to be emptied for decades. “I want a good quality one, not a government one. I will wait to get a better one,” she says.
Convincing Indians of the benefits of any kind of toilet has been a secondary priority in official sanitation drives – the Modi government’s “Clean India Mission” has halved the spending on information, education and communication activities to 8 per cent of the total budget. Once that money filters down through the states to individual districts, it is up to local officials to decide how best to spend it.Convincing Indians of the benefits of any kind of toilet has been a secondary priority in official sanitation drives – the Modi government’s “Clean India Mission” has halved the spending on information, education and communication activities to 8 per cent of the total budget. Once that money filters down through the states to individual districts, it is up to local officials to decide how best to spend it.
Government-built toilets in Parvar Poorab, for example, are emblazoned with bright red and yellow painted slogans extolling their health and safety benefits. But experts say only a concerted campaign to change behaviour and beliefs, with sustained face-to-face contact, stands a chance of making a difference.Government-built toilets in Parvar Poorab, for example, are emblazoned with bright red and yellow painted slogans extolling their health and safety benefits. But experts say only a concerted campaign to change behaviour and beliefs, with sustained face-to-face contact, stands a chance of making a difference.
“Giving people money is not a very good idea for sanitation. We should never have gone down that path,” says Nitya Jacob, the head of policy at WaterAid India, who is among many who think the government’s incentive-based approach has actually hampered progress.“Giving people money is not a very good idea for sanitation. We should never have gone down that path,” says Nitya Jacob, the head of policy at WaterAid India, who is among many who think the government’s incentive-based approach has actually hampered progress.
People need to consider toilets as aspirational items and build them themselves after understanding the benefits, rather than perceiving them as handouts, Jacob says. But the government has pressed ahead with toilet-building – a visible, easy-to-measure policy – in the absence of any consensus on how to influence attitudes.People need to consider toilets as aspirational items and build them themselves after understanding the benefits, rather than perceiving them as handouts, Jacob says. But the government has pressed ahead with toilet-building – a visible, easy-to-measure policy – in the absence of any consensus on how to influence attitudes.
In Uttar Pradesh, Santosh Kumar Singh is training community motivators who will fan out into villages like Parvar Poorab to break down community barriers to toilet use. “We have started [focusing on behaviour change], but it is too late,” he said.In Uttar Pradesh, Santosh Kumar Singh is training community motivators who will fan out into villages like Parvar Poorab to break down community barriers to toilet use. “We have started [focusing on behaviour change], but it is too late,” he said.