This week I’m in Sitapur, and it’s nice to be back after a long time. I learn so much here. Today, I was having a conversation about rural sanitation with Baby, a woman who long-time readers of our blog will already know. She’s been our research assistant in Sitapur since late 2011. For those who don’t know Baby, she has worked on a number of projects with us, including a cohort study of infants, a study of the Janani Suraksha Yojana safe motherhood scheme, and now, for over a year, she’s been collecting some original data about birth weight. Baby is a 30-something Muslim woman who has a 12th grade education, and has traveled once to Delhi, and once to Rajasthan, but has spent most of her life in Sitapur. I wanted to share our conversation from this afternoon because it highlights that the main findings of the qualitative “switching study” of open defecation that I’ve been working on this year, while certainly new to many of the policy makers we talk to in Delhi, are not new to people living in rural areas.
Lately, we at r.i.c.e. have been saying that sanitation programs should focus on behavior change — basically on convincing people to use simple latrines. But no one really knows how to do this. So, we’ve been considering the idea of asking Baby to do some interpersonal communication with villagers in Sitapur and to record the reactions and results that she gets. To help me introduce this potential project, I got out some of the Hindi language educational materials on sanitation and latrine construction that our friends at the UNICEF office in Lucknow were kind enough to give to us on Friday. We opened up a laminated flip chart about the construction of simple, honey-comb style pit latrines. This type of latrine that the Indian government typically provides and is among the latrines recommended by the WHO. It is inexpensive and safely contains feces.
I started by telling Baby about how in other countries, like Bangladesh, and Cambodia, and countries in sub-Saharan Africa, people make these latrines. I told her about how using these latrines helps keep children healthy. I pointed out that the pits of these latrines fill up and need to be cleaned out, or alternated, every 5-10 years. I further explained that our research had found that people in rural India are resistant to using such latrines because they are concerned about the size of the pit. Baby replied, “I know, in villages around here, if people build a latrine, they want the pit to last for life. They don’t want to have to clean it out.” I stopped, surprised but not too surprised. Surprised, because here Baby was filling in the details of the results of a study that I hadn’t yet told her much about. Unsurprised, because the results of the switching study are pretty much common knowledge to rural people, if not to people with decision making authority about sanitation programs. And, unsurprised because Baby is pretty perceptive when it comes to how people think, and what we outsiders need to learn — after all, it was she who initially suggested that there are big differences in latrine use between Hindus and Muslims, which helped lead to Dean and Mike’s paper about the Muslim mortality paradox.
Anyway, to get on with the story, I then said, “Yes, we heard that a lot in the interviews — that people want their latrine pits to last for life — they want really big pits that they don’t want to have to clean them out.” I paused, and then said, “And we think this is because there is caste in India, which doesn’t exist in other countries. In India, it is the job of “untouchable” (very low caste) people to clean up poop, but in other places, people are not as bothered about the idea of cleaning poop themselves, or of having it cleaned out from their latrines.” Baby considered my explanation, and replied with a story. She talked about how when she was growing up, her parents used to ask her and her siblings to clean out the drains (nalis) in front of their house once a week. This work is often done by untouchables, because they are filled with waste water and sometimes feces. But Muslims are generally less bothered about caste than are Hindus, and Baby’s family didn’t have much money to pay someone else to do the work. Baby said that when they were doing this work, other children would come by and taunt them, shouting “Bhangi! Bhangi!” Bhangi is the name for one of the untouchable castes. It is also considered to be a bad word, which you would not say, even to a Bhangi, in polite conversation.
This interaction was meaningful to me for a couple of reasons. First, the fact that Baby could so easily relate to the explanations that the switching study advances about why open defecation is exceptionally widespread in rural India suggests to me that our analysis is sound. Second, it served as a sad reminder of just how pervasive and cruel notions of caste are in rural Uttar Pradesh. If Muslim children are taunted for cleaning out the drains in front of their house, what indignities are suffered by “Bhangi” children?