The India today’s cover story for this week is called “Dirty Nation”.
Dean and Diane have a column for the cover story, called “To end open defecation, make Indians want to.” We reproduce the full text of the column.
Over half of all Indians defecate in the open, and in rural areas, this figure is about 70 per cent. In contrast, less than 1 per cent of people in China, 4 per cent of people in Bangladesh, and about a quarter of people in Sub-Saharan Africa defecate in the open. Why is there so much more open defecation in India? Considering that open defecation in rural India causes death, disease, malnutrition and the loss of economic productivity, understanding why it is so common is an important priority.
For the past year, we have been part of a team of researchers who have been investigating sanitation beliefs and attitudes of people in the rural parts of six north Indian states. What we find about why so many people in rural India defecate in the open may surprise you.
Many people think that open defecation is caused by “poverty” and “lack of access to latrines”. However, there is little relationship between GDP per capita and open defecation rates in poor countries around the world. Indeed, Muslims in India are more likely to use a latrine than Hindus, despite being poorer on average. There is little relationship between wealth and latrine use because the latrines that stop the spread of disease are actually very inexpensive. In Bangladesh, for instance, rural people build and use latrines that cost only about Rs.2,000-Rs.3,000.
Nor is widespread open defecation in India due to lack of water. Indeed, 90 per cent of rural Indians have access to what the World Health Organization (WHO) calls “an improved water source”. In contrast, in Sub-Saharan Africa, less than half of the people have access to improved sources of water, but far fewer people defecate in the open than in India. Open defecation is not a problem throughout the developing world-increasingly, it is a problem that persists only in India. So what can explain this Indian exception?
The biggest reason why so many people in rural India defecate in the open is because they want to. The rural men and women with whom we spoke saw many benefits of open defecation: open defecation is associated with rising early and being industrious, as well as with strength and exposure to healthy fresh air.
Perhaps, more important than the perceived benefits of open defecation, however, is the fact that many people do not want to own or use the kind of simple latrines that would save lives and prevent disease. Even the latrines provided by the Indian government, which are expensive compared to privately built latrines in Sub-Saharan Africa and Bangladesh, are seen as undesirable and socially unacceptable.
Why are such latrines socially unacceptable? Firstly, many people think that having such a latrine near the house would be polluting-much in the same way many rural people think drinking from the same glass as a Dalit to be polluting. Second, because cleaning faeces is associated with “untouchability,” emptying latrine pits when they are full is a critical concern for potential latrine owners. Indeed, our survey found that the median pit size of a privately constructed latrine was 240 cubic feet, which is four to five times the pit size that the WHO recommends for a family of six. People in other countries are willing to empty such pits, or have them emptied, every five years or so. In contrast, people in rural India are reluctant to ever have to deal with a full latrine pit.
Our research suggests that in order to end open defecation, we will need to bring about a change in these beliefs and attitudes. Building toilets won’t end open defecation-our survey found that most people who have a government toilet do not use it, and many others who had not received a government latrine told us they would not use one because the pits would fill quickly. The truth is that most rural households can already afford the simple latrines with simple pits that would save lives and help children grow up to be smarter and more productive-but they don’t yet want to.