Open defecation (Sequal to shameful neglect)

By Shameful, www.thehindu.com   December 7th, 2013

This refers to the editorial “Shameful neglect” (Dec. 7), highlighting the real and enormous consequences of open defecation in India. The challenge is indeed profound, so we worry that your diagnosis that “in the absence of toilets, more than 620 million people, or over half of India’s population, are forced to practise open defecation” underestimates its complexity. In our ongoing field research across rural north India into sanitation practices in India, we have observed that: although some families are indeed too poor to construct a pucca latrine, people in rural India are also unlikely to make simple but safe and inexpensive toilets — unlike, for example in Bangladesh, where even very poor people manage to make a latrine of some sort. Additionally, many relatively prosperous families have not constructed a toilet, even though they could certainly afford one. Finally, even in many rural households that do own a working latrine, many people continue to defecate in the open.

In many households, only children, the old, and the weak or sick, for whom it is difficult to walk far from the house, use latrines. Others use them to protect the modesty of young women or for the convenience of people who have to get ready quickly in the morning for a job outside the village. However, people who are young and healthy often report preferring to go in the fields or the jungle — in part because of the widespread belief that open defecation is good for health, and that using a latrine is unpleasant or disgusting.

The complexity of sanitation beliefs and practices is easy to overlook, especially when census and survey data only count latrines owned by households, not the behaviour of individuals. But mistaking a problem that is partially about access and affordability for a problem that is only about access and affordability — and thereby overlooking the challenges of changing ideas and changing behaviours — will not eliminate the deadly and enduring consequences of this practice. (Diane Coffey, Aashish Gupta, Nidhi Khurana, Angshuman Phukan, Dean Spears, Nikhil Srivastav, Sangita Vyas, Research Institute for Compassionate Economics)

Shameful neglect

By T-, www.thehindu.com   December 6th, 2013

If the central message of the need for more toilets to stop open defecation in India got lost in the “more toilets than temples” controversy in 2013, the joint estimate for the year 2011 by the World Health Organization and UNICEF of the number of people who defecate in the open is yet another reminder of why India has to address this issue on a war-footing. In the absence of toilets, more than 620 million people, or over half of India’s population, are forced to practise open defecation. This is yet another development index where India’s extremely poor performance has ‘helped’ it retain the dubious distinction of having the most people in the world defecating in the open. That the State of Bihar alone has a higher rate than any other country in the world to continue this practice speaks volumes of how much the country lags behind. While the government’s mission to rid the country of this practice by 2022 and 50 per cent of all gram panchayats by 2017 is laudable, it is an ambitious goal. For instance, if nearly 74 per cent did not have access to toilets in 1990, the figure declined to only about 50 per cent in 2011. 

Besides other countries, Bangladesh, Pakistan and Nepal have achieved the most improvement during 1990-2011. By reducing it from 32 per cent to 4 per cent during 1990-2011, Bangladesh has fared extremely well. The reduction has been about 50 per cent in the case of Nepal (84 to 43 per cent) and Pakistan (52 to 23 per cent) during the same period. But the rate of decline may accelerate in the years to come with the government increasing last year the amount to be spent for household toilets in rural areas from Rs.4,600 to Rs.10,000.

Financial incentives alone cannot end or drastically reduce the percentage of people continuing with this practice. If other countries have achieved it, there is no reason why India cannot do it. The need to aggressively address the issue cannot be overemphasized as open defecation affects children, especially those below five, the most. This practice causes diarrhoea, one of the most common communicable diseases in India and a number one killer of young children. Frequent diarrhoeal events result in under-nutrition. That explains why nearly 50 per cent of under-five children in rural areas are stunted, wasted, and underweight. Children weakened by this disease are in turn more prone to opportunistic infections such as pneumonia. Now, a World Bank report released recently goes beyond the well-known physical impact. It found a link between open defecation and reduced cognitive achievements