Open defecation is more than a sanitation problem

by Rukhsat Hussain

“I make my children sit on the wooden legs of the cot if they get nature’s call at night so that the pressure can go up, because I cannot take my young kids for defecating alone at night,” explains Kanta of Hamirpur village in the Alwar district of Rajasthan.
Women suffer
Such instances were common as women discussed issues relating to open defecation during a Sehgal Foundation research team visit to the five-villages Samra Panchayat (village council) in Thanagazi block, where only five out of 1,409 households had toilets before 2014, and those five were nonworking. Women avoid defecation in the dark due to their fear of wild animals, such as lions, boars, etc., in the nearby jungle. There is no other place available for releasing the pressure. Women are scared to defecate alone at night. Men never accompany them and they often feel too shy to ask other women to accompany them. Several women either do not eat or reduce their food intake to half after dark to avoid the need to defecate.

The unease for girls, new mothers, and elderly women
Young girls must go even farther away during their menstruation, searching for isolated places where male members of the family cannot see them defecate. They are always wary while changing clothing as well. The absence of toilets further worsens the plight of ill and pregnant ladies who cannot walk long in search of a place to defecate. Elders and women suffering from diarrhea are therefore forced to defecate close to the houses, leaving a bad smells behind and fecal matter that becomes a breeding place for houseflies/insects, which puts the health of everyone in the family at risk.
The other side
On the one hand, men seem to be comfortable defecating openly. Being farmers, they need to visit their crop fields early in the morning, which is the preferred defecation time for most adult men. They do not wait for someone else to accompany them to defecate or wait for the cover of darkness as women usually do. Unlike women and girls, males do not “schedule” defecation but rather defecate whenever the need arises, either on their way to or returning from their fields.

The population has not been aware of all the initiatives taken by the government of India to encourage toilet construction. Government of India has launched various sanitation programs starting with the Central Rural Sanitation Program in 1986 to the Swachh Bharat Mission in 2014 to promote toilet construction because it affects the dignity of women and girls the most. The Swachh Bharat Mission to clean India’s cities and villages provides a revised monetary incentive to below poverty line and identified above poverty line households. This includes up to INR 12,000 for the construction of one individual household latrine with water availability, including water for hand washing and cleaning of the toilet.

Reaping results of effective mobilization
Sehgal Foundation, in collaboration with Coca-Cola India Foundation, intervened in these villages in 2014 with the aim of mobilizing and sensitizing communities towards health and sanitation issues leading to toilet construction. Foundation staff used information education and communication materials such as pamphlets designed in an easily comprehensible manner by the community for conducting trainings on the benefits of constructing toilets, emphasizing clean surroundings, safety, and ease of use. These trainings were conducted every month separately for males and females in the villages to address the sanitation issues and spread awareness about the Swachh Bharat Mission and its monetary incentives for toilet construction. The outcome of this community mobilization and awareness has been toilet construction in 25 to 30 percent of the households. Among households with toilets, around 50 percent are not using the toilet. This indicates that the use of a sanitation facility is equally or may be more important than just having access to the sanitation facility. Open defecation continues to be a socially and culturally accepted traditional behavior by the community. Females reported that males are often not supportive of toilet construction, but some women mentioned that lack of water and money prevents us from not having a sanitation facility.
A long way to go
The major thrust of all sanitation campaigns should be to promote attitudinal change that will create demand and further lead to improved access. In the long term, behavior change communication is imperative to sensitize people to use sanitation facilities and appreciate the positive aspects associated with it. Behavioral aspects vary by gender and age. Any sanitation intervention, instead of merely achieving targets, needs to consider the above aspects that can inform adequate approaches to tackle the issue of sanitation and behavior change holistically.

(Rukhsat Hussain is a senior research associate at Sehgal Foundation.)