How to stop open defecation? Even if you build a toilet, they may not come

by Magda Mis | @magdalenamis1 | Thomson Reuters Foundation
Wednesday, 3 September 2014 07:15 GMT

In a 2005 file photo, a boy takes bath outside newly built toilets in a village on the outskirts of Nagapattinam, about 325km (202 miles) from the southern Indian city of Chennai. REUTERS/Jagadeesh NV

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Comparing India and Bangladesh, expert says key to stopping people from choosing streets and fields as toilets is shame

STOCKHOLM (Thomson Reuters Foundation) – Bangladesh and India have long tried to stop people from defecating in outdoor public places – a practice that spreads fatal diseases – but Bangladesh has had much more success than the economic giant next door in getting people to use toilets.

The percentage of Bangladeshis defecating in the open dropped from 19 percent in 2000 to just 3 percent in 2012, while nearly half of India’s 1.2 billion people still resort to streets and fields as their toilet of choice.

So how did Bangladesh do it, and why India is still struggling?

The key, according to World Bank water expert Junaid Ahmad, is shame.

Several years ago, NGOs fanned out across Bangladesh and asked villagers to mark the outdoor public places where they were relieving themselves. They then mapped it out, showing the villagers that they were defecating right next to their homes and mosques – putting their families and neighbours at risk of serious illnesses such as cholera, diarrhea, dysentery, hepatitis A and typhoid.

This mapping exercise stirred a collective sense of shame - and a seismic shift in habits.

“What Bangladesh realised very early on was that sanitation is about delivering an infrastructure and about creating behaviour change… You have to first recognise that it’s a behaviour shift that’s needed before you put in the infrastructure,” Ahmad, the senior director of global water practice at the World Bank, told Thomson Reuters Foundation on the sidelines of a global water conference in Stockholm.

“Health message is not enough to trigger people’s shift. You have to understand the behaviour, what triggers that change.”


By contrast in India, toilets were offered for free in a hope that people would simply start using them, but instead, people used the latrines for additional storage.

“In economics there are not too many goods in which if you put the price at zero the demand still doesn’t move. Sanitation is one of these goods. Even if you build toilets and hand it to people they don’t use it,” he said.

In 2013, India’s then-prime minister candidate Narendra Modi vowed to “first have toilets and then temples”. Seven months later, two teenage girls were hanged from a tree when they went to relieve themselves in a field in Uttar Pradesh.

Inadequate sanitation costs India an estimated $54 billion a year. 

Ahmad stressed the need for more than just toilets to achieve universal access to sanitation.

“It’s about well functioning utilities, local governments, efforts on behaviour change,” he said. “But the most important is to get citizens involved. When you get them involved this is when you scale up.”

Ahmad noted that India has its own sanitation “success stories” - in Haryana, West Bengal, Kerala and Maharashtra states. In order to scale up those successes, he advises the central government to ensure that money flows to the states and to local governments.

(Editing by Alisa Tang:

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