Children are at increased risk of diarrheoa and hepatitis due to poor sanitation in India.
The UN’s Millennium Development Goals (MDGs) had a key focus which centred on the delivery of safe drinking water and sanitation to the international community. However, while achieving the targets for the former ahead of schedule, the goals on sanitation were not reached, leaving 2.4 billion people around the world without access to sanitation facilities.
This is a serious problem affecting countries in Southeast Asia, in particular India, where 48% of the population do not have access to proper sanitation. This leads to half a billion Indians defecating in public, such as on rail lines and in bushes, resulting in increased rates of diarrhoea and hepatitis. These preventable illnesses contribute to the fact that half of India’s children are malnourished, with 200,000 dying each year.
In-for-a-structural change
The answer to this problem may be simple: build more toilets. Indeed, the Indian government has offered subsidies to encourage the construction of more latrines throughout the country, and overall this solution has been the main focus over recent years.
What happens then, when you check the numbers and discover that 40% of people with access to toilets are still choosing to relieve themselves in public? According to Rolf Luyendijk of Unicef, the latrines constructed were instead “abandoned, or were not used, or got used as storage sheds”, leading him to describe the results as “abysmal”.
It has become evident then that what needs to change is not the infrastructure, but the culture and behaviour. This idea, endorsed by the UN, has proven successful in countries such as Vietnam and India’s neighbour Bangladesh, where the act of public defecation has been controlled.
Cultural norms
So how is it that Bangladesh, a country that shares a border with India, with a GDP of almost half ($2100 compared to $4000), is doing laps around them? Interestingly, poorer countries such as Afghanistan, Burundi, and the Democratic Republic of Congo are outperforming India regarding appropriate sanitation, highlighting that poverty is not the problem.
Here, the Economist also points to cultural differences as the reason why. Focusing on religiosity in India, they note that child mortality rates were higher among Hindu families than among Muslim families, despite the latter being typically “poorer, less educated, and [having] less access to clean water”. Now, if we look at the religious differences between India and Bangladesh, we see that while India is predominantly Hindu, the vast majority of Bangladeshis are Muslim, therefore giving further credence to the idea that cultural norms are playing a large part.
Green for brown
Accepting the need to change the deeply rooted societal norms, the Indian government has indeed come up with a rather novel way of tackling the problem which costs them an estimated $50B USD a year – Indian children are going to be paid to poo. Children who use public toilets instead of defecating in public will be given one rupee or a piece of chocolate. A further benefit of this initiative is being reaped by Bhumi Datadia, a 5-year-old girl who spoke to the BBC: simply by going to the toilet, she is able to save the money she receives to put towards her education.
And if this cash incentive doesn’t work in the long run, I would be thrilled if the delightful “Take the Poo to the Loo” song by Unicef India made a revival.
[Image: meg and rahul]