the story of open defecation in India

 Book- where India goes? abandoned toilets, stunted development and cost of caste

Author- Diane Coffey and Dean Spears

Year of publishing - 2017

               

                It was on 15th august, the newly elected prime minister of India vowed to make the country of 125cr , an open defecation free nation. This was an unexpected declaration by a prime minister for many reasons. One, It was his first national address from red fort so people were expecting something 'big' and second, why open defecation?

              This book written by Diane Coffey and Dean spears essentially asks same question with weaving together stories of personal loss and grief with that of statistical breakdown. The book does not stop at that, it goes on to highlight and reinforce the already known but not recognized relation between issues of sanitation, its effects on human health and development and prevailing social structure's inability to create 'Swachha Bharat'.

               Novelty of book does not lie in the survey and statistics rather novelty lies in properly structuring the data with that of author's analysis humanized by humbling individual stories. Book brings back 'agency' to people who hitherto have been seen only at receiving end of public policy and at mercy of state without having to enjoy any 'real choice'. But book through interviews and surveys provides evidences of 'open defecation' as a choice for many rather than lack of anything.

                the book starts with an absurd death. Death of one year old child. This itself makes writing more real and hitting because authors do not camouflage death under numbers, jargon or graphs or mortality rates instead they provide face and name to the dead. From the very first story book glues you to keep turning pages without burdening with statistical overload. Understanding the significance of issue at hand in large sphere of public health and policy making, authors maintain logical consistency (which cracks somewhere at middle of book but comes to life again at end of it) and clarity of questions posed and answers given.

                  the book for very obvious reasons can be located at intersection of developmental economics, anthropology and public policy. One because of authors training and  academic background, second because way of doing research and survey and third because the work has direct bearing on public policy formulations.

                   the three part and 9 chapter book is clearly divided into why? How ? And what?

Why open defecation persists in India and particularly rural India ?

How does it affect individual, society and country at large?

What can be done to change the picture?

                         the book before proposing its own assumptions goes onto 'debunk' half a dozen 'fallacies' surrounding the high no open defecation in India. By comparing similarly situated countries across world and especially Asia to  that of India authors challenges those who argue that people defecate in open because they lack access, water , education, money. All these assumption or what authors call 'fallacies' held by public policy researcher have not asked a question that this book is asking and question is  'do you use it?', and answers to this question is strength of this book.

                        Important contribution of book  lies in providing substantial causes beyond the old story of governance. The book helps in closing the gap between social structure and public policy . It provides a clearer understanding of what 'hygiene' means to rural society and in turn how stratified society constructs the simple choices of personal hygiene. Cultural and social notion of 'purity' which is completely different from that of idea of 'cleanliness' in clinical term somehow entangles to such an extent that hygiene becomes entitlement of few pure people while pollution is forced on those who are born in lower caste. As book provides glimpse of it thorough one respondents story,

        'It is not that dhobi women get clothes physically cleaner than Fatima would, instead they absorb the pollution of childbirth in a public way so that whole family of Fatima can be absolved of the ritual impurity of childbirth'

 So when this presumption of pollution and purity exists in rural household, The public policy of building latrines which is indifferent to these realities is put in place , it is doomed to be less effective so it would not help in getting rid of open defecation to the proportion of monetary spending it entails. Because the practice of open defecation would solve just by having a latrine at every home is rather a misconception because having a toilet inside the house is seen as pollution and defecating in open is looked up as pure. So the idea of 'Pavitra Bharat' do not always go in sync with the dream of 'Swachha Bharat'.

                         Even when some people cross this social barrier, they are forced to build 'expensive' toilet because the concept of toilet in rural India itself is 'expensive'. Village landlord's toilet of 10 by 10 becomes a standard to measure the right size of toilet. Costing anywhere around 40 to 50 thousands. But the alternative to this 'costly affair' is pit toilets which are being used extensively in countries like Congo and Bangladesh. But here comes the social question again. 'who will empty this pit?'. Why people can't empty their own pit?

normal pit latrine used in african countries

Answer to this question lies in work of Khare as cited by authors, purity applies to people, work and places. There are pure people, there are less pure people and there are polluting people and these polluting people are meant to do the dirty work in dirty places. And now rarely lower caste is ready to the work of 'manual scavenging' even with high payment, so the question of emptying the pit poses big question marks on viability of this 'cheap option' so the only option is 'expensive' latrine.

After diving deep into the causes of high open defecation in rural India , the book switches to elaborating  'consequences' of the practice on health, economy and dignity of human life.

                       It was refreshing to read about how open defecation is one of the cause of reduced children height in India. Through lot of numerical and survey studies book converges the evidences of child height and open defecation. Another study done finds clear relation between how open defecation increases child mortality by double digit. What makes it worse in India is the population density  which increases the interaction of children to faeces. Authors bring to notice a staggering fact that Muslim babies in India are more likely to survive childhood than Hindu babies in India despite the Muslim population is socially, economically much behind than their Hindu counterparts . But is it a religion that is explanatory factor for this ' Muslim mortality paradox' as Sonia Bhalotra calls it. The big part of answer is open defecation. 

                       It was observed that 66% of average Hindu baby's neighbour defecate in the open compared to only 45% of average Muslim baby's neighbourhood and this gap of more than 20% is more than total % of open defecation in whole countries of Africa. So simply saying if you put Hindu baby in Muslim neighbourhood , her/his chances of survival increases enormously. But not to forget that open defecation is even if big but one of many reasons of this paradox. Book then goes onto discuss well known effects of lower cognitive development in children in economic development of country. And then discusses how human life can be dignified by having latrine for those who want it instead to universally providing latrines to every rural household.

                       As with any book on public policy, the past part of book devotes to few policy recommendation for state as well as for international agencies. Authors call for clear data on open defecation before announcing any universal construction drive. It ask state to do what it was initially supposed to do when nation got independence and that is to become social driver of democracy and spend more on awareness about caste discrimination. So nothing exciting about the way forward. But it is what reality is , it is not exiting rather the reality for any public policy is not meant to be exiting and rythmic or sensationalizing but it has to be clear and simple to work .

                         On may 7th 2022 , The Hindu covered a study of National family health survey which shows that 25% of Indian household still defecate in open though staggeringly less no than 2011 but still whatever government says India is still far from ODF (open defecation free) status. Surprisingly in the very last chapter of book authors have predicted the failure of Swachha bharat in 2017 itself so this legitimizes the argument made in book that mere toilet construction drive would never solve the open defecation problem of India rather it would require active involvement of state and non state organizations into convincing and creating awareness about the not only toilet use but also social norms and stratification that hinders the individual choice .

 

authors- Dean spears and Diane Coffey