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Authors: Rose George

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Orissa is not a water-starved state. Each village has a bathing pond, but this is also the animal trough, washtub, and toilet. The most pressing problem, Joe realized, was endemic open defecation. Shit was in the drinking water, on food, on the roads, on the bottom of flip-flops, on bare feet. Diarrhea was a weekly event for most people, and many children died from it. The obvious solution was to build latrines.

If Joe had been an engineer, or a bureaucrat in the CRSP program, he would have done only that. Orissa would have had a lot more goat sheds. But it seemed obvious to him that imposing toilets on some people wouldn't work unless everybody had one. It had to be total, and it had to be consensual. “I knew there was [no] point in doing anything if eighty families had toilets and ten shat in abandon.” The ten open-defecating families would continue to contaminate the water and the living environment of everyone else. If sanitation were supplied, it would have to be to 100 percent of families.

These realizations, the result of observation, investigation, and common sense, were significant policy shifts from traditional development practices. Until recently, sanitation programs always focused on the household. The family unit was the one to be persuaded to change its habits and to build the toilet. But that was treating sanitation like water, when the two are nothing like. A family can be the only household to install a water pipe in a village, and it can use clean water without harming anyone else or being harmed by anyone else. But it only takes one family without a latrine to pollute all common areas and drinking water. The irony of defecation is that it is a solitary business yet its repercussions are plural and public.

Joe thought the solution was twofold: all families in a given village would have to agree to build a toilet and bathroom, and they would all have to agree to pay for it. He calls this method “one hundred percent
sanitation.” It is also radical. It has been a standard in development thinking that poor people need subsidies. They aren't supposed to be able to pay for things without help. In fact, poor people have money, but their money is busy. They prioritize. A toilet is rarely considered urgent when there is food to buy and school fees to pay, even when the lack of a latrine contaminates that food and makes children too ill to go to school.

Gram Vikas's job was to persuade people otherwise. Joe could see that there was no point supplying latrines unless he also provided water to cleanse with. That had been the government's mistake. He tells the story of a daughter in a village where toilets had been installed. “We assumed that people would bring the water needed for the toilets from nearby hand pumps. This job was relegated to the wife, daughter, or daughter-in-law. One day, a daughter ‘accidentally' dropped a small stone in the U-trap of the toilet, making it unusable. Pretty soon, similar accidents were taking place in other households, and it wasn't long before people went back to open fields for their sanitation needs. Our lesson was clear. If water-based toilets are to function, we need to make sure running water is available.” The lesson was also that humans are complicated, and that sanitation is never only about bricks and latrine pans.

 

Gram Vikas chose to pilot their method in the village of Samiapalli. It's now the Gram Vikas success story, where visitors are always taken. But it used to be an unhappy place. There were several castes, including ostracized Dalits, who rarely got along. Alcoholism was endemic, as was domestic violence. Women had no say and kept their faces covered whenever they left the house. No one had a latrine and everybody did open defecation. All this had to be changed. The weapons were patience, wits, and bribery.

On the face of it, Gram Vikas was arriving with a gift horse. They were offering to contribute to building a toilet and bathroom for each family. They would also provide 24-hour running water by digging bore wells or channeling nearby springs, and they would build a tower to store the water in. But they were also asking for money. Under the Gram Vikas model, each family had to contribute 1,000 rupees ($25) to
a common fund. Gram Vikas would contribute the big costs—cement, doors, latrine pans—and the fund would pay for the rest and then for upkeep and repairs. Families who couldn't afford to pay cash could pay with labor or in kind. Still, when the daily wage was less than a dollar a day, Gram Vikas was asking for the moon.

The persuaders had to craft their message carefully. There was little point telling villagers they were risking their health, because health messages rarely have an impact. I call this the “doctors who smoke” theory. Doctors know the harm smoking does, but they smoke. Reason rarely persuades people to change behavior. Research in Benin into why people want a latrine found that their principal reasons were to avoid embarrassment when visitors came; to make the house complete; not to have the chore of walking to get water; and to feel royal. Improved health never came into it. Dr. Val Curtis of the London School of Hygiene calls hectoring health messages the “doctors, disease, and diarrhea” approach. It never works, and it's not culturally relative. When Curtis did covert surveillance of hand-washing rates in her own institute, she found that male students—who are, let's remember, students at the London School of Hygiene, and well schooled in disease transmission—failed to wash their hands after the toilet in 60 percent of cases. Only when the surveillance was announced by email did hand-washing rates leap 80 to 90 percent. Curtis likes to refer to the success of soap manufacturers, who got soap into nearly every household in the early twentieth century not by promoting its health benefits but by telling consumers it would make them smell better, be more attractive, be sexier. Soap companies understood that they should target their product to wants, not needs.

In Samiapalli, Gram Vikas had to create a want by bribing people with a need. They focused on women. They were the ones who fetched water from the pumps. In Samiapalli the pumps weren't far, but water is heavy. Gram Vikas told them they could have a tap in their kitchen if they'd build a latrine and bathing room, too. The bathing room was on Joe's insistence, because his catchphrase is “building dignity through toilets.” He'd seen enough women trying to wash themselves under their saris at the bathing ponds, and how that brought scabies and vaginal infections by the score. Villagers had to agree to build the latrine
and bathing rooms up to roof level, and then Gram Vikas would bring water. Sojan Thomas, the Gram Vikas sanitation director, smiling under his moustache, calls this “a by-force business.”

It took 162 meetings, and two years of talking. Gram Vikas appealed to their prejudices. Sojan gives an example. “Often richer people say, ‘Poor people don't need toilets, they're dirty people. Let's carry on the program without them.' And we say to them, ‘These people are still shitting by the pond. A fly that has touched their shit is not going to distinguish between Brahmin and Dalit food. If you have toilets and they don't, that means that your food is definitely being contaminated by lower-class shit.' We appeal to their ego and it usually works.”

After the latrine-building project was complete, people realized that their toilets were better than their houses. So they applied for housing loans, with Gram Vikas as a guarantor, and now they have concrete pukka houses that don't blow away in a cyclone. (When anthropologists complain that Gram Vikas is not preserving “authentic” thatched roof houses, Joe suggests they try living in an authentic thatched house in a monsoon.) Women got enough confidence to start speaking in meetings, then to tie wife-beating husbands to lampposts, then to set up self-help groups. With the time saved from fetching water, they can sow fields of peanuts or cultivate fish. Children's attendance rates at school have shot up, because they are sick less often and because there are fewer chores to do around the house. Before toilets, 10 percent of girls went to school. Now it's 80 percent. But the biggest thing they have got now, the village leader tells me with a big smile, is pride. “We are better than higher-caste places! People from higher-caste villages want to come and live here!”

A toilet for Gram Vikas is never only a toilet. Joe calls sanitation “the entry point.” It's the most difficult entry point and the one that people are least likely to agree on, but once they do, anything is possible. A toilet can change society in unexpected ways. For example, it can improve your marriage prospects.

 

At Bahalpur, we arrive unannounced. A woman runs up to give me a bunch of flowers, nonetheless, and a meeting is swiftly convened on a
veranda. I have learned by now to recognize a Gram Vikas village. From afar, by the yellow water tower; and from nearby by the Gram Vikas slogans and posters painted on the walls. Common to all the villages I visit is a poster that shows a middle-aged woman in the foreground, and in the background a young woman entering a clean-looking latrine. Translated from Oriya, Orissa's state language, it reads: “I will give my daughter in marriage only to a village with a toilet and a bathroom.” I'd taken this as the propaganda it looked like, but in Bahalpur I changed my mind.

On the veranda, men with towels draped on their shoulders sit on one side and women on the other. But the women are unveiled and they are chatty. They crack jokes. Joe is astonished, because he hasn't seen this before, and because in the beginning, the women wouldn't even come to meetings. I ask the women whether the poster is true. “Oh yes, our girls don't want to marry into families from Malad and Borda, because they don't have toilets.” In fact, a girl has just left her toiletless in-laws to return to the village, and she arrived home the day before. The girl, whose name is Gilli, is fetched to be questioned, and sits at the back of the group, her eyes cast down. She looks mortified. She's not supposed to speak to strangers, because she has been married less than a year and has no children. But the women give dispensation, and Gilli says, “It was very difficult. The drinking water there is from the pond. They shit on one side and take their bath on the other.” She's trying now to pressure her parents to persuade her husband's family to build a toilet, but they may also send her back, toiletless. The conversation moves on, and shortly afterward I see Gilli halfway up the hill, walking away as fast as possible.

But girls have to be married, so the villagers are trying to persuade their neighbors to sign up for the Gram Vikas project. This is sanitation contagion. The more villages that join, the easier it gets. Now, any village that is interested can send representatives to stay in a Gram Vikas village to experience a toileted lifestyle. It is one-way traffic. “We do go to other villages,” a towel-wearing man says, “but it's very hard for us now to visit villages where they defecate in the open. We stay for dinner but we'll always come back.” When relatives come to stay, they are told to use the latrine or else.

Or else what? Villagers have learned about compliance because they
had to. In the early days of the project, with the latrines built and the water supplied, people were still going for open defecation. They were too used to “going out there in the open with the wind in their sails,” in Joe's words.

The village council already had the practice of fining people who transgressed village rules in some way. It was easy to set up a new system of open defecation fines. Defecating in the open would cost 51 rupees (one rupee is added to the round number for auspiciousness). The person reporting the offender kept half the fine. The rest went to a village fund. Joe likes to say that the toilet can build livelihoods. With this fining system, a new livelihood of Toilet Spy came into being. Some people gave up their day laboring because reporting people was more lucrative. The women giggle about it now. “For the first three months people continued to go outside. But we could spy on them because they always carried an aluminum vessel of water. Then after they were caught they would still try to sneak outside and hide a bottle under their arm.” The repeat offenders were caught, too, until open defecation was finally banished. No one would dream of doing it now.

Some might find such a system too coercive. Perhaps it pits villagers against each other. Perhaps it's not democratic enough. It's all relative—in Sierra Leone, one NGO suggested bringing in the army to get people to use latrines. Anyway, fines were already imposed for transgressions. In fact, all that has happened is that morals have entered the toilet room. There is now a right and a wrong defecation behavior, and toilet habits have become a communal concern. Sanitation projects often falter, says the sanitation specialist Pete Kolsky, because of a mentality that considers that “my crap is your problem.” In Gram Vikas villages, everyone has acknowledged that it's everyone's problem. This is a very big deal.

The Gram Vikas method is effective, but it is slow. Today 361 villages have 100 percent sanitation, but there are 50,000 villages in Orissa. At present rates it would take Gram Vikas centuries to reach them all. This is the burning question for sanitation experts. There are good projects everywhere, but how can they be spread? In development language, how can they go “to scale”? Kolsky talks about “the false
question. You look at a jewel of a development project and say, why can't we multiply this by a thousand? Because you can't. You've got to have something that can be done by Joe Shmoe or an ordinary bureaucracy.” Joe Madiath admits that his two great problems are finding human beings who want to live in villages for the two or three years that projects usually take, and finding funds. “Ours is a difficult model,” he says. “I always face an inquisition from the government because we insist on one hundred percent compliance. They say it's too much. They are content to say that whoever wants can have a toilet and never mind the rest.” But he's stubborn. “We believe that if it can be done in Orissa, in the poorest state in India, it can be done anywhere in the world.”

BOOK: The Big Necessity
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