The Big Necessity (29 page)

 

The Gram Vikas model provides subsidy because Joe believes in quality. Technology for the poor, he says, should not be poor technology. But in the years that Gram Vikas has been sweating away in Orissa, a conceptual shift has taken place in government and in sanitation thinking. Subsidies, an essential of India's latrine-building program, have fallen from favor.

India's efforts to eradicate open defecation are directed from New Delhi by the Rajiv Gandhi National Drinking Water Mission, part of the Rural Development Ministry. Its offices are on the eleventh floor of a tower building whose lifts only stop at even-numbered floors. I go to the twelfth, assuming I can walk down, but this floor houses the Indian Air Force's Adventure Corps, as is revealed by several photographs on the walls of dashing Indian men with black moustaches and Himalayan backdrops, and by a locked steel gate blocking the stairway. Presumably it's more adventurous if in an emergency the air force officers leave by the window.

I arrive at the office of Sanjay Kumar Rakesh, director of the RGNDWM (an initialism that is actually used) late and in a fluster, and it's an appropriate start, because in twenty minutes Rakesh answers half a dozen phone calls and two emails, and deals twice with his assistant, all the while failing to introduce or explain the silent man sitting next to me. In between, he finds time to tell me that things have changed radically. The CRSP is dead; a new program called the Total Sanitation
Campaign (TSC) has risen in its stead. The TSC has things in common with the Gram Vikas model. It still dispenses subsidies, though less than before. Now, only poor families can get one, and only $11, a third of the old subsidy. But a more important change was to recognize the power of persuasion, as demonsrated in a remarkable regional sanitation program in the Bengali district of Midnapur. Its Intensive Sanitation Campaign, carried out by the local Ramakrishna Mission and UNICEF, abolished the subsidy-heavy model of the CRSP in favor of education and persuasion. The software was backed up by hardware, easily available in a network of Rural Sanitary Marts, local shops selling sanitary equipment at reasonable prices. It was a big success, and helped to inspire a change in policy. Before, the success of sanitation programs had been judged by compiling statistics about coverage. In short, counting toilets. The Intensive Sanitation Campaign and other similar projects throughout India tried a new approach. They counted, instead, how many people were still going for open defecation. A new acronym—ODF, for Open Defecation–Free—was created to sum up the new goal.

The TSC also aims to achieve an ODF India, though Rakesh is still counting toilets. He rattles out some figures. Coverage is increasing by 7.5 percent a year. Extensive monitoring. I ask to see a monitoring report and he tells me to check the Web site. (I do, and the links don't work.) I ask about the Millennium Development Goals and he shrugs. “We're not concerned with those. We have already met them. We have to reach 55 percent coverage by 2015 and we're already at 45 percent.” He seems bored. He says, “Everything is on our Web site. Is there anything else?”

It is a frustrating interview, but it shouldn't detract from the fact that the TSC is an improvement, or that Rakesh's boss, Rural Development Minister Raghuvansh Prasad Singh, has said that “a toilet or the lack of it is the indicator of a country's health, not the GDP or Sensex [the Bombay stock exchange].” And he has put money behind this conviction. The TSC is lavishly funded. With a budget of $810 million, it is twenty times bigger than Bangladesh's sanitation budget, though the number of India's toiletless is only ten times that of Bangladesh's. The minister has creativity as well as cash. In 2003, the Nirmal Gram Puruskar (Clean Village) prize was launched, awarded to villages judged to have 100 percent toilet coverage, 100 percent school toilet coverage,
and to be open defecation–free. In the prize's first year there were 35 winners out of 70 entrants. The following year there were 770 entrants and in 2007, ten thousand villages applied.

The awards are handed out by the president of India and get serious media coverage. Other efforts by Minister Singh have been more controversial, such as a letter he wrote in 2005 to all chief ministers demanding that they pass a law requiring anyone running for local office to possess a latrine. No toilet, no election.

TSC still had problems. Not all regional officials wanted to abandon subsidies, because doling out subsidies makes politicians popular with voters. So some states have diverted funds to keep their subsidy levels high, with predictable consequences. Researchers found half the latrines unused in some TSC project areas. Something was still not working. Meanwhile, over the border in Bangladesh, something was.

 

On a day in 1999, an Indian agricultural scientist called Kamal Kar arrived in the Bangladeshi village of Mosmoil. He was there as a consultant for WaterAid, which had asked him to assess whether the organization's subsidy approach and latrine-building program was working. WaterAid couldn't understand why its Bangladeshi branch had been building latrines for years, but 40 percent of the country's illnesses were still the excrement-related kind. Kar thought WaterAid was asking the wrong question. “Let's not talk about subsidy,” he told his employers. “Let's find out instead why people are shitting in the bush.”

I meet Kar in his spacious apartment in Salt Lake City, an affluent suburb of Kolkata. He has an intense energy, which shows through a ceaseless jiggling of his legs and speech at the speed of a machine gun. He is blunt. “You can't be a doctor and be scared of blood, and you can't work in sanitation and be scared of shit. Anyway, no one understands you when you say
sanitation
.”

At Mosmoil, Kar used techniques from a discipline known as “participatory rural appraisal.” (A layperson may ignorantly translate this as “asking people you're trying to help what they think.”) This usually involves a walk through the village—“a transect walk”—and asking locals to draw a map of their surroundings. Kar did this, but the transect walk, once it
had passed through the nice parts of the villages, carried on to the areas used for open defecation. On the map, once the houses had been chalked in, villagers were asked to indicate where they usually went to defecate. As Kar explained in a how-to guide to the method, “It is important to stop in the areas of open defecation and spend quite a bit of time there asking questions and making other calculations while inhaling the unpleasant smell and taking in the unpleasant sight of large-scale open defecation. If people try to move you on, insist on staying there despite their embarrassment. Experiencing the disgusting sight and smell in this new way, accompanied by a visitor to the community, is a key factor which triggers mobilization.”

The calculations involved villagers doing their sums. They were asked to reckon how much excrement was being left in the open. “The accumulated volume of feces,” Kar wrote, “is reckoned in units that can immediately be visualized by the community—cart loads, truck loads, boat loads. There is much amusement as people reckon which family contributed the most shit to the pile that morning. But as the exercise goes on, the amusement turns to anxiety. People are horrified by the sheer quantity of excrement left in their village: ‘120,000 tons of shit is being dumped here every year? Where the hell does it all go?'”

The answer, as the villagers of Mosmoil figured out for themselves, is “into their bathing ponds and rivers; and from there onto their clothes, their plates and cups, their hands and mouths. Onto the udders of their cows and into their milk. Onto the feet and hooves of their livestock, dogs, and chickens, and onto the flies that carry it straight to their food.” Eventually, the villagers calculated that they were eating 10 grams of each other's fecal matter a day. At this point, the brilliant core of Kar's method is revealed. The brilliant core is disgust.

 

Disgust is probably the least studied of all human emotions. It has been called “the forgotten emotion of psychiatry.” Opinions still vary as to its composition, function, and genesis. William Ian Miller, in
Anatomy of Disgust
, one of the few serious books on the topic, sets out the two main theories. Biologists, he says, think disgust is innate. What is disgusting is usually what is bad for you. This was given credence by a huge online
poll carried out by Dr. Val Curtis. Participants were asked to choose one of two similar pictures. In all cases, the picture judged to be more disgusting—the greeny-brown soup over the blue gloop; the worms, not the caterpillars—showed something that could carry disease. Greeny-brown looks like body fluids, which can be dangerous. People have worm burdens, not caterpillar burdens. Humans experience disgust, Curtis theorizes, because it keeps them alive. Anyone who doesn't find excrement disgusting risks contracting diarrheal diseases from getting too close to it. “If you've got an innate capability to avoid things that are going to eat you from the outside,” she tells me, “then probably you've got an innate ability to avoid things that can eat you from inside. Parasites are bad for you because they make you sick and die and you won't reproduce. Also they make you unattractive and you won't reproduce.” But our disgust is also visceral. When volunteers were blasted with skatole, the smelliest compound in feces, none could stand it for more than five minutes, and all expressed physical signs of disgust such as facial expressions and pallor. This needn't trouble Curtis's theory: What is more visceral than the need to survive? Another study found that when presented with a selection of dirty, unlabeled diapers (one of which belonged to their own child) mothers regularly ranked their own babies' feces as less disgusting than others. Parenting, desirable for the survival of the species, would be compromised if mothers were distracted by disgust.

Anthropologists think disgust is learned. They point to small children who show no disgust at dirt or feces until they are educated otherwise. The anthropologist Mary Douglas concluded that something is dirty because it is out of place. Soil in the garden is fine; soil on a plate is not. Disgust becomes a way of ordering a society, of creating a hierarchy of what is safe and what is acceptable. It also becomes a way of distancing intellectual humans from their embarrassingly animal origins. John Berger, in an essay for
Harper's Magazine
about cleaning his outhouse, concluded that “what makes shit such a universal joke is that it's an unmistakable reminder of our duality, of our soiled nature and of our will to glory. It is the ultimate
lèse-majesté
.”

None of the theories seemed to hold true in Mosmoil. For reasons of convenience and habit—they had no latrines, so they had to go somewhere—the villagers had suppressed disgust. Kar thought the only
way they would change is if they did it themselves. It is difficult, he writes in his guide, to break the entrenched habit of development professionals, to resist being the omniscient outsider coming into the village and dispensing instruction and free latrines. But it was crucial. Any awareness had to be revelation, not instruction. From within, not top-down.

In Mosmoil, after the fecal calculation, people started vomiting from the shock. Then Kar did something more shocking still. He left them to it, or threatened to. “I said, ‘Carry on what you're doing. Your forefathers did it; you can do it. Good-bye.'” The story as Kar tells it is suspiciously dramatic, but enough reports have been written on the Bangladesh program that I believe him. Immediately, he says, the villagers were fired up with shame and disgust and determination. Children ran off to start digging latrine pits on the spot. The villagers swore that within two months “not a single fellow would still be shitting in the open.” All this took place without a penny of subsidy being dispensed. No latrines had been supplied, no technical advice. Kar believes that once disgust has been triggered, villagers may say they can't afford a pit latrine. At that point, the facilitator can suggest a simple, low-cost design, emphasizing that it was created by poor people. Kar wanted to shift the focus away from hardware. It didn't matter, he believed, if latrines were temporary. People would upgrade if they needed to. Once they'd seen the light of disgust they would do whatever was necessary.

Kar went back to his hotel after a day in Mosmoil with the makings of a new methodology that apparently worked. He came to call it Community-Led Total Sanitation, or CLTS. Community-led, because it was not about outsiders imposing things on insiders. Total Sanitation, because it kept the 100 percent requirement of the Gram Vikas and TSC models. In Bangladesh, where WaterAid had good local partners, and where the population density made people receptive to a private latrine, its success spread fast.

 

In India, where development experts were sick of seeing their expensively provided latrines standing unused, and tired of seeing those “bare bottoms doing what they must,” CLTS looked like a ray of hope. Kar
initially refused to try it in his home country. India's huge bureaucracy meant that there were too many government meddlers to interfere with things at village level. Bangladesh had nothing and its people had nothing. It was easier to persuade people to do things for themselves. In India, too much money was still being thrown at sanitation. People had gotten dependent on subsidy. They saw the next village getting subsidized latrines, and preferred to wait their turn for handouts rather than build their own. Kar told his countrymen that CLTS would never work in India. Eventually, thanks to persistent persuasion from a man at the Water and Sanitation Program's Delhi office, he changed his mind.

Kar invites me to Dharamsala, where he's running a CLTS workshop. Dharamsala, the involuntary home of the Dalai Lama, is one of the most popular tourist spots in the Himalayan state of Himachal Pradesh. Tourists come here to see Tibetans or mountains, but it's lucky they don't come to see toilets because they wouldn't find many. Himachal Pradesh's sanitation statistics are woeful. Eighty percent of people do open defecation. The state government has therefore decided to initiate CLTS statewide. HP is a test case for CLTS, and the Dharamsala workshop will train the people who will make it a success.