But is this diagnosis right? Will more toilets lead to less open defecation and less ill-health via diarrhoea and other feces-borne diseases?
A new survey from the Research Institute for Compassionate Economics (RICE) headed up by Dean Spears is reported on in the Indian Press (although I cannot find the results on the RICE website--I'm sure they will be out soon) in this article in The Hindu newspaper.
The results are from 13 districts in 5 states (3600 households) and find:
- 57% of households have no toilet while 43% do
- of the 43% who have a toilet (I think they only included working toilets), 40% of them have at least one household member who still defecates in the open
- less than a quarter of the households with a toilet said they had constructed it for health reasons--protecting the modesty of their daughters in law was the most common reason for building one
- reasons given for defecating in the open were: convenience, healthier, tradition, pleasure, comfort: in other words, there is a tendency to do this that is difficult to change
If these findings hold up to further scrutiny, they make it clear that building toilets is a necessary but far from sufficient strategy to end open defecation.
The link between open defecation and illness (typically via diarrhoea or environmental enteropathy) must be made and communicated and then entrenched.