Reading the discussion, there does indeed appear to be too much attention on technical solutions, while the social marketing approaches being used appear to overlook deep-rooted socio-cultural determinants of sanitation behaviour.

For those who want to understand why open defecation is so persistent in India, it will be worthwhile having a looking at research that precedes the SQUAT survey :

The 1970s studies by Vijay Kocahr on the "behavioural aspects of disposal of excreta in a rural West Bengal".

Mukherjee, N., 1990. People, water and sanitation : what they know, believe and do in rural India. www.ircwash.org/resources/people-water-a...e-and-do-rural-india
This the summary of UNICEF study in 8 states. The background reports are available here

Banda, Kalyan, et al. "Water handling, sanitation and defecation practices in rural southern India: a knowledge, attitudes and practices study." Transactions of the royal society of tropical medicine and hygiene 101.11 (2007): 1124-1130. DOI: 10.1016/j.trstmh.2007.05.004

Jewitt, Sarah. "Geographies of shit Spatial and temporal variations in attitudes towards human waste." Progress in Human Geography 35.5 (2011): 608-626. Free eprint

ggalli wrote:
3) Are we not part of the problem ourselves? (this one is meant to be a bit provocative) If we see sanitation as primarily a technical issue, which can be solved with a new model latrine (with or without superstructure) do we not perpetuate the problem by avoiding discussing the real hard to crack nuts like institutions that need to change, rampant corruption (e.g. 'missing toilets') etc? I've noticed how various issues in this forum are taken up, but when it comes down to it the proposed solutions are merely technical. I don't want to insult anyone here, but I think that we need to bridge that social-technical divide. This goes both ways in my view, for instance a behaviour change campaign without any design support will only lead to latrines that contaminate groundwater.

I don't think you are being insulting at all, you are right - the WASH field is mostly led by engineering fixes (in my opinion at least). Add in science (microbiology) and the sociology of disgust, and, according to the argument, nothing would ever get done.

But, from my way of thinking, any solution which do not produce safe faecal waste and/or which people refuse to use is not a solution to the sanitation issue.

Great discussion! A similar one took also place on the Wateraid Advocacy group on Linkedin for who is interested.
Despite all these recent reports and the momentum that comes from these, it seems to me that we're stuck at the very same point. I think there are various barriers preventing us in making real progress:

1) the reasons behind continued preference for OD are multi-faceted and inter-related. This means that we need to tackle a lot of them at the same time, while institutions prefer focussing on one single aspect (i.e. construction of new latrines). How do we start consolidating the evidence and move forward in such a comprehensive campaign?

2) The level of explanation on the data remains superficial. I can follow that Hindus are more likely to practice OD than Muslims in India. But can this only be attributed to scriptures 1000 or 2000 years old? I would expect that there is more at hand here. We would need research that answers the 'why' question better. For example, why are government built latrines least likely to be used? This type of questions may even justify the need for some anthropological research.

3) Are we not part of the problem ourselves? (this one is meant to be a bit provocative) If we see sanitation as primarily a technical issue, which can be solved with a new model latrine (with or without superstructure) do we not perpetuate the problem by avoiding discussing the real hard to crack nuts like institutions that need to change, rampant corruption (e.g. 'missing toilets') etc? I've noticed how various issues in this forum are taken up, but when it comes down to it the proposed solutions are merely technical. I don't want to insult anyone here, but I think that we need to bridge that social-technical divide. This goes both ways in my view, for instance a behaviour change campaign without any design support will only lead to latrines that contaminate groundwater.

I'm curious to your thoughts!

Best,
Giacomo

Here are some interesting points from the report:

• Users had a concept of a latrine which was very expensive and would not use a simpler, cheaper model
• Missing rungs on the 'sanitation ladder' - straight from open defecation to a latrine
• Men who live in households with a latrine are more likely to defecate in the open than women who live in a household with a latrine - cultural norms whereby women must stay in the home
• Latrines least likely to be used are those built entirely by the government
• Higher numbers of people in more wealthy households use latrines

Hello again everyone: I have been having a look to see what has been published about a 'preference for open defecation' and I found the following squat report, recently released in June 2014.

I have not finished reading it yet, but the abstract says:

Despite economic growth, government latrine construction, and increasing
recognition among policy-makers that it constitutes a health and human capital
crisis, open defecation remains stubbornly widespread in rural India. Indeed,
67% of rural Indian households in the 2011 census reported defecating in the
open. We present evidence from new survey data collected in villages in five
states in India: Bihar, Haryana, Madhya Pradesh, Rajasthan, and Uttar Pradesh. We find that rural households do not build inexpensive latrines of the sort that commonly reduce open defecation and save lives in Bangladesh,Southeast Asia, and sub-Saharan Africa. Many survey respondents‘ behaviour reveals a preference for open defecation: over 40% of households with a working latrine have at least one member who defecates in the open.
In the sample from the four largest states, more than half of people in households
which own a government latrine defecate in the open. We apply a demographic model of latrine use which predicts that if the government were to build a latrine for every rural household that lacks one, without changing sanitation preferences, most people in our sample in these states would nevertheless defecate in the open. Further evidence supports a preference for open defecation: many survey respondents report that open defecation is more pleasurable and desirable than latrine use. Among people who defecate in the open, a majority report that widespread open defecation would be at least as
good for child health as latrine use by everyone in the village.
These findings suggest that intensifying existing policies of latrine construction will not be enough to substantially reduce open defecation. Policy-makers in India must
lead a large scale campaign to promote latrine use.

sorry forgot the link, here it is: www.im4change.org/siteadmin/tinymce/uplo...s%20on%20Toilets.pdf

and also this website: squatreport.in/about-the-survey/

I have just had an interesting conversation on twitter with www.3sindia.com/

We were talking about the possibility of using porta-potties for those who prefer open defecation. Of course, this requires a service system to collect the faeces, but as he/she said, maybe this is what is needed and that governments should have to pay for it.

Thanks Marijn, all good points.

When travelling in India, I wondered about this 'privacy' thing with regard to rail tracks, where defecation is anything but private!

I agree this kind of study would be very interesting to do, together with interviewing sanitation workers in various places about reasons users give for prefering open defecation over offered toilets.

Dear Joe and others,

Both interesting articles, which do indeed make the valid point that behavior change (through: education, policing, or other incentives) is key. I think this is not only the case in South Asia, and Hinduism is not the only religion that is quoted by those "resisting" the use of toilets. For example in Nepal there was a feedback from an animist woman that using the surrounding forest for open defecation was a way of "giving back to nature" and that she was worried the spirits would be upset if they stopped the practice. Having said this, India (and to a degree Nepal) are rapidly becoming regional outliers when it comes to the scale on which OD is still practiced.

It would actually be really interesting to make a study of sanitation reports world wide and see which arguments against toilet use are found. The reasons for people to prefer OD are multiple and complex. Some studies find that where OD is practiced in groups (Like when all women of the village go together in the morning.) people miss the daily social occasion. It seems to me that knowing why people locally prefer OD would be important information for those trying to get people to use toilets.

As far as toilets and super structures, often OD happens (shit happens) in places that people agree are acceptable and thus offer a certain "privacy" (even if it is along a railroad track). I think if a latrine close to a house would not have a super structure these codes would probably be violated and the latrine would not be used. For open air latrines in "commonly accepted places" you quickly run into the normal O&M issues with community toilets.

Regards

Marijn

I agree Chris, I can't see that there is really much of an operational reason why sanitation systems need to have have superstructure. I have no experience either way, and it is possible that people are just using this as an excuse because they are not liking the idea of change - however, if it really is a major psychological problem with the use of existing toilets, it seems to me to be sensible to investigate other shapes of structure which might have less stigmas. Of course, there are potentially other problems with outdoor defecation eg safety.

I also agree that the Manu laws sound like something from another age, but on the other hand it might be something which has a long-lasting impact on current behaviours. I just thought it was an interesting comment.

Hi Joe and Sinaga,

Thanks for posting these links. Both the Bloomberg and the Economist articles are quite good in pointing out that education is key.

About those open defecators who prefer to be outside, we could set up UDDTs with only hedges of plants as privacy walls ... and no roofs, such that the rain and the sun constantly clean and sterilize them. And these could be within sight of homes for more safety against rape, theft, etc. A lid could keep the rain from wetting the feces.

This could even be with this minimalist UDDT design
inodoroseco.blogspot.com/2013/10/a-free-...ist-uddt-part-1.html
A small structure, off to one side, could be built as a solar oven, for appropriate storage and treatment of the sacks of feces that get collected.

The Laws of Manu come from a time when population density was certainly orders of magnitude lower and UDDTs were not yet known in India.

Does anyone from the appropriate Indian ministries for health, water and sanitation participate in this Forum? It would be great to hear from them and to help contribute to their plans and implementation.

Best wishes,
Chris Canaday

Thanks Sinaga, that is also an interesting article from the Economist.

I was interested to read this:

Hindu tradition, seen for example in the “Laws of Manu”, a Hindu text some 2,000 years old, encourages defecation in the open, far from home, to avoid ritual impurity.

I suppose it just shows my ignorance that I had not even considered that there might be a religious reason why open defecation is such a big problem in India.

The problem is almost always cultural or habitual. In this article , you can find the perfect example of that.

This part of this article is spot on:

“Building toilets does not mean that people will use them and there seems to be a host of cultural, social and caste-based reasons for that. People need to be taught the value of sanitation.”

Latrine without a superstructure is an interesting idea, but I guess the problem will be how to prevent insects and animals from the latrine.