HASANPUR, India Every morning before sunrise, Ravi Shankar Singh, a cheerful man known to his neighbors as “Luv” Singh, sets out to patrol the potholed roads and rice fields of this north Indian village. He carries a whistle and a flashlight. He sings while he walks.
The village’s self-appointed sanitation guardian, Singh is on the lookout for anyone squatting in the fields or alleys or gutters, using the cover of darkness to do what millions of people always have done across India: defecate outdoors.
After years of programs to increase the number of toilets in homes and villages, the government still has not managed to eradicate a habit that is cited in the spread of water-borne illnesses and parasites, such as diarrhea and hookworms.
Critics say the obstacle is not so much the shortage of toilets, though that, too, remains a problem. The main challenge is getting people to use them.
Singh says he’s found a way. When he spots someone squatting , he lets loose with a blast on his whistle. Or shines his light on the offender. Or both.
No one, he says, likes being caught in the act.
“The whole idea is to put pressure on people to use the toilets,” says Singh, a 46-year-old farmer with coiffed hair and flecks of gray in his beard, standing among a crowd of men nodding their heads in agreement. He has recruited two dozen men and women to help him scour Hasanpur for offenders. And while the squatters might not like it, Singh says, humiliation is very effective.
“In some small way, there has been a change of mind-set, a revolution of sorts,” he says.
Singh’s claim that Indians can be shamed into using toilets challenges the orthodox thinking among public health officials, who say their efforts to improve hygiene are hindered by defecating outdoors remaining socially acceptable across huge swaths of Indian society.
“This is a very old practice,” says Dr. D.K. Singh, chief medical officer for the district health clinic near Hasanpur, who takes the line that it’s a difficult habit to change. “Even if they have toilets in the house, people in villages prefer to go in the fields.
“The latrine is very small,” he says, allowing a slightly embarrassed smile. “The outside is more airy.”
Much rides on finding a way to change that preference. Defecation in open places remains prevalent in rural India and persistent in the cities, contributing to disastrous levels of public health problems that belie the self-congratulatory rhetoric of India’s economic boom.
A 2003 government report said that only 30 percent of India’s wastewater was being treated, with the rest flowing into rivers and seeping into groundwater. And a 2002 report by the World Health Organization said about 700,000 Indians die each year of diarrhea, the majority of them younger than 5.
But the perils of defecating outdoors go beyond poor sanitation.
“In many places, the problem is not one of disease, it’s that women are being raped when they go into the fields at night, or young girls are being kidnapped by bandits,” says A.K. Singh, director of the UNICEF water sanitation program in the Baragaon district near Varanasi in northern India.
The Indian government has been trying since the mid-1980s to increase the number of latrines in homes and villages. Its Total Sanitation Campaign aims to end outdoors defecation across India by 2012, and the government says it is encouraged by recent surveys showing that the number of toilets, and their use, is rising. It says it has doubled sanitation coverage to almost half of rural India and aims to activate its campaign to put toilets in homes in all of India’s 597 districts by the end of this year.
But critics say even that progress leaves tens of millions of people answering nature’s call in fields, along railroad tracks and on sidewalks, even in large cities such as New Delhi. They say government programs have focused too heavily on statistical targets for installing toilets and not enough on the need to change attitudes toward using them.
The government acknowledges that its initial campaign offering subsidies to encourage people to install toilets was a failure, as chronic corruption diverted money from its intended use. And it was hampered by the indifference of people who were never clear on why they should break with age-old habits, leaving many government-provided toilets half-installed or unused.
The government’s current program asks people to pay at least half the cost of the toilets, on the premise that the investment will instill a corresponding commitment to use them.
Some health professionals see indications of change.
“Clearly there has been cultural resistance to changing behavior, but it’s also apparent that people feel some shame about going in public,” A.K. Singh said.
“We see signs, for example, of upper-class people now pressuring poor neighbors not to defecate in their fields. It is no longer always a socially acceptable act.”
Experts say widespread change won’t occur until people understand the connection between personal hygiene and public health.
But “Luv” Singh says defecation in open places is a community issue and sanitation a matter of pride for the village.
He beams when he describes his work and eagerly leads a visitor down one-lane roads that cut across Hasanpur’s rich green fields to show off new toilets and a freshwater pump at the school. Singh says he, too, grew up relieving himself in the rice paddies. Now, he says, village children find it just as natural to use the toilet.
“If we can stop it, our life span will go up,” he says.
What about public urination, he is asked? What are the prospects of stopping that ubiquitous, unsanitary habit?
The men surrounding Singh break into laughter.
“That, I can’t stop,” he says.
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