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Welcome to India's first open defecation free District

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Nadia district in West Bengal is the first district free of open defecation...It is a remarkable achievement...But old habits die hard...How do we sustain the momentum..We need to replicate the success in all the remaining 675 districts

Oct 23, 2015 [h=2]Meet India’s Toilet Police[/h]

  • By Atish Patel
BN-KW136_itoile_G_20151021070005.jpg
A member of the Nadia community patrol indicated the areas where the volunteer group operates while trying to make their district open-defecation free.
Atish Patel for The Wall Street Journal

Indian farmer Raju Biswas scrolls through his cellphone to find a photo of a man squatting, with his modesty barely preserved, in front of grass-green jute plants that grow locally.
He took the picture, he said, during an early-morning patrol of popular pooping spots.
“We threatened to make posters out of it to put up across the village,” Mr. Biswas said as he stood in a field with other volunteer patrollers.
The group police the open areas of Nadia district in West Bengal equipped with whistles to catch people going to the bathroom out of doors. “After that, we never saw him out here again,” added Mr. Biswas.
Nadia has become a rare success story in the fight against the practice of open defecation, which is so common in India that roughly as many people relieve themselves outside as in.
The district is the first in the country to be officially declared open defecation free, which is defined as every house having a toilet but does not mean that every person uses one, after a two year campaign to get two million residents to start using latrines.
Linked to a higher risk of malnutrition and stunting in children and the spread of diseases like diarrhea and cholera, open defecation is still practised by 597 million Indians, despite attempts by successive governments to stop it.
In the most-recent drive, Indian Prime Minister Narendra Modi in 2014 said every home would have an indoor toilet within five years.
And, just over a year into his ambitious Swachh Bharat Abhiyan, or Clean India Mission, the success of the toilet patrollers in Nadia is being touted as a model for how to achieve that goal.
The largely rural district’s drive to end open defecation began in March 2013, when one in three households in the district didn’t have a toilet in their homes.
That meant a population the size of Slovenia in Central Europe, without somewhere to go.
So the local government went on a toilet-building blitz. Trained masons built over 355,600 latrines between July 2013 and March 2015, the district administration says, with households contributing 900 rupees ($13.84) each for construction. In terms of public toilets, 1,102 were built, including in roadside restaurants and schools.
BN-KW138_itoile_G_20151021070503.jpg
A sign declaring Nadia open-defecation free was seen along a highway in the West Bengal district.Atish Patel for The Wall Street Journal​
But building toilets isn’t enough in India, where people often don’t use them because they prefer to relieve themselves outdoors.
Like elsewhere in the country, many in the district considered defecating away from their homes a cleaner and more comfortable option.
That is where thousands of community volunteers like 25-year-old Mr. Biswas stepped in to form neighborhood-patrolling teams to catch people defecating in the act and to put up names and photos of repeat offenders on walls of shame — part of a suite of measures to encourage and enforce toilet use. Their only incentive was a desire to clean up their area and their reward a calling card signed by the district magistrate that stated their identity as part of the “Neighborhood Monitoring Committee.”
P. B. Salim, came up with the “Toilet for All” drive when he was district magistrate of Nadia. Visiting hundreds of homes, he noticed many families who lacked a toilet owned a motorbike or a color television.
It echoed the often-quoted finding of India’s Census that more people in the country own a mobile phone than have access to a toilet.
“Even someone living in poverty has a choice. It’s about priorities we make” and clearly toilets were not seen as a priority, Mr. Salim said.
So he reached out to people who could influence the public’s toilet habits: teachers, medical professionals and religious leaders.
Schoolchildren now regularly pledge to use toilets, doctors add a note on prescriptions about the harm of open defecation and religious leaders talk about the issue in their sermons.
A campaign which compared India with neighboring Bangladesh, which shares social and cultural links with West Bengal, also helped. Despite being poorer than India, Bangladesh has an open defecation rate of just 3%.
In April, two years into the program, a Unicef-sponsored study found that among 1,742 households surveyed in Nadia, toilet usage by family members above the age of four stood at 99.8%.
Official data says the number of diarrhoea cases registered in the district has fallen from 147,270 in 2013 to 96,185 in 2014, although deaths caused by the disease rose from 18 to 19. Up to the end of July this year, the number of cases stood at 52,273.
Meanwhile, cases of severe childhood malnourishment have dropped from 1,195 to 675 between 2013 and 2014. Through July this year, the number of cases was 271.
“Now people here are embarrassed to go out in the open,” Mr. Biswas said. “I haven’t caught anyone in a long time.”
Every gram panchayat, or cluster of small villages, in Nadia, which has a population of 5.16 million, has been declared open-defecation free, although a small number of houses still don’t have toilets.
But despite this bright spot and the Clean India campaign, improving sanitation remains peripheral in most of India’s 675 districts, according to Neeraj Jain, chief executive of WaterAid India.
Nationally, only about 7% of gram panchayats, are considered open-defecation free.
And there’s another caveat. When the drinking water and sanitation ministry declares a village free of open defecation, it only currently looks at whether there is a toilet in every house, not whether it is being used, though there are plans to monitor use. As a result, experts fear that open defecation is being done away with only in writing.
“If you think construction is the only issue, then it’s a very easy thing to do,” said Dipanjan Bhattacharyya, an additional district magistrate in Nadia, who said that residents need to be constantly reminded that toilet use is essential in healthy, modern life.
So the education campaign, and the patrols, will continue, he said. “There are still some roads to travel to make it a complete social taboo.”

http://blogs.wsj.com/indiarealtime/2015/10/23/meet-indias-toilet-police/?mod=e2tw
 
I wrote about the success in Bangladesh in 2013.
Much has been made recently about the appalling rates of open defecation in India, a country that has on other development indicators shown stunning successes. Almost 600 million people in India defecate in fields, forests, bodies of water, or other open spaces rather than in closed latrines or toilets—that’s more than 10 times the number of any other single country, and 60% of the world’s total. Why, in contrast, does neighboring Bangladesh—a country not only sharing a border but many religious, social, and cultural norms of South Asia—show such sanitation success?
So vast are the differences in current open defecation rates—3% of the population in Bangladesh compared to around 50% in India—that insights from the Bangladesh experience are worth examining.

Access to toilets is not enough, which the current Indian scenario illustrates: billions of rupees have been spent or pledged to spend on building toilets in the past 15 years, but the majority of people with government latrines don’t use them. A trial last month in PLOS Medicine revealed the failings of an Indian government program providing financial incentives to build improved latrine facilities: most families continued to practice open defecation, and, even among those who received improved sanitation, rates of infections in children did not improve. More important factors are at play here: traditions, religious customs, and perceptions that open defecation is healthy, social, or “wholesome.” “Feces don’t belong under the same roof as where we eat and sleep,” Bloomberg reported a young Indian woman saying.

A national sanitation campaign by the Bangladesh government was launched in 2003 to specifically meet the millennium development goal on improved basic sanitation. It brought non-governmental organizations, international agencies, and government together to mount what was called a community led total sanitation approach, focusing on rural populations. This involved “including the people in all parts of planning and action,” says Dr Farzana Begum, a senior programme manager in water, sanitation, and hygiene at icddr,b. Public education was provided on the dangers of spreading feces, the costs of treatment for the resulting diseases, the benefits of latrines for families, plus how community wide use was necessary to stem the spread of disease. Social pressure was key: families and school children monitored the defecation practices of other families. Mapping was carried out to illustrate how close open defecation sites were to mosques or homes.
And it wasn’t just health messages, but “shame and disgust” messages that were part of the campaign, says Dr Begum. Messages such as: “if we openly defecate, you will be eating other people’s feces.”
Social norms changed too: having a household toilet became a status symbol signifying dignity. Marriage arrangements began to include latrine reviews in the homes of prospective spouses. Gender sensitivity was recognized: women were included in making decisions about the location and type of latrines, and they sat on the community committees, while men were given tailored health promotion about hygiene.
Incentives were key: local leaders were chosen as champions of sanitation and held accountable to targets, small businesses selling concrete parts for latrines were rewarded, and financial assistance was provided to help households buy equipment.
http://blogs.bmj.com/bmj/2014/09/23...proving-sanitation-but-not-neighboring-india/



It is not the government alone but the country as whole has to buy into that mindset.
 
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