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Providing the toilets people want will help Clean India’s campaign

A woman stands outside a makeshift toilet built by a resident of a slum colony based on the bank of the Yamuna River, India. Flickr/Gates Foundation , CC BY-NC-ND

Indian prime minister Narendra Modi has wowed audiences in Australia during his recent visit and used the occasion to remind people of his plan to provide a toilet at home for all Indians by 2019.

The leader of the world’s largest democracy and second-most-populous nation addressed a function in Sydney this week where he encouraged Indians in Australia to contribute to the building of toilets back in India.

Since his election in May, Prime Minister Modi has passionately pledged his support to the Swachh Bharat Abhiyaan Mission, stating that his country will be “open defecation free” by 2019. He even took the opportunity to highlight the importance of sanitation in his inaugural Independence Day speech.

Brothers and sisters, you must be getting shocked to hear the prime minister speaking of cleanliness and the need to build toilets from the ramparts of the Red Fort […] But this is my heartfelt conviction. I come from a poor family, I have seen poverty. The poor need respect and it begins with cleanliness.

The popular prime minister has used other public events around the globe to raise the issue (see video below).

The Indian government has been attempting to tackle open defecation for many years. Despite this, the country represents an ever-increasing proportion of the world’s remaining open defecators. A joint World Health Organisation and UNICEF report on water and sanitation states that, as of 2012, India had 597 million of the world’s one billion people still defecating in the open.

Varied success in India

The success of Indian sanitation programs has varied from state to state. Policies have been managed by local governments, leaving the country without a unified federal approach.

Even though recent policies have advocated a demand-driven approach, on the ground many states have instead chosen to subsidise sanitation infrastructure, with poor results. The failure of this supply-based approach is strong evidence that just providing people with functional toilets hasn’t been enough.

A Sanitation Quality, Use, Access and Trends (SQUAT) study by the Research Institute for Compassionate Economics (RICE) and the Centre for Global Safe Water (CGSW) investigated open defecation in northern India by interviewing 22,000 people. The results of this SQUAT study will be used to inform the development of the Swachh Bharat Abhiyaan Mission.

Open air toilet, near Gorakpur, India. Flickr/rpb1001, CC BY-NC

The SQUAT study focused on why people chose to go where they did. As well as open defecators, there were people in the study population who owned toilets – both those provided by government and those privately constructed by households.

Different attitudes to sanitation

The study found that 40% of households with a latrine have at least one household member who still openly defecates, while 53% of people who own a government latrine don’t use it at all. Others results included:

  • the prevalence of open defecation was not because of poverty, water availability, lack of education or poor governance
  • latrines were considered “for the weak” such as the sick and elderly
  • no negative stigma was attached to open defecation
  • open defecation was seen as part of a “wholesome life”
  • bringing waste closer to the household was considered less hygienic than open defecation
  • polluting public space was less frowned upon than polluting the home environment.

Free or cheap government toilets have traditionally been pit latrines, which need to be emptied regularly (on the order of years).

The SQUAT survey revealed that cleanliness is of such importance to their study population that in order to move from open defecation to a latrine, they required much higher toilet standards.

It was simply not acceptable to many Indians to have human waste polluting their compounds, or to have to deal with regularly removing this waste.

Cleanliness comes at a cost

Where in Bangladesh the cost of a toilet used by an impoverished household averages US$42, the minimum “acceptable” toilet design found in the SQUAT survey was US$350. This huge cost was incurred either by building a “forever pit” latrine, which never needs emptying, or investing in a higher-technology option, generally a flush toilet model.

Indians surveyed wanted to “flush and forget” – just like the majority of people in more developed countries.

It can be helpful at this juncture to consider what toilets mean to those who live in such developed countries. An interesting book, Toilet: Public Restrooms and the Politics of Sharing, offers insight into just how complicated our relationships with the act of relieving ourselves are.

A recent paper by UK hygiene expert Steven Sugden, Latrine design: go in peace, puts this into perspective in the simplest way:

[…] we (in developed countries) now take for granted that toilets are comfortable, well lit, smell-free, private, pleasant places to defecate. They are places where we can “go in peace”. Latrines provided using donor funds (in developing countries) have tended to be designed from a purely functional perspective and based on vague ideas about what poor people want, or what the implementing organisation thinks poor people should have.

So they have tended to not enhance the actual user experience.

Below is an example of toilets commonly seen in India. With the exception of being well-lit, it is difficult to see how such devices could tick the boxes of what we would consider an appropriate toilet. Why should we expect Indian users to find them acceptable?

A local resident washes in an Indian slum colony. Unsafe sanitation is a danger to the environment and billions of people across the globe. Flickr/Gates Foundation, CC BY-NC-ND

Considering the latest research from India, alongside our own preferences and expectations of what constitutes an appropriate toilet, should encourage us to step back and look at toilets from more than just a functional standpoint.

It is clear that the user experience is important. If open defecation is to cease in India (and elsewhere), we need to stop thinking of toilets as simply waste receptacles.

The loos people want to use

Design thinking is needed to enhance user experience. This needs to involve users, not just experts.

This is important for designing physical sanitation solutions, but must also transcend these to include democratised innovation of market services, which can exert just as much user impact.

In short, one needs to take a whole product-market-service-system approach to the toilet by:

  1. Understanding the marketplace: what are the needs and aspirations of potential consumers and how do you envisage your product would be used?
  2. Designing the product: can you design for multiple purposes, customisation, low-literacy users and local sustainability?
  3. Developing and delivering the product: what is the available infrastructure and will your product integrate into it? Do you need to develop further infrastructure? How will consumers access your product?

Examples are already starting to emerge in India that reflect aspects of this holistic approach. The Samagra organisation, funded by the Bill and Melinda Gates Foundation, set about first understanding the nature of the entire sanitation system in the Pune region of India: not just the physical elements, but also consumer aspirations and preferences, the local enabling environment and the opportunity for local income generation.

Samagra then redesigned the toilet market ecosystem such that it not only serves the critical, basic need of hygienic sanitation but also ensures that the service it offers is more attractive to users than open defecation.

In the south of India, the government of Tamil Nadu has initiated the Namma Toilet model. Their public toilet blocks around the capital, Chennai, are designed for low-literacy users and entirely leapfrog the lack of existing sanitation infrastructure (sewerage lines).

Both examples reflect holistic systems and a human-centred approach to design. It’s a model that considers fundamental reasons why people choose to openly defecate, but also goes on to offer a liberating user experience that potentially changes behaviour in a systemic fashion.

This treats sanitation users as active consumers who seek rewarding experiences and who will choose a solution that transforms and enhances their lives.

After all, shouldn’t all people be given the opportunity to “go in peace”?

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