India: The Open Defecation Paradox

Mitch Koss, Special to the Pulitzer Center

Mitch is part of a Vanguard team reporting about toilets, or the lack thereof, in much of the world. Vanguard is Current TV's original documentary series.

We in the news media tend to have an overblown sense of the impact of what we report. And since we in the media, by definition, also control the coverage of most circumstances, many of the news stories that you read or see or hear are laden with the expectation that the simple act of pointing out a problem is the beginning of its solution. But this might not always be the case. That's because reporting on, say, malaria, isn't the same as causing money for vaccine research to materialize. Even the prevalent coverage of global warming hasn't quite produced the international will, or funding, to combat it to the satisfaction of all climate scientists.

On the other hand, there are a few problems where publicity actually is a large part of the solution. One of them is open defecation. But, paradoxically, it gets relatively little coverage.

Open defecation—humans defecating outside—is the ugly stepsister of clean water scarcity, which we commemorate on World Water Day. Two-and-half billion people lack access to even simple pit toilets, which is three times as many people as lack access to clean drinking water and results in two million preventable deaths per year, mostly of children under five from intestinal diseases. And yet, you don't hear much about it. Jack Sim, the self-described "evangelist of toilets," from the World Toilet Organization, theorizes that's because "every politician wants to be photographed standing next to a new well, but no one wants to be photographed standing next to a new toilet." And without some portion of the powers that be to drive a story, coverage becomes scarce.

I was just in India with Current TV's Adam Yamaguchi and Lisa Biagiotti, who are circling the globe to produce a documentary on open defecation. India has the largest number of open defecators in the world, over 600 million of them. At a certain level, this fact is inescapable. Within a hundred yards of our five star hotel in New Delhi, we could find expanses of human feces—we could find them because we could smell them. Touring Delhi slum clusters with local activists, we traversed neighborhoods where 5,000 people share 20 public toilets, which is nearly the same as having no toilets, resulting in even vaster expanses of human feces. But in urban areas, open defecation can also be invisible in the way poor people can quickly become invisible.

And in rural areas, where most of India's open defecation takes place, it's completely invisible—out in the farmer's fields. To find it, we literally had to have villagers guide us hundreds of yards from the village. But it's in rural areas in particular, not only in India, but Indonesia and elsewhere, that media coverage could play a role in combating the problem.

In urban areas, while the cost of putting in toilets might not be the same as the cost of making a clean municipal water supply, it still can be substantial. But the cost of putting some form of a pit toilet in many rural areas is a cost that even poor farmers can bear—if they want to. For example, NGOs can produce statistics indicating that more households in India have cell phones and television than access to toilets. But for rural people to want to put in toilets, they have to be informed.

From India comes a classic tale of how the World Bank financed toilets in a rural area, only to find them being used as storage sheds, or accommodations. That's because people didn't want them. So, now the strategy is to try to create demand first—a demand that may or may not be related to promises of improved health. In one portion of India's Harayana state, which Adam, Lisa and I visited, they've had some success by switching the argument in favor of toilets from talking about how flies on feces lying in fields fly back to your village and dance on the food you eat, to talking about status. Toilets have become a status item via a campaign called "No Toilet, No Bride." By convincing young women—and their parents, who must give consent in this land of arranged marriages—that men without toilets do not have high enough status to be bridegrooms, a mini-surge in demand for toilets has been kicked off.

It's tough to put a number on the increase in toilets built in the region, but relief agencies are encouraged by the trend, and in a village that we visited, it was easy for Adam to interview you women who said things like, "I can live without a husband, but not without a toilet." A young man showed us a toilet he was constructing, and acknowledged that he would need it when he sought a bride.

In this one portion of a single state in India, the media coverage actually made a difference in solving a huge public health problem. But we're still lagging in addressing the rest of the 40% of the world without toilets. True, it's not a topic of polite conversation, but in a real way, it can be a topic of vital conversation.