Translator: Oksana Rotko India has a lot to be proud of: its democratic tradition, its diversity, its contributions in art,
architecture, and science, and yoga. But images like this one taint India's reputation. So, why is this image
associated with India? Well, if this circle represents
all of the open defecation that happens in the world, this is the fraction
that happens in India. And this is the fraction
that happens only in rural India. Sixty-five percent of rural Indians
defecate in the open. So, what that means is that most of the open defecation
that happens in the world happens in rural India and most rural Indians
defecate in the open. Every day, 500 million people
in villages in India go in the fields rather than
use a toilet or a latrine. That's bigger than the population
of the United States. And this is a really important issue because open defecation
is really bad for child health. Every year, hundreds of thousands
of children die in India because of exposure
to the bacteria in feces. And those that survive
are physically and cognitively stunted because of that exposure. This lives with them
for the rest of their lives. So, why do so many people in India
defecate in the open? If it's such a bad problem, if it's so widespread
and it's so poor for child health, why does it persist? That's the question that my colleagues
and I sought to answer when we started
our SQUAT survey two years ago, a survey of sanitation quality,
use, access, and trends. Some of you may be thinking that, "Well, India's a poor country, and, you know, maybe people in India
just can't afford to build latrines." I visited a village
in Uttar Pradesh last December, and I was walking around the village, looking for a household
that had a latrine. So, I was wandering
all throughout the village, and I just couldn't find
anyone that had a latrine until I entered one hamlet, and I saw all these covered pits
all over the place. I got excited because latrines have pits,
and I thought that these were latrines until I started talking
to someone who lived there. So, I approached a man,
and I asked him whether he had a latrine. He said he didn't. So, I was a little puzzled,
and I asked him, "Well, if you don't have a latrine, then what're you using this pit right here
that's in front of your house for?" He said that he and his family
had built this pit so that the water that they use
for dishwashing and clothes washing and bathing could just flow into the pit
and soak into the ground rather than going into the streets
and making the village dirty. This household could've definitely
afforded to build a latrine. A latrine just has a pit
with a slab and a seat on top of it. They had built most
of that infrastructure already. They just didn't prioritize one. And in fact, many households
in rural India don't prioritize having a latrine. So, let's compare India
to some other countries in the world. On the vertical axis of this graph,
we have the rate of open defecation in the country, and on the horizontal axis,
we have GDP per capita. Each circle on this graph
represents a country, and the size of the circle
represents the size of the population. So, there's a trend line here, which means that richer countries tend
to have lower rates of open defecation than poorer countries do. But India is really far
from that trend line. India's an outlier. Of the 55 countries that are poorer
than India on this graph, 46 of them have a lower rate
of open defecation. And these are countries
that are poorer than India. So, let's take Bangladesh as an example. Bangladesh has a GDP per capita
of less than one half of India's. But in Bangladesh, only four percent
of households defecate in the open, while in India 53% do. So, the reason why income
doesn't really explain open defecation in India very well is because simple latrines
that safely confine feces in the ground are actually very inexpensive. So, in Bangladesh, we'll commonly find
latrines that look like this. And many people use latrines like this
all over the country in Bangladesh. These latrines cost
about 50 dollars or 3,000 rupees. In Kenya, people commonly use
latrines that look like this. And this costs even less than 50 dollars. These latrines are incredibly simple. They have a pit
which is about 50 cubic feet or a cylinder in the ground
of about three feet by six feet deep. And on top of that,
there's a slab with a seat in it. Every five years or so,
these pits have to be emptied, and in pretty much
every developing country in the world where latrines like this are used, they are emptied by hand. So, the WHO recommends
the use of latrines like this because they reduce the amount
of germs in the environment. And in most developing countries, latrines like this are commonly found
all over the place. Except in India. In India, it's more common
to find latrines that have pits that look like this. And I can promise you,
my colleague Nikhil is not a short man. So, Nikhil and I met this household
in Godhra last year, and we asked them why they
were building a pit this large. They were in the process
of constructing it. This household told us
that they wanted to build a pit that would last them a generation. So, I asked them, "Why do you need a pit
that lasts a generation? I mean, can't you just build something
that's smaller and cheaper and empty it out periodically?" They were completely astonished
at this question. How could they empty
a latrine pit by hand? If they did so, they wouldn't be able
to go to the temple, they wouldn't be able
to perform their rituals, they would be completely
ostracized from their society. That's why they wanted
to build a pit this big. And this household
isn't unique in feeling that way. In fact, many households
in rural India feel the same way. And while the WHO recommends pits of about 50 cubic feet in size, what we found in the SQUAT survey
is that people tend to build pits that are five times
the recommended WHO pit size. And when we asked households
what they would ideally like to build, they told us that they wanted to build
pits that were 20 times that size. And you can imagine pits this large
are quite expensive to build, so latrines that people use in India
are much more expensive than the kinds of latrines
that are commonly used in most other developing
countries in the world. So, what's the big deal
with emptying a pit latrine? I mean, in pretty much most
other countries in the world while emptying a pit latrine by hand
isn't the most fun thing to do, people still do it. But here in India,
handling feces carries a stigma. India's unique from other
developing countries in the world because of its history of caste. I'm sure most of you in this room
know what caste you are. While the influence of caste
is slowly declining in India, most people in India
are still very conscious of it. And unfortunately, most people still think that higher-caste people are purer
than lower-caste people. Caste has a lot to do with sanitation because people from the lowest caste have been historically responsible
for doing manual scavenging or the daily cleaning of feces
from dry toilets by hand. We heard a lot about manual scavenging
earlier this morning from Mr. Shaikh. People from the lowest caste
are considered permanently polluted. And because caste is still so important
in Indian society even today, people from the lowest caste are often very socially
marginalized and oppressed. People from higher castes
try to often avoid contact with people from lower castes
and their work because they believe if they come
into contact with them, they will also become polluted. So, this has a lot to do
with latrine use in India because people associate
emptying a pit latrine with manual scavenging. And what that means is that people
from middle and upper castes would find it inconceivable
to empty a pit latrine by hand themselves. At the same time, people from lower castes tend to avoid doing such work,
understandably, because it's associated
with their past and continuing oppression. So, the market for pit emptying in India
has completely broken down. And that's why people want huge pits. So, while many rural Indians think of this
when they think of using a latrine, many people think
open defecation looks like this. So, I visited a retired army officer
in Haryana last year. And he had a big family. His four sons and their wives
and children all lived with him. This family had a latrine,
and it had a very large pit. They had probably spent 60,000 rupees
or 1,000 dollars on building this latrine. Only the children used this latrine. Everyone else in the family
went in the open, even the young daughters-in-law. So, I asked this retired army officer,
"Why do you go in the open instead of using your very nice latrine
that you have right here at home?" And he told me that going in the open
allows him to exercise his body. (Laughter) It allows him to get the impurities out. And in fact, if he used the latrine,
he probably wouldn't live as long: "That's why people in cities
only live to 60 or 70 years, while people in villages
live for 100 years." So, this gentleman thought
that defecating in the open was actually better for health
than using a latrine. And what we found in the SQUAT survey
is that many households feel that way. In fact, most people
who defecate in the open that we talked to in our SQUAT survey thought that going in the open
was just as good for child health as using a latrine. But let's remember here. Even though we may imagine
this beautiful field when we think of defecating in the open, going in the open
is really bad for child health and kills hundreds of thousands
of children each year in India. So, who's working on this issue? We heard just earlier about Gram Vikas. And fortunately, we also don't have
to prove to the government that sanitation is a worthy topic
to be working on. In fact, the government
has been building latrines in India for the past 15 years now. But many of these latrines are the kinds of latrines
that the WHO promotes. So, it's really no wonder that many
of them end up looking like this. They're used for storerooms. They're left to become dilapidated. So, if constructing toilets
isn't going to work, what can we do? What can the government do? What can you and I do? You know, I get
this question all the time, and I really wished
that I had a good answer. One thing that we could do
is just wait, wait for rural Indians to get rich enough to build
the kinds of latrines that have big pits. But I don't think
we want to wait that long. I don't think we want to lose
that many children to open defecation. What we need to do
is start having frank conversations about caste and about what caste
has to do with sanitation. And we need to be experimenting like crazy with solutions that address
people's real concerns about pit emptying. You know, you and I, and other elite Indians
who live in cities, we get to avoid talking about caste
and open defecation because they're messy
and uncomfortable topics. But India's growing children
don't have that same luxury of avoiding the germs, death, and disease
spread by open defecation. If we care about giving
these children a chance to live a happy, long, and healthy life, we need to start having
those conversations right now. Thank you. (Applause)
Open defacation is 100% going to become a regular thing on the pomcast right mommies? Try it out! You nasty as helllll.
Can confirm.
I spent a month in India and got giardia which nearly killed me, literally (http://www.dictionary.com/browse/literal).
Now that is a good poop story. Spoiler alert: It involved two hours of sitting on the toilet a day pooping. But my apartment had a bidet, so it was all ok.
Designated shitting streets.
Turd Talk
I've got diarrhea!