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How can India have a space agency and not have enough toilets? Author Rose George explains

In conversation with author Rose George about toilets and sanitation.

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Every 15 seconds, a child dies of diarrhoea across the globe. Lack of sanitation facilities and open defecation has been a menace for various countries, including India.

British writer, journalist and author of three books, Rose George, wrote The Big Necessity in 2008. It talks about sanitation and gives the issue a global perspective. The book has been widely well-received and published in nine different languages around the world. George travelled to various parts of the world, including India, for the book’ research.

Last week, she was in New Delhi for a UNICEF conference on open defecation and sanitation, where Parth MN caught up with her. In this interview, she speaks about why she wrote a book on toilets, how difficult it was to convince the publisher to take up a book that’s about shit, and the many ways in which we can address the issue by taking a leaf out of other countries' efforts.

Why did you think of writing a book on toilets?

I had no background in health or engineering or anything that could introduce me to the world of sanitation. I was just a feature writer. While working on a coffee table book before that, I came across an organisation called ‘Sulabh’. I searched more and got to know that 2.5 billion people did not have toilets. I had to read it twice to believe it. And I also could not believe, having been well educated and well travelled, that I did not know this fact. But the reason I never knew about it was because I had never had to know about it. I realised I had grown up thinking a toilet was my right. In fact, it is a privilege.

2.5 billion people worldwide have no adequate toilets, which is 40% of the world. It means 40% of the world indulges in open defecation every day. 50 communicable diseases travel through human shit. Diarrhoea is the second biggest killer of children worldwide. And you have probably been asked to take care about HIV Aids or TB or measles. But diarrhoea kills more people than three of them put together. It is a very potent weapon of mass destruction.

We know how to fix this. In mid 19th century, Victorian engineers installed sewers, systems of waste treatments and flush toilets, and diseases dropped dramatically. Child mortality dropped lower than it has ever dropped in history. The flush toilet was voted the best medical advance of the last 200 years by the readers of the British medical journal.

But sadly, as we lock the toilets behind a door, we locked it out of our conversations as well.

Was it difficult to convince the publisher to publish a book about toilets?

I remember going to see a publisher in London. You should have seen his face when I told him I want to write a book about toilets. But when I told him all the above statistics, he was on his feet, walking around the room, excited and said, “Yes, yes, yes, let us do a book about shit.”

It was a very difficult book to write in one way. How do you write a book about something that is considered unmentionable? How do you enthuse and excite people to pick up, buy and then read the book? I had to first consider the kind of language I would use. I did not want to use a medical language. I always say I wrote the book so my mother could read it. And she did. Although the first thing she said when I told her about it was, “But you have studied at Oxford!”

I wanted to shock people but only selectively. I used the word ‘shit’, which is still quite shocking in British English. But I did not use it very much. It is important to shock people to get them to read you. It is sometimes important to embarrass people. Also, humour. It is very essential to use humour. I didn’t want to it be an academic book.

During my research, I found that the people working in sanitation and trying to fix sanitation felt so neglected that all I needed to do was ask them about it and they would not shut up for hours. They were brilliant. Everybody has a toilet story. We spend almost two years of our entire life in a toilet. But they didn’t have an avenue to express themselves, and that became me.

What is the biggest hurdle in eradicating open defecation? Social, cultural or economical?

It is the human brain. It is behavioural. People trying to sell sanitation need to learn from people who it’s sold to. Advertisers, marketers are experts in persuasion. They understand how to bring about a behavioural change in people. But the NGOs come to the villages and go “you must have a toilet”. Nobody responds to that. I am not going to respond to that.

There was some research done in West Africa by a hygiene economist from the London School of Economics. She asked a sample of people, what would make you install a toilet? She gave them multiple reasons. And this was after they had decades of NGOs coming and telling them “you are unclean”, “you must have a toilet” and blah blah blah. They knew all the reasons, they knew their kids were getting sick. Anyway, health was at number eight in that study. Number one reason for which they would install a toilet happened to be that “the royal family had one”. Number two or three was to have a nicer toilet than the neighbours did. These are all soft things. But they make an impact. It’s been 50 years since well-meaning people are educating citizens about the importance of toilets. Nobody is responding to that. So, you need to change your approach and mentality.\

Watch Rose George's TED Talk 'Let's talk crap. Seriously.' — 

62% of Indians live on $2 per day. Almost all of those who indulge in open defecation belong to this group. Do you agree the problem is largely economic?

No. I have heard the economic argument a lot. If you have $2 a day, you still have $2 a day and you have to choose on what you spend those $2. Your child has diarrhoea, how much are you going to be spending on medicine? The question is not what a toilet will cost you but what will a toilet save you. A toilet can save you money. That’s a strong argument, which will appeal.

There are people who see nothing wrong with going into the fields. Sometimes it is about availability or absolute poverty. But even then, you could dig a hole, which is better than doing it outside. More people in India have mobile phones than toilets. Phones are acceptable and people want them. You need to make the toilet as desirable as the cell phone. This is why South Asia is lagging behind in the millennium development goal.

As I said, we know how to solve the problem but if you look at the budgets of various countries, there is something wrong. Pakistan spends 47 times more on military than on water and sanitation. 1,50,000 children die of diarrhoea in Pakistan in a year. Another problem is that up to 90% of that already minuscule budget goes to clean water supply, which is great. Everyone needs clean water. But a mere latrine reduces diseases by twice as much.

We are wasting the human waste as a resource, as a trigger for development. 25% of girls drop out of schools in India because of lack of toilets.

At this point, you might say the solution is simple. Give everyone a toilet. But it is not so simple because humans are not simple. In many developing countries, governments have gone out and given free latrines, but people are not using it.

The idea is to manipulate human emotions. It has been done for decades. The soap industry did it in the 20th century. Initially, they told people it was healthy. Nobody bothered. Then they sold it as sexy. Everybody bought it.     

Japan had a problem of open defecation 70 years ago. How did it go from what it was to what it is? And can India take a leaf out of Japan’s book?

It was a very long process, took about 50 years. The company that was preeminent in changing the Japanese mindset and bringing in these very clean toilets, it’s called Toto, appealed to certain Japanese preferences, which is for cleanliness, and hands-free. But even so, it did not really work until they did it by example. They would install these toilets in hotels so when people would see them, they would want them in their houses. The process was slow but it happened. 

I was going to say Japan is very different but in some ways, it is quite similar to India. They use water, so there is a culture of cleanliness. I come from toilet paper culture and it is kind of dirty. Everyone thinks they are clean but actually they are not.  

Anyway, India, like Japan, can appeal to the culture of being clean.

In India, many of the states are suffering from acute drought. There is no water to drink. And sanitation takes a backseat. In such cases, what should people do?

There is always a place for sanitation. And that is the behavioural problem I am talking about. In drought-prone areas, one could use dry toilets. There is a perfectly hygienic way of doing it. There is nothing wrong in just digging a pit. As long as it is not near ground water, as long as you can cover it and keep the flies out, there is nothing wrong with it.

You need to look at water scarce countries like Finland and Sweden. In Scandinavian countries, dry toilets are not seen as anything unusual. In the UK, dry toilets are looked down upon. But kids in Scandinavian countries grow up on dry toilets. They all have summer houses by the lake and they all have these dry toilets.

There is a story in my book about this five-year-old girl who had grown up on dry toilets and on her first day at school, she had this flush toilet and she found it disgusting. It is a question of mentality. People do not aspire to have dry toilets. It clashes with the kind of aspirational, stylish toilets that are advertised. But what is the point of that if it connects to nothing? There is no way you can build up sewers as easily and it is environmentally pointless. Dry toilets are feasible.

But imagine someone like me coming to India and telling this to the Indian government. I would be told otherwise. But we need to leapfrog beyond sewers like many countries in Africa did.

It is too late to emulate the kind of flush toilets, sewage system, expensive waste water treatment. It is not going to work. There are too many people without toilets. There is not enough water. There is not enough money for those kinds of ridiculously expensive projects.

You wrote your book eight years ago, in which you have hoped for technological advancement.

To be fair, there is nothing wrong with the technology we have right now. We have everything that we need. Do you know how sewage treatment works? They use bacteria. We already have it.

Also, I do not think nothing has changed in eight years. A lot has. There is no way eight years ago we would be standing here and having this conversation. People are not afraid of talking or writing shit anymore.

Where does India stand globally in terms of sanitation?

India can do a hell of a lot more. It is so advanced in so many ways. There is an argument, how can India have a space agency and not have (enough) toilets? Well, because they are different things. One is seen as desirable and cool. The other is not. Until we make toilets cool, we won’t see a change. There are very smart thinkers in India who need to turn their attention towards this.

 

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