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To Improve Sanitation in Rural India, Building Toilets are not enough – We need to Change People’s Attitudes about Using Them.

There is, and has been for generations, a dire sanitation situation in India. Per the latest census, nearly 70% of rural Indian households and 13% of urban Indian households defecate in the open — a practice that poses a huge health hazard for all members of the population. Open defecation is a major cause of fatal diarrhea in children under age five and a contributor to stunted growth and malnutrition. The problem goes beyond health issues as authorities “have admitted that 95% of all rapes in India occur when girls go out alone in secluded places to urinate or defecate” — and thus, “a direct correlation between crime and open defecation seems to exist.”

The obvious solution, or so it seems, is to provide more toilets to more families in more villages. Yet, it’s not that simple. As the Washington Post reported in 2015: “Building toilets is the easy part. Getting people to use them is the real challenge.” That’s because in India, many people actually prefer open defecation and are reluctant (or flat-out refuse) to use toilets. Many believe “going” out in the open is healthier for the mind and body. Some men believe using a toilet is an effeminate activity, and still others fear the eventual task of emptying a pit latrine — an act long-associated with lowly or “untouchable” members of society.

Because of these persisting (and erroneous) mindsets, the real challenge of eliminating open defecation hinges on the ability to change people’s attitudes.

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