September 3, 2014 / 3:08 PM / 5 years ago

Even if you build a toilet, they may not come: water expert

STOCKHOLM (Thomson Reuters Foundation) - Bangladesh and India have long tried to stop people from defecating in outdoor public places – a practice that spreads fatal diseases – but Bangladesh has had much more success than the economic giant next door in getting people to use toilets.

A groom comes out from a toilet as brides stand at the venue for a mass wedding ceremony at Ramlila ground in New Delhi June 15, 2014. REUTERS/Adnan Abidi

The percentage of Bangladeshis defecating in the open dropped from 19 percent in 2000 to just 3 percent in 2012, while nearly half the India’s 1.2 billion people still resort to streets and fields as their toilet of choice.

So how did Bangladesh do it, and why India is still struggling?

The key, according to World Bank water expert Junaid Ahmad, is shame.

Several years ago, NGOs fanned out across Bangladesh and asked villagers to mark the outdoor public places where they were relieving themselves. They then mapped it out, showing the villagers that they were defecating right next to their homes and mosques – putting their families and neighbors at risk of serious illnesses such as cholera, diarrhea, dysentery, hepatitis A and typhoid.

This mapping exercise stirred a collective sense of shame - and a seismic shift in habits.

“What Bangladesh realized very early on was that sanitation is about delivering an infrastructure and about creating behavior change… You have to first recognize that it’s a behavior shift that’s needed before you put in the infrastructure,” Ahmad, the senior director of global water practice at the World Bank, told Thomson Reuters Foundation on the sidelines of a global water conference in Stockholm.

“Health message is not enough to trigger people’s shift. You have to understand the behavior, what triggers that change.”


By contrast in India, toilets were offered for free in a hope that people would simply start using them, but instead, people used the latrines for additional storage.

“In economics there are not too many goods in which if you put the price at zero the demand still doesn’t move. Sanitation is one of these goods. Even if you build toilets and hand it to people they don’t use it,” he said.

In 2013, India’s then-prime minister candidate Narendra Modi vowed to “first have toilets and then temples.” Seven months later, two teenage girls were hanged from a tree when they went to relieve themselves in a field in Uttar Pradesh.

Inadequate sanitation costs India an estimated $54 billion a year. 

Ahmad stressed the need for more than just toilets to achieve universal access to sanitation.

“It’s about well functioning utilities, local governments, efforts on behavior change,” he said. “But the most important is to get citizens involved. When you get them involved this is when you scale up.”

Ahmad noted that India has its own sanitation “success stories” - in Haryana, West Bengal, Kerala and Maharashtra states. In order to scale up those successes, he advises the central government to ensure that money flows to the states and to local governments.

Thomson Reuters Foundation, the charitable arm of Thomson Reuters, covers underreported humanitarian, human rights, corruption and climate change issues. Visit

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