Risks and Challenges: Open Defecation in India ICRC March 7-9, 2016

Team members Principal Investigator: Robin Patric Clair, Professor, Brian Lamb School of Communication (BLSC), Purdue University Co-Investigators: Rahul Rastogi, ABD, BLSC, Purdue University & Western Illinois University Ernest (Chip) R. Blatchley III, Professor, Lyles School of Civil Engineering and Division of Environmental & Ecological Engineering, Purdue University Rosie Clawson, Professor & Head of the Political Science Department, Purdue University Charlotte Erdmann, Librarian, M.A., -Siegesmund Engineering Library, Purdue University Seungyoon Lee, Associate Professor, BLSC, Purdue University

Open Defecation (OD) Open defecation is urinating or defecating in the open (e.g., in fields, by railroad tracks or along the road or path to the fields) It is common in less industrialized nations, especially India (over 60% of the population practices OD) There are risks associated with it and challenges to overcoming it

RISKS (from a ‘western’ perspective) Health risks: Diarrheal Diseases –2nd leading cause of death in India (WorldLifeExpectancy, 2009) Children are most susceptible (WHO, 2015; WASH, 2013, 2015) (e.g., helminthes) Causes physical stunting, cognitive impairment, and possibly death (Spears, Ghosh & Cumming, 2013)

SOLUTION (from a ‘western’ perspective) Provide toilets-- Port-a-potties Communal bathrooms Latrines

Extended Narrative Empathy Understanding the Other Person’s Perspective (Clair et al. in press—Communication Theory) Multiple perspectives: Rural Indian perspective, men’s, women’s , girl’s, boy’s, residents’, farmers’ perspectives, historical, caste, etc.

Study: A communication ethnography Kumbhdaura and Chowka December 2014 and mid-January 2015 and again summer 2015 11 Focus groups (men, women, and marriage age girls) Translated (from Hindi) to English and Transcribed (119 single- space pages of text) Assessed by way of Owen’s (1984) thematic analysis Narrative interpretation

Risks (from a rural Indian perspective) OD Shame & embarrassment Fending off robbers Dealing with harassment and physical abuse (for women) Slipping in feces Going at night Animals (e.g., hogs) Flies and mosquitoes FEW PEOPLE MENTIONED HEALTH RISKS

Further Challenges Understanding culture People prefer the outdoors Toilets smell so bad they can make you sick Latrines will keep girls and brides from being able to go outside and socialize Men see toilets as for women, children, infirmed and disabled Understanding culture

Climate, Cost, and most importantly Culture Stifling heat waves—temps as high 120 Droughts in summer Flooding during rainy season Governm’t built toilet least used, others more expensive Solid brick No ventilation Backyard smells bad

If given the perfect toilet… Impeccably clean Hooks for hanging clothes Well-ventilated Door closure with locks Specified wall height Washing facility –running water or equivalent Everything you desire… would you use the toilet?

Would you use it if it were impeccable? NO, but others might …

Do you want toilets? YES

Current Studies Indicate Areas with toilets (Total Sanitation Campaign- toilets, hand-washing, local support, com & ed campaigns) 62% of families have one person –OD 47% of people do not use toilets regularly 39% of people said the do not use toilets at all (Barnard et al., 2013)

Health outcomes Almost no discernable health benefits from partial implementation (diarrhea and stunting among children—1.3 cm increase in height) Hammer & Spears, 2013

Challenges Identity Discourse and socialization (e.g., justification for socialization) Resistance to colonial practices (e.g., toilet) Resistance to historical caste prejudice (e.g., cleaning the pit) Ecological & Environmental (e.g., water issues) Engineering (e.g., Bill Gates Foundation—Build a better toilet)

Identity, Discourse, Desire, & Resistance Men preferred the outdoors (and many women) Women and girls would not have a justifiable excuse to meet their friends and socialize and talk They would lose their “freedom” & “joy” to talk with others

TAKE AWAY Remember risk may be defined differently across cultures Listen with “empathy” Note that cultures are complex; solutions are not always simple

Acknowledgements This project is supported by an Andrew W. Mellon Foundation grant Purdue University’s Public Policy Research Institute (PPRI) Thank you