Where India Goes

Why, the authors ask, does India’s rural population continue to practice open defecation when the practice has significantly declined in countries with comparable levels of development. In three clearly delineated sections, the book explores causes, consequences, and policy responses from the Indian government, NGOs, WHO, and the United Nations. The book’s main argument is that India lags behind comparable countries because policymakers have not considered stability of the Indian caste system and its concomitant rules of purity and pollution when planning and implementing sanitation programmes to eradicate open defecation.

Beginning with causes, the authors explore four general explanations for the crisis: poverty, lack of water, low literacy levels, and lack of good governance. Their findings show that none of these explain why a larger proportion of rural population in India compared to countries with similar levels of development and in some cases less well developed, continue to practice open defecation. A distinct difference between India and other countries studied is the permanence of caste. Although political intervention, economic development, and education have made headway in dismantling historical caste inequalities, India continues to struggle with cultural edicts of purity and pollution imbued in these belief systems. The remainder of this section of the book examines the role of caste identities and notions of ritual purity in Indian society and for people in rural communities specifically. For Indians holding these beliefs, a toilet in the home or near the home is unclean and polluting and for those who use toilets, fear of coming in contact with polluting filth, may force them to build toilets with large, expensive pits to minimize the need for frequent emptying. The authors conclude that caste identities and notions of ritual purity is a critical factor in rural India’s continued practice of open defecation, to such an extent that even when toilets built through government or NGO programmes are available they may remain unused while the cost of building a toilet to acceptable standards is economically prohibitive.

In the following section, the authors investigate the consequences of continued open defecation. Using survey data collected in five states: Bihar, Haryana, Madhya Pradesh, Rajasthan, and Uttar Pradesh between 2011 and 2014, together with existing national and international datasets, and secondary data sources. The authors focus the consequences of continued open defecation for the health of children, the impact of poor health for educational achievement, and the lack of suitable sanitation for the dignity of marginalized groups such as the elderly and disabled. The authors argue that a failure to address open defecation will have long-range negative effects on economic development of India.

In the third section of the book, the authors consider government responses to the crises. The Indian government’s answer to the problem has been to focus on building more toilets. The authors argue that as long as such programmes fail to consider the stability of caste belief systems and notions of purity and pollution, ongoing as well as future toilet construction programmes are doomed to failure. To succeed projects must consider the social context that prohibits usage of toilets provided. The book concludes with a number of recommendations to policymakers that take into account the role caste belief systems continue to play in India.

This is a thought-provoking book that could have been even better. The authors could have made a more nuanced analysis of the heterogeneity of rural India. The book’s presentation of caste as a critical factor is illuminating but weakened by a failure to explicitly analyse the diversity of India’s rural population with its various ethnic and religious groups belonging to a myriad of jatis and their subunits as they intersect with socio-economic conditions of rural life. Secondly, in their recommendations the authors appear to advocate a top-down approach. Research elsewhere has shown that bottom-up approaches where local populations are included in decision-making processes have a better prognosis of succeeding.

The book fills an existing gap in the literature on open defecation. Written in an accessible style with clearly presented and supported arguments the book serves as a reminder that implementation of sanitation programmes must consider not only technical capacity but also remain cognizance of the cultural context in which such programmes are taking place. The book offers a compelling perspective that should appeal to researchers, NGOs, policymakers, and students of development interested in understanding the multidimensional problems associated with eradicating open defecation in India and elsewhere.