Open defecation is the emptying of bowels in the open without the use of properly designed structures built for the handling of human waste such as toilets. Open defecation is particularly associated with rural and poverty-stricken regions of the world, especially Sub-Saharan Africa and Asia.
Open defecation statistics from around the world have shown a statistical relationship between the regions that have the highest percentage of those that do not use toilets or other human waste facilities and low education or poverty.
The World Bank Statistics suggest that regions with high rates of open defecation experience a tremendous problem in terms of sanitation and proper waste management.
According to Wikipedia,
“Open defecation is the human practice of defecating outside—in the open. In lieu of toilets, people use fields, bushes, forests, open bodies of water or other open space. The practice is common where sanitation infrastructure is not available. About 892 million people, or 12 percent of the global population, practice open defecation.“
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Alarming Reasons For Open Defecation
The reasons that have been given for people who don’t use toilets have either been poverty that makes it a challenge to build latrines or lack of government support in providing such facilities. In cases where the toilets are available, but people still end up preferring open defecation, the reasons can extend to cultural issues related to sharing toilets among family members.
An example is a case where it is forbidden for a man to share the same toilet with his daughter in law. In some other cases, people end up preferring open-air defecation due to the freedom it gives them as opposed to using a small dark structure or the displeasure in using toilets that are filthy or not clean.
According to the World Health Organisation (WHO), India accounts for 59 percent of the 1.1 billion people in the world who practice open defecation leading to some serious negative effects on both their own health and the environment. Let’s look at how open defecation affects human health and the environment.
Catastrophic Effects of Open Defecation on Human Health
1. Increase in Waterborne Diseases
Diarrhea and other problems associated with ingesting and exposure to human waste affect children under the age of 5 years the most since they are very susceptible to diseases. This exposure is because most of the open defecation happens next to waterways and rivers.
In urban areas, this can include the drainage systems that are usually meant to traffic rainwater away from urban areas into natural waterways.
Such areas are often preferred because open defecators have a belief that the water washes away their waste. What they seem to forget is that most of such areas are not properly empowered to treat the water to remove human waste and the microbes that move with it.
Such a practice is contrary to proper sewage channels that treat waste black water and channel it into water systems free of any disease-causing germs afterward.
Therefore, the result of open defecation near waterways is that it is carried into the water system minus treatment. As a consequence, the contaminated water ends up in the main water source.
When people in these regions use the same water as it is for drinking and cooking (since the water is not boiled most of the time because of poverty and lack of education), it results in waterborne diseases such as cholera, typhoid, and trachoma.
2. Vector-borne Diseases
Apart from waterborne diseases, when human waste collects into heaps, it attracts flies and other insects. These flies then travel around the surrounding areas, carrying defecate matter and disease-causing microbes, where they then land on food and drink that people go ahead and ingest unknowingly. In such cases, the flies act as direct transmitters of diseases such as cholera.
3. Compounding the Problem of Disease Exposure
The saddest fact about disease transmission caused by open defecation is the cyclic nature of problems that then begin to manifest. The most common diseases caused by this unsanitary act are increased cases of diarrhea, regular stomach upsets, and poor overall health.
With diarrhea, for instance, it means that people cannot make their way to distant places due to the urgency of their calls of nature, so they pass waste close to where they have their bowel attacks.
It simply ends up creating more of the same problems that started the disease in the first place and, in turn, leads to more people catching diseases and fewer people using the facilities. The result of this is more sick people and more opportunities for the disease to spread.
4. Malnutrition in Children
Malnutrition in children is another health problem associated with open defecation. Once a child is a victim of one of the diseases passed on due to the lack of proper sanitation and hygiene, they begin to lose a lot of fluids and lack of appetite for food. As a result, it gives rise to many cases of malnutrition in children.
Also, the situation is worsened by intestinal worm attacks passed through human refuse. Altogether, these problems lead to stunted growth and weakened immune system that makes the child more susceptible to other diseases such as pneumonia and tuberculosis.
5. Child Stunting
Child stunting and wasting are observed to be one of the most widespread consequences of open defecation and poor sanitation around the world. A study published by Dean Spears and Arabinda Ghosh studies 112 districts in India demonstrated that child stunting statistics were significantly higher in areas where the practice of open defecation was more frequent.
In these districts, it was noted that “Over half of the children are stunted, and almost a third of children are severely stunted.” Spears has stated in another paper that living with or near neighbors that continue to practice open defecation, the negative health effects of open defecation are significantly more pronounced owing to densely populated regions.
This is especially common in many areas in India. He mentions, “the difference in average height between Indian and African children can be explained entirely by differing concentrations of open defecation. There are far more people defecating outside in India more closely to one another’s children and homes than there are in Africa or anywhere else in the world.”
6. Gender-based Violence
Open defecation and the lack of adequate sanitation hardware have strong and disproportionate gender-based impacts. The lack of access to private latrines and toilets renders girls and young women vulnerable to sexual violence, which frustrates efforts for them to lead a healthy and productive life. This is a major public health concern, as well as one of the human rights.
As there are no private lavatory facilities for women, they are often forced to relieve themselves in public places during the early hours of the morning or late at night, when the likelihood of sexual assault or violence is higher.
Moreover, the report also outlines the water and public toilets they can use to clean themselves is far from clean, which contributes to the fear of infection or sickness in women, further exacerbating the health problems that result from open defecation.
In India, for example, The Sanitation and Hygiene Applied Research for Hygiene Organization (SHARE) report notes various instances of rape that many girls and young women live in constant fear.
Harmful Effects of Open Defecation on the Environment
1. Contamination via Microbes
The environment also suffers as a result of open defecation because it introduces toxins and bacteria into the ecosystem in amounts that it cannot handle or break down at a time. This leads to the build-up of filth. Also, the load of microbes can become so great that, in the end, they end up in aquatic systems, thereby causing harm to aquatic life.
At the same time, it can contribute to eutrophication or the formation of algal blooms that form disgusting scum on the surface of the waterways, which disturb aquatic life underneath the water by preventing oxygen and light diffusion into the water.
2. Visual and Olfactory Pollution
Heaps of human feces or just the sight of it cause an eyesore and nauseate anyone who is close. The stink emanating from the refuse is also highly unappealing and pollutes the surrounding air. Such places also attract large swarms that make the area completely unattractive for the eye.
For all those unfortunate to see the regions affected, it creates a sorry sight and reduces the dignity of all those living in the squalor of those regions. The smells augment the problem by disgusting those who live within the affected regions making life awful.
Effective Solutions to Open Defecation
To solve this issue, it takes the action of individuals and even the intervention of the government to address the cultural, economic, and social challenges in tandem.
1. Provision of Toilets
First, there is a need to ensure that there are enough toilets. Since these regions are usually very poor, it will take the efforts of the government as well as the goodwill of local organizations such as CBOs and NGOs to help fix the problem.
Construction of pit latrines and other toilet options such as compost toilets is necessary to help deal with the problem of lacking sewer systems.
Governments should also try to establish incentives for people to build their own toilets by providing subsidies and putting up public toilets in strategic locations.
2. Corrective Civil Education
Another platform that needs to be addressed is the negative cultural association that people have with toilets. The people should be informed and given civic education to enable them to break away from their cultural beliefs on issues such as the fact that toilets are not supposed to be shared.
In other words, cultural norms and beliefs must be changed over time through education and awareness creation. With time, people can become informed and drop their beliefs or at least adjust and make concessions about the ones that are most destructive.
3. Incentivize Public Hygiene Participation
By creating government programs that encourage sanitation and personal hygiene, individuals must be involved and forced to take up the responsibility of enhancing their hygiene as well as overall health.
Through such programs, people can get to learn the importance of their environments and work towards ensuring that they do not harm themselves by partaking in open defecation. It eventually reduces healthcare burdens on the government and lessens the number of those who practice open defecation as it will be seen as a terrible activity.
4. Achieve the Sanitation Target
A clear understanding is needed of what prevents and what drives the transition from OD to using a latrine if OD elimination by 2030 is to be accelerated. Sanitation marketing, behavior change communication, and ‘enhanced’ community-led total sanitation, supplemented by ‘nudging,’ are the three most likely joint strategies to enable communities, both rural and peri-urban, to become completely OD-free and remain so.
It will be a major Sanitation Challenge to achieve the elimination of OD by 2030, but presently the principal task is helping the poorest currently plagued by OD and its serious adverse health effects as we seek to achieve the sanitation target of the Sustainable Development Goals. In fact, it is a moral imperative for all governments and development professionals.
5. Swachh Bharat Abhiyan (SBA)
On October 2, 2014, Prime Minister Narendra Modi of India launched the Swachh Bharat Abhiyan or Clean India Mission on the 150th birth anniversary of Mahatma Gandhi. According to the Ministry of drinking water and sanitation, in 2015 CIM achievements report shows, nearly 80 lakh toilets have been constructed under the program. But, in December 2016, nearly 3 crore toilets have been constructed so far.
The country still has a long way to go, as open defecation is common practice in rural India. The government of India has been spending more funds to eliminate open defecation as well as toilet construction, but the progress made so far needs to be sustained and strengthened for further development.
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Benefits of Ending Outdoor Defecation