In Kannada, the word for gastroenteritis (GE) simply means “vomiting-loose motion”, and on average, one person has contracted the disease each day this year in a single taluk in northern Karnataka. This is hardly surprising given that 70 percent of the households in that taluk do not have toilets.
Since January, 270 cases of gastroenteritis (GE) have been reported from 11 villages of Aurad taluk in Bidar district. One person is even suspected to have died of the disease. The disease causes inflammation of the stomach and intestines, leading to vomiting and diarrhoea.
Despite the disease being an annual phenomenon, the district administration has been able to do little to prevent the circumstances which cause it: water contamination due to open defecation. Research has shown that open defecation not just causes diseases but also affects the growth of children to some extent.
Patients in a government hospital in Bidar
The health department appears both defensive and exasperated. District Health Officer Baburao Hudgekar told The News Minute, “Why do they (engineers) build water pipelines next to drainage lines? I don’t know why they do it, because people take illegal water connections, which cause the pipes to break, allowing (contamination) to seep in.”
However, this may only be a partial factor. The Hindu reported that only 10 percent of the 600 villages in the district have piped drinking water supply, and not all houses are covered in villages where water is supplied through pipes.
Hudgekar also that he had written numerous letters to various panchayats and departments including the department of rural development urging them to create awareness about open defecation. He claimed that he had heard nothing from them.
In several parts of northern Karnataka and Hyderabad-Karnataka, it is particularly difficult to get people to either construct or use toilets, despite the existence of central government schemes to build toilets since at least 1986. After going through several name changes, the scheme is currently called Swachh Bharat Abhiyan.
Nodal Officer for Swachh Bharat Abhiyan Gautam Arali says that people are reluctant to use toilets even if they are built. However, this percentage is very low.
In Aurad taluk, as of August 2015, 70 percent of households do not have toilets. In 2012, this figure was an alarming 92 percent. Arali estimates that even among 30 percent households with toilets, around 40 percent of people still “hesitate” to use them.
Activist and member of Jagruta Mahila Sanghatane in Raichur district Chinnamma says that there are various reasons for the reluctance to use toilets. “Once, someone told me that after they started to use toilets, they stopped fearing it. She said their fears were unfounded,” Chinnamma said. Asked to explain what the person meant, Chinnamma said that people in villages did not think it desirable to build toilets because it would be near the house, or that it would smell.
It was not easy to get them to change their mindset. “We had to tell them that it would not smell, that you could use water, that flies would spread germs from excreta to food, and also that it would reduce the spread of disease. Gradually, they believed us,” Chinnamma says. “Now, cases of malaria, typhoid, and gastroenteritis have come down.”
She says she and her colleagues convinced people in 100 of the 150 households in Muddhemuddi village to build toilets. Construction was completed by 2014.
While Chinnamma says that they provided constant reassurances to tackle unreasonable fears and gave them a reason to use toilets, the government only seems to have woken up to smell the coffee earlier this year.
Initially, when asked how the government was promoting the use of toilets to reduce open defecation, Arali said that the government was creating awareness with the help of street plays in villages and schools. Asked why the government could not utilize the network of self-help groups (SHGs), he said that the SHG network was the only thing they had to fall back on.
Officials inspecting a well in Bidar district
“If you talk to gents (men), it’s of no use. We approach the women’s SHGs which are anyway the majority. If you approach the women, you can solve the problem,” Arali says. He explained that they started by getting lists of SHGs from banks which gave out loans and through those lists, they approached the women through anganwadi workers and ASHA workers. “We began to approach them two years ago, but this year, we have seen results.”
Since 2012, when just eight percent of houses had toilets, Aurad taluk has come a long way. In 2012-13, it did miss its target by 65 percent. The following year, the gap was reduced to 20 percent and in 2014-15 by just 8 percent. During this period, the overall targets have also risen (except for 2013-14, when the targets were reduced).
While it seems to be having success with figures, on the attitude front, the government still has a long way to go even if it is on the right track.
“When we speak to people, we tell them it is not good for them, diseases will spread,” Arali says. But there is another point which automatically crops up in the ‘stop open defecation’ spiel, which even the UN is not immune to. “Adu olledalla antha helthivi, horage hogbedi, nimma mane gaurava kapadi.”
It means: We tell them it’s not good to go in the open like that, preserve the honour of your house.
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