Friday, June 29, 2012

Rihanna and the toilet: post from Ethiopia

As I mentioned before, I'm in Ethopia--sorry about the lack of blog posts, but I hope to get a couple more up before I return to the US.

The man points towards the back and says something in Amharic. My companion and fellow researcher translates: “Towards the back and to the right.” I nod, and we begin clambering towards the back of the house, trying to avoid the—mud? Mud and manure and urine, I’m guessing, but since it’s rainy season, the three mix together as to be almost unidentifiable. Maybe better that way. I duck under a wooden plank, step on a tire, and hop across to a less-wet spot, balancing myself with the wall of the back shed.

I then duck into the wooden structure with wide gaps in the walls. I fervently pray that no one is going to look over and notice the pale white farangi with her pants down. I get enough attention as is.

The boards are uneven, slanting precariously at a good 30 degree angle. Between the large cracks, I can clearly see a shallow pit of foamy urine, mud, and shit. As I squat over the dark hole and take the fastest pee of my life, my primary concern is that the boards don’t decide today is the day they are going to rot away and I plummet waist-deep in human fecal matter. As I squat, dimly, somewhere, I can hear Rihanna playing on someone’s cell phone or radio: “We fell in love in hopeless place…” I pull my pants back up and jump out of the outhouse, safe from the pit—only to plunge my foot into the pool of manure. 

Public restrooms are not really a part of life here in the rural farming town near Jimma in southern Ethiopia. They’re not a part of life in the town of Jimma, although you might think with the town being the “origin of coffee” it might also be the origin of public restrooms. But it isn’t. Restaurants might have them, but they’re often dingy and dirty. People are expected to go only twice a day—once in the morning, once at night. When I first heard an Indian woman tell me that this is what was expected of them in India, I had been horrified and in awe; now, I find myself similarly regulating my water intake so I can avoid incidents like the above one, which is also worsened by the humiliation of asking for a toilet.

I can’t help but wonder what the health effects of “holding it” are. I know that chronic dehydration can lead to kidney stones, but I haven’t been able to even figure out what to google to get scientific literature on the health effects of “holding it” simply because I haven’t figured out the fancy name for “holding it.” And I have just been discussing urine, but fecal matter as well. If people don’t want to go, they have a terrifying ability to hold it—often times causing serious health problems. (This is particularly a problem for people who go camping in places that don’t have “adequate” facilities.)

I have a great toilet back in my hotel room which I make stops at as needed if I’m in town. But for many people, thier home toilets are not much better. The one that I used was, in fact, somebody’s private toilet. It can be difficult to get children to use many of these home-done latrines because the holes keep widening, making them afraid (and rightfully so) of falling in. Toilets should be private and comfortable, clean and safe in order to be something that people will choose to use instead of risking their health by “holding it” or defecating in the open. Having a latrine is important—having one that people actually feel comfortable and safe using is perhaps even more important, because otherwise it quite simply won’t get used. Shit disposal is not usually on people’s minds when they use a toilet. Why is it the first thing we think of when designing for people?

Ethiopia has a lot of problems: latrines are only one of many. It may seem facetious in the face of that to talk about the “experience” of using a latrine as being as important than the latrine itself. But what we remember are the experiences. What people care about is not feeling like they’re going to fall in. So let’s built toilets all over the place. Let’s get public restrooms where people need them, and let’s make them awesome.

You can think of that every time you hear Rihanna on the radio. I probably will.

Monday, June 11, 2012

The cost of not keeping up sewers

Sometimes in the developed world, we pretend that we have sanitation all figured out. But infrastructure is aging since nobody wants to invest in sewage--not particularly glamorous.

To talk about my current home, Atlanta metropolitan agencies have paid more than 6 million dollars in fines in the past dozen years or so because of sewage spills into surface water sources. The policing on this? It's done by the local governments themselves, which leads one to wonder whether all of the spills are being reported. Successful structure is not only the pipes and plants (although that's a problem too)--it's the systems of accountability. Many of the water ways into which this water is spilled gets used as drinking water sources. So we inadequately clean the sewage, it gets dumped into streams, where we pick it up, clean it a lot, have it go through a series of pipes that are falling apart (during which recent works have shown that it is losing its chlorine residual that keeps the water safe in the pipes), and to people. The EPA fines the city because of the dumping and the poor water quality, resulting in the loss of millions of dollars.

What if we just took that money that we keep getting fined for and instead spend it on fixing the infrastructure instead of just flushing it?

Sunday, June 10, 2012

Going to Ethiopia

I've felt fairly self-conscious about this blogging project, but I've had a fairly positive response--so thanks to everyone who's read!

I'll be leaving for Ethiopia for the next month. I will try to post while gone, but I'm not sure how accessible the internet is where I'll be, so there's no guarantee. For those of you who are curious, I'll be researching food and water insecurity for a professor in my department. If you're interested in guest posting over the next month, please contact me.

According to UNICEF, Ethiopia has one of the lowest sanitation rates in the world, with only 18% of households with access to "improved" facilities (in other words, not an open pit latrine, a public latrine, or a bucket). I'll be recording my observations and experiences while over there, and write some new posts when I return!

Saturday, June 9, 2012

Community-Led Total Sanitation

I’ve somewhat avoided this topic, because it’s something that I feel incredibly frustrated about. But it keeps haunting me, whether it’s in The Last Taboo, The Big Necessity,  UNICEF’s website, or the Copenhagen Consensus.

As a brief introduction, I’ll let WaterAid and its snazzy video give you a summary:

This is a variation on Community-Led Total Sanitation (CLTS), an approach to tackling open defecation first brought up by Kamal Kar, an agriculturalist, in the early 200s in Bangladesh with the support of Plan International. As the above video indicates, the basic model is this:

(1)   “trigger” disgust in a community at open defecation by mapping out where shit is deposited in the community, calculating how much shit is produced, and/or illustrating how it spreads to food

(2)   The community reacts with disgust and is motivated to build latrines. The community pressures late adapters into abandoning open defecation via spontaneous pressures or more programmatically proscribed means.

(3)   The community can then declare themselves ODF free and post a sign.

Sounds good, yes? A lot of groups have thought so. It’s been adopted by UNICEF, WaterAid, Gates Foundation, Plan International, and many other organizations as their official approach.

What’s the number one catch?

We just don’t know.

And that’s the catch.

(Say what?)

There has never been an evaluation of CLTS. That’s right. We’re scaling up and vaunting a means of change that has, in fact, never been scientifically evaluated beyond a few months of the triggering event. There are no follow-ups, no long-term evaluations, no critical reflexivity. Papers on it that do appear in Google Scholar searches are predominantly written by or co-written by Kamal Kar and his colleagues.

But what’s wrong with it? What’s the worst that can happen?

Here are a list of things right off the top of my head:

  • The latrines are ineffective at containing waste.
  • As the “disgust trigger” fades, people are left with an increased resentment towards outside influences who basically came in and told them they’re disgusting. (Let’s perpetuate neocolonialism and resentment towards Westerners even more, shall we?)
  • The social pressure to not defecate openly is applied differentially to people and groups who are already stigmatized. (One means that I have heard CLTS facilitators use is to give children whistles to blow at people they see openly defecating. Who are they more likely to blow a whistle at—the chief of their village or the Untouchable kid?)
  • People who don’t have the means to construct latrines still can’t.
  • Instead of shame causing people to improve their habits, it instead makes them angry, less cooperative, and resentful of the meddling of outside influences.

And think about it, put yourself in the place of these communities—how would you feel if someone came and told you that what you’ve been doing is disgusting?

Disgust has been used to motivate public health behavior in other contexts. It was used quite effectively in this effort at a hospital in LA , where they took swabs from doctors’ hands, cultured the bacteria, and subsequently posted the pictures of the incredibly disgusting dishes and posted them everywhere: every screen saver on every computer screen in the hospital featured these pictures with the reminder to wash your hands after using the bathroom.
What are the difference between CLTS and triggering disgust amongst doctors in a hospital? The doctors already know why they should wash their hands. As they’re doctors, they’ve already bought into the belief system—specifically, Western biomedical understandings of germ spread. The posters and pictures reminded them of values they ostensibly already have; they’re just being prodded to taking the actions to match.

CLTS, on the other hand, does not necessarily work in the framework. It is attempting to incite disgust that is not necessarily based on a belief or knowledge system that is already in place. Yes, most people agree that shit is disgusting, but what value system is being reinforced with CLTS?

I’m not necessarily saying that CLTS is a bad thing. I’m really not. What I am saying is that it needs to be researched more. A lot more.

Link list: from India to our backyard

Sorry about the lateness! I've been getting ready to go to Ethiopia. In the meantime, enjoy these links.

TIME did a good 2007 article on The Right to Flush, giving a good overview of the importance and complexity and importance of public restroom access.

PRI's The World did a 5-part radio series on sanitation, including on ecosanitation, Haiti, India's toilet museum, and an MIT business plan to make human waste into a profitable business.

Salon interviewed Rose George, the author of The Big Necessity, one of the only books out there on world sanitation. (A great read, by the way.)

Authorities in India are being criticized for flagrant waste of money on building a public restroom in one of the representative's districts.

The Punjabi government outlines their budget and plans for water and sanitation next year. writes about Tanzania's push for sanitation.

Friday, June 8, 2012

Wedding port-a-john


I have a friend who is getting married, so I've been cruising ugly wedding sites so I can send her "ideas."

For what happens when your beautiful outdoor wedding has porta-potties. I will say it is a lot nicer than many restrooms.