Sanitation challenges

Campaigns to end open defecation cannot succeed if they try to shame people into using toilets

India’s efforts to end open defecation can learn from the challenges faced by other countries.

About 4.5 billion people – more than half of us on our crowded planet – do not have safe sanitation. By this we mean a toilet, at home, one which separates us from our excreta, after which the excreta are treated or buried and do not contaminate the environment. One of the United Nations’ recently adopted Sustainable Development Goals is for everyone to have safe sanitation by 2030, which is expected to improve physical and psychosocial well-being worldwide. But how do we achieve this? The answer is not as simple as building more toilets.

For people to invest in sanitation, they need to access the kinds of toilets and services that they want to use. One of the benefits of safe sanitation – and one that motivates many to invest in it – is better physical well-being. But messages about preventing disease are often insufficient to change behaviours.

One approach that combines behavioural change with improved access to sanitation products and services is sanitation marketing programmes, defined as: “The application of the best social and commercial marketing practices to change behaviour and to scale up the demand and supply for improved sanitation, particularly among the poor.”

Toolkits and guides to develop and implement sanitation marketing have been published recently, as have region- and country-specific manuals produced by NGOs and government agencies. There is a growing community working in this area, evidenced by reports and discussions of projects across the globe.

An unsafe toilet next to an informal settlement in Fiji. Author's own, Author provided
An unsafe toilet next to an informal settlement in Fiji. Author's own, Author provided

Reviewing past outcomes

In most such programmes, an external support agency conducts market research and then assists local entrepreneurs in developing a market in which to sell products and services. These might be toilet slabs and superstructures, pay-per-use toilets or pit emptying for latrine owners. The programmes normally include advertising campaigns to encourage uptake of safe sanitation.

This may seem like a sensible approach, but we and our colleagues suspected that some of these programmes use practices that adversely affect some people. In a new paper, we review 33 sanitation marketing programmes to understand what practices are used and the outcomes reported. Four of the 33 programmes reviewed reported the following adverse effects:

  • The death or injury of someone falling into a badly constructed latrine pit;
  • Social unrest where entrepreneurs were viewed as being subsidised and not passing on the benefits;
  • Negative impacts on social cohesion due to conspicuous consumption, where customers are encouraged to purchase items so as to enhance their social status;
  • The shock, shame and disgust of intended beneficiaries when practices criticised their personal sanitation behaviours.

We were particularly interested in conspicuous consumption and the criticism of personal sanitation behaviours, because these were common in the 33 cases we reviewed. Sixteen included practices which promoted conspicuous consumption and 10 included practices which criticised individuals who did not use a safe toilet.

Use of status and shame

Conspicuous consumption occurs when improving status is emphasised in promoting products and services. In this case, that means attempting to convince potential buyers that investing in sanitation will enhance their standing compared to those around them. This is achieved, for example, through promoting toilets as a status symbol, and invoking peer pressure to increase sales. The idea of “Keeping up with the Joneses”, a worldwide phenomenon whereby people purchase goods and services so as to socially and financially keep up with, or outdo, their neighbours, is very much at work here.

Some sanitation marketing programmes set out to make people feel disgusted by their sanitation behaviour to encourage them to invest in the product or service on offer. One example in Indonesia portrayed a character who defecates in the open, Lik Telek (“Uncle Shit”), as a threat to his community. One of the programme’s posters portrayed Lik Telek being driven out of his village for not investing in sanitation, reading: “My village is clean and healthy. No stench, no flies, and no more Lik Telek. The whole village is more dignified.”

Although many of the programmes we looked at which employed such tactics evaluated their impact in terms of whether toilets were purchased or used, few evaluated their impacts on well-being. But personal dignity is a human right that can be or is eroded by these practices. Reduced dignity is associated with poor physical and psychosocial well-being in the form of depression, social anxiety and alienation.

A banner in a Nepali village promoting safe sanitation, as open defecation is ‘only for cows’. Author's own
A banner in a Nepali village promoting safe sanitation, as open defecation is ‘only for cows’. Author's own

Adverse effects

Safe sanitation protects and improves physical well-being for those who acquire and use it, and for those around them. One person using a toilet reduces the amount of excreta entering the environment, with benefits community-wide for those who use toilets and those who do not. It has been argued that temporary loss of dignity leading to the adoption of behaviours that are beneficial to both the individual and community is tolerable.

This argument is only sound so long as the remedy – safe sanitation – is universally achievable. But there are often disadvantaged people who are unable to invest in safe sanitation (for financial reasons, perhaps, or because they are physically unable to contribute to construction). Many sanitation marketing programmes do not provide subsidies or other pro-poor strategies which may assist because such practices are considered to “distort the market”. Individuals who do not acquire safe sanitation are particularly susceptible to reduced well-being, and they will be unable to remedy this.

During the design and implementation phases of sanitation marketing programmes, external support agencies need to understand sanitation marketing’s potential to reduce well-being. If practices that erode dignity are used, then such agencies must consider how the programme will eventually restore it.

Dani J Barrington, Lecturer in Water, Sanitation and Health, University of Leeds and Jamie Bartram, Director of the Water Institute, University of North Carolina – Chapel Hill.

This article first appeared on The Conversation.

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Swara Bhasker: Sharp objects has to be on the radar of every woman who is tired of being “nice”

The actress weighs in on what she loves about the show.

This article has been written by award-winning actor Swara Bhasker.

All women growing up in India, South Asia, or anywhere in the world frankly; will remember in some form or the other that gentle girlhood admonishing, “Nice girls don’t do that.” I kept recalling that gently reasoned reproach as I watched Sharp Objects (you can catch it on Hotstar Premium). Adapted from the author of Gone Girl, Gillian Flynn’s debut novel Sharp Objects has been directed by Jean-Marc Vallée, who has my heart since he gave us Big Little Lies. It stars the multiple-Oscar nominee Amy Adams, who delivers a searing performance as Camille Preaker; and Patricia Clarkson, who is magnetic as the dominating and dark Adora Crellin. As an actress myself, it felt great to watch a show driven by its female performers.

The series is woven around a troubled, alcohol-dependent, self-harming, female journalist Camille (single and in her thirties incidentally) who returns to the small town of her birth and childhood, Wind Gap, Missouri, to report on two similarly gruesome murders of teenage girls. While the series is a murder mystery, it equally delves into the psychology, not just of the principal characters, but also of the town, and thus a culture as a whole.

There is a lot that impresses in Sharp Objects — the manner in which the storytelling gently unwraps a plot that is dark, disturbing and shocking, the stellar and crafty control that Jean-Marc Vallée exercises on his narrative, the cinematography that is fluid and still manages to suggest that something sinister lurks within Wind Gap, the editing which keeps this narrative languid yet sharp and consistently evokes a haunting sensation.

Sharp Objects is also liberating (apart from its positive performance on Bechdel parameters) as content — for female actors and for audiences in giving us female centric and female driven shows that do not bear the burden of providing either role-models or even uplifting messages. 

Instead, it presents a world where women are dangerous and dysfunctional but very real — a world where women are neither pure victims, nor pure aggressors. A world where they occupy the grey areas, complex and contradictory as agents in a power play, in which they control some reigns too.

But to me personally, and perhaps to many young women viewers across the world, what makes Sharp Objects particularly impactful, perhaps almost poignant, is the manner in which it unravels the whole idea, the culture, the entire psychology of that childhood admonishment “Nice girls don’t do that.” Sharp Objects explores the sinister and dark possibilities of what the corollary of that thinking could be.

“Nice girls don’t do that.”

“Who does?”

“Bad girls.”

“So I’m a bad girl.”

“You shouldn’t be a bad girl.”

“Why not?”

“Bad girls get in trouble.”

“What trouble? What happens to bad girls?”

“Bad things.”

“What bad things?”

“Very bad things.”

“How bad?”


“Like what?”


A point the show makes early on is that both the victims of the introductory brutal murders were not your typically nice girly-girls. Camille, the traumatised protagonist carrying a burden from her past was herself not a nice girl. Amma, her deceptive half-sister manipulates the nice girl act to defy her controlling mother. But perhaps the most incisive critique on the whole ‘Be a nice girl’ culture, in fact the whole ‘nice’ culture — nice folks, nice manners, nice homes, nice towns — comes in the form of Adora’s character and the manner in which beneath the whole veneer of nice, a whole town is complicit in damning secrets and not-so-nice acts. At one point early on in the show, Adora tells her firstborn Camille, with whom she has a strained relationship (to put it mildly), “I just want things to be nice with us but maybe I don’t know how..” Interestingly it is this very notion of ‘nice’ that becomes the most oppressive and deceptive experience of young Camille, and later Amma’s growing years.

This ‘Culture of Nice’ is in fact the pervasive ‘Culture of Silence’ that women all over the world, particularly in India, are all too familiar with. 

It takes different forms, but always towards the same goal — to silence the not-so-nice details of what the experiences; sometimes intimate experiences of women might be. This Culture of Silence is propagated from the child’s earliest experience of being parented by society in general. Amongst the values that girls receive in our early years — apart from those of being obedient, dutiful, respectful, homely — we also receive the twin headed Chimera in the form of shame and guilt.

“Have some shame!”

“Oh for shame!”




“Do not bring shame upon…”

Different phrases in different languages, but always with the same implication. Shameful things happen to girls who are not nice and that brings ‘shame’ on the family or everyone associated with the girl. And nice folks do not talk about these things. Nice folks go on as if nothing has happened.

It is this culture of silence that women across the world today, are calling out in many different ways. Whether it is the #MeToo movement or a show like Sharp Objects; or on a lighter and happier note, even a film like Veere Di Wedding punctures this culture of silence, quite simply by refusing to be silenced and saying the not-nice things, or depicting the so called ‘unspeakable’ things that could happen to girls. By talking about the unspeakable, you rob it of the power to shame you; you disallow the ‘Culture of Nice’ to erase your experience. You stand up for yourself and you build your own identity.

And this to me is the most liberating aspect of being an actor, and even just a girl at a time when shows like Sharp Objects and Big Little Lies (another great show on Hotstar Premium), and films like Veere Di Wedding and Anaarkali Of Aarah are being made.

The next time I hear someone say, “Nice girls don’t do that!”, I know what I’m going to say — I don’t give a shit about nice. I’m just a girl! And that’s okay!

Swara is a an award winning actor of the Hindi film industry. Her last few films, including Veere Di Wedding, Anaarkali of Aaraah and Nil Battey Sannata have earned her both critical and commercial success. Swara is an occasional writer of articles and opinion pieces. The occasions are frequent :).

Watch the trailer of Sharp Objects here:


This article was published by the Scroll marketing team with Swara Bhasker on behalf of Hotstar Premium and not by the Scroll editorial team.