Let's talk of defecation: Rethinking the future of sanitation
Jonatan A. Lassa and Dominggus Elcid Li
The Jakarta Post
It is time to rethink the future of sanitation. However, politicians in the Global South, including in Indonesia, probably don't care much about where their people defecate. It is also probably considered impolite to talk about defecation in public policy forums and the political arena.
Yet, open defecation (OD) remains a challenge for public health development. In many parts of the developing world, OD has triggered problems such as diarrhea.
The indignity of having no 'akses sanitasi layak (ASL, improved access to sanitation or proper sanitation) may not only keep the infant mortality rate high but also hurt human development. Therefore, it is important to start talking about defecation if we want healthy nations.
The concept of ASL only acknowledges latrines such as the pit-latrine with a septic tank and latrine with a goose-neck closet with septic tanks and flush toilets.
The United Nations reported that the access to improved sanitation facilities increase rate has been 1 percent over the last two decades (from 36 to 56 percent during 1990-2010) in developing countries as a whole, with the greatest success seen in eastern and southern Asia. What about the annual rate in Indonesia?
Based on the last three national surveys (SUSSENAS 1990, 2001 and 2010), Indonesia experienced a significant rise in ASL from 25 percent to 56 percent over the last 20 years.
The national annual average rate is 1.5 percent based on year-on-year calculation. Unfortunately, the actual rate of improved sanitation in Indonesia varies across the regions. The eastern parts of the country experience a much slower rate.
East Nusa Tenggara (NTT) experienced 1 percent year-on-year increase rate of ASL. Its rural districts, such as Kupang regency, only experienced a 0.36 percent annual rate of ASL over the last 20 years (or a change from 5 percent in 1990 to 12 percent in 2010).
Based on Business as Usual or the status quo scenario, Kupang will meet the Millennium Development Goals (MDGs) target (78 percent) by 2194. It means that only by the year 2255 will the entire community in the regency possibly have improved latrines in every household.
Almost all in the rural context continue to practice OD when they work in the agricultural field.
Over the last 10 years, the economic growth of NTT has been more or less 5 percent and Kupang about 4 percent. This suggests that improvement in the economy does not lead to investment in sanitation.
In this light, Action Contra La Faim (ACF) recently commissioned a systematic sociocultural study on Water/Sanitation and Hygiene (WASH) in Kupang, which aimed at understanding how the locals perceived ideal WASH practices and actual everyday life and what kinds of sociocultural/economic or environmental incentives that shape practices, beliefs and habits (PBHs) are in place there.
We found that the endogenous adoption (or self-adoption) of toilets is strongly associated with the economic level of the households. However, improved income does not necessarily lead to improvement in household sanitation.
Historically, it has been international NGOs and the UN that promoted the universal provision for sanitation (including water) during the 1970s, while in West Timor the movement started in the mid-1980s.
Oral history interviews suggest that copying toilet models by villagers occurred very recently. The distribution of modern hamlets and villages in NTT (and to some degree Indonesia in general) often follow the arterial road.
The people were encouraged (and sometimes forced) to stay near the arterial road in order to be to be easily controlled administratively.
The increase in population density in new villages creates social disincentives, such as 'the shame of being seen', which discourages villagers from openly defecating in their residential area, so that shame is the reason people need to use a latrine in settlement or residential areas.
The need to have a latrine is not only about the need for hygiene, but it is part of social problems as adult males don't want their wives to be seen defecating in the open.
Instilling a sense of shame has been one of the key tactics in campaigning the use of latrines under the auspicious of community-led total sanitation (CLTS). However, this does not help explain why 88 percent of the Kupang population has not accessed the ASL.
In addition, the issue is not simply a lack of water and poverty in the semi-arid region.
One of the problems is that the transfer of 'wet toilets' and the cultural program that encourages the West Timorese consider cleansing with water as unhealthy.
As their European and Chinese peers use toilet paper, in the past the Timorese used traditional tools that avoided direct contact with the posterior. The push for the Arabic model of sanitation (using water and soap to clean the posterior) that dominates our sanitation today should be questioned carefully.
There is also a missing link between sanitation interventions within the rural livelihood context. Our findings suggest that the persistence of OD has nothing to do with the existence of toilets. Almost all (including the educated and the richer) in the rural context continue to practice OD when they work in the agricultural field.
We found that households with high urban-rural mobility tend to adopt the idea of toilets in their houses. Self-pride also pushes some of the people to present themselves as 'modern' when they can provide toilets to visitors from nearby towns.
In addition, isolation has been one of the hurdles to the adoption of toilets. A local government policy intervention in the 1960s manifested in the role of mantri kakus, which today is being superseded by sanitation officers where there is still a lack of Puskesmas (community health centers). However, our participatory stakeholder analysis suggests that sanitation officers are hardly acknowledged by locals.
Local communities in the developing world, including in NTT and Papua, may have to wait hundreds of years for better sanitation. We therefore suggest there is a need for a radical political program that takes into account the sociocultural understanding of sanitation adoption in Indonesia.
We argue that without understanding the cultural dimension of the problem on one hand and without proper institutional arrangement on the other, it will be hard to cultivate economic change toward better sanitation.
The writers work for the Institute of Resource Governance and Social Change. Jonatan A. Lassa holds a PhD in disaster reduction from the University of Bonn, Germany, while Dominggus Elcid Li holds a PhD in political sociology from Birmingham University, UK.
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