The Toilet Revolution
An article on “toilets” may seem a little weird but to think of it, toilets are actually important parts our lives. Having worked as a primary health care professional for over a decade I had the opportunity to witness the slow but obvious “toilet revolution” that took place over the years. Besides, Bhutan’s the primary health care services have been applauded by the World Health Organization for its successful implementation of water and sanitation programme among many others. Toilets have become even more important today than ever before, especially so after the World Toilet Organization was established in 2001. This article is just a reminiscence of my own experience of graduating from the open field defecation to using the modern toilets.
Way back in the early sixties, when I was a child we didn’t have a toilet in our house. In most villages we do not have toilets inside the houses even today, but at least we have sanitary latrines almost in every household. In those days when we didn’t have the concept of toilets, we had to relieve ourselves on top of boulders, under trees or inside the bushes. My earliest recollection of a “toilet” (if I can call it), was of a relatively flat stone located some fifty feet away from our house which could accommodate at least three of us siblings at once. This stone was positioned in such a way that the faeces would fall directly from the edge to the slope below. At times a group of siblings would sit together gossiping and relieving ourselves. In fact we would enjoy defecating together rather than ‘solos’. Open defecation would be a problem only when it rained, firstly we would get soaked in the rain, and secondly we would fall prey to blood sucking leeches. Other problem was the stray mongrels which would appear behind us without warning to devour the fresh excreta, at times even offering to clean us up! It was not only children who defecated this way but even the adults would disappear inside thick bushes with pot full of water to relieve themselves.
Cleaning used to be done with either a piece of stone or a stick. My own choice was the leaves of wormwood shrubs which used to be available aplenty. Using leaves was not always safe either for at times they would harbour the leeches which would get stuck at odd places! Further, we needed experience to find the right kind of plants for one could land up using stinging nettle or other irritant species of plants with terrible consequences. Even though our parents seem to use water for cleaning themselves they somehow didn’t think it was important to teach us the technique. It took us a while to teach ourselves to use water for cleaning
I graduated to a slightly different type of toilet when I had to stay with one of my teachers in the village school. The teacher with whom I stayed was an Indian gentleman from Assam and he had made a makeshift type of toilet with shallow pit curtained with old gunny sacks. I also learnt that I had to carry a bottle of water to clean myself after defecation. A few of the villagers later copied this type of toilet, and we also had one near our house later. “Gunny sack toilets” remained in vogue for some times to come. At least, this was the type of latrine we had in our village until much later.
I came across a different type of toilet when I went to Trashigang in 1973 for my higher education. Most houses had pigs kept in the ground floors of their houses and there used to be a balcony type of projection for toilet right above where the pigs used to be. We later named this type of latrine as “hanging toilets”. The faeces would drop straight down for the pigs to feed on. I wonder whether that was an innovative way of recycling food that was so scarce in that part of the country! On the contrary, because of that unhealthy practice, life cycle of tape worms was highly successful in infesting and making us anaemic. The gunny sack toilets had not reached the villages of Trashigang. Cleaning with water was virtually unknown even among the adults, and the most commonly used materials were stones, sticks and waste papers.
Trashigang School, however, had proper sanitary latrines with wash basins and running water. In spite of that most of us seemed to lack proper education on sanitation. Most of our friends had not been able to wean away from using stick and stones into using water for cleaning. That was apparent from the fact that the toilets used to be blocked most of the time forcing us to revert back to the open fields. I, particularly, have a very vivid picture of the toilet that was right next to our dinning hall which once got so badly chocked that the whole area was flooded and the faeces were floating all around making the entire area awful. I guess sweepers were hard to find in those days thus making maintenance of toilets the most challenging job for the school authorities. Even today we have to import sweepers from Bihar in India. Even though people in the towns were exposed to better toilets by then, the villages remained without proper toilets until many years later.
When I joined the Ministry of Health as a medical doctor in 1989, the sanitation in the villages had hardly changed. In spite of rapid growth of modern houses with attached toilets in the towns and cities, villages were still either at the “open field” or the “hanging toilets” level. Even in towns and cities most of the public toilets remained blocked due to poor maintenance. Most public toilets used to be choked with faeces strewn all around without much space for someone to even squat. People would rather relieve by the roadside than inside the chocked toilets. I still remember the unsightly sight of human excreta along the stretch of road between Wangdue town to the Tencholing gate!
In 1991 when I became a district medical officer I found out that one of the important public health activities in the districts was to improve sanitation. The health workers went around the villages teaching people to make simple pit type latrines to the more sophisticated pour flush types. They also made sure that people used them. There were people who just constructed for the sake of it and stocked their commodities in them. Those who didn’t comply had to be warned of dire consequences, at times giving the threats of administrative actions against them. We had to take the help of the district administrators on our endeavour to achieve cent percent latrine coverage as this had become a very important indicator for public health achievement. We also went around educating people about the bad effect of keeping animals in the ground floor of houses. We urged them to make separate sheds for animals and we told them not to use the old ‘hanging toilets’ which sent stools flying all the way down. Our efforts paid off, and by 2000 we had succeeded in achieving almost 100% latrine coverage.
Looking back, I can see the evolution of toilets from the open fields to gunny sack structures to simple pits to ventilated pits to pour flush to water closet, and the most recent western type of commodes, as a real “toilet revolution”. In spite of such progress, at the end of the day we still find our public toilets unsanitary; they are still clogged with sticks and stones, and we still find faeces scattered on our footpaths even in cities! Somewhere something seems to be amiss! I wonder whether we are slipping back in time! Or have we failed to evolve along with our toilets?