In which I write an entire blog post about the use of toilets

For the past two days I’ve been traveling with District Health Inspector (this is a fancy title for a big government official who will oversee our tiny little village clinic and the village health workers. I’m practically 100% sure you will hear more of him in future blogs and for now I’ll refer to him as the DHI).  I’d prepared several hours of teaching for the VHTs but he made it very clear he had intentions of doing it and as I’m not one who likes to disagree with government officials here I cheerfully let him. His topic was “Heath and Sanitation” but he could have more descriptively called it “Why to not poop the way you do.” For those of my readers who are not familiar with the villages there is a lot of open defecation. OK, that is an understatement. Everyone just poops where they want without regard for health or smell or anything  (In their defense they truly don’t know the health side of the issue) and no one washes their hands. Ever. So we have been trying to teach. There are between 8,000 and 10,000 people living in the village right now and there are two latrines. Both initiated by the CLIDE staff and used exclusively by the CLIDE staff and their visitors. But it isn’t because the locals aren’t allowed to use them or anything. They just don’t want to. The UN has a reputation for coming into villages like this and just building a bunch of latrines but without investment, input or participation by the locals. And after all that money is poured in the latrines are never used. Besides, the people can easily enough make their own with the same materials they build their homes (and a lot less money!)  So lately, to get more buy in the UN has changed their strategy. They went into a village and encouraged people to make their own and offered each family who had a pit latrine a blanket. I was told by the DHI that the UN considered it very successful and had to give out hundreds of blankets.  So now when you go into these villages that the UN has had some recent influence you have your choice of latrines but it doesn’t matter which you pick because none of them have ever been used. People built them but they still won’t use them.
So back to my two days with the DHI. His strategy? Shame. The gist of his talk was how they are all eating each other’s feces because they are not washing their hands or burying the waste. 

The diagram was like this only with pictures instead of words but I’ll spare you all the graphics. 

He began by asking who had defecated? Many shamelessly raised their hands (they see it as a sign of good health).  He asked who had washed their hands. None. He asked who had buried it. None.  He brought a pile that was near the foot path we had been on between where we were teaching and the village. With it sitting right in front of him he talked of how it is in their fields so gets on the food. How it gets into their water sources. How flies land on it and with their legs carry it onto their food and how most of all, it is always on their hands. It seemed pretty effective. By the end of our second day they had a plan to go through the whole village encouraging people to clean it up and start to dig latrines. I’m slated to follow up on April 10^th (the day they picked) to see how their latrines are coming along. At that time I also plan to teach of intestinal worms and deworm all the kids. Hopefully this will continue to drive home the lessons and with the latrines in progress people will start to see that they can change and make healthy choices.