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Dr. Pathak's communal toilet centres break taboos and build communities

Dr. Bindeshwar Pathak tells the story of a young woman in an Indian village who wrote a letter to her husband, who had gone to the city for a job. "When you come home," the woman wrote, "do not bring ornaments for me. I would be more pleased if you bring money so we can build a toilet in the house."

Bindeshwar recounts the story to illustrate both a huge public health crisis - the lack of proper sanitations facilities in India - and the growing willingness of people throughout the country to confront a problem traditionally taboo. This story is of special significance to the doctor, who has invented an ingenious and affordable toilet system that addresses both elements of India's sanitation crisis: the health risk and the costly social effects.

"People for the first time saw hope with the alternative that I devised," Bindeshwar says. "It gave to them, especially women, a sense of privacy and dignity as opposed to the embarrassment involved in open-air defecation."

More than 700 million people in India have no toilets in their households and defecate in the open or in buckets. It's estimated that nearly 500,000 people die in India every year from diarrhea-related diseases. Large numbers of Indians - especially children - suffer from other gastro-intestinal disease and worm infestation as a direct result of inadequate sanitation facilities.

This deprivation has profound social consequences. In rural villages where the population still defecates in the open, women can relieve themselves only before sunrise or after sunset. Such unnatural restrictions cause physical distress and strip women of their privacy and their dignity, Bindeshwar says.

The lack of sanitation facilities in India has several causes. The most obvious is the lack of money needed to install sewer or septic systems. The shortage of funds is compounded by a rapidly growing population and a lack of awareness about the dangers of open-air defecation. The societal acceptance of this practice has been integrated into India's social structure through its caste system.

Scavengers, men and women who remove human waste, are entrenched as untouchables - the lowest of India's social classes. Although scavenging has been outlawed in India, the practice is still widespread in urban areas, and, to a lesser extent, in the countryside. Approximately four million scavengers remain in India today.

To address these issues of health and social stigma, Bindeshwar, through Sulabh International Social Service Organization, the non-governmental organization he founded, began building and installing the Sulabh system - the affordable toilet he had designed.

The Sulabh system, which uses about two litres of water per flush as apposed to the 14 required by a regular toilet, alternately deposits waste into two pits. The first pit can be used by a family of five for up to four years. When the first pit is full, the family can switch to the second pit, which also can be used for about four years. Over that period, the waste in the first pit is gradually and naturally converted into a rich material that can be removed and used as fertilizer.

Each pit is about one and a half meters deep and lined with a lattice of bricks. The gas formed by the decomposing waste is absorbed into the surrounding soil, eliminating any foul smell. Experiments conducted in India have established that bacteria from the pits travel no more than three meters vertically, and extends less than one meter downward. The design of the system and the pits can be modified as needed to protect water sources and underground soil.

A Sulabh system can be built for as little as $10, which makes it an affordable option in poor regions of India, where less than six percent of all urban areas have connections to relatively costly sewer systems. In these urban areas, Sulabh systems have been adopted as community toilets, often with an innovative modification: the attachment of a bio-gas plant. Through these plants, human waste produces nutrient-rich water that can be used for irrigation, and bio-gas that, when mixed with diesel fuel, can power electrical devices like streetlights. Bio-gas Sulabh systems have become popular in hospitals, schools and hotels.

Bindeshwar's group now has installed more than one million household toilets and almost 5,500 community toilets. The proliferation of these facilities already has brought about noticeable changes in the urban areas, where the incidence of open-air defecation has declined sharply. Since the community toilets also include urinals, the stench from human waste is "no longer as ubiquitous as it was earlier," Bindeshwar says.

"More than anything else the Sulabh system has brought a complete transformation in the living conditions of scavengers," Bindeshwar adds proudly. The availability of Sulabh systems has given meaning to legislation abolishing the practice of scavenging by eliminating much of the open-air defecation and bucket latrines that once required clean-up About 60 per cent of the money generated from the operation of "pay and use" community toilets in urban areas is given to former scavenger families or is used to pay for vocational training that helps them to reintegrate with society. The remaining 40 per cent funds programs for children from other sections of society.

With the growing popularity of the Sulabh system, Bindeshwar says: "Scavenging is on the way out. It is this social transformation of which [we] are proud. It is in this area that attitudes have changed. In fact if I may say so not only that we shall overcome, but have overcome."