Toilets Aren’t About Not Dying of Disease

I’m not nearly as far gone as Robin on the idea that social status is the predominant human motivation, but here is a pretty powerful example from an interview with British journalist Rose George about her new book, "The Big Necessity: The Unmentionable World of Human Waste and Why It Matters" (I haven’t read it, but I’ve read a bit about it, and Tyler Cowen recommends it).  Excerpt below the jump.

You found in your research there’s no single solution. Why not?

The answer is not that everybody should have a sewer or everyone should have a toilet. That is simply impractical, and most countries can’t afford it. Culturally, in sanitation, we’re very different around the world. People have different attitudes to hygiene and toilets. Some countries are fecal-phobic and some countries are not. China is quite at home with excrement, and uses it as fertilizer, whereas Indians are not. They’re quite averse to any use of human waste.

In Benin, Africa, some very interesting research was done into what would make people buy a latrine. Mothers, who didn’t have a latrine, could see that their kids were getting sick every week with diarrhea. They were spending money on medicine, and their kids weren’t going to school, but they still wouldn’t buy a latrine.

An academic named Mimi Jenkins discovered that the biggest incentive for someone to buy a latrine in Benin was to feel royal, because the royal family had one. It was a question of pride and status, it wasn’t about health. Health messages never work, because nobody wants to be nagged, even when they’ve got the evidence in front of them.

So telling people, "This is where the cholera is coming from," doesn’t have as much impact as appealing to their pride?

Exactly. It’s what I call the "doctors who smoke" understanding of people. Doctors who smoke know it’s bad for them, yet they still do it. What a lot of sanitation activists are saying is that we have to make people want toilets. It has to be something they aspire to and desire.

Isn’t part of that incentive making defecating in the outdoors unappealing?

Yeah, and there’s a very interesting movement going on in many developing countries, including India, Cambodia and Bangladesh, called Community Led Total Sanitation. It appeals to people’s sense of disgust.

A few visitors will go to a village, and the villagers will want to show off their village to the guests. They’ll take them around the village, and then at the end of the tour, the visitors will say, "Well, yes, that’s nice, but can we see your open defecation grounds?"

Because they’re polite, the villagers will take them there. The technique is to make people stand there and confront it, to not be able to turn away from the fact that they’re shitting in the open, and that their kids are tramping it back into the village, and that they’re all eating it. Someone calculated that people in villages who are doing open defecation are probably ingesting 10 grams of shit a day. That’s pretty disgusting.

People will run off and dig latrines. Once the whole village is cleaned up, nobody will want to be the dirty person in the village. And once the village is cleaned up, the clean village will be in competition with the next village, and that village will want to clean up. It’s a chain reaction.

That’s pretty damn amazing: the fact that it will keep your kid from getting sick doesn’t convince people, but making a latrine an aspirational item will.  And come to think of it it also fits in with Elizier’s idea that people can be amazingly lazy even when the stakes are very high.  But even that doesn’t fully capture the weirdness, but I’ll bet that many of these mothers truly love their kids and would, in other scenarios, go to almost any lengths to protect them.