Of these, almost 900 million still defecate in the open, in open fields, street gutters, behind bushes or into open bodies of water. Open defecation perpetuates a vicious cycle of disease and poverty. In the countries where open defection is most widespread they have the highest number of deaths of children under 5 years old as well as the highest levels of malnutrition and poverty.
Open defecation is as old as humankind. As long as population densities were low and the earth could safely absorb human wastes, it probably caused few problems. As more people gathered in towns and cities diseases spread. Mankind gradually learned the link between hygiene and health and, in particular, the importance of avoiding contact with feces. Today open defecation is declining worldwide, but of the nearly 900 million people still defecate in the open, over 550 million of them are reported to live in India. In India it is reported that almost 120,000 children under 5 years old die each year from diarrhea. Children are dying from diarrhea. Untold numbers suffer with chronic intestinal infections that reduce nutrient absorption and result in stunting.
In India and worldwide open defecation perpetuates a vicious cycle of disease and poverty. Globally most of the people who engage in open defecation live in rural areas, and that is true in India also. However, in India there is reported to be over 150 million urban slum dwellers that lack sanitation facilities and the number is rising. The situation of the urban poor poses a growing challenge as they live increasingly in slums where sewerage is precarious or non-existent and lack clean and safe water.
In the rural areas of India, in particular, cultural taboos and beliefs seem to perpetuate open defecation even when latrines have been installed. Since 1990 India has been engaged in various missions to build latrines in rural India and end open defecation. Under Prime Minister Modi there has been $40 billion allocated for latrine-building and education. The current program is called Swachh Bharat Abhiyan (Clean India Mission). This program follows the Nirmal Bharat Abhiyan (Total Sanitation Campaign) is a program in India to provide subsidies ($190 per pit latrine) for the construction of household toilets for those at and near the poverty level to prevent diarrhea, soil-transmitted helminth infection, and child malnutrition and stunting of growth.
From May 2010 until December 2013 the Bill and Melinda Gates Foundation funded a study to assess the effectiveness of installing rural household latrines in India under the Nirmal Bharat Abhiyan in preventing diarrhea, soil-transmitted helminth infection, and child malnutrition. The study attempted to investigate the effect of the installing latrines as actually delivered by the foundation and its local partners working in India within the Nirmal Bharat Abhiyan.
The study findings cast doubt on the health effect of the Nirmal Bharat Abhiyan that focus only increasing latrine construction but do not end open defecation or address other sanitation issues that might reduce other possible sources of exposure fecal contamination. Although latrine coverage increased substantially in the study villages to levels targeted by the campaign, many households did not build latrines and others were not functional at the time of the follow-up.
The study findings showed no evidence that the Nirmal Bharat Abhiyan program in rural Odisha reduced exposure to fecal contamination or prevented diarrhea, soil-transmitted helminth infection, or child malnutrition. The study found that the program was a failure and had no impact on health. These findings are consistent with another study performed in India in the Indian state of Madhya Pradesh, but in contrast to results found with improved sanitation and hygiene in other world programs.
The study found that householders with access to latrines did not always use them. Open defecation remained practiced by widely practiced by men and children in homes with latrines. The problem experienced were unique to India. Before any program can succeed India needs to address the underlying cultural acceptance of open defecation, before they can make any progress in improving childhood health and the eliminating the widespread stunting of growth in Indian children. Latrine use was nearly five times higher for women than for men or children in the study, but the study results show that the health benefits generally associated with sanitation cannot be assumed simply by construction of latrines.
Open defecation is as old as humankind. As long as population densities were low and the earth could safely absorb human wastes, it probably caused few problems. As more people gathered in towns and cities diseases spread. Mankind gradually learned the link between hygiene and health and, in particular, the importance of avoiding contact with feces. Today open defecation is declining worldwide, but of the nearly 900 million people still defecate in the open, over 550 million of them are reported to live in India. In India it is reported that almost 120,000 children under 5 years old die each year from diarrhea. Children are dying from diarrhea. Untold numbers suffer with chronic intestinal infections that reduce nutrient absorption and result in stunting.
In India and worldwide open defecation perpetuates a vicious cycle of disease and poverty. Globally most of the people who engage in open defecation live in rural areas, and that is true in India also. However, in India there is reported to be over 150 million urban slum dwellers that lack sanitation facilities and the number is rising. The situation of the urban poor poses a growing challenge as they live increasingly in slums where sewerage is precarious or non-existent and lack clean and safe water.
In the rural areas of India, in particular, cultural taboos and beliefs seem to perpetuate open defecation even when latrines have been installed. Since 1990 India has been engaged in various missions to build latrines in rural India and end open defecation. Under Prime Minister Modi there has been $40 billion allocated for latrine-building and education. The current program is called Swachh Bharat Abhiyan (Clean India Mission). This program follows the Nirmal Bharat Abhiyan (Total Sanitation Campaign) is a program in India to provide subsidies ($190 per pit latrine) for the construction of household toilets for those at and near the poverty level to prevent diarrhea, soil-transmitted helminth infection, and child malnutrition and stunting of growth.
From May 2010 until December 2013 the Bill and Melinda Gates Foundation funded a study to assess the effectiveness of installing rural household latrines in India under the Nirmal Bharat Abhiyan in preventing diarrhea, soil-transmitted helminth infection, and child malnutrition. The study attempted to investigate the effect of the installing latrines as actually delivered by the foundation and its local partners working in India within the Nirmal Bharat Abhiyan.
The study findings cast doubt on the health effect of the Nirmal Bharat Abhiyan that focus only increasing latrine construction but do not end open defecation or address other sanitation issues that might reduce other possible sources of exposure fecal contamination. Although latrine coverage increased substantially in the study villages to levels targeted by the campaign, many households did not build latrines and others were not functional at the time of the follow-up.
The study findings showed no evidence that the Nirmal Bharat Abhiyan program in rural Odisha reduced exposure to fecal contamination or prevented diarrhea, soil-transmitted helminth infection, or child malnutrition. The study found that the program was a failure and had no impact on health. These findings are consistent with another study performed in India in the Indian state of Madhya Pradesh, but in contrast to results found with improved sanitation and hygiene in other world programs.
The study found that householders with access to latrines did not always use them. Open defecation remained practiced by widely practiced by men and children in homes with latrines. The problem experienced were unique to India. Before any program can succeed India needs to address the underlying cultural acceptance of open defecation, before they can make any progress in improving childhood health and the eliminating the widespread stunting of growth in Indian children. Latrine use was nearly five times higher for women than for men or children in the study, but the study results show that the health benefits generally associated with sanitation cannot be assumed simply by construction of latrines.
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