Okhil Chandra Sen, a traveller by a train, wrote a letter to the Divisional Railway Officer of Sahibganj on July 02, 1909. It was 106 years ago. Allow this writer to reproduce the letter verbatim (courtesy of Sheepa Hafiza, Director, BRAC). Text of the letter:
Respected Sirs,
I am arrive by passenger train Ahmedpur station and my belly is too much swelling with jackfruit. I am, therefore, went to privy. Just I doing the nuisance that guard making whistle blow for train to go off and I am running with lotaah in one hand and dhoti in the next when I am fall over and expose all my shocking to man and female women on platform. I am got leaved at Ahmedpur station. This too much bad, if passenger go to make dung that dam guard not wait train five minutes for him. I am therefore pray your honour to make big fine on that guard for public sake. Otherwise I am making big report to papers.
Your faithful Servant,
Okhil Chandra Sen
Okhil Chandra Sen's historic letter is on display at the Railway Museum in New Delhi. The letter led to the introduction of toilets in trains in India!
Bangladesh can possibly claim that it has made substantial progress with regard to sanitation. Of course, there is little scope for complacency in this achievement as the kutcha (unpaved) latrine continues to be the dominant mode of sanitation. For example, from only 10 per cent of the households using sanitary latrines in 2000, the coverage increased at a snail's pace to reach 28 per cent by 2010. Modest progress could be evidenced in the use of pit latrines from 9.0 per cent to 16 per cent within the same period.
The most significant progress has, however, been made with regard to the practice of open defecation that is a major source of communication of diseases through flies. The incidence declined from 23 per cent in 2000 to only 5.4 per cent in 2010. Available information suggests that the rate is much lower than in India.
The pace of progress - and across poverty groups - in the use of sanitary latrines in place of the practice of open defecation is praiseworthy although substantial difference in the use across economic groups is in evidence. For example, in 2010, about one-third of the non-poor households used sanitary latrines compared to nearly one-fifths of the extreme poor. Interestingly, the rate of progress has been faster for the poor compared to the non-poor households. Large gaps were also observed with regard to the practice of open defecation across the poverty scale. For example, in 2000, 37 per cent for the extreme poor households went for open defecation compared to 12 per cent of the non-poor households. Rapid progress has been made with regard to the non-use of open field for defecation for all economic groups. The good news is that the progress has been faster for the extreme poor and moderate poor households. But all don't end well as four in 100 non-poor households still use open defecation indicating that some better-off households are still influenced by traditional practices.
Side by side with the government, the world's largest NGO BRAC has long been carrying out 'health is wealth' campaign in rural areas. It has been so through hygiene messages and providing sanitation facilities under the aegis of Water, Sanitation and Hygiene (WASH) programme that assists the government in achieving Millennium Development Goal on water and sanitation-related indicators (MDG 7).
An evaluation of the performance of the WASH over time covering 30,000 households shows that 57 per cent of sample households were using sanitary latrines in 2011 and posits an increasing trend in the use of sanitary latrines. This is borne out by the information that the proportion of people defecating in the open has significantly been reduced from baseline of about 24 per cent to about 14 per cent recently. Again the proportion of households owning such latrines increased from about 73 per cent to 81 per cent during the comparable periods while share of shared latrines decreased from 27 per cent to about 19 per cent. Over time, the quality of latrines used (cleanliness) also depicted an upward trend. But all sanitary latrines were not being used hygienically excepting a majority from WASH of the BRAC that has emphasised motivation by training and door-to-door visits by village WASH committee. Increasing the number of latrines alone cannot lead to improved public health if those latrines are not maintained and used hygienically.
Through the WASH programme, the BRAC has been addressing the high incidence of communicable diseases from poor access to safe drinking water, lack of good sanitation facilities and unhygienic living and eating practices. Promotion of such preventive healthcare may reduce morbidity and the cost of curative health care on which the government and the households spend substantial amount of resources.
The programme has been more successful in creating access to sanitary latrines to the poor and ultra poor households by providing loans and grants and support to local entrepreneurs for construction of good quality latrines. Also, local committees were formed and nurtured for raising awareness of rural households for using the facilities. As a result, the coverage of good sanitary practices has increased. But breaking the water seal due to the lack of adequate water for flashing the latrines remains a challenge.
With regard to good hygienic practices, lack of knowledge and substantial gap between knowledge and practice still prevails. In some critical periods such as before eating meals and handling children after defecation, the people are still unaware of the necessity of washing hand with soap. Sustained campaigns for a long period will be needed for behaviour change in this area. The campaigns should include activities such as distribution of posters and guidebooks, and staging popular street theatre, and targeting children in schools. By and large, people in rural areas no more run with 'lotas' in one hand and 'lungis' on other hand for open defecation. But still a lot is to be done.
The writer is a Professor of Economics at Jahangirnagar Univeristy.
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