In mid 2011, Diane Coffey and Dean Spears, both visiting researchers at Economics and Planning Unit of Indian Statistical Institute in Delhi and also assistant professors at the University of Texas at Austin, moved to Sitapur, a district in Uttar Pradesh, to conduct a study on poor early-life health and process of stunting among many Indian children. While Coffey attempted to understand the challenges of raising a baby in the district, Spears compiled government and demographic data to understand the correlation between stunting, cognitive development of Indian children to sanitation. Their findings—that due to poor sanitation, children in rural India die young and those who survive grow up physically and cognitively stunted—raised a further unexplainable question: how is open defecation in rural India different from the rest of developing countries? Coffey and Spears discuss the answer to this question in their book, Where India Goes Abandoned Toilets, Stunted Development and the Costs of Caste. They found that the primary reason for poor sanitation in rural areas is the persistence of caste prejudices or caste hierarchies, which relegate any work involving proximity to human waste to those considered lower-caste, and perpetuate practices such as manual scavenging. (The Caravan published an extract from the book, in which the writers discuss this finding, on its web-exclusives section, Vantage.)

Sagar, a web reporter at The Caravan, spoke to Coffey about the authors’ research and findings. According to Coffey, open defecation in India is a human-development emergency and a dwindling opportunity to prevent a million or more child deaths. Coffey also detailed her experiences speaking to villagers in rural India regarding their outlook towards sanitation, the troubles facing the Swachh Bharat Mission, and why the program is unlikely to achieve its goal of ending open defecation by 2019.

Sagar: You write in the book that, more than bad governance, or the level of poverty, or accessibility to toilets, it has been caste Hindu beliefs in the concepts of purity and untouchability that perpetuated open defecation in rural India. Could you elaborate?

Diane Coffey: One thing we did [during their research] was to look at international data on how things like GDP per capital, and governance, poverty, or education, predict using a latrine. These things do predict latrine use for many purposes, but for India, there is a relatively low level of poverty considering the level of open defecation, and governance isn’t that bad, compared to other nations. We came to understand that we were going to need a unique explanation. At the same tim we were working at these international data, we were also doing household surveys: we called it SQUAT—sanitation, quality, use, access and trend. We took the SQUAT survey of several thousand households about where they defecated and why. We partnered that with several hundred qualitative interviews, where I was personally involved with people. That is where we started to understand that the sort of affordable latrines that are promoted by the government and by the WHO [World Health Organisation] are perfectly fine and good from a health perspective, but are not accepted by people in the villages because the pits of those latrines have to be emptied by hand. People link that to manual scavenging, which is associated with Dalit labour and with the social exclusion it comes with, and the caste system, and untouchability. Whereas at other places, where the history of untouchability doesn’t exist, people see it as an unpleasant but necessary job. In India, emptying a latrine is a taboo in a way that it isn’t in other places. Instead of adopting the affordable technology, people either defecated in the open or used expensive technology that can be emptied with a vacuum where nobody has to interact with faeces.

An important point there is that if people were to use the twin-pit latrine [a system in which two pits are constructed, so that when one fills up, it can be covered and allowed to sit for decomposition] in a way that the government and international organisations recommend, it would not be an issue of biological danger from the faeces, because they’re supposed to decompose in six months and can be emptied. But of course, there’s not much education on that. People don’t know that latrines can be left to decompose. Even when we explain that to people, they tend to say that what we are saying about the biology of the matter is fine but [that they will] face a lot of social exclusion in [their] village if [they] work there.