Disposal of Human Excreta and Hygienic Behavior: Guest Blogger Dr. Mohan Lal Jangwal

Environment is an integral part of life. Survival of any living organism is not possible without a healthy environment. Put simply, the “environment” refers to the external factors around us; these factors have an influence on all human beings and vice versa. Different types of environments are all around us, i.e., physical, socio-cultural, and psychological.

Our physical environment faces all kinds of waste coming from a variety of sources. All human beings generate various types of waste, such as refuse, human excreta, and sewage. In urban settings, municipal, industrial, biomedical, and household waste are the major types of waste present. But in rural settings, the major types of waste generated are different and consist primarily of household waste, agricultural waste, human excreta and so on.

The environment affects the life and development of pathogenic organisms, the agents of disease. Many disease-causing germs spread through the external environment via the orofecal route. Poor hygiene and an overall lack of sanitation are the main factors responsible for infectious diseases, which in turn, lead to malnutrition and a high death rate, especially in children under the age of 5. That being said, one of the most significant problems to be tackled in this country is the issue of human excreta disposal.

Human excreta constitute a significant portion of the man-made waste in the physical environment. Disposal of excreta is a serious public health problem. Much of the illness in our country is due to unhygienic disposal of human excreta. Lack of sanitation is supplemented by social factors like poverty, ignorance, poor standards of living, overcrowding, etc. These factors are mainly responsible for the increased morbidity and mortality in the country.

Proper disposal of human excreta is an important aspect of the overall sanitation of the physical environment. There are many misconceptions among people that they should follow traditional ways of disposing of excreta. Due to the low literacy rates in rural areas and urban slums, especially compared to those in the posh areas of town, there are barriers to bringing rapid change to this flawed thinking. The people in these poorer areas have no arrangement of latrines, and they prefer to go to open fields or use the banks of rivers and canals for answering the calls of nature. This practice leads to environmental pollution, especially in the soil and water. In villages, the problem is largely tackled on an individual basis. Because of such a condition, the problem of sanitary condition is still taken as the “Rural Sanitation Problem,” even though urban areas are affected as well.
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The environment in which we live is an extremely significant aspect of our entire lives. Therefore, the improvement of environmental sanitation is crucial for the prevention and control of many communicable diseases. It is important to create awareness among the general population, and this can be accomplished by various methods of communication. The focus should remain on preventing the pollution of water sources by unhygienic practices of those living in under-developed areas. It is the duty of every one of us to prevent our environment from being polluted by human excreta.

Many Indians are still averse to the idea of latrines. Villagers often consider that latrines are meant for city dwellers where there is an absence of fields for defecation. Villagers are ignorant to the fact that human excreta are infectious, as they pollute water and soil, and promote fly breeding. Thus, the problem of excreta disposal is bound up with numerous beliefs and habits based on ignorance.

Simply encouraging the construction of more latrines will not be sufficient. To truly make an impact on public health, programs must include behavioral components designed to alter hygiene beliefs and practices linked to the use of latrines (Lafond, Unicef).

Constructing latrines and hand pumps, or digging wells, has little effect on public health unless the people actually use these facilities, wash their hands, and store drinking water hygienically in the home. Under various schemes and programs, a number of latrines are installed in rural areas, but still a large number of people opt for open defecation. People must first change their attitudes and beliefs toward the issue if a difference will be made. Reports indicate that a significant number of people in the awarded villages are reverting to the age-old habit (Barnard, 2013). Sanitation is more than just making a toilet through a subsidy. A large portion of the population in rural areas and urban slums has toilets in their households, but the problem is that they are still not using them. First and foremost, the latrines should be installed, but most important is changing the people’s behavior so that they actually use them and keep them clean. When we visited such households with latrines installed, we found people using them as storehouses rather than for their intended purpose. Instead of individual target-oriented programs, the overall need for the use of latrines should be created among the population; this is possible if we educate the general population through evidence-based studies.

When latrines are installed by the government on the basis of subsidy, because of corruption, the installation often will remain incomplete. Some studies have shown that sanitary disposal of children’s stool can be associated with a 30-40% lower risk of serious diarrhea (Cairncross, 1999).

Until recently, hygienic behavior has not been given its due importance in environmental health programs. Promoting the hygienic use of water and sanitation facilities is one of the most effective ways to prevent orofecal transmission of diseases, but it won’t be possible until latrines are installed and used all over the country. We should apply other measures to improve sanitation conditions in the meantime, such as burying feces deep in the fields, sweeping up children’s fecal matter immediately after defecation around the home, and most importantly, avoiding defecation near the water supply. Additionally, creating awareness regarding sanitation should be a part of classroom curriculum.

Regardless of these potential improvements, change of behavior is not a one-time event; it passes through various steps with change gradually occurring at each step. Social change takes a long time, and the case is no different for hygienic behavior, for it is not the awareness, but the action involved in it that is difficult to enforce.

Every village should be provided with public healthcare facilities as envisaged in the declaration of Alma–Ata–Ata of 1978, passed by the International Conference. The Indian government is committed to scale up the total sanitation campaign throughout the country with a special focus on schools, by covering all of the government rural schools.

Hygienic behavior should be developed as early as possible in young children, both at home and at school. While teaching children to develop healthy habits, one should be careful not to hurt their feelings by making personal remarks. Always relate the need for personal hygiene with the desire to be healthy.

Health benefits from adequate water supply and sanitation programs will not be fully realized unless hygienic behavior is promoted and achieved.

Mohan Lal Jangwal Dr. Mohan Lal Jangwal, Associate Professor, Department of Community Medicine, Govt. Medical College, Amritsar

References (click to show/hide)

  1. ICMR (1966) Review of work done on Rural Latrines in India Spl. Rep. Sr. No. 541.
  2. Towards Total Sanitation and Hygiene: A Challenge for India, Country paper series, New Delhi , 2003.
  3. Cairncross, Sandy. (1999) WELL Factsheet: Why Promote Sanitation? http://www.lboro.ac.uk/well/resources/fact-sheets/fact-sheets-htm/wps.htm
  4. Sharmani Barnard et al. Impact of Indian Total Sanitation Campaign on Latrine Coverage and Use: A Cross-Sectional Study in Orissa Three Years following Programme Implementation. Aug 21, 2013. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749227/
  5. Lafond Afford, Unicef (1995) World Bank Water Supply and Sanitation topics


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