102 NATIONAL GEOGRAPHIC • AUGUST 2017
World Bank threw in another $1.5 billion in loans.
Modi aims to build more than 100 million new
toilets in rural areas alone by 2019. Whether he’ll
succeed is one question; whether the toilets will
make much diference is another. Indian gov-
ernments have been building low-cost latrines
for at least 30 years. Millions of these simple,
free standing structures dot the countryside, but
many are crumbling. And many more are used to
shelter small animals or to store tools, bikes, and
grain—while their owners head out into the fields
with their lotas. In India deep-seated attitudes
may present an even bigger barrier to improving
sanitation than a lack of pipes and pits.
IN THE SIDE YARD OF EVERY mud-plastered
home in the hamlet of Jawda, several hours south-
west of Moolchand’s village, stands a spanking-
new concrete outhouse the size of a large phone
booth, painted salmon pink. Inside, a white
ceramic squat pan funnels waste—sluiced by
water from a bucket or lota—through a pipe
into a four-foot-deep pit. The brick-walled pit is
designed to collect feces while allowing liquids
to seep into the earth. A small pool of water cra-
dled in a U-shaped bend in the pipe helps con-
tain smells and block insects from the pit. Flies
breeding and feeding on feces are one of the main
vehicles delivering infectious organisms back to
humans; one gram of feces can contain 10 million
viruses, one million bacteria, and 1,000 parasitic
cysts. They infect us through tiny openings in our
skin or by contaminating food and water.
The health toll in India is staggering. Diarrhea
kills over 117,000 children under age five each
year. Millions more struggle on with chronical-
ly infected intestines that don’t absorb nutri-
ents and medicines well. The misery cycles on:
Underweight women give birth to underweight
babies, who are more vulnerable to infections,
more likely to be stunted, and less able to ben-
efit from vaccines. In 2016, 39 percent of Indian
children under age five were stunted.
The Swachh Bharat mission ofers each house-
hold about $190 to construct a pit latrine—far
more than other developing nations spend. In
Jawda, however, nobody uses the latrines. “It’s
for washing clothes or bathing,” says a woman
in a pink-and-black sari, resting on a rope-strung
cot in the shade. “We have a lot of open space.
Why shouldn’t we use that?” Grassy fields dotted
with wildflowers surround her village.
In surveys done throughout rural northern
India, where open defecation is more prevalent
than in the south, people express a keen pref-
erence for relieving themselves outdoors. It’s
healthier, they say. It’s natural and even virtu-
ous. Many rural Indians consider even the most
immaculate latrine religiously polluting; a toilet
near the home seems more unclean to them than
answering the call of nature 200 yards away.
Flies, however, can travel more than a mile.
The children in Jawda know, from visits by
community health workers, that toilets are a
boon for health. A girl nuzzling a tawny goat
explains with great precision how flies and fin-
gers can transfer feces from the field to food and
water, sickening villagers. “But if the toilet pits
are small,” her mother interrupts, “we’ll have
this filth near us. And if we get sick, we have no
money to cure ourselves.”IN KHARGONE DISTRICT, in southwestern
Madhya Pradesh, I walk through the unpaved
streets of a hamlet with Nikhil Srivastav, a policy
researcher ailiated with the Research Institute
for Compassionate Economics (RICE). Led by
two Americans, Diane Cofey and Dean Spears,
the non profit deploys both American and Indian
researchers to study the well-being of India’s
poor, with an emphasis on children. Trailed by
barefoot kids, Srivastav and I step over a thin,
smelly stream, in which rat-tailed maggots tum-
ble, and into a neatly swept compound. There
we meet Jagdish, a retired tour-bus driver who
recently spent 50,000 rupees (about $780) to dig a
latrine seven feet deep, instead of the government-
recommended four, and finish its superstructure
with blue dolphin tiles.
But Jagdish doesn’t make much use of
this beautiful chamber. “It’s for my wife and
daughter- in-law,” he says. Like many of his neigh-
bors, Jagdish prefers to walk uphill into the bush
to perform his daily ablutions. In rural India it’s