If you take a walk down a community in rural India you can see the results of a revolution. Not one of war and guns, but one that is environment-friendly and includes positive shaming to convince community members to build a good toilet facility in their homes as an alternative to open defecation. And almost every citizen has abandoned open defecation for a toilet facility.

Those who are failing to follow suit are being shamed by their community. Passersby acknowledge the sight of a fellow local defecating openly with a greeting. In most cases, videos of those who defecate openly are captured and circulated on social media. Indians are being empowered by their communities to promote good sanitation and preserve the environment, especially, water bodies.

No toilet, no bride

In the past, men who didn't have toilets in their homes had little chance of getting married in India. It was the standard. No woman and no man was ready to give away their daughter to open defecators for marriage. It was neither a national government policy or a directive from their sanitation minister; nor was it an instruction given by local authority officials at the district level. 

It was a community-led campaign created to stop open defecation and faecal pollution. ‘No toilet, no bride,’ worked for the larger population of women in India. For 14 years, unmarried women kept telling suitors, “No loo, no ‘I do!'”.

Their proposal that men should own toilets before marraige significantly contributed to attitudinal changes towards open defecation as men were strongly motivated to redeem themselves by fulfilling the toilet requirement brides were after on the marriage market. To push the fight against open defecation further in India, women were encouraged to demand suitors to build private latrines before they agreed to marry them.

A model toilet sits on display

According to a study published by ScienceDirect, private sanitation coverage increased by 21% in Haryana among households with young men active on the marriage market from 2004 to 2008. At the time, 626 million Indians eased themselves in the open, raising concerns about environmental and health issues of the second-most populous country in the world.

“Women and girls usually take care of business under the cover of darkness, making them more vulnerable to harassment, rape, and wild animal attacks,” according to Sunita Naraian, Director General for Centre for Science and Environment. After years of campaigning ‘No toilet, no bride’, women did not even have to make the demand themselves. 

Men began to recognize that saving up to build a toilet facility was a benchmark requirement for marriage. They worked harder to afford a toilet or they remain bachelors for life. Figures from the Indian government indicate 1.42 million toilets were built between 2005 and 2009. They included 470,000 built by households below the poverty line.

Some families took it one step further by requiring grooms obtain certificates to verify their toilets before they could marry them. Locals took their destinies into their own hands and made sure the Swach Bharat Mission (Clean India Mission) additionally aimed to clean up the streets, roads and other infrastructure of India's cities, small towns and rural areas.

The first open defecation-free state Churu District in Rajasthan State was the first to declare itself open defecation-free. District Collector, Sandesh Nayak, says community volunteering and active participation in sanitation campaigns enabled them to achieve the milestone. He indicates the government is also working hard on water management schemes by availing funds for household water reservoirs.

Every household in rural Baniyala has 20,000-liter capacity water storage system to guarantee access during the dry season for drinking and sanitation purposes. Another policy that won the fight against India’s toilet politics is “No representation without sanitation law” in some states.

The policy required one must own a lavatory to qualify to stand for election, compelling many aspirants to prepare and those who failed to meet the target rejected. Prime Minister Narendra Modi’s “Clean India" campaign included a promise to build 50 million toilets by the 150th anniversary of Mahatma Gandhi’s birth in 2019.

Toilets usher in a new dawn

It was the first time a Prime Minister was championing a sanitation mission in India. The effort aimed at halting contamination of groundwater that causes diarrhoea, cholera, and other diseases which cost the nation about $54 billion a year, according to the United Nations Children’s Fund. Another approach decided to focus on outcomes instead of toilet construction and continued sustaining behavioural changes of Indians.

Between 2014 and 2019, 60 million people were reported to have changed behaviour, 10 million latrines were constructed within the same period, $650,000 paid to grassroots motivators and $15 billion in incentive funding was released to beneficiaries by central and state governments.

India today has toilets in almost every household after claiming a greatly improved spot in the global statistics for open defecation. Prime Minister Narendra Modi credited ground-level volunteers who made the ‘Clean India Mission’ campaign and toilets a common man's topic.

He said "this mission helped make the toilet, which was earlier a difficult topic, a common topic of discussion. From girls who demanded toilets before marriage to Bollywood, everyone contributed to the mission to make India open-defecation-free.” The prime minister said that the feat of building toilets for such a large population of India within 60 months has left the world in awe and shock.

"The whole world is appreciating and awarding us [for] providing toilets to over 60 million people in 60 months by building over 11 million toilets. The world is amazed by this," Prime Minister Modi said.

India has so far taken four steps to sustain open defecation-free achievement. The country is striving to sustain behaviour change, leaving no one behind and addressing gaps, constructing community toilets for the floating population and refresher training of all grassroots functionaries.

Lessons for Ghana

Like India’s previous societal issue, Ghana also has an open defecation problem. Most houses in the city do not have private toilets, and with the few publicly-run facilities that do, they are poorly kept. 2011 statistics from the Accra Metropolitan Assembly indicates that 91% of all dwellings are without toilet facilities.

Between 2006 and 2011 the data from UNICEF recorded a slight decline in the proportion of people practising open defecation; from 24.4% to 22.9% but that figure has increased from 5.1 million to over 5.7 million. A November 2017 UNICEF District League Table indicated only eight of the country’s 216 districts have, at least, 33 per cent of their communities are not engaged in open defecation.

Figures from the Kumasi Metropolitan Assembly Sanitation Department show only 39% of households in the metropolis have toilet facilities. It means about 60% of homes are without toilet facilities. The highest rate of open defecation is found in the Upper East Region where 89% of the regional population engage in open defecation and only 3% use unshared improved sanitation facilities.

According to a report, 85.7% of Ghana’s population has no toilets. It is estimated Ghana loses an average of US$79 million annually due to open defecation. The country is classified among 34 with the highest open defecation rates of 15% and above. In the Ashanti Region, out of the 3,754 public basic schools, 1,427 are without toilet facilities.

In the Western region 1,132 out of the 2,408 schools are without toilets. In the Upper West Region, out of the 1,165 schools, 350 are without toilets. According to data published by Down to Earth, the cost of finding a place to defecate in the country is $19 million. Data indicates Liberia ($1.9 million), Malawi ($2.7 million) and DR Congo ($6.3 million) are spending less, compared to Ghana.

Annual cost of children missing school due to disease is $1.5 million. In this aspect, Liberia ($80, 000), Malawi ($0.3 million) and DR Congo ($1.1 million) are doing better than Ghana. Again, Ghana spends $54 million in health as a result of treating water-borne diseases each year. That's also according to figures published by downtoearth.org.in.

Why is Ghana failing to address its sanitation woes despite several initiatives? Ghana is yet to check the most basic of all life’s necessities – providing a good place for easing oneself rather than leave the envrionment subject to open defecation. The country is failing to have a cohesive policy though it has a ministry designated for policy formulation, financing, regulation, monitoring and implementation.

Before 2017, sanitation issues in Ghana were overseen by the Ministry of Water Resources, Works and Housing. The idea of a designated ministry was to command undivided attention and provide solutions to problems. The biggest challenge confronting every effort, however, is cultural and attitudinal.

Just like the Indians, Ghanaians need to take their destiny into their hands and initiate programs at the community level, championed by  residents. Politics has become a very negative element in championing the cause of proper sanitation. It has become very clear every initiative from any of the political groupings is always resisted or sometimes politicized by the other.

So sanitation issues should be decentralized and implemented by influential community members. Ghana should also emphasize capacity building and make clean Ghana everyone's business. Collective behaviour change, exposing the reality of local conditions as a result of open defecation, responsive low cost and eco-friendly technologies can also trigger change.

Women and children should be involved at the community level and communities that forge ahead be given incentives. What would also trigger change is the introduction of law to bind all those seeking political office at the basic, secondary, tertiary, district assembly or any kind of election in the country to either have a toilet. If Ghana is able to follow the footsteps of India, at least, some changes would be achieved in no time.