WHAT PEOPLE WANT is often quite different from what experts think they need. The medical expert may see the main goal of a sanitation project as the prevention of disease. But villagers or shantydwellers will never see a pit-latrine just as a device for protecting their health.
They may be aware of the health benefits of good sanitation, but many people acquire latrines for much the same reasons as they do glass windows or furniture: for convenience, comfort and status.
In the village of Serowe in Botswana most peoples' homes are traditionally built of mud bricks and thatch. People modernise their homes slowly when they can afford it - a new roof one year, doors and windows the next. Where households have the money and energy to improve their homes they can be encouraged to dig a pit latrine as part of the overall plan.
But where people are very poor it makes no sense to promote the building of subsidised privy huts alongside the leaking roofs of cardboard and mud shanties. Although the latrines might be urgently needed to prevent disease they may have to take second place to other improvements in housing and living standards. As one health worker in Brazil commented: `What's the use of conning people into building privies when they don't even eat enough to use them?'.
In large villages, however, and in places where population is rising fast, latrines may be urgently needed to avert serious health hazards. In this case, if people cannot afford to pay for their own, some kind of subsidy might be justified. But it is important to link any latrine subsidy to other housing improvements otherwise the latrines are likely to be misused - or rather used to satisfy peoples' rather than planner's priorities.
Even more important, where there are no nappies or potties, the improvement in hygiene made by any kind of sanitation system may be marginal because children's faeces - often highly effective - are deposited almost randomly while they are at play. This is usually one of the most difficult problems to tackle as well as being the most important for health.
A badly-planned, badly-constructed, badly-maintained latrine can create far more serious hygiene problems than existed before it was built. Some low cost latrines are incapable of being cleaned properly. Their floors are of rough porous cement - ideal for harbouring roundworm or hookwork eggs. In some places these diseases are more common in city people with latrines, than in country-dwellers with no sanitation at all.
In some places people organise their excreta disposal with a discipline that partly compensates for lack of sanitation equipment. One example comes from a group of villages in West Bengal. Latrines here are almost non-existent and most people use a special area of land for defecating. Hookworm infestation is very common in this part of India but in these villages the disease seems to be under control. This is because people avoid each others' faeces meticulously and systematically fill the designated area of land from one side to the other to make this possible. The key is good organisation.
The most impressive examples of this are probably to be found in China. Sanitation equipment in the countryside is still very crude - shallow pit latrines, bucket latrines and chamber pots emptied manually into buckets. All this would seem to be very unhealthy. Yet since the 1950s China has made great strides in reducing the incidence of excreta-related diseases such as hookworm and gastro-enteritis. They have achieved this by employing large numbers of people in sanitation teams to empty and clean latrines and to supervise the hygienic composting of wastes. In other words better hygiene was achieved by strengthening the organisation and discipline of sanitation rather than replacing the relatively primitive hardware.
People may not have very good hardware, but they often have excellent software. Without respecting and taking advantage of the software, the hardware - however 'appropriate' in design - will always seem inappropriate to the people.
This article is adopted from a booklet by Arnold Pacey 'Rural sanitation: planning and appraisal' published for Oxfam by Intermediate Technology Publications Ltd.
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