Let's talk about shit

My previous impromptu blog about World Toilet Day was discussing an entire day dedicated globally to discussing the toilet. In this blog, I am going to do a complete 180 and look at reasons as to why people don’t talk about shit, and how we can get them talking. Below you will see a TEDtalk done by Rose George (figure 1), this video gave me a lot of inspiration for this blog entry and so I thought I would share it with all of you. 

Figure 1

Source: https://www.youtube.com/watch?v=ZmSF9gVz9pg

Why don't we talk about shit more?

We have all heard of the phrase 'sex sells', and it couldn't be truer. Sanitation isn't at the forefront of aid efforts, or governmental decisions; it is something we are embarrassed to talk about, something we believe should be kept private, something which isn't sexy - this needs to change. There is no universal term for shit (see figure 1). People are embarrassed or offended to use certain words making poo difficult to talk about, particularly for those who are in a position of power, whether this is a political position or the head of an NGO (Borel, 2013). There are numerous ways we try to be discreet about having a poo, for example, men in Kenyan communities will say they are 'answering the call of nature' when they need the toilet, and many find the use of the word shit extremely offensive and vulgar, preferring the term haja kubwa (David, 2011), a word which is not used universally. It is not just in the developing world where there is a shyness when it comes to sanitation, in the UK, toilet roll companies such as Andrex are not direct about their product (see figure 2), but instead show a puppy running around with toilet roll (Borel, 2013). This reluctance to talk about shit makes global sanitation issues very difficult to engage with. The Gates Foundation was one of the first organisations to start talking about shit using mediums such as competitions among universities, which has been pivotal in getting people to start talking about shit in academia and among NGOs. With The Gates Foundation as a springboard, this has allowed for numerous new approaches to appear encouraging people to talk about shit and changing their behaviour, in the last decade the approach Community-Led Total Sanitation has become increasingly popular within Sub-Saharan Africa. 

Figure 2 

Source: https://www.youtube.com/watch?v=yx6gZAKWLHk

Community-led total sanitation (CLTS)

CLTS is a method of making sanitation issues important within communities by making them talk and work together to reduce open-defecation (OD) and improve toilet facilities. CLTS comes with many challenges, often people are reluctant to talk about shit due to embarrassment, there are also many cultural taboos that need to be addressed. If cultural taboos are not addressed, regardless of whether latrines are available they will not be used, below I have bullet-pointed a few common taboos and superstitions regarding shit in SSA:

• Pooing over someone else's poo is considered to be bad luck (Zombo, 2010).
• It is a taboo for a father-in-law and his daughter-in-law's poo to mix (Bwire, 2010).
• In Kenya, it is believed a person's poo can be used to bewitch them, this stops people using communal latrines and continue to practice OD due to fear of witchcraft (Bwire, 2010).
• In Ethiopia it is considered a taboo for both men and women to share the same latrine, also the sight of faeces is unacceptable resulting in continuing OD (Chambers and Myers, 2016).

CLTS has a variety of techniques to overcome these embarrassments and taboos. CLTS believe that rather than sitting communities down and lecturing them over the importance of good sanitation and hygiene, the most effective outcomes come from generating disgust through demonstrations. Typical demonstrations include putting a pile of food next to a pile of poo and getting the villagers to watch the flies jump back and forth between the two, people were mostly disgusted by the thought of ingesting someone else’s shit (George, 2012), you have to shock people to change their behaviour (Zombo, 2010). Shocking people is the easy part, getting them to talk shit is difficult. CLTS gets people talking by introducing them to shit through songs, proverbs, stories and laughter (Zombo, 2010). CLTS has found laughter to be the most effective tool, in Sierra Leone CLTS has created a lighthearted song to highlight how easily poo can spread:

"Kaka na kaka, big wan, small wan, na the same foot den get for waka go na chop or water."

(A shit is a shit, big shit or small shit, they all have legs and feet that move them to food and water.)

(Zombo, 2010).

In Sierra Leone alone the CLTS approach has helped 300 villages become OD free (Zombo, 2010). The successes of CLTS are very important, OD and unsafe sanitation facilities can be deadly or cause serious illness amongst communities, and so it is of utmost importance we talk about shit. 

Why is it important to talk about shit?

Every day 4000 children die from diarrhoea, a number that is higher than HIV/AIDS, tuberculosis and measles combined (Borel, 2013), however, it receives far less attention. A single gram of poo can contain upwards of 50 diseases, many of which can be fatal (Borel, 2013). Contracting one of these many diseases can have several negative multiplier effects, such as a lack of productivity in the economy, death, embarrassment, and social isolation; it is estimated that each year $260 billion is lost as a result of inadequate sanitation globally (Borel, 2013). This leads me to next week's blog which will be focusing on water and sanitation related diseases, and the cost they have on many lives.