The Big Necessity

by Rose George

  _______

  Today, SPARC fat-free toilet blocks serve 400,000 people in eight Indian cities. A SPARC employee takes me to see one in the Kamla Raman Nagar slum. To get to the toilet, you walk past small girls squatting to defecate, step over several open drains, remembering that you once saw water that was blue, not this black-gray mire, and you look for a two-story building with gaps in the concrete that serve as windows. Once you see the fish tank, you’re in the right place.

  The toilet is run by a community committee headed by Rayeen Abdul Sattar. He greets us at his desk, upstairs on the second floor opposite a small hall that will be used as a computer room when they can afford the computers. Other SPARC toilets use the second story as a classroom, or library, or video lounge, because it’s clean and people are proud of it. A toilet committee in Cheetah Camp slum used the fees to pay for the only ambulance for miles around, in installments.

  Sattar offers tea and biscuits and tells a tale he’s told before. His toilet replaced a municipal one that was neglected and decrepit. It opened on November 19, 2002, on World Toilet Day, though not without troubles. The new toilet offered a membership plan to its users: anyone who wanted to use it could join up and pay 30 rupees a month or one rupee per visit. This didn’t go down well. Nobody had paid to use the bathroom before and nobody wanted to start. Sattar spent weeks going from door to door. He had to persuade people for whom 30 rupees was a day’s wages. He also dealt with “antisocial elements,” thugs who would “go from house to house with a book saying people had to pay five rupees if they wanted to ‘go’ [defecate] outside.” If people brought water with them when they came to the old toilet, and they hadn’t paid the protection fee, the thugs threw the water away. Sattar doesn’t explain to me how he got rid of them, because by now he has pulled out his ledger and wants to show me the toilet’s vital statistics. These have been recorded with the detail that comes with idleness or pride. In and among the 310 households on the plan, there are 280 boys below the age of ten, for example, and 275 girls above it. Sattar believes in attention to detail. He knows people have to be persuaded to care and he does what he can to encourage it. Membership fees pay for a caretaker and three cleaners. They have also paid for the fish tank at the entrance.

  I’ve never been in a toilet with a fish tank before. I look at it for a while, probably because it looks so fresh, and because after several days of slum-walking I can feel the dirt going up my nose into my brain. The fish serve a design purpose, because the tank acts as a barrier between male and female entrances. SPARC’s design incorporated several innovations, including training women masons to build the toilet blocks and consulting with women on how to improve things. Separate lines were requested, as were doors that swing both ways to make it easier for women carrying heavy water pots or toddlers to enter. Children’s toilets are another innovation. They are meant to prevent children being pushed out of the way at busy times, and their open-style stalls and smaller latrine pans soothe children scared of big, dark latrines they can fall into. The children’s toilets here conform to both design criteria but they are empty and look unused. Twin boys with orange T-shirts and identical smiles have been sticking to me through the tour, and they say they don’t like to use the children’s latrines “because people can see you.” There are better hiding spots outside. The tank is supposed to stop this. “I put it in to encourage people to come here,” says Sattar. “So they don’t go outside. At least maybe they’ll come to look at the fish.”

  Not all SPARC toilets are such ringing—and fishing—success stories. There’s another in Shamabahaji Nagar. In theory, this toilet should run like clockwork. It has all the parts: a caretaker, a community membership plan. The difference is in the organization. The toilet is managed like a poorly run business. It’s five years old, but it looks three times that age. There are no doors on the stalls and no water in the taps. There is no fish tank. “We took away the taps because people were abusing them,” says the toilet’s young manager, whose uncle is the boss. I tell Siddarth Shirur about it. He’s a young architect who designed over forty toilets for SPARC in Pune and Mumbai. He has seen pictures of his toilets recently and he thought they looked run-down, unkempt. “I’m beginning to think that open defecation is healthier than those toilets. Is all we’re doing creating an enclosure for defecating? It should be more than that.”

  SPARC may not be to blame for the failure of some toilet businesses. The organization hands over control to the community after a yearlong transition. Then the making or breaking of the toilet is up to the people who use it. This is known as “self-mobilization.” It’s not the whole answer. The development writer Jeremy Seabrook writes that “it would be foolish to pass from one distortion—that the slums are places of crime, disease and despair—to the opposite; that they can be safely left to look after themselves.” Nonetheless, the genius of the SPARC alliance has been to set up partnerships that bother to include poor people. As Toilet Talk concludes plainly, “The politician is not the man to wash the poor person’s bum.”

  SPARC’s business is booming along with the slums. A new contract will see two hundred more toilet blocks built, a total of two thousand new toilet seats. It’s impressive, but it’s also not much. Siddarth Shirur, who will design some of the new toilets, sounds dispirited. What are a few toilet blocks in the face of the ever-growing slums? “People keep coming to Mumbai,” he says. “And they just keep coming.” He watched a slum appear under his windows in three months. “Four walls, an asbestos roof and the house is ready. The Chief Minister wants to make Mumbai into Shanghai! But how do you stop the slums?”

  Dar es Salaam is a pleasant city in the pleasant East African country of Tanzania. As a taxi takes me from the airport to my hotel, I realize it’s the first normal, stable African country I’ve visited, because the others have been Liberia (just after a big war), Côte d’Ivoire (just before a little war), Burundi (in the middle of a long war), and South Africa (just, well, odd). In Dar es Salaam, people walk on the streets, unlike in Johannesburg, and wait for buses, unlike in Liberia, which has none. But appearances deceive. Tanzania is one of the most studied countries in Africa. It doesn’t have wars, it does have beaches, and it’s very poor. This makes it an NGO and academic honeypot.

  I have come here to hang out with a human bundle of energy named Steven Sugden. He teaches at the London School of Hygiene and Tropical Medicine, but though he’s been there for several years, he refuses to call himself an academic. His business card gives his title as “On-site Excreta Management Specialist,” a title he chose and that he declares is “catchy.” He came into excreta management after years working on water “because water’s even more bent.” Sugden is an inventor and a doer. If he wants to find something out, he experiments. Some of the experiments he has told me about include: “shitting into a bucket for six months to see how it would decompose”; building a still and peeing into it to try to figure out how and why urine smells; and getting an old schoolmate from Bradford to cobble together a pump that might solve some of the most intractable problems of urban living.

  Sugden has come to Tanzania because the London School, via WaterAid, has been commissioned by the World Bank to solve a curious sanitation problem. It is curious because in theory Dar es Salaam doesn’t have a sanitation problem. On paper, 96 percent of Tanzanians have a pit latrine or some access to a sanitary facility. But it is a hollow figure. First, having a latrine is a legal requirement in Tanzania, so who, answering a government survey, is going to admit to not having one? Second—and this is a problem common to all figures and percentages that relate to sanitation, from Tanzania’s 96 percent to those 2.6 billion toiletless—saying someone has a latrine doesn’t mean they have safe sanitation. Proper sanitation is a system involving containment, emptying, and disposal. It’s always more than a latrine.

  In a paper accompanying the UN’s Human Development Report, David Satterthwaite and Gordon McGranahan noted that “according to official UN statistics i
n 2000, the urban population of Kenya and Tanzania appear better served with sanitation than the urban population of Brazil and Mexico. But seventy-five percent of Brazil’s households have toilets in their homes connected to sewers (and many Brazilian cities have virtually one hundred percent coverage of this); in Kenya and Tanzania . . . a high proportion of urban households classed as having ‘improved provision’ have poor-quality pit latrines often shared with many other groups, that present many problems for fecal contamination of users and the wider environment.”

  What does this fecal contamination consist of? Flying toilets and DIY emptying. The cheapest latrine in Tanzania, and in every other developing country, is a plastic bag. Kenyans call them helicopter toilets; Tanzanians prefer flying toilets. Whatever the name, the technique is the same: defecate, wrap, and throw. Anywhere will do, though roofs are a favorite target and alleys are popular. The plastic bag is a step up from open defecation because it can be done in private, and it is contained, at least in theory. The next step up is a pit latrine, if it is affordable. Pit latrines in Dar es Salaam cost up to $300 each, because they have sturdy concrete slabs and big 10-feet-deep pits, and it requires skill to dig them in Dar’s sandy soils. Money can be saved by installing “temporary toilets” instead, where the pit consists of two oil drums stacked one on top of the other or is lined with tires. Or by leaving off the roof. The walls in Tanzanian latrines, such as they are—I see hodgepodges of corrugated iron, old doors, or rice sacks, held together with hope—only reach to shoulder height. Tanzanians with sharp humor call these structures passport toilets, because they show as much as a passport photograph would, and as much as a decent toilet shouldn’t.

  But the cheapest way to save money is to use the help of the heavens to empty the pit. Wait for the rains, divert the flowing pit contents into the street, hope for the best. Because of this fecal contamination, that deceptive 96 percent figure is hollowed out still more by other numbers. These are the numbers of cholera.

  The intestinal bacteria Vibro cholerae is rightly terrifying. It can kill within twelve hours by causing massive dehydration and constant vomiting and diarrhea. Though it can be easily treated with oral rehydration salts, cholera victims who don’t have clean water or a 20-cent sachet of salts will soon have agonizing stomach and muscle cramps, they will lose up to 30 percent of their body weight in hours, then they will turn blue, their eyes will go glassy, and they will die. Since sewers and sewage treatment vanquished cholera in the industrialized world, it has become mostly a disease of the poor, but not always. After Hurricane Katrina in 2005, U.S. government officials warned that cholera was a possibility because sewage works had been knocked out, and the waters that people were wading in, drinking, and drowning in were teeming with fecal contamination. They also warned about typhoid, but it was cholera that made headlines. Perhaps cholera still strikes a chord because there is some lingering memory, in the flushed and plumbed world, of what it used to do and how it used to kill, by the tens of thousands, quickly and pitilessly. Or because untreated, it will kill half the people it infects, for certain. The World Health Organization calls the absence of cholera “an indicator of social development.” If decent water and sanitation were present, cholera would not be. Cholera means there is something wrong, no matter what the statistics say. Cholera means the city is not working.

  At a clinic in the sub-ward of Azimo in Dar es Salaam, in the month of April, I ask two nursing officials how many cholera cases they have had that year. At first they won’t say, and I understood their discomfort, because they could be fired. After a bad outbreak of cholera in Dar in 2004, six environmental health officers lost their jobs. It was their fault the cholera came, said the authorities. It was not because of imperfect disposal systems for sewage, or the dreadful lack of safe pit-emptying services, or the abject failure of Dar’s government to make the glaringly logical connection between streets swimming in excrement and the regular appearance of cholera. The nursing officers eventually say they had three thousand cases in one sub-ward in a five-month outbreak the year before. They were getting fifty new cases a week. When I repeat this figure to Sugden, he assumes I mean in all of Dar, and even then that it’s shockingly high.

  Officially, Dar es Salaam’s sewage is treated in a series of waste stabilization ponds. As sewage treatment systems go, ponds are fine if a city has sufficient land and expertise to maintain them properly. These systems clean sewage by passing it through a series of ponds at a carefully measured velocity, giving bacteria enough time to form and feed on the sewage, cleaning it of solids, and—supposedly—pathogens. There are dozens of pond systems in France and Germany, and the Australian city of Melbourne uses waste stabilization ponds to clean half of its sewage. But the flow has to be carefully regulated, and so do the ponds.

  Sugden takes me to some in a slum area called Buguruni. They are undergoing renovation but trucks are still discharging into them, including one that is pouring a yellowy-green and foul-smelling liquid into the catchment basin. There is no way that these ponds can dispose of all of Dar’s sewage even if they were working. In fact, they serve only 10 percent of the city’s population, and from the sight of them, they serve them badly. For the 70 percent majority who have on-site sanitation, which is what pit latrines are, it’s every method for itself. In practice, most of Dar’s excrement is thrown into gulleys and alleys. It is on the streets and in the water, and in the cholera outbreaks that occur every year, steady as the rains.

  At a garbage depot in the city ward of Temeke, I meet Mkuu Hanje. He’s a senior Environmental Health Officer (EHO) who has worked for the city for twenty-one years. Now, he’s had enough because his work is thankless and impossible. Officially, he is required “to make sure a community’s health is ensured through disease prevention.” When the third-biggest killer of children in his city ward is diarrhea, disease prevention should consist of promptly reporting cholera and ensuring that latrines are safe and safely emptied. In practice, he can do neither because “when you report cholera, you get into trouble.” Even when he does manage to get someone to court, the fines are laughable, because they date from 1959. His boss is a ward councillor and politician unwilling to anger his constituents. “After five years,” Hanje tells me, “he must go back to people to get their vote, and my job is touching the day-to-day life of people. When you take people to court who don’t have a latrine, and you’ve given them notice five times, the councillor thinks you are harassing them. It is a conflict.”

  There are ways to get a pit emptied in Dar, but none are cheap and only one is legal. I go to find the vacuum truck operators who hang out at a junction at the end of Garden Road, their blue trucks coiled with ready hoses but idle. My Tanzanian companion Richard, an earnest and helpful WaterAid intern, advises me to stay in the car to counteract the mzungu (white person) effect. He thinks the tanker drivers will be hostile or ask for money. Neither is true. They are courteous and chatty, probably because they’re bored stiff. They charge at least 70,000 shillings ($60) to empty a pit latrine or septic tank and not many people have that kind of money in a city where you can buy bread by the slice. Even if their service were affordable, their trucks can’t get down narrow slum alleys to reach the customers. A tanker driver named Charles does most of the talking. He is elegantly dressed with shining brogues, because “smartness is up to a person’s nature” and because his employer refuses to buy him gloves or boots. He tells me that kids call the tanker drivers nyona mavi, or shit-suckers. Charles laughs about it, but it irks. They’re doing a service, and one that the city government can’t manage to provide. By law the municipality is obliged to remove night soil from residential areas. In practice, this hardly ever happens. How can it, when the department has no tankers of its own? (When the city wants a tanker, it hires one of these, like everyone else.)

  Because of this, Hanje’s job amounts to firefighting. He must always react to crisis and never has time to prevent it. It is frustrating. He can’t understand why ther
e’s no health planning, or why Temeke’s municipal health budget in 2004–2005 allocated only $3,000 to on-site sanitation when 630,000 people rely on it (a figure that works out at less than half a cent per person). “When there is cholera, and there is a scarcity of drugs, the outcry is very high. But anyone in the street who sees their neighbor disposing of feces in the street will not complain. There is no outcry about sanitation. If people say, there is no water, or the road is very bad, politicians will react. But when it comes to toilets, no one complains. If you don’t have a toilet, it’s up to you.” If you empty it in the street, sowing the seeds of the next cholera outbreak, it’s up to you. Hanje sighs, and so does Richard. Having just finished his training to be an EHO, he realizes he’s just listened to the story of his next twenty-one years. Hanje wants out. “If I get a good office that wants to employ me as a cleaner,” he says, “I’d take the job.” Anything’s better than pointless firefighting. “Maybe sanitation can be changed,” he says with profound weariness. “But I don’t know how.”

  The pleasant city of Dar in fact consists mostly of slums. At least 70 percent of Dar residents live in unplanned areas, and urban areas are expanding at nearly six times the country’s overall growth rate. Dar’s slums are quite nice. They do not, in places, feel like hell on earth. They do not, as Mumbai did, make me angry because no one should live like that (though I might feel differently during a pit-emptying session). Dar’s slums have wide main streets and space. There are some trees, and on the main streets, half-sunken tires serve as benches. Leading off the main streets are the narrow, familiar alleys of slum living and all the poverty that goes along with them.