Originally published in Badlaav

Last year, the Bill and Melinda Gates Foundation announced the winner of the Reinvent the Toilet Challenge, a competition that sought to improve on existing toilet designs, since water and infrastructure are scarce resources and are often unavailable in the developing world. But what happens when you build environmentally-friendly, easy-to-maintain, low-cost toilets, and people decide to store grain in them? What do you do when people in rural India continue to defecate in the open and simply say aadat nahin hai – I’m not in the habit of using a toilet?

This issue of habit versus social good is certainly not limited to the rural poor. It is common knowledge in Bangalore, for example, that the city faces acute water shortages, and this coming summer will be no different. Millions of people are in thrall to the “water tanker mafia,” which sells water and has become a primary water source to many households.1 The level of groundwater in the city is precipitously low.2 Yet the middle and upper classes insist on washing their cars every day with hoses and refuse to harvest the rain that falls on their roof, despite laws that mandate saving water.3

Neither technological solutions nor awareness campaigns are a panacea for these issues. Individuals are resistant to change, regardless of the potential benefit. People from outside a given community leave out the human component, believing that under-served populations just need the right technology, whether it is toilets, water filters, or solar ovens, in order to fix everyone’s problems. These initiatives are constructed from the top down, without a clear understanding of specific challenges.

A pair of American entrepreneurs, for example, installed a number of wind turbines in a rural Nicaraguan village, hoping to create jobs and transform the community by providing electricity – which the locals are now mainly using to power TV sets. The needs of the village were much larger, and much harder to solve, than simply installing a turbine. “When you come at it from a technology perspective, you think your end goal is you build the system, you install it, and it delivers energy. And you do that, and then you get to the end of the path, and then you realize that that’s not actually the end of the path. That’s somewhere near the beginning of the path,” says Mathias Craig.4

Large awareness campaigns suffer from the same lack of ground knowledge. The people targeted by these campaigns often already know what they “should” be doing, whether it’s boiling unclean water, washing their hands, or using treated sewage water for their lawns. They might even practice those behaviors after someone in their family falls ill, or while a surveyor is observing them, or when a new law is signed, but the story changes three months later. A recent campaign promoting handwashing to reduce diarrheal disease saw “a wide reach among the target population and increased reported knowledge of germs,” but “no effect on actual handwashing behavior at key times.”5 The real questions are: how do you motivate individuals and communities to change, and how do you sustain this change?

There are no easy answers. It takes work. Agents of change have to be deeply embedded in a community, with a holistic understanding of its unique culture and challenges, before they can formulate a plan to help people change their habits. A 2006 study found that lowering Uganda’s HIV rates in the last fifteen years depended on a “low-tech” approach that relied primarily on “community-based and face-to-face communication.”6 The authors draw a contrast between this approach and previous biomedical interventions like providing condoms and the treatment of sexually-transmitted infections, which had little to no impact on HIV infection rates. The lessons from this success story are to empower women, mobilize local institutions (including faith-based organizations), and involve them in intervention activities – in this case, HIV prevention and fighting HIV-related stigma. Accordingly, money ought to go to education, training, and empowerment, enabling people to grow their own solutions. Capacity-building programs lack the donor appeal of providing water filters for schoolchildren, but ultimately, sustainability means understanding a specific community’s problems – and outsiders are ill-equipped to serve that niche.

Behavior change is critical, and it is hard. Every case is different. What works in one country, or even one village, will fail in the next. To be effective, development work needs to stop talking about scalability and start talking about specificity.

Citations:

  1. Afshan Yasmeen, “Private water suppliers hit pay dirt as water crisis worsens,” The Hindu, March 11, 2012, accessed April 15, 2013, http://www.thehindu.com/news/cities/bangalore/private-water-suppliers-hit-pay-dirt-as-water-crisis-worsens/article2984302.ece.
  2. 2. Jenny T. Gronwall, Martin Mulenga, and Gordon McGranahan, “Groundwater, self-supply, and poor urban dwellers” (Human Settlements Working Paper Series, International Institute for Environment and Development, 2010).
  3. “Despite threat, rainwater harvesting a flop in city,” The Hindu, February 27, 2013, accessed April 15, 2013, http://www.thehindu.com/news/cities/bangalore/despite-threat-rainwater-harvesting-a-flop-in-city/article4456297.ece.
  4. “Technology and the developing world,” Public Radio International, November 9, 2009, http://www.pri.org/stories/business/global-development/technilogy-developing-world1716.html.
  5. Adam Biran et al, “The effect of a soap promotion and hygiene education campaign on handwashing behaviour in rural India: a cluster randomised trial,” Tropical Medicine and International Health, 14.10(2009): 1303-1314.
  6. Edward C. Green et al, “Uganda’s HIV Prevention Success: The Role of Sexual Behavior Change and the National Response,” AIDS Behav, 10.4(2006): 335–346.