Where India Goes

Where India Goes, a book about the problem of open defecation in India, is the best social science book I have read in years. Written by Diane Coffey and Dean Spears, Where India Goes, examines an important issue and it does so with a superb combination of human interest storytelling and top-notch empirical research made accessible.

Drawing on the academic literature, Coffey and Spears show that open defecation sickens and kills children, stunts their growth, and lowers their IQ all of which shows up in reduced productivity and wages in adulthood.

The dangers of open defecation are clear. Moreover, Gandhi said that “Sanitation is more important than independence” and Modi said “toilets before temples,” yet in India some half a billion people still do not use latrines. Why not? Jean Dreze and Amartya Sen (2013), offer a typical explanation:

In 2011 half of all Indian households did not have access to toilets, forcing them to resort to open defecation on a daily basis…

The phrasing presents the problem as a lack of access that forces people to resort to open defecation. From this perspective the solution seems obvious, provide access. After all, if you or I had access to latrines we would use them so if someone else isn’t using latrines it must be because they don’t have access. A bit of thought, however, dispels this notion.

Latrines are not expensive. Many people in countries poorer than India build their own latrines. If access is not the problem then building latrines may not be the solution. Indeed, India’s campaign(s) to build latrines have been far less successful than one might imagine based on the access theory. Quite often latrines are built and not used. Sometimes this is due to poor construction or location but often perfectly serviceable latrines are simply not used as latrines. In fact, surveys indicate that 40 per cent of households that have a working latrine also have at least one person who regularly defecates in the open (Coffey and Spears 2017).

For many people in India, open defecation is preferred to latrine use. The reasons relate to issues of ritual purity and caste. Latrines in or near homes are considered polluting, not in a physical so much as a spiritual or ritual sense. Latrine cleaning is also associated with the Dalit (out)-caste, in itself a polluting category (hence untouchable). That is, the impurity of defecation and caste are mutually reinforcing. As a result, using or, even worse, cleaning latrines is considered a ritual impurity. The problem of open defecation is thus intimately tied up with Hindu notions of purity and caste which many do not want to discuss, let alone condemn.

In the villages the idea of open defecation is also associated with clean air, exercise, and health. Thus, in surveys “both men and women speak openly about the benefits of open defecation and even associate it with health and longevity.” Even many women prefer open defecation if only because it gives them a chance to get out of the house and have some freedom of movement.

Eventually, flush toilets and sewage will eliminate the problem of open defecation, but many people will die before sewage comes to rural India. Building latrines is not enough but is there an opportunity for an Indian entrepreneur? If standardized latrines were bundled with service contracts and provided by professional, uniformed workers who emptied the latrines mechanically (and thus had dignity), demand could well be high. A Walmart for latrine construction and management.

Coffey and Spears, however, offer no silver bullets. Problems brought about by belief and behavior are usually more difficult to solve than material problems. Nevertheless, by demonstrating the importance of the problem and by facing the causes squarely, Coffey and Spears have done India a tremendous service.


Maybe open defecation is part of their culture? Why should a white Canadian man parachute into their country and tell them how to run things?

Bonus trivia: open urination is common in the Philippines, I've done it myself literally in the street, leaning against a wall, no shame.

Open urination is a thing in Appalachia, too... I hate my new suburban house.

Also, on road trips, my kids are trained to open def on the side of the road. :)

When I was in the Philippines about 30 years ago it was common to see the phrase "Bawhal pag'nihi dinhi" (or something like that) painted on walls in the city. It means "Do not urinate here."


Plus, them hate-filled, racist Brits forced the indigenous population to desist immolating widows (women) on their dead husbands' funeral pyres.

My dog defecates in the street. I pick it up.

Widow immolation (Sati) was a very marginal practice in Hindu society. The number of cases was in hundreds and it was hardly a norm in India. There has been considerable criticism and condemnation of the practice within Hinduism and the campaign against it was led by one Hindu reformer named Raja Ram Mohun Roy, who used the scriptures to make a case against this corrupt practice.

The banning of Sati was as much a consequence of Indian reform voices as it was a British intervention. And no, let's not kid ourselves into believing it was ever a norm in India.

Yet the Indians couldn't be bothered about ending it until the British came along. Curious that.

I never denied the role of the British in triggering the Hindu reform movement of the 19th century.

What needs debunking are simplistic claims that would give people the impression that Sati was an accepted feature of Indian society at large. Which it wasn't.

The number of women killed every year by reported "Kitchen Fire" in India is staggering. And the unreported numbers are many many times that.

AlexT, quoting the book: "Drawing on the academic literature, Coffey and Spears show that open defecation sickens and kills children, stunts their growth, and lowers their IQ all of which shows up in reduced productivity and wages in adulthood." -

Please. Lead in gasoline (http://www.todayifoundout.com/index.php/2011/11/why-lead-used-to-be-added-to-gasoline/) causes lowered IQ, higher crime, and non-toxic substitutes --not as good but similar, like ethanol alcohol--were available even since the 1920s when lead in gasoline was approved. The BBC "50 inventions that made the world" also has a somewhat biased but good summary of this (the author blames patents, not acknowledging that lead is superior to ethanol for anti-knocking, but anyway)

Chickens lower IQ in children and creates disease. ScienceDirect had a blurb on this; should we also ban growing chickens? They are full of disease (I used to grow them in the Philippines, was up to 300 birds a month, but not enough profit in it).

Bonus trivia: I read somewhere that the common housefly is overrated as a disease carrier. I can't imagine that for a healthy person, the fact that tiny fly feet have microscopic traces of feces on them can be that harmful. C'mon. If it was that easy to get disease the human race would have died out long before now.

What on earth is your point?

The fallacy of relative privation is his point I think.

He's all-in on the Paleo thing.

Intestinal worms don't kill children. However, the chronic anemia that yields shorter, weaker and less bright children.

They're quoting this research'06.pdf

Chickens lower IQ in children? How?

Forget it, he's rolling.

Unknown, they think it's because of a virus the chickens carry (I would say chicken pox, but it sounds too pat). Google it, it's true.

Another tragedy of "public" (actually meaning nobody's) property.

Interesting framing as opposed to the usual "access to toilets" line of thought. However, I am not so sure it is any longer a "ritual purity" issue. It is just that people who have grown up with open defecation all their life (and just about everyone around them) think that is the natural way of life.
To cite a milder example, anyone who's grown up in Mumbai would not complain about the crowds on the road or the suburban (local) trains. That is just normal life the way they know it.
The latrine service entrepreneurial idea is interesting too.

Yup, just like Elder sanctioned and organized gang rapes. I wonder why the word "water" wasn't used once in the OP. But I am calling AT on his (and the authors'?) use of the strawman argument: It "suggests" lack of access is the problem? No doubt it's one of the problems, but so what? Be sure to avoid ranking - or even listing - what the EXTENSIVE literature has determined. I wonder if the stink is part of the problem? If each house has a latrine out back, then given the population density, the wind is always blowing your neighbors last meal into your kitchen...
I have no idea what I'm talking about. Nevermind.

The Chinese, hardly strangers to extreme poverty, took to latrines, toilets and communal health improvements well enough at the first trickle of wealth. Nations more impoverished than India dig latrines; these are not expensive improvements! Even low cost solutions can get you 80% of the benefits of a full sewage system with internal flushing toilets.

India clearly is an outlier; it's not just the money.

India has something even better than walmart for toilets 'Sulabh'. Its a pretty successful non government chain providing public toilets at a nominal price though cleanliness differs from place to place. It has grown well in urban areas specially near slums. For rural areas, one prob is that rural population might be loathe to paying for toilets.

"Hindu notions of purity and caste which many do not want to discuss, let alone condemn."

Since when did purity become condemnable? Sure let's condemn open defecation. There is unanimity on that. But linking it with ritual purity is a stretch. First of all ritual purity is not such a big concern for 95% of population. The Brahmins are 5% of Indian population and are predominantly urbanized and not to be found in villages anymore.

And concern with purity and cleanliness should actually greatly encourage latrine building. So it's ironical that ritual purity is being linked to lack of latrines here.

problem is that someone has to clean them, which is polluting in both senses. not just for Brahmins.

Let's suppose it's a traditional village where only Dalits undertake cleaning tasks. (I am not endorsing this occupational specialization, lest I am misunderstood)> Given that Dalits exist in every village, why would it be hard to find someone to clean them?

I assume that you are Indian, but you may not be if you are asking this question. Dalits, or their political class have decided that they should shun occupations that have been historically understood as unclean. They want to disassociate themselves from such occupations and this has led to soaring prices for the cleaning of latrines. There are simply not enough Dalits willing to degrade themselves to such an extent, they now have a mainstream view of the occupations they held a century ago. This is why many Dalits in rural areas are physically forced to clean toilets by other castes even when they are in fact doing other work.


Darnit, don't they realise there are important social goods being produced by their ruthless oppression? And they could have the decency to sing as they work, too.

Well, then the market should take care of this.

If there is such a scarcity of supply of labor to clean latrines, then wages for a latrine cleaner ought to go up to a point where even non Dalits will start applying for the job overcoming whatever prejudice they may have against the job. There is a price for everything.

Dean was an OU ba/ma in econ and international studies. Wrote his MA thesis with me as well as taking my PhD macro and metrics courses as an undergrad and acing them. Princeton PhD. Very happy to see this book and your review Alex.

Where are the millions of nice folks in Houston going? I wouldn't be surprised if the population of Houston declines during the next five years. I'd be going too if I couldn't go in the toilet for a week or more. Where would you go?

Look ma, NO zoning.

Our only problem is that kind-hearted Mrs. Savehn keeps letting the outside dogs in, and they refuse to go back out into this never ending rain and howling wind without being dragged by the collar - which occurs immediately after one of them has openly defecated on the floor - which has now happened twice. (For some strange reason they won't stay in the nice, dry garage full of freshly washed dog-beds but instead sit like Dickensian children outside the patio doors looking in at my wife and her purebred watching the weather reports from the sofa. Normally they're happiest outside and have their best hunting luck when storms have flushed vermin out of their holes).

By the way, I've stayed through every hurricane and this is definitely the weirdest. 44.1 inches of rain where I am in the last 48 hours and more to come. What you're seeing on the news doesn't do Harvey justice. And it's not just Houston that's getting it. Lake Conroe filled to overflowing at an almost unbelievable rate and now the SJRA is releasing water downstream at double the all time record rate and flooding those in its path. The openly debated question of how to balance the rate of flooding of the well-off lakefront dwellers against the flooding of the less well-off down-streamers will I suspect be a topic of heated local political debate next year.

Meant 22.1 not 44.1 inches. So far.

Average is over.

There's a Tedx talk on this available at https://www.youtube.com/watch?v=V35Vw29tay0

Maybe built toilets outside? Like, in a forest?

Public toilets hooked to a sceptic tanks seems like an obvious solution.

Excellent point; and exactly as your theories predict, both my parents used to live in homes where the toilets were constructed outside the house. These had septic tanks.

I would really like to look at the authors' numbers and methodology.

I'm sceptical (sic) of your solution.

Yeah I'm not buying the "ritual purity" explanation. I follow those rules and while it is true that feces are polluting it is a problem solved by going first thing in the morning before bathing and prayers. As long as the latrine/toilet is in a separate room it should not affect the status of the rest of the house. Indeed when my great-grandparents moved to the big city back in the 1920's and built a house it included latrines and they were orthodox Brahmanas through and through. Much later in honor of my first visit from England at the age of 2, my grandparents installed the neighborhoods first flush toilet but as we live in a drought-prone area it is seldom used.

If there was a religious influence on latrine usage a simple test would be to compare rates amongst e.g. Muslims or Sikhs. Does the book address this? If so are they any different?

Li Zhi is closer to the mark I think. Latrines are smelly and rural Indians live close together. As my great-grandfather supposedly said about his home village, "If someone farted on the Brahmana street, you could smell it on the Bhangi (untouchable) street." Better to go off into the fields to do your business rather than gross out your family and neighbors. It is also considered healthier because of the folk scientific belief of how disease is spread. Think of how malaria is so named because Rennaissance Italians thought it was caused by "bad air."

The book does address rates by religion and it finds latrine use is higher among Muslims even within the same villages.

Muslims are more urbanized than Hindus. And even if you control by villages, Muslims tend to be engaged more in commercial activities and less in agricultural activities. Muslims as a group in a given village would be marginally richer than the poorest Hindus in the same region.

"Muslims as a group in a given village would be marginally richer than the poorest Hindus in the same region."

As it happens, hindus as a group in a given village would be marginally richer than the poorest Hindus in the same region. By definition. What was your point again?

Sorry, didn't word the last line properly. My point -

a) Muslims more urbanized than Hindus
b) Even if you control for urbanization, you will find Muslims are more likely to be engaged in commercial activity than Hindus, in a given town or village
c) Median muslim per-capita income of Muslims in most villages would be higher than that of Hindus (though the mean may be lower).

I don't have studies to cite, but these are very strong hunches based on my observations.

He has no point. He was probably openly defecating as he responded to your post. Welcome to arguing with Indians. A nation of trolls.

Also it would be interesting to control by not just religion and region, but also income and caste.

Ritual purity is a greater concern for high caste rural Hindus, and I'd be surprised if their latrine usage is lower than that of Muslims. Also as I mentioned in my last comment, our villages today (especially down South) are almost entirely low caste. The Brahmins and other upper castes have bolted! They are mostly to be found in large cities across the world, commenting on MR posts :)

So there is no brahmin in the village who is going to lecture these people on ritual purity.


Where Muslims fall in social/economic status would vary tremendously from place to place. And Alex says they controlled for urbanization. Also ritual purity is not just a Brahmana thing. E.g. in my experience non-Brahmana Tamils observe the menstruation taboo more rigorously than anyone in my community. So I think it is at least plausible that there could be an influence though I agree with you that other factors are probably more salient.

@Alex Tabarrok

I'm going to have to read the book. It seems to me that there are probably some confounding effects they are missing but without actually looking at their methodology I can't say. What is fishy is that Islam has its own set of proscriptions concerning defecation (See http://www.islamweb.net/emainpage/index.php?page=showfatwa&Option=FatwaId&Id=87340 for one example.) And in the villages Muslims practice untouchability too as a cultural thing even though it is not offically a part of their religion. So I do not see why prima facie that there should be any difference in usage rates.

Jaldhar : What annoys me in these discourses is that people argue both ways and always the intent is to malign the brahmin.

For eg - If you see a positive feature of religion, the credit goes to Hindus at large. If you see a negative feature, then the finger is pointed at the upper castes (and more specifically the brahmins). You can't have the cake and eat it too!

Either we accept the "marxist" view of Hinduism as a top-down brahminical religion and ascribe everything in Hinduism (both good and bad) to brahmins. Or we ditch the marxist narrative in its entirety and let go of this brahmin obsession altogether. In which case we shouldn't mention brahmins reflexively whenever any aspect of caste is discussed.

In which case we shouldn’t mention brahmins reflexively whenever any aspect of caste is discussed.

The only person mentioning brahmins in this discourse about one aspect of caste has been you. Look to your own reflexes, sir.

The Lunatic - Jaldhar did bring up the brahmin angle as well. When anyone mentions "ritual purity" the reference to brahmins is implied. As the rules concerning ritual purity are hardly ever associated with shudras (let alone dalits). And most Indian villages are populated almost entirely by shudras and dalits. So there is little reason why these groups should be dissuaded from using latrines because of "ritual purity".

Do we see latrine usage being lower in villages with a significant brahmin presence than in villages with no brahmins? If yes, then I can buy the ritual purity angle

oh! shrikanthk, the poor caste apologist, is deeply hurt by the comments

On the new age latrine cleaners


"The reasons relate to issues of ritual purity and caste. Latrines in or near homes are considered polluting, not in a physical so much as a spiritual or ritual sense. Latrine cleaning is also associated with the Dalit (out)-caste, in itself a polluting category (hence untouchable). That is, the impurity of defecation and caste are mutually reinforcing."

Yet, America keeps supporting such a savage regime (except when it is time to help the Pakistanis to butcher Indians and Bangladeshis of course) no matter how many people die.

Sure, westerners should complain about the body function practices of dim bulb foreigners. The commenters are the same people that wipe their rear after defecation with a piece of paper, confident that this will scour their anus of septic bacteria. Notable also is the fact that in almost all western homes the sink where they brush their teeth is beside the toilet, as is the shower and tub. Flushing a toilet produces an aerosol effect that could potentially spread infectious bacteria throughout the room. https://medium.com/the-physics-arxiv-blog/splashback-how-flushing-toilets-could-be-a-hidden-killer-in-american-hospitals-f2582b2d3bbb

I guess this is all about externalities - if I don't wipe properly the problem is largely mine, if I poop outside, then my poop is everyone elses problem. If you make this about racism then you are probably going to prevent the problem from being solved.

Most cultures have their foibles. I'm working in a Muslim country at present. The men seem to wash themselves diligently with the water jets provided in all cubicles. Then hardly any of them wash their hands.

None of that matters. Proof: westerners basically never get feces-borne illnesses at home. So, no to whatever your cultural relativist argument is. "Western" sanitation is more hygienic than defecating in open fields.

(Also, no one believes that toilet paper removes all bacteria.)

Thanks for giving us the straight poop on a really crappy subject.

I will appreciate if some commenter here can point to the numbers, the actual formulations of the survey questions used etc. to justify the claim that "Hindu notions of ritual purity" has any statistically significant effect, let alone more than the non-ritual purity as suggested by the "in the villages the idea of open defecation is also associated with clean air, exercise, and health".

I am skeptical because,

1. Unlike what the article incorrectly/misleadingly suggests, there are tonnes of people who enthusiastically condemn, not merely discuss, caste, and that includes Amartya Sen and Jean Dreze, and others who are happy to get any opportunity to concern-troll, if not downright shame, Hinduism; how likely is it that they would miss an opportunity to *repeatedly* hammer in such an obvious point?

2. It somewhat worries me that Tabarrok recently retweeted something that had a "white man's burden"-type feel to it (if you feel otherwise, try to feel how condescending it sounds with Indians replaced by another group of people):


Regarding that tweet, I wonder what's so "religious" about Dera?

The founder is a deracinated corrupt Sikh, who has gained some popularity among the low castes, with freebies. How does that ever become a Hindu group? The man is a charlatan. There is nothing Hindu or religious about "Dera".

Oh I hold no brief for that Dera guy at all (though I do sympathize with the dalits who were duped into following him and mourn the loss of lives). My objection is to retweeting Kaushik Basu doing a Thiago Ribeiro - essentially saying that Indians were savages civilized by Nehru and Gandhi: he indeed used the word "civilizing" and is amazed that it was possible to start civilizing the Indians at all.

And to be sure, I am not accusing Alex himself of having a "white man's burden" complex; but his not seeing through Kaushik Basu's racism could indicate a lack of alertness in dealing with non-India-friendly literature?

I get that. I was referring to Kaushik using the term "secular" and implying that Dera guy was somehow a representative of religion. He is anything but a representative of Hinduism or religion of any kind.

The BJP in my view has not been forthright enough in coming out and disowning charlatans such as this man.

Well, the guy has been supporting various parties in various elections, and the latest was BJP (it used to be Congress before that). So disowning him now will be understandably viewed as opportunism.

The use of the term secular in its usual western connotation makes sense: Dera Sacha Sauda self-identified as a Sikh cult (it goes back to 1948 by the way), and its leader endorsed a party. However, Kaushik Basu is still of course wrong even on this because there was nothing particularly secular in the western sense about Nehru or Gandhi.

"My objection is to retweeting Kaushik Basu doing a Thiago Ribeiro – essentially saying that Indians were savages civilized by Nehru and Gandhi"
By the British actually (although Nehru called himself the last Britiah to rule India) and only with partial sucess. The point is, perfid as the British use to be, things were batter in India and Palestine when the British were in charge. https://en.m.wikipedia.org/wiki/Charles_James_Napier#On_sati

Bizarre that a notable Indian economist praising Indian leaders is seen as "white man's burden" argument.

I thought so too; but in a hammer-and-everything's-a-nail way, with every passing year there are more and more situations where the narrative of civil rights fits awkwardly. It must be made to fit nonetheless. There is no Plan B.

It all counts as a triumph for the kid in the Mississippi delta, should anyone remember him.

So calling Indians savages to be civilized is okay because he is a notable Indian economist and praised a couple of Indian leaders. Good reasoning and reading comprehension right there.

And I said "white man's burden-type argument", not your convenient truncation "white man's burden argument". Why so? Because Churchill is criticized as racist for doubting that Indians could govern themselves. Here Kaushik Basu is basically agreeing with him but saying that somehow Gandhi and Nehru made it possible for Indians to govern themselves. Can you tell me why Churchill was being racist and not Kaushik Basu?

I would not think those who frequently invoke racism, would wish to see its meaning so diluted. But perhaps the word is no longer doing the work you need it to do.

If I were one of those who frequently invoked racism, I would have accused Alex of it and not just Kaushik Basu; and what I wrote also means that Churchill is no more racist than Kaushik Basu is.

In other words, I was showing politically correct progressives of the Basu type a mirror.

Now I better understand why you guys are losing your culture war against political-correctness-nazis - you don't work well enough on your reading comprehension.

"Where India Goes: Abandoned Toilets, Stunted Development and the Costs of Caste" The first part of the title is excellent.

After the colon, however, .........

After the colon, it's someone else's problem.

Yeah, the title of a book about defecation really requires a colon in it.

a general comment: Dalits are a general category, comprised of a great number of castes,just as is the case for the rest of the population. Outcaste was/is something else, kicked out of your caste because you broke its rules badly. it's not a synonym for Dalit.

Yes, and outcaste doesn't automatically imply destitution either. Many outcastes could well be very well to do and affluent.

Outcaste simply means you are no longer affiliated with the caste group and cannot leverage the caste network for support or social security of any kind. You are on your own.

Dalits are outside of the Varna system but yes they have a jati.

Well it's not that they need to come up with a more catchy song. https://www.youtube.com/watch?v=_peUxE_BKcU

Let's be honest: America is the police of the world and is dedicated to regime change and opposing refimes it doesn't like (like the Iranian, who is harmless when comparred to America's Afghan, Pakistani and Saudi friends, and the Cuban, whose failures are par for the course in Central America and is harmless comparred to American allies). Which excuse does America have for not liberating India?

You know, what a lot of people do when they want attention constantly is get a dog.

Either that or they defend regimes who doom millions of human beings to an early grave. The xog is cheaper, I think.

So get a dog then, Thomas

As long as you seem to think that's an opposition between doing that and opposing the Indian regime, I would rather oppose regimes killing millions of innocents. Also, most Brazilians do not like dogs, they are being replaced by cats.

Yeah but Brazil sucks.

No, it doesn't. Many people who visit Brazil never, ever leaves.

Well yeah, because they've been killed in a mugging.

No, it is not true. Most of them simply like Brazil better and desert their previous countries. Brazilian food and music and weather are among the best in the world. The peaceful and welcoming ways of our people are notorious.

Well Claude Lévi-Strauss was horrified by what Brazil had become when he returned many years after his initial trips. He couldnt leave soon enough.

He couldn't accept the fact the country he had seen as a young professor did not exist anymore. Brazil is a work in progress. Less dogmatic visitors tend to feel at home in Brazil.

Been there, done that.
Take two 50 gallon barrels, bury them two feet deep. But the two barrels connect near the top and one barrel is the dump barrel, the other barrel leaks through holes in its side to the gravel, or you place one or two sewage leak pipes extending outward from the second barrel. Check coding and keep the system at the proper distance from wells.

"In the villages the idea of open defecation is also associated with clean air, exercise, and health. Thus"

Out in the countryside, this view might be factually correct.

Has anyone considered that it is actually Muslim notions of ritual purity that is affecting health outcomes rather than open defecation rates? Islamic ritual ablution, the Wudu, may simply mean that they are washing their hands more and are generally more hygienic than Hindus that don't was their hands as much.

The question is if the problem is solved in neighbouring Bangladesh, why cant it be done in India?


"""Government says it has managed to reduce the number of people who defecate in the open from 42 per cent in 2003 to just 1 per cent of the 166 million population. """

We should have research to show how British colonialism ruthlessly expropriated India's toilets and how latrines-per-capita fell under the Raj. Or something.

Comments for this post are closed