A toilet can address health concerns that result from delaying defecation



About five months ago, Kamali Lekam was the first person to have a toilet built in her home in Orchha village of Narayanpur District in Chhattisgarh. In a place where open defecation is common, the idea was sold to her as a ‘Doctor that heals.’  And she was convinced that it would help her overcome most of her health concerns that stemmed from irregular defecation practices.

Risk factors for delaying defecation

It is common for many women to delay defecation owing to work, children and other household chores.  It is worse in rural areas where open defection is common as women wait for hours to relieve themselves under the cover of darkness.  Research indicates that delaying defecation can have dire consequences – dysfunction in muscles, constipation, impacted bowel (when a mass of faeces builds up in the rectum) and worse.

According to CEO Zilla panchayat, Narayanpur, Ashok Choubey, the district administration in Narayanpur noted that a majority of women had various stomach and abdomen related problems.  They had to hold on despite wanting to go badly until it was a suitable time, place and with a suitable partner; often in the early morning hours.  Needless to say, abdominal problems were rife; and they understood that the most probable reason was their irregular defecation practice.  The situation was graver for pregnant and lactating mothers as well as elderly women.

Meanwhile, in places where the district administration held interventions earlier, it was noticed that gradually many women experienced a noticeable decrease in their abdomen related problems after regular use of toilets, as per CEO Janpad Narayanpur, Sunil Kumar Chandrawanshi.  He said that it was highlighted during interaction with villagers, mostly women.


CEO Janpad Orccha, Amit Bhatiya explained that in Orchha, very few households had individual toilets and coverage was less than 1%.  Home to about 6830 households, barely 50-60 of them had toilets.  The region is considered highly sensitive owing to Naxal extremism and almost 50% of the total population comprises of primitive tribal groups from ‘particularly vulnerable tribal groups.’


Considering that more than 90% of the villages do not have metal or kaccha roads, connectivity is poor and any connectivity initiatives are opposed by the Naxals.  While some travel by bikes, majority of them walk.  Under the circumstances, transportation of construction material is a big challenge.

Literacy levels are below 30%.  Tribal languages spoken in the area are Gondi, Halbi and Madiya.  Owing to poor penetration of Hindi language, mobilizing people for toilet construction and usage has been difficult, according to District Coordinator, Girendra Sahu.

Further, the habitations are spread over large areas.  Each of the villages have many hamlets with about 5-10 households in single hamlet where the practice of using the forest as space of defecation is common. All household chores such as washing clothes, utensils and bathing takes place at a water source. Therefore, storing water at home for toilet use is highly improbable.  Trained masons are few and far between and masons from other places are not willing to provide services in the naxal prone, hilly and interior areas.


Despite the challenges, the district administration was keen to make Narayanpur block of Narayanpur District (the other being Orchha block) ODF by early 2017.  Towards this, they held Swachhta rallies, Ratri Choupal, awareness building activities through house visits and forming Swachhta groups, using SHGs for toilet construction, training of masons including women masons through skill development schemes; enlisting children in monitoring of open defecation; mobilizing villagers and school children, encouraging GPs to support poorer families; and promoting low-cost, natural toilet construction methods using bamboo and branches.

As far as Orchha block is concerned, a target has been set for April 2017 to declare the block as ODF.  In the pipeline are plans for demonstrations to show linkage between toilets and health; and training of masons.

An inspiring incident that needs mention is that of a woman mason from Gram Karlakha who built a bathroom alongside the toilet for her home.  Now she is helping others to build their toilets.  Also, several women in that village have come together to make cement bricks which are being used for toilet construction.


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