Having worked as a primary health care professional for over a decade, Dr. Damber Kumar Nirola, Psychiatrist at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) has “witnessed a slow but steady “toilet revolution” over the years”. He personally witnessed the “the evolution of toilets from open fields to gunny sack structures to simple pits to ventilated pits to pour flush to water closet, and the most recent western type of commode”.
Dr. Nirola’s “earliest recollection of a “toilet” was a relatively flat stone located some fifty feet away from our house, which could fit at least three children at once. This stone was positioned in such a way that faeces would fall directly to the slope below. Open defecation was a problem only when it rained; we’d get soaked and also fall prey to leeches. Another problem were stray mongrels, which would appear behind us without warning to devour the fresh excreta, at times even offering to clean us up!”
In the 1990s a sanitation campaign was launched in Bhutan, which resulted by 2000 in “almost 100% latrine coverage”.
“In spite of such progress”, Dr. Nicola laments, “we still find our public toilets clogged with sticks and stones, and with faeces scattered on our footpaths even in cities! Something is amiss! Are we slipping back in time or have we failed to evolve with our toilets?”
“Although the provision of latrines is relatively high, the conditions are very poor and the amount of usage is low, ” says Ugyen Rinzine, chief engineer of the public health engineering division. Although rural people had adequate knowledge on water and sanitation-related diseases, there was little change in their behaviour. “This is because of a lack of appropriate communication approach with rural communities and the absence of choice of latrine technologies.”
In May 2008, the public health engineering division organised a workshop on rural sanitation, which discussed plans to implement a community led total sanitation (CLTS) strategy and proposals for a national rural sanitation and hygiene programme. A scoping study conducted by SNV Bhutan in 2007 found that the sanitation situation in community schools and religious institutions (temples and monastic schools) in Bhutan was poor.
The non-use of sanitation facilities is illustrated by the case of Trongsa town. “Despite having two ‘pay and use’ toilets, which have been out of use for about six years”. “Today, only a few dogs visit the one storey toilet in Thruepang” and “the municipal sweeper uses the other toilet as a residence”.
The public toilets were not used because of their location outside the main town area and because people weren’t willing to pay. “Although the municipal office had planned to repair and reuse the facilities, the municipality did not have funds”.
Sources: Dr Damber Kumar Nirola, Kuensel Online, 11 Aug 2008 ; Tandin Wangchuk, Kuensel Online, 01 May 2008 ; Tashi Dema, Kuensel Online, 07 Jul 2008
See also: Training on participatory approaches, Bhutan, IRC, Dec 2007