choices have little to do with health (53). Although the government-constructed latrines are used less and the people, in general, report a decided preference for OD, the authors concluded that this does not “excuse the government from its responsibility. India needs a large-scale campaign to change sanitation preferences and promote latrine use” (54). Thus, these studies primarily framed the problem-solution as biological-technological. In a different study, Coffey (2014) pointed to the missing ‘middle rung’ theory as crucial to explaining the continuing persistent ‘resistance’ to ending OD. The WHO, UNICEF, and JMP (Joint Monitoring Program) described latrine use on a ladder from OD to varied forms of pit latrines moving eventually to the highest rung of “improved sanitation” (i.e., defined as flush toilets, covered sewers and sewage treatment plants). According to the study, only 16% of India is on the middle rung whereas in Bangladesh and sub-Sahara Africa the percentages are 40% and 45%, respectively. This theory presupposes a proper means of moving from the lowest to the middle rung before scaling up to flush sewers. Today, the Rachel Carson National Life Refuge in Maine has moved to a “middle rung” for the sake of the environment by providing eco-friendly, composting toilets within the preserve. To think of water-based, enclosed sewage systems as the highest rung may be to promote the elitism of the ‘western’ nations. Postcolonial concerns must be taken into consideration or researchers are likely to repeat mistakes of the colonial past (Said 1978; Spivak 1988) and contribute to ecological damage as well. Indeed, researchers might need to rethink the lower, middle, and higher rungs entirely as in our study no one from the most rural village was familiar with such a higher-rung system, so it is not that they are turning down the middle rung sanitation in hopes for the top tier. Srivastav (2014) reported stories in which people said defecating in the open
When “doing one’s business” by the roadside one must get up if a lorry drives by or if a person is approaching. This is especially true for women. At times getting up and down is described only as an “inconvenience” and other times as “shameful.” One woman expressed distress saying that you could even “shit your clothes” trying to get up and down repeatedly. Both men and women suffer the embarrassment of getting up and down, but when one man mentioned the embarrassment another chided him, calling him “a woman” in a derogatory fashion. Thus, it is likely that fewer men mentioned the embarrassment. Men recognized that getting up and down is a problem for women, as one man commented: M#2, FG# 3: It is also a problem of social repute. That’s the thing. If a woman is sitting [squatting] on the streets and someone is passing by she will have to get up every time due to social respect. They have a lot of problems. Let’s say three or four people are passing by, they have to keep standing for 15 or 20 minutes in total. Going outside is not a good thing. There is definite overlap between getting up and down and shame, but shame seemed most related to gender. Shame went beyond embarrassment for the defecator. Defecating in the open was considered too shameful to be done in another village by some women (3) who demanded their daughters or nieces put in a toilet so they could use it when they visit (this will be mentioned under good things about toilets as well). Women, who often cover their faces and heads when a man or someone of a higher caste/class is nearby, have trouble covering their faces while holding their sari and the possibility of a man seeing their bare body during defecation is beyond embarrassment it makes one feel “ashamed.” If a woman is seen, she might also be called “shameful.” One young man mentioned that if he were coming down the road and saw his mother squatting, this would be shameful.