Sanitation Setback

HEALTH

Bringing millions of latrines to the poor has long been a goal of public health experts. Now, a major study has stunned advocates of latrine-building by showing that it may do little good. (New York Times)

Use our resources to learn more about sanitation and why we shouldn’t take it for granted.

Teachers, this is a great, accessible, real-world example of the scientific method. Scroll all the way down for a short list of resources in our “Teachers’ Toolkit.”

The construction of latrines hasn't changed too much since this example was built in 1917. Latrines safely isolate waste and prevent germs from leaching into water or food supplies. Latrines are almost always accompanied by a handwashing facilities. Photograph courtesy National Geographic — The construction of latrines hasn’t changed too much since this example was built in 1917. Latrines safely isolate waste and prevent germs from leaching into water or food supplies. Latrines are almost always accompanied by a handwashing facilities.
Photograph courtesy National Geographic

Discussion Ideas
The extremely short NYT article talks about a major study on the impact of latrines in poor, rural areas. This is a great way to understand the scientific method—the “real process of science.” How does the latrine study fit into the diagram below? The italicized headlines before each question suggest where the area of scientific inquiry might fit. As the diagram shows, science is not a linear process—it’s “dynamic, unpredictable, and conclusions are always revisable.”

Practical problems, Exploration and Discovery, Surprising observation, Testing Ideas

Who conducted the study? How was the study conducted? What were the expected results? What were the actual results? Read a summary of the study here.
- Western public health experts supported by international organizations, including the Bill and Melinda Gates Foundation, conducted the study.
- The study included choosing a series of 100 rural villages in Odisha (formerly Orissa), India, and monitoring the health of their residents between May 2010 and December 2013. Households were eligible to participate if they had a child younger than 4 years or a pregnant woman—this allowed the researchers to focus on children’s health. New latrines were built in half the villages, chosen at random. This allowed researchers to evaluate the health differences between the villagers who had access to the latrines and those who did not (the control group).
- Researchers expected the villagers with access to the new latrines to have better health than the villagers that did not.
- The results were inconclusive. “After more than two years, they found that the health of children in the villages with latrines had not improved,” according to the NYT.

Practical problem, Testing Ideas, Benefits and Outcomes

The NYT article says that “diarrhea rates were virtually the same” in villages with and without latrines. Why is this disease, the only one named in the article, so important? Our short article on World Toilet Day might give you a hint.
- Diarrhea is one of the most dangerous diseases on Earth—according to the World Health Organization, it’s the second-leading cause of death among young children. (Pneumonia is the leading cause of childhood deaths worldwide.)
- Diarrhea is largely preventable. Safe drinking water, improved sanitation, and handwashing are the leading ways to combat diarrhea.
- In short: This is a disease that safe, clean latrines are designed to prevent.

Surprising observation, Testing Ideas, Community Analysis and Feedback, Exploration and Discovery

What are some possible reasons why the study did not to get the hoped-for results?
- Researchers can’t quite explain the lack of expected results.
- Some possible reasons may include the fact that many users “did not wash their hands with soap afterward. And animal feces lying around may have caused problems.”

Testing Ideas, Community Analysis and Feedback, Testing Ideas

How can public health organizations work to improve the impact of latrines in poor areas?
- Infrastructure: Improve the water quality in rural villages.
- Health-care: Improve villagers’ access to vaccines and vitamins.
- Economy: Improve financial opportunities for the world’s poor.
- Education: Help villagers understand ways to use sanitation facilities—like the tippy tap.