John Payne, M.D., President, Medical Ambassadors International

In much of the developing world, a simple change to using pit latrines for toilet purposes, rather than finding the privacy of the nearest bush, brings amazing results in better health.

Believe it or not, there are many good reasons that thinking people do not want to build or use latrines. Here are ten objections I have heard, perhaps in reverse order of importance. Each of these objections has a possible answer.

10. “Latrines are not the way we do things here.” Answer: “The village over the hill was not using latrines either; but now they are. Perhaps you should ask them how the change is working for them. Their children are remarkably healthy.” Community Health Evangelism has spread so far internationally that interested people in many places can look at what others are doing before they make up their minds.

Latrines done right have saved thousands of lives

9. “This is a foreign idea. I do not trust foreigners.” Answer: “Do I look foreign to you?” We try to use nationals as our primary trainers and keep our foreign staff in the background whenever possible.

8. “The people I trust the most do not use latrines either.” Answer: “But you know me well. Do you trust me?” We look for a respected local champion to advocate for new ideas. Outsiders rarely lead sustainable change as well as respected insiders can.

7. Men in some cultures may say, “A woman might use the same latrine I use, and that would be a disgrace.” Answer: “If you and the family next door each build latrines, one could be for the men and the other for the women.”

6. “I feel disrespected when other people tell me what to do.” Answer: “But our community decided together to focus on building latrines.” MAI workers have been trained to avoid telling others what to do. We describe choices, and then wait for local people to make their own plans.

5. “I do not know how to build a latrine.” Answer: “A class in your neighborhood is going to train interested people next week. You are welcome to join them, if you are curious.”

4. “I have heard latrines really stink and have lots of flies. Who would choose to visit such a place?” Answer: “We can show you how to add a vent pipe and a screen to greatly decrease both the smell and the flies. We call this a ‘V. I. P. (Ventilated Improved Pit) latrine.’ We also will show you how to use a bottle of water on a string and soap to make a ‘tippy-tap’ handwashing station.”

3. “It sounds like too much work.” Answer: “A bunch of us from the community will be working on them together. It will be fun and easier if we divide up the work.”

2. “I live in a crowded urban slum. A two by three meter plot of land is all I have. There is no place for a latrine.” Answer: “That is why it is so important that we work together to build community latrines and shower houses. Your neighbors may be more interested than you think.”

1. “Evil spirits live in dark, wet places like latrines. I am afraid to use one.” Answer: “Jesus knows all about evil spirits, and he is much stronger than any evil spirit. He can protect you wherever you go, when you choose to trust him. Jesus has changed my life for the better.”
Latrines done right have saved thousands of lives and have been part of introducing many people to Jesus.

MAI – healing lives…transforming communities.