11 August, 2008 - An article on “toilets” may seem a little weird but not actually. Having worked as a primary health care professional for over a decade I have witnessed a slow but steady “toilet revolution” over the years. Toilets have become more important today than ever before, especially so after the world toilet organisation (WTO) was established in 2001. This is a reminiscence of my experience of graduating from the open field defecation to using modern toilets.

Way back in the early sixties, when I was a child we didn’t have a toilet in our house and always relieved ourselves outdoors. My 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!

Cleaning used to be done with either a stick or stone. My own choice was the leaves of the plentiful wormwood shrub. Further, it took trial and error to find the right plant or one could land up using stinging nettle or other irritant species with terrible consequences.

I graduated to a slightly different type of toilet when I stayed with a teacher in the village school. He was from Assam and had made a makeshift toilet with a shallow pit curtained by old gunny sacks. “Gunny sack toilets” remained in vogue for a while.

I came across a different toilet when I went to Trashigang in 1973. Most houses kept pigs on the ground floor and there was a balcony-type toilet right above. We later named these “hanging toilets”. An innovative way to recycle scarce food but, because of this unhealthy practice, tape worms infested and made us anaemic. The gunny sack toilets had not reached the villages of Trashigang and cleaning with water was virtually unknown.

Trashigang school, however, had proper sanitary latrines with wash basins and running water. Yet we lacked proper sanitation. Most still used sticks and stones, causing blockage and forcing us back to the open fields. Sweepers were hard to find making toilet maintenance a most challenging job for school authorities.

When I joined the health ministry as a medical doctor in 1989, the sanitation status in villages had hardly changed. Even in towns, public toilets remained blocked due to poor maintenance. People would rather relieve themselves by the roadside than enter the choked toilets. I still remember the unsightly sight of human excreta along the stretch of road between Wangdue town and the Tencholing gate!

In 1991, when I became a district medical officer, I realised that my most important public health task was to improve sanitation. Health workers went around teaching villagers to make simple pit latrines to the more sophisticated flush type ones. They also made sure people used them. There were some who constructed and stocked their commodities in them. Our efforts paid off and, by 2000, we’d succeeded in achieving almost 100% latrine coverage.

Looking back, I see 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 commodes, as a real “toilet revolution”. In spite of such progress, 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?