Sanitation in terai-madhesh: the final hurdle in Nepal’s ODF campaign


The national government’s endorsement of the National Sanitation and Hygiene Master Plan in 2011 intensified the sanitation campaign in Nepal. However, like any other nationwide plan, implementation had been segmented. Because Nepal’s hill and mountain districts had already made a head start in implementing a district-wide approach for sanitation (since 2008), these areas were the first to benefit from the campaign. Districts in the plains of terai-madhesh, which border with India, were the last to be reached. In 2014, the terai districts had less than 25% sanitation coverage and were tagged as the campaign’s ‘dark districts’. In this blog, I look back at some challenges we faced in scaling up new sanitation behaviours across the terai region.

In September 2014, I began working in Sarlahi district to oversee the implementation of SNV’s rural sanitation approach: Sustainable Sanitation and Hygiene for All (SSH4A). Upon reaching Sarlahi, I discovered that SNV’s working areas had already been designated by the government-led District WASH Coordination Committee (D-WASH CC). Alongside these, 15 Village Development Committees (VDCs) had been assigned to SNV.

SNV’s working areas were scattered across the southern and western parts of the district. To reach the villages, we had to pass through unpaved, dirt roads. The journey became even more challenging and treacherous whenever we'd approach the rainy season. In addition to difficulties with coordination and logistics, suppliers’ lack of information about the market potential of areas, and clients’ lack of information about the types of options and materials available, there were many other challenges to overcome.

The plains of Hattisarwa Mahottari

The plains of Hattisarwa Mahottari

Toilet construction at Mahottari

Toilet construction at Mahottari

A disenfranchised village population

The D-WASH CC had just made a district-wide declaration, which was accompanied by 13 strategic actions to be taken by all VDCs. The formation of V-WASH CCs and the inclusive preparation of a village-wide development agenda were among these. Both suffered delays due to people’s low confidence in the process. At that time, local representatives in the villages were not democratically elected. Many people felt disengaged from the decision-making process as their voices and opinions were not being heard. There was little trust on local leaders and a lack of social harmony.

Mind-sets and misinformation

District officials assumed that it was impossible to accelerate positive sanitation changes. They felt that the district’s high rates of poverty required government subsidies to realise improvements. During one VDC level discussion in Sarlahi about the necessity of toilet construction, and the enabling role of individual households and V-WASH CCs, social elites argued on behalf of people living in poverty. They asked: ‘How can poor households build toilets’? When we talked with lower income households and dalits, their response was ‘How can we build expensive toilets?’ Clearly, mind-sets had to be changed and misinformation had to be addressed.

Majority of household heads held the perception that the cost to construct a toilet was beyond their capacity and means. On the other end of the spectrum, households with the materials to start construction (e.g., rings with slab), opted to wait for government subsidies. A similar attitude was shared by some households with better economic status; specifically, those who knew of the sanitation support arrangements for households across the Indian border.

Normative practice and culturally embedded traditions

The practice of open defecation was enculturated. Along the paths and outskirts of every settlement, adults, youth and children defecated openly. Women had to develop coping mechanisms to ensure that they could defecate in ‘private’. Some went during the early mornings or late evenings. Newly married women living in the family home of their husbands consumed little food to control the ‘need to go’.

In some family homes, elderly refused to share a toilet with their daughters-in-law. People with disabilities did not have access to suitable toilets, at home and in public places.

The above challenges all seemed insurmountable. But, in a matter of five years, the eight most challenging districts of terai-madhesh – which includes Sarlahi – became open defecation free. For me, government leadership, development partners with dedicated professionals, and civil society partnership with community, private sector, local volunteers and media were the key success factors in overcoming the above-mentioned obstacles.

Finally, Nepal is in the position to celebrate the success of its ODF campaign. On 30 September 2019, I join WASH sector professionals, development partners, civil society and the citizens and government of Nepal – with happiness and pride – in celebrating this momentous achievement.