Toward the end of open defecation in
peri-urban areas of Mongolia
Case study on a new social norm
Gilles Fagninou
University of Pennsylvania & UNICEF summer programme
2012
July 2012
Draft - Work in progress.
Executive Summary
Mongolia is a landlocked country with one of the lowest density population in the world: 2.7
million populations for 1.56 million km2. The country is mostly populated by nomadic
herders who are migrating progressively and settling in peri-urban areas closer more secure
job opportunities. Recent official statistics show that more than 25% of the population is
living in peri-urban area with limited access to basic social services. According to the
Government, the majority of the people are living illegally in peri-urban since they are not
authorised to stay in those areas. One of the major concerns in peri-urban areas is open
defecation. Nomads move in peri-urban areas with the strong custom that they don’t need to
use latrines and toilets. While in rural areas where the population is highly scattered, the
impact of open defecation on mortality is not evident, it is proved that when the population is
congested and households are physically settled close to each other, open defecation has a
direct negative impact on mortality, especially on child mortality. This paper is proposing the
creation of a social norm to end open defecation in peri-urban areas where a good household
should have and use latrine. As social expectation matter a household in the community
should expect other households to have and use latrines. Therefore, progressively, household
will build and use latrine because they are convinced that other will do the same. This will be
auto-regulated by community members since people knows that when someone open defecate
it impacts not only on his health, but also on others health. That way, they will be in the
community a strong alliance against the custom and a kind of interdependence in the
community. An incentive will be created to reward the community with the highest latrine
rate.
Mongolian context
Mongolia’s economy growth was about 17.6 % in 2011 and is expecting to increase during
the coming years, mainly due to the mining sector growth. It faces high inflation, and soaring
food prices. However, a significant percentage of the population remains largely untouched
by the nation’s economic growth. The poverty rate has remained stagnant at 35% nationally
and 50% in rural and peri-urban areas. 73% of the poor work in low-paying jobs in urban
centres or in rural herding and farming households. Nationwide, 42% of children live in
poverty and 21% suffer from chronic malnutrition.
Mongolia also faces challenges related to its geography, harsh climate and lack of national
road infrastructure, which make logistical planning and implementation costlier and more
problematic than in many countries. Climate change has also engendered such challenges as
increasingly extreme temperatures in summer and winter, water shortages, poor water quality,
land degradation and desertification, all of which directly threaten livelihoods and national
food security.
According to the last national report on the MDGs published in May 2012, Mongolia is on
track to meet 66 percent of its MDG targets. However, slow progress and some regressions
have been the trend with the remainder, including those MDGs targeting water, sanitation,
hygiene and the environment.
More than 50% per cent of the rural population has no access to safe water and nearly 70%
has no access to adequate sanitation. Lack of proper water and sanitation in rural schools and
dormitories, where children spend up to nine months of the year, remains a critical area of
concern. Limited water access and improper WASH facilities are common problems in
schools and kindergartens.
Only 25% of district schools have improved sanitation and 28% have access to adequate
water. A recent study on school dormitory conditions showed that the water supply for 74%
of 502 dormitories then in use, was carried from outside water kiosks and wells, and 46% of
the water supply did not meet hygienic standards. Only 22% of the dormitories had indoor
toilets and the remaining 78 % had outdoor latrines – most of which were unsafe and
unhygienic.
The Need for Latrines and Toilets
Proper sanitation facilities (for example, toilets and latrines) promote health because they
allow people to dispose of their waste appropriately. Throughout the developing world, many
people do not have access to suitable sanitation facilities, resulting in improper waste
disposal.
Absence of basic sanitation facilities can:
-
Result in an unhealthy environment contaminated by human waste. Without proper
sanitation facilities, waste from infected individuals can contaminate a community's
land and water, increasing the risk of infection for other individuals. Proper waste
disposal can slow the infection cycle of many disease-causing agents
-
Contribute to the spread of many diseases/conditions that can cause widespread illness
and death. Without proper sanitation facilities, people often have no choice but to live
in and drink water from an environment contaminated with waste from infected
individuals, thereby putting themselves at risk for future infection. Inadequate waste
disposal drives the infection cycle of many agents that can be spread through
contaminated soil, food, water, and insects such as flies.
Nomadic culture
Mongolia is populated by nomads. Since nomads move from place to place according to the
weather and where they can find grass for their herds, they don’t care about latrines and
practice open defecation. The country land mass is huge, compare to the size of population;
1.56 million km2 for 2.7 million people according to the last Census 2012. With this low
density (1.6 person per km2), and in the context of nomadic culture, herders are not leaving in
community and very often a household is settled far from each other, there is no proof that
open defecation has a noticeable impact on child mortality. In contrary, when population is in
community, congested and physically close to each other, it’s scientifically confirmed that
open defecation has a direct negative impact on child mortality.
Progressively, with the change from socialism to open market economy, climate change and
other transformations, the proportion of nomadic or semi-nomadic people in Mongolia has
decreased over the time, from 60% in 1985 to 30% in 2010. This situation generates an
important migration from rural to peri-urban areas. In 2010, according to the Worldbank
around 25% of Mongolia population is living in peri-urban areas with only less than one out
of three of them using latrines. This situation in a congested area is a threat for public health
and is one of the causes of high mortality in peri-urban settings.
Migrants in peri-urban area are
coming from all over the
country with different
background and culture with
one thing in common: the
nomadic culture and customs.
Even though they are stable and
Figure 1: Dwelling of peri-urban area in Ulaanbaatar – Photo Gilles Fagninou
choose not to move anymore, busy with small informal jobs, they still keep some of their
behaviors and practice such as the low use of latrines.
Open defecation: a strong custom
According to Cristina Bicchieri1, a custom is “a pattern of behavior such that individuals
prefer to conform to it because it meets their needs”. Open defecation in peri-urban areas is in
line with that definition. That consistency of pattern is caused by the similar motivations and
conditions of nomads settled in peri-urban areas. Each acts individually, and the result is an
emergent pattern of action that reproduces itself. The preferences are unconditional:
“Whatever other people do, I will open defecate”. The empirical expectations (expecting
others to do) do not motivate them to act: “Yes, I know lots of people open defecate, so
what?”
Even when nomads move definitely to city centers, in peri urban area, they still believe that
they don’t need latrine. People think that no one expects them to use a latrine and the belief is
so strong that household shouldn’t have latrines is like a standard.
Past and current interventions
In the past, a range of supply driven interventions has been implemented to address the issue
of open defecation in peri-urban areas. The approach used wasn’t successful and the custom
resists strongly. The interventions were not able to influence and convince the population to
change their practice. Another approach based on WASH in school was implemented during
the last five years. The idea was to build latrines in schools and make sure that children are
using the facility, assuming that they will influence their parents to build and use latrines.
Even the family empowerment strategy used in UNICEF supported project succeeded in
pushing the population to prioritize latrine, but in practice, few toilets were built and the use
still low.
1
Professor at University of Pennsylvania - Sascha Jane Patterson Harvie Professor of Social Thought and Comparative
Ethics and Director of Philosophy, Politics, and Economics Program (http://www.sas.upenn.edu/ppe/index.html)
Create a social norm
Given the strong nomadic custom and the fact that the community is built spontaneously by
migrants with different background from all over the country, there is a need to have a norm
that governs the community. An honor code - a good household should have and use latrine can push community members to change their custom. A household in the community should
expect other households to have and use latrines, social expectation matter. Therefore,
progressively, household will build and use latrine because they are convinced that other will
do the same. An auto regulation mechanism by community members will naturally monitor
the respect of the collective behavior. People knows that when someone open defecate it
impacts not only on his health, but also on others’ health. That way, they will be in the
community a strong alliance against the open defecation with a naturel auto-control
mechanism that will create an interdependence among community members.
Reference Group, public declaration and incentive
Reference Group: the approach will be piloted in one peri-urban district (Nalaikh that has 22
communities) and will be expanded – at later stage - to other districts. The reference group is
constituted by households living in peri-urban areas – a discussion with the community
should lead to the identification of a core group with the 1st level of change agents and a
monitoring mechanism. New migrants will find a strong social norm in place and
progressively conform to it.
Public declaration: after a consultative process takes place, the community will define when a
public declaration will be made to reinforce the norm.
Creation of network and incentive: in a participative manner, Nalaikh’s communities will
form a network to share experiences; lessons learnt and challenge each other. An incentive
will be created to reward the community that has the highest latrine rate per household or
using any other performance criteria that the community may find appropriate. The reward
should target the community to strengthen the interdependence and co-responsibility among
members of community.