Major crises like wars and disasters affect the lives of millions of people around the world. Sri Lanka itself has experienced the devastating consequences of a brutal 30-year war, violent insurrection and the 2004 Indian Ocean tsunami. Whilst mental health and psychosocial services have evolved to help survivors of these crises to cope with and recover from these impacts, it has often been a challenge to providing effective support at the scale required and in a timely manner.
For some affected people, the mental health and psychosocial consequences can be serious and long-lasting. However, for others, access to appropriate material and social support can bolster their ability to cope with the losses and hardships created by disaster and conflict. Given the limited specialized human resources available for mental health and psychosocial support in low and middle-income settings around the world – including in Sri Lanka – it is vital to develop approaches that can strengthen families’ and communities’ own capacity for resilience in the face of adversity.
Fact #1: One in six people still defecate in the open.
Fact #2: Most of them are not entirely convinced that a toilet does any good.
Fact #3: Many of the recent toilet adopters still like to go in the open.
I don’t mean to be alarmist, but these signal a need for a shift in thinking about the complex problem of addressing behaviour change with respect to toilet adoption.