About one billion people, or 15 percent of the global population, practice open defecation and a large portion of them are in India. Much of the poor hygiene practiced in India is deeply influenced by the country’s discriminatory caste system. Due to the lack of proper drainage systems, manual scavenging (cleaning human waste by hand) was designated to the lowest caste Dalits, earning them the name “the untouchables”. After decades of campaigning and improving sanitation systems, in 2013 Indian lawmakers passed the Prohibition of Employment of Manual Scavengers and their Rehabilitation Act, criminalising the practice of employing individuals to clean manually, carry, dispose of, or handle human excreta from dry latrines, open drains, or pits and sewers.

According to a report by the Asian Human Rights Commission in 2015, however, many rural households in India continue to engage in manual scavenging, finding that the continued practice has less to do with poverty than with enduring caste-based discrimination.