A couple of weeks ago I was traveling through hilly eastern India, visiting remote village communities that survive on a bit of fertile land and mountain streams. At almost every stop I heard stories of stomach viruses and diarrhea epidemics—serious cases that sent dozens of families to far-off clinics.
This crisis, fueled by lack of sanitation and hygiene, accounts for the deaths of 60,000 in India alone and those of 1.5 million children under 5 years old worldwide every year, according to UNICEF. And while the sheer magnitude of the problem can seem insurmountable, one solution might be hiding in a wooden branch, recycled plastic jug, and a bit of soap tied to some rope.
It’s a mind-bogglingly simple contraption called the Tippy Tap—a low-cost hand washing station. Originally created by Salvation Army doctor Jim Watt in the 1970s, the branch acts as support for a jug filled with water and some soap dangling from a rope. The device uses just 30-40 milliliters of water per person, a boon in drought-stricken areas where families survive on just three pots of water all day.
In India, Sowmya Somnath, a sanitation expert, and her husband, scientist Jared Buono, launched a program in the western state of Maharashtra in 2012 and have now reached at least 30,000 people and seven countries. Through what eventually became TippyTap.org, they started working in government schools, training youth to build these taps both in their schools and at home.
“It’s the least sexy and least glamorous thing,” Somnath said. “But it’s immensely practical and it works.”
In the increasingly tech-savvy world of international development, low-maintenance and locally sourced Tippy Taps have succeeded where other apps and devices have failed. LifeStraw, for example, was touted as a magic wand to purify drinking water, but there is very little evidence the filters have stopped disease. And mobile health apps can’t reach villages—like Phulband in Orissa—that remain disconnected from mobile networks.
The key to introducing any sort of new change instead depends far more on the ability to change behavior and understand emotions than a product or facility, said Arundati Muralidharan, a senior research fellow with the Public Health Foundation of India. Information and technology can help, she said, but they aren’t enough on their own.
“For handwashing or hygiene interventions to be effective, and effective at scale–we need another component,” she said about focusing on behavioral change.
Knowing this, the TippyTap.org crew doesn’t depend on just educating people about germs and health problems, even though the device can reduce hygiene-related fatalities from ailments like diarrhea and pneumonia by 50 percent. Instead they use songs, videos, and pictorial manuals to get the message across, and build on emotional triggers like disgust or peer pressure.
It also helps that they make it fun. Kids at the schools where Tippy Taps were introduced had full creative license to build their own devices. Soon Tippy Taps cropped up with cricket bats as levers, or concrete footholds for stability. Having the community create the taps also serves another purpose—if one breaks, or needs maintenance, they know exactly how to fix it without needing to ask for outside help or wait for a spare part to arrive.
“A lot of people are excited by the gidget-gadget aspect of this,” Somnath said. “And there’s just a level of innovation that kids have that make them agents of change.”
Somnath and Buono's Tippy Tap project has continued to grow in both in the communities and through other social innovators.*
Prerna Seth, a 26-year-old graduate student at the Columbia University School of International Public Affairs, is pilot-testing a spinoff called CleanTaps, geared toward India’s street food vendors. (Prerna, like me, is an alum of the Indicorps fellowship program.) On a rainy monsoon day in July, she and her co-worker Dimpy Dave walked through a crooked alley in south Mumbai and stopped in front of Raju Irsat Khan, a wiry 22-year-old busy manning a creaky street food cart.
Khan is one of approximately 200,000 vendors in the city and, like most of them, doesn’t have access to clean, running water throughout the day—making hand washing a once-in-a-while affair.
“Expecting a vendor to step out of their stall and wash their hands is unrealistic. They’re cooking, handling money, serving customers,” Seth said. “But the hygiene situation is pretty bad.”
Seth’s CleanTaps will be a little more sophisticated and high-tech than the usual wooden structures. With the help of a D-Prize grant, awarded to social entrepreneurs, she worked with a product designer to make a “less makeshift, more legit” device out of sturdy plastic. But the fancier models don’t change the recipe for making them successful, so the Delhi native is focusing on the financial benefit to make her taps appealing.
“Ultimately, we want it to push business, or there’s no motivation for a vendor to buy it,” she said.
For Khan, the Mumbai vendor, that could be the deciding factor to purchasing a tap, about 1,000 rupees, or $20, for his cart. And it helps that a CleanTap, which requires no batteries, plugs, or electricity, can be pushed with his wares across the city to the different hubs where he sets up shop.
“The system might help me,” he said, offering us some fried snacks from a wok on his cart. “And it might help bring more people here if they know it’s clean.
*Correction, Sept. 15, 2014: This post originally misstated that Sowmya Somnath and Jared Buono have moved out of India. The couple actually still lives there, in Mumbai, though their projects have changed.