Despite regular awareness campaigns, tens of thousands of people, especially those in the rural backwaters, continue to defecate in open places. While most of these people are not aware of the hazards that such unhealthy habits could invite, others simply ignore the idea, as it is making ends meet which is their first priority. A large chunk of the Nepali rural populace is below the poverty line, and only 46 per cent of the people use toilets. So the idea of constructing western-style toilets, which the large majority of the people cannot afford, is not a practical one. However, this should not be the reason for Nepalis to compromise on basic hygiene and sanitation. Instead, Nepalis can adopt simple and sustainable techniques which meet sanitation standards.

There are several models, one of which is the Sulabh model, which has become popular in India and neighbouring countries. The criteria for selection of any model include affordability for the poor, need for much less water than for western toilets, and no need for costly drainage. Besides, the possibility of using night soil for producing bio-gas and as manure should provide more attractions. But even then, more awareness programmes and some subsidy for the really poor will go a long way in encouraging the masses to use toilets. Some effort has been made in this regard by various organisations, and with donor funding, too. However, much more needs to be done to make the use of toilets common in the country.