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For a Chinese farmer like Gao Zhiping living in a backward, mountainous region, all talk of toilets is like talking about sex -- it's private, and it's rude. To his way of seeing, going to the toilet is part of life, but not nearly as important as the happiness of a good corn harvest or the benefits from subsidy policy.

But a national campaign of toilet and sanitation improvement by the Chinese government on the basis of United Nations Children's Fund (UNICEF)'s pilot program in the 1990s is shifting Gao and his fellow Chinese peasants' ideas and actions.

Having lived in Gaojiagou Village, Xiangyuan County in north China's Shanxi Province for more than half a century, Gao is accustomed to the dirty environment of his toilet.

"When the summer comes, the toilet stinks, driving off passers-by. Flies are everywhere, over the roof, in the kitchen, you name it." Gao points to the shabby open toilet, which was constructed by his grandfather in the early 1950s.

In Gao's village and the larger Shanxi Province, open toilets are common. Farmers build a simple toilet by using flagstones, and most of the latrine pits are as high as two meters.

In some places, the villagers don't have a personal toilet in their house. Instead, they share an open toilet. But such a large toilet is dangerous for children, as some have slipped into the pit below and drowned in excrement, recalls 53-year-old Gao.

More alarming is the health threat imposed by this type of open toilet. In the past when tap water was not available, Gao had to go far to carry water from the Sishui River at the foot of the mountain. But the underground water was polluted by the open toilets, which further leaked into the river. "We were worried, but no one knew how to deal with the situation."

Gao's village is not the sole case. In the adjacent Dongchangyi Village, diarrhea was a commonly reported disease in the past, and there had been a high incidence of cancer, says the villager Wang Xianzhong.

One of the reasons behind the high occurrence of diarrhea, according to Wang, is the easy access to dung on the part of children. "They like to play games with it."

Game-playing is no funny thing. Statistics from UNICEF show that there are 190 million Chinese children suffering ascarid, and a further 70 million tormented by whipworms. "The bowel infection may result in retarded growth and malnutrition," says Lei Jun, an official from UNICEF.

Gao Shenghua, director of Shanxi Provincial Committee of Patriotic Health Campaign, says negligence of toilets is not only an issue of personal hygiene, but also a challenge to public health. A recent case is the outbreak of cholera in south China's Hai'nan Province in late October.

When torrential rain hit Xinying Town of Danzhou City, 51 cases of cholera diseases were reported. A major reason, according to Bai Zhiqin, the head of Hainan Provincial Department of Health, was that villagers did not build sanitary toilets in the village and the water body got polluted when the rainy season arrived.

In view of the worrying sanitation situation, UNICEF kicked off a pilot program aiming at the rural areas of northwest China in 1996, with a focus on building a new type of double-urn latrines.

The science behind this type of toilet is quite simple, but it is effective, says Lei. The first urn, filled with water, is used for storing dung. Within three months', bacteria carried by dung are nearly all killed in an anaerobic environment, and the dung will be automatically transferred to the second urn through a tunnel linking the two as a result of the difference of pressures. Then, the dung in the second urn continues the process of fermentation before eventually being disposed of.

Wang Xianzhong, one of the pilot program's beneficiaries, is happy to see that he is no longer bothered by flies, as the new toilet no longer smells foul.

Apart from a cleaner environment, the fermented dung in the second urn can be used as high-quality organic fertilizer.

Li Tuying, a fruit tree planter in Zhanghu Village, Jinzhong City, says the fermented dung complements the chemical fertilizers she buys on the market. On average, she spends 4,500 yuan per year on 10 tonnes of fertilizer, and the fermented dung can be transferred into 600 kilograms of organic fertilizer.

Another characteristic of UNICEF's pilot program is the emphasis on health awareness, as UNICEF integrated the construction of toilets with clean water and personal hygiene under its WES (water, environment and sanitation) model.

"Now, everyone in my village has accepted the idea that washing hands with soap is an effective means to prevent communicable diseases," says Wang.

In the past decade, UNICEF's practice was gradually absorbed into the policy-making process at the top level. Starting from 2007, the central government of China decided to improve sanitation in the rural areas by renovating the old-typed toilets into five new types: double-urn, three-chamber, bio-gas, urine-diversion and water flushed toilets.

"To keep a clean environment is an important element of building a socialist new countryside," says Gao Shenghua.

The expenditure on renovating toilets has risen from 4.73 billion yuan in 2005 to 7.29 billion yuan in 2007. The target is to set up 620,000 sanitary toilets in 23 provinces and autonomous regions across the country, and raise the penetration to 35 percent by 2015. Right now, the coverage of sanitary toilets in the rural areas of Shanxi is 16 percent.

Bold as the task is, both the officials and villagers have to counter a series of challenges.

The most troublesome headache is funding. Without sufficient funding from outside, says Gao Zhiping, he won't renovate the toilet himself as the expenses are no small amount for his family of four, who earn less than 3,000 yuan a year on his one hectare of land.

On average, it costs nearly 1,000 yuan to renovate a toilet, but the central government only sets aside 350 yuan for one toilet, and the provincial and local governments are obliged to contribute their portions.

But most of the local governments of Shanxi are short of revenue, especially after tax reform in the 1990s. Some officials believe that a clean toilet is much less important than introducing investment.

More embarrassing is the position of the Patriotic Health Campaign Committee, which has the responsibility of overseeing the sanitation work.

In the mid-1950s, Chairman Mao Zedong initiated a movement to "fight against the bacteria-war", and the Patriotic Health Campaign Committee was thus founded.

Throughout the 1950s, the Chinese were engaged in cleaning up their homes and communities, and both the countryside and cities took on a new look in a short time.

But the committee's functions have been sidelined over the past decades, and it has become an institution of no substantial power. For example, there are no specially assigned personnel at many lower-level committees, says Gao Shenghua.

But Gao, who has worked on the provincial committee for 26 years, is determined to push ahead. "I am happy that the Party General Secretary Hu Jintao once again emphasized the importance of the patriotic health campaign in his speech at the 17th National Congress of the Communist Party of China (CPC) last year. "

"A person can hardly be deemed healthy if a single cell is ill, and the socialist new countryside won't be realized without clean toilets in the backyard, " she says, with confidence.

(by Gong Yidong, China Features of Xinhua News Agency)