All the advice online and in guide books for staying healthy in India says:
- Don’t eat street food
- Don’t eat anything that’s not steaming hot
- Don’t drink tap water
- Don’t consume drinks with ice
- Don’t eat fruits and vegetables that you don’t peel yourself
- Don’t brush your teeth with tap water
- Wash your hand often
- Only eat at busy restaurants
- Avoid salads and fruit juices
And, yes, they’re all true. You do have to be wary of the water and try to avoid anything the could be contaminated with bacteria, germs, or parasites.
However, there is another reason that anyone, local or foreigner, could get sick in India and it has to do with hygiene, cleanliness, and bathroom practices.
A traditional Indian toilet is a squatty potty, but “western” toilets are also quite common here. As a matter of fact, in the past month I have only had to use five squatty potties, and those were usually in places like train or bus stations. Western-style toilets have been widely available (the norm, I would venture to say) everywhere else. HOWEVER, just because there is a regular toilet does NOT mean there will be toilet paper. Someone told me recently that some Asians even consider the western habit of using toilet paper disgusting because it’s like we’re smearing our own feces all over our butts. So, instead of toilet paper, what you WILL find in every bathroom is a large bucket, a pouring cup, and a water source (a faucet, spigot, or a thing that looks like a sink spray hose). Sometimes the large bucket has water in it. Apparently what you do with those items is this:
1. Put water in bucket (if it’s not already there)
2. Scoop water with pouring cup
3. Pour water onto left hand/butt
4. Rinse butt with water and hand.
And voila, clean butt! But… what about that hand??? Something else that’s frequently missing from public bathrooms here is SOAP.
So, no matter how diligent you are about your own safety measures to stay healthy, all you have to do is eat food (from ANY restaurant, no matter how many 5-star reviews it has on TripAdvisor) that has come in contact with someone who didn’t wash their hands after an Indian-style bum rinse and BAM! You’re infected and out of commission for several days.
I understand that this is a risk we all take all over the world any time we don’t prepare our own food, but the risk is inherently higher in India due to a simple, but crucial, difference in culture (and, I suppose, plumbing).
Here are some pics of various toilets I’ve used here in India (most are “Indian style” because those are more interesting), from best to worst:
This pretty bathroom was in a restaurant/club in Mumbai.
Very bizarre hybrid toilet that I had to use during my Keralan backwaters boat trip. See the bucket of water? Indian-style cleanliness. See all that used toilet paper on the ground? Western style cleanliness. Which is worse???