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7.1 Institutional marginality and silos
For many years, nutrition itself was an unwanted and insignificant orphan in governments, and shuffled from department to department. To gain recognition of its importance, to
raise its profile, to secure funding and staff and to bring it in from the wings, were battles to be fought and which generated commitment to the programmes that followed. For its
part, sanitation was always and still largely remains a junior sibling to water, with a smaller budget. It too had its own battles to fight. The resulting nutrition and sanitation silos, as is
usual, were inward looking and preoccupied with their own programmes. On top of this, both nutrition and rural sanitation have been difficult areas in which to achieve notable
success.
7.2 Psychology: Oral over anal
At both personal and professional levels, there are strong preferences, which do not need elaboration, for the oral over the anal, for things which are clean to dirty, odourless to
smelly, hard to soft and tidy to untidy Chambers 1983: 173. Valerie Curtis 2013 has examined in detail the human emotion of disgust, and subtitled her book The Science
behind Revulsion. Most adults would much rather feed a child and wipe its face than dispose of its faeces and wipe its bottom. The professional psychological dimension is
both fascinating and revealing. There has been a pervasive shift in psychology from the preoccupation of Freud and the early psychoanalysts with the anal to the current striking
focus, almost tunnel vision if the metaphor can be permitted, to the oral. According to Haslam in his delightful and insightful Psychology in the Bathroom 2012: 6-8 there are
numerous journals dedicated to the study of eating and drinking and thousands of articles and many journals that explore the symptoms, causes and treatments of eating disorders
such as anorexia nervosa and bulimia nervosa, but no psychological scientific journals devoted to the elimination of food and its disorders. The mouth remains visible and
attractive, and the anus is kept out of sight, as in daily life.
7.3 Professional specialisation, incentives, tunnel vision and inertia
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