The number and nature of the many forces that intertwine to trap rural Indians in filth and infections are still not fully recognised. Widespread preference for open defecation (OD), subsidised toilets, corruption, caste and divided communities, concepts of purity, population increase and density, faecally-transmitted infections (FTIs) causing undernutrition (‘shit stunts’), diminishing cognitive ability and damaging immune systems, and the multiple physical and social harms inflicted on women and girls – these are among the forces that interlock as a syndrome - a net, a trap, a prison - escape from which is fiendishly difficult.