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Total sanitation: Why toilets alone cannot stop open defecation

Toilets and sanitation were an obsession for UPA’s rural development minister Jairam Ramesh in 2012. He spoke about them wherever he went and committed to a 40 per cent hike in the sanitation budget. Bringing in a gender twist, he even urged women to consider a toilet as their birthright. “For her privacy, for her dignity…Every school, every anganwadi and every home must have a toilet,” was his slogan.

 Total sanitation: Why toilets alone cannot stop open defecation

Representational image.

With or without a cue from the UPA minister, the Modi government also expressed its commitment to sanitation in its maiden budget. Under “Swacchha Bharat Abhiyan”, the government has promised “total sanitation” by 2019, which means every household in India will have a toilet by the targeted deadline.

Equating toilets with sanitation is common because one of the fundamental aspects of sanitation is open defecation. Various estimates show that between 500 to 600 million people, or about 60 per cent of the country’s population, clear their bowels in the open. This number is roughly 58% of the people who defecate in the open all over the world. India is a gold medalist in open defecation.

Shitting in the open is a terrible public health hazard. Two facts can illustrate this easily - India loses at least 1000 children a day to diarrhoeal deaths, obviously because of poor sanitation; and the holy Ganges is unsafe for bathing because it is filled to the brim with faecal coliform bacteria (120 times higher than the permitted levels).

So will building toilets, as both the UPA and the NDA governments have committed to, help reduce this?

A Bloomberg story on Monday said that building toilets need not address the sanitation and associated health challenges of the country because people don't necessarily use them. Reporting from the north Indian village of Mukimpur, the report mentions a women and her family who defecate in the open despite getting a toilet from the government in February. Apparently she doesn't even remember when anybody has used the toilet last.

Public defecation for her village of 7500 people is a habit that they believe is right. According her, only Dalits need to defecate in closed spaces. Openly doing it is the natural way. Most crucial is the belief that faeces cannot exist under the same roof where people eat and sleep.

The report quotes Yamini Aiyer, director of policy research group Accountability Initiative in Delhi, who says: “Targets for construction of toilets are somewhat irrelevant to resolving the sanitation problem.” “Building toilets does not mean that people will use them and there seems to be a host of cultural, social and caste-based reasons for that. People need to be taught the value of sanitation.”

The reason, as the report rightly says, is because along with sanitation, there’s no education on sanitation. More than half the budget for sanitation education remains unspent since 1999. “Of the 18.3 billion rupees set aside for that purpose in the past 15 years, only 45 percent has been used, partly because local authorities can’t get more funds until they prove how they spent the previous year’s money and partly because the central government often simply ran out of cash.”

Another important aspect of sanitation, which in fact is related to working toilets, is manual scavenging. The Supreme Court in 2013 expressed concern over the inordinate delay in passing a new Bill to abolish this practice.

Manual scavenging, historically has been carried out mostly by the Dalits and some estimates say that more than 1.3 million Dalits are bonded to this inhuman practice. This is a vestige of the old social order which nobody wants to change.

Besides being a symbol of historic oppression, it also shows that a large number of Dalits do not have other choices of livelihood. In many parts of the country, people have no qualms in employing the scavengers to clean their septic tanks and clogged sewers.

Toilets also don’t work because it doesn’t have associated amenities such as access to water and proper sewage lines. Without them, the toilets become unusable from day 1.

So overall, sanitation is more complex than it appears and cannot be solved by simply building toilets. As in the case of public health challenges and epidemics, poor sanitation also has its socio-economic, cultural and political reasons which are never addressed by the State because it is tricky and can be politically counter-productive. It’s a symbol of the complex and gross inequality of our society: a symbol of poverty, landlessness, class and caste politics, illiteracy, the failure of the State in addressing them and finally, a poor sense of hygiene as a cultural habit.

As in the case of poverty, sanitation also is a multi-sectoral issue and cannot be handled by one or two ministries. It has to be part of a compact that will address poverty and its socio-economic determinants, and various sectors - read ministries - need to be involved. For sanitation to improve, the lives of people will have to improve, and the overall human development indicators have to improve.

Otherwise, by 2019, India will have the world’s largest number of unused toilets not only because the cultural habits haven’t changed, but also because there is no water and sewage lines.

(Some parts of an earlier report have been used in this report.)

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Updated Date: Aug 05, 2014 15:02:42 IST