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Resource centre on India's rural distress
 
 

India’s real scandal by Ashoke Chatterjee


Exposed, untreated excrement can kill by the million. One of the hardest-won UN Millennium Development Goals (MDGs) is a 2015 target of halving the proportion of those without sustainable access to safe drinking water and adequate sanitation. Even if achieved, the target would still leave some 500 million on the planet without this basic requirement for survival and dignity. As many as 79 per cent of rural and 46 per cent of urban Indians have no access to improved sanitation. Of the 40 per cent of global population (some 2.6 billion people) forced to defecate in the open, some 665 million are Indians.

Diarrhoea claims 5,000 children every day worldwide, most of them on this subcontinent. The loss in lives, work days and school attendance (particularly by girls) is estimated at $38 billion per year.

Water and sanitation are inextricably linked: without sanitation, safe water cannot remain safe. “Access” is a key word with a variety of interpretations. In planning circles, targets are set in terms of coverage. “Coverage” is normally measured by the number of latrines, hand-pumps, water pipes and sewerage systems installed. Whether these are functioning, properly used and well-maintained is quite another matter.

India’s response is centred largely on its Total Sanitation Campaign (TSC), admired globally for its scale and effort to move beyond infrastructure towards a demand-driven, people-centred approach. Yet dependency on mobilisation and communication capacities at district and village levels has meant that huge outlays remain unspent. Again, TSC is not really “total”. It is targeted at rural India, with incentives only for those below the poverty line, a division flies and germs do not respect. India’s urban population lacks a comprehensive sanitation plan, affecting most of all the vast numbers of slum dwellers who are unrecognised, with no land rights and in constant danger of displacement. At the Centre, responsibility for sanitation is divided between the rural development ministry and the Jawaharlal Nehru National Urban Renewal Mission, while as a state subject, no set pattern of administrative responsibility exists. While drinking water is politically charged, particularly at election time, no comparable will exists for sanitation. Politicians stay clear of toilets, even in a land where the Mahatma made clean latrines and the end of human scavenging central to his ideals of freedom and dignity.

It is not as if India cannot do it. The TSC has achieved important successes in several locations, reaching over 210 million citizens between 1990 and 2008. Nine states claim 75 per cent achievement of targets. The Nirmal Gram Puraskar is given by the president, making it a force for recognition, despite slippages that have led to serious second thoughts. NGO Gram Vikas in Orissa has achieved 100 per cent open defecation-free villages within some of the most difficult tribal conditions.

Another NGO, Gramalaya in Tiruchirappalli, has achieved wonders through women activists in an urban environment. The Sulabh Corporation is known worldwide for extraordinary achievement in providing public facilities at an affordable cost. SPARC in Mumbai and Pune is a model for urban community-centred action. Elsewhere, Karachi’s Orangi Pilot Project, established by the legendary Akhtar Hamid Khan, is perhaps the most celebrated slum sanitation project in the world — and entirely community financed. Bangladesh, Sri Lanka and Nepal also have important achievements to share. Yet the subcontinent remains burdened with the largest share of a global shame.

Many answers lie in institutional reform factors. Sanitation, seldom recognised as a priority in its own right, is usually twinned with water —- which gets all the attention and funding. Accountability is scattered and most solutions remain largely driven by engineering, not the sustainability that comes from decentralised community action. Despite rhetoric, the empowerment of women remains ignored, while experience clearly shows that unless women, as managers of household health, are put firmly in charge, sanitation simply does not happen. Political will remains slow, despite flashes of commitment. Hygiene education is another powerful weapon that remains devalued. Decisions on defecation take place within the mind, an area closed to government, medical and engineering diktats unless awareness leads to acceptance, and acceptance leads on to behaviour change. This needs a mission approach, including hygiene education within schools. That in turn will depend on functioning school toilets, separate toilets for boys and girls. This critical need will remain unattended until India gets its sanitation act together.