It’s not that Indians are dirty but that the Indian state has never invested in the complete sanitation chain
The Swachh Bharat Mission (SBM) was launched last year with the goal of eliminating open defecation from India by October 2019. It aims to catalyse a nationwide commitment towards hygiene and sanitation and help generate lasting behaviour change among the people. The mission is a commendable one and its message is one that needs reinforcing. But the underpinnings of the mission raise serious and troubling questions.
The SBM is built on a fundamental premise – that people are dirty, and defecate in the open even when they don’t have to. It claims that once toilets are provided, and the behaviour of Indians has been modified, all sanitation problems will be solved. India will become clean and consequently healthy. What the SBM does is to equate poor sanitation with open defecation (OD), and lay the blame for this, not so subtly, at the people’s door. But is this really the case? Are behaviour change and toilets all we need to achieve a swachh Bharat, or clean India?
Yes, the problem of defecating in the open is huge. Fifty per cent of our population does so. And behaviour is an important cause. Studies show that in 20-49% of even those households which have toilets within the house, at least one member defecates in the open. But most such studies have been conducted in rural settings among households who have benefitted from government toilet subsidies. The same studies also show that some of the most important reasons for OD, apart from sheer non-availability of toilets, are the poor quality, inadequate numbers and poor maintenance of toilets or lack of water supply. Indeed the condition of most of our public toilets is such that users may as well defecate in the open. In other words, blame for OD due to poor infrastructure must rest squarely at the government’s door. Moreover, we have had subsidy schemes identical to SBM since 1999; over 9.5 crore rural toilets have been constructed under the Total Sanitation Campaign and Nirmal Bharat Abhiyan. Yet the Census shows only an 11% reduction in rural OD between 2001 and 2011. Obviously, constructing more of the same, as the SBM proposes, cannot be the answer.
Most critically though, toilets are just the initial collection points for the entire excreta management chain. Sanitation, however, includes not just safe collection, but also transport, treatment and safe disposal. Till excreta is safely disposed so as not to contaminate land and drinking water, the sanitation chain remains incomplete and the risk to our health ever-present and severe.
Unfortunately in India, if the toilet situation is bad, the status of excreta treatment and disposal – a domain that is entirely the responsibility of the government – is abysmal. Just about 34% of the population’s latrines are connected either to septic tanks or underground sewerage; the rest have pit latrines where the waste decomposes, usually in unhealthy conditions. Local bodies provide little or no services for septic tank cleaning. An informal industry flourishes to fill this gap. In the complete absence of any monitoring of their functioning, private septic tank emptiers dump this polluting waste on any available empty lot or water body. Government capacities to treat sewered excreta are also extremely limited. Just 30% of urban sewerage from only the largest cities reaches sewerage treatment plants (STPs). The woes don’t end here; STP inefficiencies ensure that a large part of this sewerage flows into our rivers untreated. In short, even when we do use toilets, our government’s apathy has ensured that we unsuspectingly continue to contaminate our land and our drinking water sources. No wonder we are a sick nation; not surprising that we lose over 3 lakh children to diarrhoea each year.
So, what do we realistically need to achieve a Swachh Bharat? First of all, it’s obvious that merely building toilets and ‘changing people’s behaviour’ is not the solution. Pushing the problem under the surface, literally and figuratively, will in fact compound the crisis. We need end-to-end solutions. Toilets are only the first step, they have been built before, and as we’ve seen above, the results are appalling. The sooner the government accepts this, the better.
If we are to seriously have a clean India, there must be a ‘behaviour change’ within the government. While a deadline to deliver on a scheme is a welcome step, it must also allow for results the country needs – the complete sanitation chain.
It is the government’s responsibility to ensure quality in its subsidised toilets – to provide transport, treatment, and disposal of excreta, not the people’s. It is the government that has failed to provide services for septic tank cleaning, for underground sewerage, for adequate efficient STPs or to regulate service providers, not the people. It is heartening that a Prime Minister has made the call for a clean nation. It is now up to him to deliver too. But if his administration focuses on modifying people’s behaviour, rather than its own, the SBM will go the way most government schemes do – start with much fanfare but fade out without a whimper. Modi’s government needs to look beyond toilets; into the pits and along the drains. Else, we may eliminate open defecation come October 2019 but we will still be drinking crap from our rivers.
Anjali Chikersal is a Senior Fellow at Centre for Policy Research with over 20 years of clinical and public health experience. She is leading the Urban Health Program (UHP) of the Scaling City Institutions for India (Sci-Fi) Sanitation project