Last year, the World Health Organization and UNICEF Joint Monitoring Programme estimated that 61 percent of rural Indians defecate in the open. Even as the world is transitioning from the Millennium Development Goals (MDGs) to the Sustainable Development Goals, India continues to lag behind on the sanitation related MDG indicators.

 

To give a fillip to efforts focused on making India open defecation free, the Prime Minister launched the Swachh Bharat Abhiyan (Clean India Mission) in October, 2014. The Mission aims to facilitate the construction of 120 million toilets in rural India by the year 2019, in addition to 500,000 community and public toilets and provision of solid waste management facilities. Since its launch the Mission has organised well publicised campaigns across the country involving the Prime Minister himself, ministers, bureaucrats, celebrities and civil society. A fund has also been set up for seeking charitable contributions as well as a 2% surcharge which will be levied on certain services for financing initiatives under the Mission. It is certainly one of the most ambitious civic initiatives to have been launched in the country over the last several decades.

 

For someone who has been working in public health and sanitation in India over the last few years, I can confidently say that the launch of this Mission by the Prime Minister has given the problem of sanitation the attention it deserves.

 

The challenge is not a new one of course but the attention it has started receiving from a range of stakeholders is heartening.

 

On a more tangible note, within a year of its launch, the Mission enabled the construction of over 10 million toilets across the country. A survey conducted by the National Sample Survey Office, however, revealed that less than half the toilets that have been built under the programme are actually being used. So what is going wrong? The challenge with sanitation is that it is as much about software issues as about hardware.  One of the biggest challenges is bringing about behaviour change. One would imagine that someone who has been defecating in the open would immediately welcome the opportunity to use a safe and functional toilet. However, it is not that straightforward. Habits do not change easily or quickly, especially when they have persisted for years. For instance, it is natural to assume that women are the most concerned about having a toilet in their homes for greater convenience, privacy and safety. While this is true in a majority of cases, I have met women from slum communities who say that they are so accustomed to defecating in the open that it simply does not bother them anymore. Others prefer open defecation over using a closed toilet which makes them feel claustrophobic. The widely varying sanitation practices across different parts of the country therefore need to be appreciated and tailored strategies developed to modify them. One way in which this can be achieved is through the cultivation of local champions. Women and children, in particular, have the potential to become change agents by championing the cause of sanitation in their local communities.

 

Quality of construction is another factor that plays a major role in determining whether or not the facilities are used on a regular basis. A number of toilets do not have a reliable water connection which leaves the toilets in a dirty and unusable condition. Furthermore, in areas where pit latrines are constructed, people are concerned about what will happen when the pits fill up and need to be emptied. In some places there are socio-cultural reservations about emptying the pits as the activity is considered to be related to manual scavenging.

 

Capacities of officials who are responsible for actually implementing the Mission guidelines and overseeing construction need to be strengthened. For instance, Public Health Engineering Department staff who oversee toilet construction in villages and schools need to be sensitized so that they are also cognizant of the quality of construction. In some cases, the holes of squatting toilets are too big and children are scared of falling into them. Toilet doors in schools often do not have latches, which is a safety concern, especially for girls.

 

Moreover, the indicators that officials are held accountable to need to be expanded beyond the number of toilets of constructed. Indicators related to functionality must be given equal importance so that in the race to build more toilets, usability of infrastructure does not get overlooked. Appropriate incentives for implementing the initiative are also needed. I once spoke to a Government official from the Education Department in the State of West Bengal who told me that they had implemented an award system for schools to encourage implementation of sanitation initiatives and adherence to quality norms. Although the prize money was modest, the award had become a matter of prestige for the schools.

 

The Swachh Bharat Mission holds a lot of promise no doubt. It has helped to mainstream the dialogue around the enormity of the sanitation challenge in India. However, in order to attain the overarching goal of an open defection free India, it needs to ensure that the problem is tackled holistically with due importance given to both the hardware and software aspects.