People & Their Problems

‘Total Sanitation’ Drive

FLUSH OUT HUMAN WASTE

By Dhurjati Mukherjee

President Pratibha Patil recently issued a clarion call for implementing the “total cleanliness mission” in all villages by 2012, saying that sanitation was a key issue. Nearly 250 crore people in the world, most in the Third World, lacked this facility and that the international community, including the UN, was taking steps to motivate people to go in for complete sanitation, she noted. This is clearly significant as 2008 was declared as the ‘International Year of Sanitation’ and that the problem in India is terribly acute.

According to reports, coverage rates of sanitation are shockingly low. Only about one in three persons in Sub-Saharan Africa and South Asia and one in seven in Ethiopia have access to sanitation. Regional losses estimated due to sanitation and water deficit is highest in Sub-Saharan Africa totaling $ 23.5 billion or 5 per cent of the GDP followed by $ 66 billion foe East Asia, $ 34 billion for South Asia and $ 29 for Latin America.

In India, the “total sanitation campaign” is now operational in 590 districts with an outlay of Rs 14,015 crores. The unit cost of each rural toilet increased from Rs 1,500 to Rs 2,500 and will be “turn pit-pour flush toilet”. Since 2001, around 4.7 crore rural household toilets have been constructed with the goal to achieve “Open Defecation-Free India” by 20012. While the government’s endeavour in recent times is indeed laudable, it is difficult to believe that the target can be achieved by the end of the 11th Plan.    

In the country, though economic parameters are quite encouraging and a model for most countries, the infrastructure development with special reference to sanitation has been a major problem. According to estimates, only 237 out of 5,000 towns and cities have proper sewerage facilities with the situation in rural areas being dismal. The lack of adequate sanitation, specially in the BIMARU states, has led to a rise in various diseases affecting the health of the poor.  

Meanwhile, a recent report titled “Progress on Sanitation” by the World Health Organization and UNICEF has revealed the startling fact that India has the highest number of people who defecate in the open – around 665 million followed by 66 million Indonesians, 52 Ethiopians, 50 million Pakistanis and 37 million Chinese. Further, 31% of the world’s rural population practices open defecation with the problem highly acute in South Asia, where 63 per cent (778 million) people indulge in such practice. Regrettably, improved sanitation facilities have increased from a mere 14% in 1990 to 28 per cent %.     

At such a juncture, it is indeed gratifying to note that the government recently announced an accelerated sanitation campaign and advancing the original deadline by three years to 2012. The Rural Development Ministry is expected to achieve “total sanitation” by providing all households’ access to toilets in the next five-six years, which no doubt, is an ambitious plan.

However, some development experts feel the target is unachievable. They estimate that half of the rural population uses open fields, railway tracks or the sides along highways as toilets. Even in cities, 10 per cent of the population (if not more) do not have access to toilets. The problem is aggravated in the metropolises, specially in slums and squatter settlements where lack of sanitation ranges around 40 to 50 per cent.

If facilities are created, the problem could be solved easily in cities, but not in rural areas. More needs to be done. The hard fact would be a sustained campaign for educating people to use the facilities through an attitudinal change. Experience tells us that most rural people are comfortable with the open spaces as this has been the practice for long. As such, the efforts to build toilets would need to be accompanied with public education about the benefits of sanitation and its effect on human health.  

The “total sanitation campaign” launched as late as 2003, has built 31 million household toilets, 9997 community sanitary latrines and 357 school toilets in anganwadis. However, several problems exist to the entire approach. While reluctance to use is one major impediment, the others are: lack of cleanliness and unhygienic conditions; scarcity of water to clean toilets at regular intervals; inadequate toilets in schools and no separate toilet for girls in rural areas; lack of fresh air in toilets which motivate people to defecate in open spaces; and superstitions regarding the use of toilets. 

Both in India and Pakistan, as also elsewhere, slum dwellers’ associations and NGOs have collaborated to bring sanitation to millions of people, using the power of communities to mobilize resources. The famous Orangi Pilot Project in Karachi has evolved over the past two decades into a programme that brings sanitation to millions of slum dwellers. As a result, mortality rates fell from 130 deaths per 100 live births in the early 80s to fewer than 40 today.

In India too, since the early 90s the National Slum Dwellers Federation (NSDP) and the Society for Promotion of Area Resource Centres (SPARC) pioneered a new approach to design and management of public toilet blocks. This was in response to the poor households’ inability to install latrines in high-density areas of Mumbai. In 1999-2001, over 440 toilet blocks and 10,000 new toilets were constructed in and around Mumbai. In West Bengal, where the campaign was launched in 1990, over  two million toilets were constructed and installed during 2000-2005, thus increasing the state coverage of sanitation from a mere 12% in 1991 to around 45%.

Today, on-site sanitation has become the most viable in the most low-income regions, given the high cost involved in connecting to a sewer. It is, however, important that urban local bodies (ULBs) and developmental authorities need to create an enabling environment for the development of services such as pit emptying and disposal that are lacking in many of our cities.

Interestingly, success stories have different roots. Divergent public policies have been developed to respond to local problems. But in most cases, community initiative and involvement have been the most critical. Equally critical is the government agencies-local communities’ interaction. However, in many rural areas, public toilets have been abandoned either because of the people’s reluctance to use these due to either lack of motivation or proper planning to clean these at regular intervals.

The big question then is: what are the prospects for the world achieving the Millennium Development Goals (MDGs)? Though progress is commendable in high population countries such as India and China, the world is “off track on sanitation”. South Asia’s rate of sanitation will have to rise from 25 million people a year to 43 million a year.

At any given time, close to half the population in the developing world suffer from one or more of diseases associated with lack of sanitation as also water such as diarrhea, guinea worm, trachoma, schistosomiasis and hepatitis. And, these diseases fill half the hospital beds, specially in rural areas.

Clearly, proper sanitation along with clean water is among the most powerful medicines for reducing child mortality. These are to diarrhea what immunization is to measles or polio. In addition to saving lives, upstream investments in sanitation and water make economic sense because downstream costs of health systems will be cut.    

Thus it is imperative that there be coordinated action between the government and the NGOs and CBOs to sanitize all districts. The State has to rely upon grass-root organizations that are capable of carrying the work faster, with efficiency and simultaneously motivate the people to use sanitary latrines to protect their own health. Financial constraints should not be an impediment to accomplish this urgent task. ---INFA 

(Copyright, India News & Feature Alliance)