Andrés Hueso, WaterAid’s Policy Analyst – Sanitation, asks whether India’s new Prime Minister can eliminate open defecation by 2019.
“Has it ever pained us that our mothers and sisters have to defecate in the open?”
With these words, the new Indian Prime Minister Narendra Modi pushed sanitation up the hierarchy of national concerns. Using the solemn speech in the annual commemoration of the Independence Day, Modi announced a new campaign to eliminate open defecation – the practice of people relieving themselves in the open – by the 150th anniversary of Gandhi’s birth in 2019.
Modi’s ongoing display of political commitment around sanitation is crucial in a country that houses over 60% of the world’s open defecators. The unhealthy environments resulting from 600 million people defecating in the open have terrible health impacts, which are borne especially by children: nearly half (48%) of under fives are stunted and over 200,000 die yearly from diarrhoea – unparalleled figures compared to countries with similar income levels. Open defecation also has broader impacts on the wellbeing of the country as a whole, affecting education, income, gender, equity and dignity.
His speech also has the potential to galvanise the efforts of politicians and administrators, shaking up a bureaucratic system which has historically neglected sanitation. I witnessed this for myself during my visit to India last month; I have been keeping track of rural sanitation in India for some years now, and I observed an unprecedented level of interest in and prioritisation of rural sanitation among the government officers I met.
The key question now is the direction in which the sanitation campaign will evolve. Over the past years, India has implemented well-funded sanitation campaigns that failed terribly. The census shows that total numbers of open defecators in rural India actually increased by over 40 million between 2001 and 2011. Will the lessons from these failures be taken into account?
A need for behavioural change
The main lesson in my view is that better sanitation is not about building toilets but about people’s behaviour. If someone doesn’t feel the need to change their sanitary practices, government will spend millions on building toilets – if at all – that simply won’t be used and will soon fall into disrepair. Making the sanitation campaign behaviour-focused is not a simple task; you need more and better trained human resources at local levels, citizens’ involvement, smart targets and good monitoring systems, as well as room for experimentation and learning; but above all, you need a change of mindset of politicians, officials, the media and the public.
The language used so far by Modi remains steadfastly focused on “building toilets”, and initial measures taken consist of renewed pressure to achieve unrealistically high targets of toilet construction. But if significant change is to happen, Modi will have to navigate himself and the Indian bureaucracy through the contradiction between the ambitious infrastructure targets he has set himself, and against which he will be judged, and the imperative of revamping the sanitation campaign – which would inevitably lead to initial slow progress.
If there is anything more neglected than household sanitation (in India and elsewhere), it is school sanitation, mostly because it seems not to be anyone’s responsibility and it falls off the ‘major’ radars.
School sanitation information is not captured in the sanitation monitoring system in India. It is also not included as a target in the Millennium Development Goals (although hopefully this will change with the post-2015 Sustainable Development Goals). As a result, the situation in Indian schools is abysmal not only in terms of access to sanitation, but also to water sources and handwashing facilities.
Modi has talked about sanitation before, but in this speech he made a new – and very welcome – pledge: “All schools in the country should have toilets, with separate toilets for girls” by next year.
The key to success here is not toilet construction, but functionality. During my same visit last month I visited a school in rural Madhya Pradesh (central India), which had three toilet blocks. One was permanently locked, another was out of use due to parts being damaged and the last one has remained unfinished since 2012. The teachers blamed local leaders, local leaders blamed the school management committee, and committee members blamed the teachers. The end result was that nobody took responsibility for providing access to sanitation.
One of the consequences, apart from open defecation within the school compound, was that girls stay at home during menstruation (having nowhere private and hygienic to manage their needs) or even just drop out completely. This situation is sadly widespread, and almost all 15 rural schools I visited last month – and close to 100 since 2011 – present similar stories: toilets are constructed, are used briefly and invariably become defunct. After some years new toilets are constructed, suffering the same fate soon after.
Ensuring access to sanitation in schools is not just about constructing toilets, but also about their operation and maintenance: ensuring cleaners are appointed, toilets are maintained and repaired, and water and soap is available. Institutional change, which will take more than a year, needs to happen first. This will include clarifying roles, ensuring adequate accountability and monitoring, and providing separate budget lines for toilet maintenance.
There is also a need for the different departments and ministries involved to be better integrated and for proper collaboration to take place, which, as the Prime Minister pointed out in his speech, is currently lacking. This is needed not only for schools, but also for nurseries (anganwadis), health centres and other public spaces, which experience similar sanitary situations.
Answering the question I raised in the title, I’d say that Modi’s commitment to sanitation is the required first step to make India open defecation free. However, for this sanitary revolution to materialise and yield positive results, the campaign has to shift from its present construction-only focus and become behaviour change oriented, while addressing the institutional issues that have led to the cycle of failure.Andrés Hueso is Policy Analyst – Sanitation based at WaterAid's Policy Team. He Tweets as @andreshuesoWA