At a time when sanitation has attracted national attention, there is a need for State governments and local bodies to take the effort from construction of individual toilets and community or public toilets, to total sanitation.

India is infamous for the extremely poor status of sanitation. In addition to open defecation, human excreta is not safely disposed of and managed properly, causing severe health and environmental impacts. Inadequate sanitation causes diarrhoeal and other diseases, deaths of infants, and leads to long-term effects on the development of human capital.

Sanitation, however, is not merely a hygiene concern; it has serious health and economic implications. A World Bank study on the economic impacts of inadequate sanitation in India estimated that India lost the equivalent of 6.4 per cent of GDP due to inadequate sanitation. More than 70 pe rcent of this (₹1.75 lakh crore or trillion) was accounted for by premature mortality and health-related costs.

Contrary to the popular perception, sanitation poses a challenge not only in rural areas (access and defecation practices especially) but in urban areas as well (safe disposal and treatment being big issues). The same study found that the poorest household groups in urban areas bore the highest per capita economic impacts, more than other population groups, including the rural poor.

Now, a priority It is only in recent years that the management of human wastes in India, whether solid wastes or human excreta, have graduated from being a taboo to receiving the attention and priority it deserves. The launch of Open Defacation Free Tamil Nadu in 2012 and Swachh Bharat Mission (SBM) in 2014 has drawn national attention to sanitation.

In order to improve sanitation levels in urban areas, it is imperative to immediately stop dangerous practices like dumping faecal waste in open ground and water bodies. Adopting faecal waste and septage management practices will provide the cities an opportunity to address this challenge and make improvements along multiple dimensions. This will require cities to innovate and identify the appropriate technology options and institutional arrangements.

Best practices can be adopted from regions of Africa and South-East Asia where onsite sanitation systems along with faecal waste/septage treatment plants have been successfully implemented. In India, Tamil Nadu is committed to sanitation through a call to become Open Defecation Free (ODF) in both rural and urban areas. To further address the sanitation challenges, the State rolled out ‘Namma Toilet’ (Our Own Toilet) or public toilets in urban areas.

The Tamil Nadu government has prioritised septage management (management of onsite systems) and in 2014, issued the Septage Management Operative Guidelines. These guidelines exhorted local bodies to secure the full sanitation chain: ensuring proper construction of septic tanks and regular emptying by desludging operators.

The missing piece A major piece missing in the sanitation puzzle is paying attention to septic tanks and pit latrines, known as onsite sanitation or OSS systems. At 40 per cent of total urban households, these systems remain the most prevalent, but are not accorded the necessary attention. Proper construction, regular emptying and cleaning, and safe disposal of septage or faecal sludge from OSS are essential to ensuring public health. Septage management provides a lifeline for small and medium towns, particularly to immediately stop mis-management of human waste and protect public health.

Following these guidelines, all the cities with sewage treatment plants can make arrangements for receiving septage (waste from onsite systems) in their sewage treatment plants, thus linking network systems with non-network systems, and ensuring safe disposal of septage, apart from ensuring better utilisation of the treatment plants. In addition, septage decanting stations can be constructed at strategic locations for convenient disposal, cutting down the distance to be travelled by desludging lorries.

A critical approach to scaling up involves orienting government personnel and urban local bodies, careful planning, and empowerment of urban local bodies and communities to plan, implement and operate total sanitation solutions. Realising that no one size fits all, the scaling up strategy will need to adopt differentiated approaches in different contexts or locations, such as vulnerable areas like coastal towns.

The writer is secretary to the Tamil Nadu government

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