When constantly assaulted by a problem, human beings learn to ignore it. India is thus habituated to open defecation.
When we care to look from a train or a bus, the magnitude of the problem confronts us starkly. We also see sewage from indoor toilets everywhere. Such faecal waste, untreated and released into the environment, is equivalent to open defecation.
We often hear that “nothing is being done” about the problem. This could not be more incorrect. Efforts have been made for years to tackle this challenge, but the tsunami of defecation is overwhelming.
To understand what various government agencies and NGOs are up against, we need to get a measure of the matter. Poor sanitation is an issue affecting the entire developing world, with 2.5 billion people living without toilets, one-third of them in India.
Of the 1.1 billion people practising open defecation throughout the world, almost 60 per cent are Indian. With more than half our population defecating in the open and massive amounts of faeces infecting our waterways, India is confronting multiple serious health threats.
Every year, more than 600,000 children under the age of 5 die of diarrhoea or pneumonia; 88 per cent of those deaths can be linked to insufficient water and sanitation services. Of the children who survive, almost half will suffer from reduced growth and low weight. According to a Unicef report, poor sanitation has stunted the growth of 62 million Indian children below 5. We are dealing with entire generations of young people whose lives are being dramatically affected, not to mention the millions of adults, particularly women, who suffer from the diseases and indignities brought on by open defecation.
Creating solutions The solutions for India will have to be constantly creative. The ones used in the West are far too wasteful of space and water at the scale of the individual. The access to and treatment of waste poses extraordinary challenges in the Indian context. Experts believe technology holds an answer to the sanitation conundrum.
But social scientists also point out that one reason this problem is so difficult to manage is that its roots go deep into our history, our practices, and our urban and rural structures. Here, it is pertinent to note that not all low-income societies defecate in the open, although sewage treatment is substantially a similar problem in all low-income societies.
Human waste is not usually a topic discussed in our homes. Traditionally, defecation takes place outside the home, not inside it. Household toilets and latrines are rare among lower-income people; many who have them use them as storerooms or sheds. Many are compelled defecate outside.
Access to toilets is, therefore, not just a problem of technology, it is also a problem of culture and customs. Waste management is more technology-dependent but putting it into practice in an effective and non-exploitative manner requires socio-cultural changes. But we should not be daunted. Just look at some of the other major health crises that India has dealt with more successfully. We have made tremendous gains in using vaccines to combat childhood diseases such as polio, reducing the infant mortality rate, and controlling the spread of HIV/AIDS. But in each case, it has been a national and state-level effort in partnership with NGOs.
Not insurmountable India has the talent and know-how to deal with the issue. Our deep and diverse talent pool in the areas of research and development, manufacturing, science and social innovation provides us with the tools we need and allows us to play a leading role in this global crisis. We also have the financial support of the government, which allocated about $1 billion to sanitation between 1999 and 2008 and currently spends about $250 million annually.
There is a new opportunity for science and technology to provide routes for more effective use of these resources. Until now, the direction taken by the government has been investing in sewer systems and septic tanks. We now see that when traditional methods of sanitation are used without addressing their associated risks, the problems multiply.
For example, even where there are sewers, there is the danger of waterway contamination due to inadequate sludge management. And when latrines are not properly emptied and waste sufficiently treated, people continue to suffer harmful effects.
Solutions using the latest technology need not be complex or driven by expensive gadgetry. But they need to be innovative and address the many aspects of this multifaceted problem. They must deal with the high density of people in India’s urban centres. They must function in diverse climatic and hydro-geological areas and keep groundwater free of contamination.
Community and public toilets must be available on scale so the large homeless population and those living in temporary housing can be served. They must be affordable for even the poorest since studies show a very low willingness to pay for sanitation services. They must also address the deep-seated stigma of handling faecal matter by not requiring people to come into contact with waste.
Owning the problem Most of all, solutions will address the biggest challenge of all: encouraging individuals, communities and entrepreneurs to take ownership of this problem and embrace the solution as their own.
Top-down, supply-driven programmes have not worked and will not work. We can learn from experience, such as the government’s efforts to implement a community-led, demand-driven total sanitation campaign. It is clear that for such efforts to work, we need not just toilet technology and a budget, but the involvement of elected officials, monitoring, accountability, incentives and ensuring the absence of corruption.
As big a problem as sanitation is for India, the truth is that we simply and urgently need commitment and leadership to navigate our way out of this predicament.
In today’s India the young have the vision and zeal to provide this leadership.
Almost 90 years ago Mahatma Gandhi said, “Sanitation is more important than independence.” In India today, sanitation is independence.
( The writer is Secretary in the department of biotechnology)