Think clean and then build toilets, let's not flush the opportunity away
India’s record, when it comes to sanitation, has been most unsanitary. Of the estimated billion people who defecate in the open across the world, more than half are here. Poor sanitation impairs the health of Indians, leading to high rates of malnutrition and productivity losses. According to the World Bank, India’s sanitation deficit leads to losses worth 6% of GDP. In such a scenario, Prime Minister Narendra Modi’s decision to fast track the building of toilets is commendable. The target of achieving total sanitation by 2022 has now been revised: The government wants to reach the target in 2019, to coincide with 150th birth anniversary of Mahatma Gandhi.
But will all this lead to a change in the (sanitation) status quo? Unlikely, says Dean Spears of the Research Institute for Compassionate Economics. Spears, who has worked in El Salvador, India and South Africa, and his colleagues have done a study on the issue in Bihar, Haryana, Uttar Pradesh, Madhya Pradesh and Rajasthan. This is what they have found: More than half of the people in households that own a government-subsidised latrine still defecate in the open and many of the respondents thought that open defecation was as good for child health as latrine use by everyone in the village. This thought process needs to change before starting the next round of toilet construction.
While funds, though not enough, are earmarked for communication strategies when sanitation projects are sanctioned, there is no accountability when it comes to deciding which department will be responsible for ensuring behavioural changes of the people. That whatever communication strategy has been deployed till now to do that has been ineffective is evident from the fact that India does very poorly on the “sanitation ladder”, which ranges from open defecation to flush toilets with a piped sewer. Successive rungs on the ladder represent more hygienic and more expensive sanitation options — for example progressing from open pit latrines with a slab to pour-flush toilets that connect to a septic tank or a sewer. However, the sanitation ladder in India appears to be missing the middle rungs.
To get people interested in building toilets, the NDA is mulling raising subsidies for individual household latrines from Rs 10,000 to Rs 15,000. This would be a misguided decision, contends Spears’ colleague Diane Coffey. She says it will not work for three reasons: The plan overlooks the fact that people in rural India do not want to use latrines — even latrines that cost Rs 15,000 — because use and pit-emptying are seen as ritually polluting, and open defecation is seen as healthy and socially desirable. Moreover, building a Rs 5,000 latrine for each of the 123 million households that lack one would cost Rs 1,84,500 crore, which is 45 times the money the government budgeted for rural sanitation in 2014. It is one-tenth of the Union budget for 2014.
That there is no demand for latrines in rural areas is also evident from the fact that you hardly see any shops selling the wares; the ecosystem is just not there. Moreover, when people do not want to use latrines, it is very hard to give them one and so they don’t mind much when contractors steal the money earmarked for latrine construction. If people do get bricks and cement to make a latrine, they will use these materials for something they want, adds Coffey.
The 2011 National Sample Survey Organisation report showed that in rural areas the average monthly consumption per person was only Rs1,430. So can the government give away bricks and cement worth 10 times the amount that a person spends in a month and expect him to use it for a latrine he does not want? Will he not sell the bricks, or use them to build a better house?
The NDA should put in money for a massive behaviour change campaign to increase the demand for latrine use. This will require changing how people in rural India think about the socially acceptable ways to defecate: Villagers must be encouraged to stop associating latrine use with pollution and untouchability but rather to think of it as a step towards a healthier future.