Like it or not we have to accept the fact that open defecation is widespread in our country. Except for a couple of states, it is practised widely in a number of Indian states. It is present both in rural and urban settings. It is a problem.
Open defecation is insanitary and unhygienic and leads to a number of health and economic problems. Thanks to open defecation, diarrhoea and other gastrointestinal illnesses are common and lead to increased childhood mortality. Intestinal parasitic infestation is common and may lead to stunting in children according to a recent study. Moreover it is unsightly and revolting to outsiders and taints the reputation of the country leading to economic and other losses.
Some will make the case that toilets are alien to India and open defecation has always been the norm. They will assert that toilets are a Western invention and habit. This is colonial thinking at its worst. There is plenty of evidence that toilets existed in houses and urban sanitation was widely practised in the cities of India long before anywhere else. The many Harappan sites including the ruins of Dolavira in Gujarat give ample testimony that urban sanitation was present in India 4000 years ago.Yet we do have to admit that in rural settings open defecation has been present in India for a long time perhaps forever.
When the population was sparse, open defecation in a tropical country may not have caused many problems. Organic matter does decay very fast in a tropical climate. But today, ours is country of a billion people. The sheer amount of fecal waste generated cannot decay naturally in a safe manner. Human waste will flow into our rivers and lakes and contaminate them. It will contaminate the ground water. It will spread disease and death and lead to economic ruin for the country.
Our cities as well as our villages are becoming crowded and congested. Vast numbers of rural folk are moving to cities in search of better opportunities and will continue to do so for many more years. Many move into urban slums. If they practised open defecation in the villages they will continue to do so in the cities, where it becomes a more acute problem.
To solve the problem of open defecation, we have to concentrate on both the urban and rural landscape at the same time. One cannot work without the other.
In urban settings public toilets have to built and maintained. Access to public conveniences should be regarded as a fundamental right and legislated. Local governments have to be held accountable. Businesses have to be forced to provide toilets for their customers. Cities should have by-laws regulating the construction of toilets in homes and businesses. Underground sewage systems have to be designed intelligently, properly built and connected to sewage treatment plants. Sewage treatment plants with excess capacity should be built and maintained. These facilities should be fiscally viable so that their maintenance is guaranteed. We cannot ban open defecation without giving people an alternative.
In rural areas, people have to be encouraged to build toilets in their homes. Loans and grants have to be made available to them. They have to be given the know how to build and maintain toilets. Where appropriate, community toilet facilities have to be built and maintained.
Funding for ending open defecation is widely available. Vast sums of money are being spent by the government through the Nirmal Bharat Abhiyan, the total sanitation scheme in rural areas as well as the Jawaharlal Nehru Urban Renewal Mission in urban areas to improve sanitation. Many NGOs are also involved in this effort.
Although there have been successes, there have also been many barriers. The biggest barrier has not been a lack of funding or resources but a reluctance on the part of the population to adopt good sanitation practices. The reasons for this resistance has to be explored to find a rapid and lasting solution to this vexing problem.
When people think of populations that practice open defecation, they tend to think that these people have no sense of hygiene or cleanliness. This is not true in the Indian context. These people do have an acute sense of toilet hygiene. How they practise it is cultural and learned through many generations. For them, defecating in a place away from places where they eat and sleep is hygienic. They are usually appalled when they learn that in some places people defecate inside houses. They would actually find this amusing and disgusting. In some rural cultures defecating inside the house is taboo.
To make people, who have defecated in the open for generations, use sanitary toilet facilities is a huge social change which will face a lot of resistance. The human act of defecation or the bowel habit is a highly personal affair. People learn this habit over a lifetime and there is a whole psychological structure around it. Just as it is difficult for someone who has used a toilet, to suddenly start defecating in the open, it is equally hard for someone who has been defecating in the open to start using a toilet. That is why toilets built with government and NGO money in rural areas are often used as granaries and tool sheds.
For adults above a certain age, it will be a difficult if not impossible transition. They will continue to defecate in the open until they die, no matter how beautiful a latrine you build for them in their houses. For them the act of defecating in their houses will be an unclean habit. They would not know or care that open defecation leads to disease and pollution. To eradicate open defecation we have to target the young before they too become entrenched in the habit and cannot break it. For this to happen a concerted campaign has to start now, if we are going to succeed in the next ten to twenty years.
Education is key. To make the young adopt sanitation, it has to be taught in schools from a young age. It might be the most important lesson they learn and might be lifesaving for many. We have to maintain clean toilets in schools. If they do not learn at school they might not get an opportunity anywhere else. We have to break the transmission of the open defecation habit to yet another generation.
It is often said that more people in India have cell phones than access to toilets. If this is true, the reasons have to be explored. Although cell phones are relatively expensive, they are affordable to many and they buy them to better their lives. They do so because a cell phone adds value to their lives and makes it easier. On the other hand toilets are affordable yet people are slow to adopt them. The reason has to be that they do not see the value in them. People have to be convinced that toilets will add value to their lives.
People in any society value health. The connection between good health and sanitation has to be taught. It is not always clear to rural, illiterate folk. In a recent campaign the ubiquitous house fly was used to establish this connection. Flies will sit on open feces as well as exposed food. These are common sights in many villages. People often do not realize that the same flies with their feet and tentacles coated with feces will alight on food and leave some for people to eat. Such graphic demonstration often drives home the point. Certain villagers who would not let some other villagers from certain castes or communities into their houses for fear of "contamination", are shocked to learn that they have been consuming their shit all along. This usually leads to adoption of sanitation by all villagers.
For people who are resistant to defecate in their homes, community toilets are an option. This gives them the opportunity to defecate away from their homes, yet in a safe and hygienic manner. Local governments, panchayats, district administrators, NGOs, rural community leaders all have to cooperate to establish these. They have to be built in a culturally sensitive manner according to local customs and traditions. However building community toilets are not as challenging as maintaing them. The question as to who will maintain them is a barrier. This issue is relevant to the urban scene too. Traditionally in Indian societies certain "castes" were and are assigned the work of sanitation. They were/are the "scavenger" castes and treated as "untouchables". This is a gross human rights violation and cannot be allowed to continue. As these communities progress economically they refuse to do these jobs that other communities shun. Who then will clean our public toilets in urban or rural India? For many Indians coming into contact with the body fluids or excreta of others is an absolute taboo. Sanitary work is considered a low and unclean job entrenched in the caste system. Yet we will walk around in bare feet with raw sewage streaming over our public spaces in the rainy season. We will eat at roadside eateries where flies abound and unconsciously and blissfully consume food tainted by other's feces.
The only way around this problem is to remove the stigma from sanitary work. Sanitary workers have to be respected, given proper equipment, training and paid well. If the wages are decent, respect will follow. People from any community should be able to do these jobs without shame or discrimination. It is a tough challenge in the Indian context, but not impossible to overcome. The example that comes to mind is the medical profession. There was a time in many Indian cultures the healer or physician was thought to be unclean and impure. The reason was that medical practitioners regularly come into contact with the body fluids of others. Although they were respected for their knowledge and skill they were usually from a downtrodden community. It is hard to believe this today, but is true. Today the job of a doctor is sought after by all sections of Indian society. It is prestigious and lucrative. The change has come about because the profession has been sanitized and remunerated well. Doctors work in clean environments and use protective aids such as gloves and masks when doing a rectal examination or a colonoscopy. Although the sanitary worker's job is never going to be elevated to that of a doctor, much can be done to make it respectable and acceptable to many without stigma.
The other reason for unsuccessful implementation of toilet programs is the lack of skilled manpower to maintain and repair toilet and sewage systems. In most Western societies the plumber is the best paid tradesperson. They are often quite rich. In the Indian context there is a vacuum in this industry that has to be filled. Anything that is built is bound to breakdown at some point. Vocational schools have to design programs that train people in the repair and maintenance of toilet facilities.
Grandstanding statements such as those made by the central minister Jairam Ramesh recently are useful in creating awareness, but do not further the cause of ending open defecation by themselves. High profile celebrities such as the Bollywood actress Vidya Balan getting involved in this cause is welcome as it does create awareness and lends credibility to the effort. At the end of the day, hard work by social workers, community leaders and NGOs will be needed to make this a reality.
Despite all the gloom brought about by the recent statistics, there is cause for a lot of hope. More and more more communities are adopting sanitary practices. The Eco-San dry toilet promoted by many NGOs is gaining popularity around the country. Sulabh International has done amazing work in many areas. Slowly but steadily toilets are becoming the norm among rural people and the urban poor. The day is not far off when we can take a deep breath and heave a sigh of relief without the smell of shit in our nostrils.
