By Ruhi Saith, www.thehindu.com October 2nd, 2014
WIDENING SCOPE: “While Swachh Bharat Abhiyaan Photo by: SBA The Hindu
The programme needs to retain the momentum of a movement than that of a litter-cleaning project
“Slum districts...
consisted of poorly built houses, a deficiency of ventilation and
toilets, unpaved narrow streets, mud, and stomach-turning stenches due
to the presence of decaying refuse and sewerage. In such conditions, ill
health was observably endemic.”
This is not a
description of Indian cities today (though it may well be), but of
Britain around 150 years ago, prior to Britain’s sanitary reform
movement, by Dr. James Kay-Shuttleworth. The movement that began in
Britain and then spread to other industrialised countries like the
United States was spurred in London by Edwin Chadwick’s report “Inquiry
into the Sanitary Conditions of the Laboring Populations of Great
Britain”. The sweeping changes it brought about in the industrialised
world are believed to have saved many lives and contributed to increases
in life expectancy — much more than advances in medicine like
antibiotics and vaccination.
A momentous opportunity
Given rapid urbanisation and similar conditions today
in our cities and towns, Swachh Bharat Abhiyaan is a programme whose
time has indeed come. It is a momentous opportunity that has opened up a
policy window (having caught the attention of the media, legislators
and the public), especially at a time when a new health policy is being
framed. At present, the focus of Swachh Bharat Abhiyaan seems to be on
exhorting individuals not to litter.
But the programme needs to retain
the momentum of a movement rather than a litter-cleaning project.
Besides, Purna Swachhata is not just about litter. As Professor A.K.
Gosain, Professor of Civil Engineering at IIT Delhi, who is working on
issues of urban sanitation, says, Purna Swachh requires three things to
be addressed. The first is sewerage or wet waste generated from
bathrooms, for which we need a proper system of sewers and sewerage
treatment plants; the second is storm drainage or rain water, for which
water tables need to be recharged through natural and man-made water
drains which remain dry during the monsoons; and the third is solid
waste which needs to be dealt with through landfill, incineration, and
so on. Given the range of tasks that need to be undertaken, just
sweeping litter from the roads under the carpet is not going to solve
much.
Action is needed to
increase knowledge, change attitudes and transform practice. While an
excellent start has been made by targeting attitudes, synchronous action
on other fronts is needed to ensure progression from one step to the
other.
There are gaps in
knowledge and so we need to ask the following questions: Has the Swachh
Bharat Abhiyaan instituted campaigns to make people aware of the links
between cleanliness and health? Is there going to be a campaign to
increase citizen awareness of their rights to healthy and clean
environments? This could then translate into demands of municipal
authorities to deliver on their responsibilities.
(Read Post: Will the new broom sweep clean?)
In the context of
promoting practice, we could well ask of the SBA campaign: When are
dustbins, clean public toilets, functional sewers and adequate sewage
treatment plants going to be provided? For instance, in Delhi, only
around 30 per cent of the sewage is treated, with the remaining either
flowing into the Yamuna or seeping into the ground and contaminating our
drinking water. Also, are there any plans to ensure the presence of
motivated municipal staff (with protection to their health and dignity),
to undertake tasks related to keeping bins empty, storm drains dry and
clear, and sewers unblocked and functional?
Lessons from Britain
Besides, action at the level of individuals is
clearly not enough. Sanitised and clean public spaces are a public good
and have to, by definition, be provided by the state. It is worthwhile
reflecting on the broad swathe of interventions, including pieces of
legislation, which accompanied sanitary reform in Britain and other
industrialising countries about 150 years ago. First, the sanitary
movement involved linking cleanliness with sanitation and water supply —
one cannot happen without the other. Second, it established the
inescapable links between public health and sanitation in the form of a
Public Health Act, initiating the idea of public health districts with
sanitary inspectors and public health officers. (It is important to note
that the only State in India that separates public health from medical
departments is Tamil Nadu.) Third, it made municipal authorities
responsible not just for cleanliness, but for health (given the
necessity of one for the other) in cities, with a gradual transition
from permissive to compulsory legislation.
It is also important
to realise that all these changes took place over a century or so. We
cannot wait that long, but the good news is that we are well down the
road to reform, beginning from a much later point. A Swachh Bharat is
however not going to be achieved by 2019 by focussing solely on citizen
participation in clearing litter. This is a start, but it is going to
require appropriate budget allocations, which reduced government
expenditure on health care and higher growth due to a healthy labour
force would more than make up for. It is also going to require
multi-sectoral, well-planned and well-executed policies. Exhorting
individuals needs to be accompanied by extensive action if the goal of a
clean and healthy India is to be realised in our lifetime.
(Dr. Ruhi Saith is a
public health expert and is currently working as a senior consultant in
public health at Oxford Policy Management. She is also the Developing
Countries Editorial Consultant with the Cochrane Public Health Group.)
