Commendable Initiative

By T-, www.thehindu.com   August 31st, 2014

At a time when open defecation remains something of a taboo subject and is seldom discussed in public, it is commendable that Prime Minister Narendra Modi turned the spotlight on the practice while addressing the nation on August 15 and brought the discourse straight into lakhs of drawing rooms. Soon after he urged the corporate sector to “prioritise the provision of toilets in schools” under corporate social responsibility programmes, the social movement is slowly gaining traction. Two companies — Tata Consultancy Services and Bharti Enterprises — have committed themselves to playing their part in achieving the monumental task of ensuring that all schools in the country have toilets for boys and girls in a year’s time. Hindustan Zinc Limited has increased by 10,000 the number of toilets it would build in villages in three districts of Rajasthan; its earlier target number was 30,000. There is an urgent need for many more companies to follow suit quickly. But building toilets alone would achieve next to nothing if providing access to water does not go hand in hand with it. That over 620 million people in India still defecate in the open is at once a shameful and disgusting statistic. The ignominy becomes all the more striking as India has the most number of people in the world continuing with this abhorrent practice; Indonesia is a far second with 54 million people doing that. That Bangladesh reduced the prevalence from 34 per cent in 1990 to 3 per cent in 2012 is a potent reminder that the war against open defecation has to be won in double quick time. This can be achieved only if building toilets, both in schools and in households, continues to be a priority for the government and every other sector in the country.

The ramifications of open defecation are too grim to be ignored. Many of the water-borne diseases — cholera, diarrhoea, dysentery, Hepatitis A, typhoid and polio — are linked to open defecation. Hence, it is no coincidence that nearly 14 per cent (over 300,000) of deaths among children in India under five years of age are caused by diarrhoea-related diseases; diarrhoea is the second biggest killer in this age group. Also, frequent diarrhoeal events result in malnutrition and, in turn, stunting in children under five. The absence of toilets in schools is one of the reasons why girls drop out of the system at an early age. There is a huge economic cost, too. According to a document of the World Bank’s Water and Sanitation Programme, the economic impact of poor sanitation is about Rs.2.4 trillion (which represented 6.4 per cent of India’s GDP in 2006). It is important to remember that building toilets without building awareness and changing the mindset, would still yield poor results

India unveils cheap new village toilets

www.bbc.com   August 12th, 2014

Almost half of all Indians do not have access to a toilet at home 

An Indian charity has unveiled 108 new lavatories in a village which gained notoriety when two young girls were found hanged from a tree there in May.

The teenage cousins were killed in Katra Sahadatganj in Uttar Pradesh when they went unaccompanied to relieve themselves in the fields.

Campaigners say the lack of toilets and the need to walk long distances makes women vulnerable to attack. Nearly half of India's 1.2 billion people have no toilets at home.

Unveiling the brightly-coloured, cheap lavatories on Sunday, the sanitation charity Sulabh International said it aimed to provide the same facility for every dwelling in India.

"I believe no woman must lose her life just because she has to go out to defecate," Bindeshwar Pathak, founder of the charity, said. "Our aim is to provide a toilet to every household in the country in the not-too-distant future," Mr Pathak told the AFP news agency.

The circumstances of the murder of the two young cousins in Katra Sahadatganj remain unclear. But they were killed when they - like countless other girls and women - walked to the fields in the dark, for privacy, to relieve themselves. 

In his Independence Day speech on 15 August, Prime Minister Narendra Modi vowed to end open defecation. "We are in the 21st Century and yet there is still no dignity for women as they have to go out in the open to defecate and they have to wait for darkness to fall," he said. "Can you imagine the number of problems they have to face because of this?" he asked.

India’s Toilet Race Failing as Villages Don’t Use Them

By Kartikay Mehrotra,  www.bloomberg.com  August 3rd, 2014

Sunita’s family in the north Indian village of Mukimpur were given their first toilet in February, one of millions being installed by the government to combat disease. She can’t remember the last time anyone used it. When nature calls, the 26-year-old single mother and her four children head toward the jungle next to their farm of red and pink roses, to a field of tall grass, flecked with petals, where the 7,000 people of her village go to defecate and exchange gossip. 

Only dalits, the lowest Hindu caste, should be exposed to excrement in a closed space, “or city-dwellers who don’t have space to go in the open,” said Sunita, who uses one name, as she washed clothes next to the concrete latrine. “Feces don’t belong under the same roof as where we eat and sleep.” Sunita’s view reveals one of Prime Minister Narendra Modi’s biggest challenges in combating the world’s biggest sanitation problem, one that costs India 600,000 lives annually from diarrhea and exposes a third of the nation’s women to the risk of rape or sexual assault. With no toilets for half the population, Modi promised to build 5.3 million latrines by the end of his first 100 days in office -- one a second until Aug. 31, according to the Ministry of Drinking Water and Sanitation. Without education, they’ll make little difference.

 A woman collects human waste while cleaning a toilet in Nekpur village, Uttar Pradesh, India.

Photo by: Photographer: Prakash Singh/AFP/Getty Images

Irrelevant Target

“Targets for construction of toilets are somewhat irrelevant to resolving the sanitation problem,” said Yamini Aiyar, director of policy research group Accountability Initiative in New Delhi. “Building toilets does not mean that people will use them and there seems to be a host of cultural, social and caste-based reasons for that. People need to be taught the value of sanitation.”In most cases, that isn’t happening. More than half of the country’s sanitation education budget since 1999 hasn’t been spent, according to the Ministry of Drinking Water & Sanitation. In at least five of India’s poorest states, the majority of people in households with a government latrine don’t use it, according to a survey of 3,200 rural households by the Research Institute for Compassionate Economics in the capital.

The government has set Mahatma Gandhi’s 150th birthday in 2019 as its target for achieving “total sanitation,” including access to toilets for all 1.2 billion residents, Finance Minister Arun Jaitley said in his budget speech on July 10. While Jaitley doubled spending on new toilets to 40 billion rupees, the ratio of those funds that can be spent on information, education and communication, remains at 15 percent. 

Unused Funds

Of the 18.3 billion rupees set aside for that purpose in the past 15 years, only 45 percent has been used, partly because local authorities can’t get more funds until they prove how they spent the previous year’s money and partly because the central government often simply ran out of cash, said Avani Kapur, an analyst with New Delhi-based Centre for Policy Research. “This often creates a vicious cycle as funds get released in the last quarter or even the last month of the financial year,” Kapur said. “Then it becomes difficult to spend all that money during the same financial year, resulting in a cut in funds the following year.” 

While villagers remain ignorant of the dangers, about 100,000 tons of their excrement heads to markets every day on fruit and vegetables, according to Unicef, the United Nation’s children’s fund. Each gram of feces in an open field contains 10 million viruses, 1 million bacteria and 1,000 parasite cysts.The excrement contaminates groundwater, causing illnesses such as diarrhea and cholera, and deters tourists whose immune systems are at the highest risk from the drug-resistant strains of fecal bacteria, according to the World Bank report. 

Workers Shunned

About 800,000 Indians worked as feces removers in 2008, often carrying excrement in baskets on their heads, an occupation that causes them to be excluded from parts of society.For women, heading to the fields alone raises the risk of assault, a danger that gained international attention in May when two girls from the village of Badaun in Uttar Pradesh were raped and hanged from a mango tree after they went to defecate outdoors.“This vicious, horrifying attack illustrates too vividly the risks that girls and women take when they don’t have a safe, private place to relieve themselves,” said Barbara Frost, the London-based chief executive of WaterAid, a charity that helps poor communities get access to sanitation. “Ending open defecation is an urgent priority.” 

India accounts for about 60 percent of the world’s residents without toilets, according to a report released in May by the World Health Organization and Unicef. The country’s 50 percent open defecation rate compares with 23 percent in Pakistan, 3 percent in Bangladesh and 1 percent in China, the report said.

Cultural Shift

“The problem has gotten worse with the government thinking this is a supply driven problem,” said Archana Patkar, program manager at the Water Supply & Sanitation Collaborative Council in Geneva. “The problem is that germs are invisible, and so understanding the threat of open defecation is far removed from reality until they are sick and dying. And even then, they don’t really understand.”India’s previous government in 2012 created a five-year “Sanitation and Hygiene Advocacy and Communication Strategy Framework” to advise states on how to counter the culture of open defecation, including setting up local education committees. Health Minister Harsh Vardhan said more needs to be done by government and private agencies to build national awareness of the dangers of poor sanitation. 

Granddad’s Latrine

“The fact that India’s health administrators failed to spread mass awareness on diarrhea management speaks volumes of the inefficiency of previous programs,” he said in a written statement on July 28.

India spent 2.6 billion rupees in fiscal 2013 on a campaign to help eradicate polio after 44 cases were reported between 2010 and 2011, according to the World Health Organization. In the same year, the nation spent half that amount on education for toilets and sanitation. 

Some rural residents are constructing their own latrines. In Saunda, a village of about 6,000 people, 30 miles northeast of New Delhi, 70-year-old Hemraj Kumar sits on a cot near his new, 12,000-rupee, porcelain toilet.“My son built it for me,” he said, wearing a tattered white shirt, as cows tethered to trees defecated in the space between him and the concrete cubicle. “It’s because I can’t walk all the way out into the fields.” The rest of the family still prefer to head to the mustard field, including Hemraj’s 20-year-old grandson Sonu, who’s studying engineering in college. 

’Clean’ Villages

Saunda is among 7,971 villages -- about 1 percent of India’s total -- labeled “clean” by the government in the year ended in March.With little access to running water, government latrines typically consist of a large, concrete septic tank with a ceramic squat-toilet on top, enclosed by a cement or brick cubicle with a narrow door. The government says it has built 138 toilets in Mukimpur since February.Sunita finds them disgusting.“Locking us inside these booths with our own filth? I will never see how that is clean.” She points to the field. “Going out there is normal.”

Contact Kartikay Mehrotra in New Delhi at kmehrotra2@bloomberg.net

Sanitation in India

By From The Print,   www.economist.com   July 19, 2014
 
Fixing dreadful sanitation in India requires not just building latrines but also changing habits

CHEER any Indian leader who takes on the taboo of public hygiene. India’s finance minister, Arun Jaitley, used this July 2014 budget to set a goal of ending defecating in the open by 2019. That will be 150 years since the birth of Mohandas Gandhi, who said good sanitation was more important than independence.

Ending open defecation would bring immense benefits. Some 130m households lack toilets. More than 72% of rural people relieve themselves behind bushes, in fields or by roadsides. The share is barely shrinking. Of the 1 billion people in the world who have no toilet, India accounts for nearly 600m.

The costs are high. Public safety is one underappreciated problem, as young women have to leave their rural homes after dark. In May two teenage girls in Uttar Pradesh visiting a field used as a communal toilet were raped, murdered and strung up from a tree. That case won notoriety for its extreme barbarity, but similar attacks are distressingly common.

A broader matter is public health. Open defecation is disastrous when practiced by groups in close contact with each other. Because India’s population is huge, growing rapidly and densely settled, it is impossible even in rural areas to keep human faeces from crops, wells, food and children’s hands. Ingested bacteria and worms spread diseases, especially of the intestine. They cause enteropathy, a chronic illness that prevents the body from absorbing calories and nutrients. That helps to explain why, in spite of rising incomes and better diets, rates of child malnourishment in India do not improve faster. UNICEF estimates that nearly one-half of Indian children remain malnourished. Hundreds of thousands of them die from preventable conditions each year, especially in the north, which has most of the open defecation (see map below). 

Faeces in groundwater spread diseases such as encephalitis, an annual post-monsoon scourge in eastern Uttar Pradesh. Diarrhea leaves Indians’ bodies smaller on average than those of people in poorer countries where people eat fewer calories, notably in Africa. Underweight mothers produce stunted babies prone to sickness who may fail to develop to their full cognitive potential. Dean Spears, a Delhi-based economist, says the costs of all this, in incomes and taxes forfeited, are far greater than the price of fixing it.

How to do so? India fares worse on sanitation than a host of poorer places including Afghanistan, Burundi and Congo, partly because too many of its leaders are too squeamish to face up to the issue. Thankfully, that appears now to be changing. The government, gung-ho for infrastructure, has just said it will build 5.2m toilets by September, or one every second. Pouring concrete will not in itself solve India’s problems. Leaders need also to confront the cultural reasons for bad sanitation. Hindu tradition, seen for example in the “Laws of Manu”, a Hindu text some 2,000 years old, encourages defecation in the open, far from home, to avoid ritual impurity. Caste division is another factor, as by tradition it was only the lowliest in society, “untouchables” (now Dalits), who cleared human waste. Many people, notably in the Hindu-dominated Gangetic plains, today still show a preference for going in the open—even if they have latrines at home.

Evidence is growing that India must urgently correct its cultural practices, though it is sensitive to say so. Studies of India’s population show how since at least the 1960s child mortality rates have consistently been higher in Hindu families than Muslim ones—though Muslims typically are poorer, less educated and have less access to clean water. Today, out of every 100 children, 1.7 more Muslim than Hindu ones survive to five years, a big gap.

Mr Spears and his colleagues argue that this can be explained only by differences in sanitation habits. A 2005 government survey, the most recent national one, found that 67% of all Hindu households, rural and urban, practiced open defecation, compared with just 42% of Muslim ones. (In rare places where there is more open defecation among Muslims than Hindus, the mortality gap is reversed.)  A new household survey of nearly 23,000 north Indians offers more evidence, especially from Hindu households. Led by Diane Coffey, an economist at Princeton, it found that even among households with a working latrine, more than 40% reported that at least one family member preferred to defecate in the open. Those with a government-built toilet were especially likely to choose a bush instead.

In an unpublished parallel survey of Hindu-dominated villages in north India and Nepal, respondents lauded open defecation as wholesome, healthy, and social. By contrast, latrines were seen as potentially impure, especially if near the home. Men often described them as for use only by women, the infirm, and the elderly. In short, demand for latrines is constrained.

This suggests that the mere availability of government-built latrines will not end open defecation for decades yet. What is needed instead are public campaigns, in schools and in the media, to explain the health and economic benefits of using toilets and of better hygiene. Researchers found that only a quarter of rural householders understood that washing hands helps prevent diarrhea.

Such campaigns not only mean government-built latrines have a better chance of being used; they would also encourage households to build them for themselves. Precisely how to raise awareness about a touchy subject is not clear, but some at least are trying. A catchy animated music video put out by UNICEF urges Indians to “take the poo to the loo”. The intention is right, even if the dancing turds will not immediately be to everyone’s taste.