Raising a stink

India’s leading political parties, the Congress and BJP, are at loggerheads on most issues, but none of them has created a stink of the kind witnessed recently. Both leading contenders in the middle of a do or die electoral battle for 2014, reached a strange kind of convergence over the most basic of issues rarely addressed in the high voltage world of political cloak and dagger – public sanitation. No laughing matter this. One of the most serious challenges that face India is finding latrines for some 600 million of it aam aadmi, but given the political flavour of the season, and quite knowingly, found its way into the raging Narendra Modi vs the rest discourse.

cover-story-2-25102013BJP’s prime ministerial candidate and Gujarat chief minister told students in Delhi: ‘‘I am known to be a Hindutva leader. My image does not permit to say so, but I dare to say. My real thought is pehle shauchalaya, phir devalaya (toilets first, temples later). We spend lakhs of rupees on building places of religious worship but not on washrooms.” Coming from a so-called right wing icon, it was cannon fodder time for daily byte wallahs and enough to provoke a national outrage. Union rural development minister Jairam Ramesh, himself a prime propagator of public health, came out all guns blazing. “The prime ministerial aspirant has spoken and it demonstrates that in this search for the prime minister’s post, this aspirant of the BJP is capable of saying anything and doing anything. It is not conviction that has made Modi say this, it is political compulsion,” he said. Ramesh questioned BJP’s double standards. “I had made a similar statement (October 5, 2012) that India needs more toilets and less places of worship. BJP, RSS, Bajrang Dal, VHP activists protested outside my house, kept bottles of urine as a token of their presence and I was met with black flags and my effigies were burnt,” the minister said.

cover-story-3-2510-2013(1)It is obviously a sensitive debate. Not many are keen to stick their necks out, certainly not over the political stink it has raised. Says Bindeshwar Pathak, well known founder of Sulabh toilets, the man credited with turning public sanitation into a social movement: ‘‘They spoke about sanitation. It is a serious issue, which I began in 1968. After 45 years, they are speaking which is good.’’ (See interview). In his book Billions of Entrepreneurs: How China and India are reshaping their futures and yours, Tarun Khanna writes: “Even Dr Pathak’s effort has barely scratched the surface of India’s needs.” In Khanna’s assessment, the toilet revolution here is gathering steam but has miles to go before India will become open defecation free. According to the 2011 Census, toilets are still a pipe dream in an overwhelming 69.3 percent of rural India and 18.6 percent urban areas compared to the ownership of mobile phones and television sets. Nearly 50 percent of India’s 122.9 million households practiced open defecation.

Global and national institutions – including the Union health ministry – are warning India repeatedly. The Asian Development Bank (ADB) study ‘Sanitation in India: Progress, Differentials, Correlates, and Challenges’ looked at the dismal scenario. “India is losing billions of dollars each year because of poor sanitation. Illnesses are costly to families, and to the economy as a whole in terms of productivity losses and expenditures on medicines, health care, and funerals. The economic toll is also apparent in terms of water treatment costs, losses in fisheries production and tourism, and welfare impacts, such as reduced school attendance, inconvenience, wasted time, and lack of privacy and security for women. On the other hand, ecologically sustainable sanitation can have significant economic benefits that accrue from recycling nutrients and using biogas as an energy source.”

cover-story-4-2510-2013Consider the following:

•  Thanks to open defecation, 21 per cent of communicable diseases in India are water-related.
• More than 100,000 Indians die every year due to diarrhoea
• About 88 per cent of diarrhoea cases are linked to lack of water and sanitation
• India is home to highest burden of the mosquito-borne disease with 24 million cases
• 14.8 million are affected by dysentery in nine states in India
• Rampant worm infestation and repeated diarrhoea episodes result in widespread child malnutrition
• 11 out of 28 states are in the grip of cholera outbreaks for three consecutive years.
•  Nearly 600,000 children annually below 18 have lost their lives to diarrhoea and pneumonia.
• India also has the largest number of stunted children in the world.

Total Sanitation Campaign (TSC)
The TSC, launched by the centre in 1999, was subsumed into the Nirmal Bharat Abhiyan (NBA) in the Twelfth Five Year Plan to eradicate open defecation by 2017. The campaign is yet to achieve its target.
According to the Planning Commission, nearly 73 per cent households in rural India practice open defecation despite sanitation drives launched by the government. The study considers a household under the open defecation category if at least one member does it in the open. Its ‘Evaluation Study on Total Sanitation Campaign’ is for the reference period April 2001 to March 2009 but was submitted in May this year. The study covered 122 districts, 206 blocks, 1,207 gram panchayats and 11,519 beneficiary households across 27 states.
“According to our estimates, out of 73 per 100 rural households where at least one family member practices open defecation, 66 households are forced to do so due to unavailability of toilets, one household is forced to do so due to inadequacy of number of toilets…,” the report states.

cover-story-5-25102013According to it, except in Karnataka, Kerala, Sikkim, Tamil Nadu, Haryana and Gujarat, households in most other states have reported issues relating to toilet-structures. “Only 59 per cent households have toilets that are covered on all sides and have a roof,” it says. It says only 46 per cent households have adequate water for flushing and tap water is available in latrines in only 3.61 per cent households.
It is not that the Union rural development ministry is not making efforts. In May last year Jairam Ramesh roped in Bollywood actor Vidya Balan as brand ambassador of the Nirmal Bharat Abhiyan; she also featured in a series of advertisements for a healthier and cleaner India.

Budget Allocations:

As part of its commitment to TSC, the UPA II last year had converged for more than doubling the amount for construction of individual household latrines from the existing Rs 4,600 to nearly Rs 10,000. The centre has to dole out Rs 3,200, states have to give Rs 1,400 while families have to provide Rs 900. MNREGA funds will be to the tune of Rs 4,500.
Statistics show how budget for drinking water and sanitation over the last years from 2008-09 to 2013-14 too has increased from Rs 8,493 to Rs 15,260. In FY 2012-13, Rs 3,500 crores has been allocated to the programme. This is a considerable increase of 133 percent from the revised estimates of the previous financial year. However, budgetary allocations for TSC accounted for 0.04 percent of India’s GDP in FY 2011-12.
The Centre for Budget and Governance Accountability points out to several hurdles relating to the existing budgetary processes under the TSC and how it impedes fund utilisation. A delay in fund transfer from the Union government to state governments down to the district level are major constraints.

cover-story-7-25102013Civil society activists say funding is not the only issue.  “Funds are not an issue in India. Budgetary allocations have gone up. The convergence of TSC and MNREGA has facilitated resources. India has enough money compared to Pakistan and Bangladesh,” says Mamata Dash, Adviser-Rights, Equality & Inclusion of WaterAid (UK) India office,’’ adding that the main issue is implementation. ‘‘It is faulty design of the implementation mechanism. On the face of it Nirmal Bharat guidelines looks fine. Then why is it that village water and sanitation committees are not functioning,’’ Dash questions.

Clearly, it will need more than just government assistance. There has to be community participation on a large scale to spread awareness, particularly in backward and depressed states, whose record in matters of public health has been less than inspiring so far.

India’s first Prime Minister Jawaharlal Nehru once said: ‘‘The day every one of us gets a toilet to use, I shall know that our country has reached the pinnacle of progress.” His successors, however, did not deem to see things in the same light.

‘It will help focus on the burning issue’

cover-story-8-25102013Bindeshwar Pathak, founder of Sulabh Shauchalaya movement and the country’s best known authority on sanitation, tells KS Narayanan that the recent war of words over toilets in the political class will create public awareness.

Do you believe that the war of words between Narendra Modi and Jairam Ramesh over toilets would interest the political class?
Actually they spoke about sanitation. It is a serious issue on which I began work in 1968. After a lapse of 45 years, they are speaking and considering it now. They think it is important which is a very good thing.

Are they serious or is it just political rhetoric?
I don’t know whether they are serious or not. If they have spoken it has gone into people’s minds. It has created some awareness.

India has an ambitious Nirmal Bharat Abhiyan or Total Sanitation Programme. How close are we to make India open defecation free?
We are not any close to making India open defecation free. Nirmal Bharat is a very successful programme and it has created awareness among people and in panchyats as well. But its lacks a clear strategy.
What is wrong with the strategy?
First, the government of India has decided to disburse subsidies from two organisations- the rural development ministry and department of drinking water and sanitation. One is given by the ministry and the other from MNREGA scheme. How could you tie a person and ask him to run? It is difficult. So to begin with, funding is the problem. It should come from one source. Now, two ministries are controlling it. Secondly, it is about designs. People should have more than one design to choose from. Thirdly the amount of subsidies is limited. It cannot cover everybody. The subsidy amount is meager- Rs 7,500 from the government and Rs 1,500 from state government and rest by beneficiaries. I have advocated that the beneficiary’s contribution should not be restricted. If they want better toilets and want to invest they should have the freedom to do so.

What is the cost of building a toilet in India?
It depends on various factors. If the user decides not to have a roof then cost can be very low and little. The minimum cost for roofed toilets is Rs 1,500. More importantly allow them access bank loans for building toilets. If you have a budget of Rs 1,000 crore for sanitation, only that much amount can be disbursed on paper! But the need is for about Rs 50,000 crore.

The budget for sanitation has been increasing over the last few years.
The requirement far exceeds the budget. There is a huge gap. That is why I am insisting on bank loans. It would fill the gap.

India has more mobile phones than toilets.
We need to create missionaries of sanitation who can motivate people to build and own toilets. Only then we can tackle not just the lack of toilets but also water-borne disease and malnutrition. Also builders or contractors need to give guarantees to rebuild toilet if it breaks. This is to ensure quality construction. These missionaries should be motivated to stay back in the villages for which we need sufficient government funds. Also culture plays an important role in shaping attitudes. In Devipuran (a religious text) it was suggested to Indians not to defecate near human habitations and do it at a distance after digging pits and putting some grass and sand. So there was no toilet in rural areas for the last 5,000 years, neither were their toilets inside the house. Now we have toilets inside the house. So it will take time to change.

How long will it take to change?
At least 15 years.

So we will miss the millennium development goals of making India open defecation free!
We have to give toilets to half of the people by 2015.

Can we do it?
Not India I am taking about countries of Asia, Africa and Latin America. No country has achieved the target.

Is that a consolation for us?
We must understand the government is dependent on the sewage system. It is so costly in terms of construction, maintenance and huge quantity of water is required for flushing. The first sewer in India was laid in Kolkata in 1870.  Out of 7,000 towns in India only 270 have sewage facilities. Had I not invented Sulabh toilets, nothing would have happened to end open defecation in these towns as well. This technology is suitable not only for India but for 2.5 billion global population who do not have access to toilets.

cover-story-9-25102013Can Sulabh and a few NGOs be enough to meet the target?

No. We have to train people on a larger scale. We have started our district offices in 600 districts. The government should also do it. They are doing it partially. Seminars and conferences will not make it happen. There has to be constant monitoring.

Can India be more serious in achieving total sanitation? It could problems like manual scavenging, diarrhoea, cholera, dysentery, malaria, malnutrition, bacteriological contamination, communal hygiene? 
The question is who is sleeping and who is awake on the idea of sanitation.

There are examples of community-lead toilets.
They are far and few. For a country like India we need to have a large scale programme implementation and monitoring. Those who head departments at various levels should have sound knowledge of the issue. I do not want to take names. They know little. I have the knowledge to tackle it at the practical issue, but I am not in the government.

Are you hopeful of India becoming open defecation free in our life time?
I hope so but I don’t think people are serious. They do some patchwork. I once asked a bureaucrat how he knew so many numbers of toilets has been built. He equated the allotted amount to the number of toilets built. They believe it is already built!

What’s the way out?
A national board of sanitation has be established to take a call on sanitation issues. Those who are handling these issues at various levels do not have any long tenure and face frequent transfers.
How do you rate the performance of states?
Every household in Goa and Jharkand has a toilet.
What is India’s fund requirement to make the country open defecation free?
The funds we have are not adequate to meet the demand. So it is better to give loans. Banks give loans for building a house, fertiliser, crops, and car. Why not give loans for toilets?