Out of the 17 Sustainable Development Goals (SDGs), SDG 6 specifically refers to ‘clean water and sanitation,’ wherein there are 8 targets and 11 indicators. World Toilet Day has been celebrated every year, on 19 November, since 2001. In the development world, toilet infrastructure and the ease of having an access to toilets are not only indicative of the socio-economic status of a region but are also determinative of the fact as to how societies see inclusiveness and have respect for individual dignity and human rights.
While the Government of India’s Swachh Bharat Abhiyaan has been successful in creating a buzz around sanitation needs, yet a lot needs to be done. This flagship programme has encouraged in expanding the toilet infrastructure through the construction of Individual Household Latrines (IHHL), community toilets (CT) and public toilets (PT), thus making an effort to reduce the burden of water-borne diseases because of unsanitary practices.
India is a huge country and pan-India solutions put a strain on sustainability because geography, planning, cultural context needs to be taken into account for best results.
The Ministry of Housing and Urban Affairs (MoHUA) comes out with its annual ‘Swachh Survekshan’ which is deemed to be the world’s largest sanitation survey and ranks different urban local bodies (ULBs) across various indicators of cleanliness. Through this survey different cities have been earning the tag of being open defecation free. Swachh Survekshan 2020 laid out the definitions for ODF (open defecation free), ODF+, ODF++ cities with an added focus on declaring a few wards, zones or cities water-plus.
If a ULB is declared ‘water-plus’, it essentially means all wastewater released from households, commercial establishments, drains, nallahs and others are treated to a satisfactory level (as per CPCB norms), before releasing it into the environment. Further, the adequate capacity of wastewater and sewage treatment facilities is to be ensured. Infrastructure should be maintained properly and cost recovery ensured through reuse or recycling of treated wastewater to ensure sustainability.
Toilets: A Medium For Sanitation And ‘Health Democracy’
Women have always been left behind in sanitation needs that compromise with their health. For instance, the needs around menstrual hygiene that are looked down upon or mocked at. This topic found it difficult to occupy space as a topic of discussion and dispensation in the surveys of Swachh Survekshan all these years.
Most of these issues are not addressed because of a patriarchal setting, and even after more than seventy years of independence, somehow launching rockets into space seems easier than achieving total sanitation! While this might look like comparing apples to oranges but both the instances have their answer in politics. How a citizen views it through different lenses and dimensions would build the respective debates and discourses.
There were a few old advertisements starring Vidya Balan that emphasised on the need to build toilets (Shauchalya Banao) to curb open defecation that was designed under the campaign of ‘Jahan Soch Wahan Shauchalya’. These advertisements were women-centric and gave the message of how women and girls were affected by it. It is interesting to note that, open defecation as a practice in the wee hours of the day is also a time for socialisation among women because after attending to nature’s call they are pushed into the four walls of their homes to nurture and attend to the domestic chores.
Not having an access to toilets is another major reason for girls dropping out of schools. In many areas, parents willingly send their children to school because they are ensured free mid-day meals and basic sanitation needs through toilets. This clearly makes toilets as a make-or-break point to win the hearts of the downtrodden and also to win politics!
The state of Uttar Pradesh, which mostly attracts news headlines for all the wrong reasons, has some positive news on the aspect of sanitation. The Firozabad district has paved a way for sanitation democracy through ‘Toilet Parliament’ or Toilet Sansad that addresses the issues surrounding health and hygiene and making the place open defecation free. It has been a grassroots level development by forming a committee via democratic elections.
It comprises villagers who own a toilet, including the sarpanch, sanitary workers, village secretary, school headmasters, Asha, Anganwadi, Auxiliary Nurse Midwife (ANM) and retired government employees, Swachh ambassadors. The committee is also responsible for conducting awareness drives around water, sanitation and hygiene (WASH), handling of menstrual waste, encouraging people to strictly use toilets to end open defecation, and more.
The focus on declaring areas open defecation-free also ensures to keep a check on groundwater contamination, as a large population in the country is dependent upon groundwater for their sanitation and other domestic needs.
The ‘F-Diagram’
Diarrhoea is a major cause of death among children under the age of five in South Asia and the least developing countries (LDCs). Water-related illnesses that are linked (directly and indirectly) to WASH practices are grouped into the following:
- Virus-laden: Water-borne diseases are transmitted through the ingestion of water contaminated with human or animal faeces containing pathogenic bacteria or viruses. Some examples are dysentery, typhoid, cholera, and other diarrheal diseases.
- Water-washed: Water-washed diseases are caused by a lack of water for personal and domestic cleanliness or contact with contaminated water. Some examples include skin and eye infections such as trachoma and scabies.
- Host-based: Water-based diseases are transmitted via an intermediate host which lives in water and causes illness in humans who ingest the water or use it for washing. Some examples are guinea worm and schistosomiasis.
- Insect-borne: Water-related insect vector diseases are transmitted by insects which breed in water or bite near water. These diseases are not associated with lack of access to clean water, but their spread is often facilitated by the construction of large-scale irrigation systems and reservoirs that create conditions favourable to their hosts. Examples of these diseases include malaria, dengue, yellow fever, and filariasis.
These vector-borne diseases have seen a high rise with every passing year due to a changing climate.
It is a burden on public health, especially in a pandemic-hit world when there has been a huge focus on hand-washing and related WASH practices more than ever before. And all of this requires access to water. When a majority of the country’s population is poor, they are pushed into social compression which is fraught with inequalities and inequity and unequal distribution of basic resources like water.
It also gives rise to disease-burden which can be further understood with the help of an ‘f-diagram’ which explains the causes of diseases all beginning with the letter f, viz., faeces, fluids, fingers, flies, fields, floods and food. This can be tackled very effectively by creating WASH barriers, which means ensuring access to clean water, having toilets in place and having hygienic sanitary practices before and after, while preparing food and consuming it.
A few days ago, an article was published which showed the correlation of bad hygiene practices to better immunity, hence, making India fight COVID-19 better in comparison to the developed world. This is laughable and sad at the same time and a reminder that so much more needs to be done in the health and hygiene sector.
Talking about toilets also brings in question the evil practice of manual scavenging which is a reality, no matter the denial. It has been a centuries-old casteist practice which in real terms is a crisis of human dignity. It is here that the best practices like the use of a robotic scavenger like Bandicoot needs to be scaled up.
Turning The Sanitation Crisis Into A Sustainable Business
Just as the crisis of COVID-19 has brought in great business opportunities to let the masses consume hygiene products like masks and sanitisers; likewise, I feel that fear needs to be injected in the minds of people for adopting sustainable sanitation practices.
A sanitation crisis in the developing world could be used as an opportunity to create jobs in the sanitation business, both in the rural and urban areas with a special focus on marginalized communities. For instance, slums in cities need a sanitation infrastructure in place.
A report by USAID in March 2020 talks about sustainable sanitation enterprises in rural Bihar. It explores the idea of scaling up market-based sanitation (MBS) that essentially looks into the barriers of a market system, viz., the core sanitation market, the business environment and the broader context.
To cater to such needs or demands, sustainability as a concept becomes difficult to execute, both at an environment and economic level. For example, the manufacture and supply of cement rings, water equipment, etc for building toilets could be an option for job creation in the upcoming sustainable sanitation businesses.
Moreover, research on incorporating locally available materials for building toilets that are accessible and will be cost-effective is much needed. Hence, sanitation infrastructure has to be made affordable to ensure viability and sustainability on all fronts.
Having the right toilet infrastructure in place, with gender-sensitive toilet designs be it IHHL, community toilets and public toilets could also help in mitigating the impacts of extreme weather events like floods due to climate change. Sustainable sanitation is an adaptive strategy for communities to become resilient and it is here that smart cities need to come into picture wherein treated wastewater utilisation happens to reduce water stress. There has to be a focus on behavioural change targeting all sections of the society.