Where Do They Squat?

Vidya Balan, the Bollywood star and ambassador of the Indian government’s programme for building household toilets, asks the mother-in-law who is busy toying with her bahu’s ghunghat at the wedding ceremony: “Do you have a toilet at home for the dau­ghter-in-law to use?” Mum-in-law replies: “No.” Vidya then asks her, “Then why are you extending her ghu­nghat so much when you can’t provide her a toilet at home?” It’s the smartest ad for toilets. But is the message getting through?

India leads the world in open defecation, with about 600 million people defecating in the open every day. Women and children are most affected. Close to 300 million women and young girls sit out in the open braving heat, cold, rain and under constant threat of being watched, molested and raped. This is not just a national shame, but also a human trag­edy. Open defecation is a major cause of undernutrition on account of poor absorption, illness, stunting, poor school performances, damaged immune systems, leading to impaired mental development and redu­c­ing future earnings and human capital. 

A half to two-thirds of stunting results from open defecation, most of all where OD populations are dense, as in the Hindi belt. Much of the mid-day meals in schools is eaten by intestinal worms, or lost to diarrhoea or a host of sicknesses. The 2,12,000 children who die of diarrhoea each year are only the tip of the iceberg. The costs (6.4 per cent of GDP, estimates a 2010 World Bank study) and suffering are immense.

How did earlier programmes fare? The Central Rural Sanitation Programme (CRSP) from 1986-1999, the Total Sanitation Campaign (TSC) from 1999-2012, the running Nirmal Bharat Abhiyan (2012-2022)—they have all failed. The TSC, started by the previous NDA government, had 2012 as the target date for a Nirmal Bharat. Instead, with population increase, there were 8 million more rural households defecating in the open in 2011 than in 2001 (Census data).

This situation 28 years after the first programme started indicates basic design weaknesses in the approach: the focus on individual financial subsidies to build toilets has continued.  The rural development ministry was reporting that the government built toilets for 68 per cent of households; but Census 2011 found that 60 million toilets reported construc­ted were not found on the ground in 2011. Disbursements were taken as a proxy for construction. Research evidence is that people defecate in the open because they don’t see fit to change centuries-old behaviour. (Poverty is not the issue, as open defecation is rampant even in Haryana and Punjab, where most well-off farmers even now defecate in the open.) But bureaucrats believe villagers don’t build/use toil­ets because they are too poor. If so, how did the 2011 census rep­ort a higher proportion of households with TVs than toilets?

A campaign led by the PM will send out a clear message that this time there is serious commitment to universal collective behaviour change, not just building toilets for people. This should be backed by a radical revision of policy at the GoI level and the design of a new national sanitation programme.  Trained youth should be ‘trigg­ers’ of collective behaviour cha­nge in each village. Households would construct and use their own toilets, monitored by the triggers. Replacing incentives for individual household latri­nes with subsidised con­struc­t­ion mater­ial including cement, rural and urban pans, P-traps and pipes could be another trigger. These will have to be widely available in the market and cheap. This will require giving households a voucher to lower the cost of building a toilet, especially for poor househ­olds. The financial costs will be much lower than the Rs 10,500 subsidy per toilet being given currently, which is to be incre­ased to Rs 12,000 under the Swacha Bharat Mission (SBM).

Giving rewards to credibly OD-free habitations, gram panchayats, blocks and districts following independent verification and certification of actual use of toilets would be ano­ther good move. Right now, there are contradictory elements in the SBM itself. That giving individual subsidies to households to construct toilets does not encourage toilet use has been corroborated in India. Yet the SBM continues such subsidies.It does recognise finally the need for triggering behavior change at community-wide level. One can only hope the money set aside for this does not remain unutilised, while the money for construction is absorbed rapidly (as happens so often in government programmes).

(The author is a professor at JNU. With inputs from Vinod Mishra, Nisheeth Kumar and Robert Chambers.)