Hygiene is the very first step of preventive health care. This was recognised and acknowledged by Mahatma Gandhi years ago when he had said, “Clean India first and independence later’. Dr Lee Jung Wook, a past director general of the World Health Organization (WHO), has said that water and sanitation are primary drivers of public health.
Over the years, the increasing population, deteriorating climate conditions and enhancement in pollution have made preventive healthcare much more essential. It is expected that as time goes by, the environment around us will deteriorate further, making preventative actions a greater priority.
Availability of safe water in adequate quantities, universal sanitation and proper garbage management are all essential for having a clean environment for maintaining hygiene. At the endpoint, hygiene is the most critical factor because all other efforts may only be recovered if this is maintained.
The government of India, realising the importance of sanitation, took a remarkable step in 2014 to embark upon a marvellous initiative to provide usable latrines for everyone. This initiative, called the Swachh Bharat Mission, completed its five-year goal in 2019. The sanitation scenario in the country was inadequate (about 42%) in 2019, which sharply increased, and the government has now reached nearly universal coverage.
It is now being implemented as Swachh Bharat-2, covering the solid-liquid waste management (SLWM), which aims to make our environment garbage accessible by proper management using innovative techniques. Many studies have shown that accumulated garbage and improper disposal lead to pollution of the surrounding environment, water and food, leading to several diseases.
India has only 4% of the world’s water resources, but 18% of the world’s population lives here. So, the nation needs a unique water management process to overcome this shortage. The government of India in 2019 initiated another path-breaking programme, the Jal Jeevan Mission. This incredible programme aims to provide safe drinking water in adequate quantities to every individual in the nation by 2024. For this, it aims to cover 19.22 crore rural households, including the most challenging, water-scarce and hard-to-reach areas. Other supportive programmes are also being implemented, such as proper wastewater treatment, rejuvenation of water sources, groundwater recharging and rainwater harvesting. Availability of safe and adequate water and good sanitation facilities are the basic infrastructure and need support. Still, the end effect will be positive only if these inputs are linked to proper hygiene-related habits.
Proper hygienic habits are essential for reducing infections, resulting in lower burden of diseases, including water and food-borne diseases like diarrhoea, dysentery and hepatitis. These eventually have many other advantages too, like reduced cost of medical treatment, saving of time and exertion, etc. The numerous other related benefits are—nutritional benefits (reduces anaemia, loss of nutrients and energy from the body, lowers worm infestation, etc. and enhances food safety); socio-economic benefits (reduces loss of working days, school absenteeism, drudgery, especially for women, etc., thereby giving them free time to take up other activities, personal care, etc.); gender benefits.
So, the ‘H’ of WASH is perhaps the most critical and ultimate need to achieve the success of every water and sanitation programme.
While hygiene at all levels is essential, for example, in environmental surroundings, schools and workplaces, maintaining personal hygiene by an individual is most critical. Keeping oneself clean will prevent the onset of numerous diseases. The modern world is facing severe epidemics like Covid-19, dengue, flu, etc. These can be controlled if the environment is kept clean and the community maintains proper hygiene.
Handwashing is one of the most essential and critical issues related to personal hygiene. Proper handwashing means using soap and water and cleaning hands following a suitable method. A meta-analysis of several studies has shown that handwashing with soap and water can reduce 37% to 48% of diarrhoea in children. Studies have shown that respiratory tract infections ( like ARI), the highest killer disease in children, can also be reduced with proper handwashing.
So, a combined multi-pronged approach—of providing safe sanitation, a clean environment and safe potable water—to good personal hygiene is expected to do wonders. But the key focal point is that hygiene has to be made a way of life for every person in India, whether children or adults, literate or illiterate, urban or rural, cross-cutting among all social classes involved in any occupation and every geographical area of the nation.
This humongous effort must be conducted by someone other than the government, as reaching every individual in our vast nation is a near-impossible task. So, partnerships must be created that support, help and initiate new initiatives. Hence, public-private partnerships are the most needed inputs.
At this point, it is worth mentioning that, as a multinational company, Reckitt has been doing a remarkable job in this regard, generating a positive impact and getting the concerned communities deeply involved and motivated to become self-reliant and change agents. Some of their remarkable initiatives are mentioned here.
The Banega Swasth India (BSI), one of the longest running public health programmes in the country of Reckitt, was initiated in 2014 with the objective of “Lakshya Sampurna Swastha Ka”, which complimented the Swachh Bharat Mission as it was an evolution from Dettol Banega Swachh India Programme. Its mission was to reach out and improve the hygiene and sanitation standards of 100 million Indians. So, it provided a double engine push, linking the programme to public health for the first time in the country. Nine years later, the 10th season was launched by the President of India, Draupadi Murmu, on October 2, 2023. This remarkable programme has shown an all-round success with tremendous reachability and an excellent positive impact.
The Dettol School Hygiene Programme, which continued unabated even during Covid-19, reached 13 million children in four years. It has helped children acquire hygienic skills and internalise hygiene in their formative years, helping them and their families, neighbours and entire communities. The data on outcomes shows immense KAP and related improvement, namely 54% increase in handwashing, 51% increase in sanitation practices, 37% increase in clean water-related practices, etc. This has led to a 14.6% reduction in diarrhoea and a 39% reduction in school absenteeism, indicating that the frequency of other diseases has also decreased.
The Dettol Hygiene Olympiad is India’s biggest hygiene olympiad for schoolchildren today. It has completed two years and reached 80 million children with an objective of “Lakshya Sampoorna Swasthya Ka”. It has contributed significantly towards awareness of the safe hygiene concept in a multi-dynamic way at a pan-India level.
The Harpic Sanitation Hygiene Education Framework in collaboration with Sesame Workshop India Trust is aligned with the National Curriculum Framework (2022). It aims to cover 17 lakh children in ashramshalas to enhance their healthy toilet habits.
The Harpic World Toilet Colleges in five states of India aim at upskilling sanitation workers and improving their livelihood. This eventually leads to reduced open defecation, leading to improved hygiene. Those mentioned above and many other Reckitt endeavours have been universally recognised. The sanitation preamble of Reckitt was presented and accepted on World Toilet Day on November 19, 2021, at the World Economic Forum in Davos and was highly praised. The NITI Aayog acknowledged in its publication the nutrition and hygiene-related models created by Reckitt.
Many other programmes are being supported and successfully implemented by other national and international agencies in the country. However, Reckitt possibly comprehensively targets the hygiene issue by considering its multi-dynamic impact on public health.
Dr Indira Chakravarty is a public health specialist and Padma Shri awardee.