SC Directive
By Dhurjati Mukherjee
The recent directive of the Supreme Court to ensure that all schools in the country should be provided with permanent toilets by the December-end this year is undoubtedly a significant judgment, more so because sanitation has emerged a crucial problem in India and most developing countries of the Third World, specially in South Asia.
It is estimated that around 40-45 per cent of schools in India have no toilets though a report of the education think tank, National University of Educational Planning & Administration, revealed that nearly 30 per cent of the 13 lakh Government schools in the country do not have toilets. The dimension of the problem is so acute that communicable diseases have increased rapidly due to lack of access to sanitation and/or lack of adequate awareness about the direct and indirect effects of open defecation. Way back in 2003, it was estimated that in South Asia approximately 653 million people – 76 per cent of the total population still lack access to adequate sanitation. And the figure for India may be anything between 55 to 60 per cent of the population presently which was much higher earlier.
Sanitation is broadly defined to include management of human excreta, solid waste and drainage. The World Health Organization (WHO) defines improved sanitation as a means that hygienically separates human excreta and hence reduces health risks to humans. Inadequate sanitation is thus lack of improved facilities – toilets, conveyance and treatment systems – and hygienic facilities that exposes people to human excreta and thus to disease-causing fecal-oral pathogens through different transmission pathways.
According to a study by the Water & Sanitation Programme – South Asia (WSP-SA) of the World Bank ‘The Economic Impacts of Inadequate Sanitation in India’, the total economic impact of inadequate sanitation in the country amounts to Rs 2.44 trillion (US $ 5.8 billion) a year, this being the equivalent of 6.4 per cent of India’s GDP in 2006. The per person annual impact comes to around Rs 2180.
Economic impacts of inadequate sanitation were as high as the State incomes of Andhra Pradesh or Tamil Nadu and were more than Gujarat’s State income on 2006-07. As is quite obvious, the health-related economic impact of inadequate sanitation at Rs 1.75 trillion (US $ 38.5 billion) amounts to the largest category. Experts feel that diseases such as diarrhea have conveniently been called ‘water borne’ diseases but many communicable diseases are overwhelmingly explained by inadequate sanitation i.e. having fecal origin rather than water that acts as a medium to spread diseases.
After health, access time – production time lost to access sanitation facilities (shared or public toilets) or sites for defecation – and drinking water-related impacts are the other two main losses at Rs 487 billion (US $ 10.7 billion) and Rs 191 billion (US $ 4.2 billion) respectively.
The World Bank study pointed out that 79 per cent of the premature mortality-related economic losses under health impact was due to deaths and diseases in children below the age of 5 years. Diarrhea in children below 5 years accounted for more than 47 per cent of the total health-related economic losses impact. The poorest 20 per cent households living in urban areas bear the highest per capita economic impact of inadequate sanitation of Rs 1699 – this is 75 per cent more than the national average per capita economic losses of Rs 961 and 60 per cent more than the urban average (Rs 1037).
Rural households in the poorest category bear per capita losses of Rs 1000 which is 8 per cent more than the average loss for households on rural areas (Rs 930). The total losses for rural households in the poorest quintile are enormous (Rs 204 billion) as compared to their counterparts in urban areas (Rs 16 billion).
The Government initiated the Total Sanitation Programme (TSP) since the mid 80s and formulated the National Urban Sanitation Policy in 2008. But very little has been achieved compared to the dimension of the problem. It is a well-known fact and also aptly emphasized in the WSP-SA study that not only are substantial investments needed but these can become effective when they result in reducing morbidity and mortality, mitigating impacts on drinking water, reaching the unserved and poorer sections of the populations, generating awareness on the need for proper sanitation etc.
Conventional approaches in India and South Asia have not achieved the desire results because of the lack of availability of sanitary latrines in rural and backwards areas of the country. Moreover, behaviour change is a key ingredient of the Community-Led Total Sanitation (CLTS) strategy that has been in operation for the past few years. Though it could help achieve4 better results, it requires more thrust.
The basic principles of the CLTS approach in rural areas are: Collective action: mobilizing the community rather than establishing household contacts; Local choice: accommodating a variety of technological options and getting people to access affordable technologies; Setting up local level institutional frameworks: giving local governments a central role in gearing up work through sustainable options; directing incentives to the community and rewarding outcomes rather than subsidizing household toilets; and Market development: promoting the availability of sanitary materials and motivating private suppliers and NGOs to respond to the demand at affordable costs.
Whether the Millennium Development Goals (MDGs) of extending access to improved sanitation to at least half of the population by 2015 and 100 per cent by 2025 will be achieved remains to be seen. The CLTS in the rural areas and the City Sanitation Task Force are carrying out their efforts in full swing. The concept of rewarding totally sanitized blocks has been in operation but it has to be extended to totally sanitized cities, as has been outlined in the National Urban Sanitation Policy.
However, what is most necessary at this juncture is the need for awareness generation about sanitation and the health effects of open defecation on the community. The City Sanitation Plans should outline these aspects with the involvements of all stakeholders.
Clearly, fresh impetus and adequate funds need to be made available at the grass root level to motivate the community. — INFA