Water and sanitation India's open defecation elimination goal

Mobile toilets in India. Photo by: PraveenaSridhar / CC BY-NC-SA

BANGKOK — By 2019, India will be 100 percent free of open defecation and full of functioning toilets — or maybe it won’t be. Either way, official figures or government grandstanding are less important than the visible behavior change the Swachh Bharat Mission has spurred across a country of 1.35 billion people, according to several sanitation experts.

India’s Prime Minister Narendra Modi launched the $31 billion Swachh Bharat, or “Clean India,” mission in 2014 with the aim of constructing 111 million latrines in five years. He tackled toilet taboo by stressing pride in cleanliness and immediately attached the national sanitation drive to Mahatma Gandhi: A sanitation convention held in New Delhi this week to take stock of the movement coincided with the revered Indian activist’s 149th birthday. Modi promises to mark his 150th by celebrating a toilet for every household, a bold goal in a country where 53 percent of households had no toilet just seven years ago.

Critics and concerned development actors have raised questions about inflated numbers, wondering whether the rush to achieve targets has led to false claims and too much focus on new toilets rather than encouraging the use of them. Under the Swachh Bharat Mission, 76 percent of India's villages have so far been declared open defecation free: "The radius of rural sanitation before 2014 was approximately 38 percent, but today it is 94 percent,” Modi said during the convention this week.

With the scale of India’s campaign, “there is going to be a gap between desire and reality,” said VK Madhavan, chief executive at WaterAid India, which works to facilitate Swachh Bharat in rural areas. “But even if you leave aside the government's own figures on coverage or on usage and you were to just base it entirely on what other institutions are collecting, the fact of the matter is that there has been dramatic progress with regard to both coverage as well as usage since October 2014.”

The effort hasn’t just been for show, according to Val Curtis, director of the Environmental Health Group at the London School of Hygiene & Tropical Medicine. The Indian government put money behind a huge opportunity for government officials, private sector players, and regular citizens to do good — then followed up to reward them for doing it. And it’s working, despite shortcomings and a long road ahead, said Curtis, an expert in behavioral change who helped advise on the program and is now conducting a study on the results.

Many of her conversations with people at various levels of power have allowed her to understand how meaningful it’s been for them to contribute to the health and pride of their own villages.

She recalled one interviewee who described that when an official from the Ministry of Drinking Water and Sanitation used to visit his district, “he would say ‘Here, hold my briefcase, and by the way, where can I buy a sari for my wife?’” Curtis said. “Now the secretary arrives and asks, ‘How many toilets have you built?’ And he checks.”

“The fact of the matter is that there has been dramatic progress with regard to both [sanitation] coverage as well as usage since October 2014.” — VK Madhavan, chief executive, WaterAid India

Almost 80 million household toilets are estimated to have been built since Modi’s 2014 pledge. The effort has been lauded for its creative tactics, from village-level toilet-building races to injecting young talent into government to create provocative information campaigns. Some areas have designed elaborate monitoring systems, involving night watches and sanctions, to stop people from defecating openly.

“I cannot think of any other campaign that has touched more people and had more demonstrable impact,” Curtis told Devex.

Still, others say the government has been slower to support necessary infrastructure, such as fecal waste management centers or plumbing for clean water. If not managed properly, the concentrated waste near people’s homes could pose a new public health problem. A 2017 WaterAid report that covered 1,000 rural households in eight states showed that 33 percent of constructed toilets would need major upgrades to remain safe, and 31 percent posed immediate health hazards.

The resounding word of international sanitation experts this week is to celebrate progress and to be patient. The government isn’t blind to the current shortcomings or ignoring the fact that reaching the last mile will present problems, according to Water Supply and Sanitation Collaborative Council Chief Executive Rolf Luyendijk.

“I know that the government is very, very well aware of these challenges, but at this point they’re really focusing on making sure that all people have access and are using a toilet,” Luyendijk said.

Some of this is already being addressed with the government-led ODF Plus protocol, a sustained campaign for areas that have been deemed “open defecation free” to focus on waste management, cleanliness of toilets, and maintaining a culture of personal hygiene. Luyendijk was also pleased to hear private sector partners discussing market opportunities for fecal sludge management this week, he said.

WaterAid’s Madhavan now wants to see continued political support for Clean India beyond ODF Plus — and beyond 2019 — in order to address gaps in infrastructure and to ensure quality sanitation access for the last mile. Toilets for early childhood care centers, schools, and health care facilities are particularly important to sustain the movement, he added.

In the meantime, the way Madhavan talks about his own work in sanitation has changed greatly in the past few years. Previously, he couldn’t garner much interest even among family members about his work on a largely taboo subject.

“Now I know every time I meet someone, the first question they ask me will be: ‘Is the mission working?’” he said.

“Sanitation [has] suddenly become an acceptable topic for conversation.”