Walking above the village of Mehrauli on Delhi’s southern perimeter, we pass a woman with a half-empty bottle of water—one of several we have already noticed since daybreak. Dressed immaculately in a brightly-colored sari, she emerges from behind a prickly bush on a tract of waste ground. If she were a man we might not have merited such discretion. India is about the only country in the world where you actually see human adults defecating. When traveling by road or rail you can be struck by the image of men squatting openly, impervious to the public gaze. The UN estimates that 600 million people—or 55 per cent of the Indian population—still defecate out of doors. The practice is clearly born of necessity in a crowded country where the development of public amenities has conspicuously failed to keep pace with economic and demographic growth.

Conspicuous defecation, however, is restricted to males. Female modesty—enjoined by Hinduism, Islam, and Sikhism alongside age-old patriarchal codes—dictates that women may relieve themselves only after dark, or in the most secluded reaches of the forest, a practice that exposes them to violence or even snake bites. The consequences for women’s health can be devastating. Women of the poorest classes notoriously suffer from a range of urinary and bowel disorders born of taboos about pollution and other social constraints applied to the most basic and banal of bodily functions.

My companion and I are looking for the walls of Lal Kot—the oldest of Delhi’s seven cities, dating from the tenth century, before the first Muslim invasion. The three-kilometer walls enclose a space that has been largely abandoned to jungle. The cladding of irregular quartzite blocks has been cut so accurately that no mortar was needed to hold them together. Set high on a ridge overlooking the present-day city, Lal Kot is a magnificent outpost of a forgotten civilization—a worthy precursor to the great Delhi Sultanate that flourished during the centuries of Islamic rule, as well as to its grandiose successor, New Delhi, designed by Edwin Lutyens and Herbert Baker barely two decades before Britain was forced to abandon its empire.

Lal Kot is far from the tourist trail. To reach it you have to cross a large rubbish dump, and negotiate the odiferous detritus—what used to be known as night soil—left by Mehrauli’s less favoured human residents. They sleep rough, in old tombs or in flimsy home-made shacks erected near the open sewers that intersect the area’s magnificent architectural monuments. In the absence of municipal services, refuse disposal is performed by long-haired pigs, which eat up every kind of organic matter, not excluding human and canine waste. (As Moses and Muhammad taught their followers, ham and bacon are best avoided in southern latitudes.)

The lack of sanitation is emblematic of India’s failure as an emerging economic giant to include most of its population in its achievements. India is now home to the fourth largest number of billionaires. According to Tim Sebastian, the former BBC journalist who chairs a forum in Doha, Qatar, for debate about social and political issues in the Middle East, some 60 million people in India—who make up the world’s most populous and most powerful middle class—now enjoy living standards higher than Britain and France. Yet the vast majority are excluded from India’s version of the American dream. As a former government minister Mani Shankar Ayar told Sebastian:

“We have a tiny elite that is obsessed with itself. If democracy doesn’t deliver for the rest—we could be heading for violence. We’re seeing a failure to bring 900 million people inside the system of entitlements. Without entitlements, you pick up the gun.”

A third of the country’s districts are now facing rural insurgencies spearheaded by the Maoist Naxalites. Is it not just a matter of time before violence spreads to major conurbations such as Delhi, home to 20 million people, many of them living on less than a dollar a day?

A visit to one of Delhi’s poorest quarters provides a glimmer of hope. The Nizamuddin district takes its name from the shrine of a holy man— Shaikh Nizamuddin Auliya (1238–1325)—renowned for his religious inclusiveness, his commitment to the poor, his disdain for rulers, and a love of music and dance that set him apart from his more austere Muslim contemporaries. The shrine attracts visitors from all over the Islamic world, as well as non-Muslim devotees. It typifies the spiritual syncretism one finds in India, where the tombs of holy persons attract followers from all religions. Until recently this run-down area was crammed with rural migrants and pilgrims hoping to benefit spiritually from the Shaikh’s baraka (blessedness), or materially by taking odd-jobs serving other pilgrims.

With no serviceable toilets available for pilgrims, the ground beneath the pillars of the overhead metro railway that is now under construction (causing a huge disruption to Delhi’s burgeoning traffic) has become an open latrine, a magnet for flies and disease. Now the Aga Khan Foundation, in partnership with other NGOs and agencies, is rehabilitating the area in a major initiative with the municipal corporation of Delhi. Measures include the organized collection of refuse, the provision of public toilets managed by the community, where users are charged a small fee for cleaning and supervision, and the re-housing of squatters who had constructed precarious additions to the fourteenth-century baoli or stepwell—the water is reached by descending flights of steps—now being dredged and reconstituted using the latest radar technology.

The local government school in Nizamuddin has received a comprehensive make-over funded by the Aga Khan Foundation in collaboration with one of India’s oldest charities, the Sir Ratan Tata Trust. In addition to bright new classrooms, well-designed for children, a vital outcome of the project, the headmaster suggests, is the renovated toilet block with separate cubicles for girls and boys. In Delhi—as in rural Gujarat, where similar conditions prevail—school drop-out rates have been highest among girls. Purely cultural factors—such as the demands of mothers for domestic help—are partly responsible. But teachers and aid workers see the lack of toilets as the primary reason girls have not been attending school, since there is no private place where they can relieve themselves. A program for building school toilets in Gujarat I looked at several years ago has yielded not just improvements in family health and hygiene, but a marked increase in female school attendance. Fifteen of the girls who took part in the program—whereby the children themselves cleaned the toilets—were going on to higher education.

Since the introduction of the new toilets in the Nizamuddin school, female drop-out rates have declined dramatically: the ratio of girls to boys attending the school is now 55–45 percent. Living in London one takes the humble loo for granted. A fortnight in Delhi reveals its potential for kick-starting a social revolution.