Sixty per cent of the "global total" who do not have access to toilets live in India, and hence are forced to defecate in the open. In actual numbers, sixty per cent translates to 626 million. This makes India the number one country in the world where open defecation is practised. Indonesia with 63 million is a far second!

At 949 million in 2010 worldwide, vast majority of people practising open defecation live in rural areas. Though the number of rural people practising open defecation has reduced by 234 million in 2010 than in 1990, “those that continue to do so tend to be concentrated in a few countries, including India,” notes the 2012 update report of UNICEF and the World Health Organisation (WHO).

For instance, of the 2.4 lakh gram panchayats in the country, only a mere 24,000 are completely free of open defecation.

More than half of the 2.5 billion people without improved sanitation live in India or China. The high figure prevails even as four out of 10 people who have gained access to improved sanitation since 1990 live in these two countries.

“Rapidly-modernising India is drowning in its own excreta,” notes the New Delhi-based Sunita Narain, Director General of the Centre for Science and Environment in a Comment piece published on June 14 in Nature.

The only silver lining is the determination with which Rural Development Minister Jairam Ramesh intends to rid the country of open defecation within a decade. His endeavour got a shot in the arm recently when the Cabinet Committee on Economic Affairs increased the amount of money to be spent for household toilets in rural areas from Rs. 4,600 to Rs.10,000.

But increased spending alone will in no way turn out to be a magic bullet in solving the malaise of open defecation. Numerous examples from other countries serve as testimony to this. Bringing about a change in mindset is the paramount need.

Awareness of the link between open defection and diseases like diarrhoea will in one way change the way people defecate. After all, almost 10 per cent of all communicable diseases are linked to unsafe water and poor sanitation. According to WHO, open defecation is the “riskiest sanitation practice of all.”

According to the global health body, compared with 1990, more than two billion people have access to improved drinking water sources. Thus the Millennium Development Goal's drinking water target has been reached — “over 2 billion people have gained access to improved water sources from 1990 to 2010, and the proportion of the global population still using unimproved sources is estimated at only 11 per cent.”

The fine print

But the fine print reveals the rider. WHO does not have the critical information about the safety of the drinking water, though. Since testing for microbial and chemical parameters to designate drinking waters as safe is expensive, WHO used a proxy indicator — measuring the proportion of the population using drinking water sources that supposedly are protected from contamination, particularly from faecal matter.

But access to drinking sources can hardly be a true indicator, as is the case in India. “Leaking and incomplete sewage systems contaminate rivers and lakes, causing diseases like cholera,” notes Nature. “Around 97 million Indians do not have access to clean drinking water.” The problem arises due to contamination of drinking water by leaked sewage. Sewage inevitably pollutes water bodies, both surface and aquifers.

According to the Comment, only a few facilities exist in the country to treat waste water. “Officially, the country has the capacity to treat 30 per cent of its waste water.” But in reality it is far less at “20 per cent.”

While ridding open defecation will go a long way in improving sanitation and reducing disease outbreaks, Sunita Narain makes a strong case for larger investments in sewage systems and effective use of water. The need for newer technologies cannot be ignored.

Current technologies use “large amounts of water to transport small amounts of excreta through expensive pipes to costly treatment plants, she states. This is “unworkable and unaffordable,” especially considering the fact that cities are growing at a rapid pace and infrastructure is always lagging behind.

This article is corrected for factual error.