In May last year, Ravindra Kumar, an e-rickshaw driver based out of New Delhi was beaten to death after he opposed two individuals urinating in public.

In another incident reported in February this year, a photograph of Kanchan Saraf, the health minister for Rajasthan state, urinating in public went viral on social media, highlighting the fact that despite a call to end open defecation or public urination by February 2019, changing the outlook of an individual is still a challenge.

10.5% of urban households in India practiced open defecation; 14.9% used toilets where waste comes into contact with humans and 6.1% used shared facilities, according to the National Family Health Survey data of 2015-16.

In October 2014, when Prime Ministrer Narendra Modi originally launched the Swachh Bharat Mission, one of the key points was to make India Open Defecation Free (ODF). When he made his speech on the fourth anniversary of the launch of the mission, he also claimed that 25 states of the country had declared themselves ODF.

However, an India Spend report that was published soon after the Prime Minister's speech suggests otherwise. "Swachh Bharat Mission-Urban originally targeted the construction of 10.4 million individual household latrines (IHHL). States undertook a reassessment of toilet needs, and in February 2017, the overall IHHL target was reduced across 23 states and union territories (UTs) by 36% to 6.64 million. Andhra Pradesh, for instance, saw its target reduce by 52%. By this point, however, a few states had already claimed construction numbers based on initial targets," the report stated, adding that sizeable differences were noted in other states, too. For instance, Uttar Pradesh lost close to 37,000 toilets, and Chandigarh had almost 13,000 fewer toilets in a year.

Yet, despite the ‘disappearance’ of these toilets, Jack Sim, the founder of World Toilet Organisation says that building the toilets is the easy part. "Getting people to use toilets is harder because it requires cultural adjustments to their habits of open defecation which is a community meeting when they go to the toilet together to chit-chat," he explained.

A CSE report, quoting its director Sunita Narian corroborates Sim's statements. While 83.8 million toilets have been constructed across the country, the switchover involving century-old behaviour of over 600 million people is no mean feat, she said.

Another problem that India faces is the management of human waste. A 2016 government report highlights the poor state of waste management in the country. Several villages have no proper facilities to dispose drain water, urban areas cannot manage their waste, and community toilets aren't cleaned regularly.

The survey results also show that 22.6% of the villages and 8.6% of urban wards—urban administrative divisions—do not have anyone to clean community toilets used by locals. Filthy toilets already are one of the biggest reasons for skin ailments and urinary tract infections among Indian women. Besides, fecal waste breeds over 200 viruses.

In the case of rural India and people resorting to ODF, some human waste can also be used as night soil – an organic fertilizer. Here, however, Sim cautions, "We must not let the night soil contaminate the water bodies both surface water and underground water like wells."

Stressing that safe-recycling of human waste into fertilizers and energy is encouraged by the World Toilet Organisation, Sim says that there is a need to have a close loop design to make sanitation treatment sustainable and affordable. “We are very glad that the Gates Foundation has taken the initiative to reinvent the Toilet and now progressed to Reinvented Toilets and setting ISO standards on treatment and safe recycling.

The Reinvent the Toilet challenge that was set up by the foundation in 2011 aims to create a toilet that removes germs from human waste and recovers valuable resources such as energy, clean water, and nutrients, as well as operates off the grid without connections to water, sewer, and electrical lines, just to name a few. The foundation has also spent $200 million over seven years funding sanitation research, showcased some 20 novel toilet and sludge-processing designs that eliminate harmful pathogens and convert bodily waste into clean water and fertilizer.

While there are challenges, Sim, however, hails India for its progress. “It’s not easy to convince a country of over a billion people to change their habits overnight. So it’s a step-by-step procedure. In a country such as India where religion and faith play such an important role, religious leaders like Swamiji Chidanand Saraswati have been encouraging people to use toilets through his Global Interfaith water, sanitation, and hygiene (WASH) Alliance.

A number of other non-profits have also been actively involved in their individual WASH missions. Divyang Waghela, Head, Tata Water Mission, Tata trusts says, "Our approach for WASH is demand-responsive where the community has been at a center. To create a genuine demand for WASH services among communities, the Trusts adopted ‘progressive nurture’ as a core and universal motive of its Behavioural Change Communication strategy. There is a clear aspiration among communities for improving one’s quality of life and more importantly, that of their children which helps to create ‘Toilet’ as a progressive element of their priority choice to make life better. As a part of two-pronged approach, the use of social art as a medium to engage with the communities has been more effective whereas to achieve scale at a lower cost, use of digital platforms helps to reach out to larger communities across the geographies.”

World Toilet Foundation has also inaugurated ‘Toilet Colleges’ in Rishikesh Parmath Ashram and in Aurangabad, Maharashtra, where professionals are trained in design, building, cleaning, maintenance, hand washing, ecological sanitation treatment, advocacy, schools programs, machines operations and also to train and place the graduates from the colleges.

While Sim is confident that India will have full sanitation coverage by Oct 2, 2019, he admits that it will take another decade to ensure ODF remains ODF. "Bangladesh with a smaller population, took 13 years to reduce their open defecation level to 3%. So India will need 10 years of continuous effort to promote good hygiene and proper sanitation habits after achieving full sanitation coverage. The good thing is that Swachh Bharat is irreversible now. As people start to see their neighbors having toilets, social norms will change. A toilet has become a status symbol in many communities and this trend will spread," he signs off.