In a recent speech, Union Rural Development Minister Jairam Ramesh said India is one of the filthiest countries in the world. Despite spending Rs 19,626 crore ($4.3 bn) in last 10 years on the Total Sanitation Campaign (TSC) programme, a large portion of India's population still defecates in the open. Shantanu Gupta writes from rural Uttar Pradesh on how an ambitious scheme is floundering because of slow execution and a flawed understanding of social dynamics.

A recent United Nations study had this to say on sanitation in India.

“India’s mobile subscribers totaled 563.73 million at the last count, enough to serve nearly half of the country’s 1.2 billion population. But just 366 million people — around a third of the population (31%) — had access to proper sanitation in 2008, said the study published by the United Nations University, a UN think-tank.”

Sanitation Problems Persist

The situation is no better today, except of course for the number of mobile phone connections which have crossed 850 million. The Rural Ministry claims 27% of India does not have access to toilets. But the problem is that Government (as it does mostly) measures the success of TSC on 'input parameters’ – which is the number of toilets constructed. Not on ‘how many people are using it’. Experts believe that more than 60-70% of India still defecates in open. This writer has visited villages in states such as Uttar Pradesh, Rajasthan, Bihar, Madhya Pradesh, Andhra Pradesh, Maharashtra, Chhattisgarh, Jharkhand and West Bengal in India and noticed the somewhat curious sight of women stepping out of their homes after dark to answer nature’s call. As a result, they develop multiple infections. Young girls meanwhile drop out of school after 7th to 8th grade because of non-functional toilets in the schools. The bacteria travels home through footwear leading to health issues for the whole family.

Under the TSC programme, the government provides a subsidy of around Rs 2,200 to Below Poverty Line (BPL) families and Rs 1,500 to Above Poverty Line (APL) families to build toilets. In states like Uttar Pradesh, the government gives Rs 4,500 to BPL families in Ambedkar Villages (special villages selected every year for focused development).

Funds Get Misused Along The Way

A robust, long-lasting traditional individual toilet costs between Rs 4,000 to Rs 5,000.

In many cases, the Pradhan (Sarpanch) or head of the village and other officials of Panchayati Raj department (being the administrator for such funds) are known to siphon away the money, without constructing any toilets or by constructing a shoddy unusable structure.

Villagers don’t protest much against this misappropriation, as they are not quite inclined to use toilets because of their long held habit of defecating in the open. More often than not, the villagers use the toilet structures for various other purposes. This writer has seen toilets being used for storing cow dung-cakes, being used as a kitchen and for storing agriculture produce and fertilizers.

Sanitation vs Social Beliefs

Moreover, villagers have also expressed apprehensions of having toilets built in their houses. Some families have a notion that it’s not auspicious to have a toilet within the house premises. Some find it claustrophobic; some say it needs a lot of water. And other orthodox families say the father-in-law and daughter-in-law can’t use the same toilet.

So a mere subsidy under TSC can’t change these complex social equations. It needs very carefully designed messaging to promote usage of toilets and latrines. The 15% IEC (Information, Education and Communication) budget, meant for this purpose is used in some wall paintings and occasional messaging through folklore. The scientifically designed social frameworks like CLTS (Community Led Total Sanitation), to do focused village level workshops in community and build opinion against defecating in open do not have many takers against the subsidy based, Total Sanitation Campaign

To motivate the panchayats, the Ministry has also been awarding the 'Nirmal

Gram Puraskar' (Clean Village Award) since 2003. Rewards are based on the

size of the population and range from Rs 45,000 to Rs 5 lakh. There was a

dramatic increase from 45 Nirmal Grams in 2005 to 5,000 in 2007. Currently,

more than 30,000 Panchayats have applied for the award. These figures look

impressive. Most of these villages, that received the award in previous years, on days of inspection, showed that 100% of the open spaces in their village were defecation free. However, visits to any of these Nirmal Grams (clean villages) today shows that they are far from clean.

Practice What You Preach

The village level 'Accredited Social Health Activist (ASHA)’, a trained female community health activist, who works under India's Health Ministry's flagship program, National Rural Health Mission (NRHM) is also supposed to play the role of a promoter to motivate people not to defecate in open. She is even incentivized for this (Rs. 40 per

toilet constructed based on her persuasion). But more often than not, you

will find that ASHAs don't have toilets themselves in their houses and thus

fail to set an example. Same is the case with the elected representatives to

head the villages - Pradhan/Sarpanches, many of whom don't have toilets in

their houses and thus hardly care for the Total Sanitation Campaign (TSC) at

the village level.

A complete failure in universal sanitation is becoming a health nightmare

and in turn putting a higher health burden on the exchequer. The Government

needs to completely redesign the TSC program. The Total Sanitation Campaign needs restructuring and should largely focus on igniting and facilitating change. The first step can be to work closely with the change agents of the village - the ASHAs, the

Anganwadis, the Pradhans and the primary school teachers to bring about this

huge change in the mindsets of people. The IEC money should be well spent in

educating people through models like CLTS. Mere subsidies and budget

enhancements will not give us a 'Nirmal India'.