Access to Toilets in India
Originally featured on GivingRise.org as “The Path to Adequate Sanitation in India”
“If all 774 million people in India waiting for household toilets were made to stand in a line, the queue would stretch from Earth to the moon and beyond. That queue would take 5,892 years to work through, assuming each person needs about four minutes in the toilet.”
When we consider the greatest inventions in history, there will always be a place for sanitation systems and plumbing in the conversation. We take toilets for granted as a staple of modern society, but they are still an extravagance for about 1 billion people in our world who defecate in the open. Open defecation is the quickest one-way street to illness, as feces will contaminate the environment and get transmitted to the new host via fluids, fingers, flies and fields.
Access to adequate sanitation is a basic human right. Sustainability demands sanitation. Advancements in sanitation depend on eliminating open defecation. When we think about how to make a difference — with the limited resources available — adequate access to clean toilets creates positive ramifications across an entire society. “Sanitation brings the single greatest return on investment of any development intervention,” Dasra reports. “For every $1 spent on sanitation at least $9 is saved in health, education and economic development.”
Societal Costs and Challenges
India is not only the world’s second most populous country, but it is also the world’s largest democracy and the seventh-largest nominal GDP; India is where the button, the radio, shampoo, suits, and more were all invented. Yet with approximately 50% of Indians lacking access to a toilet, India accounts for 59% of the 1.1 billion people worldwide that defecate in the open. India’s market liberalization and growth since the 1990s lead to the growth of many industries, especially the telecommunication network, which is the largest in the world. Far more people in India have access to a cell phone than to a toilet. While this telecommunication growth is remarkable, universally executing on older, more basic tenets of modern society — specifically the elimination of open defecation — could have a greater overall impact on the economy.
The societal costs of fecal matter can be found in health, equality and education. It’s negative externalities are very interconnected. Of India’s 2.3 million annual deaths among children aged under five years, about 334,000 are attributable to diarrheal diseases that improved sanitation can easily prevent.8 “Until everyone has access to adequate sanitation facilities the quality of water supplies will be undermined and too many people will continue to die from waterborne and water-related diseases,” said the WHO’s public health department director, Dr Maria Neira.
In Indian cities, the low supply of toilets leads women to hold their bladders for 13 hours a day, leaving them at risk of urinary and reproductive tract infections. Additionally, lack of toilets in schools is leading to girls dropping out of school; 23% of girls drop out of school upon reaching puberty, and they cite lack of toilets as a top factor for why. From long term health to the classroom to the street, a lack of toilets is proving costly to the betterment of women and children across India. Too often, open spaces used for defecation in India’s urban slums are often the only open spaces children have to play.
The government is taking a positive step forward. India’s Prime Minister has vowed to banish the practice of open defecation by 2019. However, modernizing sanitation standards in India is about more than access to toilets; with open defecation comes behavioral and cultural obstacles. On the behavioral side, one study indicated that people in households with functioning toilets, continued to defecate in the open as they found it “pleasurable, comfortable or convenient” and regarded open defecation as “part of a wholesome, healthy virtuous life.” On the cultural side, Delhi based RICE Institute’s Sangita Vyas says, “Emptying a pit in any other developing country… doesn’t carry a social stigma in the same way as it does in India,” referring to the caste system which implies that dealing with human waste is the responsibility of those at the bottom of the social hierarchy.
How to Create Adequate Access and Usage
The solution to modernizing sanitation standards in India must be two fold: infrastructure improvements across the entire sanitation service chain, and behavior changes to the tolerance of open defecation.
When it comes to efficiently increasing the supply of toilets,, Civil Society Organization (CSO) Shelter Associates breaks it down into five action steps:
- setting up a very robust spatial data platform to pinpoint families who lack access to basic sanitation,
- facilitating the construction of individual toilets,
- conducting workshops to increase awareness within the community of environmental issues,
- providing a forum for sanitation issues to be discussed,
- and establishing solid waste collection systems.
The infrastructure problem is much greater than just increasing the supply of toilets; for a toilet that is not connected to a proper sanitation system is still creating similar societal costs as open defecation. Likewise, The Gates Foundation also emphasizes the structural improvements that span far beyond just more toilets, “tackling this problem requires an understanding of issues across the entire sanitation service chain, including waste containment (toilets), emptying (of pits and septic tanks), transportation (to sewage treatment facilities), waste treatment, and disposal/reuse.”
Changing behavior is a less predictable but an equally necessary initiative. Campaigns in India must have behavioral residue if they are to have a chance at successfully making open defecation less culturally acceptable.
Savita, a 22 year-old resident of Parvar Poorab describes the government’s attempts to change the behavior in his peaceful North Indian village, “The government employee who constructed it told me we had to use it now and we shouldn’t go in the open. But it’s better to go in the open. The pit is very small and will fill up very soon. We only use it in an emergency or at night. I like going outside.”
Solving for quality sanitation access across India is going to take a multi-prong approach with collaboration from non-profits, social purpose companies, the government and the the citizens themselves. The future of the country depends on improving sanitation: 48% of children under the age of five are undernourished because of bad sanitation, $15 billion a year is spent on treating water borne diseases, and an estimated $10 is lost in worker productivity hours due to people looking for toilets. Ultimately, adequate sanitation is a staple of modern society, and giving back to create access to toilets in India is one of the most efficient ways to grow the economy.
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