Bringing Swachh Bharat to 4,041 Cities One Neighborhood at a Time

USAID Global Water Coordinator Christian Holmes gathers with students from the Madhura Nagar School in Vizag, India, during a visit earlier this year. Photo Credit: USAID/India

In 2014, the Government of India launched the ambitious Swachh Bharat (Clean India) Mission to improve urban quality of life by eliminating open defecation and increasing sanitation coverage in its more than 4,000 cities by October 2, 2019 — the 150th anniversary of Mahatma Gandhi’s birth. During my visit there earlier this year, I saw significant progress being made toward this goal and was proud of the technical assistance the United States Agency for International Development (USAID) is providing to strengthen national sanitation and support this effort. As of now, thousands of cities are on track to achieve open defecation free (ODF) status by October 2019.

The importance of this campaign should not be understated. Roughly one out of every three Indians lives in a city, with the poorest living in slum settlements. In these areas people are disconnected from municipal water and sanitation services and are frequently without access to improved sanitation facilities. These residents are particularly susceptible to diseases spread by improper wastewater disposal and open defecation, which is still practiced by nearly 600 million people nationwide. Illnesses due to intestinal disease result in the loss of an estimated $54 billion — or 6.4 percent of the nation’s gross domestic product. Moreover, this contaminated water increases the spread of potentially deadly waterborne illnesses including diarrhea — a top cause of childhood stunting in India that claims the lives of 300,000 children every year.

Putting Words into Action

Our work to support the Swachh Bharat Mission began in 2015 when USAID, along with the Bill & Melinda Gates Foundation, entered into a Memorandum of Understanding with the Government of India Ministry of Urban Development (MOUD). Under this agreement, USAID is cooperating in the field of water, sanitation, and hygiene (WASH) through technical assistance, sharing best practices and knowledge, and supporting public private partnerships. An important part of our work with the MOUD has been through the staffing of the Program Management Unit (PMU).

The Swachh Bharat (Clean India) Mission is improving urban sanitation across India to help reduce the prevalence of waterborne illnesses that contribute to stunting and other serious children’s health issues. Photo Credit: Bonnie Carlson, USAID/India

With USAID technical assistance, the PMU is building capacity in 4,041 cities through an e-governance platform that trains municipal workers in sustainable sanitation, and setting up Swachh Bharat city support units in 75 cities. Recognizing one city’s success story is another city’s roadmap, the PMU has also organized city-to-city exchanges to promote best practices for sustainable water and sanitation management.

Some of the key capacity building initiatives include: launching a national survey that ranks 500 cities on cleanliness, encourages citizen participation, and creates awareness on how to work together to make Indian cities cleaner and healthier. A national student campaign around sanitation is engaging 1.6 million students across 2,000 schools and 700 cities have made new commitments towards achieving ODF status by March 2017.

Sanitation successes have provided a blueprint for eliminating open defecation in other urban areas in India.

Currently, technical assistance has been focused on ten cities including the city of Visakhapatnam (Vizag), a population of 2 million people located on the central eastern coast of India. In Vizag, USAID partner Water and Sanitation for the Urban Poor (WSUP) has collaborated with city officials to complete a rapid assessment guide for gauging local sanitation needs, developed a behavior change communications strategy for the Greater Visakhapatnam Municipal Corporation, and provided a public-private partnerships manual for engaging the private sector in the city’s sanitation. To promote post-intervention sustainability, WSUP has also produced a training manual for city officials detailing best practices for maintaining ward-level ODF status once it has been achieved.

On the ground in Vizag, some amazing changes have also been taking place. I shared a story a few months ago about the inspiring work of the city’s women-led self-help groups and how their efforts have helped 24 of the 72 wards of Vizag achieve ODF status.

USAID Global Water Coordinator Christian Holmes meets with schoolchildren in the city of Visakhapatnam (Vizag), where improved sanitation facilities in schools are helping female students better manage their menstrual hygiene. Photo Credit: USAID/India

Their success is being complemented by work being done in schools across Vizag. During my time in the city, members of the USAID India Mission and I were able to visit the Madhura Nagar School, located in a low-income neighborhood. The school has 350 students, boys and girls through high school age. The Coca-Cola Foundation and Plan India are at work in many municipal schools in Vizag, including this one. Here, the partnership is working to strengthen WASH efforts through a program entitled Support My School (SMS), which is helping to provide toilets for all students, and rehabilitating girls’ restrooms to provide more privacy in support of menstrual hygiene management. These improvements have meant big changes for the students and the school. Before SMS, this school had no functional latrines for boys, and girls had little to no information about menstrual hygiene management. Teachers and girls now say they can share what they learn about this sensitive subject with family at home. To further promote student health, the school has added an on-site child nutrition program to help prevent malnutrition and stunting that is currently supporting about 20 children.

Through SMS, the school now has running water in toilets, rainwater harvesting, a large sink with multiple faucets for handwashing, trees for more shade, and sports equipment. The headmaster said both attendance and academic performance have significantly improved, and the school’s academic ranking in its district has advanced from seventh to first place. The school is now ranked the number one Swachh Bharat School in Vizag.

Sanitation successes like these have provided a blueprint for eliminating open defecation in other urban areas in India. Inspired by these successes, USAID, the Coca-Cola Foundation, and Plan India have formed a partnership to provide WASH services in schools in two additional cities, Dehradun and Pune.

Organizing Cities by Need and Scaling Up

As the Swachh Bharat Mission prepares to expand, variations on the Vizag model are now being custom-designed and operationalized for the next round of target cities. Just as Vizag targeted specific city wards based on unmet sanitation needs, the PMU has created a system to rank all of India’s 4,041 cities by cleanliness, so that Swachh Bharat can prioritize interventions in areas of greatest need.

The magnitude of India’s urban sanitation challenges is substantial — but so has been the government’s response.

Swachh Bharat is increasing public involvement, and attracting young people by taking advantage of India’s extensive mobile connectivity. The number of wireless telephone subscribers in India is greater than the combined populations of the United States, Indonesia, Brazil, and Pakistan. A Swachh Bharat hotline now allows cell phone users to quickly report sanitation issues, or instantly share sanitation problems or success stories on social media using the hashtag #MyCleanIndia.

Swachh Bharat is taking advantage of widespread cell phone usage in India to improve urban sanitation; a hotline now allows residents to easily report issues. Photo Credit: John Hoey

Cleaner Cities, Healthier Futures

While much success has been seen, developing and implementing a successful fecal sludge management system for communities that reach ODF status will not be quick or easy. It is important to recognize the magnitude of India’s urban sanitation challenges is substantial — but so has been the government’s response. The campaign is now well positioned to build on its early successes and take root in India’s more than 4,000 cities.

One neighborhood at a time, Swachh Bharat is laying the foundation for a healthier and more prosperous future for the 300 million who call India’s cities their home. We at USAID will continue to support these efforts, help enable sustainable sanitation improvements, and eliminate open defecation.

By Christian Holmes, USAID Global Water Coordinator and Deputy Assistant Administrator in USAID’s Bureau for Economic Growth, Education and Environment (E3)

To subscribe to Global Waters magazine, click here, and follow us on Twitter @USAIDWater. This article appears in Global Waters, Vol. 7, Issue 4; for past issues of the magazine, visit Global Waters’ homepage on the USAID website. For more information on USAID/India, click here. For more information on Swachh Bharat, click here.

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