Creating a new normal

Swachh Bharat has garnered international support and emulation, and NGOs, national and international development agencies have mobilised across India’s least well-off districts.

Written by Val Curtis | Updated: July 22, 2017 12:35 am
swachh bharat, open defecation, toilets, swachhta status report 2016, big hairy audacious goal, bhag, indian express columns According to the Swachh Bharat dashboard, 44 million toilets have been built since the declaration of the BHAG in October 2014.(Illustration: C R Sasikumar)

India has set itself a seemingly impossible goal, to end open defecation by October 2, 2019. This is a tall order, as Diane Coffey and Dean Spear’s new book: Where India Goes, points out. Why do organisations set themselves such apparently impossible tasks? Ending open defecation for all Indians by 2019 is what is known, in management parlance, as a BHAG, a Big Hairy Audacious Goal. Leadership experts know that by offering a worthwhile, but difficult to achieve vision, you can mobilise an institution, motivate a workforce, drive change and, sometimes, even reach that goal. The archetypal BHAG was set by the great leader John F Kennedy in his speech in 1961, when he said, “We chose to go to the moon in this decade and do the other things — not because they are easy, but because they are hard.”

It has long been known that lack of toilets allows faecal germs to spread, which cause sometimes fatal illnesses like cholera and diarrhoea, especially among children. But there is a more insidious danger from human excreta. As Coffey and Spears’ book sets out, Indians are shorter than they should be, and this pattern of stunted growth cannot be explained by genetics, poverty or lack of food. Being born and brought up in a place where open defecation is common means that guts are constantly being damaged by faecal pathogens and parasites. Undernutrition sets in, leaving kids more vulnerable to infections, which in turn make them more malnourished. Energy is diverted from cognitive development, lowered intelligence compromises the ability to earn and poverty is entrenched. By one estimate, open defecation costs India a staggering 6.4 per cent of its GDP.

Seen in this light, India has no choice but to declare war on open defecation. And with the declaration of the BHAG, the government machinery from the prime minister to chief ministers to district magistrates, has swung into action. Across India’s more than 600 districts, hundreds of thousands of village sarpanches and pradhans, teachers, youth groups, women, children and entire communities have come together, joined vigilance committees, made pledges, built toilets and stopped defecating in the open. Billboards and wall paintings talk about the previously unmentionable toilet and excitement is maintained through events, competitions, awards, social media and now a new feature film called Toilet — A Love Story is about to release. Even the PM devotes a section of his radio address to the nation, Mann ki Baat, each month to the campaign. Swachh Bharat has garnered international support and emulation, and NGOs, national and international development agencies have mobilised across India’s least well-
off districts.

According to the Swachh Bharat dashboard, 44 million toilets have been built since the declaration of the BHAG in October 2014. Over two lakh villages are open-defecation-free, as are 149 districts and 5 states. And the numbers keep ticking up, even as you watch the dashboard http://sbm.gov.in/ sbmdashboard/ all adding to the sense of excitement and movement towards a goal. The BHAG is doing what it is supposed to do, igniting institutions around a visionary, but hard to achieve, goal.

There is, of course, still a long way to go to achieve the BHAG, as Coffey and Spears repeatedly state. Getting toilets to every household in India is a huge task, with more than a third of the country still to be covered. But there is another challenge to the BHAG: Not everyone who has a toilet, chooses to actually use it. Government has thus had to switch focus from building toilets to encouraging behaviour changes that can make villages truly open defecation free. Their surveys now aim to measure use as well as construction. The Quality Council of India as well as the World Bank’s Independent Verification Agents (IVA) have been commissioned to survey nearly 1,00,000 households sto measure both toilet coverage and usage. The NSSO’s Swachhta Status Report 2016 puts usage among toilet owners at upwards of 90 per cent, which is encouraging.

So can Swachh Bharat achieve its BHAG of ending open defecation? After a clearly argued data-backed analysis of why open defecation is harmful and why it persists, Coffey and Spears depart from their area of expertise and turn to a rambling and emotive attack on current policy. Coffey and Spears seem to be saying that incentivising building toilets at a rapid pace is damaging because many are poorly constructed and some are never or partially used. This makes little sense from three perspectives.

In the first place, it is incorrect to argue that a policy is poor for the reason that some aspects of implementation are challenging. Second, even if 20 per cent of these new toilet owners continue to go to the bush, the reduction in infection from the 80 per cent who use toilets will provide substantial benefits. Third, it flows from behavioural science that the very presence of a toilet is a constant reminder that society is changing, that new norms of hygienic behaviour are expected. It will inevitably take longer to change the behaviour of some stubborn individuals, but as the conveniences and advantages become obvious, toilet usage will become a new routine, the new normal.

Academics will continue to play their important role of questioning government policy and remind them to use best practices. Government must listen, but it must also continue to march on to achieve results. Will India prove able to do something that seems even more difficult than getting to the moon? Will 130 crore Indians be free of open defecation by the 150th birthday of Mahatma Gandhi in 2019? Only time will tell, but India is at least on a mission to reach its BHAG sooner rather than later.

The writer is professor, London School of Hygiene and Tropical Medicine

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