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Thursday, July 19, 2018

From swachh to swasth

India does need these toilets badly. Over half a billion people practice open defecation, the highest number in the world.

Written by Poonam Muttreja | Updated: March 28, 2016 12:14:19 am
household_toilet_759 This momentum has prompted the finance minister to almost triple the allocation towards the SBA in the just-announced budget — from Rs 3,625 crore in 2015-16 to Rs 9,000 crore for 2016-17.

The Swachh Bharat Abhiyan (SBA) has a target of 12 crore toilets by October 2019. That makes for 2,739 toilets a day, almost two toilets every second! Work on the toilets is on track. In fact, reports show that the targets are being surpassed. In 2014-15, the very first year of the programme, 87 lakh toilets were built, far more than the target of 60 lakh. Now, we are set to cross the target of 1.2 crore toilets by March 2016. This momentum has prompted the finance minister to almost triple the allocation towards the SBA in the just-announced budget — from Rs 3,625 crore in 2015-16 to Rs 9,000 crore for 2016-17.

India does need these toilets badly. Over half a billion people practice open defecation, the highest number in the world. We pay a heavy price for this: Stunted growth of children, high child mortality, and a massive economic cost due to ill health. A World Bank study estimated that India loses 6.4 per cent of its GDP or $53.8 billion (approximately Rs 3,689 billion) every year due to lack of sanitation.

Yet, recently, about 90 families in a village in Bareilly district in Uttar Pradesh demolished the toilets that had been built under the scheme; toilets for which they did not have to pay a single rupee. The government had borne the entire cost of Rs 12,000 per toilet. What then, went wrong?

Surveyors from the National Sample Survey Organisation found that only half of the toilets built in rural and urban areas are being used for defecation. The remaining are being used to stock grains or animals, while the people continue to go in the open. Why is this happening?

After the Bareilly incident, the district panchayat raj officer expressed frustration and amazement at the razing of the free toilets. “We had tried to educate the villagers through documentaries and lectures on the harmful effects of defecating in the open,” he was quoted as saying.

How the message is delivered is of the greatest importance. The message has to resonate with the audience and grip them. The efficacy of “edutainment” in changing behaviour has been demonstrated in many experiments across the world. The Population Foundation of India (PFI) in March 2014 sought to change deeply entrenched thinking and practices on child marriage, early pregnancy, sex selection, the acceptance of domestic violence and the non-use of contraception through Main Kuch Bhi Kar Sakti Hoon, a transmedia initiative.

An independent endline evaluation carried out in selected districts of Bihar and Madhya Pradesh showed that through a mere 52 episodes (aired by All India Radio and broadcast by Doordarshan) over eight months, there was a shift in peoples’ deeply entrenched views. Married men and women and mothers-in-law, the groups that we studied, were now more aware of the dangers of early marriage, the necessity to space pregnancies, the laws on sex selection and child marriage. They had become confident in accessing family planning services.

When demand is generated, people go all out to get the product or service, are ready even to pay for it. In one of our field programmes, two women, both sisters-in-law in an Agra slum, wanted to build a toilet after being convinced by our partner NGO of its necessity. They stood up to their father-in-law, who insisted that the family did not need a toilet as they were used to going in the open.

When they failed to convince him, they asked the NGO outreach worker for help. The worker too made little headway with the old man. After a few days, the sisters-in-law called the NGO worker and told her to complete the formalities. They were ready to pay their share of Rs 3,000 through their individual savings. The toilet was built. The women are happy as they no longer have to get up at dawn and rush to a field a kilometre away. The toilet offers them dignity, privacy, hygiene, and personal safety.

It is essential for communities to be involved in the initiative for them to own it. When this happens, there is no doubt that health services improve. The administration is forced to act. Currently, the focus seems to be solely on meeting targets — targets that focus on construction, not usage. We must move from construction to demand. For that, reaching out to the communities with powerful messaging is important. Toilets that are constructed then will never be razed. They will be cared for and used.

The writer is executive director, Population Foundation of India

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