Sanitation: keystone of public health – K V Venkatasubramanian

                                                                                                                                               K V Venkatasubramanian

New Delhi,May 29, 2017 : Safe water, adequate sanitation and personal hygiene are indispensable for human health and progress. Lack of these can seriously impact psychological and social development of communities. The worst sufferers are women and children.

Some 300 million women and girls, mainly from underprivileged sections of society, defecate in the open, by one estimate. Deprivation of sanitation and toilet facilities imposes immense stress on women, who are forced to relieve themselves under cover of darkness. This poses threat to their safety and even life. Often, they are forced to reduce their food and water intake to minimise the need to exit home to use toilets.

Nearly 23 per cent of adolescent girls drop out of school for want and need of access to functional toilets, clean water and proper sanitation. These also affect children’s learning, safety and quality of their lives.

Unsafe water, poor hygiene practices and inadequate sanitation contribute to high incidences of diarrhoeal diseases, and under-five mortality caused by pneumonia, neonatal disorders and undernutrition, according to UNICEF. Contamination causes infection.  Absence of sanitation leads to contamination and results in infection.This contamination is a major cause of diarrhoea and leads to other major diseases such as jaundice, cholera, schistosomiasis (snail fever, caused by parasitic flatworms called schistosomes) and trachoma (a chronic contagious bacterial infection of the eye). Diarrhoeal diseases are also responsible for stunting in children (low height-for-age).

Poor sanitation and its resultant diseases have a telling effect on everyone and a country as a whole. It imposes heavy burden on human, economic and environmental health. Hence, a clean nation alone can make sustained progress.

Realising the magnitude of this problem, Prime Minister Narendra Modi gave a clarion call to end open defecation by providing clean toilets and improving sanitation. Nearly three years ago, he launched the Swachh Bharat Mission (SBM) on October 2, 2014. The SBM offers a promising solution to address the issues of sanitation and water, and aims to achieve universal sanitation coverage and make India open defecation free by 2019, the 150th birthday of Mahatma Gandhi.

The mission’s objectives are also to eradicate manual scavenging, effect behavioural change in healthy sanitation practices, and generate awareness about sanitation and its linkage with public health. It has two sub-missions— SBM-Urban (SBM-U) and SBM Gramin (SBM-G). The SBM-U focuses on making urban India free from open defecation and achieving 100 percent scientific management of municipal solid waste in 4,041 statutory towns. The SBM-G intends to bring about an improvement in the general quality of life in rural areas, by promoting cleanliness, hygiene and eliminating open defecation.

The progress on various fronts is being measured continually and updates are posted on the dashboard of the SBM website. So far, the advancement is impressive. Under SBM (Gramin), household toilet availability has improved by 22 percent to 64 percent since 2014; and over 2 lakh villages have self-declared to be open defecation free (ODF). Similarly, under SBM (urban), almost 32 lakh individual and community (and public) toilets have been built and 662 cities are ODF. Himachal Pradesh, Sikkim and Kerala have achieved 100 percent ODF status.

The Clean India campaign has, innovatively, induced a healthy competition among cities. The focus is on monitoring outcomes—the number of ODF cities and towns. A public survey places Indore as the cleanest city, and New Delhi (Lutyens Zone) among the top 10 clean cities in India. Gonda in UP is at the bottom of sanitation rankings of the survey of 434 cities. The study assessed cities and towns largely on improvement in processing of municipal solid waste and ending open defecation.

Infrastructure creation and citizen participation have created visibility on ground and begun showing promising results. Through several initiatives, the campaign has shaped a conducive environment for citizen participation. A social movement has steadily gathered impetus. Continually, the limelight is on stirring up attitudinal and behavioural change among society so as to make it a people’s movement.

Intensive multimedia communication campaigns through various media streams, ads on social media, introduction of apps, and billboards on streets remind public about the prime minister’s rallying cry. Celebrities have been roped in as brand ambassadors to motivate viewers and listeners on broadcast media to understand the importance of sanitation.

The mission stresses on toilets as key to women’s security. Ads on television and signs on village walls advise families to prevent their womenfolk from defecating in the open. To further the toilet construction programme, anew ad campaign on social media depicts women demanding their right to sanitation. The video ad, which highlights the plight of women, advocates a change in mindset among rural men folk about open defecation.

The campaign’s consistent thrust on cleanliness around historic monuments, public places and landmark cities–including heritage sights like Varanasi, Mathura, Agra and Lucknow—has changed public sensitivity about tourist places.

Toilet-building and sanitation are the two buzz words today. Clean India is not business as usual anymore—living with poor sanitation, that kills 50,000 people annually. Rather, it has stirred the collective conscience of people and has become everyone’s business—to throw filth out and bring health and happiness in.

*Author is an independent journalist and columnist with four decades of experience in all media forms – print, online, radio and television. He writes on developmental issues. 

Views expressed in the article are author’s own.