As the Swach Bharat juggernaut rolls on, homes in villages across Andhra Pradesh (as I am sure in other States) are trying to build a toilet. Here is a glimpse of the process that is to be followed in Andhra Pradesh (or at least in Chittoor District of Andhra Pradesh). Families interested in building toilets must inform the Panchayat Secretary. Once their application is approved the Panchayat Secretary gives the family the go ahead. The toilets have to be built according to Rural Water Supply and Sanitation Department’s specifications which has to be communicated to the family. The conditions are – site must be located away from the house, it must be a brick and cement construction with an Indian Style latrine. A soak pit must also be constructed. The family contacts neighbours / masons / construction labour who have some experience building toilets and gets an estimate. This ranges anywhere from Rs. 25,000 to 35,000 (July 2015 figures) depending upon the size of the toilet and local costs and availability of cement, brick, sand, sanitary fitting, labour etc. Government will release funds of Rs. 12,000 – 15,000 (numbers are not clearly communicated to the family but the Panchayat Secretary) after completion of the toilet and when a photograph is provided as proof. How does the family raise the money to build this toilet? Women borrow from Self-Help groups, private money-lenders at high interest, friends and family etc. In almost all cases the costs incurred are at least Rs. 10,000 – 15,000 higher than the amount allocated by the Government. The actual cost is even higher when you factor in the cost of loan repayment. Take the case of a all women household – an old widow who receives an old-age monthly pension of Rs. 1000. She is 70 years old and therefore cannot be a member of the SHG and hence cannot avail a loan. Her widowed daughter is 40 years old with a daily wages job earning about Rs. 2000-3000 a month. They desperately need a toilet since the mother is ageing and cannot make that early morning trip to the fields to receive herself. Where are they going to get the money? Even if the daughter takes a loan from the SHG how is she going to repay it and feed herself and her mother. Where are the achhe din and swachh bharat for these families? If the Government is serious about improving sanitation it must (a) provide simpler toilet design options that are not so material intensive (let us learn from sanitation programmes in African countries, Indonesia, Malaysia, Sri Lanka) and therefore cheaper to construct while being functional (b) create a cadre of on-the ground masons and construction workers who people can hire to build these units rather than be at the mercy of various contractors and (c) create a Fund for women-headed or elderly-headed households and other marginalised sections of society, which will provide interest-free loans with flexible repayment options. For once let’s really put our best foot forward and not resort to tokenism and political gimmickry!
A version of this blog is available on the Down to Earth blogs site.
The dust has settled (literally) after the October 2 sweeping gesture by politicians from the Prime Minister to local MLAs and we are back to business as usual. Dirty villages, towns and cities and the “swachata” is compounded by ope defaecation – a country that is one big shauchalya rather than swachalya! The sanitation problem of open defaecation and its effect on malnutrition, stunting has been debated extensively but there is no visible impact on the ground. Rural families interested in building toilets continue to run around for financial and technical support. Any Government support for construction of toilets requires that the CPHEEO manual’s design be followed – complex, water intensive and expensive. So what is the solution? How can we, seriously, address this problem of open defaecation? There are two studies that must be consulted and taken seriously both by planners and those working on the ground in the area of sanitation: the first is a paper in EPW by Diane Coffey and others. It provides very valuable insight into revealed preference for open defaecation through a survey of rural areas in some states of North India. This paper clearly shows the need for a region and state specific strategy taking into consideration local attitudes and preferences rather than merely focussing on infrastructure. The study urges the need for a large-scale campaign to promote latrine use together with investing in infrastructure (http://www.epw.in/system/files/SA_XLIX_38_200914_Diane_Coffey_ Aashish_Gupta_Payal_Hathi_ Nidhi_Khurana_Dean_Spears_Nikhil_Srivastav_ Sangita_Vyas.pdf). The survey reports that – “Many survey respondents’ behaviour reveals a preference for open defecation: over 40% of households with a working latrine have at least one member who defecates in the open. Our data predict that if the government were to build a latrine for every rural household that lacks one, without changing sanitation preferences, most people in our sample in these states would nevertheless defecate in the open. Policymakers in India must lead a large-scale campaign to promote latrine use.” What works in the Southern States may not work in the Northern States and the Western and Eastern States may require a different strategy.
Another study that must be looked at seriously is a recent paper published in the medical journal Lancet by researchers from Emory University in the United States. They found that increased toilet coverage did not lead to any significant improvements in the occurrence of child diarrhoea, prevalence of parasitic worm infections, child stunting or child mortality (http://www.thehindu.com/news/national/increased-toilet-coverage-has-little-health-impact-study/article6486660.ece). This new evidence is indeed troubling given India’s 25 year strategy that has focussed mainly on building toilets. The researchers have indicated that the absence of health impact could be “the patchy implementation of the scheme, and uneven rates of use of toilets — at the end of the study period, just 63 per cent of households in the villages where the scheme ran had any toilet, and two-thirds of this group reported a family member using the toilet. Usage was substantially lower among men than among women”. This gender difference was also notes in the study of the Northern States.