I have just had two remarkable weeks in India with the National Rural Livelihoods Mission.  This is a national movement of, so far, 2.4 million women’s self-help groups (SHGs).  Each has about 10 members.  Then there are Village Organisations of SHGs and Federations above them.  I was there to help explore whether these SHGs and their organisations could take a lead in the drive for rural sanitation.  This involved field visits in Telangana (formerly part of Andhra Pradesh) and Bihar, and three brainstorming workshops, the last one at national level in Delhi, convened by the World Bank which supports the NRLM.

The appalling conditions of much of rural India are well known. Things have been getting worse.  India has 60 per cent of the open defecation in the world, up from 55 per cent in 2000 and 51 per cent in 1990. The 2011 census found 8 million more rural households defecating in the open than in 2001.  The amount of shit deposited in the open daily per square kilometre has been going up in many Districts, especially in the north in the so-called Hindi belt. International comparisons of Demographic Health Surveys by Dean Spears has found 65 per cent of stunting accounted for by a combination of open defecation and population density.  In India the percentage of children stunted has stubbornly dropped only slowly, slowed by faecally-transmitted infections (FTIs), exposure to which has in so many places intensified.  This is a national emergency.  Open defecation in rural India is one of the greatest challenges of the first half of the 21st century.  If it could be eliminated, the gains in human wellbeing would be immense.   For some who read this, this is well known.  But it bears repeating, again and again.

In the middle of my visit came August 15th, Independence Day and a dramatic surprise.  The newly elected Prime Minister, Narendra Modi, made his first major speech to the nation.  Unexpected and inspiring.  A poll that asked if it was a good speech registered 90 per cent yes and only 6 per cent no.  He attacked female foeticide, said he would introduce an oath in marriages not to practice it, stressed the suffering of women from lack of toilets and having to wait until dark, and gave much prominence to his target of a Swachh Bharat, a Clean India, by 2019.  Sanitation and women are very high on his agenda, supporting so well the idea of the women in SHGs taking a lead with rural sanitation.

We can hope for a massive national campaign.  Collective behaviour change, by all in communities, all together, is the key.  But can SHG women, their Village Organisations and Federations, spearhead this?  With their many other activities, do they have the time to give this priority?  Can they be fired up with energy and passion to make something happen?  Can they do this at scale?  Certainly, SHGs are very widely spread and there are plans to cover almost all the country.  But can they reach out beyond their members, and trigger other families in their villages?  They may persuade men to dig toilets.  But can they persuade those many men who prefer OD and consider it healthier and better even for children, to use them, and to use them all the time? 

These are some of the big questions and challenges.  To meet and overcome them needs creativity, experimentation, trials, learning rapidly what works and what does not, and then spreading the solutions.   If in, say, a year there were approaches and methods that were proven, and if these could then become widely practised by SHG women, the impact could be immense.

And the need?  In Bihar we were taken to a village close to our hotel.  It was relatively clean, and the SHG was active.  It was not ODF but making good progress.  Then we asked if we could visit another on our way back to Patna.  The members of the SHG were lively but poorly informed – they thought there was nothing between a latrine and a septic tank which cost Rs20,000 or more. So they were stuck without toilets.  We walked around.  Gruesome.  Mud, dirt, a ruined government built toilet, and rubbish, rubbish, rubbish everywhere.  An image haunts: a small boy with swollen belly standing in mud, leaning listlessly against a tree, and other children playing in the squalid filth behind.  This is what it is about.  This is not something to tolerate in our world.  This has to be put an end to.  Let us hope that the vision, energy, courage and commitment of India’s rural women will show the way to a Swachh Bharat, the Clean India the children deserve.