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Reflections on India's enormous sanitation challenges and some opportunities

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I was in Delhi recently. It was great meeting people. There was much debate and discussion going on about sanitation and hygiene. These are much higher up the public agenda than before. And the new Minister, Jairam Ramesh, was spoken of highly by everyone. If anyone can make a difference through political leadership, perhaps he can.

NGP Awards
Vinod Mishra managed to wangle me a ticket to go to Nirmal Gram Puraskar awards. This is when those who have been outstanding in achieving ODF conditions at the local level in their states are recognised and rewarded by the President. It was a celebration and gave a sense of progress and hope. The President and the Minister both spoke.

Reality check
But the reality ‘out there’! Yes, there are champions and islands of success, represented on such an occasion. But the scale of India just blows the mind. The enormity of the challenge and task is stark in the latest figures. Both the JMP (Joint Monitoring Programme of UNICEF and WHO) report for 2010 and the India census for 2011 had just come off the press. They confirm each other.

Latest sanitation data
Population increase, and slow progress compared with other countries mean that India now has 59.4 per cent of the open defecation (OD) in the world (626 million) up from 56 per cent in 2000. The proportion doing OD in rural areas is down in percentage terms from 79 in 2000 to 67 in 2010 but the absolute numbers have barely changed – 599 million earlier and 574 million now. According to the census, the number of households without latrines in India has actually risen.

Missing toilets
And then there was this statistic which I found it hard to believe, of ’60 million missing toilets’, meaning toilets or latrines reported constructed but not found by the census on the ground. Someone may have a better figure than this. The money has been spent but the structures are not there. 2012 had been the national target date for achieving ODF conditions. As the Minister had some weeks earlier publicly pronounced, the Total Sanitation Campaign has been a failure. And on OD he has now called for’ a social revolution to remove this blot from society’.

Just imagine what this would mean
Imagine an ODF and hygienic India where there had been radical behaviour change. There is an economic point, that the annual increment to GDP would be the 6 per cent or so that is currently lost, but that is far less important than the gains in human wellbeing. These would be prodigious. Faecally-related infections would not stand a chance. They would all be cut off at the anus. Diarrhoeas, hookworm (200 million cases), intestinal worms that steal food, and the many other faecally-related infections would be decimated. Child undernutrition, with India having currently a third of those undernourished in the world, might be halved or more (who knows how much, are there any studies?). Poverty (over a third of those in the world on under $1.25 a day) would be reduced, with far fewer unable to work, or weak, or becoming poor or poorer through sickness and its costs. And the transformation for the physical wellbeing of many, many millions of adolescent girls and women would be profound.

India’s new sanitation policy
The new target date for ODF India is 2022. The Minister has announced the provisional outlines of a new policy. They include a much larger budget, more than doubling the hardware subsidy to individual households, abolishing the positive discrimination (which did not work) towards poorer households,and decentralising funds to the Gram Panchayat (cluster of villages) level. A very good development is that the focus is to be on achieving ODF communities rather than toilets constructed.

But will this work? Will this deal with the problem of targets, of misleading reports and missing toilets? Will the poor gain, or will the better off once again cream off the benefits? How will a bigger budget feed through the system? Will Gram Panchayats do any better than the previous system? A cynic might see in this scope for more, not less, corruption, and yet more gains to local elites. So much depends on detail, process, procedures, checks, transparency, truly democratic processes empowering the poorer, the weaker, the excluded….Let us hope that somehow the new policies and practices can overcome the deficits of the past.

And in all this, what about CLTS?
It has not been a significant part of the public debate, so far as I am aware. But given its extraordinary transformative power, is there a place for it in this strategy? It was a vital part of the strategy which was so successful in Himachal Pradesh. Indeed, without CLTS, is there any chance at all of getting close to the target of ODF in 2022? That is a tremendously important question.

How could CLTS fit in the new policy? What are the constraints? The higher rate of subsidy looks likely to make CLTS even harder than before. Can clever and leak-proof ways be found to prevent the extra funds for household hardware subsidies acting as disincentives, as they have donein the past? And given the prodigious scale of the challenge and opportunity, are there anything like enough good CLTS trainers and facilitators to make a significant difference? Suppose most, or several, states recognised CLTS as one way they wanted to go, how could the demand for training be met without a disastrous lowering of standards?

What are good ways forward?
It is too easy to make suggestions from a distance. But let me throw four ideas into the pot. Might these complement and supplement whatever the GOI and the States decide to do?

  • Champions and campaigns There is a lot to learn from the experience of Himachal Pradesh, where there have been strong champions in the Chief Minister, Deepak Sanan, as the responsible Secretary, and others at all levels, and where the State and Districts mounted sustained campaigns, supported by CLTS. So find and support champions. Mount campaigns with many initiatives and a sustained high profile. Assure champions continuity in post for a matter of years.
  • Monitoring and reporting Some way is needed to assure honest and accurate monitoring and reporting on what is happening. ICTs may present the way forward, perhaps based on the system already tested in Bihar using GPS, and recording progress in real time.
  • Multiplying CLTS training capabilities A first step would be a review and inventory of the very limited proven, quality CLTS training capabilities in India. These are a very, very scarce and valuable national resource. The assessment would be followed by a focused and funded training programme to concentrate these few key people and organisations on finding, training and mentoring others, to multiply and sustain good trainers and facilitators.
  • Learning enclaves States wishing to explore further the potentials of CLTS could ring fence and support ‘learning enclaves’ with champions where CLTS has been or will be piloted, as Madhya Pradesh has done, and which can then provide examples and inspiration to others.

What do others think?

Robert Chambers, Research Associate, IDS, UK

You may also like to read the following related news stories:

60% of world’s open defecators in India
Curb open defecation UNICEF tells India
Sanitation: India can’t meet target before 2054
Sanitation drive: a policy mismatch

Date: 2 April 2012