For Swachh Bharat to succeed, open defecation must end

According to the World Health Organisation one gram of human faeces may contain 10 million viruses, one million bacteria, 1,000 parasite cysts and 100 worm eggs. A scary fact when you remember that globally India has the highest population of people, some 595 million who defecate in the open and not in a toilet. It is an equally scary fact for Vandana born into a family without a toilet at home. Due to the poor life circumstances of her mother, she is already joining India’s 61 million children under five years of age who are stunted - a stunted body, a stunted brain, a stunted life. Stunting and poor sanitation are linked. A child growing up in an environment where there is a constant risk of fecal-oral contamination is less likely to be able to absorb nutrients and therefore will not gain full nutritional value of food.

Through "Swachh Bharat" there is a clear commitment to end open defecation by 2019. This is good news because the intention aims high, yet significant challenges remain if this target is to be achieved. To stop "poo" wreaking havoc on India’s health, environment and economy, some 2.25 crore quality toilets must be built annually between now and the 2019 deadline. And here’s the crunch - each one must be a wanted toilet so that it will be used.

Only a wanted toilet will help Vandana’s plight and only wanted toilets will positively impact the whole population. Wanted toilets are the result of a process where households and communities learn about the benefits of safe excreta disposal and then make a collective and conscious decision to invest in household toilets. An open defecation free India would mean that wherever you reside, regardless of your status and wealth, you will no longer risk living, travelling, playing and working in an environment that is overloaded with toxic fecal matter. Your risk of diarrhea will be reduced and India’s rivers will be much cleaner.

Yet Vandana and her mother do not read government guidelines and those around them may not understand the benefits of using a toilet. They and millions like them need someone else to help them realise good change in their lives. While local development is the domain of communities and their leaders, the role of district administrations has never been more important. District administrators have an unprecedented opportunity to be public health champions. Carrying responsibility for multiple social welfare programmes they can ensure that investments in health, nutrition and sanitation come together in an easily accessible way for every mother, child and household.

For Vandana’s sake, it is time to think big. A district in India can have up to a crore population and this means tackling the complexities of planning for open defecation free status at scale. It also means mobilising armies of foot soldiers able to inform and educate where knowledge of the importance of sanitation is missing or where inculcating new habits requires persistent reasoning, triggering and persuasion. It requires an environment where community based organisations and self-help groups can flourish and where local markets can readily supply the component parts required to construct a quality toilet. Administrative processes need to be rationalised and converged to allow local governments and other planning entities to plan, implement and monitor together. Achieving this situation is challenging and it is all too easy to lose sight of Vandana’s needs. In many states the institutional structures for sanitation are not yet in place and district administrations ask how they can possibly meet ambitious targets for toilet construction while grappling with the human resources needed to motivate mass behavior change at community level. Yet despite the challenges some districts are moving forward and Nadia District in West Bengal is but one example. Here the District Magistrate has his sights set on achieving open defecation free status by the end of March this year. After starting the "Mission Sabar Shouchagar" in late 2013 the initiative is reaching its final stage. Leadership and an oath by the people are proving central to this dramatic change with some 2.72 lakh toilets already in-situ.

Champions do exist at all levels. However India will only be open defecation free when people are able to connect with their rights and understand what they and others are responsible and accountable for. Finding ways for those without facilities to tell their stories to those for whom access to a toilet is taken for granted will help this process. This is why UNICEF is committed to supporting both a people’s movement to create demand for toilets and the process of societal change. Everyone in India needs to understand the problem and be part of the intention to see an open defecation free nation.

So, is it possible to realise an India where a new sense of citizenship emerges? Citizenship that supports this most basic social issue – the need to end open defecation and start using toilets. A society where readers of an article like this one are motivated to raise their voice to maintain political pressure and demand that institutional reform is fast tracked to empower champions wherever they emerge.