Talking about revolution is easy. But try discussing sanitation in the same animated way, and watch jaws drop.
Polite society will sniffily walk away. Submerging or emerging, India has traditionally treated sanitation like a taboo subject, much like sex. Even today, we speak about it mostly in whispers or in lingo that is so jargon-laden that it obfuscates more than it reveals. Net result: report after report confirms that India is a world leader in ‘open defecation.’ We still don’t say clearly or loud enough that we are in deep shit.
Which was why I was delighted when minister for rural development and drinking water and sanitation Jairam Ramesh tossed a teaser, ‘Why do women want mobile phones more than toilets,’ before an august gathering during the launch of the UN’s 2011-12 Asia Pacific Regional report on Millennium Development Goals.
Ramesh has been hauled over the coals for that remark. Fuming activists have accused him of being insensitive and for blaming women for poor sanitation in India. But the good thing is that the brouhaha has brought the toilet-cell phone debate back in the spotlight and we are discussing sanitation in the run-up to the budget. I suspect that was exactly what the media-savvy minister intended.
More Indians have access to a mobile phone than to a toilet. Everyone knows that. The issue became a major talking point in 2010 when a report by the Ontario-based UN University’s Institute for Water, Environment and Health pointed out that while India had roughly 366 million people with access to improved sanitation in 2008, a far greater number, 545 million, had cell phones.
Today, nearly 74% of India’s population, over 880 million, own mobile phones. The latest figure for toilets is not available but all reports including those from the UN and other agencies indicate that India lags woefully behind in sanitation.
Why do so many people feel the urgent need for a mobile phone but not a toilet? Why do so many of those who have toilets not use them? Why don’t they wash their hands with soap before a meal and after defecation though the authorities have been asking everyone to do so, and are pointing out the link between water, sanitation, hygiene and health?
The Total Sanitation Campaign has been a bit like a token sanitation campaign, in Ramesh’s words, because of the ‘pittance’ it received in government funds.
This leads to several problems. The government doles out Rs3,000 to poor people to build a toilet. But a proper one costs at least Rs8,000, as Ramesh himself noted. There is little support from banks to lend the rest.
But it is not just the money. The crucial reason is the perception of ‘need’. Today, every Indian feels he or she ‘needs’ a mobile phone, something that cannot be said for toilets.
In the early days of the TSC, officials focused on increasing the number of homes with toilets. But they found this did not lead to a proportional increase in toilet use.
There are pockets of progress in the country. For example, Sikkim does not have ‘open defecation.’ But there are millions who are still not aware of how strong the link between toilet use, health, and development actually is. As the UN report points out, ‘countries that offer better access to safe sanitation are likely to have lower levels of maternal mortality… and sanitation is also seen to be associated with a lower proportion of underweight children.’
So like the mobile phone, having and using a toilet at home is also a tool for progress. Why is it not seen as such? The major problem, of course, is the tradition by which toilets are seen as unclean, which should not be inside the house. Associated with that is the social acceptability of open defecation. Rising literacy and exposure have significantly helped change such attitudes. But vast numbers of people in this country remain illiterate and the challenge of ‘selling’ sanitation to them is harder.
Studies show that there is a link between high income and ownership of toilets. But significantly, ownership does not always mean usage or maintenance. The key factor is effective communication, taking the gender and caste dimensions into account. Just because there is a toilet at home does not mean everyone at home gets to use it. Maintenance of community toilets hinges on who is tasked to clean it.
Far too often, official communication campaigns do not make these points strongly enough. Nor do they draw the link between open defecation, diarrhoea and medical bills as clearly as they can. That may be the only way to make people think they need a toilet as desperately as they need a mobile phone.
The author is a New Delhi-based writer