A Reality Check on Sanitation at the Grassroots

This paper was presented at the Water, Sanitation and Hygiene (WASH) Institute
NATIONAL CONFERENCE ON “COST EFFECTIVE SUSTAINABLE SANITATION – AN INDIAN EXPERIENCE”
28th  –  30th June 2010

ABSTRACT:

The paper will share the experience of initiating a village sanitation project and offer some solutions on how sustainable sanitation at the grassroots level can be promoted based on the project’s experience.  The paper details the various obstacles that had to be overcome before the project could be implemented, examine why these problems were faced, discuss the methodology of how the project was implemented and finally share with the participants some out-of-the-box innovative solutions used to overcome the challenges.

SANITATION: A HUMAN RIGHT

India, the world’s largest democracy, is a land of sharp contrasts. On the one hand, India’s economic boom has enabled millions to raise their standard of living, yet, approximately 40 percent of India’s population still continues to live in poverty without access to the basic human necessities of safe drinking water and adequate sanitation. India’s advances in science and information technology are extolled the world over and yet, 600 million of our countrymen still defecate in the open. A recent study published by the United Nations University, a UN think-tank, revealed that only one third of India’s population of 1.2 billion had access to improved sanitation while mobile phone users numbered around 545 million. Apparently, the average Indian considers a mobile phone a greater necessity than a toilet.

Access to sanitation is as basic a necessity as food, shelter and clothing and plays a crucial role in improving human health leading to a better quality of life. Yet, worldwide, 39 percent of the world’s population, roughly 2.6 billion people has no access to basic sanitation with around 1.1 billion people still defecating in the open according to a joint WHO/UNICEF report released in March 2010. Although there is a global decrease in open defecation, 44 percent of people in S. Asia continue to practice this unsanitary habit.

In addition, contaminated water and lack of sanitation claim the lives of 2.2 million children under the age of 5, with 1.5 million of them dying from diarrhea. Under such a scenario, how is it possible to achieve the Millennium Development Goal (MDG) of halving the number of people without access to proper sanitation by 2015? The urgency and benefits for human and economic development in achieving this goal are manifold — the lower cost of health-care, a higher standard of living, boosted school attendance, increased productivity and cleaner surroundings. Sufficient funds and resources therefore, need to be allocated by governments to speed up progress towards the MDG target of sanitation for all.

The Total Sanitation Campaign (TSC) launched by the Government of India in 1999 had, as its major goal the improvement of sanitation and hygiene in rural areas and the eradication of the practice of open defecation by 2010. As per the census data of 2001, only 36.4 percent of the total population in India had latrines within or attached to their houses. Thanks to TSC however, an additional 31 percent of the population, or roughly 366 million people are now using improved sanitation facilities, according to UN sources. Incentives offered to promote sanitation are in the form of subsidies to poor families to construct toilets, as well as cash awards like the Nirmal Gram Puraskar to villages which have achieved TSC goals.  In addition, there are also disincentives for defecating in the open such as heavy fines and the withholding of important documents like ration cards, income certificates, and 7/12 extracts required for registration of property for new homes, etc.

A large gap however, still exists between urban and rural areas. Statistics provided by UNICEF in 2006 have clearly indicated that lack of sanitation is largely a rural problem with only 18 percent of people living in rural areas having access to improved sanitation facilities as opposed to 52 percent in the urban. The number of rural families in Maharashtra with access to toilet facilities has more than tripled, but it accounts for only 20 percent of the rural population, far short of the target that the government is hoping to achieve. Therefore, it is debatable whether – even by 2020 – TSC’s target of 100 percent sanitation coverage will be achieved.

Development of India’s many villages has been recognized as a central plank of the country’s development agenda ever since Mahatma Gandhi drew attention to their plight. Gandhi rightly deplored the poor sanitation in villages with this apt description, “The approach to many villages was not a refreshing experience. Often one would like to shut one’s eyes and stuff one’s nose; such is the surrounding dirt and offending smell. A sense of national or social sanitation is not a virtue among us.” It is sad to note that even after more than sixty years of India’s independence, not enough change is visible despite crores of rupees sanctioned for rural development and campaigns like TSC.

Each day, an estimated 100,000 tons of human excreta are left along the roadside and railway tracks, in rivers, and lakes, in fields, and near wells used for drinking allowing diseases to spread rapidly. Yet, major priorities like the provision of facilities and infrastructure for adequate and clean drinking water and sanitation including toilets, which would lead to better hygiene and health for villagers are still sadly lacking. Local Governments mouth slogans like “Swachhata Abhiyan ” (Operation Clean up) but do not provide adequate funds to build sanitation facilities in village homes or even for village clusters. Efforts made by TSC have only been able to make a dent in improving village sanitation.

From the macro picture, let us move to the micro and examine the reality of a sanitation project implemented at the grassroots level by Ashta No Kai (ANK), a rural NGO started a decade ago with a desire to empower and improve the quality of life for women and girls in India’s underdeveloped rural areas. In the past decade, ANK has successfully transformed the lives of hundreds of rural women and girls. More than 2,000 women have been deeply influenced by ANK’s commitment to education, literacy, health, financial independence, and social justice. They have been helped to personal empowerment and some degree of financial independence by the activities started and sustained by ANK since 1999.

The combination of added financial autonomy and increased confidence levels has given rural women a significant voice in their communities. It has assisted women in search of their own voices to make the transition from passive acceptance of their fate to becoming vocal and active partners in the development of their communities. Women in ANK villages have begun to assert themselves as can be seen by their active participation in Gram Sabhas (village assemblies) and their campaigns against social maladies such as alcoholism, early marriages and infrastructure problems like water shortages, lack of toilets and bad roads.

PROJECT LOCATION: Shirur Taluka, District Pune, Maharashtra

The project area is spread over 10 drought prone villages and hamlets located in the interior of Shirur Taluka at a distance of about 55 to 70 kilometers from Pune along the Pune-Ahmednagar highway, with an approximate population of 15,000 (male: 7663 and female: 7329). The villages lack basic infrastructure, such as adequate schools, clean water supply, toilets, electricity, health care facilities, and transportable roads.

The project’s target area villages have been divided into three divisions as per their geographical proximity:

Area I: Kasari, Khandale, Karanjawane, Kondhapuri
Area II: Parodi, Takli Bhima, Dahiwadi
Area III: Sone Sanghvi, Dhok Sanghvi, Nimgaon Bhogi

SOCIO-ECONOMIC STATUS OF PROJECT AREA

The project area receives scanty rainfall and its low ground water table further affects crop cultivation. A typical village consists of a central cluster of houses, surrounded by many satellite hamlet settlements, which are two to five kilometers away. Accessibility to many hamlets is difficult due to lack of transportation and bad roads. As in many parts of the country, the status of women in Shirur Taluka too is low. Poverty, ignorance, illiteracy, social traditions, superstitions and political pressures still continue to hamper women’s progress and affect the quality of their lives.

STATUS OF SANITATION IN ANK VILLAGES

Open defecation is still widely practised in ANK villages too. A large number of village homes in the ANK target area have no toilets. An area within the home is often cordoned off for washing and bathing but no space is allocated for a toilet. Public spaces continue to be used for the purpose of human defecation, but the pressure on land has led to the gradual shrinking of space for such purposes. Although some of the wealthier villagers have built toilets perhaps as a status symbol, the poor, until recently, had no other option but to use the outdoors as a toilet. The hygiene situation in the villages is further exacerbated by the scarcity of water leaving much to be desired in terms of personal hygiene.

The lack of toilets is particularly hard on women in ANK’s villages making daily life for them an even greater struggle. The need for privacy often forces many of them to walk long distances and relieve themselves only before sunrise or after sunset. It is even worse for expectant mothers and mothers who have just given birth.  Other difficulties women encounter while defecating in the open are adverse weather conditions and the danger posed by wild animals. There have been several known cases in the villages of women getting severe injuries due to such attacks, which cost them dearly in medical bills. Worse, there is also the fear of sexual harassment and assault, or even rape when a woman ventures out alone. For the above reasons, many women are afraid to go to the toilet in the outdoors but have no other option. The men folk have no qualms about using public spaces to relieve themselves, but the need for privacy at such times for women is essential to their well-being.

Until recently, there were no toilets in the schools in ANK villages. Children were forced to use the surrounding open ground, resulting in a lack of privacy and in highly unsanitary conditions. This posed an even greater problem for adolescent girls in particular. Some of them dropped out of the school system in higher grades, due to this lack. As a result of the TSC campaign, today all the schools in ANK villages have toilets. However, they are unsanitary and unhygienic. It is quite clear that it is not enough to provide toilets. It is equally important to educate the school authorities and the children on their correct usage and maintenance.

SANITATION INITIATIVE LAUNCHED BY ANK

This paper will focus on and share the experiences of an initiative that ANK undertook to build individual toilets in Nimgaon Bhogi village in 2008. Wherever the Need (WTN), an NGO that was “committed to working in line with the Millennium Development Goals (MDGs) of 2015” was looking for a partner in rural Maharashtra to launch a pilot sanitation project using a new concept: the Eco-sanitation (Ecosan) toilet.  WTN had expertise in promoting sanitation through this innovative model and had successfully completed several communal, individual and school toilet projects in Tamil Nadu. When approached by WTN, ANK readily agreed to partner in the project, as the women of Nimgaon Bhogi had been repeatedly requesting ANK’s help in building toilets. The local government authorities had threatened to levy heavy fines on villagers who were defecating in the open. After a visit to several of the school, communal and individual toilet projects that WTN had successfully executed in Cuddalore, ANK was convinced that the Ecosan model rather than the traditional flush system type of toilets would be most beneficial to villagers from the environmental, the ecological as well as the health aspects.

The Ecosan Toilet Model:
The Ecosan model is one of the most effective models yet for promoting long-term sustainable sanitation. The toilet’s eco-friendly design breaks up human excreta into a dehydrated odourless compost-like material using a natural biological process. The toilet is an effective alternative to the commonly used flush toilets, especially in water-scarce areas, as it needs only about three liters of water as compared to 12 to 15 for a conventional one. Another feature of the toilet is that it has a concrete bottom which entirely isolates it from the surrounding environment. There is therefore, no contact between human excreta and the soil thus preventing surface soil and underground water sources from getting contaminated.

The Ecosan toilet consists of a raised platform above two watertight compost chambers which are used alternatively; while one is being used the other is composting. After defecation into the drop hole, ash or mud is sprinkled over the excreta after which it is closed with a lid to prevent any fly or mosquito menace. One of the hygienic features of an ecosan toilet is that it separates urine and excreta preventing possible bad odours as the faeces and urine are not allowed to mix. The urine is piped out directly into the soil and used to fertilize crops. This results in speeding up the growth of plants in the close vicinity of the toilets.

When one of the chambers is full, it is sealed at the top and left for about six to seven months to turn into compost. The compost is then removed by detaching a concrete slab at the rear portion of the compost chamber. When the first chamber is sealed the family uses the second chamber. The compost produced is either sold or used by the villagers themselves replacing expensive and harmful chemical fertilizers.

ANK felt confident that the simplicity of the Ecosan toilet design and the low cost construction would make it easy for the villagers in Nimgaon Bhogi to build it, using local labour and materials. However, it was important for villagers to understand the features of the new Eco-san type of toilets and appreciate its suitability for the village which lies in a water scarce zone.  The villagers were shown a CD to give them an idea of what the Eco-san toilet actually looked like and how it was to be used. It also demonstrated the various ways in which the toilet would be of benefit to the villagers besides the saving of precious water:

  • Their surroundings would become hygienic, and free from foul odours and unsightly conditions.
  • The villagers would be able to augment their income through selling the surplus compost.
  • The compost when used in their fields would yield a better crop.
  • It would improve the quality of their lives and the overall health of the villagers by reducing the spread of diseases, and preventing contamination of surface soil as well as water sources such as springs or wells.
  • This, in turn, would lead to considerable saving of medical expenses for village families as the incidence of disease would decrease.

METHODOLOGY

1) Mobilization of Local Community:
It is a well-known fact that the key to successful project implementation is to effectively sensitize and mobilize the local community and involve all stakeholders. Therefore, ANK held a joint meeting with the WTN staff, village women and members of the Gram Panchayat (local government at the village level) and proposed the idea of a communal toilet which would considerably improve the hygiene and sanitation in Nimgaon Bhogi village and encourage villagers to adopt better sanitary practices. A village survey was conducted to examine the feasibility of implementing the project there and to select an appropriate site for the communal toilet. During the survey however, it became clear that a communal toilet would not serve the needs of the village community as most homes were spread far apart. WTN then agreed to donate the same amount of funding to build Ecosan toilets for individual families.

Villagers often tend to depend on outside agencies like the government or NGOs to develop their villages. They are generally reluctant to take matters in their own hands and participate actively in the development of their village. However, when the villagers were advised that the project could only be initiated if they were willing to actively participate in it, both financially as well as in kind, they readily welcomed the initiative and agreed to cooperate fully in the project’s implementation. Convincing the community to invest in the construction of toilets was not a great challenge as the timing for launching the project was favorable. The building of toilets had already become a priority for the villagers since the local Zilla Parishad (ZP) (District government) had been threatening to levy heavy fines on villagers who were defecating in the open.

It was estimated that the total cost of one Ecosan toilet would be around Rs. 11,000. The villagers would be required to pay or provide material equivalent to one third of the total cost as well as donate their labour, a practice popularly known as Shram Daan, for its construction. ANK offered to bear the entire cost of construction for BPL (below the poverty line) families but required them to contribute their labor. Each family had to also ensure that they would help maintain the toilet in a hygienic condition.

ANK selected Nimgaon Bhogi for the project because it had a strong base in the village. There were 23 Self-Help Groups (SHGs) there with 300 women members who had strongly supported ANK’s past initiatives. Since women play a key role in influencing the family’s sanitary habits, it was felt that they would readily lend their support and promote the initiative. Financing for the toilets would not pose a problem either as the women would have access to loans from their respective SHGs should they require them. Moreover, the ANK worker in the village was a forceful leader and could help mobilize the villagers for the project.

2) House to House Survey:
Students of a Pune college volunteered some of their summer vacation time to conduct a house-to-house survey to help ANK select the beneficiaries for the project. The survey revealed that only 70 households among 244 in the village had toilets. Although all the villagers wanted ANK to build toilets for them, the NGO had to restrict the number to 80 as per the funding. While selecting the beneficiaries, first preference was given to poor families and then to SHG members.

3) Awareness Raising and Education:
To ensure the long term sustainability of the project, an awareness campaign on health and hygiene education was carried out with the help of a motivated resource person. Six workshops were held for the villagers, but were mostly attended by women from the 23 village SHGs. The focus of the workshops was both on the breaking of sanitation taboos as well as on the benefits of toilets in combating disease and the overall positive impact they would have on their lives.

It was important to deal with sanitation, particularly discussion of defecation in a culturally appropriate and sensitive way as it is generally regarded as a taboo subject, one that is not usually discussed in public. Using games, songs, slogans, and role play to get his point across on such an issue, the resource person made the women realize the critical need for sanitary latrines. The women were oblivious of the fact that squatting to defecate in the open led to greater pollution causing ill health and the spread of water borne diseases like chikungunia, typhoid and cholera, etc. It had not occurred to the women that faeces were a perfect breeding ground for a wide variety of flies and mosquitoes which settled on humans and contaminated the food they ate or the water they drank. At the end of the workshops the women realized the undeniable benefits of hygiene and cleanliness and were able to relate the significance and importance of sanitation to their everyday lives.

4) Model Toilets:
Model toilets were built initially for two of ANK’s field workers from the village. WTN sent expert masons from Tamil Nadu to help train local masons to build them. These toilets it was hoped would demonstrate the benefits of the Ecosan model; its simplicity of design, and ease of use. Women from all the SHG groups were invited to the toilet inauguration to see the toilet for themselves. During subsequent visits, the women were amazed at how odour free the toilets were and how little water was needed for their use. Subsequently, one of the field workers planted marigolds and a papaya tree near her toilet. Many of the women who visited the toilet were impressed by the healthy growth of these plants in such a short span of time.

5) Toilet Construction:
After three months of building the model toilets, toilet construction for the remaining 78 was carried out in stages, hamlet-wise. Experienced masons from WTN were sent again to work alongside local masons and thus expedite the completion of the project. Material for the toilets was collectively purchased bringing down the overall cost per villager and credit facility, if needed was provided through access to SHG loans. In addition, members from each of the beneficiary families volunteered their labour.

ANK faced many problems during the construction phase. The villagers would often not keep their part of the bargain causing unnecessary delays and problems for the masons. The NGO provided the bricks, cement, door and the toilet pans. The villagers were required to bring sand, and the material for the roof. Often the toilet construction would be kept pending as one villager or another had not brought one or more items thus causing needless delay. The contribution of labor too left much to be desired as often there would be no family member to help the masons. The villagers, in short, did not walk the talk.

6)  Monitoring:
After all 80 toilets were completed, ANK staff continued to monitor their use as well as conduct sanitation education programmes to encourage villagers to keep them clean. Surprise visits were continually made. Soon after the toilets were built, it was discovered that many families were using them to store farming implements, cattle feed etc. Other families found more ingenious uses for them. On one such surprise visit, the door of the toilet opened to reveal two chickens just having laid eggs there. It was evident that more than the lack of toilets it was the cultural taboos and attitude of villagers, particularly their unwillingness to change, that posed the biggest problem. Despite the fact that villagers had a toilet at their doorstep and the undeniable benefits of hygiene and cleanliness that would ensue if they used them, they continued to defecate in the open.

After the 80 toilets were constructed, ANK requested the local authorities to help monitor their use. For the first month or so, an officer came occasionally to the village to monitor them, but after it was reported that a man caught in the act of defecating in the open had died of a heart attack, the local ZP authorities slowed down their vigilance.

7)  Bal Panchayat (Children’s village council)
ANK formed a Bal Panchayat to encourage the use of the toilets in the village. Local school children from Standard 5 onwards were recruited to spread the message. A monetary reward of Rs. 50 was offered to any child who could persuade families who were not using the toilets to start doing so. To give greater impetus to the campaign, the children were also given inputs regarding the dangers of defecating in the open.  The weekly Kishori Mandals (adolescent girls’ group) that were held in the village also mobilized the girls to promote the toilet campaign by ensuring that their families and neighbours used them. It was truly heartening to find that many of the girls decided on their own that they would only marry into families which had household toilets.

8) Survey
Several toilet usage surveys were conducted in the village. The first survey done a few months after the toilets were constructed revealed that only one third were being used. Since villagers tend to be highly respectful and mindful of government authorities, ANK approached the local Block Development Officer (BDO) to hold a meeting in the village to persuade the villagers to use the newly constructed toilets. When asked why they were reluctant to use them, the women made several excuses saying that the roof had blown away or small children found it difficult to sit on them. The BDO warned that a heavy fine would be levied if they were found using the outdoors as a toilet. Despite these threats the villagers continued to defecate in the open. However, thanks to ANK’s relentless campaign, the most recent survey conducted in April 2010 showed that considerable progress had been made. Only 6 of the 80 family toilets were not being used.

9) WTN’s Role
ANK was fortunate to partner with WTN as it played a very supportive role in the project’s implementation. Thanks to WTN, the innovative Ecosan model was introduced which was found to be very suitable for the project area. More importantly, WTN generously provided the funding for the project as well as gave technical inputs and other support without which the toilet project could never have become a reality.

CHALLENGES FACED

In ANK’s experience, the biggest hurdle it faced in implementing the sanitation project was the difficulty in challenging age-old traditions and conservative rural mind sets and in convincing people to transform their way of thinking. It was hard to accept the fact that despite having a toilet at their doorstep, people still preferred to defecate in the open. It was also felt that the major responsibility for sanitation and hygiene in the village should be on the village community itself. Villagers needed to take a much more active part in monitoring the practice of open defecation and prohibiting it completely. The Gram Panchayat could have fined people found defecating in open spaces; similarly rewards could have been given to those who reported such incidents.

According to ANK, implementation of TSC at the grassroots level also left a lot to be desired. The lack of support and apathy on the part of the district TSC authorities was very discouraging. The stated goal of TSC was “to educate and unite people at the local level so that they are the motivators for change.” It was therefore, the responsibility of TSC to train and motivate people to take active part in sanitation campaigns in their respective villages. The role of TSC was extremely important in providing and sustaining momentum to the sanitation drive, but, in fact, until ANK stepped in to promote toilet construction in the village, no government programme on sanitation had been held there and no guidance or funding had been provided by the local ZP or the district TSC cell. The only information the villagers received from the local Gram Sevak was that the government had launched TSC and that all villagers were required to build a toilet near their home or face dire consequences.

As with most government welfare schemes, the implementing authority showed no commitment towards ensuring the success of the scheme and no concern for the well-being of the villagers. TSC showed greater interest in reaching targets in terms of the number of toilets built, rather than whether they were being used or not. The local officials tried to encourage BPL families to avail of special schemes that were offered by TSC to build toilets so they could reach their targets. All the schemes however, required that the toilet be built first and the subsidy be given later. The initial subsidy of Rs. 5000 per toilet soon dwindled to Rs. 1200 per family, a tenth of the amount it would cost to build a toilet. Is it any wonder that TSC finds it difficult to achieve its goals with such government policies that make for a “lose-lose” situation for all? One cannot help but ask, that, if the poor had access to funds and could build a toilet on their own, why would they need the subsidy in the first place?

RESULTS

Since 2008, ANK has persisted in its relentless campaign to persuade villagers to change their sanitary habits. Thanks to the efforts of ANK’s dedicated field worker as well as members of the Bal Panchayat and the Kishori Mandal who visited the women often to promote the toilets’ use, more families have started using them. Although the early survey results were disappointing there has been a steady and gradual increase in usage. ANK is determined to persevere and sustain the sanitation campaign until there is 100% usage and thereafter, keep monitoring to ensure that the use of the toilets is not discontinued.

In group discussions held with the women about the toilets, many positive aspects came to light. The women had begun to perceive the many benefits resulting from having individual toilets. They felt that the toilets gave them shelter from the monsoon, and more safety and privacy. No longer did they have to face the embarrassment, shame, fear and anxiety of going to the open fields. It greatly benefited the elderly as toilets were within easy reach, and ensured comfort and safety for pregnant women and adolescent girls, especially when they were menstruating. They were also grateful that the toilets had helped to keep their children and families relatively free from diseases enabling them to put the money saved on medical expenses to better uses. Although it was too early to remove the compost from the chamber, they were looking forward to the rich fertilizer they would soon be getting for their farms.

Despite the obstacles in its path, ANK was able to play an important role in providing a very basic amenity that would promote the well-being of the rural people. It had brought a better quality of life for the villagers of Nimgaon Bhogi, especially the women, and had helped to make a better tomorrow for at least some rural families.

CONCLUSION

There are still huge challenges that India will have to overcome before it reaches the MDG goal of providing environmentally safe sanitation to more than a billion people by 2015. Although the TSC programme has had limited success, statistics indicate that the progress has been slow but continuous. According to one UN study, open defecation in rural areas has dropped to 74 percent in 2006 from 89 percent in 1990. Oblivious of the health hazards not only to themselves but the entire community, however, large numbers of rural people still continue with the demeaning practice of open defecation. The road ahead is a long one indeed as the harmful effects of open defecation on the health of the people are still not sufficiently comprehended. Through a sustained government and media campaign, a greater emphasis needs to be placed on educating the public about the importance of sanitation and cleanliness. Discussion on sanitation needs to come out of the closet and into the public sphere to generate a mass movement if the MDG vision of universal access to sanitation for all is to be achieved sooner rather than later.