India’s campaign to end open defecation has been widely celebrated by officials as an innovative and aggressive success. Even Bill Gates recently declared that the country is “winning its war on human waste” with a 360-degree video. But independent surveys and investigations have come to a vastly different conclusion – that victory, unfortunately, is not in sight.
Three years ago, Prime Minister Narendra Modi launched the country’s most aggressive sanitation drive ever, called “Swachh Bharat” or the Clean India Mission. Among its targets is to make the entire country open-defecation free by Oct. 2, 2019 – initially, with the construction of 12 million toilets, but now, according to Gates, 75 million toilets.
According to the World Health Organization (WHO), almost half of India’s population – 626 million people – defecate in open fields, water sources, forests or other open spaces. That is more than double the number of people who practice open defecation in the next 18 countries combined.
Not only is the practice a major source of disease, but it also compromises the safety of women and girls. In order to maintain some measure of privacy, they often wait until dark to relieve themselves, which makes them more vulnerable to kidnapping, assault, rape and wild animal attacks.
So far according to a real-time dashboard by the Ministry of Drinking Water and Sanitation, more than 40 million household toilets have been built. Nearly 200,000 villages and three states have been declared open-defecation free.
“Officials know which states are on track and which are lagging behind, thanks to a robust reporting system that includes photographing and geotagging each newly installed toilet,” Gates wrote on his blog.
If those reports are accurate, then Gates is right to praise Modi for the “amazing undertaking.” But in December 2016, Indian Express journalists found grave discrepancies when they visited two districts, Dhamtari and Mungeli, that had just been declared open-defecation free for less than two months.
In order to be declared “open-defecation free” by the government, a village much achieve “the termination of fecal-oral transmission.” Therefore, no feces can be visible, and disposal by each household and institution must not contaminate soil or water, be accessible to insects or animals, involve the handling of fresh excrement, smell or appear “unsightly.”
In Dhamtari, reporters discovered that out of more than 300 households in Modhi village, roughly 100 did not have a toilet. One woman said she had never had a toilet or a visit from an official. Another Dhamtari resident said that officials told him construction of a toilet for his home was impossible and then asked him to pose for a photo with a neighbor’s toilet. When he went to check on his 12,000 rupee ($185) incentive grant, records showed it had already been disbursed.
The problems reported by the Indian Express were not new. Back in December 2015, Accountability Initiative at the Center for Policy Research in New Delhi surveyed 7,500 households in 10 districts across five states to study the implementation of Swachh Bharat.
They wanted to track down specific households that had constructed toilets to understand what motivated them to do so. But instead of a “robust reporting system” that Gates wrote about, Accountability Initiative found a list full of errors that made it “really hard to actually track those households.”
“Looking at the list, we found a large number of duplicate entries – so the same household being mentioned multiple times,” Avani Kapur, Accountability Initiative’s lead researcher in public finance, told Humanosphere. “We also found households and even villages misclassified – a household that’s supposedly in this village is actually in another village.”
Because the reporting system is bottom-up – households reporting to local leaders, who report to national ministries – Accountability Initiative found a “big disconnect” between the number of villages that have been declared open-defecation free and those that have been verified as such.
“Without having proper checks and balances of data verification, that’s where I think a large number of duplicate entries and misclassifications happened,” Kapur said.
To be fair, Kapur and her colleagues conducted the survey barely more than a year after the campaign was launched and she noted that government agencies are “taking steps to clean up the system.”
But even if the official construction numbers were accurate, both Indian Express and Accountability Initiative found that many people are just not using the constructed toilets. Villagers complained to Indian Express reporters that pit latrines were so shallow they would overflow after a month. Others found their toilets so useless they used the stalls for storing crops instead.
“Too many of the toilets that are built to achieve 100 percent open-defecation free zones are simple pit latrines,” Kirk Anderson, director of international programs at Water1st International, told Humanosphere. “Pit latrines smell; the sides of the pit tend to fail; sticks that form the platform rot and break. …These are solutions that users aren’t excited about, and when the users don’t like them, they usually don’t invest much time and energy in maintaining or replacing them.”
But according to Accountability Initiative the problem is not just about the toilets themselves – rather about information and education changing behaviors. In their research, they found that although there was a big rush to construct toilets, public awareness of the campaign was low. According to Kapur, people are building toilets without understanding why and what kind of toilets they’re building.
However, Anderson is not convinced that people are not adopting the toilets for lack of education. Based on his experience in India, “people embrace toilets that are odorless and easy to clean.” In some cases, families have even built their homes around their simple, new pour flush toilets that Water1st helped install.
“But that type of toilet is rarely the approach taken in these [community-led total sanitation] approaches,” he said. “The interesting research would be comparing long-term use of pit latrines versus pour flush toilets. I think you would see a big difference in use and replacement that would point towards a very different conclusion: It’s not the education that drives toilet use – it’s the convenience and lack of odor.”
Kapur maintained that there are cultural obstacles specific to India that need to be overcome with education, especially because community-led campaigns like Swachh Bharat are supposed to be fueled by demand from the people. However, the way the campaign is actually being implemented is also contributing to the disconnect in a significant way.
“A lot of the construction activities are happening due to coercive pressure to undertake construction, rather than a genuine demand from the ground,” Kapur said. “That is something from the ground that we have heard and that a large number of people have written about – name and shame techniques and threats to cut down entitlements to other schemes.”
As a result, many families have taken out loans with outrageous interest rates to construct toilets that are beyond their means, that may not be usable and may never be used.
Again, Anderson believes that a better product would eliminate the “need” for shaming and rewards. A good toilet that is odorless, easy to maintain and doesn’t require a person to walk 100 feet in the dark or in the rain should be a “sufficient reward in and of itself.”
“What we – the water, sanitation and hygiene sector – should be looking for is approaches that really improve people’s lives in ways they readily perceive,” he said. “Don’t shame and bribe people into accepting inferior toilets. Are we trying to save money? If [the toilet]isn’t working, we’re not saving any money.”
These are all situations on the ground that Gates should be aware of, and there’s no reason to believe he isn’t. But unlike Water1st, which supports what Anderson argues are existing and proven solutions, Gates has focused his attention on developing new water-less technology for treating waste.
He also appears to be focusing on the positive aspects of Swachh Bharat. For example, it is estimated that today 63 percent of Indians have access to proper sanitation compared to 42 percent in 2014 when Modi first launched the campaign.
“While one may question the sustainability of a movement that is focused so much on construction, the fact is that more Indians have toilets now than they did before,” Kapur said, acknowledging that actual improvements cannot be denied. “More money is going into sanitation than ever before, more political visibility to sanitation than ever before and there is more construction than ever before.”
Still, budget allocations for sanitation education have fallen from previous campaigns, according Kapur, and if the construction numbers being reported can’t be trusted, then how close is triumph really?
“We’ve heard from many people that the administration is very determined sometimes to show success and then work toward the success,” Kapur said.
If that’s the case, then even if India declares itself open-defecation free by October 2019, we’ll have to wait a few more years to see if it really has won its war on human waste.