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By Ishaprasad Bhagwat, Indira Khurana and Richard Mahapatra
As policymakers from across South Asia meet in Delhi for the Third South Asian Conference on Sanitation, 665 million Indians continue to defecate out in the open. If India is to meet its target of 100% sanitation by 2012, we will need to set up 78 toilets a minute, or 40,000 toilets a day, over the next four years. Can we do it?
Every day, around 665 million Indians go through the experience of defecating out in the open. Globally, 1.2 billion people practise open defecation, two-thirds, ie 778 million, in South Asia alone.
According to the 2001 census, only 36.4% of India’s population has a toilet within the house. Rural areas have 21.9% toilet coverage and of this, only 7.1% of households have a toilet with a water closet. What’s more, only 34.2% of households in rural areas have drainage facilities for wastewater disposal. In 2004, rural sanitation coverage increased to about 35%, according to the Rajiv Gandhi National Drinking Water Mission (RGNDWM).
Open defecation poses one of the biggest threats to public health. So many people defecating out in the open constitutes a faecal load of 200,000 metric tonnes every day, which finds its way into the soil and water contaminating them with pathogens.
This is a major reason for the high prevalence of soil and waterborne diseases in rural India. The magnitude of the challenge has been underscored by the World Health Organisation (WHO) that ascribes around 80% of all sickness and diseases such as diarrhoea, cholera, malaria, etc, to lack of safe water and sanitation in the country.
Although a large segment of India’s urban population has provision for sanitary excreta disposal, only half has a sewerage system. The rest use low-cost sanitation facilities. But even where a sewerage system does exist, the facilities are often inadequate. In the case of solid waste disposal in urban areas, only around 60% of generated waste is collected and disposed of; only half of it is disposed of in a sanitary fashion. There is generally no separate arrangement for the safe disposal of industrial, hospital and other toxic and hazardous waste, resulting in contamination of groundwater and other water sources.
In monetary terms, the disease burden indicates an annual loss of 180 million person-days and Rs 12 billion to the economy from sanitation-related diseases, according to the Union Ministry of Health and Family Welfare’s Central Bureau of Health Intelligence.
Are we committed enough?
India has committed to the United Nation’s Millennium Development Goals (MDGs), officially adopted in 2002 by 189 countries. The issue of sanitation has come into focus in India within the goal of environmental sustainability. India is a signatory to the UN International Year of Sanitation 2008. Beyond committing to halving, by 2015, the number of people in the country that lack access to safe water and sanitation, India is hoping to achieve 100% coverage by 2012.
India launched the Total Sanitation Campaign (TSC) in 1999, aimed at eradicating open defecation by 2010. The target has been reset to 2012.
With India’s commitment to the MDGs, the budget outlay across the entire spectrum has jumped from Rs 16,711 crore in 1992-97 to Rs 39,538 crore in 1997-2002 and Rs 42,000 crore in the Tenth Five-Year Plan till 2007. The total project outlay for the TSC, since its inception, is Rs 14014.27 crore, while total expenditure reported during the same period is Rs 47093 crore.
Sanitation coverage received a big boost when the government introduced an incentive scheme, the Nirmal Gram Puraskar, for clean villages. The award is given to panchayati raj institutions for the elimination of open defecation. Around 30,245 panchayati raj institutions have already applied for the award for 2008.
However, according to a survey by Unicef, which provides technical support and capacity-building facilities to panchayati raj institutions to help promote sanitation, many Nirmal Gram Puraskar-winning villages have slipped back to open defecation after receiving the award. Although 85% of households have access to individual, community or shared toilets, only around 66% use them as toilets. Reasons for non-use are poor or unfinished installations, no super structure, and no behavioural change among the people.
Can we do it?
Considering the large size of our country (more than 16,00,000 habitations, according to National Habitation Survey 2003), huge population and complex structure of society, government statistics often look impressive. On the face of it, India appears to be taking the right steps in the right direction. But the task at hand is difficult, if not near impossible.
In order to accelerate sanitation coverage, the Government of India launched the Central Rural Sanitation Programme (CRSP), under the Ministry of Rural Development, in 1986, in supply-driven mode. The objective of the CRSP was to improve rural people’s quality of life and provide privacy and dignity to women. The programme was intended to supplement the efforts of the various states.
CRSP offered 100% subsidy for the construction of sanitary toilets for people belonging to the scheduled castes, scheduled tribes and landless labourers; for the general public, the subsidy was in accordance with the prevailing rate in the state.
Important lessons drawn from CRSP were that people were initially reluctant to use their new toilets because they feared they would break them; they thought defecating out in the fields away from the village was more hygienic; they preferred using the toilet as a storage facility. In addition, the cost of the facility proved well beyond the means of the rural poor, who in any case assign the service very little value.
Is the sanitation campaign total?
The Total Sanitation Campaign was initiated in 1999, when CRSP was restructured making it demand-driven and people-centred. It follows a “low-to-no-subsidy” principle where a nominal subsidy, in the form of an incentive, is given to poor rural households for the construction of a toilet. TSC emphasises information, education and communication (IEC), capacity-building and hygiene education for effective behavioural change, with the involvement of panchayati raj institutions (PRIs), community-based organisations (CBOs), and non-governmental organisations (NGOs). Key intervention areas are individual household latrines (IHHL), school sanitation and hygiene education (SSHE), community sanitary complexes, anganwadi toilets supported by rural sanitary marts (RSMs) and production centres (PCs). The objective is to eradicate the practice of open defecation by 2010.
A study of government data on fund allocation, release and expenditure raises serious questions about rosy “performance figures” and “coverage”. On the one hand, the government claims it is increasing plan investments and sector investments and attempts are being made to identify alternative sources of funding as the government is unable to come up with the required funds to meet its targets. On the other hand, the government is finding it difficult, almost impossible in certain cases, to utilise the available funds or to release approved funds on time.
Gaps between allocation and release
There are four areas of concern: the gap between allocation and release, the gap between release and expenditure, selective allocation of funds, and disparities at the national, state, district, block and village levels in allocating, releasing and expending funds.
If we look at the TSC data, we find that there is a huge gap in the approved amounts both in the share of the Centre and the states. In the TSC, only districts whose state release share is more or equal to the Centre’s release share, and the expenditure of the Centre and the state is equal or more than 60% against released funds are eligible to claim the next instalment. This helps ensure proper expenditure at the district level. However, this must be supported by other positive mechanisms to improve performance. In the absence of such positive mechanisms, districts that perform poorly continue to do so.
A quick look at the data reveals the real picture for fund allocation and expenditure on sanitation in India. The difference between release and expenditure is huge and is fast becoming the biggest obstacle to India achieving her target at any point in the near future (see Graphs 1 and 2).
Graph 1
Graph 2
Selective allocation
Even in fund allocation, we find serious disparities among the states. In most cases, five or six states are being allocated over 50% of the total allocated amount. Of a total of Rs 3,32,353.19 lakh released under the TSC in the last 10 years, from 1999-2000 to 2008-09, Rs 1,63,536 lakh was released to only five states -- Andhra Pradesh, Madhya Pradesh, Maharashtra, Tamil Nadu and Uttar Pradesh.
In the TSC, the national expenditure average reported against the amount released is 71.94%. Only four states -- Assam, Manipur, Meghalaya and Punjab -- and one union territory (Pondicherry) spend less than 50% of the total amount released, while 15 states spend more than 70% of the total released amount.
However, the gap between allocation and released expenditure under the TSC is huge. If we look at the TSC’s country-level report card, as on July 28, 2008, we find that out of an approved amount of Rs 13,83,779.40 lakh only Rs 6,23,069.81 lakh was released. That’s 45.02% of the total amount approved. This is the national average. Of this, only Rs 4,48,071.83 lakh was spent -- 71.9% of the total released amount.
This is the situation at the national level. As far as the states go, the gap, in some cases, is larger and varies from state to state. For example, out of Rs 50,501.53 lakh approved for Assam, only Rs 9,169.27 lakh was released, which is only 18.15% of the total amount approved. This serious gap between allocation and release, in the TSC, is adversely affecting the current sanitation coverage growth rate per year.
Disparities at every level
The study on allocation, release and expenditure goes beyond national and state-level averages. One has only to look at the variations and disparities among the states; in the states, among districts; in the districts, among various blocks; and in the blocks there are disparities between different villages. Even among states that perform well there are districts that are performing poorly. For example, according to the TSC report card for West Bengal, the state is all set to achieve the TSC target of 100% coverage by 2010. Out of the total amount approved (Rs 71,158.54 lakh), Rs 46,083.97 lakh was released -- 64.76% of the total amount approved. However, according to the TSC district-level report card, Darjeeling district in West Bengal will achieve the target only by 2310. Of the total amount approved (Rs 1,144.02 lakh) for the district, under the TSC, Rs 250.77 lakh has been released, which is only 21.92% of the total amount approved.
Disparities like these are present at every level. If we study the TSC data for Andhra Pradesh, we see that the state is set to meet the target by 2013. That would mean it is doing well. But a close look at the data raises some serious questions. Five out of 21 districts will not reach the target before 2020; Srikulum district is expected to reach the target only by 2038. The question then remains: how can Andhra Pradesh meet the target of 100% sanitation coverage by 2013 with 25% of its districts not reaching the target before 2020 and one district reaching it in 2038?
An area of concern
The government is now emphasising “behavioural change” through IEC, although the ground realities tell a different story. Utilisation of the IEC fund is an area of serious concern. In Andhra Pradesh, out of Rs 71,455.54 lakh of the total amount released, the state has spent Rs 55,266.73 lakh -- 77.34% of the total amount released. If we study the utilisation of IEC funds in Andhra Pradesh, the gap is huge. Of the Rs 13,522.07 lakh targeted under the IEC fund for Andhra Pradesh, only Rs 2,388.5 lakh has been utilised, which is 17.66% of the targeted amount. If we look at the country-level data we find that out of Rs 1,65,011.162 lakh targeted under the head, only Rs 28,608.49 lakh has been utilised, which is only 17.33% of the total amount targeted. This is the national average for utilisation of IEC funds.
The way forward
Despite significant investments over the last 20 years, India faces perhaps a more daunting challenge than any other country in South Asia, in the area of sanitation. According to one estimate, India ranks second, after China, among the worst places in the world for sanitation. Although government figures claim that India is set to achieve its MDG target, poor rural inhabitants still constitute a vast majority of the unserved population. And rapid urbanisation is putting further strain on already stressed urban sanitation systems. Slums are very rarely connected to the city’s sanitation infrastructure, and the sanitation situation in them is deplorable.
Given the large population of slum-dwellers and unaccounted for urban populations, and their exclusion from formal urban sanitation and sewerage systems, the coverage status is about the same for both urban and rural India. The sheer concentration of people in towns, coupled with poor drainage and the impact of poor sewerage affecting safe drinking water, makes urban sanitation a major challenge too for India.
For urban areas, more public toilets in commercial areas and integrated community-managed infrastructure (bathing and washing complexes, plus toilets) are required on a large scale in a tropical country like India. The trend towards privatising and contracting out public infrastructure in slums and in mixed areas (commercial and slums) must be curtailed. Community owned and managed infrastructure with subsidised electricity and free water is needed for urban slums. Making the government more accountable for delivering urban sanitation to the poor and ensuring that subsidies reach the poor should be the priority, as also the need to build up demand from the people to make and use toilets in rural areas.
There is an urgent need to integrate water and sanitation access in rural areas, as experience shows that availability of water is an important driver of safe sanitation, apart from behavioural changes. The strategy should be multi-pronged and include local groups, clubs, self-help groups and NGOs which will help bring about behavioural changes towards the promotion of hygiene and sanitation, in place of infrastructure-driven toilet coverage promotion in rural areas.
(Ishaprasad Bhagwat, Indira Khurana and Richard Mahapatra are senior staff at WaterAid India)
InfoChange News & Features, November 2008 |
