Human excreta are the potential source of transmitting many infectious diseases such as cholera, typhoid, infectious hepatitis, polio, cryptosporidiosis, and ascariasis. Ensuring that people have access to safe drinking water is another critical dimension of sanitation.
Unsafe water, poor sanitation and hygiene leads to under nutrition, pneumonia, worm infestations, reduced physical growth, weakened physical fitness and impaired cognitive function, particularly for children under the age of five.
Heavy metals, toxic organic and inorganic substances also can pose serious threats to human health and environment, particularly when industrial wastes are added to the waste stream. Therefore, benefits of sanitation are immense, but the task ahead is not so easy!
The PM has given the countrymen a task to be achieved in a holistic manner. Sanitation is not only about maintaining cleanliness around human habitats. If looked at in totality, sanitation is all about ensuring a healthy environment to all living creatures, which can come by self-realisation and awareness on good health.
A survey conducted by the National Sample Survey Office (NSSO), Union Ministry of Statistics and Programme Implementation between July 2012 and December 2012 had made some startling observations, which were based on the findings covering 4,475 villages in rural areas and 3,522 urban blocks spread over all states and Union Territories.
About 88.5 per cent households in rural India had improved source of drinking water while the corresponding figure was 95.3 per cent in urban India. Among rural households, 85.8 per cent had sufficient drinking water and for urban India the corresponding figure was 89.6 per cent.
This means that making available safe drinking water to Indian masses is not a difficult task. It just needs one major push, which will bring the whole populace within the ambit of pure and safe drinking water supply chain. It will also tremendously help animal husbandry as well. By providing safe drinking water, we will only save our people suffering from water borne diseases.
To have pure source of water, overall sanitation needs to be improved upon. What about latrines? The survey shows that 59.4 per cent and 8.8 per cent households in rural and urban India, respectively, had no latrine facilities. It needs to be addressed on a priority basis. A healthy India needs toilet facilities for all. About 38.8 and 89.6 per cent households in rural and urban India, respectively, had access to ‘improved’ type of latrine.
Providing airy accommodation is another important dimension of sanitation goals. If we force a large populace to live in compressed accommodation, then most of them will end up picking up many ailments. We will never have healthy children from these areas. It is a major problem in urban India, where a chunk of people are constrained to live in slums against all odds and health hazards.
If one goes by the survey, then only 26.3 and 47.1 per cent households in rural India and urban India, respectively, had dwelling units with ‘good ventilation.’ As much as 31.7 per cent of rural households and 82.5 per cent of urban households had ‘improved drainage’ facility in the environment of their dwelling units.
It is not that people do not want to move out of slums or squatter settlements, but they need to be provided with opportunities to do so. At all India level, 70.8 per cent of households had cited ‘better accommodation’ as the main reason for which they thought to move out of slum or squatter settlement whereas 11.7 per cent households had identified ‘proximity to place of work’ as the main reason.
Best practice models
There is a need to spread awareness on sanitation related issues and opting for the ‘best practice’ models. We must understand that sanitation is a cross-cutting issue and has implications for a variety of development areas.
To attain the target of total sanitation, we need to work as well-knit unit. Total sanitation has to go beyond just toilets. Urban women use sanitary napkins but in rural areas, women use a piece cloth and have no private space to dry the piece of cloth in sun. It is used while still wet. This has health and hygiene implications.
Sanitation has also a strong connection with human dignity and well-being, public health, nutrition and even education. Which is why Mahatma Gandhi once said: “Sanitation is more important than independence.” Sanitation issues should be given priority in our development policy approaches.
Its implications need deep study and greater understanding. The role of community leadership in changing old habits and ways of thinking will be crucial as our own experience has shown. Similarly, sanitation has to be located in an integrated framework of public health policy to ensure that sanitation activities are indeed adequately funded.
For example, hand washing with soap can reduce the incidence of acute respiratory infections (ARI’s) by around 23 per cent according to the World Health Organisation.
There is also a need to develop sanitation technologies for diverse eco-systems. New technologies have to be affordable and sustainable. Traditional water systems had been engineered in our villages to optimise scarce resources including the use of water.
We must use scientific ingenuity to take India to the next generation of sanitation technologies. Human waste should be treated as a resource to be recycled. With more urbanisation and industrialisation, this challenge will gain importance. We have to strive for sanitation for dignity and health. Good sanitation should be a birthright of every citizen of India. Total health will only come through total Sanitation.
(The writer is Director, BLK Super Speciality Hospital, New Delhi)