A step towards safe sanitation

Amrita Prasad
Sunday, 18 November 2018

On World Toilet Day, we speak to Pratima Joshi, co-founder and executive director of Shelter Associates, a civil service organisation in Pune, that works extensively towards improving the living conditions and standards of the urban poor in India by providing safe sanitation through household toilets

Toilet: Ek Prem Katha, Akshay Kumar-starrer Bollywood movie, may have drawn some attention to the lack of toilets in India, but ground realities remain quite unchanged. Not having enough number of toilets leading to open defecation is still a serious issue that needs immediate attention and solution. World Toilet Day, which is observed today, is about taking action to ensure that everyone has a safe toilet by 2030. But can we achieve it?   
With a mission to empower communities living in informal settlements to pursue their right to dignity and an elevated quality of life, Shelter Associates (SA) has been working relentlessly to improving the living conditions and standards of the urban poor in India by providing safe sanitation through household toilets. The organisation that has a passion-driven team of accomplished architects, social workers, geographic information systems (GIS) analysts and community workers strives towards upholding the vision of an India where every citizen has access to basic infrastructure. 
SA recently also launched a programme called Tool-kit that details out the methodology for delivery of household sanitation systematically. Pratima Joshi, co-founder and executive director of Shelter Associates, tells us more about the initiative: 

Can you throw some light on the sanitation problem in India and globally? 
A staggering 70 per cent of Indians live in villages and some 550 million people defecate in the open, including the 13 per cent of urban households. Open defecation continues to be high despite decades of sustained economic growth, despite the obvious and glaring health hazards. The situation is so bad that open defecation is more common in India than in other poorer countries such as Bangladesh, Kenya, Democratic Republic of Congo, Malawi, Burundi and Rwanda. Today, 4.5 billion people live without safely managed sanitation and 892 million people still defecate in the open. The exposure to human faeces on this scale has devastating impact on public health, living conditions, nutrition, education and economic productivity across the world. Along with these, lack of structured data is a huge problem.  

How are organisations, the government and other authorities trying to tackle the issue of lack of toilets and poor sanitation in our country?
The Government of India has launched one of its most transformative schemes — Swachh Bharat Mission (SBM) towards freeing India of open defecation by ensuring access to safe sanitation in urban and rural areas. The objectives were clearly laid out with elimination of open defecation, eradication of manual scavenging and evoking a behavioural change regarding healthy sanitation practices. SBM movement provided an immediate push to non-profit entities across the nation already working in the field of urban sanitation. With the deadline of Octover 2, 2019 fast approaching, it is important to take a holistic view of the positive outcomes of SBM, and, more importantly, what we can learn from identifying the gaps and bridging them going forward. The programme focusses on giving flexibility to each state to allocate funds under across each city and Urban Local Bodies (ULBs) to further make budgetary provisions towards strengthening/ adding infrastructure and disburse SBM funds into the bank accounts of beneficiaries through two installments. However, certain shortcomings in the programme such as absence of real-time spatial data to inform decisions and target communities strategically, lack of community engagement and absence of an inclusive approach and poor monitoring and tracking mechanisms have been observed. 

India has the highest number of people practising open defecation. What are some of the perils of open defecation to humankind and the planet?
Lack of safe toilets is a health, safety/ dignity and environmental problem. Open defecation poses a serious threat to the health of children in India who succumb annually to diarrhoea killing 188,000 children under age of five. According to UNICEF, children weakened by frequent diarrhoea episodes are more vulnerable to malnutrition, stunting, and opportunistic infections such as pneumonia. Safety and dignity is another important aspect: Out of India’s 120 million adolescent girls, 63 million (52.5 per cent) lack access to private toilets. On an average, women and girls in Indian cities, hold their bladders for 13 hours a day, leaving them at risk of UTIs and RTI. Elimination of open defecation by facilitation of individual toilets enables a cleaner, healthier living environment.

How is Shelter Associates tackling the issue? 
Based on data that we had collected from slums across cities, it was evident that access to safe sanitation was acutely missing. This led us to focus our undivided attention to household sanitation in slums by launching the ‘One Home One Toilet’ (OHOT) model. This initiative was highly amplified and validated with the launch of Swachh Bharat Mission in 2014. With the successful implementation of this model, we have reached out to over 15,000 families directly with household toilets. Having worked in the sanitation space for more than 25 years, we recently launched Tool-kit, which is a guide consisting of three books for facilitators who want to work towards improving the sanitation condition in the country and a Policy Review Paper that highlights recommendations for strengthening the SBM policy and roll out a more robust and effective programme. 

What are some of the challenges that you face while carrying out the programmes? 
Convincing ULBs to invest in creating spatial data by leveraging technology driven platforms for effective service deliveries has been one of our biggest challenges. While sanitation is a national issue and schemes have been launched, just looking at toilet numbers is not enough — we need a holistic approach with behavioural change communication for long-term sustainability and impact. A change in the administrative head of the city where there is an ongoing project can cause delays or setbacks, especially if the commissioner changes and a new one does not drive forward the project with the same zeal. The municipal corporation staff needs intensive training to understand the usage of GIS (graphic information system) technology and spatial data related aspects.
Tell us about your ‘One Home one Toilet’ approach.  
SA’s OHOT model has evolved over the years and is a multi-stakeholder, cost-sharing, technology and data driven, community centric model that not only solves  sanitation problems relating to health, safety and environment but also provides a data driven mechanism that supports effective policy implementation and government fund utilisation. This model precisely addresses the gaps in the service deliveries and lays emphasis on a strategic, phased, planned intervention which also brings in an effective monitoring, tracking and implementing mechanism.  

Are people living in slums willing to change their attitude towards open defecation?
Yes, they are more than willing to change it and our evidence based data has shown so as long as they are provided with secure and safe access to sanitation like household toilets. In most cases, the major concern is the poor condition of community toilet blocks and the waiting time to access it as the burden on CTBs is huge, that dissuades them from using it and as they have no other option, they resort to open defecation. Our research and study has shown that the percentage of people practising open defecation reduced from 30 to 0.8 per cent in a span of more than a year.

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