Improving sanitation in rural India – a road to sustainable hygiene and health

Until a few months ago, the women in Dahalewadi, a little hamlet in Nashik’s Trimbak taluka walked long hours in the dark, to relieve themselves each day. “We women would have to carry a torch or sometimes ask our husbands to accompany us in the dark because of the fear of snakes and scorpions. Monsoons and menstruating days were worse,” Vatsala bai tells us, recalling the days when she and her family lived without access to a toilet. In January this year however, communities in Dahalewadi received an individual household toilet through a Swades-CSR partnership.

A milestone moment for the village, the toilets were welcomed with an aarti, cracking of a ceremonial coconut and a formal cutting of the red ribbon. For most urban folks the celebration may seem dramatic, but it is a grim reminder of the sanitation that exists in rural India.

Water and hygiene are crucial to a nation’s wellbeing and especially that of women and girls – an idea revisited during the pandemic. 

Access to clean toilets, clean and safe drinking water and following good hand hygiene practices have the potential to bring down the mortality rates triggered by diarrhoeal diseases and other infections – reasserting the age-old wisdom of prevention being better than cure for the following reasons. 

Women’s health and safety

In parts of rural India where access to toilets is limited or non-existent, women walk for miles to find a suitable spot of relieve themselves. In order to ensure privacy, they make the trek either very early in the morning or after dark – risking their safety and often, dignity. Animal attacks (snakes and scorpions) are not uncommon in the interior villages. Neither are cases of women being abducted or abused. 

In 2017, to stress on how a household toilet symbolises dignity for women, the government under the Swachh Bharat Mission had coined a new name for toilets - “Izzat Ghar”. But apart from the safety and dignity aspect, women are also most vulnerable to health hazards triggered by lack of sanitation – such as urinary tract infections and kidney problems due to infrequent urination. 

Menstruating days are a whole other battle. In fact, 23 million girls in India reportedly drop out of school annually due to lack of proper hygiene management facilities and information about menstrual hygiene. (Dasra, 2019 report). Apart from proper sanitation at home, separate toilets for girls and boys in secondary school is crucial to ensure that our girls stay in school.

Child health

Diarrhoeal diseases (caused by bacterial infections breeding in unhygienic environments) is the second leading cause of death in children under five years old according to WHO. Malnutrition, another leading cause of child mortality is also linked to diarrhoea – so much so that close to half of the malnutrition cases are associated with repeated diarrheal episodes.

Access to clean drinking water and hand sanitisation can have a direct impact on curbing instances of such water and vector borne diseases. Swachh Bharat Abhiyaan and Jal Jeevan Mission are two other extremely ambitious programs of the Government of India, aiming to improve public health and hygiene.

Environmental hygiene

In rural hamlets with little or no access to clean water, water and vector-borne infections are a result of untreated faecal matter. Most often there is no effective drainage system in place either.

However, they have a resource far more precious – space – that can be leveraged for setting up a conscious and self-sustaining sanitation infrastructure - such as twin-door compost pit toilets. Communities can be trained in periodically cleaning them and using the rich compost to enrich their soil.

While ODF (open defecation free villages) are a measure of a country’s sanitation infrastructure, we need to aspire at declaring ODF plus villages (with sustained ODF status supported by solid and liquid waste management systems etc) to ensure long-term hygiene.   

Community ownership

For communities that have for generations been deprived of sanitation practices, using a toilet is a big behavioural change. Even if they may receive a toilet or a tap, to ensure that a village earns and maintains its ODF (open defecation free) status, has been a battle for local administrations and grassroots organisations alike.

For this, it is crucial that the community is educated about the importance of hygiene by engaging government workers such as anganwadi sevikas and ASHA workers. Next comes taking ownership of the practice. One way to do so is the formation of Nigrani Samitis (as suggested under Swachh Bharat Mission) to persuade people to stop open defecation and encourage them to use the toilets.

Clean water and sanitation are corner stones to public health. Additionally, they are custodians of our women’s dignity. I remember the smile on the face of an elderly woman in Indore, Nashik when she told me how she needn’t time her visits to the fields anymore. It is a necessity and a right that we as local administrations, civil institutions and CSR organisations need to address as such – for every man, woman and child in our villages.  

(Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the views of YourStory.)