Guest Post by APURV MISHRA 

“Sanitation is more important than independence”, said Gandhi, the godfather of our freedom fighters, in 1925. Unlike Nehru, who believed that sovereignty and self-rule were a prerequisite for social change, Gandhi insisted that true Swaraj could only be achieved when political independence was accompanied by a parallel program of social reform. As we go through the perfunctory national routine of remembering Gandhi on his death anniversary every year, it is a good time to take stock and reflect on the irreconcilable gap between Gandhian values and our societal priorities. I am not talking about the ambitious Gandhian ideas of village republics, Nai Talim, strict vegetarianism, zealous celibacy or his suggestion of disbanding the Congress, but simple principles like cleanliness and sanitation.

Out of the 1.1 billion people around the world who openly defecate everyday, 626 million belong to India. Indonesia is second with 63 million. Our step-sibling China has just 14 million who defecate in the open, despite having a larger population. In fact, India has more than twice the number of the next 18 countries combined. Just think over these numbers for a minute.

This is not just a hygiene issue; open defecation is the single largest threat to the long term well-being of our country. Diahorrea and respiratory infections, caused primarily due to the lack of adequate sanitation, are the number one cause of child deaths in India, killing about 2,00,000 children every year. That is more than 200 times the total number of deaths due to all terrorist attacks last year. And yet, the difference in the allocation of resources between these two sectors by our government is embarrassing. Even countries like Rwanda, Senegal and Sierra Leone perform better than India on sanitation. As our nation was reaching for the stars, we were content with digging holes in the ground. These holes have now become the graves of our children.

A World Bank study on India concluded that the economic impact of inadequate sanitation due to loss of economic value and human capital was around twenty four thousand crore rupees. Just to give you some perspective, this is equal to the government’s allocation for the entire health sector in last year’s budget. If child deaths and economic loss were the only fallouts of open defecation, it should already have been a national calamity. But these were just the starters; let’s go to the main course.

Lack of clean toilets has a perverse multiplier effect on a nation. Dean Spears published a ground-breaking paper last year that studied the co-relation between heights of children and access to toilets in India. Height is an important indicator of a child’s well-being because it reflects early-life health, absorbed nutrition and immunity against disease. His conclusion can be roughly summed up in a simple equation: poor sanitation + high population density= malnutrition.

India has 61.7 million children with stunted growth; our malnutrition rates are worse than Sub-Saharan Africa. According to Spears, this is because children are exposed to germs from faeces which attack their intestines and reduce its capacity to absorb nutrition in the critical early years of a child’s life. The problem is compounded by a high population density which increases child’s exposure to these debilitating germs during the formative years, especially in states like Bihar and Madhya Pradesh, which have the highest levels of malnutrition. These stunted children will grow into a workforce with low productivity and smaller life expectancy, having a direct bearing on the competitiveness of our economy in the coming years.

This study also raises doubts about the logic of using the Food Security Act to solve India’s malnutrition problem, which is primarily caused by open defecation. Giving extra food to children whose bodies cannot absorb its nutrients is like “giving comb to a bald man”.

The fact that two out five children in India are malnourished may not provoke us into action because most of us have been lucky enough to be one of the other three- healthy, well-fed and pampered by technology. However, malnutrition is not just a poor man’s disease. On the average, even the richest 2.5 % children in India are shorter than normal standards. Simply using toilets in your home is not sufficient if the people in your neighbourhood continue to defecate in the open. Faecal germs are democratic entities which do not distinguish between the rich and poor.

Poor sanitation also has a direct impact on school attendance and especially affects the drop-out rate of girls. Recent survey conducted by Dasra, a strategic philanthropy foundation, shows that nearly 66 % of girls skip school during menstruation and one-third of them eventually dropout. Despite a Supreme Court ruling in 2011 that all government schools must have separate toilets for girls, the ASER Report released last week showed that only 54 % of the schools sampled had a separate and usable toilet for girls.

You will probably not have heard of Anita Narre, a woman from a rural village in Madhya Pradesh, who is an unlikely role model for women empowerment. She refused to enter her husband’s home till he built a flush-toilet within the household premises. It is surprising that building toilets is never an important part of any discussion on women’s safety. In rural areas and urban slums, most attacks on women happen when they relieve themselves. The Dasra survey mentioned above, showed that 66% of the women in Delhi slums are verbally abused, 46 % are stalked and more than 30 % are physically assaulted while accessing toilets. Why is this so? For fear of embarrassment, women go to relieve themselves at night or early morning before sunrise. Further, they need to keep changing locations to avoid being spied on. As a result, they end up going alone to far-off fields and vegetable patches. This combination of factors provides the perfect opportunity for assaulting them.

We could go on discussing the second order consequences of open defecation like its impact on soil fertility and river pollution, but it will not cut ice with most people. Open defecation is a silent killer; there are no dramatic cases which will capture media attention. When was the last time you saw a primetime TV debate on sanitation? The other problem with sanitation is that it is not sexy enough for most of us.  No contestant will win a Miss-Whatever competition by pledging to build more toilets. Open defecation does not make for a very marketable topic when NGOs are pitching project proposals inside the sanitised boardrooms of a company in the mood to do some CSR.  This means that eventually, our government will have to do the dirty work. Predictably, their track record in this area has not been very impressive. Total Sanitation Campaign was launched in 1999 by the Rural Development Ministry to give every citizen in India access to toilets by 2012. That was two years ago. I am hoping against hope that its revamped version, the Nirmal Bharat Abhiyaan, will have better success.

What killed Gandhi for us was not the bullet from Godse 66 years ago, but the terminal decline of his principles from our national life. Half our population has mobile phones but only one-third has access to clean toilets. I am embarrassed to think of what Gandhi would say about this state of affairs. Bapu’s obsession with sanitation and clean toilets was not another of his personal quirks that we should conveniently brush under the carpet, but the highest wisdom of a man who had an intimate understanding of Indian society. For his sake, if nothing else, let us pledge to give every citizen the right to take a dump in peace.

Had we done this earlier, we could have reduced our disease burden, increased family incomes, kept girls in school, improved the environment, raised workforce productivity and enhanced human dignity- just by building more toilets. Shit!

Apurv Mishra is a Young India Fellow at Ashoka University, Haryana