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Swachh Bharat Mission: Big Move or Failure????

The Swachh Bharat Mission (SBM) was initiated in 2014 to achieve universal sanitation coverage in India by 2 October 2019. This largest cleanliness drive in the world is also an attempt to effect behavioural change in rural India, which accepted open defecation as a way of life. As per the Economic Survey, about 100 million toilets have been built and 564,658 villages are Open Defecation Free. The curious case of Goa indicates how numbers are being fudged to meet deadlines.

What are the impressive achievements of SBM?

“Sanitation is more important than independence.” ~ Gandhi

The Swachh Bharat Mission (SBM) was launched as a multi-pronged approach to enhance the level of sanitation in India. The focus under this mission has not just been on construction of toilets but also on effecting a behavioural change in the local communities.

The result has been substantial gains in health parameters as shown by various studies, as concluded by Economic Survey 2018-19, released in July. The gains from a cleaner India are important inputs, directly as well as indirectly, for achieving broader economic development objectives.
As on 14 June 2019, 98.9 per cent of India has been covered under SBM. Since October 2014, about 100 million (10 crore) toilets have been built all over the country. The pace of construction has also improved every year since the launch. The total number of household toilets constructed from 2014 till 2018 shows a rapid progress, starting from less than 5 million (50 lakh) household toilets per year in 2014-15 and reaching up to over 30 million (3 crore) toilets per year in 2017-18.

To put this in context, even after 67 years of India’s independence, in 2014, around 100 million (10 crore) rural and about 10 million (one crore) urban households in India were without a sanitary toilet and over 550 million (55 crore) – about half the country’s population – still practiced open defecation. So, a major focus of SBM has been on making villages Open Defecation Free (ODF).
The number of ODF villages has significantly increased since 2015. As on 29 May 2019, 5,61,014 villages (93.41 per cent), 2,48,847 gram panchayats (96.20 per cent), 6,091 blocks (88.60 per cent) and 618 districts (88.41 per cent) have been declared ODF, as per the Economic Survey.

The numbers appear to speak in one voice: mission accomplished.

Why is SBM effective?

“If people of India can reach Mars with minimal expenditure, why can they not keep their streets and colonies clean.” ~ Narendra Modi, October 2, 2014
Recognising the need for urgent action on the sanitation front, on 2 October, 2014, the birth anniversary of Mahatma Gandhi, Prime Minister Narendra Modi announced India’s Swachh Bharat (Clean India) Mission to enhance the quality of life by promoting cleanliness and eliminating open defecation.

The mission’s targets were to be met by 2 October, 2019, coinciding with the 150th birth anniversary of the Father of the Nation. This was to be achieved by promoting community participation, providing flexibility in choice, building capacity, instilling behavioural change and using technology.

SBM, therefore, adopts a multi-faceted approach including:
  • Community participation: Ensuring appropriate participation of the beneficiary/communities, financially or otherwise, in the setting up of the toilets to promote ownership and sustained use.
  • Flexibility in Choice: SBM offers flexibility by building in a menu of options so that the poor/disadvantaged families can subsequently upgrade their toilets depending upon their requirements and their financial position. This is done to ensure that sanitary toilets are constructed, which ensures safe confinement and disposal of faeces. An illustrative list of technology options, with cost implications is provided to meet the user preferences and location-specific needs.
  • Capacity Building: SBM augments the institutional capacity of districts to change behaviour at the grassroots level and strengthen the capacities of implementing agencies so that the programme could be rolled in a time-bound manner and collective outcomes could be measured.
  • Instilling Behaviour change: SBM incentivizes the performance of state-level institutions to implement activities for behavioural change among communities. This includes emphasizing on awareness generation and triggering mind-set changes that lead to community behaviour change and demand generation for sanitary facilities in houses, schools, anganwadis, places of community congregation and for solid and liquid waste management activities.
  • Broad-based Engagement: SBM set up the Swachh Bharat Kosh to encourage Corporate Social Responsibility and accept contributions from private organizations, individuals and philanthropists.
  • Use of Technology: Information technology and social media engagement is imperative to this program as it allows citizens to keep a check on the availability of toilets for every rural household in India. Nearly 90 per cent of all SBM toilets have already been geo-tagged. Many mobile applications have been launched by not only the government but also by the civil society, which direct the municipal corporations’ attention towards unclean areas.

When will India reap the benefits of improved sanitation?

As per the Economic Survey, India is already benefiting from the success of SBM. In fact, if there was a way to monetize the gains, SBM can even be considered a profit-generating social welfare scheme. The success of SBM can be assessed from the gains that the actions under the scheme had on the various socio-economic outcomes of the rural populace. A direct impact of improved sanitation should manifest on the health indicators.

Diarrhoea, a leading cause of death among the under-five children in India, accounted for around 11 per cent of deaths in 2013. Diarrhoea cases among children below 5 years in India have reduced significantly over the past 4 years. With improved sanitation and 100 per cent ODF, diarrhoea cases reduced significantly in many states like Gujarat, Tamil Nadu, West Bengal and Bihar.

Similarly, improvements are evident in malaria, still births and low birth weight cases. This has been verified by a study sanctioned by the government. The Sanitation Health Impact Assessment study was conducted by Ministry of Drinking Water and Sanitation (MoDWS), to understand the impact of ODF status on the key child health and nutritional indicators in five states - Karnataka, Madhya Pradesh, Rajasthan, Uttar Pradesh and West Bengal.  Becoming ODF had a positive impact on the child health and nutrition, evident from the fact that the health and nutritional indicators of the children and mothers belonging to the ODF areas were comparatively better than their non-ODF counterparts,” reports the Survey, citing the study.

Another study, “Swachh Bharat Mission – Preliminary estimations of potential health impacts from increased sanitation coverage”, was conducted by the World Health Organization (WHO) to estimate health gains based on the latest available evidence linking sanitation and mortality from diarrhoeal disease. The study results show that in 2014, i.e. before the start of the SBM, there were an estimated 140,000 deaths from diarrhoeal disease attributable to unsafe sanitation; about 39,000 of those attributable deaths occurred in children younger than five years. Since the start of the SBM, mortality from unsafe sanitation is estimated to have declined to about 50,000 deaths in 2017-2018.
The studies show what we already know: that there is a clear relation between progress on sanitation coverage and health gains. And health gains can contribute directly to the economy of India.

The World Bank estimated the economic impacts of inadequate sanitation in India in the year 2006 – showing an annual economic impact of Rs 2.4 lakh crore ($53 billion), implying a per capita annual loss of Rs 2,180 ($ 48) or 6.4 per cent of the GDP in the same year (World Bank 2011). A recent study conducted by UNICEF on behalf of MoDWS assessed the economic benefits of SBM. The study focused on the household and community financial and economic benefits as well as costs of improved sanitation and hygiene. The study found that on an average, every household in an open defecation free village saved about Rs 50,000 per year on account of financial savings due to lower likelihood of disease from using a toilet and practicing hand washing and the value of time saved due to a closer toilet.

The findings of the UNICEF study suggest that when costs and benefits are compared over a 10-year time period and when 100 per cent of households in a community use a toilet, the financial savings exceed the financial costs to the household by 1.7 times, on average. For the poorest households, the value is higher at 2.4 times. When household time savings (from closer toilet access and less sickness) and the time for cleaning and maintaining the toilet are valued, the benefits exceed costs by 3.0 times. When benefits of lives saved are included, the benefits exceed costs by 4.7 times.
Hence, the realized and expected gains from improved sanitation are considerable.

Where else is SBM improving conditions?

SBM has brought in a remarkable transformation and traceable benefits to the society as a whole.

Many states have achieved the status of 100 per cent ODF and Individual Household Laterine (IHHL) coverage, significantly adding to the dignity of people, especially women. This mission acts as a driver for reducing gender disparity through the construction of gender-specific latrines in public areas such as schools, roads and parks. This public movement has an indirect positive impact on the rural society by increasing the enrolment ratio of girls in schools and improving health standards. One of the leading causes for girls to drop out in the secondary school is lack of access to a separate toilet.
Importantly, SBM is also aligned with the 2030 Sustainable Development Goals (SDGs), especially the SDG 6.2“By 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations”.

Those who value sanitation also care for their environment

In terms of the impact of SBM on the physical environment, a recent study by UNICEF, in association with MoDWS indicates considerable impact on combating contamination of water, soil and food. The study was conducted on the basis of a list of ten ODF and ten non-ODF villages each in the states of Odisha, Bihar and West Bengal (total of 20x3= 60 villages). Four villages of each classification (ODF versus non-ODF) were randomly selected from the shortlisted villages in each of these states (total of 8x3=24 villages).

Overall, in terms of faecal contamination, ODF villages were, on average: 11.25 times less likely to have their groundwater sources contaminated (12.7 times less from contaminants traceable to humans alone). 1.13 times less likely to have their soil contaminated, 1.48 times less likely to have food contaminated and 2.68 times less likely to have household drinking water contaminated. The findings from the study indicate that these substantial reductions may potentially be attributed to the improvement in sanitation and hygiene practices, as well as supportive systems such as regular monitoring.

Who made us doubt the truthfulness of SBM numbers?

It is absolutely certain that Prime Minister Narendra Modi would declare SBM to be a massive success on October 2. So, you don’t really want to be the Chief Minister who prevented him from declaring an all-round victory, especially if you belong to the Prime Minister’s own party. This brings us to the curious case of Goa. The state that is the worst performer in meeting sanitation targets is not just last; it is last by a huge margin. As per the Economic Survey, Goa has the lowest individual latrine coverage followed by Odisha and Telangana.

Goa also has the lowest ODF coverage followed by Odisha, Telangana and Bihar. As of 14 June this year, as per the Economic Survey, Goa had a shameful 5.84% ODF status, meaning that less than 6% of its villages were declared ODF. The next worst was Odisha, which was at 45.36%. Telangana had 73.99% and Bihar 82.95%. All other states were either at 100 percent or very close to it. That was on 14 June. But a lot can happen between June 14 and Oct 2.

After receiving the ‘Global Goalkeeper’ Award by the Bill and Melinda Gates Foundation on September 24 in New York, Modi said that Swachh Bharat Mission is proof that when 1.3 billion Indians take a pledge, any challenge can be overcome. He was perhaps also referring to one Indian who took it upon himself to achieve the impossible.

Goa’s Chief Minister, Pramod Sawant, is not a man to give up easily. Truly believing that ‘impossible is nothing’, he declared Goa as open defecation free on August 301. Yes, you read that right. In nearly five years, Goa had achieved 6 percent. The remaining 94 percent was achieved in flat 77 days. Goa proudly joined the ranks of ODF states after the directorate of panchayats and directorate of municipal administration declared rural and urban areas in the state open defacation free.

Where there is a will, there is a toilet.

Unfortunately for Sawant, a few people had read the Survey. Since the survey is the official document of the government of Modi-led BJP government at the center, its numbers cannot be publicly doubted by the Sawant-led BJP government in Goa. After facing criticism for fudging numbers, Sawant finally surrendered to the truth, a rare quality in public leaders these days. Sawant said on September 25 that if Goa had not been declared open defecation free (ODF), then it would have faced embarrassment in the country.  
“In Goa, a few migrants come and stay in huts without toilets and people come and tell me that in this circumstance we cannot declare Goa ODF,” Sawant said.

“But if we had not declared the state ODF, we would have faced shame in the country,” he added. The chief minister then indicated that what he had done was no different from what the ‘big states’ had done to report 100 percent ODF. He told reporters that in big states, villages had been declared ODF even if they housed just one toilet. This then is the crux of the matter – how is it that Goa was at less than 6 percent and almost all others at 100 percent on June 14? Either Goa was too poor, too inefficient, too lazy or too unconcerned to do what all others could achieve easily. Or...

How can the SBM numbers be fudged?

We are not saying the numbers are definitely fudged. We are arguing they can be easily manipulated. If you torture the data long enough, it will show you exactly what you want to see. In this case, the devil is in the definition of ODF.
This is how, as per the Economic Survey, an ODF status is granted: “ODF would mean the termination of faecal-oral transmission, defined by a) no visible faeces found in the environment/village and b) every household as well as public/community institution(s) using safe technology option for disposal of faeces.”

Now, let’s say you are Chief Minister Sawant and you want to achieve 100 percent sanitation is 77 days. There are two ways to go about this. One, make sure a functional toilet is installed in every household of every village in 77 days. Or two, hire an audit agency that exploits the loophole in the definition of ODF. The auditors merely need to tour a village for about half an hour, look around (or appear to look around) and report that ‘no visible faeces were found’ in the village. We do not want to spoil your next meal, but please appreciate the challenge here. In the vast fields and with the constant glaze of rural onlookers, the poor auditor is supposed to look for traces of faeces. If he is given, let us say, just a couple of hours to complete the survey of one village, it’s unlikely he will find faeces unless he steps on some.

Sawant is right. There is just too much pressure on everyone to ‘achieve’ the targets of SBM. And things are getting deadly in the fields. Two children were beaten to death in the village of Bhavkhedi, Madhya Pradesh after they were seen defecating in the open near a village council building. The victims, a 12-year-old girl named Roshni and Avinash, a boy aged 10, were cousins from the Dalit community. Two men, brothers from the upper-caste Yadav community, have been arrested on suspicion of murder.

Ironically, the attack took place at around 6.30am on September 25, at almost the precise moment when - 7,500 miles away in New York - Narendra Modi was being honoured by the Bill and Melinda Gates Foundation for his work to eliminate open defecation.

Bhavkhedi itself was declared “open defecation free” in 2018. The family of the victims in the Bhavkhedi attack told reporters they have no toilet in their home, and that despite being eligible have been unable to access funds to build one under SBM. Police believe the children’s attackers took pictures of them on their mobile phones before “beating them mercilessly with sticks resulting in their death.” Civil society groups have criticised the government’s record keeping track of its own progress, saying that plenty of households in rural areas still remain without access to toilets. A January 2019 study by the independent Research Institute for Compassionate Economics (RICE) found that as many as 23 per cent of rural schools surveyed had toilets that were unusable due to lack of water supply or failure to keep up maintenance. The study concluded that as much as 44 per cent of the rural population across four states “still defecate in the open”.

Despite the fact that community-led total sanitation (CLTS) has brought about change in the last few decades, the pressure of targets has changed the C in CLTS to collector, said VK Madhavan, chief executive, WaterAid. “We need community involvement to look at the hygienic behaviour, but sanitation is becoming a political imperative.  
 We are seeing tunnel vision lead to a narrow emphasis on toilet construction and usage, to some extent, but hygiene is left behind. The assumption is that you have access to a toilet and you use it to adopt hygienic behaviour, but there isn't enough evidence to support it,” said Madhavan.
Indeed, sanitation was dear to Gandhi. But let’s not forget that his first two absolute favorites were truth and non-violence.
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