Squatting with Dignity: Lesson from India

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Kumar Alok

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    Dedication

    To all the dedicated souls who worked selflessly for promoting sanitation in rural areas of India and to my parents.

    List of Tables

    List of Figures

    List of Abbreviations

    AEOAdditional Executive Officer
    AFCAgriculture Finance Corporation
    AIIH&PHAll India Institute of Hygiene and Public Health
    APAndhra Pradesh
    APLAbove Poverty Line
    ARWSPAccelerated Rural Water Supply Programme
    AS & FAAdditional Secretary & Financial Advisor
    ASHAAuxiliary Social Health Activist
    BDOBlock Development Officer
    BPLBelow Poverty Line
    BPOBusiness Process Outsourcing
    CBOCommunity Based Organization
    CCDUCommunication and Capacity Development Unit
    CDMClean Development Mechanism
    CDOChief Development Officer
    CEOChief Executive Officer
    CEPChild Environment Programme
    CLTSCommunity Led Total Sanitation
    CMPClean Milk Programme
    CRSPCentral Rural Sanitation Programme
    DANIDADanish International Development Agency
    DAVPDirectorate of Advertising and Visual Publicity
    DDCDeputy Development Commissioner
    DDWSDepartment for Drinking Water Supply
    DEE&LDepartment of Elementary Education and Literacy
    DFIDUK Department for International Development
    DLMDistrict Level Monitor
    DMDistrict Magistrate
    DPEPDistrict Primary Education Programme
    DPRODistrict Panchayati Raj Officer
    DRDADistrict Rural Development Agency
    DWCDDepartment of Women and Child Development
    DWSDrinking Water and Sanitation
    DWSCDistrict Water and Sanitation Committee
    DWSMDistrict Water & Sanitation Mission
    ECOSANEcological Sanitation
    EFCExpenditure Finance Committee
    FCFinance Commission
    GHGGreen House Gas
    GOIGovernment of India
    GPGram Panchayat
    HRDHuman Resource Development
    IAYIndira Awas Yojna
    IASIndian Administrative Service
    ICDSIntegrated Child Development Services
    IECInformation, Education and Communication
    IFDIntegrated Finance Division
    IHHLIndividual House Hold Latrine
    ILEInternational Learning Exchange
    IIMCIndian Institute of Mass Communication
    IRIndian Railways
    IRCInternational Water & Sanitation Centre, Delft
    IRMAInstitute of Rural Management, Anand
    ISPIntensive Sanitation Project
    ITInformation Technology
    ITNIndia Training Network
    JMPJoint Monitoring Programme
    KAPKnowledge, Aptitude and Practice
    KFWKreditanstalt für Wiederaufbau
    KRWSSAKarnataka Rural Water Supply and Sanitation Agency
    LPGLiquefied Petroleum Gas
    LPTLeach Pit Toilet
    MDGMillennium Development Goals
    MHMMenstrual Hygiene Management
    MICSMultiple Indicator Cluster Survey
    MoHFWMinistry of Health and Family Welfare
    MPMember of Parliament
    NABARDNational Bank for Agriculture and Rural Development
    NCERTNational Council for Education Research and Training
    NDDBNational Dairy Development Board
    NFHSNational Family Health Survey
    NGONon-Governmental Organization
    NGPNirmal Gram Puraskar (Clean Village Award)
    NHRDPNational Human Resource Development Programme
    NICNational Informatics Centre
    NJANari Jagriti Abhiyan (Women Awakening Movement)
    NRHMNational Rural Health Mission
    NSSNational Service Scheme
    NSSCNational Scheme Sanctioning Committee
    NSSONational Sample Survey Organisation
    NYKNehru Yuvak Kendra
    O&MOperation and Maintenance
    ODFOpen Defecation Free
    ORSOral Rehydration Solutions
    PCProduction Centre
    PHEDPublic Health Engineering Department
    PIPProject Implementation Plan
    PMUProject Management Unit
    PPTPower Point (Presentation)
    PRAIPlanning, Research & Action Institute
    PRIPanchayati Raj Institution
    PTAParent Teachers’ Association
    PWDPublic Works Department
    RCCReinforced Cement Concrete
    RDSOResearch Designs and Standards Organisation
    RGNDWMRajiv Gandhi National Drinking Water Mission
    RKMLPRamakrishna Mission Lokshiksha Parishad
    RSMRural Sanitary Mart
    SACOSANSouth Asian Conference on Sanitation
    SCScheduled Caste
    SCERTState Council of Educational Research and Training
    SCOPESociety for Community Organisation and Peoples Education
    SEIStockholm Environment Institute
    SGSYSwarna Jayanti Swarojgar Yojna
    SGBVSCSant Gadge Baba Village Sanitation Campaign
    SHGSelf-Help Group
    SIDASwedish International Development Cooperation Agency
    SIPARDState Institute of Public Administration and Rural Development
    SIPRDState Institute of Panchayat & Rural Development
    SLWMSolid and Liquid Waste Management
    SRPSector Reform Project
    SSASarva Shiksha Abhiyan (Universal Education Campaign)
    SSHESchool Sanitation & Hygiene Education
    STScheduled Tribe
    SWASTHHSchool Water and Sanitation Towards Health and Hygiene
    SWSMState Water & Sanitation Mission
    TIFACTechnology Information, Forecasting and Assessment Council
    TLBToilet Linked Biogas
    TLCTotal Literacy Campaign
    TSCTotal Sanitation Campaign
    UNUnited Nations
    UNDPUnited Nations Development Programme
    UNICEFUnited Nations Children's Fund
    UPUttar Pradesh
    USAUnited States of America
    USDUS Dollar
    WAPCOSWater and Power Consultancy Services
    WATSANWater and Sanitation
    WBWorld Bank
    WESWater and Environmental Sanitation
    WHOWorld Health Organization
    WSP-SAWater and Sanitation Programme-South Asia
    VHCVillage Health Committee
    VWSCVillage Water and Sanitation Committee
    ZPZilla Panchayat
    ZWMZero Waste Management

    Foreword

    Despite the fact that lack of sanitation and hygiene is responsible for a number of diseases especially among the most vulnerable sections of the society, this subject has been treated with a lot of apathy by policy makers across the globe and India has been no exception to this. Only during the last one decade the subject of sanitation especially rural sanitation has started getting attention from the policy makers and implementers in India. With the introduction of Total Sanitation Campaign (TSC) in 1999, a bold beginning has been made in India to accelerate rural sanitation coverage.

    A country as vast as India faces enormous challenges in operationalizing any policy decision. Efficacy of the implementation of the government policies has always remained a big challenge and rural sanitation sector has been no exception. The paradigm shift made by launching community-based TSC has witnessed a slow but continuous process of adoption of the key reform principles by the states over the years. It is interesting to learn the factors which induced different states in adopting TSC principles and also the reasons for not accepting some of them. Introduction of Nirmal Gram Puraskar in 2003 further accelerated the ownership of sanitation issue by the states and districts.

    Unlike other sectors, like education and health, policy evolution in rural sanitation has taken place in a relatively short time frame; as a result it is easy to study and analyze the process of sanitation policy evolution and the associated debates and conflicts. Within a few years, TSC, which remained a neglected subject for our policy makers and implementers, gained the status of one of the seven key national flagship programmes of the Government of India and was the only sector where Planning Commission had increased the 10th plan outlay by more than 100 per cent. As per the claims made by the Government of India, Millennium Development Goals are likely to be achieved ahead of 2015. This calls for a study of the key factors which helped in building the sanitation movement in India. The author of this book, Mr Kumar Alok, had the privilege of working as Director, Sanitation in the Government of India at a time when the TSC programme was gaining roots in many states and has been closely involved in a number of policy decisions and initiatives related to programme implementation.

    He has made a sincere attempt to document the policy development and the spread of the sanitation movement in various parts of India including the ongoing policy debates. The book is also about the constraints it faced, intense debate it has gone into and the competing role of its stakeholders that played a critical role in shaping and re-shaping the rural sanitation world of India. A careful reading of this publication will provide the required knowledge.

    The way forward as outlined in the last chapter of the book offers enough opportunities for the sanitation professionals to make a strategic shift in both the content and approach of future sanitation interventions. The opportunities available in recycling of waste, bio-methanation and saving in carbon emission are some interventions which have the potential of transforming the whole sector in near future. Even though the book discusses examples from the Indian programme, the experiences gained in India are of significance to many developing countries that face almost similar types of challenges. I am sure the book will be able to guide practitioners of rural sanitation not only in India but in other developing countries too in meeting the global sanitation challenge.

    Dr N.C.Saxena Former Secretary, Planning Commission, Government of India

    Preface

    Sanitation, like education and health, is a fundamental building block in the fight against world poverty. That is why leaders worldwide have committed to halving the proportion of people without access to basic sanitation by 2015, as part of the Millennium Development Goals. History tells us that investments in basic sanitation can help lift people out of poverty, ill health and early death. Today, 2.6 billion people—more than 40 per cent of world's population—lack access to basic sanitation. Meeting the needs of these women, men and children for a private, clean toilet—something taken for granted in developed countries today—is both possible and imperative. Together we can do it—and together, we must do it.

    India is one of the countries where the government has committed to address the challenge of sanitation, a much neglected subject with a lot of taboos attached to it. With strong political commitment, the Total Sanitation Campaign was introduced in 1999. Within a decade the sanitation budget increased nine-fold and the programme shifted from a supply-driven programme towards a community demand-based programme with the Panchayati Raj, the local governing body, in the lead.

    As a result the riskiest sanitation practice, open defecation, in rural areas has dropped from 89 per cent in 1990 to 74 per cent in 2006 and there are over 142 million new users in the country. Despite such concerted efforts, one in two people or some 600 million Indian still defecate in the open. The quantities of human excreta they produce in an increasingly densely populated environment allow diseases to spread easily. This is taking its daily toll in sickness, deaths, absenteeism from school, loss of productivity and exposing young women to risks of violation of privacy and violence.

    The actual account of the current achievements, approaches and experiences in India deserve to be put on paper. The author of this book, Kumar Alok, worked as Director, Sanitation in the Government of India and as Water and Sanitation Specialist in UNICEF's Delhi office. He is widely acknowledged for his contributions in the development of the sanitation sector in India.

    I am in no doubt that this book will inspire and guide many people to address the sanitation challenge and that the lessons drawn from the vast and rich Indian Total Sanitation Campaign can be applied within and far beyond India.

    KarinHulshofUNICEF Country Representative, New Delhi

    Acknowledgements

    Founder of All World Gayatri Pariwar and great seer, Pundit Shriram Sharma Acharya has observed, ‘As opposed to writing something worth reading, it is always better to achieve something which deserves writing.’ Sanitation movement in India in the beginning of this century has been one of such initiatives which deserves special writing and documentation. It is a saga of thousands of dedicated sanitation volunteers from all walks of life who have worked selflessly and tried to promote sanitation and hygiene in rural households of the country. In my opinion rampant open defecation has been the biggest national shame and these volunteers have tried their best to wipe out this slur afflicting national pride and glory. One can see thousands of fellow country men and women defecating in open field, along the roadsides, railway tracks, rivers/lakes and any other open space completely oblivious of the health hazards as well as the associated human indignity. In such a situation promoting sanitation and hygiene has been one of the biggest challenges in the country. Implementation of Total Sanitation Campaign (TSC)—the national sanitation programme—has been one of the largest sanitation initiatives ever taken up in India and that too in a very short time frame which has directly or indirectly influenced the lives of millions of rural people across the length and breadth of India. It has been the story of large scale behaviour change of millions of people who had been used to the extremely demeaning practice of open defecation for ages but adopted sanitary toilets for safe disposal of their excreta.

    Poor sanitation coverage is a challenge not only in India but many other developing nations. National Governments, Development agencies, donor community and sanitation professionals have been struggling to tackle this problem and meet the Millennium Development Goals related to sanitation but so far limited success has been achieved. Considering the vastness of India and variety of situations—administrative, economic, social, geographical—there are a large number of success stories as well as failures and challenges which need to be shared among the sanitation professionals and the key stakeholders. This book is an attempt to analyze the growth of sanitation movement in India—the evolution of policy and associated achievements and challenges in operationalising the policy and programmes in various provinces of India. It was my fortune to be an active participant in this national movement initially as Director of the Total Sanitation Campaign in the Government of India and later on as WES specialist in UNICEF, New Delhi. An effort has been made to correctly capture the evolution of the programme and strengthening of the sanitation movement in India so that development professionals can make best use of the learnings. Any critical comments on the policy, programme, opinion of individuals or organizations have been made only to give the correct perspective to the readers so that they may avoid the mistakes, if any, in future development of a similar programme.

    Sanitation is a noble mission for the nation and a large number of dedicated individuals and organizations have worked for this mission. I acknowledge the contributions made by each and every such individual and organization in building this movement who have been a source of inspiration for me to take up this documentation with the prime objective of correctly capturing the process of programme evolution as well as contributions made by various key players. The readers will be able to judge how effective I have been in this endeavour. Even though I had the desire to write this book, there was hardly enough determination to reach the destination. But for the continuous persuasion and encouragement of Dr Kamal Mazumdar and Mr Manu Prakash, this book would have been a non starter. I am extremely thankful to both of them.

    The entire team of sanitation professionals working in West Bengal deserve special thanks as they have provided me immense support for writing the book. Mr Chandi Charan Dey has been kind enough to spend considerable amount of time with me. He has always given his invaluable inputs to me. Dr M. N. Roy and Mr Chandan Sengupta not only encouraged me but also spent plenty of time in sharing their precious experience in the sanitation sector. I express my gratitude to both of them. Dr S. V. Mapuskar, Mr Srikant Navrekar, Mr K. K. Jadeja, Dr M. S. Kalshetti, Mr A. K. Singh, Mrs Sumita Ganguly, Mr C. Srinivasan, Mr P. Toshniwal, Mr P. S. Ojha, Mr S. N. Singh, Mrs Alka Malhotra, Mr Prakash Kumar, Father George have always been proactive in extending their support whenever I needed. They have given their vital and significant inputs in writing this book. My special thanks to Ms Arpita Choudhary for drawing the various sketches used in this book.

    I am thankful to all my ex-colleagues in Government of India and UNICEF for giving me required support in this initiative. My special thanks to Ms Lizette Burgers who not only encouraged me but also gave important suggestions in improving the content of the book. My wife Preeti, son Anshumaan and daughter Shradha have been the real supports and sources of strength for me. I am grateful to a large number of officials and sector professionals who have not only encouraged me to write this book but also actively supported me and without their help this work could not have been completed. I hope that the book will be useful for large number of sanitation professionals both within and outside India.

    KumarAlok
  • Glossary

    [Above/Below] Poverty Line: The Planning Commission of the Government of India uses a food adequacy norm of 2,100 to 2,400 calories per capita per day to define state-specific poverty lines separately for rural and urban areas.

    Accelerated Rural Water Supply Programme: National programme of the Government of India to augment water supply in rural areas.

    Additional Secretary & Financial Advisor: Each ministry in Government of India has a financial advisor who is usually in the rank of additional secretary.

    Anganwadi: Pre-school initiative under the Integrated Child Development Scheme of the Government of India.

    ASHA: Auxiliary Social Health Activist appointed on honorary basis at village level under NRHM.

    Block Development Officer: Key development functionary at block level, serving a population of about 100,000.

    Central Rural Sanitation Programme: First national sanitation programme introduced by Government of India in 1986.

    Chief Executive Officer: Administrative head of the district panchayat (Zilla Panchayat).

    Child Environment Programme: UNICEF's water and sanitation programme to improve child environment.

    Clean Development Mechanism: Carbon emission reduction mechanism approved under Kyoto protocol.

    Clean Milk Programme: Initiative taken up by National Dairy Development Board to improve the quality of milk through a number of initiatives, including sanitation and hygiene promotion.

    Communication and Capacity Development Unit: Set up in each state to take up communication and capacity development activities for TSC, Swajaldhara, water-quality monitoring and other programmes supported by Government of India.

    Community Led Total Sanitation: A community-wide approach based on participatory principles which seeks to achieve 100 per cent open defecation-free communities.

    District Water & Sanitation Mission/Committee: Separate institutional structure promoted by Government of India to implement TSC and Swajaldhara at district level.

    Ecological Sanitation (ECOSAN): A sanitation method which regards human waste as a resource. In ECOSAN, urine and faeces are separated at source and not mixed with water. The separated urine can be applied as fertilizer after treatment and faeces can be composted.

    Expenditure Finance Committee: Committee headed by Finance Secretary, Government of India for appraisal and approval of government-funded plan schemes/projects.

    Finance Commission: Statutory commission set up every five years to recommend distribution of net proceeds of taxes between union government and state governments.

    Gram Panchayat: Local governments at the village level in India.

    Green House Gas: Gases in atmosphere that absorb and emit radiation within the thermal infrared range.

    Indira Awas Yojna: Rural housing scheme sponsored by the Ministry of Rural Development, Government of India.

    Infant Mortality Rate: Refers to number of deaths per thousand live births in the first year of a child's life.

    Information, Education and Communication: Software activities, for example, media campaigns, capacity-building activities and community hygiene promotion, that support and promote the programme implementation.

    Integrated Child Development Services: A centrally sponsored programme aimed at providing services to pre-school children in rural, tribal and slum areas in an integrated manner so as to ensure proper growth and development.

    Integrated Finance Division (IFD): Every ministry in the Government of India has an integrated finance division which is responsible for providing advice and support on all financial matters and monitoring the progress of expenditure on various activities.

    Intensive Sanitation Project: Community-based sanitation project taken up in Medinipur district of West Bengal in early 1990s.

    International Learning Exchange: Learning exchange in water and sanitation sector initiated by UNICEF, New Delhi in partnership with Government of India for international professionals.

    Joint Monitoring Programme: Established by WHO and UNICEF at the end of the International Drinking Water Supply and Sanitation Decade (1981–90) to report globally on the status of water supply and sanitation sector.

    Menstrual Hygiene Management: Promoting hygiene and sanitation amongst adolescent girls and women during menstruation period.

    Millennium Development Goals: The Millennium Development Goals are eight goals to be achieved by 2015 that respond to the world's main development challenges.

    Nari Jagriti Abhiyan: Women's wing of All World Gayatri Pariwar working for empowerment of women.

    National Bank for Agriculture and Rural Development: The apex institution accredited with all matters concerning policy, planning and operations in the field of credit for agriculture and economic activities in rural areas in India.

    National Council for Education Research and Training: An autonomous organization set up in 1961 to assist and advise the governments at centre and in states in implementation of their policies for education.

    National Dairy Development Board: Founded in 1965 to transform dairying into an instrument for the development of India's rural people.

    National Family Health Survey: A large-scale, multi-round survey conducted every 5–6 years in a representative sample of households throughout to provide essential data and information on important health and family welfare issues.

    National Informatics Centre: A government organization set up to provide network backbone and e-governance support to central government, state governments, districts and other government bodies.

    National Rural Health Mission: National Mission to provide effective health care to the rural population.

    National Scheme Sanctioning Committee: A committee headed by Secretary, DWS, with official and non-official members to scrutinize and sanction TSC projects.

    National Service Scheme: An initiative aimed at inculcating the spirit of voluntary work among the students and teachers through sustained community interaction.

    Nirmal Gram Puraskar: Innovative incentive scheme launched by the Government of India for local self-governments to attain open defecation-free status.

    Panchayati Raj Institution: Three-tier institutions of self-governance mandated by the 73rd constitution amendment.

    Parent Teachers’ Association: Outlet for parent participation at most public and private schools.

    Production Centre: Promoted under TSC to produce low-cost sanitary wares.

    Project Implementation Plan: Comprehensive plan to be developed by each TSC-implementing district, covering both software and hardware activities.

    Rajiv Gandhi National Drinking Water Mission: Mission set up by the Government of India in 1986 to mitigate water supply and water quality problems in India.

    Ramakrishna Mission Lokshiksha Parishad: Rural and social development wing of spiritual organization Ramakrishna Mission which was set up by Swami Vivekananda.

    Rural Sanitary Mart: Promoted under TSC to procure and supply sanitary wares, toilet technology and services for setting up sanitary toilets.

    SACOSAN: South Asian Conference on Sanitation organized every two years in one of the South Asian countries to promote sanitation in the region.

    Sant Gadge Baba Village Sanitation Campaign: An incentive scheme introduced by Maharashtra government to promote rural sanitation. The scheme promotes competition among PRIs to claim the sanitation awards.

    Sarva Shiksha Abhiyan: A national flagship programme to universalize elementary education by community-ownership of the school system.

    Scheduled Caste: Indian population groupings that are explicitly recognized by the Constitution of India, otherwise known as Harijans.

    Scheduled Tribe: Indian indigenous population groupings explicitly recognized by the Constitution of India.

    School Sanitation & Hygiene Education: An important component of TSC to promote sanitation and hygiene in schools and among children.

    School Water and Sanitation Towards Health and Hygiene: A USAID-funded project implemented by UNICEF in select districts in Jharkhand and Karnataka to promote water supply, sanitation and hygiene in schools.

    Sector Reform Project: Demand-responsive reform initiatives introduced by the Government of India in 1999 aiming at decentralized management of water and sanitation programmes by the local communities.

    Self-Help Group: A group of rural poor who volunteers to organize themselves into a group for eradication of poverty of the members.

    State Water & Sanitation Mission: State-level institution usually headed by the chief secretary to plan and monitor water supply and sanitation programmes.

    Total Literacy Campaign: District-specific campaign launched throughout India in early 1990s for eradication of adult illiteracy in India.

    Total Sanitation Campaign: Revamped central rural sanitation programme launched in 1999.

    Village Health Committee: Village-level committee to plan and implement health and family welfare programme under NRHM. It is also being used to implement sanitation programme in many states.

    Village Water & Sanitation Committee: Village-level committee set up for implementation of TSC and Swajaldhara.

    Zero Waste Management: Innovative solid waste management initiative taken up in Tamil Nadu.

    Zilla Panchayat: District-level elected body as part of three-tier Panchayati Raj system.

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    About the Author

    Kumar Alok is an Indian Administrative Service (IAS) officer of the 1990 batch and presently the Chief Executive Officer of the Tripura Tribal Areas Autonomous District Council (TTAADC), an autonomous institution created under the Sixth Schedule of Indian Constitution for overall welfare of the tribal population in Tripura. An M. Tech. from Indian Institute of Technology (IIT), Kanpur in Aeronautical Engineering, he is a social development professional with wide-ranging experience in various social sectors. He has long and rich experience in sanitation and hygiene promotion at the national level in India as well as in the international agency—UNICEF. He played a key role in designing and scaling up of India's national rural sanitation programme while working as Director, Rural Sanitation in the Department of Drinking Water Supply in the Ministry of Rural Development, Government of India. He was responsible for initiating a large number of innovations in ‘Total Sanitation Campaign (TSC)'—the flagship rural sanitation programme in India, including designing and operationalizing the innovative incentive scheme, Nirmal Gram Puraskar, and an effective online monitoring system for TSC. These innovations were instrumental in revamping and rejuvenating the rural sanitation programme in India.


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