The importance of the old tried and tested adage that prevention is better than cure has been firmly reinforced during the COVID-19 pandemic. People collectively across the country have taken precautions like wearing masks, maintaining distance and avoiding public places to protect themselves. However, there remains a large part of the population for whom some of these precautions are not a choice. For the urban poor in India, a section that relies on shared toilets, the risk of contracting the disease is much higher – as numerous studies have since shown. A report from the Observer Research Foundation1 noted that in Mumbai “the presence of overused and poorly maintained mega community toilets is seen as the ‘main reason’ for the explosion of Covid-19 cases in the city”. Already burdened by job loss and lack of access to health facilities, people living in urban slums are further left with meager resources to cope with the prolonged stress caused by communicable diseases. Women and girls who use shared toilets remain at constant risk of harassment when accessing these facilities. Burdened by the roles of the care economy and other needs related to the management of their menstrual hygiene, they suffer from more inequalities. These inequalities were further compounded during COVID when access to shared facilities added further danger in terms of the transmissibility of infections.
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In this scenario, individual household toilets (IHHTs) play a key role in the overall health and well-being of communities. Having a toilet in the home can address the privacy and safety concerns of women and adolescent girls and meet their menstrual hygiene management needs. For the elderly, people with disabilities and transgender people, a household toilet can be a remedy. Even though an awareness-raising and incentive-based approach has been adopted to motivate citizens to build toilets in their homes, there are several barriers to constructing these toilets. Some of the main concerns include:
- Lack of space in high density areas with small dwellings
- Other infrastructural issues such as lack of water supply, inability to get a sewer connection, especially in compact city agglomerations
- Behavioral issues such as preference for community toilets, perceived lack of need, and reluctance of community members to build toilets inside the house
Several experiences from different cities have suggested possibilities and ways to deal with these constraints. Appropriate measures are carefully adopted by community members and government stakeholders to provide adaptive reuse of space in small dwellings, opportunities for group settlements, access to sanitation credit through the through self-help groups and access to sewers in urban slums. For example, Pune Municipal Corporation, in partnership with Shelter Associates (SA), has built 3,186 IHHTs under its One Home One Toilet (OHOT) program. Under this model, SA covers the cost of materials needed to build the toilets, community members cover the cost of labor, and the materials are delivered to their doorsteps to help speed up the construction process. The continued focus on building these toilets, especially from a safety perspective for women and girls, encourages community members to take a step in this direction.
Similarly, to meet the constraint of adequate space for constructing toilets, some cities like Wai, Mahad, Sinnar, Vadagaon and Vita in Maharashtra have introduced the idea of group toilets, in which joint families or two three households share a toilet. Communal toilets, even if not entirely used by a single household, exponentially limit access to large numbers of people, make it easier to maintain hygiene, and reduce the multiple risks associated with community and public toilets.
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Sanitation credit through banks and micro-finance institutions (MFIs) through self-help groups has also helped women and other groups in vulnerable communities to construct individual household toilets. Living in a tiny house of just 12 square meters hasn’t stopped Suman from building a toilet and bathroom in his one-room house in Jalna, Maharashtra. Suman is a member of a Self Help Group (SHG) through which she was able to borrow Rs. 11,000 from a private bank and Rs. 5,500 as an internal SHG loan for her toilet. Sanitation loans have been mobilized for over 300 women by linking self-help groups with regular commercial banks in Jalna.
Data collected and behavior change programs improve understanding of community sanitation needs. These, when combined with community awareness programs emphasizing the need for home toilets and the dangers of open defecation, and information on the use of adequate measures, have generated optimal results. . With the aim of highlighting the role of communities, in particular the essential role played by women and local government in the construction of individual toilets in the most vulnerable areas of the country, the Center for Water and Sanitation from CRDF, CEPT University, along with partners from the National Fecal Sludge and Septage Management Alliance (NFSSM Alliance) developed a casebook to show how these perceived barriers to building IIHTs were successfully overcome.
Sustainable Development Goal (SDG) 6 and its target 6.2 for 2030 emphasize access to adequate and equitable sanitation and hygiene for all, ending open defecation and granting particular attention to the needs of women and girls, as well as people in vulnerable situations. Given the interconnectedness of social issues, the multiple impact of access to safe sanitation can be evidenced by improving public health indicators, improving access to education and livelihood opportunities for women and girls, and security for marginalized people and groups. There cannot be sanitation for all as the price of access to toilets is people’s health and safety. This makes individual household toilets important in solving the myriad of problems that are compounded by poor maintenance of community toilets and therefore their construction requires sustained impetus.
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(Dhruv Bhavsar is Senior Program Manager at the Center for Water and Sanitation (C-WAS) and Arwa Bharmal is Program Manager at the Center for Water and Sanitation. C-WAS at CEPT University ( formerly the Center for Environmental Planning and Technology) focused on action research related to urban water and sanitation.)
(Dr. Vivek Chauhan (Phd.) is Director – WASH at Reckitt)
Disclaimer: These are the personal opinions of the author.
NDTV – Dettol have been working for a clean and healthy India since 2014 through The Banega Swachh India initiative, led by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the interdependence of humans and the environment, and of humans on each other, with an emphasis on One Health, One Planet, One Future – Leaving No One Behind. It emphasizes the need to care for and consider the health of everyone in India – especially vulnerable communities – the LGBTQ population, indigenous peoples, various Indian tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically distant populations, gender and sexual minorities. With the current Covid-19 pandemicthe need for WASH (The water, Sanitation and Hygiene) is reaffirmed because handwashing is one of the ways to prevent coronavirus infection and other diseases. The campaign will continue to raise awareness of the same while emphasizing the importance of nutrition and health care for women and children, the fight malnutritionmental well-being, self-care, science and health, adolescent health and gender awareness. Along with the health of people, the campaign realized the need to also take care of the health of the ecosystem. Our environment is fragile due to human activity, which not only overexploits available resources, but also generates immense pollution due to the use and extraction of these resources. The imbalance has also resulted in an immense loss of biodiversity which has caused one of the greatest threats to human survival – climate change. It has now been described as a “code red for humanity”. The campaign will continue to cover issues such as air pollution, Waste Management, plastic ban, manual scan and sanitation workers and menstrual hygiene. Banega Swasth India will also advance the dream of Swasth Bharat, the campaign believes that only a clean Swachh or India where bathroom are used and without open defecation (ODF) status obtained under the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014 can eradicate diseases like diahorrea and the country can become a healthy Swasth or India.