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Ending Open Defecation in India: Long Way Ahead

India's flaw: Dr Agrima tells us why public health has remained a casualty despite all the progress in a variety of fields

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photo: www.sunuptimes.com

photo: www.sunuptimes.com

Pessimists claim that world is in a mess. Optimists however differ. Their contention is that progress in science, technology and communications has comparatively made the world a better place to live in. Optimists are right in their own belief. Their belief emanates from their air-conditioned chambers located in highly developed metros in the world. Obviously, they are far from factual realities. The ground realities are entirely different.
The overall living conditions of a very large number of the people on the planet remain extremely pathetic, to say the least. This pitiable condition of the people, who cannot afford even a morsel of food, makes the pessimists to conclude that the world, is in a mess. Public health is a major causality .There has been remarkable progress in various fields including agriculture, medical research, diagnostic means and communication, to name a few that concern a common person, but sanitation and hygiene have remained a major dilemma demanding an imperative and immediate solution. That is why public health has remained a casualty despite all the progress in a variety of fields. To get a clearer picture of the state of public health, one has to travel through the dark and dingy mud lanes of Asia, Africa, Latin America and other continents and reach an objective conclusion. Despite all the tall talks, sometimes doling out cash incentives by international agencies and even the UN agencies, hygiene and sanitation remains a major concern in all under-developed, least developed, developing and even many areas in developed countries.

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Take for instance India, the largest democracy and a fast developing country, which has made marvels in space technology. Indian political capital New Delhi looks like the most developed place in the world but a casual visit to one of the scores of slums would reveal the darker side of the picture. India’s financial capital, Mumbai offers a stark contrast to its high-rise towers in the slums where people live like sardines cramped in one shack, making every effort to just survive. For them caring about health and sanitation is a luxury they can simply not afford. Kolkata, the cultural capital of India is no better nor is the IT capital, Bangalore. Smaller cities are obviously even worse.

Nearly 600 million people defecate in the open in India. This lack of sanitation facility can commonly cause diarrhoea and intestinal infestations and diseases like hepatitis, cholera, typhoid among others. Every minute, more than 1 million litres human excrement enters the longest river of the country, Ganga. A WHO report claims loss of nearly Rs.6500 (approx. $104) per person in India due to highly preventable diseases caused by lack of hygiene. If affluent households having access to proper sanitation and hygiene are excluded, this figure rises to almost Rs. 12,000-15,000 per person.  These diseases cause much more than poor health, which is, loss of income. Due to illness, an auto rickshaw driver may not be able to go for work causing the worthy daily income, which is quite necessary to feed children. Things get even worse for the lone bread earners of the family adding them to vicious chain of poverty and ill health.

India Poo

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An early morning walk along the tracks of world’s fourth largest train network, Indian Railways will force you to notice men squatting every now and then at a considerable distance from the track defecating in open. This practice is more grieve for women who simply cannot afford the luxury to ‘openly’ defecate in open. “We have to spot where most men are going and then go in the opposite direction to find a deserted place in fields to defecate,” explains Laxmi, a labourer from outskirts of Delhi. The plight of women does not end at finding suitable place, but fears of privacy and sexual abuse haunt them every day. Meanwhile dangers of snakebites and worm infestations remains to be quite common. Moreover, many teenage girls drop out of schools when they start menstruating due to lack of toilets taking a toll on education and future of these young girls.

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Prime Minister Narendra Modi launched a massive cleaning and sanitation campaign aimed for cleaner surroundings as well as build sanitation facilities throughout the country. The programme targets to build 12 million Toilets in current fiscal year and more than 110 million toilets in next five years with budget of 600 billion Indian Rupees. A number of business houses as well as NGOs have also pitched in to build toilets in villages and school. Advertisements have started rolling on television for the importance of building toilets in every household. Women organisations have initiated campaigns urging women to demand constructing a toilet in the house before marriage if it is lacking. However, a more daunting task in the horizon is change. A change in the centuries old practices of relieving themselves under the open skies. Meagre toilet building would probably not solve the problem, or say yes, may be for females, but what about those men who love their freedom in the natural surroundings? They would still be out there. Mass media campaigns on importance of toilet use perhaps would be the next on list for building clean and healthy surroundings for the future generations. Though, road is far ahead, at least the journey has started.

Dr Agrima Raina (@agrimaraina)

South Asia Editor, Health & Politics Today

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