Over a decade ago when the world began discussing targets for sanitation the idea seemed simple — build toilets and people will use them. When the United Nations’ Millennium Development Goals (MDG), set in 2000, came to an end in 2015, over 2 billion people had gained access to improved sanitation. But this left nearly 2.6 billion people still with no or poor sanitation facilities — it was the world’s unfinished agenda. The Sustainable Development Goals (SDGs), which succeeded MDGs, set an ambitious global goal to completely get rid the world of this wicked problem by 2030. India (within India, the states of UP, Jharkhand, Bihar, Odisha) and Africa hold the key to this transition. So, where are we today?
The past nearly two decades have taught the world some crucial stuff. First, it is clear that toilets do not equal safe sanitation. The faecal matter, if excreted into a poorly made pit in the ground or a latrine connected an open drain (as is the case in most places), will contaminate and add to health burden. So, if building toilets must lead to the benefits that they designed to do — reduced water-borne diseases, improved nutrition of children and improved productivity — then sanitation has to differently done. The toilet has to be built with provisions for management of human excreta. The toilet must also be built with provision for water. Once again, if people cannot wash hands or clean the toilet then it will add to the health burden. This is the toilet+ strategy.
Second, there is the realisation that toilets without changes in behaviour will also not work — they could be built but not used. This is why the world now agrees that it must focus on educating people about the benefits of using toilets. The most important trigger is to link the benefits of using toilets with the most obvious one — how it will impact health. It is also clear that entire communities are the best to cajole so that there are social acceptance and some pressure that makes people change habits. This is the toilet ++ strategy. The question is if these bits of learning are enough.
Currently, India is pushing hard to meet its own open-defecation free goal of 2019. There is no doubt that much headway had been made in building toilets and in communicating the message of safe sanitation. The Indian government has been dogged and aggressive, which is much needed in this sector. It has also put its money where its mouth is. The government’s Swachh Bharat (clean India) mission has, on the face of it, no financial constraints. It is expected that by 2019, most of the toilets will be built; cities and villages will be declared Open Defecation Free (ODF). This is good news for the world, as till now six of 10 who defecated in the open were from India. This is good news. No question.
But will this be enough? I suspect that post-2019, the sanitation questions in India will be different, yet the same. The challenge will remain: How to ensure that the toilets continue to be maintained and used and how to ensure that human excreta is safely handled. If this is not done then the massive investment of counting toilets could be wasted — worse, governments would now believe that their task is done and priorities will change. But the expected health outcome, which requires not just building and using toilets but ensuring that water is not contaminated, will not be realised. This clearly must be avoided at all costs. But for the Indian toilet success to have a sustainable future, monitoring and public scrutiny must continue. The Indian government must not rush to claim success, not yet.
What then are Africa’s options for safe sanitation? Remember also that Africa is urbanising fast. It is living increasingly and explosively in peri-urban and urban settlements, which are brutally poor and invariably informal or illegal. The fact is that African cities, like all of us in the now fast-developing world, are building a completely unsustainable and unaffordable water and waste system. Cities are bringing water long distances; losing much in distribution and spending all they have in supplying expensive water to some and never all.
This means finding cheaper, much cheaper options for treating waste that comes out of toilets. As yet the toilet technology is either rudimentary, one or two pits in the ground, or so expensive that it cannot be afforded by most — flush toilets connected to miles of underground pipes leading to treatment plants.
But this is where the next toilet revolution must come. It must not be in building toilets but in building toilets with a system for safe disposal of waste. And this is where the opportunity lies. Human waste is a resource — it is about nutrients that could potentially enrich the soil, add to productivity. The problem is that it also has pathogens and many things that are not so nice. So, can this resource be reused — reworked into the land and not disposed of in water. Can the water and sewage paradigm move towards local recharge and local recycling? Can it? It must.
The writer is at the Centre for Science and Environment