In 1925, Mahatma Gandhi said, “The cause of many of our diseases is the condition of our lavatories and our bad habit of disposing of excreta anywhere and everywhere.”
It has been 89 years since Gandhi urged India to give utmost importance to sanitation, however little improvement has been made. The World Health Organization (WHO) approximates that 60 percent of India’s population practices open defecation, and 97 million people do not have access to clean drinking water. There is no centralized system for garbage disposal, and the majority of sewage is currently untreated and disposed of improperly, leading to a variety of health problems. This lack of infrastructure disproportionately affects the impoverished, further burdening already disadvantaged groups. All major cities in India have an intermittent water supply, and 72 percent of Indians are still in need of hygienic sanitation facilities.
How will India address its worsening sanitation problem? According to Narendra Modi, the country’s recently elected prime minister, a “Clean India” campaign pledging that all Indians will have access to toilets and clean water by 2019 is the solution. Wielding a broom, Modi kicked off his campaign urging all citizens to dedicate 100 hours per year to clean India. Pictures of government officials, celebrities and schoolchildren sweeping trash in India have been posted on social networks. “A variety of activities such as pledge-taking marches, debates, street plays, essay competitions, and cleaning drives that may be used to focus public attention on this campaign and on the need for cleanliness,” cabinet secretary said Ajit Seth, India’s Cabinet Secretary.
Sanitation issues in India are the result of years of neglect and inaction. While Modi’s “Clean India” campaign is certainly laudable, its feasibility is uncertain.
Civic responsibility is an important characteristic to promote, but a government-backed awareness campaign that encourages citizens to volunteer two hours a week to clean India is not going to solve the country’s deeply rooted sanitation issues. For the “Clean India” campaign to be successful, civic responsibility must be combined with a government responsible for regulated and mandatory cleaning.
For example, the “Clean India” campaign encourages the picking up of trash. However, there is no infrastructure for proper disposal systems in place, making it more difficult for India to handle its sanitation crisis. Organized, institutional action, not just individual action, is needed to properly collect and dispose of garbage.
Modi’s campaign also includes the installation of 12.5 million latrines. Reducing open defecation would decrease vulnerability to infectious diseases, including intestinal parasites such as soil-transmitted helminths (STHs). Research has shown that the implementation and use of latrines alone can reduce the incidence of STHs by 50 percent. However, without proper systems for disposing fecal matter and treating wastewater, these latrines will be of no use.
Even though it is a G20 nation, India has a high incidence of the world’s neglected tropical diseases; 284 million cases of STHs a year, or 15 percent of cases worldwide, develop in India. In conjunction with water, sanitation, and hygiene (WASH) development programs, which aim to educate the public and address the lack of access to safe drinking water sources, a significant decrease in STHs and other preventable diseases can occur. This could also have a significant economic benefit. It is estimated that inadequate sanitation costs India almost $54 billion or 6.4 percent of its GDP per year due to increased health risks from lack of cleanliness.
A clean India is an ambitious goal. To meet this goal by 2019, increased government investment in sanitation is an utmost necessity. Modi was elected through large popular mandate. His unprecedented widespread support combined with his reputation as an efficient and effective leader have given him the ability to mobilize the country. Through social networking, Modi has managed to engage India’s youth to address prominent social issues and gain momentum toward his policies. However, until now, Modi has only made small steps toward addressing cleanliness in India. The success of his program will require giant leaps.
Anjali Bhatla is a sophomore at Rice University majoring in Health Sciences and Policy Studies. She is also working as an intern under the supervision of Jennifer Herricks, Ph.D., postdoctoral fellow in disease and poverty at the Baker Institute and the National School of Tropical Medicine at Baylor College of Medicine.