The Hindu Business Line : Prize for ‘open defecation’

Last Friday, the papers carried two reports which project the stark reality of the co-existence of opposites in India. At one level, this phenomenon can be said to be indicative of the travails of trying to catch up with the developed world as quickly as possible. At another level, it could portray the slow but unmistakable growth of a “two-nation” syndrome, which could lend itself to any number of political and social interpretations.

Briefly, one of these reports said that India had formally notified to the Vienna-based International Atomic Energy Agency its plan to separate the country’s civilian and military nuclear establishments, a scheme that had previously been approved by the IAEA but has only now become officially operative.

Essentially, what this means is that India has been formally accepted into the exclusive club of nations which have excelled in the development of nuclear technology beyond a certain threshold level, the attendant message to the world being that India’s scientific prowess is now an established fact.

Sanitation facilities

The second report quoted a study carried out by UNICEF and WHO which said that India was in the forefront of countries regarding the number of people defecating in the open because of a shortage of proper facilities maintaining the minimum standards of hygiene.

On being presented with this none too wholesome picture, the first thing that comes to mind is the view that India is way behind the world with regard to its sanitation facilities.

Alternatively, one can also argue that the vast bulk of its population is so poor that it has nowhere else to go but out into the open to answer Nature’s call, probably looking up at power transmission lines carrying power generated by nuclear power installations.

Clearly, what has been represented above is the co-existence of the modern and the ante-modern which, on the scale given, will be difficult to comprehend by the Western world.

While the West cannot be blamed if it tempers its view of India’s scientific and economic prowess with the unimpressive performance on the hygiene and sanitation front, the fact is that this is the way quintessential India has grown up, not only now — that is, in the 21st Century — but from time immemorial.

If the subcontinent is considered to be the home of one of the great civilisations of the past and is seen to be an even greater civilising influence on the modern-day world, then it has got to be accepted in the way it presents itself today and has always been in the past, which stretches back a long way indeed.

Observed dichotomy

To say all this, however, is not to condone the proven poor performance on the hygiene and sanitation front, the awareness of which has grown exponentially with the progress of the Indian scientific and economic capability since 1947.

While the West should not view the observed dichotomy in the Indian situation through the prism of its own social experience if it wants to get a true feel of the temper of Indian society, those who are in charge of India’s economic and social development today should not hark back to the past to gloss over the present drawbacks.

Admittedly, given the colossal numbers involved, the job of trying to make life healthier for the masses in India is hugely difficult, which cannot be compared with similar challenges faced by the West in the formative years of its social and economic development.

The question that should be asked is whether everything possible is being done to improve the situation, which is not merely giving Modern India a bad name in the world at large but, perhaps more importantly, also having a pernicious effect on the growth and development of Young India, which the country can ill-afford in view of the innate value of that precious resource. In general terms, the WHO-UNICEF report referred to above says that nearly nine million children under the age of five perish every year, the largest number of victims being felled by pneumonia followed by diarrhoea.

Prevention package

Focusing on the latter, the report probes the reasons for the specific ailment, which is easily preventable and treatable and is considered in the developed countries to be no more than an inconvenience, taking the lives of an estimated 1.5 million children every year?

While the point is made that reducing the number of deaths “depends largely on delivering life-saving treatment of low-osmolarity oral rehydration salts (ORS) and zinc tablets to all children in need”, it is also underscored that progress will require “focusing on prevention, whether through the new rotavirus vaccine or by addressing the factors that lead to children developing the disease in the first place”.

The prevention package highlights five main elements that require a concerted approach in their implementation, two of which are promotion of hand-washing with soap and community-wide sanitation promotion.

The report says that an effort should be made to implement the results of existing consumer research on how to motivate people to wash their hands with soap to increase this beneficial and cost-effective health practice (hand-washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent). It also wants increased pressure of every kind to discourage the community-wide practice of open defecation.

As the report says, “Until recently, national governments and their development partners promoted the use of improved sanitation facilities primarily by constructing toilets. Today, a fundamentally new approach has been adopted — one that relies on the demand of a community to stop open defecation, which has proven far more effective”.

One result of this is that the stimulation of collective action to stop open defecation is now relying on “behavioural triggers related to status, pride, shame and disgust, rather than relying solely on health-related arguments”.

Diarrhoea deaths

More than 80 per cent of the annual child deaths due to diarrhoea occur in Africa and South Asia, just over 15 countries accounting for almost three quarters of the victims. According to the latest figures, India accounted for 386,600 deaths annually followed by Nigeria (151,700) and the Democratic Republic of the Congo (89,900). Though better access to safe drinking water and adequate sanitation, as well as promoting good hygiene, were key components in preventing diarrhoea, the report said that in 2006 an estimated 2.5 billion people were lacking improved sanitation facilities.

This apart, nearly one in four people in developing countries were practising indiscriminate or open defecation. While 1.2 billion people were practising open defecation worldwide, India topped the list of countries in this regard by accounting for as many as 665 million. Indonesia, Ethiopia and Pakistan were responsible for 66 million, 52 million and 50 million, respectively.

To say the least, this is not something that Indians can talk about with aplomb. Neither Zambia nor Bangladesh is any more affluent than India though they may be much smaller in size. Yet, as the report points out, some districts in these two countries have been declared “open-defecation-free”. Why cannot New Delhi take a leaf out of the book of these developing countries, district by district, and, in the process, shed its rather dubious distinction of being the topper in open-defecation?