Unsanitised lives

A recent World Bank study, which reported that lack of good toilets and poor hygiene costs about $54 billion (Rs 24,000 crore) to the Indian economy every year, should be an eye-opener for the government and society. The loss is equivalent to 6.4 per cent of the country’s GDP. It could only be a conservative estimate because the survey is based on random sampling and the actual figures could only be higher. The study, conducted by the Bank’s South Asia water and sanitation unit, found that premature deaths, treatment of sick people, fall in productivity as a result of illness and poor health, and loss of revenue from tourism as the main reasons for the loss. Poor sanitation is the basic cause of ailments that afflict the majority of the people and it goes without saying that the poor are affected more than others.

Diarrhoea, malaria and tuberculosis take the largest toll of life in the country and these are avoidable if basic health and sanitation facilities are available to the people. About 4.5 children die of diarrhoea every year. Access to clean drinking water and proper toilets is limited. In urban areas, sewage facilities are available to only 28 per cent of the people and 21 per cent have basic toilets. Government programmes and initiatives like the Sulabh scheme have only had limited impact. Arrangements for solid waste collection and disposal are bad. The situation in rural areas is worse. Defecating in the open is the norm and the use of soap is not common in many areas.

Greater investment in public health and sanitation is the only remedy for the situation. Much importance is given to the creation of physical infrastructure for development. But adequate attention is not paid to soft infrastructure like health and education facilities. The losses are invisible and it is the poor who mostly pay the cost of poor hygiene. The awareness of the need for good hygiene, which should come with education, is also low.

India’s position is much worse than many other countries like the Philippines and Cambodia where too the study of sanitary facilities was conducted. Individual and private initiatives cannot address the needs of public health and sanitation. Only governments have the means and machinery to improve the situation. The problem is not just economic, it is social also. A strong political will, large use of resources and great efforts are required to tackle the problem.