Change behaviour to ease India's tough 'swachh' dream

Barely had the dust and excitement of the Independence Day action settled on the Red Fort in Old Delhi, for the second time in the year, the city got engulfed in stinky, unmanageable piles of garbage, all spilling out of the dumps onto the road.

So, while Prime Minister Narendra Modi’s I-Day speech resounded with the golden promise of a Team India beavering away to dramatically improve the access our countrymen and women have to toilets and the great dream of a Swachh Bharat, a simple management issue like the chronic shortage of workers (because they were off work owing to Independence Day) led to a stinking paralysis in garbage disposal.

This was a fairly rapid repeat of a similar situation just two months ago, when protesting against non-payment of their salaries for over two months, sanitation workers of the East Delhi Municipal Corporation deliberately threw garbage all over the streets so as to grab the government’s attention.

Providing facts to back-up what most Indians don’t need a survey to be enlightened by is a recent assessment by the Ministry of Urban Development of the Swachh Bharat Abhiyaan, releasing cleanliness rankings for 476 cities. 39 cities from the Southern states are among the top 100 followed by 27 from the East, 15 from the West, 12 from the North and 7 from the North-Eastern states.

Delhi, as the capital city, is at a dismal 379, although its New Delhi Municipal Corporation has the distinction of being No 16! With minimal open defecation and effective solid waste management, seepage and water management as yardsticks, the survey places the southern city of Mysuru in Karnataka on top and Damoh in Madhya Pradesh at the bottom.

If you were to shut your eyes for a moment and try to think of a clean India, chances are a million images will flit by. Public places in India are often characterised by great grubbiness and while we aren’t very effective with managing our garbage; the situation with toilets is as bad, if not worse. Just about 50 per cent homes have access to a toilet, and the situation of public toilets across the country is pitiable, despite major improvements in the last few years.

So, it seems like a dramatically unattainable expectation couched in a symbolic rhetoric, that India will present Mahatma Gandhi a Swachh Bharat as a tribute and gift on his 150th anniversary in just about four years. Modi – with his now familiar, even popular, bluster – congratulated his Team India for having nearly completed the task of building 4.25 lakh toilets – separately for boys and girls – in 2.6 lakh schools across the country during his August 15 speech this year.

The intent was announced by him in 2014, “I had announced it without consulting anybody. It was not announced after collecting relevant information from districts and villages. It just came into my heart.” But Modi agrees that it is more than just about building toilets.

In fact, if the “relevant information” had actually been collected from districts and villages, a scenario of complex and inexplicable human behaviour and of exercising choice, of avoiding a badly-built or maintained toilet, and of why exactly countless Indians still defecate in the open, would obviously emerge.

It is beyond argument that sanitation and hygiene are perhaps the most critical and also the toughest public health challenges we are facing today. More than a third of the world’s underweight chil-dren live in India and hunger and under-nutrition, we know, require aggressive interventions in sanitation and hygiene if they are to be addressed.

Disregard for sanitation

Also, it is well-established that among the most powerful actions that can lead to an improvement in girls’ education is the availability of water and sanitation facilities in educational institutions. Diarrhoea is a major burden too. And we need no surveys to tell us that a lot of this is because of an utter disregard for cleanliness, sanitation and hygiene.

Interestingly, we know very little about this disregard, and where it really comes from. Very little is said about, and even less is invested into understanding, the extensive human behaviour change that would be essential among communities and civil society for our cities to look cleaner, and for India to become really “swachh”.

Behaviour change can be catalysed to some extent through awareness and knowledge, but it also requires a certain measure of stringent control, law enforcement and an emphasis on public behaviour that can help set in a culture of human responsibility and accountability for the upkeep of the shared commons.

Maybe, Modi should have ordered a survey to study people’sattitude to using a toilet, or dissecting the perception that open defecation is somewhat cleaner as a practice than using a dirty toilet. Or why we dump garbage wherever we go? So again, who is this ‘Team India’? It is us, isn’t it?

Goal 7 of the Millennium Development Goals is one that India is lagging on, in improving access to adequate sanitation and hygiene for all, and thereby eliminating open defecation. So, what is the Swachh Bharat Team India really working on?

A clean-up act is not easy, and is likely going to take years. The systems are in place, and so are the resources (staff, finance, policies and programmes), but, as has been the case time and time again, the bottlenecks are around implementation on the ground. Meanwhile, it is our behaviour that we can change, for it rests within our circle of influence.

(The writer is Professor of Health Communication at the Public Health Foundation of India)