Swachh Bharat: India Achieves the Unachievable
Professor, Columbia University
DURING A BRIEFING session several months prior to the 2014 elections, I had the opportunity to discuss with the then Chief Minister of Gujarat, Narendra Modi, the future course of economic and social policy. When it came to the health sector, I urged the Chief Minister to pay special attention to public health as Prime Minister, should he win the upcoming elections.
I reasoned that over the decades, the Government had concentrated on the provision of medical services, which even the private sector provided. At the same time, it had neglected public health, which only the Government can provide. The result, for instance, was that the drainage systems in our cities had become so badly clogged that even moderate rains resulted in stagnant water bodies that then served as breeding grounds for vector-borne diseases. I went on to add that the old tradition of parents inculcating in their children the habit of washing their hands first thing after entering home and before every meal had also been dying. As Prime Minister, through television broadcasts and other mediums, Modi could exhort parents to instill good personal hygiene habits in children.
The Chief Minister patiently listened and then said: ‘2 October 2019 will be the 150th birth anniversary of Mahatma Gandhi. Why not resolve to gift the father of the nation a Swachh Bharat on that day!’
I must confess that I did not fully appreciate the significance of what he had said at the time. It was only when I heard him announce, in his maiden address to the nation from the Red Fort on 15 August 2014, the Swachh Bharat Mission (SBM) that I understood the meaning of his words that afternoon in Gandhinagar. In retrospect, it is clear to me that Modi had been thinking about transforming India in all its aspects for a lot longer than any of us may have realized.
Of the numerous schemes, projects, and policy reforms that Modi launched during the last five years, if I were asked to pick just one that will have the greatest long-term impact on the lives of people, it would have to be SBM. Ending open defecation, freeing cities and villages from litter and stagnant water, cleaning up the air we breathe, and bringing clean drinking water to all are essential to the long and healthy lives of citizens. While the current focus of SBM has been on ending open defecation and freeing cities and villages of litter, eventually, providing clean drinking water to all should be a critical component of policy as well.
Unprecedented Success of Swachh Bharat
SBM has made a perceptible difference to the level of cleanliness in Indian cities, with citizens sensitized to the importance of a litter-free environment as never before. But its greatest impact has been ending open defecation in rural areas. On 2 October 2014, the day SBM was officially launched, only 38.7 per cent rural household had toilets. With 9.7 crore additional toilets built, this proportion stood at 99.1 per cent in early May 2019. All states and Union Territories (UTs) except Goa, Odisha and Telangana had achieved 100 per cent sanitation coverage in rural areas by this time.
These are the official figures of the Government of India. It can be plausibly argued that the pressure to show progress leads local officials to exaggerate their achievements. But the National Annual Rural Sanitation Survey (NARSS 2018–19), conducted by an independent verification agency selected via open competition under the World Bank support project to SBM-G, broadly confirms these achievements for rural India. This survey is supervised from beginning to end by an expert working group – co-chaired by Professor Amitabh Kundu, a former member of the National Statistical Commission, and Dr N.C. Saxena, a member of the National Advisory Council chaired by Mrs Sonia Gandhi during the United Progressive Alliance Government. The expert group also includes as members, representatives of the World Bank, UNICEF, WaterAid, BMGF, NSSO, NITI Aayog and the Indian Sanitation Coalition.
Based on a sampling framework that covers 6,136 villages, 92,040 households, 5,782 schools, 5,803 Anganwadi Centres, 1,015 public toilets and 6,055 public spaces, NARSS 2018–19 is among the largest sanitation surveys conducted in India until 2019. The selection of villages and households within them is random and statistically representative in each state, making the sample representative of India. It collected its data between November 2018 and February 2019 and found that, nationwide, 93.1 per cent of households had access to toilets. Of the villages verified as Open Defecation Free (ODF) by the Government, the survey confirmed 90.7 per cent as being so. The survey also found 95.4 per cent of all villages surveyed having minimal litter and stagnant water. A particular concern among critics has been that households with toilets often do not use them. Therefore, NARSS 2018–19 made special effort to collect data on toilet usage. Contrary to popular belief, it found that a whopping 96.5 per cent of the households with access to toilets used them.
The first round of NARSS was carried out in 2017–18. This fact allows us to measure the progress achieved in 2018–19 over that in 2017–18. The proportion of households with access to toilets rose from 77 per cent in 2017–18 to 93.1 per cent in 2018–19. The proportion of households with access to toilets that used toilets rose from 93.4 per cent to 96.5 per cent. But the proportion of villages officially verified as ODF and confirmed to be so fell from 95.6 per cent to 90.7 per cent. This last finding suggests that sustaining collective behavioural change at the level of the village over a long period is a challenge and this is where the Government will need to persist in its efforts.
Notwithstanding its large sample size and supervision by multiple independent experts and agencies, critics have questioned NARSS for its overly optimistic findings. They cite their own surveys to argue that the actual achievements are far more modest. However, these surveys are relatively small and unrepresentative of the country as a whole, and as such cannot serve to make any generalizations of the findings to the nation as a whole. As of now, NARSS remains the most reliable survey. That said, it is important to take the critics seriously wherever outside agencies are conducting scientifically sound surveys without any involvement of the Government.
Even if one disputes the findings of NARSS, there is little scope for doubting the fact that since the launch of SBM, unprecedented progress has been made in ending open defecation in India. Even if the achievements as documented by NARSS are substantially discounted, it can be safely concluded that India is within striking distance of becoming open-defecation free. What had seemed a distant goal five years ago is within India’s grasp today. Unsurprisingly, early scepticism that building toilets does not mean much since they go mostly unused, commonly expressed by critics, has all but receded into the background.
The Road Ahead: Three Additional Swachh Bharat Challenges
To be sure, as we enter the year of the 150th birth anniversary of Mahatma Gandhi, we must applaud and celebrate those who helped bring India this close to eliminating open defecation. At the same time, in the midst of the euphoria generated by this success, we can scarcely afford to lose the momentum SBM has generated. Much remains to be done to sustain a Swachh Bharat in all its aspects and we must capitalize on the momentum generated by the journey so far to end open defecation.
In particular, perhaps in another ten years, we must aspire to improve our cleanliness standards to globally acceptable levels in three important areas. First, we must further accelerate the movement towards achieving clean cities and villages. This will require behavioural change on at least as large a scale as has been necessary to end open defecation, if not larger. As Indians, we like to clean our immediate surroundings, but only to then drop the waste and litter outside our premises. We must inculcate the habit of collecting waste, separating what can be recycled and then safely disposing the rest using modern methods and technology – local governments have a significant role to play in this enterprise. We also need to make drainage systems in the cities and villages functional so that rains do not create bodies of stagnant water. This is a critical aspect of public health that remains unaddressed.
The second important area that requires attention for the creation of a healthy environment is the air we all breathe. Pollution levels in Indian cities today are many times what any reasonable standard would recommend. This has resulted in a high incidence of breathing problems. For parents bringing up their children in even smaller cities, air pollution is a major cause of worry today. This is an area on which both the Central and state governments must turn their focus as soon as possible.
Finally, we need to ensure the availability of clean water for all. With vast economies of scale in laying down pipelines carrying water, this is a natural monopoly at the local level and calls for provision or coordination by the Government. Over the years, the quality of tap water in India has deteriorated so much that even citizens with limited incomes have had to resort to the costly solution of relying on bottled water. Besides the problem of contamination of piped water where it exists, we also have the problem of lack of availability of any piped water in large parts of the country. In many of these cases, the absence of clean water reservoirs that could serve as the source of piped water adds to the challenge.
The Government has already begun to make efforts in this direction. I am given to understand that piped water supply for all will be implemented in mission mode by making it a people’s movement, on similar lines as SBM.
In Conclusion
The challenge of a Clean India that meets the standards observed in developed countries is one we will have to work towards in the years to come. The good news, however, is that the success in ending open defecation in rural India in the last five years offers us hope as well as inspiration for conquering the challenges that remain in the foreseeable future. As India emerges as the third largest economy in the world in the next eight to ten years, it can also emerge as a nation with clean cities, clean air and clean drinking water for all.