Swachh Bharat and the Ripple Effect

HENRIETTA H. FORE

Executive Director, UNICEF

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THE MOST ENDURING development victories are not those that are imposed, but those that are embraced by communities, carried forward and made an intrinsic part of people’s daily lives. When people decide to change their behaviours, they set in motion a ripple of progress that spreads from child to parent, household to household, neighbourhood to neighbourhood, community to community. India’s Swachh Bharat Mission (SBM) to end open defecation practices is a remarkable illustration of this phenomenon. By all accounts, this represents an unprecedented behaviour-change programme in development history, reporting over 500 million people now living in Open Defecation Free villages in 42 months.

Prior to SBM, 12 per cent of the world’s population practised open defecation. They often had no choice: their communities lacked even the most basic toilet services. In fact, one in three people – 2.3 billion in all – lacked even a basic toilet or sanitation service. Thanks to the leadership of Prime Minister Narendra Modi, who launched SBM in 2014, India now stands as an inspiring example to other countries travelling the same path to end open defecation – still one of the world’s great development challenges.

The lack of toilets and other sanitation services is just one part of the problem. In many communities, open defecation is seen as an acceptable practice – a cultural norm that has endured over generations, despite the enormous risks to people’s health and lives.

Indeed, open defecation and poor sanitation extract a significant human cost. For children it can mean illness and death from disease. They are also at risk of stunted growth because of faecal contamination in drinking water, leading to diarrhoea, worm infection and other diseases, damaging their guts and leading to malnutrition in their earliest years. Girls are often kept home and not allowed an education because schools lack separate toilets or proper sanitation. As always, the poorest and most disadvantaged children and families are affected most. This locks them into an intergenerational cycle of risk to their health and their futures.

The tragic human cost is matched by the steep economic cost to societies. According to the World Health Organization, poor sanitation results in an estimated global GDP loss of $260 billion annually, because of related health costs and productivity losses.

At the same time, the benefits of improved sanitation are significant. A 2017 study by UNICEF found that within open-defecation free environments, Indian households can save up to Rs 50,000 per year thanks to medical costs averted and time saved.

Countries simply cannot afford to miss out on this important development opportunity.

Guided by these clear health and economic benefits, India launched the Swachh Bharat Mission in 2014. Its goal was to finally make this accepted practice of open defecation unacceptable. The Mission’s success has been undeniable. Since its launch in 2014, the Government of India reports that over 500 million people in rural and urban areas have gained access to toilets. In rural areas, coverage has more than doubled from 39 per cent in 2014 to 99 per cent at the beginning of 2019.

To put this in perspective: sanitation coverage has increased more in the last four and a half years than it did in the preceding 67 years since India’s independence in 1947.

This achievement is even more impressive when we consider the longstanding, interlocking barriers that stood in the way for generations of Indian communities. Open defecation has long been an accepted behavioural practice in communities across the country. Cultural taboos prevented the building of toilets near homes. And enduring poverty kept hundreds of millions of people from accessing the facilities they need and deserve.

In an amazingly short timeframe, SBM successfully broke down these barriers by mobilizing every part of Indian society behind it, including communities, families, all sectors of Government, religious leaders, entertainment and sports stars, and businesses. In keeping with the vision of making sanitation ‘everyone’s business’, SBM brought together various development sectors, in order to support better progress in not only sanitation, but education and health as well. Schools need handwashing facilities and separate toilets so girls can manage their menstrual cycles and still attend classes. Clinics and hospitals require clean, sterile environments to prevent infection and disease. Households and communities need toilets to prevent contamination and the spread of illness.

Global development partners also gathered around this important effort, lending their experience, reach and advice as India embarked on this Mission. Together, we are working closely with Ministries to help them integrate hygiene and sanitation across local systems for nutrition, health and education, to reach every community and every family.

Supported by UNICEF, the Word Bank, WaterAid and other agencies and NGOs, the Government focused its investments in areas of greatest need, including high-burden states like Uttar Pradesh and Bihar.

On the corporate front, companies like LIXIL, Unilever, Johnson & Johnson, and corporate philanthropies like Tata Trusts have lent their expertise and investment to this effort, supporting community and school-based sanitation programmes and menstrual hygiene management programmes across India.

SBM also opened the door to innovations, including new toilet designs in disaster- and flood-prone states like Assam and Gujarat. A series of simple design changes keeps these toilets functional even during emergencies, minimizing the risk of disease transmission.

Innovative financing, in this respect, played an important role, by developing alternative credit models to provide affordable loans for households to build toilets. Initially launched in Maharashtra in partnership with Water.org and public and private financial institutions, these loans are now being expanded to Madhya Pradesh and Odisha.

To attract greater investment in this cause, the Swachh Bharat Kosh fund was established in 2014, raising more than Rs 8.7 billion in just four years, thanks to the generosity of companies and philanthropists all dedicated to ending open defecation.

The real secret to SBM’s success is more than just ‘building more toilets’, or policy reform or funding and investment. It is ensuring that people in communities are using these toilets, changing their behaviours, and convincing their neighbours, friends and family to do the same.

From the start, SBM was designed and rolled out as a jan andolan – a people’s movement. While the Government’s commitment and various funding sources are essential, the true heart of the initiative is an army of volunteers, including women, youth, and frontline workers. From densely populated urban slums to tiny, remote villages, these dedicated agents of change went into communities to work directly with families and leaders to convince them of the need to end open defecation.

Especially inspiring were the children and young people who adopted this cause as their own. Some 20 million wrote letters to the Prime Minister informing him of the action they had taken in their communities. In India’s Kabirdham district, 1,38,000 students from over 1,700 schools wrote letters to their parents to request that toilets be built in their homes, and the district declared itself ODF soon after. Just last year, over 4,00,000 students registered for the Swachh Bharat Summer Internship, through which they contributed to setting up sanitation infrastructure and worked directly in communities to change behaviours and attitudes. As SBM proves, children and young people are ready, willing and able to be change makers – and change leaders – in their communities.

This is where SBM’s ‘ripple effect’ comes in. As more people of all ages become involved, community demand grows. Local governments and decision makers discover a powerful and popular political incentive to continue investing in the issue and ensure that every community – from rural villages to crowded urban areas – has effective sanitation systems, along with safe water supplies.

Leaders have realized that training and employing local, community-based workers to install and maintain water and sanitation infrastructures can have a positive economic impact in impoverished areas. This sets in motion a cycle of progress and opportunity in the communities that need it the most. For example, UNICEF and the Tata Institute of Social Sciences joined forces to train cohorts of skilled sanitation specialists every year, the majority of which are women. They’re learning how to manage water, sanitation and behaviour-change programmes in communities. In fact, water and sanitation is an opportunity to help more young people, in more communities, gain vital skills and knowledge that they can carry with them in the years to come.

As sanitation increasingly becomes a social norm in every city, village and rural community, the demand for quality, well-managed systems will grow. According to the Toilet Board Coalition, the market for toilet-related products and services in India is predicted to double to $62 billion by 2021. In other words, this sector represents a significant opportunity as young people consider their future job prospects, especially in poor and disadvantaged areas.

This ripple of progress that has affected communities across India can also extend far beyond its borders, inspiring other countries to follow India’s example.

SBM’s many achievements were showcased when India hosted the Mahatma Gandhi International Sanitation Convention in 2018. This four-day event brought together delegates from over 70 countries. It was deeply inspiring to see countries gathering to share experiences and best practices in their journeys to ending open defecation.

The conference reminded us that we, as a global community, have much to celebrate – but more importantly, much to do. The last mile of any journey is the most difficult. Without urgent acceleration of our efforts around the world, many countries will not reach the 2030 goal of sanitation for all.

But the conference also reminded us that, embedded in the progress that nations like India have made, we can find the seeds of how to achieve true, lasting global progress. As countries live up to their commitments and targets under Sustainable Development Goal 6, the world can learn from India’s approach and find similar ways to put community empowerment and ownership at the heart of national plans to end open defecation.

Changing behaviours, constantly improving products, operation and maintenance, and drawing more partners, ideas, support and dedicated national resources to our important cause by building movements that can ripple across communities, countries and entire regions will be the path to success. SBM, in its grassroots-focused approach, is very much a model of sustainable development in action – taking action together now, for the future.

In the words of Mahatma Gandhi, the inspiration for this movement: ‘The future depends on what we do in the present.’

The country he loved so well has taken Gandhi’s words to heart. The time has come now for other countries to follow India’s inspiring example to end open defecation, and finish the last mile of their own journeys towards health, progress and prosperity for all people – including our future generations.