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KEY FINDINGS
Village immersion and sanitation in India:
Financial assistance for this study is gratefully acknowledged
by the Institute of Development Studies (IDS), Sussex and
the Water Supply and Sanitation Collaborative Council
(WSSCC), Geneva. We are in debt to Prof. Robert Chambers
of IDS and Mr. Vinod Mishra of WSSCC for supporting the
study from inception. Prof. Robert helped in designing
the methodology for this study in the orientation session
as well as the structure of the report that took shape
during the debrief session. Along with Mr. Jamie Curtis,
he provided valuable inputs on the draft report. Special
thanks to Ms. Stacey Townsend at IDS, Ms. Manali
Bhatnagar of WSSCC and Mr. Manoj Singh of PHAD for
their facilitation and support.
We also acknowledge the assistance provided by Shri
Parameswaran Iyer, Secretary, Ministry of Drinking Water
and Sanitation, Government of India and his team. Our
NGO partners, Pradaan, WaterAid, Sewa Mandir and
Garo Para Nabadia Samiti provided field level insights
and logistical support to four state teams. We also thank
the numerous officials, panchayat functionaries and
civil society stakeholders and villagers with whom the
team members interacted and stayed with during their
visit to 58 villages across 20 districts and 14 states in
the country. We acknowledge the insights provided by
Mr. V K Madhavan, Executive Director, WaterAid, Mr.
Tom Thomas, CEO Praxis and Mr. Sowmyaa Bhardwaj,
Deputy Director, Research & Capacity Building, Praxis
briefings during the orientation session of the village
immersion study.
Satyajit Singh (University of Delhi)
Abhijeet kumar, abhinay yarlagadda, adazia ophrii,
akanksha kapoor, akash kumar, akshay bhambri, anjana
ranjith, ankita choudhary, barkha dubey, carol wilson,
deepa mehra, devender kumar dubey, divya shikha,
g rajiv murti, harshita prajapati, harshvardhan arya,
ishleen kaur, kamini mishra, karan meena, khriebino
kera, khunai nancy key, krishna mech, kriti seth, kunzes
dolma, manisha arya, rubina khan, mhadeno jungi, milind
malhotra singh, mithilesh kumar, mo yousuf, neha purohit,
nilesh anand, nilesh roy, nilofar anjum siddiqui, om rai,
prachi das, princi verma, rama mukhiya, rinki, sandeep
jaiswal, savita regar, shalini anand, sristi kumari, suman
maurya, surya gadde, surya prakash, sushil yadav, syed
hafsa altaf, t k khuveio, tanmita kundu, vatsalay singh,
vijay prakash singh, yamin chowdhary & yasmin siddique.
Acknowledgements
Meeting with Jeevika SHG members in Bihar
VILL AGE IMMERSION AND SANITATION IN INDIA 1
The methodology of the study was adapted from the
Reality Check Approach and enriched by previous village
immersion research conducted by the researchers of
the Institute of Development Studies, Sussex. Students
in teams of two to three spent 3-4 days in two villages
in each state. The students were selected on the basis of
their familiarity with the state. A total of 54 students, out
of which 32 were women, visited 58 villages across 14
states and 20 districts in the country. The states covered
were Jammu & Kashmir, Punjab, Himachal Pradesh,
Rajasthan, Madhya Pradesh, Chhattisgarh, Kerala, Uttar
Pradesh, Bihar, Jharkhand, Sikkim, Assam, Manipur and
Nagaland. Of these 18 were Non-ODF and 40 were ODF
villages as officially declared by the GoI.
The students had an orientation session for three days,
including a workshop at the Ministry of Drinking Water
and Sanitation that familiarized the students about
Swachh Bharat Mission (Gramin) (henceforth SBM(G))
it’s aims and achievements till date. The core study team
and experts from Praxis and WaterAid, briefed about
various toilet technologies, introduced them to the Reality
Check Approach and familiarized them with tools and
techniques to have conversations in the villages, how to
become aware of the local power structures, and able to
get to the voices of the poor and marginalized sections
of the society. Various types of participatory games were
played to underline that the study team observes rather
than provides leading questions for expected answers.
They were also introduced to the participatory transect
walk and how they could get villagers to draw their own
village maps , its institutions and sanitation related issues.
The students were given a check list prior, but it was
underlined that the reality of the village may make some
of the issues in the check-list redundant and open new
issues and concerns that the study team should follow. It
was emphasized that they reside in the village in people’s
households and build trust so that they can identify issues
and specific concerns that a visiting survey team would
not be capable of. Once the teams returned , the research
team designed a three-day de-brief that ensured that all
the students were able to interact with the other teams.
The core study team wanted that the specificity of the
experience of the individuals and their teams, did not
influence the conclusion of the wider report. Hence, it
was desired that the entire team familiarizes with the
different complexities in other villages, districts and
states. Methodologically this was an uncharted territory
for the facilitating team and a considerable challenge,
with 54 students each having contributions to make on
most topics and representing huge diversity from 58
villages in 14 states, as noted above. The process was
evolved and improvised, drawing on other techniques
and approaches, but largely inventing on the run. This
was made easier by the outstanding commitment and
energy of the students, and their desire to give inputs into
most of the topics. Without which this process would
have been less productive.
One student remarked that it was as if the field trip was in
preparation with the actual field investigation across states
that took place during de-brief. And another remarked that
they learnt more during de-brief, than they did during the
course of the field trip. Clearly their individual window
with rural sanitation during the village immersion, was
combined with multiple windows of immersion from
across the country. During the second day of the de-brief
we had state teams making their presentations, which
was followed by a brief presentation by the thematic
teams. On the basis of feedback from the study team,
the thematic teams finalized their reports on the third
afternoon of the debrief session.
Short note on Methodology
Robert Chambers briefing students in the orientation workshop at Delhi
Debrief by students after returning from field
KEY FINDINGS2
Despite all attempts made to avoid biases and distortions
during the study, some of them may have inadvertently
crept in. A few important ones could be as a result
of, duration of the study, location bias, , presence of
Government/NGO partners, choice of communities,
villagers accustomed to our methodology, language/
semantic barriers and so on. There were also some of
the distortions in the ODF claims of the Government and
misinformation in the system. It is also important to point
out the observer profile whilst we discuss the biases and
distortions. Nevertheless, we have made every effort to
not let the study become a hostage to our prejudices. It is
also important to point out that the study has had nearly
equal number of male and female participants thereby,
helping to ensure gender inclusivity and diversity of
opinions. The workshop prior to the study also helped
the teams to negotiate the complex reality in the field
as well as to break ice and build trust with individuals
and communities.
When SBM-G was launched on 2nd October , 2014,
individual household latrines were available to only 38.7
percent of the rural population. The government placed
behavioral change at the centre of the program which
required creation of a huge pool of trained motivators,
facilitators, implementers and trainers for the behavioral
change campaign. These multiple-stakeholders were
neither in place, nor part of the administrative framework
at the disposal of the State at that time. In a short span
of time, the government has constructed more than 8.75
million toilets and declared 25 States/Union Territories
open defecation free (ODF). The Ministry of Drinking
Water and Sanitation claims 95 percent sanitation
coverage by 25th October 2018. These claims are yet to
be verified by independent government agencies such as
the National Sample Survey Office (expected July 2019)
and the next Census of India (to be held in 2021) that will
give independent figures.
Whatever the statistics say, this is the biggest and
quickest toilet construction programs in the world. The
Mahatma Gandhi International Sanitation Convention
(MGISC) held in Delhi and Ahmedabad during September
29th to October 2nd, 2018 celebrated this laudable
achievement. The MGISC brought together over 200
international participants from 70 countries, including
55 sanitation ministers. The MGISC 2018, declared that
Political Leadership, Public Funding, Partnerships and
People’s Participation are necessary to provide the world
with safe sanitation.
Prior to the launch of the program, India and Africa were
the laggards as per rural sanitation globally. The United
Nation’s 2030 Agenda for Sustainable Development calls
for universal access to clean water and sanitation as per
SDG-6. With the targeted achievement of ODF rural India
by early 2019, there is an opportunity to achieve other
aspects of SDG-6 well within the time frame set by the
United Nations, in this country. The way this has been
done in India, is another model for the world to replicate.
In a short time, SBM (G) has ensured that India is in the
midst of a sanitation revolution. This has been achieved
with significant public funding and the backing of the
highest political authority in the country and states,
followed by a dedicated cadre of district level officials and
below. SBM (G) under the leadership of MDWS Secretary,
Parameswaran Iyer, ensured a continuous engagement
with the grassroot implementers through the creation of
regular knowledge and experience sharing platforms. The
program created a Management Information System and
Swachhta App that was accessible to all. It is claimed that
all toilets are geo-tagged on construction, for verification.
The sanitation sector has never witnessed this level of
enthusiasm by the international and national development
partners. The Tata Trusts supported the program with
500 Zila Swachh Bharat Preraks, who acted as facilitators
at the district level and below and as communication
nodes to the centre.
Biases and Distortions
Introduction
VILL AGE IMMERSION AND SANITATION IN INDIA 3
SBM(G) is designed to be a demand driven model. It places
behavioral change as a focus of the program. It uses the
approach Community Approach to Sanitation (CAS),
accommodating multiple facets such as the use of tools
like Information, Education and Communication (IEC)
including wall paintings, Nukkad Naataks, Swachhata
Raths, Behaviour Change Communication (BCC) and
Inter Personal Communication (IPC), among others.
At the core is an army of Swachhagrahis (grassroot
motivators), one per village across the country. They are
engaged through existing institutions like Panchayats, co-
operatives, ASHAs, Anganwadi workers, women groups,
community-based organisations, Self-Help Groups, etc.
These Swachhagrahis are the Mission’s boots on the
ground and they move within and outside their villages,
generating awareness, facilitating safe sanitation practices
and ensuring sustainable practices.
On the ground, the entire process leading to the achievement
of the Open Defecation Free status aims to be democratic
in its functioning. Through the community approaches to
sanitation, people are brought together, and they decide
to make their village ODF. When the village becomes ODF,
the declaration is made by the people themselves in their
respective Gram Sabhas. For technical sustainability and
maintenance, the village sanitation coverage is formally
verified by the district and then by the State teams. Various
activities run parallel to the declaration and verification
of an ODF village to reinforce and maintain its status.
Nigrani Samitis are supposed to remain active to keep
all individuals sensitised towards the goal. They perform
regular morning and evening follow-ups at traditional open
defecation sites to reinforce the community’s commitment
to the goal and to ensure usage of toilets built.
The key finding of the study that can be summarized in
a sentence is that the story of rural sanitation in India, is
complex. There is no single story of good or bad, rather
it presents many stories of how different parts of the
country have dealt with and are dealing with WASH
practices; how the preference for toilet technology is
dependent on information, intermediaries, as well as
what is accepted socially by different income groups;
why its use is dependent on many variables such as
technology, seasonality and the availability of water
and social acceptance across states; the ways in which
the provision of functional and clean toilets can impact
other outcomes related to gender, education, health and
livelihoods; the varied agencies and mechanisms that the
different state governments utilize to impact behavioral
change or provide incentives for toilet construction; how
the story of rural sanitation cannot be limited to toilet
construction but needs to urgently address concerns
about its use and maintenance in the medium and long
term; and of course how successful toilet construction
opens other aspects of sanitation that have so far been
neglected and need urgent attention. While a lot has
been achieved in the last few years in terms of toilet
construction, there is a lot more that needs to be done
for behavioral change and usage, toilet technology as
well as other aspects of sanitation.
The study tries to understand the range of problems
that different people faced across India due to varied
background, geography and socio-economic factors.
Various problems including semi-built toilets (Assam),
broken seats and pipes (poor quality material used in
Punjab, Manipur), extreme water scarcity (Rajasthan),
and financial concerns (Chhattisgarh, Punjab, Assam,
Manipur, UP) to absence of inclusive policies (Jharkhand,
Chhattisgarh, Punjab), myths and beliefs related to sub-
structure and many more. While the central government
undertook such a bold behavioral change program, the
state governments have not lived up to the expectation
in its implementation.
KEY FINDINGS4
Himachal Pradesh, Punjab, Sikkim, Kerala and Chandigarh
had already achieved close to 90% household (HH)
toilet construction by 2nd October 2014 when SBM (G)
was announced. Naturally, these were the first states
to achieve ODF status and the approach adopted here
was based on years of work towards demand driven
behavioral change at the local level by the government
and the panchayats. Hence the achievements in the best
performing states visited by the team, were achievements
prior to the announcement of SBM (G).
While the government statistics for Jammu & Kashmir
was less than 25 per cent at the time of the announcement
of SBM, our report suggests that nearly all houses in the
Ladakh region have been using traditional toilets for
generations. These are being replaced by modern toilets,
much against the wishes of the people.
The earliest village level use of toilets was found by the
study team in villages in Kargil and Leh (Ladakh region)
of Jammu and Kashmir. Every living person in these
villages, no matter how old, had been using toilets all
their lives. This means that toilet use has been a part of
the culture in these villages for multiple generations.
An ancient monastery in Kargil constructed in the 19th
century had toilets. The toilets are unique to the region.
It is a dry latrine system through which the villagers
are able to collect the human waste in the pit below the
toilet and then mix it with cattle dung to make fertilizer.
This system developed because of extremely cold climate
which forced people to defecate indoors, and the scarcity
of water resulted in the use of a dry latrine. Since most
of the villagers are farmers, such toilets allow them to
make their own fertilizer instead of buying expensive
fertilizers from the market. Given that the data for toilet
coverage for the entire state is quite low, we need to
examine how the rest of the state is different and ask
as to why the traditional toilets are being sought to be
replaced by septic tanks in the region.
On the other side of the country, in Kerala, many people
have been using toilets and the government thrust since
the 1980s made them accessible. The oldest people living
in Kerala today were the first to witness the introduction
of toilets to villages and began using them. The toilets
in Kerala have changed over the years, from single pit
toilets to twin pit toilets. Presently, the high population
density has made septic tanks most popular. The high
amount of rainfall that the region receives increases
chances of contamination of open defecation as well as
contamination of ground water – a perception that has
gone against the twin pit latrines.
During the last decade of the previous century, toilets
started appearing in villages in most states including
Sikkim, Himachal Pradesh, Punjab as well as some
villages in Nagaland. By the beginning of the 21st
century toilets had become commonplace in all states
throughout the country, but not all states were able to
successfully integrate toilet use as a part of their culture.
With successive government programs promoting toilets,
the states of Sikkim and Himachal Pradesh were able to
successfully spread the use of toilets. The people in these
states were quick to understand the benefits of adopting
the new technology and today, hardly anyone from these
states defecates in the open. So much so, that we heard
people in these states say that they believe the earth is
sacred, and open defecation pollutes the earth. Further,
the hilly terrain and extremely cold climate during the
winter poses challenges to people when they defecate
in the open. However, while the people of Sikkim and
Himachal Pradesh were able to create a toilet culture and
evolve from the use of single pits to septic tanks, toilets
in most other states in the country remained accessible
only to the rich and upper caste. Toilets in states like
Punjab, Bihar, Jharkhand, Uttar Pradesh, Chhattisgarh,
Rajasthan were only used by the well-off while the rest
of the villagers would defecate in the open.
It is seen that most top-down approaches that have been
implemented in the past have not been very successful
and when sanitation was introduced and enforced by the
villagers themselves it has better success. For example, in
2009 a women’s society in a village in Manipur ordered
the construction of toilets throughout their village and
ensured that the villagers develop a culture of regular
toilet use. Top-down approaches have not been very
successful as they do not give people the right awareness
or enough sense of ownership over their toilets for them to
create habits of healthy toilet use. A bottom-up approach,
Pre-SBM and post-SBM initiative
VILL AGE IMMERSION AND SANITATION IN INDIA 5
led by the people themselves is more likely to create a
sustainable, long term behavioural change toward toilet
use. Sikkim, Kerala and Himachal Pradesh were the first
three Indian states to be declared Open Defecation Free.
So why did these three states ensure the use of toilets
into their culture while the other states did not? Before
discussing why toilet use became so prevalent in these
states, we first need to explain the way by which toilet
use spread within these states. The primary way through
which toilets spread across these states was through
imitation. If someone in the village (usually someone
educated, well-off and with links in cities) constructed a
toilet to the village and started using it, then other villagers
were intrigued by this new technology and would start
constructing and using it. Why did such imitation take
place in Kerala, Sikkim and Himachal Pradesh and not
in other states? Our experiences in each of these states
showed us that there was a lack of social inequalities
among communities of the three states. The people we
came across were socially inclusive and believed in strong
communal ties. We believe this was an important reason
that contributed to the spread of toilets as imitation was
possible only in an egalitarian society. It is because of the
fact that people would talk about the new technology that
arrived and would debate about the possible advantages
and disadvantages that they could bring, toilets spread
in these states. While in other states, the presence of
inequalities and discrimination meant that the toilets
of rich villagers would stay with them only and the idea
would not be shared by the poorer villagers or by those
who belonged to a lower caste. So, while in Sikkim, HP
and Kerala toilets became accepted as a necessary part
of basic human living, villagers in states like Bihar and
UP never saw toilets as anything other than the caprice
of the rich. The villagers in the states of Kerala, Sikkim
and Himachal had actively adopted the use of toilets, they
had become aware of the benefits that toilets provided
through the discussions they had with their neighbours
as well as their own experience of using toilets. Thus, they
had a good idea of how toilets worked and soon began to
make improvements in toilet use to make it easier and
more comfortable. Toilets with bigger superstructures
started being made and single pits were replaced with
the use of septic tanks. During this village immersion, the
use of toilets had become such an essential part of their
culture that we saw toilets being made within houses and
some houses had multiple toilets with both Indian and
Western style so that even the elderly and disabled could
use a toilet with ease. Thus, toilets gradually became a
part of the culture in these villages through the active
involvement the villagers had in the construction of
the toilets and the pride and sense of ownership they
got from building a toilet. This is completely different
from the situation in other states where toilets are built
for the villagers by the government – in fact they are
called sarkari toilets. The lack of awareness and sense of
ownership ensured that the toilets made in this fashion
would not be used by the villagers.
An added reason why Sikkim, Himachal Pradesh and
Kerala could easily adopt toilet technology was because of
collective action and better governance. Collective action
works better in homogenous societies and government
programs are also adopted better due to social cohesion
and lack of conflict. These are states that have led in
human development indicators due to a strong welfare
thrust given by successive governments.
Apart from social cohesion and collective action, high
literacy rate in each of these states also have contributed
to the popularity of toilets. People were quick to catch on
to the benefits that a toilet would bring into their lives.
There was awareness of the diseases that could possibly
spread by defecating in the open which motivated people
to turn to toilets.
The people of these states also faced certain hardships
when they used to defecate in the open. The hilly regions
of Himachal and Sikkim make it difficult for people to
walk around and find spots where they could defecate
comfortably. The mountains are also dangerous to walk
on at night. The cold winter months also posed a huge
challenge for people to defecate in the open. While in
Kerala the heavy rainfall that occurs for 6 months every
year would be a problem to people who would want to go
out to defecate. Kerala is also a very populous state, leaving
little land for open defecation. For these reasons the use
of toilets spread in these states and now has become a
part of their daily lives. As mentioned earlier, much of
this achievement was before SBM(G) as only 1.58 percent
toilets in Sikkim, 5.15 percent toilets in Kerala and 14.11
percent toilets in Himachal Pradesh were constructed
during the SBM(G) (see Table 1 on the overleaf).
Punjab provides a sharp contrast to Kerala, Himachal and
Sikkim, in terms of social cohesion, collective action and
KEY FINDINGS6
hardship. However, the upper caste Punjabis benefitted
from the green revolution and international remittances
and made pucca houses for themselves, comparable to
urban infrastructure. High income levels and aspirations
of a modern life had ensured that the prosperous Punjabis
had built and use toilets. It seemed that this had little to
do with the government thrust for behavioural change
and more to do with changes in aspirations of the people
with a rise in income levels. Hence the SBM(G) was quick
to wrap up ODF coverage in the state by targeting the
poor and the lower castes. In all, only 9.42 percent of the
total toilets built in the state was under SBM(G).
S. No. QuestionsKerala, HP, Sikkim
Punjab, J&K, Manipur & Nagaland
Assam, UP, MP,
Bihar, Jharkhand,
Rajasthan,
Chhattisgarh
1. Total villages visited 14 13 31
2. How many visited villages declared ODF 14 12 15
3. How many visited villages were not declared ODF
0 1 16
4. How many villages declared ODF were actually ODF
14 2 6
5. How many of the villages you visited had a nigrani samiti (or some sort of community group)
0 9 9
6. How many were in villages with twin pits with fertilizers
0 0 0
7. Was there anybody that you met who had seen a twin pit fertilizer
1 4 0
8. How many were in villages where there was one or more than one twin pit constructed or under construction
0 2 16
9. How many were in villages that had a septic tank – one or more – without a soak pit
0 9 18
10. Households had a check-list on what to how to check if mason had constructed the twin-pit right
0 0 0
11. How many villages did not have an anganwadi
0 0 7
12. How many villages had anganwadis 14 13 24
13. How many had anganwadis with toilets 14 9 8
14. How many of the schools had separate toilets for boys and girls
14 7 9
15. Schools with girls who would be likely to be menstruating
8 9 12
16. Toilets in schools used by teachers only 7 4 5
17. How many of you saw a brush for cleaning in the toilet
14 10 10
18. More than 10 % toilets brush with 14 3 5
VILL AGE IMMERSION AND SANITATION IN INDIA 7
S. No. QuestionsKerala, HP, Sikkim
Punjab, J&K, Manipur & Nagaland
Assam, UP, MP,
Bihar, Jharkhand,
Rajasthan,
Chhattisgarh
19. How many found school toilets so filthy that no one could use
0 10 21
20. How many would use school toilets clean enough
10 3 2
21. Activity of community triggering was organized in the Gram Panchayat/Community
10 6 6
22. Villages had IEC Campaigns 8 8 7
23. Community/Gram Panchayat role in declaring village ODF
14 2 6
24. Word was out that Pardhans, masons & others had made money from the incentives
0 7 28
25. Village with Swachagrahi 0 4 7
26. Villages without swachgrahi 14 9 24
27. PHCs with toilets 7 7 3
28. Panchayat bhawans with toilets 8 2 16
29. Usage90% and above50 % and above 10% - 50%0- 10%
14000
9
4
00
5
1
1612
30. How many villages were part of gram panchayats that had women mukhiyas
3 1 13
31. How many women mukhiyas did not know about SBM
0 1 5
32. Number of villages with Asha workers 14 6 13
33. Number of villages with SHG 6 6 9
34. How many of ODF villages got prioritized water supply?
0 1 0
35. In how many villages faulty twin pit structures were found?
0 2 15
36. In how many villages did you find distorted government data?
0 6 16
37. In how many villages western toilets were spotted?
14 6 0
38. In how many villages facility for people with disabilities were found?
6 0 1
39. In how many villages government used coercive methods for toilet construction?
0 7 8
KEY FINDINGS8
Toilet under construction at Uttar Pradesh
Single leach pits existed in villages with ample land that is
presently available. However, this may not be sustainable
in the long run. Teams from only 23 villages reported
observing one or more twin pits, already constructed
or under construction. In the states of Sikkim, Himachal
Pradesh, Punjab, Manipur and Nagaland the team reported
a high use of septic tanks. Septic tanks had single, double
and triple chamber. In as many as 27 villages, septic tanks
without soak pit were observed.
While the government considers twin pit as the most
cost effective and environmentally sustainable toilet
technology for most rural areas, a lot of misconceptions
appear to surround this technology that have not been
addressed. In 23 of the villages with twin pits,, the
construction in 17 villages of the same was very poor.
The research revealed that only in 10 villages, out of
57 villages, twin pits were actively promoted and built
by Panchayat. There has been other scepticism among
people regarding twin pits like- the cleaning, improper
construction and handling human waste fertilizer, all
of which has not been addressed well by the concerned
authorities. IEC on twin pits was non-existent. In low
lying village of Nagaland and Assam during rainfall these
latrines become non-functional.
In Assam, when the pit is full, people revert to OD. The
construction of toilet structures and sub-structures does
not always ensure full usage. It has been observed that
toilets were left un-used, used for other purposes (store
rooms), or left un-used also due to family conflicts.
Faulty construction of septic tank and tanks without soak
pits has led to contamination of ground water in Punjab
and Himachal Pradesh. The issue of safe disposal of
sludge from these tanks have emerged in Kerala, Sikkim,
Ladakh and Manipur.
Traditional toilet in Ladakh (single dry pit system)
historically present were fully sustainable and eco-friendly.
In Ropar, Punjab and block Thekma, Uttar Pradesh, the
toilet substructure constructed under SBM had three
cemented cylinders about 10 feet in height without a soak
pit. A biodigester was also observed in the community
toilet at Ganeshnagar, Nagaland.
Toilet Technologies & Environmental Impact
VILL AGE IMMERSION AND SANITATION IN INDIA 9
On Solid and Liquid resource management, some states
are undertaking piece-meal efforts. Kerala, seems to
be the only state with a comprehensive policy in the
form of Haritha Keralam Mission (HKM) that needs to
be replicated across the country. However, the problem
of dealing with septic tank waste disposal still remains.
The condition of other states is somewhat similar – while
biodegradable waste is used as manure, the plastic waste
is largely burnt or even used as fuel for cooking creating
serious environmental and health concerns.
In state of UP, Jharkhand, Chhattisgarh, Nagaland and
Punjab the liquid waste from washroom and kitchen
gets drained to nearby pits, fields and water bodies thus
posing a serious health hazard.
To deal with liquid waste, soak pits have been built in
Himachal Pradesh to deal effectively with the liquid waste,
and in Kerala bio-septic tanks have been constructed to
deal with the same.
In Ladakh the menace of plastic bottles has been dealt
by using them as boundary walls of fields.
In Uttar Pradesh, Bihar and Madhya Pradesh there was
much talk about corruption, misappropriation of funds for
toilet construction and use of substandard materials. In
Bihar, the siphoning of funds has affected the construction
of toilets. In Jharkhand and Chhattisgarh many needy
individuals were not made beneficiaries.
Incentive mechanism for toilet construction differed place
to place. UP, MP, Bihar, J&K and Chhattisgarh reported
misappropriation of funds and lack of adequate amount
of money sanctioned by the government. In Jharkhand,
high transportation cost to difficult terrain was not been
covered in the incentive scheme.
There was an absence of information about twin-pits in
almost all states. The septic tank has become the preferred
toilet technology across India. In the poorer states like
Uttar Pradesh, Bihar, Madhya Pradesh, Chhattisgarh
and Assam, poorly constructed twin pits were rampant.
Only in Rajasthan, skilled masons with knowledge about
twin-pits were present.
In Assam, Nagaland and Manipur it was found that state
departments had contracted work to local SHGs or NGOs,
approved by the Gram Panchayats. This resulted in the
provision of substandard materials and construction.
About fund allocation in time, and providing transparency
in this regard, these states had failed. This has resulted
in ‘half-built sarkari toilets’, as they are being called.
Overall, poor quality toilet construction puts the question
whether the supply driven toilet technology could induce
a sustainable behavioral change that is at the centre of
the program.
The state governments have also not invested time, money
and effort on training masons, getting feedback from the
community and checking the quality of construction.
Verification of toilet constructions is far-fetched when
the states are being pushed to meet targets in the last
few months.
Solid & Liquid Waste Management
Construction
KEY FINDINGS10
Community engagement in Ladakh
Availability of water in the villages showed great variation.
States like Rajasthan, Madhya Pradesh and Chhattisgarh
reported water scarcity. Villages in Roopnagar district of
Punjab fall on the banks of river Satluj, hence face no
scarcity. Villages in Shimla district not only get water
from springs called chashma but are also supplied water
through pipelines. In the case of Assam and Kerala, heavy
rainfalls ensure sufficient water availability. In Bihar,
the water of the Ganges was used for everything, from
drinking, washing, bathing and defecating..
Interesting variations were found in different villages
of the same state. For instance, in district Kargil, while
one village had copious amount of water resources, the
other faced such extreme shortage that villagers are
planning to migrate from the settlement if it does not
rain for another year or so.
In some cases, people living in villages with less water
availability resorted to openly defecating and not using
toilets at all, such as in Udaipur district, Rajasthan. Yet, it
was also observed that there was no such corresponding
relationship between usage of toilets and water. For
instance, in UP abundant water was given as the reason
for OD. It was claimed that it was easier when a water
body was in the vicinity. In Leh district, water was not
used in the traditional toilets which were the most
commonly used.
Seasonality was found to be one of the key factors
affecting partial usage of toilets in many areas. It was
observed that the changes in season impacted the toilet
usage leading to increase or decrease in OD, either due to
shortage of water or due to excess water during rains.. In
the summer season, the scarcity of water was cited as a
major reason for OD in villages in states such as Jharkhand
and Madhya Pradesh. In some parts in Rajasthan usage
of toilets increased during the monsoons as there was
greater availability of water at the same time decreased
due to the added danger with the increase of reptiles,
insects and such. In UP too, rainy season resulted in
reduction in OD as the plain areas where they went for
OD got flooded with water. In some cases, people even
used their neighbour’s toilets during the rains if they did
not have one. The winters witnessed shortage of water
in states like Manipur and Jammu and Kashmir as the
water available would freeze due to harsh temperatures
Water contamination was observed in Roop Nagar
(Punjab), Kerala and Assam due to lack of liquid waste
management.
Boiled drinking water practice was found in J&K, Sikkim
and Kerala. In Bihar and Jharkhand water contamination
with arsenic and fluoride content was found respectively.
In Punjab contamination due to open sewage was found.
Rain water harvesting was prevalent in Sikkim, HP,
Assam, Chhattisgarh, Kerala and Manipur.
Toilet Technologies & Environmental Impact
VILL AGE IMMERSION AND SANITATION IN INDIA 11
Meeting with Jeevika SHG members in Bihar
With respect to female OD, it was absent in Kerala,
Jammu & Kashmir, Himachal Pradesh and Sikkim. In one
village in Madhya Pradesh, only men defecate openly. In
Manipur, Assam, Punjab, Jharkhand, UP, Rajasthan, Bihar,
Chhattisgarh and MP, both men and women continue to
defecate in the open.
It has been observed that women bear the burden of OD
more than men because of the lack of water.
In case of both men and women practicing OD at the
same space, it has been observed that both have different
timings of defecating - Bihar men (day) and women
(night/dark); UP women-3 am (before men) after men
7-8 pm, men- 4 am (anytime); Punjab women go for OD
at night (dawn and night); in Rajasthan in common area
for OD - if men and women come at the same time, the
women has to leave.
Women’s group (Anganwadi, SHG, Mahilla Samiti, women
society) were active in J&K, Manipur, Kerala, HP, Assam,
Jharkhand, Sikkim, Rajasthan and MP. And in Bihar and
UP they were present but not effective. In Punjab and
Nagaland, they were virtually absent. Non ODF states
have active women groups in states like Jharkhand (Jal
Shaiya, Mahila Gram Sangatham) MP (SAMUH). The
states where these Anganwadis are actively involved in
cleanliness awareness seems to be doing well. Effectiveness
of Anganwadis and ASHA workers has strong bearing
on sanitation. Kerala (Kudumbashree, Bala Sabha) Leh
(Ladakh Women Alliance) Manipur (Thingba Khullen
women Society) are the states that have women groups
besides ASHA and Anganwadi
In states like Jharkhand, Rajasthan, Himachal Pradesh,
Uttar Pradesh, Madhya Pradesh and Manipur women
were the primary actors who fetched water. In contrast,
in Leh, Kargil, Sikkim, everyone participated equally in
fetching water.
Gender and Women
KEY FINDINGS12
Practices of exclusion are very evident in states like,
Rajasthan, Madhya Pradesh, Uttar Pradesh, Bihar,
Jharkhand and Punjab. Women experience exclusion
in terms of space and time, hence they have different
timings for defecation. For instance, in Rajasthan, women
leave the common area for OD if there is presence of
men, highlighting the power relations. On the other hand,
states like Kerala, Sikkim, Himachal Pradesh, and Jammu
& Kashmir are inclusive and collective action ensures
that the entire community benefits from state provision.
Surprisingly, many poor were found to be excluded. In
states like UP, Bihar, Jharkhand and Assam, the poor are
left out as they do not have any say and their interests
are subverted by the higher authorities. In Bihar, it was
found that BPL families are registered under APL category,
and those in APL category get themselves registered as
BPL. Local politics, favouritism and the discrepancies
with the baseline figures are some factors affecting the
poor in Punjab and Madhya Pradesh. Similarly, the tribal
population, in both Rajasthan and Jharkhand due to
resources and territorial constraints have been excluded.
Women participate in panchayat and other activities
in great numbers in the states of Kerala, Himachal
Pradesh and Sikkim has ensured that proper facilities
are available in anganwadis and schools. Across other
states, the condition of toilets in anganwadis and schools
were unsatisfactory.
The disabled and elderly need special attention, which is
missing from SBM(G), as is a concerted effort on menstrual
health. Similarly, the needs of migrant population seem
to have been neglected which is an important issue in
Punjab, Assam, J&K and Chhattisgarh and needs urgent
attention.
In Assam, the elderly women and widows did not have
access to toilet whereas in Jharkhand the dropout rate
of girls from school was high due to lack of access to
hygienic toilets.
Except in Kerala, Sikkim and Chhattisgarh, no disable
friendly toilets or any such assistance were found in any
of the states visited by the teams.
Migrants and laborers in Ladakh and Punjab were not
provided any toilet facilities.
Information, Education and Communication took place
through formal structures like Gram Panchayat, BDO,
Mukhiya, Aanganwadi, Asha workers who also work
as swachhagrahis, the Village Water and Sanitation
Committee (Assam, Himachal Pradesh, Jammu and
Kashmir, Manipur, Jharkhand and Punjab) and group
activities led by government officials. Informal sources
included women’s Self-Help Groups (UP, MP, Rajasthan,
Kerala) andstrong religious beliefs (as Jammu and Kashmir
and Sikkim – Buddhist and Nagaland - Church)
Nigrani Samiti was formed in most states, however,
was dissolved once the village was declared ODF or was
inactive post its formation (UP, MP, Himachal Pradesh,
Rajasthan, Jharkhand, Chhattisgarh. There was no social
monitoring mechanism in Nagaland and Bihar.
Usage being an important factor was ignored under SMB.
Toilet construction was considered as the only way for
behavioral change whereas several other socio-economic
factors, local belief and knowledge, traditional technology
and geography were disregarded.
Only few areas have been officially verified after being
declared ODF, hence any data regarding toilet triggering
behavioral change in not reliable.
People were aware of the health aspects of toilets in
Assam, Manipur, Rajasthan, HP, Kerala, J&K, Nagaland,
Sikkim and Punjab. Lack of awareness was evident in
UP, Bihar, MP and Jharkhand. People in majority of states
were aware of the sub-structure of their toilets and twin-
pits. In Jharkhand people believe that their faeces will
Inclusion & Exclusion
Behavioral Change
VILL AGE IMMERSION AND SANITATION IN INDIA 13
be consumed by the wild pigs and therefore OD is not
an issue for health issues.
Economic incentives played a motivating role for people to
build toilets. Many were motivated by IEC to build toilets.
Convenience was considered as an important factor for
desiring toilets. Toilets were also seen as aspirational,
especially among children and youngsters. Sense of toilet
ownership ranged from ‘need’ (Chhattisgarh) to ‘burden’
(Jharkhand, Bihar and Rajasthan) to ‘luxury’ (Punjab).
Coercive implementation of toilet construction also played
its role. Top-down approach, fear of fines and penalties
amongst people (Punjab), dread of losing ration and job
cards (MP, HP) were also reported. Intimidation through
public and social media shaming were being adopted
in Chhattisgarh, Rajasthan and Jharkhand. Coercive
measures were also adopted by VWSC in Manipur to
increase the toilet usage.
In many states like Kerala, Sikkim and J&K the practice
of using toilets pre-existed SBM(G). In states like UP and
Bihar people were willing to use toilets, conditional to
their availability and access. For some, poor quality of
material used in construction of toilets (resulting in
cracks in walls, broken seats and additional expense
for their maintenance) discouraged them from using
such ‘sarkari’ facilities. Partial usage was reported from
Bihar, Jharkhand, Punjab, Assam, Manipur, Chhattisgarh,
MP and UP.
Since most of the promotional activities focus on women,
it was found to be a general conception that toilets
are built to secure and protect the dignity of women.
This might be one of the reasons behind women using
toilets more than men. In Bihar, women and pregnant
ladies were found using toilets constructed under SBM.
Children/youngsters were seen to be more aware about
sanitation practices and therefore using toilets. It was
also considered to be a social status for them among
their peers. On the contrary, elderly, because of their
orthodox and conservative thinking were seen to be
having a strong believe supporting OD in Manipur, UP,
Punjab & Chhattisgarh.
Apart from Rajasthan, Jharkhand and Bihar, a sense of
ownership towards toilet was seen in all other states. In
Chhattisgarh, it was seen somewhere in between a ‘need’
and a ‘luxury’ (for people who could barely mange to
eat, Panchayats constructing a toilet was considered as
luxury). However, in Punjab, sense of ownership (luxury)
was present for those who constructed the toilets by
themselves. For those who were pressurised to build
toilets in spaces that were meant for cooking or a room,
a toilet was considered a ‘burden’.
KEY FINDINGS14
Interaction with Children at Jharkhand
Out of all the fourteen states, the conditions of school
toilets were hygienic only in Kerala, Himachal Pradesh
and Sikkim. School toilets in Assam and Udaipur were
found to be locked by the administration. The Jharkhand
team interacted with students outside the school who told
them the toilets were locked, hence OD was prevalent.
In Nagaland, UP, Kargil, Punjab and Bihar the conditions
of the toilets were unhygienic. There were no separate
toilets for boys and girls in Nagaland. There was one
disable friendly toilet in Kerala, Chhattisgarh and
Himachal Pradesh.
Most of the anganwadis focus on issues of women health
including those of pregnancy and menstruation. Hand
washing and toilet training were on a back foot. In Assam,
the anganwadis have not been very inclusive of the tribal
communities. In Nagaland, out of the two villages visited,
the toilet at an anganwadi was present in only one. In
Jharkhand, anganwadi toilets were under construction.
In Sikkim, awareness regarding hand washing with
soap was the highest resulting in decreased chances of
diseases. In Himachal Pradesh, the hand wash practice
was observed both at the school and in household by
the team. In Kerala, hand wash was seen only at the
household level and not at school level. In Bihar the
children were seen using soil to clean their hands. In
Punjab children washed hands in dirty water that was
disposed out of their homes. In Nagaland, most people
had knowledge about hand washing and children used
soap in school. At the primary school in Kargil, the young
children did not wash their hands as there was no water
available. The awareness of hand-washing generally
lacked among children and in some adults across the
states. In Bihar, children were found cleaning their hands
with soil after OD.
Across all states, the similar practice of burning or
burying of children diapers was observed (where ever
it was used). Only the rich households used diapers for
their children. The use of cloth was found to be the most
common practise. In Kerala, a very effective women
empowerment organisation known as ‘Kudumbashree’
gives training to women on management of diapers.
Similarly, in Kargil, an ancient technique of using sheep
wool to make diaper shaped garment filled with heated
goat dung was common until a decade ago.
In Kargil, another unique practise was observed - the
use of diapers and cloth was a new practice to deal with
children’s poo. There existed a local practice for the
disposal of children poo, in this ancient practice the wool
of the sheep was given the shape of a diaper in which
slightly heated goat dung was kept and baby was made
to wear it. This ensured that the baby remained warm
especially during the sub-zero temperatures in winter and
that the urine and faeces get absorbed without causing
any smell or infection to the child.
Hygiene Facilities and Practices
VILL AGE IMMERSION AND SANITATION IN INDIA 15
In case children defecate inside their homes, the faeces
were covered with ash and disposed in the field. Plastic
potty training was found in Kerala and Sikkim. In Nagaland
it was observed that dogs ate Children’s poo.
The awareness level about menstrual hygiene differed
from region to region. The women in Kargil were open to
talk about it. In Kerala the women were not so comfortable
to about it but an incinerator was found in one of the
schools. An incinerator was also found in Sikkim. Across
all the fourteen states, the disposal of used pads took place
by either burning or burying. There were several taboos
with regard to access to worship places or kitchen was
found in the Hindi belt. In Manipur, a woman believed
the use of sanitary pads causes cancer. In one of the
areas of Himachal Pradesh, the women had to sleep
in a separate space outside the house while they were
menstruating. The high caste women slept in a separate
luxuries room especially built by the family, while the
low caste women who could not afford this slept in the
cattle shelter.
Affordability emerged as a major factor, as some women
wished to use pads but found the prices very expenses.
The most common was the use of cloth across all states.
In Chattisgarh there were pictures found on the walls of
the school premises that highlighted the benefit of using
cloth over pads. In Jharkhand the women were involved
in making their own cloth pads. It was also observed that
awareness played a key role about menstrual health; the
younger generation was more aware and informed than
the older generation. Menstrual hygiene and awareness
differed from region to region. However, across all the 14
states the disposal of cloth and pads took place through
burning or burying. Affordability emerged as a major
factor in terms of sanitary pads usage for menstruating
women.
In Bihar, UP and Assam the elder people faced problem
in defecating in open. They wanted toilets to be built
under the SBM. On the other hand, in Sikkim, there were
western toilets for elderly to make defecation easy. In
Himachal Pradesh, the elderly welcomed the septic tanks
system as, in winters OD becomes difficult.
The conditions of community toilets such as in schools
are extremely unhygienic and non-functional, except
in Kerala, Sikkim and HP. Operation and maintenance
emerged as major issues.
KEY FINDINGS16
The present scenario of rural sanitation in India is complex.
There is no single reality to it; rather there exists several
simultaneous and overlapping experiences of people
about how & why, and about SBM-G in different parts
of the country. Our study tries to uncover some of these
realities; however various questions remain unanswered.
While a lot has been achieved in the last few years,
the idea of sanitation is much more and beyond toilet
construction. The scheme seems to have a set uniform
agenda of constructing toilets across the country without
giving much consideration to innumerable factors that
form a crucial link between toilet construction and
behavioral change, like - toilet technology, usage and
maintenance, adequate water, seasonality, geography,
local beliefs, gender, waste management and other aspects
of sanitation. Importantly, misappropriation of funds
and manipulation of data makes the dream of modern
toilet facility even more difficult for the rural masses.
Our findings for the study across all fourteen states
revealed one thing similar - the regional differences
and diverse social factors cannot be clubbed under the
same umbrella of Darwaza Bandh Karo (the SBM slogan).
Swachhta cannot be only limited to declaring villages
ODF. Additionally, it also needs to focus on issues of
environmental pollution, spread of waterborne diseases,
inadequate hygiene information to manage children
and animal faeces, menstrual hygiene, handwashing,
segregation and safe disposal of waste and other aspects
of sanitation, as part of the bigger public movement to
make India Swachh in its real sense. The behavioral
change approach needs to be holistic. It should include
educational tools and community level approaches
along with government mechanisms to ensure complete
implementation of policies. The initiative by the central
government is noteworthy as a vision for change and
the energy that it has bought to the sector. This needs to
be complimented by making rural institutions like the
panchayat more robust and understanding of sanitation
needs. Allied functionaries like the Asha workers,
Swachhagrahis, Self-Help Groups, Mahila Sanghatans and
Nigrani Samitis must look beyond toilet construction and
focus on other aspects of sanitation and its sustainability.
The sanitation revolution has a long way to go and it has
to start looking beyond construction.
Conclusion
VILL AGE IMMERSION AND SANITATION IN INDIA 17
Institutional
• Panchayati Raj institutions to be empowered to play a greater role
• Empower Women: Asha workers have contributed to sanitation and incentives should be given to them to sustain
behavioral change. Also empowering Self Help Groups & Mahila Sangathans with information
• Institutionalization and greater inclusion of Swachagrahis and nigrani samitis
• Reduce government coercion and focus on behavioral change
• Village institutions should have clean toilets
• Collection of data should not at village level (as it leads to distortions by officials), but from individual household
toilet level
• A Grievances Redressal Body – on the lines of the RTI on SBM. SBM funds distribution should be written on the
panchayat wall
• District and Village plans to be prepared in a participatory manner
• Parents and schools to be empowered with information and incentives. Government schools (barring those in a
few states) are not sensitive to hygiene requirements of students
• Targeting of children with education on sanitation
• Cleanliness – Rs 200 per month for cleaning toilets in schools – allotted money should be increased – Cleaning
by students and teachers
Technology
• Toilet technology based on local demand and requirements
• Proper information on twin-pits and other toilet technologies, emphasize on standards of construction
• Not just building toilets – but measures needed to ensure usage and its cleanliness
• Replacement of old toilets (under older schemes) with usable toilets
• Instead of camp like situation during construction, focus on sustainability
• Peripheral villages not involved in GP, hence need special attention or will be excluded
• Focus on Solid and Liquid Waste Management System in Villages
• Local women to be empowered with technology and know how to make cotton pads
Financial
• Transport cost of materials in hilly areas is very high
• Economic aspects discouraged families – if MNERGA is combined with SBM it would provide added incentives
and result in better oversight in the construction of toilets
• In Ladakh, J&K as people already have toilets, funds should be diverted for waste management and to curb use
of plastic
Others
• In-Migration and construction of roads etc leads to OD – particularly rampant in Sikkim, Manipur, J&K, Chhattisgarh
& Bihar. This can be solved by building community toilets. Some of these can be managed by individual families
that have been left out (for various reasons and they themselves) and they too do not have access to toilets.
• Tourists OD in public places. There should be well marked toilets on highways
Recommendations
KEY FINDINGS18
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