World Toilet Summit Puts Spotlight on Sanitation in India

UNCLAS SECTION 01 OF 04 NEW DELHI 005102 SIPDIS SIPDIS STATE FOR OES/PCI, OES/ENV, AND SCA/INS HHS FOR OGHA STEIGER, HICKEY AND VALDEZ NIH FOR GLASS AND MAMPILLY CDC FOR BLOUNT AND FARRELL STATE PASS TO NSF FOR INTERNATIONAL PROGRAMS E.O. 12958: N/A TAGS: SENV TBIO SOCI KSCA IN SUBJECT: World Toilet Summit Puts Spotlight on Sanitation in India NEW DELHI 00005102 001.2 OF 004 ¶1. SUMMARY: ESTHOff attended the 2007 World Toilet Summit from October 31 - November 3 in New Delhi. The event was hosted by Sulabh International Social Service Organization and sponsored by the Government of India (GOI). The conference brought together senior Indian government officials, NGOs and experts from 40 countries to discuss sanitation in developing countries, although most presentations focused specifically on India. The Indian Ministry of Housing and Urban Poverty Alleviation used the summit to announce that the Planning Commission has submitted a new $150 million low cost sanitation plan to the Cabinet for approval. END SUMMARY. ¶2. Worldwide, 2.6 billion people do not have access to toilet facilities. This translates to 700 million Indians practicing open urination and defecation, making it impossible to travel anywhere in India, including the major cities, without witnessing the practice countless times a day. The lack of sanitation assists the spread of numerous diseases including cholera, diarrhea, typhoid, hepatitis, intestinal worms, and polio. To combat the problem, the World Toilet Summit adopted the Delhi Declaration on Sanitation which includes numerous goals designed to provide improved sanitation facilities to all. The text of the declaration can be found at http://www.worldtoiletsummit2007.org/delhi_dr aft.php. -------------- INDIAN MINISTERS TALK SANITATION -------------- ¶3. MINISTERIAL PRESENCE: The World Toilet Summit featured numerous speakers from the GOI and from several state governments. The Ministries of Housing and Urban Poverty Alleviation, Health and Family Welfare, Rural Development, and Social Justice and Empowerment were all represented at the ministerial level for the inauguration ceremony. The former President of India, Dr. Abdul Kalam, noted the significance of the presence of the four ministers, observing that cooperation between the ministries is critical since each holds responsibility for different aspects of improving sanitation. The Ministry of Education was conspicuously absent, as one American speaker, Dr. Tom Keating of Project Clean, highlighted after much discussion about the poor condition or nonexistence of toilet facilities in most government schools. ¶4. NEW SUBSIDY PLAN: Minister of State Kumari Selja of the Ministry of Housing and Urban Poverty Alleviation announced that the existing system of loans and subsidies for constructing toilets was being "radically reformed" with a new $150 million program for low cost sanitation involving a 75% subsidy to families constructing toilets along with an emphasis on collaborating with NGOs. The plan has been approved by the Planning Commission and now awaits approval by the Cabinet. Minister Selja also noted all new houses built by the GOI are now required to have a toilet. ¶5. PUBLIC EDUCATION: Insufficient public education regarding the health impacts of poor sanitation remains a key problem in driving the public demand for toilets. In a follow-up meeting, WHO Sustainable Development and Environmental Health Officer A.K. Sengupta commented that he had visited households that were being paid by the GOI to show advertisements for India's Total Sanitation Campaign (introduced in 1999) that did not have toilets. In such an environment he argued, no amount of subsidy will solve the problem until citizens speak out and demand improved toilet facilities. -------------- -------------- INDIA AND MILLENIUM DEVELOPMENT GOAL 7, TARGET 10 -------------- -------------- ¶6. MILLENNIUM DEVELOPMENT GOAL (MDG): The GOI has set a goal of meeting MDG 7, Target 10, by 2012, three years earlier than the originally anticipated 2015. MDG 7, Target 10 aims to reduce by half from 1990 levels the proportion of people without sustainable access to safe drinking water and improved sanitation which is defined as facilities that are likely to ensure privacy and hygienic NEW DELHI 00005102 002.2 OF 004 use. As of 2004, 41% of India's urban population and 78% of its rural population did not have access to improved sanitation facilities. While this is a substantial improvement from 1990 when the percentages were 55% and 97% respectively, it is still far from reaching the goal. To address the issue, the GOI has increased funding for its Total Sanitation Campaign by 43% from the previous year to a total of INR 10.6 billion (approximately $271 million USD). If the GOI can sustain this level of funding and if the program is properly implemented, India will be on track to meeting MDG 7, Target 10 by 2012, according to government estimates. ¶7. BEWARE STATISTICS: Dr. Kulwant Singh, Chief Technical Advisor for the UN-HABITAT program Water for Asian Cities, warned officials to look beyond the simple statistics to make sure the services were actually being provided. He warned that the official statistics can hide reality, such as when slums are considered to have sanitation coverage, yet huge lines of people have to wait to use a small number of toilets. This issue tends to arise most often when toilets fall into disrepair and aren't fixed which is common. In addition, Singh noted the figures represent the availability of infrastructure rather than actual usage which can be misleading considering the extraordinarily high prevalence of open urination and defecation in India. -------------- MAKING TOILETS "SEXY" -------------- ¶8. INTERNATIONAL AWARENESS: Conference delegates repeatedly brought up the need to market sanitation, both to the end-users in developing countries and in developed (donor) countries. Delegates were enthusiastic about using the UN's designation of 2008 as the International Year of Sanitation to increase awareness, with several organizations planning advocacy programs. World Toilet Organization President Jack Sim told conference delegates they need to help "make toilets sexy," i.e., find ways to break down mental and cultural barriers that prevent people from discussing sanitation and taking the issue seriously. ¶9. MARKETING SANITATION: Innovative marketing experiences were shared, such as UNICEF Indonesia's success in creating a "Clean Friday" movement, in which UNICEF worked with Muslim religious leaders to teach their followers about the importance of sanitation. Another example utilized social pressure in the state of Orissa, where a village painted on its town walls, "We will not marry our daughters off to villages without toilets!" In addition, programs that recognize village leaders who meet their sanitation targets were also praised. -------------- THE SCOURGE OF SCAVENGING -------------- ¶10. MINISTERIAL VIEWS: Minister of Social Justice and Employment Meira Kumar noted the GOI had formally abolished manual scavenging (the process of manually removing human excreta) and stated the GOI aims to rehabilitate all scavengers by March 2009. (Comment: Scavenging was banned by an Act of Parliament in 1993 but persists in much of the country and will continue until the use of improved sanitation facilities replace dry toilets. End Comment). Unfortunately Minister Kumar did not provide details on how the GOI would meet the fast-approaching deadline for this goal. ¶11. FAKE NUMBERS AND CONTRADICTIONS: Former Member of Parliament Maneka Gandhi stated that the contradiction between the legal ban on scavenging and the circumstances as they really exist has unfortunate results such as discouraging district administrators from admitting that there are scavengers in their district. District administrators can be held personally responsible and punished if scavenging is occurring in their district, resulting in denial that scavenging is taking place or severe underreporting of actual figures. According to Ms. Gandhi, the real tragedy is that NEW DELHI 00005102 003.2 OF 004 funds appropriated for the rehabilitation of scavengers often go unused. -------------- GOVERNMENT SCHOOLS FAIL HEALTH -------------- ¶12. FAILING GIRLS: Conference participants repeatedly noted sanitation statistics regarding the approximately 760,000 government schools in India: 40-45% have clean water, 19% have urinals, and only 8% have toilets. Boys typically practice open urination and defecation outdoors but girls are often forced to "hold it" through the day rather than risk the humiliation of being seen heeding nature's call. (Comment: There appears to be no corresponding stigma for boys or men who perform these acts constantly in public view. End Comment). This is a major factor contributing to the high dropout rate of girls from government schools and the low literacy rate among women (48% for women as opposed to 73% for men.) However, Sulabh International noted student health clubs, which focus on sanitation, are now present in schools in 8-10 states and that some schools in Gujarat are now teaching their students about sanitation and the "dignity of labor" in an effort to address the social stigma surrounding the issue. -------------- CONSERVING RESOURCES AND RECOVERING WASTES -------------- ¶13. CONSERVING RESOURCES: There was consensus among the speakers that the developing world could not afford to widely adopt western-style toilets and would need to construct less resource-intensive facilities based on eco-sanitation processes in which resources in excreta and wastewater are recovered. Both septic tanks and sewer systems were viewed skeptically as too expensive and/or unsustainable. (Comment: This view is supported by current conditions as less than 20% of all Indian households are connected to sewage systems and in total, 33 billion liters of sewage are produced in India each day despite current treatment capacity of 6-7 billion liters per day. End Comment). ¶14. ECO-SANITATION AND HUMAN RESOURCES: The lack of qualified local personnel in the sanitation field was repeatedly raised as a substantial hurdle. Sanitation jobs have traditionally been filled by Indians of low social status who have little or no formal education. An Indian organization, Ecosan Services Foundation, with support from the European Union's Asia Pro Eco Programme, will begin offering training courses on eco-sanitation in early 2008 to help address the shortage of skilled workers. -------------- PUBLIC TOILETS -------------- ¶15. MAINTENECE PROBLEMS: Many Indians, especially those living in urban slums, have neither the money nor the space to build toilets. In these areas and in public places, public toilets are an important part of making sanitation facilities available. Many government-built toilets are neglected and are subsequently abandoned. The two primary reasons for this are poor management of the facilities or the non-availability of water - either because of erratic supply from municipal corporations or exhausted wells. The Principal Secretary of Urban Development in Andhra Pradesh, S.P. Singh, stated community involvement is critical to avoid waste and mismanagement of government operated toilet facilities. A retired government official from Tamil Nadu told the conference he had to personally visit the public toilets to discover they were in disrepair because he was "shielded from information" by his staff. ¶16. PAY AND USE FACILITIES: Market-driven, pay and use toilet facilities have sprung up to address the need for quality sanitation. Customers typically pay one or two rupees which go to an individual whose job it is to maintain and clean the facilities. NEW DELHI 00005102 004.2 OF 004 Although there are concerns that some destitute families can't afford the fee, these facilities provide an important service and are typically well maintained and widely used, unlike many of the free public toilets. A motion to include a clause in the Delhi Declaration on Sanitation stating that public sanitation facilities should be free met stiff opposition and was not adopted. In a follow-up meeting, one WHO official informally suggested that government-issued cards with a small credit for use of toilet facilities could be given to families below the poverty line to speed the adoption of sanitary practices by impoverished families and subsequently improve health among these communities. ¶17. COMMENT: Poor organization and inadequate screening of presenters led to an overloaded schedule with no room for discussion of the issues. This left attendees disappointed with the overall quality of the conference. However, many attendees emphasized the positive effect the summit would have by increasing awareness of sanitation issues among both the public and politicians and would help make the need for improved sanitation and toilets part of the national discussion. END COMMENT. MULFORD