Significance of the Role Played by Rural Women in Making Swacch Bharat Mission a Success

I. Introduction

The right to health is a fundamental human right that was first acknowledged worldwide in the preamble of the World Health Organization, which defines health as "a condition of complete bodily, mental, and social well-being, rather than merely the absence of disease or infirmity" (World Health Organization [WHO], 1948). The definition broadens the meaning of health to include measures taken to avoid disease transmission, food and sanitation requirements, and pollution restrictions. However, as stated in the WHO preamble, every being has the right to the best possible quality of health, and it is the responsibility of every government, as well as every individual, to preserve and not violate this right.

Other international instruments such as the Universal Declaration of Human Rights (UDHR), the International Covenant on Economic, Social, and Cultural Rights (ICCPR), and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), among others, place a strong emphasis on the protection and promotion of the right to health. The right to health is an umbrella right that encompasses a variety of other rights. The right to sanitation and hygiene is one of the many rights that lie under the umbrella of the right to health.

The UDHR was drafted in 1948 and at the same time Indian Constituent Assembly was working on the draft of Indian Constitution. Finally in 1950 Indian Constitution came into force, which explains why the UDHR's various human rights have been incorporated into the Indian Constitution. According to the Constitution, India is a welfare state, which indicates that one of the most important tasks of a democratic government like India is to provide basic services to its citizens (Bhagat, 2014, p. 43). When we gained independence in 1950, we were dealing with a slew of social ills that were preventing us from progressing, but as time passed, our country progressed. According to Bhagat (2014), it is because of these ongoing efforts that our per capita income is increasing now.

Indian Constitution was framed in 1950, two years after the UDHR came into force that is the reason that various human rights laid down in UDHR have found their place in Indian Constitution. India is a welfare state according to the Constitution which means providing basic facilities to the people is one of the important responsibilities of a democratic country like India (Bhagat, 2014, p. 43). In 1950, when we got independence, we were struggling with many social evils which were holding us back from developing but with time our country progressed. Bhagat (2014) also states that it is result of these continuous efforts that today our per capita income is rising. The literacy rate is steadily increasing, and the average lifespan has increased from less than 40 years at independence to 66 years currently. However, there are still some issues in this developing country that make us underdeveloped, such as the percentage of malnourished people, and according to UNICEF and WHO reports, 82 percent of the one billion people who practise open defecation in the world live in just ten countries, with India continuing to be the country in which nearly 60% of those who practise open defecation live (Samerth Charitable Trust [SCT], 2015, para. 1). Along with this, in rural areas of states like Madhya Pradesh, Bihar, Jharkhand, Odisha, and Chhattisgarh toilet usage is just 13.6% to 22% (Koonan, 2016, p. 1). So it is high time for Indian Government to not just bring different schemes related to sanitation programmes but to implement these schemes at grass root levels, so that the marginal group of the society could be benefitted.

II. Inter-linkage of the Right to Health and Sanitation

Father of our nation, Mahatma Gandhi said that, ‘Any city that would attend to its sanitation in a proper spirit, will add to both its health and wealth’ (Bhagat, 2014, p. 52). He rightly pointed out this because according to him, there are certain things which today’s India need to adopt from the west and right of everyone to access to proper sanitation facilities is one such thing. In today’s fast pacing world in terms of population and pollution access to safe water and sanitation has been considered one of the most important social determinants of health (Bhagat, 2014, p. 11).

As we can see in today’s world that all nations are concerned about increase in their economy, and growth of economy is directly proportional to the health of citizens. Only a healthy person could be expected to participate in nation’s growth otherwise loss of health will result in loss of working days. One of the precautions to safeguard health of people is to facilitate and to aware them about the sanitation. Here sanitation does not have a simple dictionary meaning of absence of garbage around our homes and in streets, but it includes facilities to access toilets, safe drinking water and proper drainage system and it is very difficult in rural India to get access of all these facilities. ‘Sanitation’ as defined by the various international agencies, emphasizes on hygiene and good health for a dignified life (Koonan, 2016, p. 1). The right to sanitation is still a goal to be realized in India because this right is clubbed with the right to water. As a result, earlier more attention was paid to the right to water, and the right to sanitation was neglected (Koonan, 2016, p. 4). Though both rights are inter-dependant and cannot be separated if we have to fulfil the goal of protecting right to health and ensuring adequate standard of living for all as mentioned in article 48 of the Indian Constitution (The Constitution of India 1950, 2015).

If water is considered as an important element for human survival then we should consider sanitation as a lifestyle to lead our life in a healthy manner. According to the World Health Organization, 80 per cent of all diseases in the developing world are associated with lack of access to safe drinking water, inadequate sanitation, and poor hygiene (Bhagat, 2014, p. 51). In these reports open defecation or lack of maintaining sanitation hygiene was considered as the main reason behind causing these severe water diseases. Research in India has shown that detrimental health impacts are even more significant from open defecation when the population density is high (SCT, 2015, para. 3).

A joint United Nations Children’s Fund (UNICEF) and World Health Organization (WHO) report in 2006 categorized India as “not on track” toward the MDG sanitation target (Bonu & Kim, 2009, p.1). This report focused on the sanitation coverage in India, and it was found that the speed by which India is going, it will be possible to achieve total sanitation in 2080. So, to increase the percentage of toilet usage in India, government need to focus separately on urban and rural areas due to diversities of problems these area face. According to the 2011 census, 68.84% of the total population of India resides in rural areas (Ministry of Home Affairs, 2011). Since majority of population in India still resides in villages, so keeping that in vision various schemes have been brought by the government and timely changes have also been brought in implementation mechanism. Recent schemes have focused on behavioural changes to bring in rural people rather than just providing them with the subsidies to build toilets. Some of the important elements of rural sanitation package include safe handling of drinking water, disposal of wastewater, safe disposal of human excreta, safe solid waste disposal, home sanitation and food hygiene, sanitation in community and personal hygiene, particularly washing one’s hand with soap (Tenth Five Year Plan, 2002, p. 606). Tenth five-year plan (2002) studies have shown the importance of washing one’s hands with soap as it reduces diarrhoeal disease by 43 per cent.

As Swachh Bharat Mission was launched in 2014, with an aim to free India from open defecation by 2019. Household toilet coverage has increased tremendously after launch of this mission, such toilet construction spree makes one wonder whether the whole idea of this Mission is just about having toilet in every household (Sengupta, 2018). Sengupta (2018) also stated that construction and usage of toilets do no guarantee safe sanitation, people still need to adopt behavioural changes and that could only be done if along with financial help administrative attention is provided, ensuring effective management and disposal of solid and liquid waste.

III. Importance of Sanitation for Women

Right to health include within its umbrella the right to sanitation, whereas sanitation is a very broad right covering right to access to toilet facilities, to have a safe drinking water, to have proper waste management etc. Recent programmes launched by the government focused on the abovementioned aspects separately, but still the section of society that is least benefitted by these programmes are women residing in rural areas. They are under double burden; one is that they belong to the weaker section of the society and secondly the area in which they reside is not always the priority of government schemes. But recent sanitation coverage programmes involved and focused on women for rapid progress because they play a central role in efforts to create hygienic conditions in the home and halt the transmission of diseases (United Nations Children’s Fund [UNICEF], n.d., p.12). UNICEF (n.d) reports also show that women now is considered as a key to the success of these programmes as they are more likely than men to take care of household duties such as collecting water for their families, washing clothes and dishes, cooking, and handling food, and ensuring that children wash their hands and bath.

The scenario has changed a little with time but still the administration faced many difficulties in educating women about the benefits and need of maintaining sanitation hygiene. Keeping in view the gender dimensions of the issue, separate meetings were held with women to make them understand their special needs (SCT, 2015, para. 30). Earlier consultation sessions regrading construction of toilets in house used to involve group of villagers, usually men and hence women were ignored, and their views were not taken in this regard. As a main user when their special needs were asked then many issues which they face because of lack of sanitation facilities came up like lack of privacy for bathing, lack of safe private toilets makes women and girls vulnerable to violence, rapes and sexual molestation are taking place when women are searching for places for open defecation that are secluded and private, often during hours of darkness (SCT, 2015, para. 6). The government have started providing subsidies and incentives to persons who built toilets by creating several schemes and programmes. These programmes ensure that every school, anganwadi, and balwadi has a separate toilet for women. The increased number of toilets being built in private homes and public areas is a welcome respite for women, who are the ones who suffer the most from the lack of toilet facilities. Practicing excellent hygiene during menstrual days is a basic need for women of all ages, and that could be possible achieved if they have access to toilet facilities with sufficient water supply and other sanitation measures.

In India we follow a societal structure in which views and problems of a woman are often neglected. These traditional and discriminatory practices are some of the reasons that even today in rural areas women’s health and well-being are under-mined by the male members of their own family. Keeping the rights of women in mind the government made separate sanitation programmes to cover rural areas under which exclusive public toilets were made for women wherever necessary (Bhagat, 2014, p. 4). But again, in these programmes also that section of society were left from consulting, who were against the concept of construction of toilets. With regards to psyche of the people to go out for open defecation has no answer but it is closely related to culture and hygiene issues as some of the studies in Northern Indian states revealed that even if the toilet is constructed and water is available one or two family members, especially elderly men and women still prefer to go out to respond to their natural calls (SCT, 2015, para. 2). So it has been observed that women’s active participation in the programme is an important first step, but making services more responsive to the needs of both women and men requires a gender sensitive examination of the situation and potential solutions (UNICEF, n.d., p. 13).

The problems faced by women are very different and difficult to understand by their counterparts as it is torturous for women and girls to wait all day until it is dark to go to the toilet, increasing their chances of infections, ill health and this incurs health risk to women due to discomfort (Bhagat, 2014, p. 4). Along with health concerns, women and girls face difficulties during their menstruation cycles. Lack of sanitation facilities in school is an impediment for girl’s education as it could constrain school attendance during such days. A constructed toilet is not enough of a facility to promote menstrual hygiene but for adolescent girls in rural areas, regular supply of sanitary napkins and enabling other sanitation measures such as access to water is also very necessary (Ministry of Health & Family Welfare, n.d.). Children are one of the sources to promote sanitation and hygiene practices that is why providing facilitates of maintaining menstrual hygiene and making them aware of the safe sanitation practices should be made a compulsory part of school curriculum, and of all programmes where women are trained in community, economic and health issues affecting the household (Tenth Five Year Plan, 2002, p. 606).

So, lack of sanitation facilities in rural areas leads to violation of various other basic rights of a women and hence to keep the dignity and privacy rights of a women intact proper sanitation facilities should be provided. Availability of separate toilets for women in all schools, community houses, hospitals and any other public place should be made compulsory considering the gender differences as they are more prone to infections due to usage of unhygienic toilet facilities. Rendering improved water and sanitation facilities to women are the first steps to empower women in developing countries (“Sanitation for Women”, 2014).

IV. Government Policies to enrich the path for Sanitation in Rural India

In 1950’s government of India was concentrating on different areas which needed development and government support. They constituted the planning commission to handle the responsibilities of making assessment of all resources of the country, augmenting deficient resources, formulating plans for the most effective and balanced utilisation of resources, and determining priorities (Ministry of Statistics and Programme Implementation, n.d., para. 7.2.3). The first five-year plan was launched in 1951 by the planning commission, in this plan a budget of Rs. 140 crore was allocated to improve sanitation and health (Dutta, 2017). As a part of five-year plan, in 1954 the National Water Supply and Rural Sanitation Programme was launched, this was the first ever programme launched by the government to improve water facilitates to boost health and sanitation conditions. Dutta (2017) also stated that due to various reasons this programme was an utter failure and not even 50% of the target was achieved. Same thing happened during second five year plan and that is the reason that in third five year plan, government shifted its focus from water and sanitation supply.

Later UN declared 1981-90 as the International Decade for Drinking water and Sanitation, and 1981 census revealed that that rural sanitation coverage in India was only 1% (Public Health Engineering Department, n.d.). So, in 1986 to emphasize the water and sanitation supply in rural areas government with the help of UN and other external support agencies, government introduced the Central Rural Sanitation Programme (CRSP). This programme had a primary objective of improving the quality of life of the rural people and to provide privacy and dignity to women (Public Health Engineering Department, n.d.). The focus of this programme was to encourage people for toilet construction by providing 100 percent subsidy for scheduled castes, scheduled tribes and landless labourers (Bhagat, 2014, p. 58). Though this programme was later revised by the government after receiving feedback from states and various other survey agencies. So, in 1991 the main changes which were brought in the programme were that both central and state government were now contributing in achieving the target of water and sanitation supply. Secondly, government reduced the subsidy amount by 15% and utilized it in training of masons, creating awareness and spreading health education and they also suggested gram panchayats to construct village sanitary complexes with bathing facilities hand pumps, latrines and drainage facilities (Bhagat, 2014, p. 59). After 1991 also this programme was revised many a times and included the steps which suited the conditions and need of the rural area and people respectively.

The regular changes brought in the programme till 1999 had more focus on conducting awareness camps and inclusion of low cost sanitation methods and technologies rather than on providing subsidy. Use of technology came in picture to effectively dispose of the human excreta and solid waste. One of the main focus of this programme was also to convert dry latrines to pour flush latrines, and eliminate manual scavenging practice, wherever in existence in rural areas (Ministry of Rural Development, 2004, p. 5). A prominent role has been played by the Panchayat Raj Institutions and NGO’s in bringing the behavioural changes among rural people.

Central Rural Sanitation Programme, the first structured programme made to achieve full water and sanitation coverage failed to achieve its target, hence Total Sanitation Campaign (TSC) was launched in 1999 to eradicate the practice of open defecation by 2010 (Planning Commission of India, 2013, p.11). Planning Commission of India (2013) also stated that TSC gives strong emphasis on Information, Education and Communication (IEC), capacity building and hygiene education for effective behaviour change. Alongside these programmes numerous other schemes were passed by the central and state government to strengthen the mechanism of attaining total sanitation coverage like schemes related to National Rural Health Mission, Sarva Shiksha Abhiyan etc. Awareness programmes taught people that good sanitary practices are necessary to prevent water and soil from contamination and this prevention will lead to reduction in water-borne diseases. Other incentives and awards were created to generate awareness and to create a sort of competition among gram panchayats to attain open defecation free status. Nirmal Gram Puraskar (NGP) was instituted for this purpose and in 2005, former President of India Dr. APJ Abdul Kalam gave away NGP awards to 40 gram panchayats from six states for open defecation free status (Bhagat, 2014, p. 83). Later when UN Millennium Development Goals were laid down and the deadline was kept in 2015, our government became more concerned about the targets to be achieved by the TSC programme, so a periodic evaluation was done by various reputed institutions and organizations and the collective results were sent to the central government. The planning commission reviewed the performance of TSC and it was concluded that the target set to be achieved was to cover 10.85 crore households, and the number of houses with toilets was just 2.89 crore in 2007 (Bhagat, 2014, p. 87). Though TSC programme brought many behavioural changes and brought a shift in psyche of people. Community participation and demand increased in construction of toilets. But some policies need constant revision and upgradation.

In 2012, TSC was replaced by Nirmal Bharat Abhiyan (NBA). The objective of NBA was to accelerate the sanitation coverage in the rural areas so as to comprehensively cover the rural community and for rapid progress fund allocation was also increased (Public Health Engineering Department, n.d.). Under this programme Bollywood celebrities like Amitabh Bachhan, Vidya Balan were made brand ambassadors to lead the nationwide campaigns on water, sanitation and hygiene issues. The goal of this Abhiyan was not to reach individual households but to cover the whole community, the deadline for this Abhiyan was to achieve the open defecation free nation by the year 2022 (Bhagat, 2014, p. 92).

Change in government in a democratic country like India, often leads to change of missions and campaigns without any major change in the key components. So on the name of elimination open defecation by 2019, NDA government changed the NBA to Swachh Bharat Mission on 2^nd October, 2014. This mission was divided further in two sub-mission, one was Swachh Bharat Mission- Urban (SBM-U) and Swachh Bharat Mission- Gramin (SBM-G). SBM-G have a five tier implementation mechanism at national, state, district, and block and at village level to ensure that sanitation facilities are made part of each and every household of the country. It is India's biggest ever cleanliness drive and 3 million government employees and school and college students of India participated in this event (Jain & Ruhela, 2018). Participation of people on such large scale made this programme a success and as stated by an economic survey 2018-2019 over 9.5 crore toilets have been built all over the country and 564,658 villages have been declared open defecation free and as on 14^th June 2019, 30 states/UTs are hundred percent covered with individual household latrine (“Swachh Bharat Mission Launch", 2019).

V. Conclusion

The new programmes and schemes of government related to sanitation give people a hope of better tomorrow with hygienic environment around them and disease-free surroundings. Though India still must put in many efforts to bring the standard of health and sanitation facilities at par with those of developed nations because of the issues like continuous growth in population, poverty, traditional and cultural practices and many more. Nevertheless, we have done exceptionally well in the Swachh Bharat Mission and in achieving the set targets Panchayati Raj Institutions and NGO’s played an important role because they were in constant contact with the rural people and the whole community. International agencies like UNICEF and WHO also provided many insights in programmes related to water and sanitation supply.

The major impediment faced while implementing sanitation programmes was to bring behavioural changes in people. It is so difficult to change psychological thinking of some people especially elderly people in rural areas. They are so rigid in their approach and in changing the century old practice of open defecation. Regardless of this, government and supporting organizations long term efforts and continuous commitment exhibited positive outcomes when large number of villages have been declared open defecation free in 2019.

VI. Suggestions

A rapid progress has been seen in construction of toilets in households after launch of Swachh Bharat Mission in 2014. Government have paid attention to the challenges faced in previous programmes and have taken proper steps to overcome the obstructions. In spite of the success of SBM, government cannot deviate from focusing on health and sanitation because to keep India open defecation free constant efforts are required. So, to maintain and raise level of health and sanitation in our country following suggestion could be considered:

a) Any scheme, programme or campaign related to health and sanitation should also focus on sufficient water supply.

b) Prior attention and extra efforts should be put in to protect women, SC and ST’s and poverty-stricken people when programmes related to health and sanitation facilities are made.

c) Health and Sanitation related policies should be made considering the local realities including behaviour, traditional and cultural practices of the people.

d) Help of technological advancements should be taken from time to time and old schemes should be revised accordingly to increase use of new technology.

e) Awareness programmes related to health and sanitation should also focus on water management as it is a limited resource and should be used sustainably.

f) While implementing proper sanitation and hygiene, natural resources should be used wisely.

g) Periodic surveys should be conducting even after achieving 100% sanitation coverage and economically weaker sections of the society should be given repair costs of toilets biennially.

h) Subsidies provided by the government for toilet construction should reach the person concerned within time and long procedural delays in releasing subsidy should be avoided.

i) Corporate bodies should be motivated to invest in ‘Clean India Mission’ as part of their Corporate Social Responsibility.

VII. References

1. Bhagat, R. B. (2014). Rural and Urban Sanitation in India. Retrieved from https://ww w.researchgate.net/publication/269702342

2. Bonu, S. & Kim, H. (2009). Sanitation in India: Progress, Differentials, Correlates, and Challenges. Retrieved from http://www.indiaenv ironmentportal.org.in/files/sanitation.pdf

3. Dutta. S. (2017, August 11). India@70: Two Decades And The Five Year Plans Which Focused On Sanitation. In Sonia Bhaskar, NDTV India. Retrieved from https://swachhindia.ndtv. com/india70-two-decades-and-the-five-year-plans-which-focused-on-sanitation-10604/

4. Jain, A. K. & Ruhela, A. K. (2018). A Review on Swachh Bharat Abhiyan. https://www .researchgate.net/publication/324275343_A_REVIEW_ON_SWACHH_BHARAT_ABHIYAN)

5. Koonan, S. (2016). Right to Sanitation in India: Nature and Scope. In K.J Roy & Sarita Bhagat (eds.), Right to Sanitation in India: Nature, Scope and Voices from the Margins (pp. 1-14). Retrieved from http://itswww.uvt.nl/lis /es/apa/apa-guide.pdf

6. Many states became open defecation free, achieved 100 pc toilet coverage since Swachh Bharat Mission launch: Economic Survey. (2019, July 04). Economic Times. Retrieved from https://economictimes.indiatim es.com/news/politics-and-nation/many-states-be came-open-defecation-free-achieved-100-pc-toil et-coverage-since-swachh-bharat-mission-launc h-economicsurvey/articleshow/70071414.cms?f rom=mdr.

7. Ministry of Health & Family Welfare (n.d.). Promotional Guidelines: Promotion of Menstrual Hygiene among Adolescent Girls (10-19 Years) in Rural Areas. Retrieved from https://sanitation.indiawaterportal.org/sites/default/files/attachment/Operational%20guidelines%20%E2%80%93%20Promotion%20of%20menstrual%20hygiene%20among%20adolescent%20girls%20in%20rural%20areas.pdf

8. Ministry of Home Affairs. (2011). Census of India 2011. http://censusindia.gov.in/ 2011-prov-results/paper2/data_files/india/Rural _Urban_2011.pdf

9. Ministry of Rural Development (2004). Guidelines on Central Rural Sanitation Programme: Total Sanitation Campaign. http://drdakangra.com/guidelines/TSC_guidelines.pdf)

10. Ministry of Statistics and Programme Implementation (n.d.). Five Year Plans. http://mospi.nic.in/sites/default/files/Statistical_year_book_india_chapters/Five%20Year%20Plan%20writeup_0.pdf

11. Planning Commission of India (2013). Evaluation Study on Total Sanitation Campaign. http://planningcommission.gov.in/reports/peoreport/peo/rep_tscv1_2205.pdf

12. Planning Commission of India (n.d.). 10^th Five Year Plan – Rural Water Supply and Sanitation. http://planningcommission.gov.in/pl ans/planrel/fiveyr/10th/volume2/v2_ch5_5.pdf

13. Preamble to the Constitution of the World Health Organization 1946. (2006, October 20). http://www.who.int/governance/eb/who_co nstitution_en.pdf

14. Public Health Engineering Department, Government of Meghalaya (n.d.). Swachh Bharat Mission (SBM)/Total Sanitation Campaign (TSC). Retrieved from http://megphe d.gov.in/tsc.htm

15. Samerth Charitable Trust, Private Public People Partnership Strengthens the Swachh Bharat Mission (Grameen). (2015). Samerth Sanitation Intervention in Kutch, Gujarat. https://sanitation.indiawaterportal.org/sites/default/files/attachment/Samerth%27s%20sanitation%20programme.pdf

16. Sanitation for Women: The Problem and Solution (n.d.). Retrieved from https://lifewater.o rg/blog/sanitation-for-women/

17. Sengupta, S. (2018, May 8). Swachh Bharat Mission will achieve ODF target much before October 2019, but... [Blog Post]. https://www.downtoearth.org.in/news/waste/swachh-bharat-mission-will-achieve-odf-target-much-before-october-2019-but-60393

18. The Constitution of India 1950. (2015, November 9). http://legislative.gov.in/sites/def ault/files/coi-4March2016.pdf

19. United Nations Children’s Fund (n.d.). Learning from experience: water and environmental sanitation in India. https://www. unicef.org/publications/files/pub_wes_en.pdf

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Footnotes

1. Author is an Assistant Professor at Manipal University Jaipur, India.

2. Author is an Assistant Professor at Manipal University Jaipur, India.