A Complete Guide to Sanitation in India
The World Bank links 1 in 10 deaths in India to poor sanitation. That is almost 10 million deaths a year just in India. Since over 50 percent of people worldwide do not have access to basic sanitation, this issue is very prevalent and needs to be solved soon. Identifying the root causes behind this is the most important step to solving it.
What is Sanitation and its Main Aspects
Sanitation has an extensive definition in that it refers to “public health conditions related to clean drinking water and adequate treatment and disposal of human excreta and sewage.” All of these facets are very important to society in general but unfortunately many people lack access to them.
Treatment and Disposal of Waste
Open defecation is one of the largest issues that falls under this category. Open defecation cuts off the treatment possibilities and is a very unsafe practice. It can result in many diarrhoeal deaths annually and is a major factor in several neglected tropical diseases, including intestinal worms, schistosomiasis, and trachoma.
Open defecation is very difficult to fix in India because many people do not have access to water to run adequate toilets.
Access to Clean Drinking Water
- India’s water crisis is generally attributed to a lack of government planning and government corruption while the private sector increases corporate privatization.
- Most of India depends on groundwater that comes from wells that are rapidly depleting. This has led to the average semi-rural Indian family drinking 8 liters of water a week compared to a 100 in the US
- India’s sanitation investments have been focused on building toilets and not on the fact that there is not enough water to sustain these toilets
- Most rainfed reservoirs are inefficient and catch only 6 percent of water and have been depleting rapidly.
- A large amount of water is contaminated by sewage leading to extremely unsafe water conditions leading to unhygienic sanitation conditions
Since India’s water intake is very focused on groundwater supply and there is not enough infrastructure in most rural places to collect water, the rapidly increasing population has led to a shortfall.
Impact of Good Sanitation
A WHO study in 2012 calculated that for every US$ 1.00 invested in sanitation, there was a return of US$ 5.50 in lower health costs, more productivity, and fewer premature deaths. This is an enormous 5.5x ROI by investing in helping people. In addition, better sanitation would result in lower health system costs as well which can save an estimated $7 billion a year.
A National Center for Biotechnology Information study found that better sanitation can reduce rates of diarrhoeal diseases by 32%–37%, fewer days lost at work or at school through illness or through caring for an ill relative, and convenience time savings which all result in billions of dollars in economic potential.
What's Preventing Adequate Sanitation
Subsidies
Many governments in the past have chosen to give subsidies to citizens in the form of a stimulus or in other ways. The Indian government created a plan for many people without access to adequate waste disposal to gain access to modern toilets.
The Indian government previously pledge 12,000 rupees ($187) for each family to construct their own toilet, The initiative has pledged 29 billion USD which has constructed 49m household toilets to date, with another 61m still to go.
However, a large problem with this is that people chose to use the money they were given towards something else rather than building toilets. Since the sarpanch (village head), the junior engineer who surveys the site, and the local contractor are working together, they often do not supervise the construction adequately and skimp on necessary materials.
Bias Towards Open Defecation
Many people in India have a bias towards open defecation due to many factors such as the previously existing caste system and cultural pressures. Some consider defecating in the open to be a sign of virility. Many also believe that open defecation aids digestion. Toilets, often the only concrete structure in the house, are used to store firewood, cow-dung cake, grass, and food grains.
- A survey by the Research Institute for Compassionate Economics in 2014 found that in 40% of households with a working toilet, at least one family member preferred to defecate outside.
- A BMJ Journals study determined that majority of the bias was due to a lack of awareness about proper sanitation and hygiene
- Europe PMC stated “respondents who defecated in the open tended to overestimate open defecation prevalence, whereas consistent toilet users tended to underestimate open defecation prevalence” in a recent study
Groundwater Crisis
In India, there is a massive groundwater crisis that affects most of the population. Since the crisis is only intensifying through disrupted weather patterns and frequent droughts, the already feeble water source has become even more stressed. This has made contamination a nationwide problem, and people no longer trust municipal water systems that they used to receive most of their water from.
This has led to a rise in bottled water sales in India, however many cannot afford it as it is a large price increase. Due to this many startups have risen to the challenge to create water vending machines and water ATMs that are cheaper than bottled water, however, people in poverty are still paying much more for water than they would have if the municipal systems in place were safe
- Many of the municipal groundwater sources contain fecal coliform that is responsible for many acute diarrheal cases
- Over 117,000 Indian children, under the age of five, die each year, from drinking water-borne diseases acute diarrhoeal diseases
- Although there has been much effort to fix this problem, only 9% more people got access to improved safe water from 2000–2015
- Although Indian economic health has strengthened tremendously over the past decade, public health has not increased as much widening the economic inequality gap
Successful Organizations
Bill and Melinda Gates Foundation
The Bill and Melinda Gates Foundation has a large amount of capital to invest in different sectors. This includes sanitation, global development, malaria, and more. The foundation invests in many innovative sanitation projects such as their omni-processor.
- The foundation works with governments to promote policies and steps that can be taken to establish more adequate sanitation. These priority geographies are generally slums.
- They also invest in priority geographies, in city-wide inclusive sanitation to accelerate the adoption of safely managed sanitation at the city level.The foundation also invests in different technologies, such as the reinvented toilet and the omni-processor, that can redefine the management and disposal of waste with almost no need for water and electricity
- Conducting research to help the sanitation sector develop data and evidence about what works.
The foundation also had a “Reinvent the Toilet Challenge”. The challenge aimed to create a toilet that
- Removes germs from human waste and recovers valuable resources such as energy, clean water, and nutrients.
- Operates “off the grid” without connections to water, sewer, or electrical lines.
- Costs less than US$.05 cents per user per day.
- Promotes sustainable and financially profitable sanitation services and businesses that operate in poor, urban settings.
- Is a truly aspirational next-generation product that everyone will want to use — in developed as well as developing nations.
Water.org
Water.org is a global organization that works to bring water and sanitation to all parts of the world. They are able to accomplish their vision by partnering with large financial institutions to provide small loans and other affordable financing.
To create small loans, the organization created the WaterCredit Initiative®.WaterCredit brings small loans to people who need access to financing and resources to help develop household water and toilet solutions.
Through this program, Water.org has been able to give out 7.2 million loans for water and sanitation that are valued at around $2.6 billion. This has been able to impact 33 million lives across 13 different countries.
The reason why Water.org is able to make a very large impact is through its partnerships. Other than just financial institutions, Water.org partners with schools, communities, and more.
An example of one of their partners is a primary school in Rasulpur, New Dehli. The schoolmasters were able to fund a water connection and toilets for the students with Water.org. One-third of schools around the world lack these resources, yet when they are in schools attendance increases by a significant amount. The school also works with Water.org to educate students on the importance of hand-washing and drinking safe water. Students, in turn, are able to bring these lessons home to their parents and brighten their community as a whole.
Water Equity
Water Equity is an innovative organization as they work as an investment fund manager that is able to deliver returns to investors and create micro loans for sanitation and clean water. Water Equity’s multiple funds have made 30 investments across three countries.
Water Equity was established by Water.org to mobilize capital for water and sanitation enterprises serving the needs of emerging consumers.
WaterEquity’s first fund invested in Sanghamithra — a microfinance institution providing affordable financing to families in India. An example of how this investment paid off can be seen through Nandini. Nandini is a mother and a shop owner in the Mysore district. She was given a microloan to install a household water connection. With this water connection, Nandini is able to spend more time at the shop and provide interest on the microloan. Water Equity’s fund has been able to impact millions of people in this way
- Water Equity has reached 1.7 million people and provided them with clean water or sanitation
- There is $18 billion in market demand from individuals for microfinancing to meet their water and sanitation needs
- 55–68% of small and medium enterprises in emerging markets are underserved by financial institutions.
Water Equity is able to take advantage of the large demand and low supply in emerging markets such as India and turn a profit for investors.
Some of Water Equity’s investors include Bank of America, The Conrad N. Hilton Foundation, and the US International Development Finance Corporation.
Major Solutions Vs. Indian Government
Many major organizations are focused on financing affordable loans however as can be seen through the Indian government's attempt to provide a subsidy, this can sometimes be difficult to govern. The key factor that affects the success of these organizations rather than the Indian government's attempt is the loan based format of any monetary payouts. Since organizations such as Water Equity and Water.org provide loans rather than subsidies there is a larger desire to create a meaningful impact to generate the interest needed to repay the loan. In addition, there is much more monitoring through Water Equity and Water.org’s part to provide the resources and to make sure sanitation and water solutions are developed rather than on the Indian government’s part
However, part of the reason the Indian Government was not able to create a much better solution was due in fact to its large impact. Since they were impacting many more people at once rather than Water.org, Water Equity, and even the Bill and Melinda Gates Foundation, it was much harder to create a scaled, closely monitored, rollout.
Repurification and Sewage Treatment Facilities
There are many root causes to this issue that are not being addressed enough or are not being addressed at all.
One large root cause is the repurification and sewage treatment facilities in India.
This becomes a large issue because many of the communities that are in need of toilet solutions are located in rural areas. In this case, it is very hard to create a functioning pipeline especially without much access to water. India’s largest cities have access to centralized sewage systems, complete with underground pipes, pumping stations, and treatment plants. However, these systems are very expensive to create and operate and require uninterrupted power, skilled operators, and extensive maintenance.
Of course, this is unfeasible for a rural town that cannot afford it. Although many solutions have created technologies that do not require much power to run, they still require manpower and very frequent maintenance. An example of this is the CDC’s Decentralized Wastewater Treatment System.
A larger issue that having no sewage treatment facilities causes is that about 80% of the sewage in India flows into rivers, lakes, and ponds. This sewage is untreated and pollutes water bodies. It also often goes underground, which is very concerning since as mentioned above most of India’s clean drinking water is from groundwater.
Takeaways
- Sanitation is a large issue in many parts of the world that is especially prevalent in India.
- 60% of the world doesn’t have a toilet that safely manages waste
- Many solutions trying to solve this problem in India are working through loans and microfinancing
- In rural India, most waste goes contaminates groundwater which is a large source of India’s freshwater
- In India, many people have a bias towards open defecations due to beliefs that it is a sign of virility and helps digestion
Thanks for reading my article! I’m Krish Lulla, a 15-year-old learning more about the world’s biggest problems and working to solve them. Reach out to me on Linkedin here:
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