“Sanitation is more important than political independence,” Mahatma Gandhi said in 1947.

The nation won its political independence, but sanitation still remained a struggle for decades. It was estimated by the World Bank in 2011 that 626 million people defecated in the fields and streets rather than use toilets. This poor sanitation caused significant health problems such as typhoid and childhood stunting, as well as economic impacts estimated at 6.4% of its GDP lost to the problem.

In 2014, the Indian government launched the Swachh Bharat (Clean India) Mission, an initiative that aims to make India open defecation free by October 2nd, 2019 – Gandhi’s 150th birth anniversary.

GovInsider spoke to Parameswaran Iyer, India’s Secretary of Drinking Water and Sanitation, and head of the Swachh Bharat Mission, to find out about the progress of the campaign and what remains to be achieved.

Changing behaviour

The level of open defecation in India remained high despite many campaigns by the Indian government over the years. There was even a hit Bollywood movie Toilet: A Love Story, which is based on a true story of how people resisted the invention as a Western idea. Public toilets were destroyed; women are still forced to walk into the fields at dawn each morning, risking predatory men who wish to catch them at their most vulnerable.

Building toilets is not enough – the Swachh Bharat Mission is prioritising culture change. “It’s so important to trigger the behaviour change to stimulate the demand for a toilet and only then the supply chain comes in,” Secretary Iyer says. Subsidies are still available, but only a new approach will ensure that they are taken up.

The government has launched campaigns to broadcast the harms of open defecation and emphasize the importance of sanitation. It works with the media and celebrities to promote hygienic practices in the newspaper, radio, and television. A Swachh Bharat hashtag was launched for celebrities to promote the initiative and build a broader social movement to encourage people to ditch their old ways.

Young people are vital for the movement’s success. Schools have introduced the topic into their curriculum, and children are expected to influence their families and even their entire communities. The Mission also enlists ‘grassroot motivators’ who travel to different villages to build positive engagement.

This approach is known as Community-Led Total Sanitation (CLTS), which was created by Indian activist Dr Kamal Kar. CLTS encourages local people to acknowledge the harms of their own practices and take ownership of the solution. “While doing their own analysis, they realise that they had been ingesting each other’s shit,” Dr Kar explains. “People may be poor but they’re human beings… nobody wants to live in shit.”

“Nobody wants to live in shit.”

The shame elements of this broader approach have proven controversial, but CLTS seems to be working across the world. In India, the Mission has raised the rural sanitation coverage from 29% to over 96%, it says, and over 90% of household toilets are now being used. The struggle still persists for sanitation, of course, but it changes from using toilets to keeping them well maintained.

International approaches

It is also replicable in other parts of the world. For example, India’s neighbour Bangladesh faced the same problem in the 1990s, with an open defecation rate of 34%. Today, that number is less than one percent.

The behaviour change approach has since spread to over 70 countries in Asia, Africa, and Latin America. It follows in the footsteps of Gandhi’s successful campaign for independence, in that respect.

The great campaigner would certainly be pleased with India’s progress, particularly given that this practice was closely associated with religious and cultural norms by villagers across the nation. This led Gandhi to rail against the“thoughtless ignorant men and women use for natural functions the sacred banks of the river where they are supposed to sit in quiet contemplation and find God. They violate religion, science and the laws of sanitation.”

The Swachh Bharat Mission still has another year to go, but Secretary Iyer says that there are already observable health, economic, and social benefits. “There is a significant reduction in diarrhoea, in stunting,” he says. “The Swachh Bharat Mission will probably save 300,000 lives by the time this mission is over.”