Prime Minister Narendra Modi's exhortation to end open defecation has resulted in two large donations for the cause: Rs 100 crore each from the Bharti Foundation, the charitable arm of the Mittal family, and Tata Consultancy Services. The money may be large but it begins to look small when seen in the context of the problem. For instance, the Bharti Foundation has decided to make all the 965 villages in the Ludhiana district of Punjab free of open defecation. The programme will start next month and is expected to get completed in two to three years' time. Rakesh Bharti Mittal, the co-chairman of Bharti Foundation, reckons this will require the foundation to construct about 50,000 toilets. At Rs 25,000 to Rs 30,000 apiece, that could cost at least Rs 125 crore. And there are over 650 such districts in the country! According to the 2011 census, 67 per cent of rural households and 13 per cent of urban households defecate in the open. As much as 60 per cent of the entire open defecation in the world happens in India. In all global maps that depict the unhygienic practice, the reddest zone is India. The Water and Sanitation Program of the World Bank had estimated that inadequate sanitation cost India $53.8 billion in 2006 - 6.4 per cent of the country's gross domestic product in that year. Open defecation breeds various illnesses, which cause a loss of output. Also, people often have to walk some distance before they reach a defecation site. This, too, impacts output. The health problems created by open defecation are known to create stunted children, and this affects productivity when they join the workforce. Parents don't send girls to schools because they don't have toilets. For women, open defecation causes loss of dignity. It also deprives the country of serious earnings from tourism. These are strong economic and social reasons to end the practice. Health benefits kick in, experts say, when 30 per cent of the community starts to use toilets. At 70 per cent usage, half of the benefits are reached. Some might say that there is some correlation between water availability and open defecation. Theoretically, it would seem so. Every time a flush is used, almost 15 litres of water get used. Even in the most economical toilets, at least three litres of water are required. For a family of five, that means additional 15 litres of water in a day. As women are the water carriers in rural households in the arid regions of the country, a toilet at home means more work for them. But research carried out by the World Bank shows there is no correlation between water availability and open defecation. In fact, women, followed by infirm people, are the biggest champions of toilets inside homes. There is only one block (sub-district) in the country that is totally free of open defecation - in the water-scarce Churu district of Rajasthan. Even in the remotest corner of the country, everything required to set up a toilet is available within a radius of 20 kilometres; yet there is widespread reluctance to install a toilet at home. One reason is monetary.
For example, the per capita income of Bihar is Rs 25,000 a year. For a family of five, that means income of Rs 1.25 lakh. For it to spend Rs 25,000 on a toilet is a tough choice. To help such families, Rural Development Minister Nitin Gadkari has proposed to raise the money allocated for a toilet from Rs 10,000 to Rs 15,000. But like all subsidies, only a fraction of the toilet subsidy reaches the intended beneficiaries. That is why researchers say the improvement in the sanitation standards of the lowest quintiles of population has been marginal. The biggest deterrent to toilets is actually the Indian mindset. Recent work by Research Institute for Compassionate Economics in five states (Bihar, Haryana, Madhya Pradesh, Rajasthan and Uttar Pradesh) found that over 40 per cent of the households with a functional toilet have at least one member who defecates in the open. These people find open defecation more pleasurable and desirable. In other words, even if the government were to fit every home with a toilet, the problem is unlikely to vanish. There is ample evidence to suggest that toilets built with government help are often used as store rooms or even cowsheds. The Punjab government had launched a programme to build community toilets in the state, but these quickly fell into disuse. That is why it is necessary to instill some sort of behavioural change amongst people. More than the money, Prime Minister Narendra Modi has helped the cause of sanitation by bringing it to the forefront of the national conscience. It now needs to travel down the chain. Mr Mittal expects students of the 48 schools that the Bharti Foundation runs in Ludhiana to be the agents of change. While the money is important, people first need to build toilets in the mind. It is also surprising that though it is such a problem, there has been very little work on toilets, especially in developing low-cost ones. Though Kolkata in 1870 became the third city in the world after London (1850) and New York (1860) to get a sewer system to dispose of human waste, the country's sewer system is far from adequate. Less than 15 per cent of Indian cities have sewerage. Less than a fifth of these have sewer-treatment plants. Due to the high costs and logistical challenges involved in setting up sewer systems, the country for quite some time will depend on the septic tank system. But it can have serious health hazards in flood-prone areas. This is clearly an area that is waiting for some serious investment in research and innovation.