India is the world's second most populous country, with a population estimated at over one billion. The country has made great progress in ensuring that clean water is available to its population, especially during - and since the close of - the International Water Supply and Sanitation Decade (1981-90). Nearly 88 per cent of the people are now covered.

But the story is very different with regard to sanitation. About 71 per cent of the country's population, some 733 million people, or roughly three times the entire population of the United States - still either defecate in the open or use unsanitary bucket latrines or smelly public toilets. This is true even in urban areas, where hardly 28 per cent of the population has access to water-flush toilets connected to a sewerage system and 21 per cent enjoy water-borne toilets connected to septic tanks or leach pits. In rural areas, a mere 20 per cent of the population has access to sanitary toilets.

This deplorable lack of adequate sanitation is responsible for severe health problems, to say nothing of the foul odours wafting through the air that diminish the quality of life for everyone living in underserved communities. Cholera, dysentery, typhoid, infectious hepatitis and many diseases caused by various types of worms in the body may be traced to human excreta. Some 50 infections can be transferred from a diseased person to a healthy one via a direct or indirect excreta route.

Lack of sanitation also has grave social consequences. The need to have "night soil", as human waste is called, removed has given rise to the profession of "scavenging" or collecting it from bucket latrines, the streets and other locations. For generations, those practicing this profession have been stigmatized and scorned as "untouchables", the lowest of the low. Although the Indian Constitution bans their segregation, these people often live apart from the rest of society, under appalling conditions, and lacking dignity and human rights.

A pioneer improves the quality of life of the poor

As the statistics make clear, India's sanitation problems have long defied solutions - until the last few years. Thanks to the pioneering work of Dr. Bindeshwar Pathak and the Non-Governmental Organization (NGO) Sulabh International Social Service Organization he founded, an affordable and socially acceptable method of human waste disposal has moved from the drawing board. It is already improving the health and quality of life used by over ten million people everyday, demonstrating how a local government-NGO partnership, backed by community participation, can have substantial impact on improved environmental quality in areas habited by the weaker segments of society.

Dr. Pathak is a member of the Geneva-based Water Supply and Sanitation Collaborative Council (WSSCC), a multi-stakeholder organization with members in some 140 countries, all working to make sanitation and safe water a reality for everyone, especially the poor and the underserved of humanity. The WSSCC has embarked on a new global advocacy effort by launching WASH - Water, Sanitation and Hygiene for all - to generate political will and mobilize action to ensure an end to the suffering of some 2.4 billion people, mostly in the developing world, who still have no access to sanitation and the 1.2 billion without a safe and affordable water supply. According to Sir Richard Jolly, Chair of the WSSCC, during the recent Dialogue for Pro-Poor Policies for Water and Sanitation at the World Urban Forum in Nairobi: "Clean water alone leads only to minor health improvements; sound hygiene behaviour must be addressed in its own right with adequate sanitation and clean water as supporting components." "While each of the three elements has some health benefits, it is their combined effort that has far greater impact," he added.

Unaffordable remedies

Two common sanitation technologies internationally known to be ideal for the disposal of human excreta and waste water have proved too expensive for widespread installation, operation and maintenance in India, as well as in other developing countries: septic tanks and sewerage. Septic tanks were introduced in India about 150 years ago but today less than 20 per cent of the houses are equipped with latrines connected to them. In addition to their cost, one disadvantage is that they require a large volume of water for flushing. Another is that they have to be cleaned periodically and sludge disposed of so that it does not cause health hazards or serve a breeding ground for mosquitoes.

Sewerage was first tried in India in the late 19th century, yet only about 232 of the country's 5,005 towns and cities have yet been hooked up to a system. Even in these places, the entire municipal area is not covered, let alone the adjoining suburbs, and not all houses have connections.

Low-cost solution takes hold

Dr. Pathak is an eminent, action-oriented sociologist, social reformer, environmentalist and internationally-known expert on low-cost sanitation and the production of biogas from human excreta. Over the years, he has seen first-hand the deficiencies inherent not only in expensive technologies but n alternatives like public toilets and various kinds of house-based latrines that failed to gain public acceptance. His solution, called "Sulabh Shauchalaya," is a low-cost, pour-flush water-seal toilet with twin leach pits for on-site disposal of human waste.

This technology has many advantages: it is affordable, even by the poor, as there are designs to suit different levels of income. Flushing requires only two litres of water, instead of the ten litres needed by other toilets. It is never out of commission since, with two pits, one can always be used while the other one is being cleaned. The latrine can be built with locally available materials and is easy to maintain. It has high potential for upgrading because, while it is a stand-alone, on-site unit, it can easily be connected to a sewer system if and when one is introduced in the area. The toilet is also culturally acceptable inasmuch as it remains free from filth and foul odours. Neither does it require the services of scavengers.

In 1970, Dr. Pathak set up Sulabh Shauchalaya Sansthan (now called Sulabh International Social Service Organization) as an NGO, to disseminate the idea of conversion to the Sulabh Shauchalaya and assist communities in adopting it. So far, more than 1.2 million toilets have been constructed (or substituted for existing latrines) in houses, and 5,500 have been installed in pay-and-use public toilets. Staffed by an attendant 24 hours a day, the latter supply soap powder for washing hands, include facilities for bathing and doing laundry as well as offer free services to children, the disabled and the poor. As a result, more than 1.2 million people have been provided with improved, low-cost sanitation while 50,000 employment opportunities have been created.

Keys to success and lessons learned

Despite the virtues of the technology itself, introduction of the Sulabh Shauchulaya might not have been so successful had not Dr. Pathak realized early on that public awareness and community participation are critical aspects in any sanitation improvement programme, and that people's perceptions and attitudes on sanitation would need to be changed. Among isolated populations, unlikely to feel responsible for wider environmental conditions, the Sulabh International Social Service Organization has undertaken educational efforts to help reverse this frame of mind and instill strong community awareness. In mega-cities, where public agencies might be expected to provide critical services but are financially unable to do so, this NGO has offered residents a chance to seize the opportunity for low-cost, self-help development.

The approach includes door-to-door campaigns by Sulabh volunteers and workers who persuade people to convert from bucket latrines. Once approval is gained, the organization takes responsibility to relieve the beneficiary the bother of constructing the twin-pit, pour-flush toilet. Sulabh also educates people on the use and maintenance of their new latrine and promises to fix construction, removal of defects and solve technical problems at no cost. After construction, service is provided and problems in use and maintenance are resolved by locally posted Sulabh workers.

Building local capacity and income generation

Technical training is also given to enable local people to construct more latrines themselves. In rural areas, latrine-builders are also trained in such fields as brick-laying, social forestry and biogas production, since it has been shown that latrine construction alone may not provide artisans with sufficient, sustainable income.

Special attention is given to the needs of women, especially those living in impoverished areas and belonging to scavenger families. They are included as both students and instructors in the re-education process and trained as sanitation volunteers, with the expectation that they will pass the message along to other women. In the urban areas the wards of scavengers liberated from the inhuman practice of manual scavenging have been trained in market oriented vocations e.g. computer, stenography, typing, electrician, tailoring, beauty parlour, embroidery, dress designing, electronics, etc.

Sulabh also helps local communities set up, operate and maintain the community toilet complexes, run on a pay-for-use basis. In some municipalities, Sulabh has taken over these complexes from city officials for contracted period of 30 years, relieving the municipal authorities from the task of operating and maintaining them. This has vastly improved the quality of facilities available to users. Often these comfort stations are the cleanest ones in town, even in major cities like New Delhi, Bombay, Calcutta and Madras.

Recycling and promoting alternative sources of energy

The organization also works with local groups on production of biogas from human excreta derived from the community toilets, and on the generation of electricity as an alternative source of energy. Its research and development activities are geared to practical solutions for solid and liquid waste disposal, including recycling and resource recovery.

Overall, Sulabh's experience shows that, where financial resources are constrained by central administrations, functions can effectively be delegated to grassroots and community level organizations. It also demonstrates how sanitation and health education can be integrated, and how the energies of the poor can be harnessed to reach their full potential. The model Sulabh has developed can be easily replicated by NGOs and governmental organizations. The Government of India, Indian state governments and various national, international agencies and WSSCC members such as UNICEF, the World Bank, UNDP, WHO and UN-Habitat among others, have accepted the design and are advocating its use all over India, as well as in other developing countries in South-East Asia, Latin America and Africa.

As part of the global campaign, Sulabh is launching the WASH campaign in New Delhi on 29 June as a follow-up to the World Summit for Sustainable Development in Johannesburg in 2002 and the 3rd World Water Forum in Kyoto, Japan in March 2003. One of the Johannesburg Summit's major outcomes was to complement the existing UN Millennium Development Goal (MDG) for water with a corresponding goal for sanitation: to halve the proportion of people who lack access to proper sanitation by 2015. Sulabh is already moving towards the implementation of this new goal that is also linked to the alleviation of poverty, another MDG.

In identifying the top five issues addressed by the Summit, UN Secretary-General, Kofi Annan, said that the issue of water and sanitation ranks first, followed by energy, health, agriculture and biodiversity - "… five areas that make up ambitious but achievable agenda - five areas in which progress would offer all human beings a chance of achieving prosperity that will not only last their own lifetime, but can be enjoyed by their children and their grandchildren too."

Source: Dr. Bindeshwar Pathak, Founder, Sulabh International Social Service Organization,
Sulabh Bhawan, Mahavir Enclave, Palam Dabri Marg, New Delhi - 110045, India. E-mail: Sulabh1@nde.vsnl.net.in OR Sulabh2@nde.vsnl.net.in

For more information, please contact:

• Water Supply and Sanitation Collaborative Council
  International Environment House
  Chemin des Anemones 9
  CH-1219, Geneva, Switzerland
  Tel.+(4122) 917- 8657; Fax.+ (41 22) 917- 8084; E-mail: wsscc@who.ch
  Website: www.wssc.org
• In New York:
  Ms. Eirah Gorre-Dale
  Water Supply and Sanitation Collaborative Council
  c/o United Nations Department of Economic and Social Affairs (UNDESA)
  Water, Natural Resources and SIDS Branch
  Division for Sustainable Development
  2 U.N. Plaza, DC2-2018
  New York, N.Y. 10017, U.S.A.
  Tel.+1(917) 367-2420; cellphone:+1 (914) 309-5491
  New York, N.Y. 10017, U.S.A.
  Tel.+1(917) 367-2420; cellphone:+1 (914) 309-5491
  Fax.+1(917) 367-339; E-mail: gorre-dale@un.org