Can you briefly describe the situation concerning the so-called “toilet crisis” in India?

One way of describing the crisis is in terms of numbers and percentages, which I consider a very thin description. Even using the thin descriptions of the averages, rural India is at the crux of the crisis with over 50 percent having no access to toilets, and therefore, open defecation is a big problem. In terms of averages in urban areas, there is nearly 80 percent availability of toilets, but there is a lot of masking. The masking happens because in urban areas, these numbers reflect only the supply of toilets. But the supply is of uneven quality and there are far more barriers to access toilets in urban areas than in rural areas. The thin description does not tell us that the urban crisis is also a very serious problem. Putting both crises together, the urban and the rural, India does have the highest number of people still unable to access toilets. This means that the important right of human beings to be able to use toilets in solitude and in privacy has not been realized. The government was absolutely right in putting the toilet issue on the forefront, as the prime minister did in his very first year of coming to power. Making toilets one of his first priorities was and continues to be very significant, coming from the most important political figure of the country.

Before this government came to power, I was interacting with community-level NGOs that worked directly with the urban communities in Delhi. That’s when I realized that public toilets provided by the government were not adequately accessible, especially to poor women. Sometimes the door of the toilet would not be there and women would have to pay a middleman to be able to access the toilet. Other times, the public toilet provided by the government was in a condition of disrepair.

An example that I heard from a South Delhi slum colony was that there were public toilets with very good supplies. However, community members, and girls especially, told me that they were forced by the landlord to only access the toilets in the morning or later at night. On repeated visits, I realized that the water supply from these toilets was being diverted to the neighboring gas station and was being used as car wash. When girls went and used these toilets, the patrons would come and bang on the doors and scare the girls away. In fact, the thin sheds on these toilets would have small holes in them and the men would begin to peep through these holes. So there are barriers to access toilets that come from the use of patriarchal power by men controlling the rights of when women can use the toilet. And if women are to use it, then they are to pay a fee or else they cannot use it in the times that men do not allow them to use it.

Another urban slum considered unauthorized in Delhi would have a toilet, but the defecation waste was not connected to the pipeline so there was no way to dispose the sewage itself. Here, the government actually sends incinerating machines and they dig out and manage the waste. The technology to dispose of the waste continues to be disrupted. Many of these unauthorized colonies are not on the pipelines set by the civic authorities. In sum, there may be a toilet, but you can’t defecate in it because the pipeline is not connected to the disposal system, or there is a lack of water supply, or it is controlled by men as intermediaries.

Waste disposal is at a very low level of mechanization. It is still managed by the lowest of the caste system. They have to dig out these toilets and their safety is not considered. Therefore, the pipelines that work to dispose this waste actually work as gas chambers and many of the workers could actually lose their lives. There are no new young people that want to join this profession any longer. Indeed the lack of toilets continues to be a problem due to social ills, power, and hierarchy more than due to technology.

How has the government responded to this issue? How effective have its efforts been?

There is the issue of the allocation of money. The central government itself reports advances in its supply sites. State governments report building many toilets. But where does the real challenge lie? It lies in the fact that even though you emerge as a supply site actor and increase the supply of toilets, there remain barriers to access, lack of adequate technology, and the social stigma of the caste hierarchy. All of these lie in the domains of the social and political community structures of power and that still need to be addressed.

Can you explain what Swachh Bharat Abhiyan (SBA) is and how it came about? What substantial changes have come from the campaign? How has the campaign approached the issue of widespread public defecation?

The SBA is the prime minister’s mission to provide government support to build toilets and provide the necessary monetary support. The government has also stepped up its vigilance in terms of construction and supply sites. The government has also promoted awareness. The government is also working with state governments to push this to the forefront of activities on the state governments’ agendas. We hear that a lot of stuff is happening in the states and that villages have been declared defecation free. We hear that people have innovative technologies. But what is not quite clear is to what level the acuteness of the problem has been handled.

SBA has two initiatives: the construction of infrastructure and facilities such as public toilets and the aim to change behavioral factors through educational means. What behavioral factors are SBA trying to change, and what educational programs has SBA implemented in order to change these factors?

The government is focused on constructing toilets, which increases the supply and encourages people to change their behavior. Whether the behavioral campaigns are fighting with the powers that stop or impede the use of toilets is unclear but I don’t think that has been happening. The emphasis is really on encouraging individuals to change their behavior. And the presumption here is that even if there is a toilet, people may say that they would rather defecate in the open. That behavior must change. My own work tells me that that is only part of the truth. Women in urban areas, for example, don’t want to go and defecate in the open. They would much rather have a private facility. There is a long way to go in removing the barriers to access toilets. For example, with the middlemen who have control over doors of toilets and charge women fees, is it possible to file complaints and grievances? Are there places that are saying that if men divert the water supply of toilets that were built in slums, the state will take direct and penal action? What I see is that the government has emerged as a very important actor in increasing the supply -- that’s a welcome step and it should succeed. But simply increasing the supply will not handle the fact that the lack of access is not just because of scarce toilets but because powerful people stop the poor, especially the women, from accessing toilets when that should be their free right. The other constraint really is in terms of how you dispose of the excrement. Higher-order mechanization is still required. That is the road ahead: that we make a better disposal of excrement so that we can decouple the stigma of the lowest of the caste system dealing with human waste. These are all issues of a societal transformation with challenges in inequality and hierarchy.

Outside of the SBA, what has the government been trying to do to improve public sanitation, hygiene, and clean drinking water? How would you evaluate these efforts?

India lacks a holistic approach. The urban slums that lack proper waste disposal are also festering with diseases. Nobody who looks at the health data actually connects these dots. My work in the urban slums tells me that there is the severe stunting of children – these children do not have the adequate height and weight according to their age. There are rampant waterborne diseases, like diarrhea and typhoid. There is also a lot of breeding of mosquitos. At this point, the efforts of public health are not being linked to public sanitation.

India has a vibrant civil society. How are Indian NGOs working to address this problem on their own?

One of the important achievements of the SBA has been that the government has made the toilet issue as one of its missions. This is a very important step in the sense that it’s no longer a stigma for the NGOs to hide that they do toilet work. There is now a lot more focus in the media about the constraints posed by the lack of toilets. I discovered the urban toilet problem as a part of my work on social protection in Delhi urban slums. I realized that social protection was not what people were asking for. Water, toilets, and defecation were the most important things that people were asking for. We were wrong about what urban slums needed. The government is saying that this agenda is very welcome. It takes us one step ahead in the debate on rights. We are now looking at the fine grain of what constitutes the rights of being a full human. This is allowing the NGOs to come and say that they are engaged in this activity. It is also causing a lot of people to challenge the problem of waste disposal. The problems of stench and disposal are now being discussed openly, which was not the case before. How you smell, feel, and perceive are becoming important in understanding social predicaments of the poor and inequality. It is no longer about people having low incomes. The right to a private place to defecate and to safe disposal of human waste are coming to the forefront of the human rights agenda in India.

Research suggests that the root cause of malnutrition may be from an abundance of human waste polluting soil and water, rather than from a scarcity of food. Do you think there is such a link between the lack of toilet facilities and malnutrition?

Absolutely. I am shocked to see in Delhi that there is a child crawling on the ground and she is only two years of age. These urban slums are areas where pipelines do not exist either to supply water or to remove defecation. These are the areas where I see rampant malnutrition. Not only that, but people do not have drinking water. Therefore, they buy available, unbranded, locally-made water in plastic jars. We do not know what the quality of this water is. There are also private clinics where the doctors do not have certified degrees for medical practice in India. These are doctors who are practitioners of traditional medicine. If you go and ask these medical providers, they will tell you that most people are only reporting waterborne diseases. They dispense antibiotics to kill the bacteria inside when the first step should really be to kill the bacteria on the outside. I have worked with a lot of the cleaners of the human waste in Dehli slums. They come and tell me that they are doubly disadvantaged because no one ever comes and cleans their drains as they live in these urban slums. So while they are responsible to clean the drains of the city, nobody cleans their drains. If disease is bred anywhere, it will spread into the city. There needs to be holistic thinking. The rich and poor of the city have one shared future and that future is that of their disease burden. The lives of the rich and the poor in the city are interconnected. Putting the poor in underserved urban slums will not lock out diseases itself. An attitudinal change here is extremely important.

In some important ways, the “toilet crisis” may reflect the lack of political voice and power of India’s urban poor. Based on your academic research, where do you believe the root causes of this problem lie?

At first was a sense of shame. No one wanted to articulate this as a problem and talk about the situation of toilets. I myself came to Claremont McKenna College and talked about elections in the Indian state. I didn’t talk about [the toilet crisis]. These are problems that are in the private domain. While the challenge to the personal being political has been done, there is still an under-articulation of defecation rights on the human rights agenda. There is an intersectionality in the sense that this is a gender right, this is a problem of the poor, and this is a problem of those who live in segregated zones. To talk upfront about these issues is the real challenge. That discourse has just begun and people are beginning only now to openly talk about it.