HEALTH: FOR ALL, BY ALL
In view of the paper published in the medical journal Lancet in which researchers from the U.S. based Emory University negate any significant improvement in health (child diarrhoea , parasitic infections etc) upon increasing the toilet coverage, one is provoked to wonder what could be the reason for such statistics, presuming that the study is free from any flaw or bias.
We must realise that building toilets alone is not sanitation.
Although the concerns of 'patchy implementation of scheme' and 'uneven rate of use of toilets' are very genuine, it must be realised that health and sanitation are more intricately linked than commonly believed.
Effective sanitation is multifactorial and while building toilets is a necessary prerequisite for implementation of sanitation, what is really needed is 'Behaviour Change' to implement aspects such as 'proper disposal' and 'hand washing' to decrease contamination of our food and water bodies. After all, diarrhoea is feco-oral in its transmission and childhood stunting is directly related to (although not exclusive to) the prevalence of diarrhoea.
Behaviour Change or BCC is the reason why health and sanitation is a part of schooling. Although, in a society too busy in the rat race of survival: acquiring the most basic of education and struggling for jobs, even the "mature" adults are seen neglecting the very essence of our survival- 'respect for each other and for the mother nature'. The situation is so sorry that even the most "learned" members of our society are seen mindlessly littering roads and public places.
Research has established that children essentially learn by copying/imitating the adults around them. A child has an inherent urge to 'try what he sees'. Hence we see little kids trying to put on their mothers' nail enamel etc.
Thus in a set up where "responsible" adults pay the minimum attention to 'swachhta' it is unlikely that the children would be any different.
Toilets ensure that one aspect of the basic infrastructure for sanitation is improved as well as salvage the poor boundary walls and pillars from road-side urination and thus are in no way a wasteful investment.
However , we also need to change our attitude towards our role in basic cleanliness as well as in instilling the same in our children.
Attaining proper waste disposal is a far cry in a community where waste disposal itself is neglected.
Also, no number of toilets are useful if people do not use them. Continued usage of toilets will only be ensured if the toilets are thus maintained.
While toilets provide a socially and environmentally appropriate place when nature calls, diseases such as diarrhoea cannot be prevented unless sewage management and proper hand washing is ensured.
Thus sanitation is an important path walking on which, by combined efforts of the government, the NGOs and most importantly, by the parents, can create really significant improvement in our health at relatively nominal expense and by simple measures.
The much debated 'Swachh Bharat Abhiyan' is a simple yet powerful step encompassing both infrastructure as well as BCC via social media. The government can only launch it and sanction funds for it. The onus of its success lies purely on us.
Are we really socially intransigent or are we ready to change for our own benefit?
-Kriti Gangwar