New Delhi: Swachh Bharat Mission is the world’s largest sanitation initiative launched by Prime Minister Narendra Modi in 2014 to achieve an Open Defecation Free (ODF) India by October 2, 2019, as a tribute to Mahatma Gandhi on his 150th birth anniversary. The programme led to the construction of over 10 crore individual household toilets, taking sanitation coverage from 39% in 2014 to 100% in 2019, when around 6 lakh villages declared themselves Open Defecation Free (ODF). In 2021, the Government of India launched Swachh Bharat Mission (SBM) 2.0, with its focus on waste management.
What has been achieved so far under the 2.0 version of the campaign and what has been the impact of the campaign on public health parameters? Team Banega Swasth India speaks with Dr. Arumugam Kalimuthu, the Executive Director at the Water, Sanitation, and Hygiene (WASH) Institute, to delve into the transformative journey under the ‘Swachh Bharat Mission 2.0’ (SBM 2.0). Dr. Kalimuthu provides a comprehensive overview of the progress so far, and the transition to SBM 2.0, and the emphasis on community sanitation. Here are the highlights:
NDTV: Since its launch, what progress has India made under SBM 2.0? If you could share in numbers.
Dr Arumugam Kalimuthu: SBM has witnessed significant progress since its launch in 2014. In 1981, sanitation coverage in the country was only 1 per cent, increasing to less than 35% in 1994. By October 2, 2019, we achieved 100 per cent coverage in both rural and urban areas.
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After achieving individual household toilet coverage, SBM 2.0 was initiated because we have constructed toilets, what will happen once the pit or the septic tank is filled? So, we need to address the solid waste management aspect of it. Under SBM 2.0, the emphasis is on community and public toilets, along with greywater and blackwater management. If you look at the government data, about 4,355 statutory towns have achieved ODF status.
As of now, nearly 81 per cent of the towns have achieved ODF+ status in urban areas, indicating people have access to household or public toilets, along with sustainable maintenance and treatment of faecal sludge. This is ODF+.
ODF++ in urban areas goes further to ensure the safe management of sanitation, including the proper extraction, transportation, and treatment of faecal sludge. In rural areas, SBM 1.0 focused on five components: solid waste management, greywater management, blackwater management, plastic waste management, and cattle waste management promoting biogas. The ODF+ definition in rural areas encompasses these five components. If we look at the rural achievements, nearly 5,17,000 villages have achieved ODF+ status within a span of three to four years, marking a major achievement.
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NDTV: How does achieving the parameters set under ODF+ and ODF++ help in improving the health of the citizens?
Dr Arumugam Kalimuthu: Addressing safe sanitation access and toilet availability plays a pivotal role in preventing water-borne diseases, particularly Diarrhoeal diseases. The major source for Diarrhoeal diseases is faecal contamination. It leads to a lot of health impacts, primarily water-borne diseases such as Diarrhoea, Dysentery, Cholera, Typhoid, and Jaundice. Focusing on controlling faecal-oral transmission through access to safe sanitation and toilet prevents these diseases.
National Family Health Survey data from 2015-16 to 19-21 indicates a nearly 1.9 percent reduction in Diarrhoeal diseases nationwide. States like Uttar Pradesh, Chhattisgarh, and Tamil Nadu show even greater impacts due to improved sanitation coverage, contributing significantly to the reduction of water-borne diseases.
NDTV: What are some of the common diseases arising out of a lack of WASH facilities?
Dr Arumugam Kalimuthu: WHO classifies WASH-related diseases into five categories: water-borne diseases, water-washed diseases, water-based diseases, water-related vector-borne diseases, and soil-based diseases. Waterborne diseases include Diarrhea, Dysentery, Cholera, Jaundice, and Typhoid due to faecal contamination. We have prevented this by constructing toilets; particularly for faecal-oral transmission the root gets eliminated. That’s a major achievement.
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The second one is water-washed diseases resulting from insufficient water for personal hygiene, leading to conditions like scabies and skin diseases. Water-based diseases are the third category arising from bathing in contaminated water, causing diseases like Schistosomiasis and Guinea worms. Guinea worms were eradicated in the country long ago; however, still there are cases of Schistosomiasis in the country.
The fourth one is water-related vector-borne diseases, caused by mosquitoes breeding in stagnant water, along with freshwater as well as black water and dirty water. The mosquitoes breed in the water and spread diseases including Malaria, Dengue, and Chikungunya. Through greywater and blackwater management under the SBM 2.0, we are addressing that issue as well.
The other one is soil-based diseases. Open defecation leads to certain soil-based diseases like Hookworm and Pinworm, because it’s there in the soil when you are walking without a slipper, then you get these soil-based diseases.
NDTV: Which state/city has shown a reduction in disease prevalence as a result of improved levels of WASH facilities?
Dr Arumugam Kalimuthu: Nationwide, the National Family Health Survey indicates a considerable reduction in Diarrhoeal diseases. Uttar Pradesh, for instance, witnessed a reduction from 15 per cent to 5.5 per cent, reflecting a 9.4 per cent decrease. Tamil Nadu and Chhattisgarh also demonstrate notable reductions of approximately 4.5 per cent and 5.5 per cent respectively. Global studies by organisations like WHO, UNICEF, and the Bill and Melinda Gates Foundation affirm the significant reduction in waterborne diseases across the country.
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NDTV: How can we sustain the efforts made under SBM2.0 and continue to reap its health benefits?
Dr Arumugam Kalimuthu: I think India is the one country that has invested significantly in sanitation over the last 10 years. Since 2014, the government has been providing infrastructure, Information, Education and Communication (IEC) activities, Behavior Change Communication, and other services are also available. At the end of the day, it’s people who need to take the ownership and practice sustainability. That’s crucial. Sustainability lies in the hands of citizens. People must follow practices like source segregation, proper waste disposal, and avoid single-use plastics. While constructing new houses, people should follow proper norms for construction of septic tank or twin-pit toilets.
It is the citizen’s responsibility to ensure that the septic tanks are as per the design and should be emptied every three to five years.
Regular maintenance of infrastructure, adherence to sanitation practices, and personal responsibility contribute to sustaining the health benefits achieved through SBM 2.0.
NDTV: Where are we lacking, and what more is needed to ensure One World Hygiene and a healthier tomorrow?
Dr Arumugam Kalimuthu: Faecal-oral transmission prevention relies on two primary barriers: toilet usage and handwashing. Nearly 42 per cent of Diarrhoeal cases can be simply avoided by using handwashing with soap, as per the World Health Organization (WHO) reports.
Handwashing, especially with soap, is critical in preventing Diarrhoeal cases. Personal hygiene, including handwashing, should be a primary focus for preventing Diarrhoeal diseases and promoting overall health.
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NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which in its Season 10 is helmed by Campaign Ambassador Ayushmann Khurrana. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In a world post COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental well-being, self-care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.
