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For A Truly Swachh Bharat, Water And Sanitation Issues Need A Renewed Focus

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Globally, Water, Sanitation and Hygiene (WASH) have been part of the discourse from the beginning of the millennium. The United Nations Millennium Declaration signed by 189 countries including India in September 2000 brought it to the fore by instituting the Millennium Development Goals (MDGs) wherein countries agreed to combat poverty, hunger, disease, illiteracy, environmental degradation, and discrimination against women.

Water and sanitation was under the ambit of the Goal 7, which was about ensuring environmental sustainability. Target 7.C of the goal stated that by 2015, reduce the proportion of the population without sustainable access to ‘safe drinking water’ and basic sanitation by 50%. It also broke the silence on open defecation.

The report by the United Nations on the output of the MDGs published in 2015 was quite encouraging. It revealed that access to ‘improved drinking water’ source for more than 90% of the global population and access to improved sanitation for 2.1 billion people has been achieved through global efforts.

The India-specific report on the MDGs brought out by the Ministry of Statistics and Programme Implementation, Government of India in November 2017 highlighted that 89.9% of households had access to improved sources of water and 48.4% of the households had access to improved sanitation facility post MDG. These estimates are from the data collected in 2015-16.

The question that arises now is that why has the term ‘improved water’ being used as a proxy to ‘safe water’ while evaluating the MDG programme? Let’s first understand the definition of ‘improved water’ that has been given by the international organisations. The joint monitoring report by WHO and UNICEF brought out in 2012 defines an improved drinking water source as, “a facility that, by nature of its construction, is protected from outside contamination, in particular from contamination with fecal matter. The sources include: piped water into dwelling, plot or yard; public tap/standpipe; borehole/tube well; protected dug well; protected spring and rainwater collection.”

Perhaps, the organisations included the sources based on their experiences in the developed world with the assumption that improved water and safe water are conceivably synonymous.

A woman uses the local tubewell to access clean water. (Photo: Kristen Kelleher for USAID via

An objective assessment of the sources mentioned in the improved water category in the context of global south, brings out that most developing countries do not have uninterrupted (24×7) water supply, making the pipelines vulnerable to external contamination. Also, the water lines often run parallel to the sewage lines resulting in the water quality getting compromised even through the minutest leakage in the water pipeline.

In addition, the piped water supplied by the utilities are mainly treated for pathogens and turbidity and due to the lack of access to the information on the true water quality and near absence of trust in the utility; almost every household in the urban area in India invests either in a personal reverse osmosis water filter (wherein the wastewater generated is 3-4 times the treated water produced) or buy water for consumption.

Recently, a growing trend has also been observed in the installation of water ATMs at public places for accessing safe water. Furthermore, in India, 85% of the rural population uses ground water for drinking and domestic purposes. The contaminants present in the ground water drawn through boreholes, tube wells or dug wells ranges from salinity, nitrates, iron, fluoride to life threatening heavy metals like arsenic, cadmium, chromium, lead and mercury.

The contaminants put people to risk, which often they are unable to perceive. When a few of our students, during their project work, met the community members in Mewat, who were suffering from both dental and skeletal fluorosis, all they said was that the problem is in the air (“hawa mein kharabi hai”). They could not comprehend that it was water that they were drinking was crippling them.

Also, the MDG indicators had no mention of the quantity of water available per capita per day or the distance from which it is fetched and the gender roles in provisioning water at the household level. Women, especially in the rural areas, bear the burden of carrying water for domestic use. They are usually accompanied by the girl child; often at the cost of their education and health. The drudgery increases when the terrain is steep, or the water source breaks down or wanes as the new source may be farther away.

Thus, it is pertinent that development strategies need to incorporate gender and social inclusion indicators to cater to the needs of the people who have been historically marginalized from the planning and decision-making processes. It is also critical to document the differential impact of the solution provided on different sections of the society based on gender, caste, class and ethnicity. Reporting the disaggregated outcomes will help in taking corrective measures to ensure equity in the distribution and use of resources.

The MDGs in 2015 were replaced by the UN Sustainable Development Goals (SDGs), which unlike MDGs are a network of goals and endorse human rights-based approach to development. Through Goal 6 of the SDGs, the countries of the world resolved to achieve universal access to safe drinking water and adequate sanitation and hygiene by 2030. India is one of the signatories to the UN 2030 Agenda and has committed to working towards the realization of the SDGs.

Coincidentally, even before the SDGs were instituted, the Government of India, taking cognizance of the fact that India topped the global list of open defecation, launched the Swachh Bharat Mission (Clean India Mission) on October 2, 2014 with an objective to make the country open defecation free in five years. The scheme also had the provision of giving ₹12,000 to households below poverty line (BPL) for building the toilets.

The Swachh Bharat Mission’s (SBM) official page on SBM Gramin reports that, till date, 9,93,09,115 toilets have been built and the total coverage as of date is 99.99%. In February 2019, the Financial Express reported that the centre and state governments have jointly spent ₹69,782 crores for building 9.21 crore toilets in the country under the SBM Programme in the last three years.

While it goes without saying that the mission has been effective in so far as building infrastructure and generating awareness on the importance of sanitation is concerned, the output may not be representative of the desired outcome of the initiative.

During my recent visit to a north-western state of India, villagers expressed their inability to use the toilet due to lack of water. Likewise, people living in urban areas in the jhuggi jhopdi colonies (JJ clusters) and slums prefer open defecation to using community toilets due to lack of cleanliness and long waiting time. Also, large cities in India have huge influx of floating population and squatters who invariably settle on vacant land or low-lying areas and resort to open defecation as there is no other alternative for them.

The World Economic Forum, quoting the research on Changes In Open Defecation In Rural North India: 2014 – 2018 conducted by the Research Institute for Compassionate Economics (RICE), which is based on surveys of over 9,812 people and 156 government officials, mentions that even in 2018, 44% of households in the states of Rajasthan, Bihar, Madhya Pradesh and Uttar Pradesh practised open defecation.

While Swachh Sarvekshan (Cleanliness Survey) are being undertaken annually to evaluate the adherence to the guidelines (output), a detailed study on the outcome and impact of the mission from an independent agency will be vital to estimate the tangible impact of the mission.

In its second term, the government has announced the Jal Jeevan Mission to achieve ‘Har Ghar Jal’ (piped water in every house) for all rural households; which today stands at a meagre 18%. However, it would be worthwhile investing in conducting an appraisal of the Government of India’s earlier schemes like National Rural Drinking Water Programme and Jawaharlal Nehru National Urban Renewal Mission (JNNURM) later renamed as Atal Mission for Rejuvenation and Urban Transformation (AMRUT) prior to deciding an intervention programme.

It should not so happen that people end up having access to ‘improved water’ on tap instead of ‘safe water’ with no minimum guaranteed quantity or quality; a zero-sum game where people continue to buy water for drinking.

About the author: Dr Fawzia Tarannum is an Assistant Professor in the Department of Regional Water Studies at the TERI School of Advanced Studies (TERI SAS). She is an inter-disciplinary water professional with 20+ years of experience in project management, teaching and training. Her research interests are gender, equity and water resources management, integrated water resources planning and management, water governance and food-water-energy nexus. She is the recipient of the prestigious Fulbright Hubert H Humphrey Fellowship for the year 2017-18. She also serves as an advisor for the GuruJal Society formed under the Municipal Corporation of Gurgaon. She can be contacted at

Featured image for representative purpose only.
Featured image source: mmmktk555/Pixabay.
This post is a part of YKA’s first user-run series, Water Wars, by Zeba Ahsan. Join the conversation by adding a post here.
This post is also a part of YKA's first user-run series, Water Wars, by Zeba Ahsan. Join the conversation by adding a post here.
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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

Read more about his campaign.

Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

Read more about her campaign.

MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Read more about her campaign. 

A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

Find out more about the campaign here.

A native of Bhagalpur district – Bihar, Shalini Jha believes in equal rights for all genders and wants to work for a gender-equal and just society. In the past she’s had a year-long association as a community leader with Haiyya: Organise for Action’s Health Over Stigma campaign. She’s pursuing a Master’s in Literature with Ambedkar University, Delhi and as an MHM Fellow with YKA, recently launched ‘Project अल्हड़ (Alharh)’.

She says, “Bihar is ranked the lowest in India’s SDG Index 2019 for India. Hygienic and comfortable menstruation is a basic human right and sustainable development cannot be ensured if menstruators are deprived of their basic rights.” Project अल्हड़ (Alharh) aims to create a robust sensitised community in Bhagalpur to collectively spread awareness, break the taboo, debunk myths and initiate fearless conversations around menstruation. The campaign aims to reach at least 6000 adolescent girls from government and private schools in Baghalpur district in 2020.

Read more about the campaign here.

A psychologist and co-founder of a mental health NGO called Customize Cognition, Ritika forayed into the space of menstrual health and hygiene, sexual and reproductive healthcare and rights and gender equality as an MHM Fellow with YKA. She says, “The experience of working on MHM/SRHR and gender equality has been an enriching and eye-opening experience. I have learned what’s beneath the surface of the issue, be it awareness, lack of resources or disregard for trans men, who also menstruate.”

The Transmen-ses campaign aims to tackle the issue of silence and disregard for trans men’s menstruation needs, by mobilising gender sensitive health professionals and gender neutral restrooms in Lucknow.

Read more about the campaign here.

A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in’s flagship program ‘She Creates Change’ having run successful online advocacy
campaigns, which were widely recognised. Through the #BleedwithDignity campaign; she organised and celebrated World Menstrual Hygiene Day, 2019 in Guwahati, Assam by hosting a wall mural by collaborating with local organisations. The initiative was widely covered by national and local media, and the mural was later inaugurated by the event’s chief guest Commissioner of Guwahati Municipal Corporation (GMC) Debeswar Malakar, IAS.

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