Draft Eco-friendly Sanitation System with Emphasis as Rural Areas India Water Week 2013

Background Individual health and hygiene is largely dependent on adequate availability of drinking water and proper sanitation. Consumption of unsafe drinking water, improper disposal of human excreta, improper environmental sanitation and lack of personal and food hygiene have been major causes of many diseases in developing countries. Prevailing High Infant Mortality rate in India is also largely attributed to poor sanitation. It was in this context that the Central Rural Sanitation Program (CRSP) was launched in 1986 primarily with the objective of improving the quality of life of the rural people and also to provide privacy and dignity to women. The concept of sanitation was earlier limited to disposal of human excreta by cesspools, open ditches, pit latrines, bucket systems, septic tanks etc. Today, it connotes a comprehensive concept, which includes liquid and solid waste disposal, food hygiene, and personal, domestic as well as environmental hygiene. Sanitation is one of the basic determinants of quality of life and human development index. Good sanitary practices prevent contamination of water and soil and thereby prevent diseases. The responsibility for provision of sanitation facilities in the country primarily rests with local government bodies Gram Panchayat in rural areas. The state and Central Governments act as facilitators, through enabling policies, budgetary support and capacity development. In the Central government, the planning Commission, through the Five Year Plans, guides investment in the sector by allocating funds for strategic priorities. The disparities in rural and urban sanitation are even more pronounced than those in drinking water supply. Globally, 79 per cent of the urban population uses an improved sanitation facility, compared to 47 per cent of the rural population. In rural areas, 1.8 billion people lack access to improved sanitation, representing 72 per cent of the global total of those un-served. However, a great deal of progress has been made in rural areas since 1990: 724 million rural dwellers have gained access to improved sanitation while the number of people un-served in urban areas has grown by 183 million.

Government of India Initiatives: In 1986, the Rural Development Department initiated Indias first nation-wide program, the Central Rural Sanitation Program (CRSP). This was a late start compared to rural drinking water supply, which was given higher priorities in 70s and 80s. CRSP focused on provision of household pour flush toilets with little accent on communication mechanism for behavior change. Despite an investment of more than Rs. 6 billion, rural sanitation grew at just 1 per

cent annually throughout the 1990s and the Census of 2001 found that only 22 per cent of rural households had access to a toilet.

With a less than satisfactory performance of the CRSP, Government of India restructured the program with the launch of the Total Sanitation Campaign (TSC) in 1999. TSC advocates a participatory and demand driven approach, taking a district as a unit with significant involvement of Gram Panchayats and local communities. It moves away from the infrastructure focused approach of the earlier programs and concentrates on promoting behavior change.

TSCs, convergence with the rural water supply programs and the National Rural Health Mission (NHRM) program is of utmost importance. Integrating sanitation programs with initiatives to improve water availability and health care would increase the likelihood of achieving public health outcomes such as reduction in diarrheal and other water borne & infectious diseases. Similarly, TSC convergence is to be properly established with Department of School Education and Literacy (DSEL) and the Sarva Shiksha Abhiyan (SSA), the flagship program of GoI to achieve universal elementary education. The emphasis is on providing a school environment equipped with necessary inclusive sanitary facilities as well as ensuring these facilities are safe and well maintained and help to inculcate improved hygiene behavior in children.

Ministry of Drinking Water and Sanitation (MDWS) has now renamed TSC as Nirmal Bharat Abhiyan (NBA) in 2012. The objective is to accelerate the sanitation coverage in the rural areas so as to comprehensively cover the rural community through renewed strategies and saturation approach. The main objectives of the NBA are as under: 1. Bring about an improvement in the general quality of life in the rural areas. 2. Accelerate sanitation coverage in rural areas to achieve the vision of Nirmal Bharat by 2022 with all gram Panchayats in the country attaining Nirmal status. 3. Motivate communities and Panchayati Raj Institutions promoting sustainable sanitation facilities through awareness creation and health education. 4. To cover the remaining schools not covered under Sarva Shiksha Abhiyan (SSA) and Anganwadi Centres in the rural areas with proper sanitation facilities and undertake proactive promotion of hygiene education and sanitary habits among students. 5. Encourage cost effective and appropriate technologies for ecologically safe and sustainable sanitation. 6. Develop community managed environmental sanitation systems focusing on solid & liquid waste management for overall cleanliness in the rural areas.

Access: Provision of sanitation and a clean environment are vital to improve the health of our people, to reduce incidence of diseases and deaths. To address this challenge the international community has pledged to halve the proportion of people without access to safe drinking water and basic sanitation facilities by 2015 as part of the Millennium Development Goals. The Indian census 2011 shows the coverage of sanitation and water supply. The census report shows that 49.8% of total 122.9 million households in India practice open defecation. While in rural India the situation is still worse. 67.3% i.e. 113 million households practice open defecation in the country. TSC is being implemented at scale in 607 districts of 30 states/Union Territories (UTs). Against an objective of 12.57 crore Individual Household Latrines (IHHL), the sanitation facilities for individual households reported to be achieved is about 8.38 crore as of December 2011. In addition, about 10.32 lakh school toilets, 19,502 sanitary complexes for women, and 3.46 lakh anganwadi (preschool) toilets have been constructed.

The above figure shows Individual household latrine coverage has more than tripled, from around 22 per cent in 2001 to 67 per cent in September 2012.

Training and awareness Education and training provokes thought, heightens awareness and raises consciousness. The availability of adequate number of trained personnel with the requisite caliber and motivation is the main source of success of any programme. The lessons learnt from the projects implemented done so far reveal poor operation and maintenance, lack of preventive

maintenance and break down repairs, lack of quality and quantity monitoring and above all lack of definite systems or mechanism or approach in solving day to day problems. Though finance may be one of the problems for proper O & M of the sanitation systems developed, lack of trained manpower and management short comings are also being responsible for the loss of huge investments going on year after year. It is, therefore, necessary to evolve a perspective training plan with the following broad objective. To develop in the existing personnel adequate conceptual appreciation, technical skills and capacity to motivate people To ensure that technical personnel get abreast of latest technical developments thus guarding against the ever present danger of obsolescence To provide periodical in service training to refresh current knowledge To familiarize with appropriate low cost technologies which are specially suited to the conditions prevailing in the country To train grass-root level people to operate and maintain water supply and sanitation systems available in the rural areas To bring about participation of the beneficiaries in the planning, implementation, operation and maintenance of rural water supply and sanitation system To introduce the concept of training of trainers of the institutions in the field of low cost water supply and sanitation technologies at the district level

The linkages between grass-root level training and the training of the trainers are rather two missing links in the whole chain of the training programme. Another very important issue that is not being monitored is how best these trained persons are being made use of. The training material being used for different training programme also require a thorough review as most of them require updating and inclusion of newly developed approaches. Moreover, a number of new training programmes at different levels are to be introduced to meet the needs of the rural water supply and sanitation sector.

Lack of trained Man power: Report of the National Water Supply and Sanitation Committee (1960-61), Ministry of Health, recommended that the district Centre would be the pivot of future activity for implementing the rural programme. It is desirable that the Centre is so developed that it has a manufacturing yard for casting, curing and storage of different sizes of concrete pipes, specials, latrine pans, squatting slabs, traps etc. required for rural water supply and sanitation works. The district level resources planning and availability are still inadequate though five decades have passed. Keeping in view the recommendations of the said committee and present status and needs of the sanitation programme in the rural areas of the country following issues needs to be considered:

 A mechanical section should be entrusted with the production, stocking, supply and distribution of all materials required for the programme. Though some sanitary marts have been established under the present programme in some selected locations, these are grossly inadequate to meet the large demands of rural India. The availability of adequate number of trained personnel with the requisite caliber and motivation is the main source of success of any programme. Most of the masons available in the rural areas have got some knowledge about constructing a septic tank rather than any other safer and sustainable designs. Each centre could, train the required number of masons, carpenters, mechanics, mistries and other artisans in their respective works to handle the field work in rural areas. Individuals and institutes having expertise in building sanitary toilets can provide training to masons. Once the toilets are built, proper follow- up activities should be done. The district Centre could, in addition, arrange for the necessary orientation, refresher and training courses for the subordinate technical personnel.

Issues and suggestions in achieving the Sustainable Sanitation coverage in rural areas: Sanitation and Health Improving health is one of the main goals of water and environmental sanitation interventions. Sanitation refers to all aspects of excreta disposal- human and animal faeces and urine. It includes sanitary structures; material needed for the proper operation and use of structures and the human behavior and attitude relating to excreta and its disposal. Faecal-oral infections are one of the major transmission routes caused due to open defecation. Transmission occurs mainly through direct contact with contaminated fingers; food contaminated directly with excreta, contaminated hands, domestic flies, soil, or water; contaminated drinking water; or contaminated soil. Faecal-oral infections include diarrhoeal diseases such as cholera, bacillary dysentery, typhoid, hepatitis A, and poliomyelitis.

The common transmission routes of faecal-oral infections Around seven lakhs death takes place annually due to diarrhoeal diseases in the country, 80% of which occur to children below 5 years. Majority of these deaths are due to lack of sanitation practices in the country and is one of the major causes of high infant mortality rate. Soil-transmitted helminthes penetrate the skin when pathogen enters the body through skin, which is in direct contact with the contaminated soil (bare foot walk in the contaminated area).This is the method used by hookworms and threadworms. Another way of helminth entering the human body is ingestion. When either contaminated soil, or food or hands

contaminated with polluted soil come into contact with mouth, the pathogens can be transmitted. This method is used by roundworms and whipworms.

Again, poor sanitation practices cause majority of these diseases and reduce the productivity of the country. A simple way of reducing hookworm disease in rural India is by wearing slippers, while moving around on the contaminated soil.

Poverty and disparities: Under MDWS programme, an incentive is provided only to Below Poverty Line households under the scheme. While the incentive for Individual Household Latrines (IHHL) has been revised from time to time and stands at Rs 3200/-(Rs. 3700/- for hilly and difficult areas) per IHHL constructed and used by BPL household, including State share of Rs 1400/-, the BPL households are expected to find resources for the remaining cost. Most assessments have calculated IHHL cost at about Rs 12,000/- to Rs. 16,000/- with the substructure alone costing about Rs 6000/- to Rs. 7000. Those who are Above Poverty Line (APL) are expected to be motivated through IEC to construct toilets on their own. Apart from these incentives, it has now been decided that sanitation programme activities can be undertaken under MGNREGA in accordance with these guidelines: a) Construction of Individual Household Latrines (IHHL) as per instructions/guidelines of Total Sanitation Campaign administered by Ministry of Drinking Water and Sanitation (MDWS). b) Construction of Anganwadi Toilet unit and School Toilet Unit as Institutional Projects. c) Solid and Liquid Waste Management (SLWM) works in proposed or completed Nirmal Grams. {Unskilled labour (up to 20 person days) and skilled labour (up to 6 person days, under material component under Mahatma Gandhi NREGS) on construction of Individual Household Latrine. The total amount to be booked under MGNREGA will however not exceed Rs. 4,500 per IHHL.} Through MDWS guidelines suggest these linkages to enhance the funding for the reveal sanitation programme, it is extremely difficult to converge these two programmes as mandays estimated under MGNREGS are not required to constrict individual household toilets. Material cost is as high as 70-75% of total construction cost of the IHHL. In this regard, I met Honble Prime Minister in May 2006 and requested him to give loan for construction of toilets. He issued an order to the Ministry of Rural Development and Ministry has given guidelines to the RBI. Then RBI issued guidelines that 15,000/- loan should be provided for construction of toilet but I am not aware where the circular has gone. While the policy of Government of India under TSC has been to disburse incentives to the BPL households, considered the poorest in the rural areas, poverty continues to be a curse

and a barrier for accelerating rural sanitation coverage. In a study done by Centre for Media Studies (CMS), engaged by the Ministry of Rural Development in the year 2010, 41% of the respondents cited poverty as the main reason for non-construction of toilets.

Dysfunctional toilets and O & M: Studies have shown existence of many incomplete/poorly constructed toilets due mainly to lesser availability of funds that are now dysfunctional as a reason for non-usage. Attainment of Nirmal Gram objective requires policy interventions to ensure that these may be made functional and appropriate Maintenance and Operation mechanism evolved especially for Community and Institutional toilets. One of the important factors as emerging from various studies show lag between coverage and usages has been poor quality construction of sanitation facilities and dysfunctional toilets for reasons like pit/septic tank full, chocked pan/pipes, wrong location, filled with debris and used as storage space among others. The issue of water availability is one of the major concerns while dealing with water-seal toilets.

Behavioral change: In addition to hardware issues, large scale efforts are still needed to create and sustain community demand for hygiene and sanitation. The capacity for behavior change programming, which is decentralized under TSC, is also limited at the state and local levels. Though the country has come a long way to break the traditional barrier and taboo associated with toilets, open defecation in rural areas continues to be a socially and culturally accepted traditional behavior at large, by both rich and poor. The level of awareness about the importance of sanitation is low amongst the people and knowledge alone is not sufficient unless it is put to practice. Lack of public awareness regarding basic sanitation and hygiene is also very low. It is, therefore necessary: To provide support to the existing personnel with technical skills to motivate people. To provide technical personnel with latest technical knowledge. To involve the grass-root level functionaries for proper O & M of systems. To involve beneficiaries at all levels of the system.

There is thus a need to systematically understand factors around effective behavior change and to support a comprehensive behavior change program with consistent strategy and messages at the program level through detailed communication strategies coupled with sufficient funding for Information, Education and Communication (IEC) activities.

Caste based distribution of toilets:

Construction of household toilets has got significant linkage with caste educational background, economic factor and concept of cleanliness amongst households. Various studies have highlighted these issues. In one such study conducted by ORG Centre for Social Research shows that more households of the general caste own toilets, and there is a significantly lower proportion of SC and OBC households which was found to own household toilets. The survey was conducted in year 2009 under PRWSS World Bank Project in all the districts of Punjab with a sample size of 20 households in each village. 90 percent general category households, 69.5 percent households in OBC category and 57 percent households in Scheduled caste category had this facility.

Different Sanitation Technologies In the developed countries, the standard practice for the sanitary disposal of human waste is sewerage. Due to financial constraints and exorbitant maintenance and operational costs, sewerage is not the answer at present to solve the problem of human waste management in India. To achieve sustainable sanitation it is necessary for our country to go for the nonconventional technologies. As these technologies require less money, water, space and do not require skilled labour for operation and maintenance, these are sustainable and replicable in different geological conditions. The technologies which are maintained by the beneficiaries and rectified with limited technical knowledge should be promoted because as and when the system collapse they could be able to fix the problem by themselves. There are large numbers of sanitation technologies available for adaptation in the country. However, the one that may be universally adopted is two pit pour flush compost toilet. Two pit pour flush compost toilet Two pit pour flush compost toilet is eco friendly, technically appropriate, socio-culturally acceptable and economically affordable. It is an indigenous technology and the toilet can easily be constructed by local labor and materials. It provides health benefits by safe disposal of human excreta on site. Advantages of Two pit pour flush compost toilet Hygienically and technically appropriate, and socio-culturally acceptable. Affordable and easy to construct with locally available materials. Design and specifications can be modified to suit householders needs and affordability. Eliminates mosquito, insect and fly breeding. Can be constructed in different physical, geological and hydro geological conditions. Free from health hazards and does not pollute surface or ground water, if proper precautions and safeguards are taken during construction.

Can be located within the premises as it is free from foul smell and fly/mosquito nuisance etc. Can be constructed on upper floors of houses. Pits are generally designed for 3-year desludging interval, but if desired, it can be designed for longer periods or it can be reduced even to two years. Maintenance is easy, simple and costs very little. Needs only 1.5 to 2 litres of water for flushing, while conventional flush toilet needs 12 to 14 litres of water. Needs less space than septic tank toilet system. Does not need scavengers for cleaning the pits or disposal of sludge. This can be done by the householder. Makes available rich fertilizer and soil conditioner. Can be easily connected to sewers when introduced in the area. A low volume flushing cistern could be attached to avoid pour flush.

Technology choice needs to be approached carefully, with proper reference to local conditions, human and financial resources available, and the needs and preferences of service users. Though not required in general, a follow up corrective measures need to be established to make the programme sustainable. Various cost options may also be available to the beneficiary to select from. This may range from as low as Rs. 6000/- to as high as Rs. 40,000/-. Hence different types of designs should be shown to the beneficiary and they will choose one according to their choices.

Two Pit Pour Flush Toilets by Sulabh Technology

After the completion of construction of toilets a 2 years guarantee should also be given to the beneficiary for construction of toilet so that defects should be rectified free of cost. Like a guarantee Card is issued by Sulabh accepting the responsibility of rectifying defects free-ofcost for a period of five years. As proof of construction done, a photograph is also taken of the toilets and beneficiaries. Generally speaking, the more complicated the technology, the greater the need for specialist personnel and equipment. Simpler technologies, such as flush toilets with soak pits offer better prospects for management at the household or neighborhood level. This suggests that it will be best to use simple technology options.

Septic Tank:

Septic tanks are also big problem in achieving sustainable sanitation target. A septic tank requires more space and the construction needs regular technical assistance and supervision. De-sludging of septic tank is required on a regular basis which is rarely being done. The sludge and effluent from a septic tank cannot be used as a fertilizer straight away without causing health hazards. Disadvantages of Septic tank: The leaching system is often not constructed and common practice is to discharge effluent directly into an open drain and thereby polluting the environment in the long run. Septic tanks often receive too much wastewater. As a result, the retention time in the septic tank is insufficient and the soak away becomes hydraulically overloaded. Mainly householder bypasses the soak away and connects the overflow directly to a surface water drain. Shock loadings and disturbance of settling zones caused by large inflows (typically from sullage discharges) can affect the efficiency of the septic tank and causes excess solids to flow into the soak away. Performance monitoring of septic tanks is rarely undertaken and regulation to control private de-sludging operators is problematic. This creates pollution as well as a potential health hazard. However, people do demand for septic tanks, as most of masons available in the rural areas have got some knowledge about constructing a septic tank rather than any other safer designs. These masons unknowingly motivate villagers to go for septic tank. Individuals and institutes having expertise in building sanitary toilets can provide training to both motivators and masons. Once the toilets are built, proper follow- up activities should be done. Community approach for sanitation and health benefits: The programme of construction of Individual Household Latrines by MDWS is aimed to cover all the rural families. Incentives as provided under the scheme may be extended to all Below Poverty Line (BPL) Households and Above Poverty Line Households (APL) restricted to SCs/STs, small and marginal farmers, landless laborers with homestead, physically handicapped and women headed households. However, the current allocations are restrictive towards adoption of a community approach to sanitation. An assessment undertaken by WSP-World Bank in Himachal Pradesh in 2005 revealed that in villages with approximately 30% sanitation coverage, the incidence of diarrhea was reported by approximately 38% households. Even in villages with 95 per cent sanitation coverage, the diarrheal incidences were reported by around 26% households. Only open defecation free (ODF) villages with 100 per cent sanitation coverage reported significantly lower incidences of diarrhea by approximately 7% households. In effect, even if a few individual households switch to using toilets, the overall risk of bacteriological contamination and incidence of disease continues to be high. To achieve the full goals of

sanitation, community saturation approach cutting across the APL/BPL barrier is suggested for creation of Nirmal Grams. The community is sensitized by creating awareness about the impact of open defecation and lack of sanitation on health, dignity and security especially of women and children. In rural sanitation, encouraging cost-effective and appropriate technologies for ecologically safe and sustainable sanitation should be one of the main objectives of the approach.

Energy from Waste: Earlier a public toilet used to be connected to the sewerage or a septic tank. As the provision of sewerage was limited, most of the toilets used to be connected to septic tanks. In a septic tank there are no technological benefits and besides after every 2/3 years it has to be cleaned, the sludge removed and kept separately for decomposition, and later to be used as a fertiliser.

The other technology developed is the biogas digester with the Sulabh Effluent Treatment (SET) plant. In this technology, human excreta from public toilets, through a gradient, goes inside a biogas digester. Biogas is produced and used for various purposes, like burning lamps, body warming during winter, heating water, cooking and where there is no electricity, it can be converted into electrical energy. Earlier the conversion required 80% biogas and 20% diesel, but now is run 100% on biogas.

The water discharged from the biogas plant is treated through sand, charcoal, aeration tank and finally exposed to ultraviolet rays. The water becomes pure and the Biochemical Oxygen Demand (BOD) comes down so that it can be discharged into any water body with no chance of pollution. This technology may be utilized in housing colonies, high-rise buildings, hospitals etc. and in non-sewered areas. It functions very well, even in cold climates.

Rehabilitation of Scavengers: To stop defecation in the open and to end the practice of manual cleaning of human excreta by scavengers, a new technology was needed. Gandhiji had once said, so long as these unfortunates cleaned nightsoil, nobody would eat with them. So, the first thing I did was to convert the dry/ bucket latrines into Sulabh flush toilets. Nai Disha Vocational Training Centre was set up at Alwar, Rajasthan in April 2003 to liberate and rehabilitate women hitherto engaged in the profession of scavenging till end March 2003.

Education is the key to human development. A comprehensive 2-year training is being provided to women scavengers in various vocations to help them earn their livelihoods. They were also taught to read and write through adult literacy classes. I opened an institute to give the scavengers and their children primary education to enable them to sign their own cheques, draw money from the bank etc. Later, came vocational training and various courses like tailoring, embroidery, plumbing, electrical trade, beauty care, making eatables such as papadums, noodles etc. to help them towards self-employment and thus earn a livelihood.

Nai Disha trainees in a vocational training session making noodles

A New Dawn - Nai Disha trainees are making and stitching Namda a handicraft work which are very popular in Rajasthan, India.

Institutional framework with participation of NGOs: NGOs have an important role in the implementation of TSC in the rural areas. They should work towards ascertaining public welfare as per the policy direction of the government in the sector of sanitation. They should assist and complement government to reach previously unreached communities. Ministry of Housing and Urban Poverty Alleviation (HUPA) agreed to implement the Integrated Low cost Sanitation Scheme (ILCS) after the recommendation of Planning Commission. The objective of the Scheme is to convert/ construct low cost sanitation units through sanitary two pit pour flush latrines with superstructures and appropriate variations to suit local conditions (area specific latrines) and construct new latrines where Economically Weaker Section(EWS) Household have no latrines. The scheme is funded in the following manner: - Central Subsidy 75%, State Subsidy 15% and beneficiary share10%. The States will select NGOs having adequate experience in this field that will be funded to a maximum extent of 15% over and above the total project cost to be borne by the Centre and States based on the ratio of 5:1 at different stages of

implementation. 1% of total central allocation is retained by the Ministry every year, to be utilized for MIS, Monitoring System, Capacity Building and IEC components. NGOs have to be actively involved in IEC (software) activities as well as in hardware activities, communication, promotion, and subsequent follow-up at the community level. Their services are required not only for bringing about awareness among the rural people but also ensuring that they actually make use of the sanitary latrines. Experienced NGOs may also play a major role in human resource development within rural community. Personnel from these organizations may have valuable knowledge and insights on the adequacy of current services and priorities for improvement. NGOs can also open and operate Production Centers and Rural Sanitary Marts. They may also be engaged to conduct base line surveys and PRAs specifically to determine key behaviors and perceptions regarding sanitation, hygiene, water use, O&M, etc. It is now recognized that programmes impacting social practices require greater involvement of civil society and its organizations. Local Self Help Groups, womens organizations, CBOs youth associations and NGOs have a crucial role to play in making the local people aware and mobilizing them to inculcate the sense of ownership in them. NGOs can contribute immensely in ensuring sustainability of ODF status and monitoring apart from demand generation, resource mobilization and capacity building of stakeholders. Appropriate mechanisms need to be built for them to be encouraged to engage in the sanitation sector.