Sanitation and Health, and Why It's Not Going Anywhere

      No matter what I read or told myself to be prepared for, there are certain things about India that I never understood until I saw or experienced them for myself.  While I myself never experienced a lack of sanitation facilities during my time in India, I was a witness more than once to the fact of life that is public defecation.  More than any other example of poverty, these were the moments that I was able to truly distinguish the quality of my life compared to the 300 million people in India that live in poverty.

      Sanitation is a large indicator of quality of life in a developing nation like India; it is important not only for improving health conditions in communities, but also represents education on health and hygiene.  In rural India open defecation and urination happens in fields and paddies. When presented with public or private toilets, many of these people do not take advantage of them because they do not see it as a more hygienic alternative.  Why would someone want a room in their home that held waste? In their minds it is better to “do their business” out in the open away from0 their homes and it is easy to see the logic of that decision.  The problems begin when these people migrate to urban areas for employment opportunities.  They take their village-logic with them and apply it to a very different set of living conditions.  Instead of an open field, defecation is taking place in allies and open sewers which run thru the slums and shanty towns that migrants often populate. 

The first time I witnessed this for myself, a young child was utilizing the sewer which was little more than a depression in the concrete alley of the slum I was visiting.  I didn’t feel disgust as I expected I would, but sadness that the people living in these situations had few other options and no education of the dangers of germs or disease passed through waste.  We often take our knowledge of bacteria and viruses for granted, but imagine yourself coming from a remote village in India where superstition has a much stronger hold than science.  It is not unexpected that people do not react positively or with understanding to initiatives to improve public health through proper sanitation.  In reality, this education is paramount to decreasing mortality rates in urban India.  More than one-third of urban deaths in India are due to waterborne illnesses like Cholera (World Health Organization) which are passed through the waste of humans. It is important to recognize that any sanitation infrastructure implemented in these slums must be accompanied by a way of educating the public of its importance.  Otherwise, public toilets will remain unused and there will be little encouragement to put further funds into sanitation infrastructures.

The illegal status of slums also presents a problem for government intervention in this public health issue.  While the government of India and its enforcement agencies often turn a blind eye to illegally built and occupied slums, they cannot offer public infrastructure services without condoning their existence.  However if the government does not intercede they allow entire communities (legal and illegal alike) to become victims of the waterborne illnesses and diseases that breed in the open sewers.  It is a great point of contention whether the government should offer sanitation services and cement these communities, or if they should remain uninvolved and allow for dangerous public health issues to grow.  This is one example of many issues which get caught up in bureaucratic dead-ends concerning slum life.

After my first experience in the slum, I became much more aware of open defecation across northern India.  I saw it in streets and by riverbanks, and soon it was with the casual interest of someone observing and oddity.  It was then I realized that I had adopted the same apathetic attitude of the natives; I had become so used to it that I had ceased to see it as a problem.  My mind justified it as a way of life but upon reflection I know that isn’t true.  My apathy made what was once abhorrent, acceptable.  It is not that India and its people do not wish to address its problems, but the system has become so entangle in the bureaucracy that it is not making decisions or moving forward.  This causes people to lose interest and requires crusaders to step forth and push these issues.  I firmly believe that India will make great leaps and bounds in regards to all its infrastructure in the coming century, but it will not happen as long as we surrender to our apathy and accept things because they have always been so.