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Can 'cleanliness' protect India from COVID-19?

Over the course of the next few months, Oxford Urbanists will be publishing dispatches from around the world on what feels like an unprecedented era in modern history, both for cities and the world, during — and perhaps after — the COVID-19 pandemic. We want to know how cities are responding; what lessons we can learn for the future; and how we think cities might change indefinitely.

Business as usual in a basti [1] situated along the railway lines Dhakuria bridge in Kolkata, West Bengal [Image by Craig Boehman, 2015]

A Sanitary Tale of Two Cities: Kolkata & Delhi, India

“I come from a poor family. I have seen poverty. The poor need respect and it begins with cleanliness,“ - Prime Minister Narender Modi, in his first Independence Day speech, August 15, 2014


On the birth anniversary of Mahatma Gandhi — who believed cleanliness was next to godliness — Prime Minister Narendra Modi launched Swachh Bharat Abhiyaan, or ‘Clean Indian Mission,’ in August of 2014. Aimed at eradicating open defecation across India by October 2019, the Mission identified the rather unsanitary phenomenon as a national priority.

The pan-India Mission runs separately for urban and rural India as Swachh Bharat Abhiyaan (Urban), and Swachh Bharat Abhiyaan (Gramin/Rural). The components, implementation mechanism, funding and private party participation differ across the Urban and Rural Abhiyaan, as the reasons for — and challenges posed by — open defecation vary.

The urban Mission, for instance, aims to ensure elimination of open defecation; eradication of manual scavenging; modern and scientific municipal solid waste management; behavioural change regarding healthy sanitation practices; awareness about sanitation and its linkage with public health; capacity augmentation for urban local bodies to create an enabling environment for private sector; and participation in CapEx and OpEx.

Allocated with 62,009 crore INR (~8.4 billion USD), the urban module is actionable across 4,372 Statutory towns of India, and has six key components: household toilets, including conversion of insanitary latrines into pour-flush latrines; community toilets, primarily in low-income and/or informal settlements/slums, where space and/or land are constraints in providing a household toilet, which are for fixed user groups; public toilets and urinals, provided for the floating population or general public in places such as markets, train stations, tourist places, near office complexes, or other public areas where there are considerable numbers of people passing by; solid waste management; Information Education Communication (IEC) and public awareness; and finally, capacity building and Administrative & Office Expenses (A&OE).

One of the several IEC messages issued in public domain by the Government of India to promote behavioural change. In this image, a toilet is called as ‘Izzat Ghar’ or House of Dignity, a space where everyone (Har Koi), everyday (Har Roz), all time (humesha) should relieve nature’s call. (Image by Department of Drinking Water and Sanitation, Ministry of Jal Shakti, 2020)

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But what does ‘progress’ mean in the COVID-19 pandemic?

Open defecation has become a bigger challenge in a world rattled by the virus. Reports from different parts of the world — not just India, or other Global South countries — are indicating higher impacts of COVID19 on city spaces and citizens who lack access to water to cook or bathe, let alone wash their hands regularly, and/or who do not have proper sanitation facilities. This population at higher risk of COVID19 is often found in urban informal settlements, where overcrowding makes it near impossible (and a privilege) to follow the World Health Organisation’s recommendation of social distancing and self-isolation.

In select spaces, the United Nations and its different arms and partners, governments, civil societies and citizens are taking actions to break the COVID19 chain and maintain cleanliness in these urban informal settlements. For example, in Kenya’s Mathare informal settlement, Kenya, the UN-Habitat and Mathare Environmental One Stop Youth Centre have partnered to protect the community by setting up hand washing stations at one stop resource centre. In the Moria camp — situated on the Greek island of Lesbos — residents have taken matters in their own hands, sewing face masks for the refugee camp and spreading the word on the importance of hygiene. On another Greek island of Samos, the Vathy refugee camp is fighting the virus with the support of two NGOs: Still I Rise NGO, which is enabling children to lead awareness campaigns; and Movement on the Ground, which is taping dispensers of hand sanitiser to olive trees.

In India, however, no such practice or action specifically dedicated towards urban informal settlements has emerged yet. COVID19 has started knocking the doors of bastis or slums in Mumbai. It’s all but certain the virus has entered other bastis around urban India, but little data exists as the testing has been very limited. In the following sections, we’ll take a look at how the initiative has unfolded, to hopefully glean insight into pro-sanitary reforms’ role in the COVID-19 era.

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In the 5 years since the launch, the urban module of the mission has brought about a string of changes in India’s sanitary state. Back then, it would have been considered unthinkable for an Indian person to talk openly about matters of defecation, let alone have the Prime Minister say on national airs that open defecation was now one of the country’s top priorities. You would’ve been hard-pressed to see Bollywood celebrities wielding brooms or campaigning for a cleaner India with hygiene products on social media. Government employees were not cleaning their work places at least once a year, and romantic movies abut a toilet (no, seriously: Toilet: A Love Story) probably were not earning 180+ million INR on the box office.

If a woman in select parts of rural India rejected marriage because the husband’s home lacked a toilet facility, that would’ve been blasphemous. Now, it’s common. Advertising campaigns usually only promoted the product, but now also convey a message of behavioural change. Art works in public spaces, too.

In the past five years, a lot has changed in the sanitary state of India, a country where sanitation — and everything and everyone linked to sanitation — is associated as dirty [2]. A whopping 90 million new toilets have been built across the country.  Of course, several problems persist. Several of these broom-wielding actions are just public stunts. Millions of these ‘new’ toilets lie unused. Thousands of ‘old’ toilets, built prior to the Clean India Mission by local governments and city or state governments, lie defunct or in need of repair.

But it is still worth noting the success of it all. Post-1947, India launched a series of policies and action programmes aimed at sanitation, running separately for urban and rural India. Yet none of these policies focused on eradication of open defecation. None of the myriad of policies even acknowledged open defecation as a challenge to India. Until 2008, urban sanitation was a small component of water schemes, or housing policies, or poverty alleviation programmes, or basic minimum services schemes.

Interestingly, India’s ‘modern’ sanitation systems find their pipelines from the Raj. After the 1857 mutiny, key urban centres of British India — Delhi; Calcutta (now known as Kolkata); Bombay (now known as Mumbai); and Madras (now known as Chennai) — were drowning in unsanitary living conditions. To improve the sanitary state of British India, a sanitary revolution was launched by the British colonial government. This revolution focused on four key action areas: controlling the use of land; spatial and social segregation of European and indigenous populations and unequal provision of infrastructure in the two areas; empowering local level bodies to collect taxes, which could be used for improving the public health of urban areas; and the establishment of improvement trusts to demolish informal settlements and relocate them to the periphery and build housing estates and/or arterial roads on the cleared land.

With this sanitary revolution, inspired by actions led in Britain post-Industrial Revolution, town planning established its roots in British India. Inequalities and social divide based on sanitation aggravated in India. Ironically, the country also boasts having one of the earliest sanitation systems intertwined with town planning, as excavated from the Indus valley civilization in 2600 BC. It is also evident from a critical assessment of colonial and post-Independence sanitary actions that certain colonial practices and policies of social and spatial segregation, which have persisted in Independent India, and a crisis management approach are critical in perpetuating open defecation.

But why is the human right to adequate sanitation still then a luxury for millions across the country? And does this present a major vulnerability during the COVID-19 outbreak?

Let us try to answer that with a sanitary tale of two cities:

Dhakuria bridge, a space where housing hugs the rails [Image by Craig Boehman, 2015]

Kolkata

Once upon a time, Kolkata was the capital of British India. Now, it is the capital of the Indian state of West Bengal, and well known for its diverse sweets/desserts, tea, fish and intellect. Whilst undeterred by 4+ million urban population living in the shadows of the city, thousands of residents defecate in the open everyday.

The Dhakuria bridge basti is one such shadow of the city, where huts and homes hug the rails; access to household toilets or community toilets remains a dream; and promise of quick death or an awful maiming looms. Living as ‘illegal’ squatters on central government land[3]’, 10,000+ inhabitants of the basti have become accustomed to using active railway tracks as toilets, unhindered by the dangers of using the railway tracks as an open space to play, bathe or defecate.

People defecating on the railway tracks in Dhakuria bridge. [Image by Craig Boehman, 2020]

Interestingly, the basti has a natural order of (in)sanitary functioning. Along the railway tracks, women have a well-defined area — often hidden from the public eye — to address nature’s call. Men aren’t allowed to step anywhere near this open toilet, yet they have no well-defined space. Any space that is open is used for doing the business. A walk through this basti makes us wonder why people have grown accustomed to this plight.

The answer lies entrapped in the vicious cycle of poverty. Everyone wants to live a life of means, but it isn’t easy. Dhakuria bridge basti is no exception. Living in the underbelly of Kolkata, inhabitants of the basti dream of a better life, where inhabitants do not have to live in shanties, where going to the bathroom is confined to four walls of a toilet block, and where each day is not a survival of the fittest.

Between 2017 and 2018, shanties of the basti were given official addresses, enabling the residents to receive posts and register for unique identification per the state and national government rules. This official recognition also rekindled the hope of a reality where residents do not have to worry about evictions, and the dream of toilets away from the active railway tracks may transform into reality.  

But still, that future remains uncertain.

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Business as usual in a basti along the Prem Bari Bridge in northwest Delhi [Image by Mahak Agrawal, 2018]

Delhi

The capital of India has seen the rise and fall of seven cities. Becoming the capital of British India in 1911, Delhi was unveiled in 1931 as the seat of British India power that moved from Calcutta. Just like modern-day Kolkata, Delhi continues to expand its spatial extent and population, as well as the subsequent pollution and other inequities.

Home to 18+ million residents, the National Capital Territory of Delhi has ~2 million inhabitants living in the crevices of the city, of whom nearly 40 percent continue to defecate in the open.

Open defecation in closed confines. Women have installed spare doors from own homes to create a makeshift barrier between two squat toilets installed by the government [Image by Mahak Agrawal, 2018]

Basti along Delhi’s Prem Bari bridge is one such scenario, bound by active railway tracks on one end and an industrial area on the other. This linear settlement of ~4,000 shanties contributed to the development of Delhi amid the 1982 Asian Games, witnessed countless eviction notices in the 1990s slum clearance drive, and bore the birth and loss of limbs and lives on tracks, amongst other things.

Identified as a JJ cluster[4] by the Delhi Urban Shelter Improvement Board in 2015, the basti of ~20,000 inhabitants is provided with a community toilet complex equipped with 17 facilities for women and 23 for men, separated by temporary walls. Despite the dilapidated infrastructure and inadequate number of toilets, inhabitants have accustomed themselves to using it. Interestingly, inhabitants have developed a time coordinated system to use the facility at peak morning times. As soon as the sun sets, the facility becomes an avoidable zone, as women, children and elderly avoid the facility in fear of sexual and physical harassment. Yet that doesn’t deter men who need to go at night.

‘User by day, open defecator by night’ is the way of (un)sanitary living adopted by basti. For a settlement that extends nearly half a kilometre in length, the provision of one toilet complex is not going to put an end to open defecation. Why?

Well, ask yourselves: would you travel more than 20 metres every time you had to use the bathroom?

On the other side of the gendered toilet blocks at Prem Bari bridge basti [Image by Mahak Agrawal 2015]

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On October 2, 2019, the Swachh Bharat Abhiyaan turned five.

In a speech to a crowd in Ahmedabad city, Modi boasted that villages had “declared themselves open-defecation free,” and that in the time period, 600 million people had been given access to toilets. The whole world, he said, was delight. Three months later, the Finance Minister dedicated 2650 crores INR (~352 million USD) for sustaining the programme.

On paper, India was declared Open Defecation Free, with a few states joining the ODF status in December 2019. But the reality differs — what the paper indicates is coverage, not usage. In this sanitary tale of two cities, open defecation in Delhi or Kolkata has become a way of life for millions, not a matter of choice. Rather, it’s the result of no choice.

As urbanists or as an urban dweller we assume the India is the open defecation capital of the world because people are poor, or uneducated, and that it’s an ingrained cultural behaviour. While that may be true for a few, there are 1.35 billion people across urban and rural India. What do we say then about the 421+ million urban residents for whom open defecation is not a matter of choice, no matter how educated or uneducated, how rich or poor, how culturally biased or liberated, one is?

This disparity calls into question how can India or any other country (China, USA, Belgium, Nigeria, Indonesia, etc.) affected by — and often ignorant of — the challenge of open defecation address this multidimensional challenge?

Any action must first begin with acknowledgment of the challenge. Accept that open defecation is a reality. Accept that data hides more than tells. Accept that open defecation is not a problem of the poor. Accept that open defecation is not a local problem. Accept that one solution does not (and never will) fit all.

In light of the looming threat and pre-existing challenge of open defecation, the COVID-19 pandemic makes us reconsider the state of sanitary affairs our cities’ poor are living in. It makes us reconsider the deep-rooted challenge of open defecation which seems tough to eradicate. And it makes us accept that shit matters.

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Mahak Agrawal is a medical candidate turned urban planner, exploring innovative, implementable, impactful solutions for pressing urban-regional challenges in her diverse works. In different capacities, Mahak has worked with the Intergovernmental Panel on Climate Change, Town and Country Planning Organization, Government of India, Institute of Transport Economics, Oslo, to name a few. In 2019, she founded The Spatial Perspectives as an enterprise that uses the power of visual storytelling and open data to dismantle myths and faulty perspectives associated with spaces around the world. Based out of India, Mahak spends spare time to experiment and create sustainable art works which showcase cultural heritage of India.

Craig Boehman is an American photographer based out of Mumbai. He’s been photographing the lives of those at the “Dhakuria railway colony” in Kolkata since 2015. His photo essays of the colony have appeared in several publications, including Huff Post India. Apart from his commercial and artistic photography work, Craig hopes to raise awareness to the plights of colony residents internationally in order to bring about possible solutions to the ongoing crisis in this hazard-prone region, which in many ways resembles a war zone more than a place one would call home. 

Footnotes

[1] Basti is a hindi term often used to describe an informal settlement in urban India.

[2] The notion of ‘dirty’ in India’s sanitation history finds roots in the Laws of Manu, famously known as the Manav Dharma Shastra of 500 B.C., identifying toilets and the caste cohort ‘responsible’ for cleaning them as untouchables, thereby calling for their social and spatial separation from place of habitation.

[3] Situated on the land owned by the Indian Railways (a body of the Government of India or central government), inhabitants of the basti are designated as illegal squatter settlement. The basti and its inhabitants do not enjoy security of tenure.

[4] JJ cluster or Jhuggi Jhompri cluster is a settlement of urban poor identified by the Delhi Urban Shelter Improvement Board (DUSIB), Government of National Capital Territory of Delhi (GNCTD) as “an encroachment on public or private lands. They are therefore seen as illegal” (DUSIB, 2014).