It is a sad truth to know that we are still breathing the theme of 2018 International Women's Day, which is "#PressForProgress," yet we don't render even the basic facility to many women in India by keeping them toilet-deprived and ignorant about its utility while putting their health, hygiene and life at stake. Can you recall the "lota party"? Yes, it's from the movie, "Toilet", which tried to highlight the importance of using a toilet rather than continuing the tradition of using open fields as toilets. Open-field defecation isn't just unhygienic, but is also life threatening, especially for women. Let us move our eyeballs on certain eye-opening statistics from WHO. This is where India is:
- With 626 million people in India, who practice open defecation, India has more than twice the number of the next 18 countries combined;
- It accounts for 90 per cent of the 692 million people in South Asia who practice open defecation;
- It accounts for 59 per cent of the 1.1 billion people in the world who practice open defecation;
- It has 97 million people without access to improved sources of drinking water, second only to China.
Another study reveals:
- India has 17% of the world's population, but accounts for 60% of all people in the world without sanitation
- 10% of urban India defecates in the open - these are majorly people who have migrated to towns in search of better earning opportunities, but have failed to find a home and live in slums.
- In the slums of Mumbai, 81 to 234 people share one toilet
- Rural folk in India have more number of TVs and cell phones than the number of toilets!
You would be shocked to know that every year, 2,00,000 children in India die from diseases caused by fecal contamination. Despite the fact that open defecation has declined by 31 percent since 1990, approximately 300 million females (women and girls) in India still have no other choice left with them. Every morning, they struggle to deal with the nature's call. They squat with a mug of water in a field while keeping a watch for the evil-minded people. In case you aren't aware, health and sanitation have been considered as part of Article 21 on various occasions by the courts in India.
Of 17 Sustainable Development Goals, 6th Goal is focused on "Clean Water & Sanitation," and underlines that 2.4 billion people worldwide do not have access to basic sanitation services like toilets or latrines.
To resolve these problems that have arisen due to Sanitation Crisis, UN has set among its official observances, 19th November as the "World Toilet Day". This day is about inspiring & encouraging actions to tackle the global sanitation crisis. Considering this, we'll be discussing the allied concerns with a high dimension focus on the plight of women, because equality should be evenly spread across, and as Jane Galvin Lewis has quoted, "You don't have to be anti-man to be pro-woman". It means being sensible & responsible enough to support the ideology that women deserve to be fully equal members of society.
Dr. Rita Bakshi, Senior Gynaecologist and IVF Expert, International Fertility Centre, has thrown some light on the issues faced by women due to unavailability of toilets or open defecation. "There are several problems faced by women due to unavailability of toilets or open defecation as women have to go in open to urinate. These aggravates the problem as men, then, take it as an opportunity and often force themselves on these innocent lives. The dirty and contaminated surroundings expose them to several diseases. It is also a host to urinary infections, which can be really treacherous for women."
In fact, as much dangerous is the action of defecating in the open areas that risky is using unclean and ill-managed public toilets. We came to know about "toilet seat sanitizer" by PeeSafe, which is India's leading personal hygiene brand that facilitates all to use public toilets in a healthy way without getting vulnerable to infections. It's an amazing product. Vikas Bagaria, Founder of PeeSafe expressed, "Poor sanitation practices are depriving women to use public toilets for the chances of getting infections, vaginal burns and UTI. It can be even worse, however, PeeSafe aims at giving women a comfortable and safe experience while they use the toilets - with the help of toilet seat sanitizer spray that protects users from the deadly germs and bacteria while using the toilet." Useful!
Amazing solution indeed! But we were curious to know if it is safe for pregnant women and children, to which Mr. Bagaria clarified saying, "It is a unisex spray which is completely safe and can be used by pregnant women as well as children above five years of age."
Relating with the statistics of defecation in the open areas, in the urban localities, we asked Dr. Bakshi that in the urban areas, due to the facilities and lifestyle, nearly everyone understands the use and importance of a private toilet or a toilet as a whole. How can people in the rural areas be counseled about it? She replied, "For a country to grow and prosper, it is very essential that its people must have proper hygiene and sanitation along with basic civic sense. This is where our country slopes and this is what really needs to be instilled within the people of the country. The right education and the realization of the need of these basic amenities must be taught and apprehended from the school level. They must be imparted and communicated that the toilets and basic sanitation are as vital as food and a house."
Temsutula Imsong, Social Activist from Nagaland, and a Pioneer of Mission Prabhughat, shared "whichever religion, race, culture, and society you talk about, the basic tenets advocate respect for women. When there is a violation it's easy to understand that we are following none of them. Having said that, I wanted to convey and point out that hygiene is imperative for all, be it personal or of surroundings. It is a basic need that we have to pay attention to on priority to. Many years after independence, when I get to see that a paramount importance is being given to the construction of toilets it makes me happy because I have come across many females who shared their experiences that will shrink your heart. What they've underwent was no less than being raped. Rather than lamenting we should take charge to do whatever is possible in our own capacity to ensure that women are respected."
A fact by UN: One-third of schools worldwide do not provide any toilet facilities, which is a particular problem for girls during menstruation.
Dr. Parinita Kaur, Consultant - Internal Medicine, Aakash Healthcare Super Speciality Hospital, is of the opinion, Education for all works the best. "Awareness of fundamental rights for all and outreach programs so that people are able to differentiate between right and wrong. Constantly highlighting the achievements of women of the world and advertising how each girl has the potential to reach such heights, given a chance… Better sanitation and separate toilets for girls may probably be an incentive." She also added that the schools providing sanitary napkins may be a good idea, but along with it, separate and neat toilets will also be required. As apt she is saying, "we need to understand, menstruation is physiological and not a disease. If a girl is uncomfortable or unwell, she can very well take a leave, but mandatory leave is not advisable."
Ms. Lina Ashar, Founder of Kangaroo Kids Education Ltd. added, "Once parents are educated and facilities are provided by the government and schools on hygiene (mainly sanitization) and safety this issue will not arise.
Dr. Kaur is also of the same opinion that the importance of education and need to know the world needs to be emphasized to the Girls and their families… And, that the schools can opt to provide sanitary napkins through vending machines; they should also provide medical assistance and counseling sessions to cope with the monthly cycle."
Hygiene and sanitation plays a significant role in women's health, Dr. Geeta Baruah Nath, HOD Obs & Gyne Department, Artemis Health Institute, Gurgaon expressed. "Maintaining Hygiene and Sanitation is extremely important for a woman to remain healthy. Good habit of washing and drying, to use cotton undergarments and lowers so that skin can breathe to prevent infection need to be inculcated from childhood. Unhygienic habits and unsafe sex can lead to bacterial, fungal, mixed infection, which in turn can cause tubal block and infertility along with other health hazards even reproductive tract cancer."
Getting back to Temsutula's views on hygiene also drift our thoughts towards another dimension of susceptibility for harassment, which is not often spoken about i.e. the security issues that open defecation brings in to women. Recent real-life based movie, "Toilet" has already given an essence of this gloomy condition. Did you know 60% of the world's open defecation happens in India? Latest census data reveals that 636 million of over a billion Indians don't have access to proper and clean toilets.
This contributes to disease, childhood malnutrition, and loss of economic productivity (due to early deaths) and sexual harassment of women.
A study by certain researchers, including Apoorva Jadhav, states that the household sanitation facilities and women's risk of non-partner sexual violence (NPSV) in India. The results are that the net of their socioeconomic status, women who use open defecation are twice as likely to face NPSV as women with a household toilet. This is twice the association between open defecation and child diarrhoea. “The results of our falsification test indicate that open defecation is not correlated with on intimate partner sexual violence (IPSV), thus disconfirming a simultaneous selection of women into open defecation and sexual violence.”
In 2011, Rithika, who now suffers from post-traumatic stress disorder, was repeatedly raped by a man from her village when she used to go to the forest to defecate. According to UNICEF, 50% of the rape cases take place when women defecate in the open areas. Indian National Family Health Survey reveals that at least 50 percent of structures built for sanitation purposes in India remain unused or are used for other purposes. This sanitation tragedy not only leads to the forfeiture of the dignity of women, but also makes them susceptible to infections and ailments, and even to death, in worse case.
These risks are real and grim. In 2014, two girls were found hanging from a tree in Katra Sahadatganj. When did this happen? These two girls had gone out into the field as a toilet where they were gang raped and lynched. However, considering the post-traumatic stress disorders, we checked with Dr. Bakshi as to what other problems can also crop up for that victim. “There have been many incidences of rapes and sexual assault occurring with females (both girls and women) when they go out into the open areas to defecate. Your remarks on their gynaec problems of the victims.”
She further added, “The rapes and sexual assault victims have severe impacts on their body and mind, whereas, these ruthless brutal often leave these blameless souls pregnant and infected. They are often infested which includes Sexually Transmitted Diseases like AIDS, dyspareunia, vaginitis or even UTI's. Such instances often hit the females very hard and these can also have very long lasting effects on their body, physically and mentally.”
After this 2014 lynching incident, Sulabh installed 100 toilets in the village. Even if someone builds a lot of toilets, yet there is no guarantee that people would use them. A lot of people either shy away from the topic or are ignorant about how to use a toilet. We asked Dr. Bakshi about how this can be resolved, and she replied, "The lack of understanding of the natural human body system still lacks amongst the people of our country. The people in the rural areas and most of them in the urban areas still take menstruation as a taboo and unmentionable. The mindset of the people is what really needs to be worked upon. The mindset is what needs to be developed of the citizens of this nation and still remains a challenge in the country."
PM Modi's Swachh Bharat campaign is not getting enough speed and effective in reaching its vision of making India open defecation free, because of many reasons including the fact that many people don't know its importance and how to use it. A RICE institute study has discovered that 40 percent of respondents who had a toilet or latrine had at least one family member who continued to defecate in the open.
Most importantly, even if this problem is curbed, one of the issues that refrains a woman from using a public toilet is that she doesn't consider it to be women-friendly.
Dr. Bakshi shared her opinion about how a women-friendly toilet can be built and what facilities should it have. "With constant support and backing from the government for financial and non-financial aspects, a women-friendly toilet can be built. The women friendly toilets must be easily accessed and afforded by women (in cases where maintenance charges are required). It must have a provision of a women care taker and restrict loitering of men around it as this eventually leads to increased rapes and malpractices in and around the toilet. Along with this, it must cater to menstrual hygiene management with access to sanitary pads, clean water and hygienic toilets for prevention from various threats of diseases."
We would like to underline here that there are other points that matter when it comes to women-friendly toilets. Safety as well as privacy comes first. There shouldn't be any scope of peeping in, recording or any kind of threat of being harassed. Toilets must have separate entrances. It should have trained and well-mannered female wardens.
Next is accessibility and affordability part. Toilets should be designed in a way that everyone, be it a pregnant women, disabled woman, old woman or children, all should be able to access it. Any fees charged for the utility should be affordable. Third point is cleanliness. Each washroom should have proper bins for any disposal. The washrooms should have automatic soap dispensers to avoid over usage and theft and tissue papers. Fourth is the facility. Apart from loo facility, shower and sanitary pads vending machine would be like cherry on top.
This year's theme is "When Nature Calls," which is an elaborated version of when nature calls, we need a toilet. But, billions of people don't have one. This means human faeces, on a massive scale, are not being captured or treated - contaminating the water and soil that sustain human life. We are turning our environment into an open sewer. We must build toilets and sanitation systems that work in harmony with ecosystems." In fact managing human waste should be added on to the nature-based sanitation solutions so that the human waste can be treated before it returns back to the environment. One can try composting latrines to collect and treat human waste for the growth of the crops.
There are many alternate solutions for using the human waste for the benefit of the planet, but first thing is making toilets available for the citizens, especially women, who are equally rightful of getting respect, facilities and happiness, and more susceptible to the danger of health risks and life, because when nature calls, everyone needs a toilet.