The document discusses sanitation challenges in India and outlines strategies to address them. It notes that over half of India's population practices open defecation, putting people at risk of disease. Poor sanitation costs India billions annually and stunts economic growth. However, interventions like increasing access to toilets and promoting handwashing can significantly reduce diarrheal diseases. The document argues for community-led efforts, education campaigns in schools, and messaging through cell phones to help eliminate open defecation and improve hygiene practices. With concerted action, India can overcome its sanitation crisis and reap major health and economic benefits.

1. SANITATION A CHALLENGE TO HUMAN SOCIETY? - INDIA’S VISION
Dr.T.V.Rao MD
Mr Modi our Hon Prime Minister, like Mahatma Gandhi, wants to change things on matters of
hygiene and sanitation, it is everybody’s responsibility not only those born to a certain castes and
poor work out of poverty and helplessness to keep India clean. And every one must have a role and
responsibility, India after > 60 years of independence woke up to the issues, thanks to the Vision of
the New Government which woke with a machinery zeal for a change in Social issues suppressing
National Development and growth of GDP. However the issues are more important today than in the
past with large scale migration of rural poor to urban employment. Less than a third of India's 1.2
billion people have access to sanitation and more than 186,000 children under five die every year
from diarrheal diseases caused by unsafe water and poor sanitation, according to the charity Water
Aid, The United Nations said half of India's people defecate outside - putting people at risk of
cholera, diarrhoea, dysentery, hepatitis A and typhoid The majority of illness is caused by faecal
matter. Diarrhoea is the second leading cause of death among children under five in India as in the
world. Around 1.5 million deaths each year - nearly one in five – are caused by diarrhoea. It kills
more children than malaria, AIDS, and measles combined every minute at least one child dies from a
water-related illness. The rates of infection are no less Globally 2.5 billion people live without access
to improved sanitation and 1.1 billion people practice open defecation. Despite significant gains
sanitation remains one of the most off-track Millennium Development Goals (MDG) globally. Only
64% of the world’s population has access to improved sanitation, but 70% of the Sub -Saharan Africa
population and 59% of South Asia still lack access. At current rates of progress, the world will miss
the MDG for sanitation by over half a billion people. Sanitation lies at the root of many other
development challenges, as poor sanitation impacts public health, education, and the environment.
Poor sanitation, water, and hygiene lead to about 700,000 premature deaths annually. Without
sanitation girls are more likely to drop out of school or are vulnerable to attacks while seeking
privacy. Recent analysis shows that ending open defecation can save children’s lives by reducing
disease transmission, stunting, and under-nutrition, which are important for childhood cognitive
development and future economic productivity .Lack of sanitation also holds back economic growth.
Poor sanitation costs billions to some countries, amounting to the equivalent of 6.3% of GDP in
Bangladesh, 6.4% of GDP in India, 7.2% of GDP in Cambodia, 2.4% of GDP in Niger, and 3.9% of GDP
in Pakistan annually. The economic losses are mainly driven by premature deaths, the cost of health
care treatment, lost time and productivity seeking treatment, and finding access to sanitation
facilities. Pollution resulting from improper disposal and treatment of waste water and domestic
fecal sludge also affects both water resources and ecosystems. At the same time, fecal sludge and
waste water and can provide valuable resources (water, nutrients, and energy) and economic
opportunities, especially in urban areas and in water-scarce environments. Focusing on youth and
using education. Well-designed education programmes to demonstrate the link between sanitation,
hygiene, health and economic development can contribute to increasing demand for improved
sanitation. Hygiene promotion campaigns are most effective among younger populations, and
students can be targeted both as beneficiaries and as agents of behavioural change within their
families and their communities. Medical students can be great contributors in change in Social
aspects, the community medicine departments can be real expert centres to disseminate the health
educations to many folks living around the teaching hospitals Hygiene education should be included
in school curricula, together with the provision and maintenance of sanitation facilities at school
premises. These are essential elements of marketing campaigns in schools. Indians have more
mobiles than toilets, Hand washing with soap, particularly after contact with excreta, can reduce

2. diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. According to the
Public Health Association, only 53 per cent of the population wash hands with soap after defecation,
38 per cent wash hands with soap before eating and only 30 per cent wash hands with soap before
preparing food. • Mothers and Caregivers: Hand washing with soap at critical times is important for
protecting the health of the whole family. By being a role model, mothers and caregivers can also
help install in their children the good hygiene practices which will serve them for life.
• Only 11 per cent of the Indian rural families dispose child stools safely. 80 per cent children’s stools
are left in the open or thrown into the garbage.
• Only 6 per cent of rural children less than five years of age use toilets.
• WASH Interventions significantly reduce diarrhoeal morbidity; statistically it has been shown that:
• Hand washing with soap reduces it by 44 per cent
• Household water treatment by 39 per cent
• Sanitation by 36 per cent
• Water supply by 23 per cent
• Source water treatment by 11 per cent. Diarrhoea and respiratory infections are the number one
cause for child deaths in India Over the past years, the elimination of open defecation has been
recognized as a key contributor to improved outcomes in the health and nutritional status of
children and has emerged as an area where UNICEF programmes are achieving results at scale. This
is being done through Community Approaches to Total Sanitation (CATS) - an approach that is
rooted in community demand and leadership, focused on behaviour and social change, and
committed to local innovation.. Hand washing with soap is among the most effective and
inexpensive ways to prevent diarrhoeal diseases and pneumonia. With 594 million people defecating
in the open and 44 per cent mothers disposing their children’s farces in the open, there is a very high
risk of microbial contamination (bacteria, viruses, the Government of India should campaign the
sanitary drive through SMS and Multimedia information to reach every corner of the country, with
many slogans on HAND WASHING, CLEAN SURROUNDINGS AND REDUCTION OF OPEN DEFECATION.
At the global level, UNICEF will use World Toilet Day to raise public awareness on the sanitation crisis
through a massive social media campaign that follows-on from Global Hand-washing Day in
October.. The major issues in India remain to stop open defecation, protected water supply and
practice of hygiene with Hand washing. Our younger generation of Students can bring in change in
the country complementing the efforts of Governmental agencies as we have brought lot of change
in our attitude towards smoking, child labour, gender equality and social equality in many fronts. BE
A MAN OF CHANGE TO IMPROVE THE NATIONAL LIVING STANDARDS WITH SANITATION.
Ref WHO and UNICEF resources
Dr T.V.Rao MD Professor of Microbiology Freelance write