A Solution to India’s Public Hygiene Problem
It’s been over a year since Narendra Modi held his second cabinet meeting, an event where he outlined his famous “10-point” agenda. In it, he proposed reforms in education, innovation, and infrastructure, among others. One area of continued focus for the administration has been public hygiene through the implementation of toilets to individual households. Below is a quick glance of the existing problem by the numbers today:
- UNICEF estimates that 594 million people (130 million households) in India currently do not have access to toilets, accounting for approximately 50% of the country’s population
- This number is more than double the rate of the next 18 countries in the world combined
- In rural communities, this number increases to 72% that relieve themselves openly
- According to the World Health Organization, lack of public hygiene is a main cause of preventable illnesses such as malnutrition, cholera, and diarrhea (diarrhea kills ~300,000 people/year alone)
- Of the $30 billion that has been earmarked for public hygiene, only 8% will go towards information, education and communication activities (IEC)
- In 2014, Uttar Pradesh made worldwide headlines when two girls were raped and murdered while walking into an open field to relieve themselves

Despite the construction of 5.8 million toilets in the past year alone, Modi’s emphasis on supply instead of education and communication has been at the center of criticism from journalists, opposing parties and even late-night talk show hosts: https://www.youtube.com/watch?v=sDA8yZUP_cI

At Micrograam, a primary area of concern has been to address health concerns for rural communities across the country. In the past, loans provided to borrowers have been used to provide smokeless stoves, supply organic goods, or even purchase groceries. Unlike Modi’s administration, however, Micrograam’s focus on both execution and governance has allowed the organization to not only supply goods and services but also understand borrower opportunities and concerns.

While visiting borrowers in Tamil Nadu last week, I spent time with People’s Action For Transformation (PAT), an NGO partner of Micrograam, to understand how they were able to convince borrowers to purchase smokeless stoves, an alternative to using firewood for preparing meals. Mr. Stephen Xaviar, current secretary at the organization, noted that although smokeless stoves were purely discretionary purchases, communication was a driving factor to success in the field (it was clear through my interaction with borrowers that they understood the harm caused by inhaling smoke). 

In Jharkhand, I had a chance to work with MESP and meet several groups of men and women in rural communities. I quickly realized that, despite their male counterparts lack of interest, many women would actually prefer using a toilet. In fact, several younger, more educated women even cited toilets as their next major purchase upon receiving a new loan.

By providing toilets to the most credit worthy borrowers first, I believe success can be achieved in curbing open defecation. Funding and monitoring new and existing loans are essential to Micrograam’s existing operation. However, borrower communication remains the core of what Micrograam’s expertise. Going forward, I believe that maintaining an open and constant dialogue with target groups will allow us to consistently focus on behavioral changes.

If you would like to help or receive more information, please visit us at: www.micrograam.com
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