7,86,000 Dead and still Counting- Lack of sanitation has cost India not less than an epidemic by PRASOON S MAJUMDAR , ECONOMIC AFFAIRS THE SUNDAY INDIAN | January 9, 2011 11:29

Lack of sanitation has cost India a staggering Rs.2.4 trillion or 6.4 per cent of the GDP! This shocking revelation has been made by a recent World Bank report, which revealed that in 2006, every tenth death was on account of inadequate sanitation. What is more shocking is that of the seven and a half lakh people who died on account of lack of sanitation in 2006, some 4 lakh were just children, who died due to diarrhoea! As per the report, "While premature mortality and other health related impacts of inadequate sanitation were costliest at Rs.1.75 trillion, the productive time lost to access to sanitation facilities or sites for defecation caused loss of another Rs.487 billion." Over and above these losses, drinking water related impacts drained another Rs.191 billion!’

Probably, there cannot be a more shameful exhibit of the state of prevalent basic infrastructure of the country! No doubt, this report by the World Bank is not just startling, it is a blotch on the face of everyone who has been boasting about the Indian growth story and how inclusive it has been! And mind you, this report is for the year 2006! And I am sure that things have only worsened in the last four years, and I can say that almost conclusively because there has not been any adequate action taken, or budgeting made towards the same. Here I would also like to state that lack of adequate sanitation does not just have health and economic costs, there are other associated social costs as well. For there exists a huge stigma for women in particular to defecate in the open, but then on account of lack of options, they have to go through this ordeal almost everyday. And the harshest possible truth is that the cost of accessible and hygienic sanitation is actually a pittance relative to the cost that the economy is currently incurring on account of lack of it! As per various estimates, there are almost 600 million Indians who don’t have access to safe sanitation. Considering the Sulabh model, the cost of constructing one toilet for a family of 5 is around Rs.5000. So if India has to construct one toilet for each family, it would cost just Rs.60,000 crores (equivalent to the amount given to the farmers under loan waiver scheme)! This can be allocated over a span of five years with Rs.12,000 crore annually. This figure is still far lower in comparison to the humongous loss that the economy is incurring on account of lack of sanitation. Moreover, one toilet can be shared by joint families.

There is another perspective to this problem. Construction of toilets alone might not solve the issue as a whole. There have been innumerable experiences wherein toilets have been constructed by NGOs, but people still prefer defecating outside in the open. If not this, then the toilets are found to be in such unhygienic conditions that people in general prefer not to use them! So the task would not be accomplished until we help in educating people to make it a habit to get used to the idea of using the toilet facility; and in ensuring it is kept clean and hygienic! And for that, a systematic and sustained intervention is required at multiple levels. This intervention has to be assertive and transformational!

But above all, there has to be an intent towards making this basic facility universally accessible to all. In reality, this was such an imperative that it should have been ideally taken care of long back. And had that been the case, we could have saved the lives of so many people and so many children in particular. And as that wasn’t and still isn’t a priority – for lack of better words – it is nothing less than a genocide! 7,86,000 dead in 2006 and still counting.

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