Anyone who has been to India has experienced the crisis in sanitation firsthand. Visitors are warned to avoid the filthy tap water or risk facing the wrath of ‘Delhi Belly’. Driving through any Indian city one may encounter someone relieving themself in public rather than in a proper facility. Open defecation and its impact on water supplies have created a public health calamity that has caught the attention of the country’s leadership. In 2014, Prime Minister Narendra Modi launched the five-year Clean India Mission to improve sanitation by 2019. While this program represents official acknowledgement of the sanitation predicament, more still needs to be done. Only through the use of technology and creating localized solutions can India begin to tackle this issue and its effects on public health and the environment.
At first glance the sanitation issue and its impact on India’s waterways appears daunting. Over 600 million people lack access to toilets. The Ganges River has over 100 cities that dump raw sewage directly into the river; 400 million people live near the river and depend on it for their drinking water, and two million people bathe in the river daily, as the river is considered sacred by Hindus. And 58% of Delhi’s sewage goes straight into the Yamuna River, which has fecal contamination levels 10,000 times over what is considered safe. The lack of access to toilets leads to widespread water contamination and the spread of waterborne diseases. Diarrhea kills approximately 200,000 Indian children under the age of five each year. Furthermore, over 60 million children suffer from stunting, which slows their growth and development. India’s stunting rates are higher than poorer countries in sub-Saharan Africa. Stunting is caused by enteropathy, a disease that prevents the body from absorbing calories and nutrients, and which is the result of persistent exposure to fecal bacteria. The lack of toilets is devastating to the health and well-being of the public.
To address the impact poor sanitation practices and infrastructure have on health, the Clean India Mission was established as an ambitious, national level program. Prominently, the campaign seeks to end open defecation and human scavenging, which is the direct handling of untreated human waste by ill-equipped people, by the 150th anniversary of Mahatma Gandhi’s birth in 2019. To date, eight million toilets have been built as part of this effort. Unfortunately, many are pit latrines that require emptying when the pit fills.
Direct handling of human waste goes against the cultural norms of the caste system in India. Hindus consider this to be the work of untouchables, or Dalits. Many higher caste Hindus are adamantly against manually emptying latrines, and even lower caste members balk at the practice. As a result, in many rural communities where the government has built toilets, the residents prefer to defecate in the fields. This contaminates water supplies and leads to health problems.
Due to the cultural stigma associated with the direct handling of human waste, solutions developed to improve water sanitation must utilize technology that is culturally appropriate. Non-governmental organizations (NGO) in Europe, the United States, and Australia have all sought to create solutions to the toilet shortage. Given the lack of existing water and sewer infrastructure in slums and rural communities, these efforts have focused on creating facilities that can operate in self-contained atmosphere. Unfortunately, most of these require human intervention for waste removal, which is doomed to failure in India.
An Indian company, Banka BioLoo, has developed the Bio Digester Tank System, an environmentally friendly system that can be used with new or existing toilets. Its approach is to use bacteria in a tank to degrade waste on its own and requires no handling by humans. The technology was locally developed by India’s Defense Research and Development Organization and eliminates cultural concerns that impact other initiatives. Banka BioLoo is working to install 300,000 units by 2020. It has been working with the Indian Railways since 2012 to replace onboard toilets that deposit waste directly onto the tracks with their bio toilets. This will lead to less contamination along the 71,000 miles of track and the waterways impacted by runoff by the time the project is completed in 2021.
Additionally, given the scale of the problem, solutions must be localized as compared to a one-size-fits-all approach. Only 21% of wastewater in India is treated. It goes without saying that cities must expand their sewage treatment facilities. However, this will take years, if not decades, to do, and even then will only affect those who are connected to the existing sewage infrastructure. Due to the prevalence of illness spread by contaminated water, steps need to be taken that can make an impact immediately. Slum residents are dependent on communal taps and pumps or from vendors who sell directly from tanker trucks. The locations of these water sources are likely tainted by bacteria due to the limited sanitation facilities, thus making the water itself contaminated. Providing purification systems that can be used at the neighborhood, village, or household level would have an immediate impact. It would not only eliminate the existence of bacteria, but would also offer a means for people to access safe water supplies and reduce the spread of disease.
Higher end technology could be used to enable campaigns by NGOs or the Clean India Mission to have a greater impact through the use of big data and analytics. Big data tools and visualizations could identify geographic areas that have the greatest need for toilets or clean water systems by correlating existing data with future trends. By measuring outdoor defecation rates, presence of waterborne disease, child development rates, and population growth, a visualization or graphic depiction could be developed to show which target areas would benefit from new facilities and the type of assistance that would be most beneficial. India’s sophisticated information technology companies or universities could provide the computer modelling for such an effort.
The sanitation crisis in India has been years in the making and will not be solved overnight. The government deserves credit by openly discussing the issue and taking steps to address the root causes. What makes this problem especially challenging is that the disparate causes in urban and rural communities. Whether lack of access to facilities or cultural preferences, addressing these factors require unique solutions. A national campaign has a place in this effort; however, even small scale initiatives can yield immediate benefits. Innovation and technology will have to play key roles in taking steps to begin to reduce the existing contaminants in India’s water supply and stop new bacteria from being introduced. With the health and well-being of millions on the line, the stakes of addressing the water sanitation crisis could not be higher.

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