It is all about Infrastructure and money

– India has made tremendous progress on economic front, in infrastructure, industries, healthcare and tourism. But when it comes to awareness about cleanliness and hygiene, we are still lagging behind and we blame it on our country’s increasing population.

– Our main problems are sanitation and waste management. We do not have enough clean public restrooms, especially for women.

– How can the government and the people come together to achieve cleanliness?

– The world is moving towards green cleaning and professional cleaning…

Educating ourselves

Sunita Shahaney: While population is a matter of concern, it is the lack of education in hygiene, which is the primary issue. Cleanliness is a part of healthcare. Healthcare cannot be what it is without cleanliness but cleanliness can be what it is without healthcare. Recently, the CII has demanded infrastructure status for healthcare, but we need to afford Cleanliness and Hygiene also the infrastructure status.

“Our education from the childhood level determines what we do at our workplace or at public places. So, we need to teach our children the value of cleanliness.” Sunita Shahaney, Consulado Honorario De Chile, runs an organic food and lifestyle store ‘Ahumcara’ in Chennai which is housed in a 100-year-old castle.

Trade visitors to India are often put off by the sight of dirt and debris at the entrance to an office or on the roads. The issue of citizens dirtying the environment have to be tackled in its entiretyand this can happen only through education.

Tishani Doshi: As Indians, we pride ourselves culturally about our obsession with cleanliness. Cleanliness is Godliness, we say. We take multiple baths a day and keep our houses immaculately clean. But somehow, this habit of cleanliness doesn’t always extend beyond the boundaries of our home.

Often, while people do maintain impeccable standards of cleanliness inside their homes, they have no trouble throwing garbage over the wall, or spitting paan in the corner of a building. It doesn’t bother them visually to see garbage piled up in the street or rolling down their window and casually throwing out a chocolate wrapper or a chips packet.

We need to create a sense of civic consciousness that extends to our public surroundings and makes people take pride in that. It has to be indoctrined at an early age that it is not okay to litter or spit and there have to be legal and societal consequences if one litters.

Sharan Apparao: In a way, I think clean habits come from teaching children when they are very young. We need constant reminders in our education system and somewhere in our day-to-day life. We need more programmes focused on this at various levels. Keeping the environment and city clean has to happen on a mass scale movement.

“I always think that our movies should carry messages on cleanliness, as they are powerful media.” A promoter of contemporary Indian art, Sharan Apparao runs the well known Apparao Gallery in Chennai.

Sunita: Implementing and maintaining Naina: We need to bring in ‘management’ into solid waste management (SWM).

The mantra of SWM is source segregation and this starts in your home or in your institution. One has to take responsibility of what is being thrown to be taken away by the Municipal Corporation. All recyclables may not be thrown. To bring about this change, we need a change of mindset. The best way is to start with school children. The message will reach their parents through them.

While addressing students of a lower income school, I asked the students, “How many of you want pocket money from today?” All hands went up. I told them to go home and collect all the things that were thrown away as waste and could actually be recycled – newspapers, envelopes, toothpaste tubes, milk sachets, rubber slippers… At the end of every week, they could sell these to the kabadiwala and make a note of the money earned. The next time I visited the school, I found that the average earning by a child was Rs100 in a month. With 3000 students, it was Rs3 lakhs in one month; the children gave value to the garbage.

India and China are the only countries which give huge value to waste.

You throw anything and they will find value in it.

In Korea, styrofoam is recycled into beautiful frames, fruit trays, furniture and other utilities. These get exported too. In Thondiayarpeth in Chennai, and also in Delhi, styrofoam gets melted in unsophistcated methods to be made into jewellery cases or fruit trays.

We have recycling industries over here, which import PET to make yarn. They make polyfill which is used to fill washable pillows. They approached us but we couldn’t find enough PET for them. They are receiving PET from Sri Lanka. There is need for a lot of emphasis on source segregation and that’s the catch.

Vidya: I feel the City Corporation of each town needs to do a lot more in clearing roads, collecting garbage and removing rubble. There has to be some system. One cannot dump the construction rubble on the streets and just walk away. The city has to fine you, if you do not clear your own rubble.

Naina: The government has to enforce segregation of waste and bring in the system of decentralisation.

“We tend to think that the chocolate is ours and the minute it is consumed, its wrapper belongs to the municipal corporation.” Naina Shah is an environmentalist specialised in Decentralised Solid Waste Management and Waste Water Treatment System. She is the Trustee & Vice-President of Exnora International.

Recyclable and non-recyclable waste should be collected in different trucks. There should be yards to manage recyclables alone in the same division or same zone depending on the size or area. Waste must be managed in a decentralised way. For example, why should the waste collected in the Nungambakkam area be taken to Kondagaiyur or Pallikarnai marsh to be segregated further? In the existing system, all waste gets mixed in spite of all efforts. It doesn’t make any sense. Nungambakkam can manage almost 90% of the waste locally and only 10% of the waste can go to the dumpsite. It will save a lot on energy and reduce the number of trips the truck has to make to the dumpsite. It will also cause less pollution.

In Sikkim, every household drops the segregated waste into different trucks. There are no bins and yet, the streets are very clean. If we want litter-free areas, we have to knock out the bins. But the problem is: Even if the bins are removed, people will still throw garbage at the same place.

The system of door-to-door collection has to be brought in. Citizens can take some initiatives and organise garbage collection in their own localities. They may also contribute an amount for the upkeep of their locality. I do not understand why do you have to wait for the municipal corporation to take responsibility of the garbage you create?

Solid waste management rules were framed in 2000 and by 2003, all the criteria, including a sanitary landfill site, were to be met. We didn’t have even one sanitary landfill in India then. The existing dumpsites are very close to residential areas and pose a huge health hazard to the residents.

The existing urban landfills, which are of no use, have to be closed; the land is wasted. Advanced landfill remediation technology can convert this land into a new township or an industrial area. In this remediation process, the soil is neutralised by removing the methane and the pH balance is maintained. The garbage is then excavated up to three metres and all materials that have not decomposed are removed. There are technologies, but the willingness of the government to adapt them is needed.

Tishani: What bothers me is the way by which the waste is managed. For me, one of the most difficult sights is the rag-pickers or the men going down the sewers. I have not seen that anywhere else in the world. In India, there are more than a million rag-pickers. Millions of children, instead of going to school, use their nimble hands to segregate garbage. What urban planners and the government need to focus on is to eliminate or at least minimise this direct human contact with waste entirely and to stop relying on this endless supply of cheap labour to do their dirty work.

“The sooner we recalibrate our systems so that we segregate garbage and waste in our own homes and the more mechanised we make our cleaning systems, the sooner we can hope to move towards a more dignified community.” Tishani Doshi is a Chennai based writer and dancer. In 2006, her book of poems ‘Countries of the Body’ won the Forward prize for best first collection.

Naina: We throw the mixed waste out but the rag-pickers find some value to it.

We did a study at a rag-pickers colony. They earn approximately Rs3000 a month even on a rainy day and if I multiply this with 10,000 rag-pickers just in Chennai, in 12 months they earn Rs36 crores. This is the value of waste which they have handled. Whom did it cost – the corporation? No. Did they get any sponsorship from the corporates? Did anyone look at the health of the workers or get insurance for them? No.

It’s a myth that we need support of all these corporations. May be a little support and finally, a little push to start up a project.

We had this very unique project at a mofussil bus stand in Vellore. It was handed over to a Federation made up of four Self Help Groups (SHG). The Federation employed 118 people, including 47 physically challenged, 21 widows, 12 battered women, four orphans and 34 unemployed. They designed a self sustaining model without external means and also generated high income, month after month. User friendly toilets and cycle/scooter stands were constructed and income was generated from them. They charged Re1 for the cycles and Rs2 for the scooters. They worked 24 hours round the clock. They got Rs3 for every bus that was parked at the bus stand. The bus stand was kept litter-free and the waste collected was taken to a shed for further segregation and sale.

Green waste from the kitchens of two hotels was collected and segregated and fed to the cows. Forty eight cows were integrated in the waste management. The cow dung and urine were collected very meticulously. The cow dung was mixed with equal amount of water and put into the bio gas system. Bio fertilizers like Panch Kavya, Amritpani, Vermiwash, vermicompost, Gunnaapjalapam and biopesticides were also made and sold.

All the wastewater from the urinals, toilets and other sources was collected in a pond and cleaned with the help of 1000 ducks. The income at the start of the project was Rs55,000. Slowly, it increased upto Rs450,000 per month. In 39 months, the income through SWM (inorganic material alone) was Rs1.04 lakhs and the total income generated by the federation was Rs1,37,10,458.

This was truly a novel way of managing a bus stand, empowering women and creating employment. However, when there was a change in the organisational structure of the Vellor Municipality, all these people were thrown out from the bus stand! Still, this experiment is being successfully replicated at many places.

Vidya: The important thing is that we need to continue with our efforts. I took photographs of certain areas in boat club road – corners dumped with garbage, cows eating sewage… I blew up these pictures and sent them to the Corporation. Within a day, the areas were cleaned.

Sanitation

Dr Priya: I work in a hospital for children which has the potential to be one of the dirtiest places in the world. Our hospital has 243 beds for new babies and children up to 18 years of age. The hospital caters to all sections of the society; a certain number of patients are treated at subsidised rates and some pay for deluxe treatment. We see cross-sections of the society.

“After my return from abroad, I was told the air in India caused different infections, but it was not true. The evidence showed that the infection came from cross-contamination.”
Dr Priya Ramachandran is a Consultant Paediatric Surgeon with Kanchi Kamakoti Childs Trust Hospital in Chennai.

The problem is that the standard of hygiene followed by mothers is what is being followed by them at their homes. I have mothers who let their children roam around without diapers. The child urinates anywhere and the mother picks up the baby and leaves the place. The next child runs right across it. Literally, on every floor, whether OPD or reception area, you need a cleaning crew not just with mop and towel, but with twin buckets system. You need one person walking around all the time. Because their standard of personal hygiene is so low, the mothers are very nonchalant about the fact that they are dirtying the hospital where the possibilities of spreading of infection are very high. They are not only jeopardising their kid’s lives, but even that of other kids.

We have put in place a waste segregation system by which different medical wastes go into different colour coded bins. The nurses have to constantly keep the mothers aware of it because on every floor, we have general ward and deluxe rooms. And in the general ward, mothers dump waste as they please, they don’t follow the segregation system. We have to tell the patient, “If you do this, we will have to throw you out of the ward.” We have to resort to threats.

The major issue is the level of care we have to give to the ICUs. Again, another major problem is the transmission of infection from one child to another. This happens more commonly in new-born babies because they are more susceptible. The 1:1 (one child:one nurse) ratio is impossible to achieve in neo-natal units. There are 3-4 babies per nurse. So there is hardly any time for the nurse to wash her hands in between taking care of these babies. The result is enormous rate of neo-natal infections because the nurses are the carrier of infections. Now, we have kept bottles of sanitizers by the side of every patient in every unit. It is an alcohol based solution and is given to the mothers when they come in. If the nurse touches the babies without using the solution, the babies’ lives are at risk. So the mothers have to ensure that whoever touches the baby, should have cleaned their hands. When you tell this to the mothers, they are uptight about it. They do it themselves and ensure others like the doctor and junior doctors do the same. We came to know that the senior most doctors were the ones flouting the rules and the junior most were the one diligently following them. The best way to avoid the transmission is by sanitizing the hands in between examining patients.

Naina: There is no facility anywhere for sanitation for anybody, leave alone women. It is very easy for a man to relieve himself anywhere. What happens to the women? The first thing is to introduce the system of ‘pay-and-use’ toilets which have to be of ‘star quality’. That means they should be absolutely beautiful toilets. These toilets or facilities exist in Delhi, Jaipur and Mumbai. You can even find a handwash there. A person is stationed there to welcome you inside the toilet and you pay just Re1or Rs2. They sustain it by putting advertisements on the outside. These are started by a person called Faud Lokhandwala.

Mangala Chandran: At least Delhi and Mumbai have made good efforts; there are some good public conveniences. But there is a lot more to be done.

“We, at Clean India Journal, have been looking at the issue of school restrooms very seriously. The conditions of the restrooms, even in many higher income schools, are not satisfactory. As in many other sectors like hospitality and healthcare, cleaning activities in schools should also be outsourced to professionals.” Mangala Chandran, Editor of Clean India Journal.

Again, the slum women in the urban areas face a lot of difficulties. They have to face snake-bites, insect bites because they have to go before sun-rise or after sun-set. But, many villages have done remarkably well for themselves.

Naina: There is a government scheme called Self-Sufficiency scheme for total sanitation in India. There is a huge amount of funding given to the municipalities and panchayats only for solid waste management and for its awareness. But there is not much of an accountability. Still, some panchayats are doing amazing job. It is difficult to find any litter or open defecation in their areas.

But children defecating in the open in spite of having community toilets is a big hurdle. Mothers do not send the children to the pay-and-use tolilets. The children usually do not wash themselves and wait for their mothers to do so. After defecating they run home to their mothers. If a mother is busy or not found, the child just goes away without a wash. Again, a change has to be brought about.

We did a lovely project in Trichy just to change the habits of the children. We put up a child-friendly toilet with small toilet seats, so the legs are not apart. We gave them water to clean themselves, washbasin and free soaps to wash their hands.

Children get claustrophobic if they have to defecate in a closed space. Instead, this toilet was open but in an enclosed area; they could chat with their friends, they could see their mothers standing out there. All of them washed themselves and also washed their hands due to free availability of the soap.

The self-help women groups manage this community toilet. To encourage more children to use this facility, we also formed a children’s club and organised activities and picnics. Whoever utilised the facility was allowed to go for picnics. The number increased in no time and today the children use the toilet properly. It is a wonderful example of how to stop open defecation and this is being replicated. At this community toilet, there are 20 cubicles for women, 10 for men and five seats for children.

All the wastewater is treated with decentralised wastewater treatment system and bi-products like bio-gas are used for lighting of the toilets and for cooking. The treated water is used by the Women SHGs for the kitchen garden; all the produce of which is sold in the market. These women have also made presentations at the “World Water Forum” and other forums. This effort has also received the Best Practice Award from Dubai Municipality and UN-HABITAT in 2006.

Dr Priya: Many children face the problem of wet panties. They wet their panties during the day and at night. This issue is especially pronounced in girls because they don’t want to use the school restrooms as they are so dirty. Under these circumstances, the bladder becomes abnormal and empties infrequently and incompletely, so the urine keeps on dripping onto their panties. In such cases, we do a bladder training programme where we make the child go to the toilet every one-and-half to two hours compulsorily. You have to make them do that regularly but the school does not give them permission to do so. They won’t let them leave the class and go to the toilet and they fall sick. I don’t know if there is a higher authority that can be approached to enforce this because it poses a health hazard to the child.

Sunita: Schools keep women (ayahs) as helpers to look after toilets. Where do these ayahs learn their hygiene from? Who supervises them? Who cleans the toilets?

Sharan: There are girls working in my office from different backgrounds. I use the same toilet as my staff and I used to find the toilets dirty. I just told them: You either learn how to use a toilet or I am locking the toilet. I locked the toilet for one month and I was getting to know who had not used the toilet properly. Now we have no problem.

Sunita: Exactly. We have to take responsibility for our own environment. If we can take responsibility for our homes, staff members, children, drivers and others around us and make sure they follow a hygiene and cleanliness regimen, I think each one would have contributed their bit to the society. And they go out hopefully as better trained human beings.

Vidya: I agree with all of this. My point is that everything has got to do with education and creating that awareness. We all live and work in fairly comfortable surroundings. We are talking more about the man on the street, people who live in the slums, who come to work from those areas, children in those areas… those are the people who actually need some help in training themselves to be clean.

“Cleanliness has to come from the grassroots level. We should have the consciousness not to dirty the streets – this is my street, my town, my home. The prevalent notion here is that, it is dirty anyway. So why not?” Vidya Singh is a successful organiser of elegant and creative events and a social activist.

I worked on a project with Naina at a slum for an Apollo funded children camp. It was my very first exposure to a slum where you have these little huts and narrow lanes going all along into the river. You get appalled that people can actually live in such places. It is a very frightening and shocking sight. There are some public toilets but the women are afraid to go there because of rowdy elements. They are also afraid to send their children alone.

The huts were little shacks with tarpaulin sheets on top. Though the inside seemed fairly clean, children were doing the big job right outside the door. Garbage was piling up and flowing into the Khumb river. You and I individually probably can’t do anything about it but the government can get some agency to get into these slums. We cannot get away from slums as they exist in every city. But we can help them in some way to lead a more hygienic and cleaner life.

Sunita: It is ok that we are going to police these people, make sure that they don’t dirty the streets but we have to give them some place to go and relieve themselves. You have to provide some infrastructure. We keep coming back to the first point of toilets for every family, every street… if we do that, then people can probably use them and stop using the streets.

Sharan: Toilets are one thing. Garbage is another. But, according to me, the most polluting agencies are the industries. The industrial effluents contaminate the ground water and water bodies. The government should address this problem very seriously.

Tishani: Sanitation is a big issue for women. It has to do with a kind of invisibility of a woman’s place in India. In the villages, for instance, it is a fact that a woman has to carry out her most basic toilet functions before sunrise or after sunset. On the other end of the spectrum, is the complete visibility of the male – be it in villages or cities.

Any man in India feels like he has the right to pull up on the side of the road and urinate. Why is there no sense of shame accorded to this? Why is it all right? The other part to this problem is of course: Where are the public toilet facilities for men and women on the kind of scale that our population requires? And we come back to it: infrastructure and money.

Making a difference

Tishani : I think it’s key that women kickstart the process of change when it comes to this issue of cleanliness and hygiene. When women have been given control of things, be it over their reproductive rights or in micro-credit projects, they have been very good at effecting change. So, I think it’s imperative that we educate ourselves and the people around us about the importance of tackling this problem in the most holistic way possible. Essentially, it’s a lifestyle change that we’re talking about. It can be as simple as having a compost pit at home, taking your own bag to the supermarket instead of using plastic, recycling newspapers and bottles, and getting involved with neighbourhood communities. If we work on the micro-level in our own homes and communities, and if this is combined with a larger push from governmental organisations and a legal system that comes down hard on littering/spitting/urinating, then there is every hope that we can begin to see change on the macro-level in India.

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