Basic Sanitation Problems Because of Cultural Attitudes


By Bula Devi,Womens Feature Service

Access to safe drinking water is an important Millennium Development Goal but in Bihar, which is ironically enough blessed with innumerable rivers, it is proving to be a huge concern.

The evidence from the ground is compelling. Take Shankar Yadav, 44, of Tilathi village in Saharsa district. He may have enough land to feed his family but is still very troubled. “Earlier our water used to be clean. The root cause of our present health problems is impure water,” he says. The water in Yadav’s well has traces of iron. As if that is not bad enough, the swamp adjoining his home is a breeding ground for flies and mosquitoes, and diseases like kala azar (visceral leishmaniasis) and malaria are common.

The groundwater in this region straddling the River Ganga is the main source of drinking water. But it has become contaminated with arsenic, fluoride and iron as shallow and middle-level aquifers get overexploited. Anindo Banerjee, head of Programme Initiatives, Praxis, a Patna-based NGO, estimates that women in certain pockets have to walk at least five kilometres to find safe drinking water. “If they don’t do this, they will have to depend on stagnant water in nearby ponds,” says Banerjee.

If one travels along the embankment of the River Kosi, where about one million people live spread across about 384 villages, it’s common to see children and cattle bathe in the same water, even as women wash their clothes and utensils nearby. But this water is unsafe. According to Ashwini Choube, State Public Health Engineering Department Minister, out of 38 districts in Bihar, 13 are affected by arsenic contamination, 12 by fluoride and 10 by iron.

The World Heath Organization’s permissible limits allow for 10 ppb (parts per billion) arsenic in drinking water supplies. But in 2008-09, Dr Ashok Ghosh, professor-in-charge of the Environment and Water Management department at Patna’s A.N. College, found in a study he conducted that there was 1,861 ppb arsenic in Panday tola, Bhojpur district, while in Khagaria and Supaul districts drinking water contained 300 ppb and 250 ppb, respectively. Says Dr Ghosh, “In groundwater 87 per cent of the arsenic is in trivalent form, which is very harmful.”

The three common sources of arsenic poisoning are drinking water, water used for irrigation which enters the human body through food, and the burning of cow dung cakes. Dr Ghosh makes the connections, “The fodder given to cows has been irrigated by arsenic contaminated water, so the cow releases arsenic-laced dung. When cow dung cakes are burnt, arsenic is released as arsine gas.”

It is the women who are largely affected by this. Not only do they drink contaminated water, they spend most of their time in unventilated kitchens inhaling the smoke from the cow dung cakes used as cooking fuel. Infants imbibe the toxins with their mother’s milk.

“What people are actually drinking is not groundwater but flood water,” says Eklavya Prasad, of the Megh Pyne Abhiyan (MPA). Since the level of the water table is high here, hand pumps go down only up to 15 to 20 feet, which raises the possibility of the water getting contaminated by arsenic and iron – even pesticides thanks to the careless spraying of agricultural crops.

At Patna, the Mahavir Cancer Sansthan (MCS), a cancer facility, is teeming with women patients. “They are mostly from the Gangetic plains and they suffer from cervical, breast and ovarian cancers,” says Dr Akhileshwari Nath, head of the research centre of MCS. In regions like Ara, Buxar, Vaishali, Bhojpur, Hajipur and Bhagalpur, where these women live, drinking water has become gravely contaminated and sanitation facilities remain negligible.

“The basic sanitation problem is because of cultural attitudes. But it is also a poverty issue,” says Dinesh Mishra, an MPA activist. Open defecation is a big concern in Bihar, with dirty surroundings becoming the breeding ground for the sandfly, which causes kala azar. It is the poorest who are the worst hit. Dr Ashok Kumar, a private practitioner in Khagaria, estimates that 90 per cent of his kala azar patients are Dalits, mostly ‘mushahrs’, who are among the lowest of the low castes in Bihar.

Clearly, rural Bihar is paying a high price for the lack of clean water and proper sanitation. But there are some innovative responses to the crisis. The MPA, for instance, has spearheaded two initiatives. They began by convincing local communities to undertake rainwater harvesting. Recalls Prasad, “At first activists were met by a lot of resistance because of a local belief that they could get goitre if they drink rainwater. The question of proper storage also arose. We learnt from the local villagers in Supaul district about the ‘matka’ filter. We further developed it by using bamboo and waterproof cement to protect it from secondary contamination.”

The second initiative involved better sanitation. This too was challenge because people resisted the idea of toilets. Says Mishra, “They just could not adjust to confining themselves to a 3 ft x 3ft cell even for a while!” But things are slowly changing. Some villages now have the ecological sanitation system known as the ‘faidemand shauchalay’ (beneficial toilets). “These are dry latrines. The excreta is used for manure and urine for urea,” explains Prasad.

The state government has introduced a slew of measures to improve access to drinking water. Some 200,000 handpumps have been made functional across the state and an additional 100,000 will be dug between 2012 and 2015. There are plans to set up 200-500 new mini water plants in areas with 1,000 to 1,500 inhabitants. The state government has also promised to make access to drinking water and sanitation a fundamental right.

Another welcome move is the construction of dugwells. The administration plans to construct 600 dugwells. Observes Dr Ghosh, who is trying to develop solar powered arsenic mitigation technology suited to Bihar, “An open dugwell could have bacterial contamination but its effects can be controlled through antibiotics and the like. There is no medication for arsenic poisoning.” In such a situation, dugwells are useful. Even if dugwells are covered by an iron sheet or mesh there is sufficient air to oxidise the ionic arsenic, thus reducing its capacity to cause harm.

There is also a growing understanding about the importance of sanitation. The government has coined slogans emphasising general health and social dignity, especially that of women. One of these slogans goes: ‘Ghar ghar mei ho sauchalay ka nirmaan, tabhi hoga laali betiya ka kanyadaan'(a toilet in the house is the right wedding gift for one’s dear daughter).

Khagaria District Magistrate (DM), Abhay Singh, has taken the initiative of getting dry toilets and dugwells constructed under the Mahatma Gandhi National Rural Employment Guarantee Act. After monitoring MPA’s success in the area, the DM has implemented the model in the ‘mahadalit’ areas where the extremely backward among Scheduled Caste communities, including ‘mushahrs’, live. He too is convinced water from dugwells is safer to that of handpumps.

The efforts of people like Singh are being carefully watched by the world as it prepares to review progress on the Millennium Development Goals in September. According to its MDG commitments, India is to halve the proportion of people without sustainable access to safe drinking water and basic sanitation by 2015. According to government projections, while India is on course to meeting its target on safe drinking water, basic sanitation for all is still a distant prospect.

But Singh says he will strive on, “The most important factor in this effort is social acceptability. We are going ahead with our plan wherever villagers willingly accept it.”