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Promoting sanitation during floods

Jan 18, 2010

For many women in India’s north east, floods bring additional worries as it makes defecation problematic. Even after the introduction of the low-cost toilets, villagers feel the practice of open defection will continue unless government formulates effective sanitation programmes.

Finding a place to answer nature’s call involves drifting in a raft until she finds a dry place, and the polluted flood waters are the only source of drinking water and bathing. This, at a time when India has launched a Total Sanitation Campaign that aims to eradicate open defecation by the end of 2010.

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Salma Begum is a frail woman who lives in Kurukani village near Napaam on the banks of the Jia Bhoroli river in Assam’s Sonitpur district.

A widow with two daughters, she works as a maid in several houses to make ends meet. Like all the other villagers, she dreads the floods which wreck havoc for at least three months every year.

Salma puts her wooden bed on an elevated platform, ready to perch on it to eat, cook and sleep when the floods come. Every drop of drinking water will have to be stored, as the floodwaters drown the well in their compound which is their only source of water. Often, Salma’s belongings are swept away.

The floods also bring back ugly memories of how, five years ago, Salma was displaced from her land that was completely inundated by water from the swollen Brahmaputra.

But there’s one thing Salma dreads above all: the floods make defecation problematic, especially for women.

On an average day, Salma’s village looks clean and pleasant. Every house has a makeshift toilet, however small the landholding. “We are very careful not to defecate out in the open. It’s considered a matter of shame,” Salma explains. But things change drastically during the monsoons when the village and the surrounding areas are submerged in the waters of the Jia Bhoroli.

Salma explains how they have to keep a makeshift raft made out of banana stems ready before the onset of the monsoons. The raft is the only means the women have to search for a dry spot on which to defecate. Salma’s predicament becomes worse at night as she is a widow. She cannot take a man with her to row the raft. She has to row it herself, which is scary. So, when she has to go, she takes a small lamp and sets out on the raft to look for a suitable dry spot.

Salma recalls with horror how once a leech attached itself to her buttocks. She discovered it much later when she saw that her sari was stained with blood. She shudders as she narrates the story of how her eight-year-old niece had to be hospitalised when a leech entered her body through her private parts as she was defecating in the open.

Defecation becomes more of an ordeal for the elderly and the sick. Salma recounts the misery her aged mother had to go through when she suffered from diarrhoea during the annual floods last year. Besides having to cook, eat and sleep on top of the bed, they had to take care of the old woman who needed to defecate at frequent intervals. They had to make do with a polythene bag that had to be cleared every time she defecated as it was impossible to take the frail lady by rickety raft to a dry place so frequently. The polythene bag had to be emptied into the floodwaters itself.

Elderly women often hurt themselves when they venture out on the raft to defecate. Jamila Khatun of Singlitoli village in Napaam, in the same district, walks with a limp. She injured her leg while trying to wade through water in search of an appropriate spot to defecate. As for urinating, they do it in the water itself. “How long can you restrain the call of nature? The men and children of course ease themselves wherever they can. We women have to restrain ourselves as we have a sense of shame,” says Jamila. The women are compelled to bathe in the same water.

“Sometimes we have to seek permission from the owners of a dry patch in order to defecate. Most often we have to do it discreetly, on other people’s land, as it becomes difficult to control oneself. Sometimes, during the floods, we starve ourselves so that we do not need to defecate,” she adds.

During the dry season too, Salma and her 21-member joint family have to make do with the kuchcha toilet (a pit with a bamboo frame on top of it) in their backyard that fills up every two to three months. They then have to dig another spot nearby and keep repeating the process in an area dedicated for this purpose on their small landholding of one-and-a-half katha. People with small landholdings find it more difficult as they do not have enough place to keep digging new holes. And the area is not used for any other purpose, like a kitchen garden, as they cannot bear the thought of growing vegetables in the same spot.

Salma’s family now has a low-cost toilet as part of the Total Sanitation Campaign (TSC) spearheaded by the Assam Public Health Engineering Department (APHED) which has been the nodal agency for rural water supply and sanitation in the state since 1999.

The Total Sanitation Campaign is a comprehensive programme to ensure sanitation facilities in rural areas, with the broader aim of wiping out the practice of open defecation.

The Total Sanitation Campaign was initiated in 1999 when the central rural sanitation programme was restructured making it demand-driven and people-centred. It follows the principle of “low to no subsidy”, where a nominal subsidy in the form of incentive is given to rural poor households to construct a toilet.

The key intervention areas are individual household latrines (IHHL), school sanitation and hygiene education (SSHE), community sanitary complexes, anganwadi toilets supported by rural sanitary marts and production centres.

But Salma knows that things will not alter much during the floods as the toilet too will be inundated. Furthermore, the pit in the low-cost toilet has already filled up and Salma has no clue what to do with it. She thinks that it could have been deeper, but there are reports that deeper pits could cause faecal contamination of sub-surface water sources. “We will have to go back to our old and familiar kuchcha toilet. They should have taken into consideration the annual floods while giving us the low-cost toilet,” she says.

For adolescent girls and women who are menstruating during the floods, things are much worse. The tattered clothes they use as pads, known as nuara or chua, are often dried inside the house or underneath other clothes to save embarrassment. These women usually wait for late evening or early morning to answer the call of nature.

Septuagenarian Sulukjan Khatun from Tupamari village in Assam’s Kamrup district has been going through the same ritual every year from the day she got married at the age of 12. She carries a lamp and a stick in each hand to get to a spot to defecate. As they are forced to drink the same contaminated water, Sulukjan was once seriously ill with diarrhoea. She became almost unconscious and had to be rushed to the doctor in a boat. Her eight-year-old granddaughter was not so fortunate; she succumbed to diarrhoea after three days.

Some tribes in Assam build houses on stilts to combat the raging floodwaters, and have a space in their elevated house where they can defecate. The droppings fall to the ground or into the water below and are swept away. Those who can afford it use a country boat to ferry them to dry places in search of food and livelihood; those who don’t make do with makeshift rafts.

Recurrent floods have led to displacement and pauperisation of communities. Government relief camps provide food and clothes, etc, that help people survive fairly long periods of flooding.

APHED undertakes a slew of flood-related activities. They include disseminating leaflets on the do’s and don’ts to be followed during a flood, distributing chemical packets (alum, bleaching powder, and lime) for water purification by households, disinfecting spot sources, installing spot sources at relief camps, raising hand pumps, repairing and restoring piped water supply and spot sources affected by floods.

In a bid to lessen people’s exposure to disease, and provide a hygienic environment, the rural sanitation programme aims to promote ‘environmental sanitation’ as a package. It seeks to adopt measures to break the cycle of disease through improved management of human, animal and domestic waste. An official of APHED says: “This includes sterile management of human and animal excreta, safe disposal of waste water and storm water, safe disposal of garbage, safe handling of drinking water, domestic and food hygiene, personal hygiene including promotion of handwashing and the surroundings.”

APHED has been involved in promoting participatory sanitation programmes as self-help programmes, without any subsidy, with Unicef support since 1993. Social marketing is adopted as a key promotion strategy. Promoting sanitation as a package and developing alternative delivery mechanisms were initially piloted through a Unicef-supported ‘intensive sanitation project in Kamrup district’, in Assam.

Capitalising on the lessons learnt from pilot initiatives, the strategy has been replicated in more and more districts; because of its acceptance it has spread to 16 of Assam’s 23 districts.

The government may be all geared to eradicate the practice of open defecation by 2010. But as long as annual floods continue to inundate villages for weeks at a time, women like Salma Begum will be forced to carry on the practice. The Indian government’s total sanitation programme has yet to impact women like her.

Source : Infochange
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