Poor toilet infrastructure is a major cause of health problems among women - Newztezz Online

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Friday, August 5, 2022

Poor toilet infrastructure is a major cause of health problems among women


Public Toilets: Researchers surveyed over 600 women in the slums of Maharashtra. 
They found that among those who did not have proper toilets, more than 21 percent complained of blockage in their urine

Ruchi Kumar

On a sultry May afternoon, a handful of local residents gathered in a one-room house in an unplanned residential settlement in Mumbai. The women greeted each other and then sat on the small porch and on the tiled floor inside, and they all shared their stories about the day's events through the door frames. Their conversation was light-hearted until someone mentioned hydration and the mood didn't change. Kalavati Yadav, 31, said, 'We will not consume any more fluids today, if we do so, we may need to go to the toilet later in the evening.' By that time, public toilets would become dirty after a day's use and would become dark without light. Yadav said, 'This is not a safe time to go.'

However, the time of day is not much better, as the toilets are rarely clean. According to women, public toilets are generally dirty, unlit and lack of water. Their number is also less. Settlements like Subhash Nagar, where more than 9,000 people live as of 2020, have only two public facilities. Each of these has a dozen toilets, six for women and six for men, covering about a tenth of a square mile. The responsibility of cleanliness lies with the Municipal Corporation, but very little attention is paid to it. (Continued requests were made to city officials to talk about the issue, but they did not respond.)

no better toilet facilities

The result is that bathroom schedules for millions of low-income people across India, like residents of Subhash Nagar, are often dictated not by biological needs but by inadequate toilet infrastructure. Several women told Undark that they regularly hold their urine and avoid drinking fluids to avoid going to the toilet. These habits lead to stomach ache and constipation, but women said they did not have better options.

Their neighborhood was unplanned, starting out as tin-framed houses, which were later replaced by concrete structures, so the houses are not connected to septic tanks. There are no private toilets, people living here cannot regularly visit other parts of the city to use fee-based facilities.

This plight is part of the larger story of India's efforts to provide affordable and clean toilets for a population of 1.4 billion people. According to the daily newspaper 'The Hindu', as recently as 2013, nearly half of all Indians defecate in the open in fields, ponds or other places. Without public sanitation, especially septic tanks and water and sanitary equipment, germs spread easily, causing serious health problems. The Deputy Secretary-General of the United Nations has called for no open defecation and Prime Minister Narendra Modi launched the Swachh Bharat Abhiyan or Swachh Bharat Mission in 2014. Due to these efforts, more than 1000 lakh toilets were constructed across the country. According to the World Bank, today only 15 percent of the population defecates in the open.

Public toilets are overcrowded

Public health researcher Sarita Vijay Panchang, who authored her research paper on India's urban sanitation in 2019, told Undark via email that having a new public toilet is "like providing services". But he said that many public toilets in India are overcrowded. This leads to long lines, sewage overflows, concerns about personal safety and all these causes public health problems.

Surveys show that the situation is particularly dire in urban areas like Mumbai. Security concerns as well as cultural norms prevent women from defecating in the open. (Men are more likely than women to defecate in the open even when public toilets are available.)

Physicians and activists say continued practices of caste and class-based discrimination add to the harm, as some women are forbidden to use toilets at their workplaces.

Long lines for toilets

Ambika Kalshetty, 35, the host of the meeting and a maid in a nearby high-rise apartment, said, "The plaster of the toilet's ceiling once fell on me." He told that toilets for men were built on top of women's toilets, whose dirty water leaked on us many times, which causes disgust.' She said that she doesn't really feel well until she comes back home and cleans herself thoroughly with soap and antiseptic.

Another woman, Sangeeta Pandey, saw a pregnant woman fainting while waiting in a long line for community toilets. She said, 'It was humiliating, but what could she have done?'

Local activists have worked to raise awareness and bring about improvement. Still, the women gathered at Kalashetty's home say that the pace of change is slow, and that they deal with this difficult situation on their own.

There is a problem of obstruction of urine

Researchers several years ago surveyed more than 600 women in 33 slums in Maharashtra, including Mumbai. They found that among those who did not have proper toilets, more than 21 percent complained of blockage in their urine and more than 26 percent said they changed their diet to avoid using the toilet at night. Huh. Almanac's research in these areas supports these results, which also found that women avoid urinating and defecating when they feel unsafe in their community toilets.

Suchitra Dalvi, a Mumbai-based gynecologist and women's health activist, said such behavioral changes can have negative health effects. Frequent urination helps in flushing out any bacteria, thereby reducing the risk of urinary tract infections. (Women in Subhash Nagar said they regularly experience urinary tract infections (UTIs), some every few months.)

Even relatively affluent people are affected. Dalvi recalled the conversation he had with the former state health minister and the young woman, who often has to go out for work. Knowing that the public toilets facing her on the street would not be enough, the health minister would limit her water intake. Dalvi said that this is an example of how the problem of women has become common in India.

Social activist Deepa Pawar, who focuses on gender and youth issues in marginalized communities, said toilet infrastructure is not just an issue of sanitation. “It is a huge problem that includes issues of health, gender and social justice.

Cleanliness in toilets is not good

Pawar's organization 'Anubhuti' conducted several toilet audits across Mumbai in 2017. Subhash Nagar is under the municipality. An audit conducted in the K/East ward of this area found conditions similar to those reported by UNDARK such as damaged toilets, lack of water and inadequate sanitation services. Although according to the central government there is talk of imposing one commode per 30 persons, but its number was very less in the audit.

Pawar grew up in low-income areas of Mumbai, so his matter is personal. He said, 'When you use your toilet at home, there is no problem in it. But while using public toilets one has to face a lot of concerns.

Pawar says the problems escalated during the Kovid lockdown when many free public toilets in the city were closed. "They only kept the pay-and-use toilets running," she says. From where will the poor get money to use these toilets if they are not allowed to work?' The lockdown particularly affected nomadic communities, which comprise about 10 per cent of India's population. These are communities that have traditionally moved around, and while many are now settled, they are economically weaker and face discrimination.

toilet fee waived

Women and men were also forbidden to use toilets in Subhash Nagar during the lockdown, but they used them anyway. Not only this, many men all over Mumbai only defecated outside. Although the government ordered a waiver of toilet fee for all, Pawar and residents of Subhash Nagar say that in practice women were charged fees. "Of course women were being punished for their gender while men were being given free passes," Pawar said.

As a member of a nomadic tribe, Pawar is well aware of the social dynamics that prevent some women from accessing basic services like toilets. “During our campaigns, we ask local officials about the disparity in access to toilets for members of nomadic tribes, and they often ask us to use free public toilets at malls instead,” she says. Why don't you do it.'

The reality is that places like malls cater to the needs of the middle and upper classes, and people of lower socioeconomic status are not preferred there. He asked in his own style, 'Will a female laborer in a bullock cart be allowed to enter the mall? Has our society inspired such etiquette among those who work in these malls and allows nomadic laborers to their premises?'

Dalvi said Mumbai is a large commercial city which is dependent on the labor of women and marginalized communities. Therefore businesses, the government and wealthy residents must all 'accommodate' facilities.

Taking this work forward, the Panchang wants that efforts should be made to build more household toilets in India that are connected to the sewer. Local residents will be able to maintain these toilets well and women will not have to pay such a heavy price for the country's efforts to get rid of open defecation. "Public toilets are not a substitute for domestic toilets," he wrote in his email.

Ruchi Kumar is a freelance journalist reporting on South Asia. She has appeared in outlets including Foreign Policy, The Guardian, NPR, The National, Al Jazeera and The Washington Post, among others.)

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