As World Toilet Day was marked on Tuesday, India’s sanitation and toilet statistics continue to raise a stink. The World Health Organization and United Nations Children’s Fund (UNICEF) estimate that there are more than 620 million people practising open defecation in the country; over 50 per cent of the population.

Moreover, the latest Census data reveals that the percentage of households having access to television and telephones in rural India exceeds the percentage of households with access to toilet facilities. The economic impact of inadequate sanitation is about Rs. 2.4 trillion ($38.4 million), or 6.4 per cent of India’s gross domestic product, according to the Water and Sanitation Programme.

According to a World Bank Report, released on Monday, access to improved sanitation can increase cognition among children. Further, Indian households defecating in the open, absence of toilet or latrine is one of the important contributors to malnutrition.

“Our research showed that six-year-olds, who had been exposed to India’s sanitation programme during their first year of life, were more likely to recognise letters and simple numbers on learning tests than those who were not,” said Dean Spears, lead author of the paper ‘Effects of Early - Life Exposure to Sanitation on Childhood Cognitive Skills.’

The paper studies the effects on childhood cognitive achievement of early life exposure to India’s Total Sanitation Campaign, a national scale government programme that encouraged local governments to build and promote use of inexpensive pit latrines.

“This is important news - the study suggests that low-cost rural sanitation strategies such as India’s Total Sanitation Campaign can support children’s cognitive development,” Ms. Spears said.

Threat to human capital

The results also suggest that open defecation is an important threat to human capital of developing countries and that a program accessible to countries where sanitation development capacity is lower could improve average cognitive skills.

According to UNICEF, hand washing with soap particularly after contact with excreta, can reduce diarrhoeal diseases by over 40 per cent and respiratory infections by 30 per cent. Diarrhoea and respiratory infections are the number one cause for child deaths in India.

With 638 million people defecating in the open and 44 per cent mothers disposing their children’s faeces in the open, there is a very high risk of microbial contamination (bacteria, viruses, amoeba) of water which causes diarrhoea in children.

Children weakened by frequent diarrhoea episodes are more vulnerable to malnutrition and opportunistic infections such as pneumonia. About 48 per cent of children are suffering from some degree of malnutrition.

According to Nirmal Bharat Abhiyan, government’s programme to solve ‘toilet crisis’ in India, by 2022 the country will be declared as free from open defecation.

Correction and clarification

A sentence in “Half of India’s population still defecates in the open” (Nov. 20, 2013) read: “The economic impact of inadequate sanitation is about Rs. 2.4 trillion ($38.4 million), or 6.4 per cent of India’s gross domestic product, …” A reader said Rs. 2.4 trillion is $38.4 billion and not million.

Also it is 6.4 per cent of India’s GDP at ‘purchasing power parity’. Else it will be 2.133 per cent (of $1.8 trillion).

The writer’s clarification: According to a UNDP-Water & Sanitation Program report, it is estimated that the total economic impact of inadequate sanitation in India amounts to Rs. 2.44 trillion (US$53.8 billion) a year — this was the equivalent of 6.4 per cent of India’s GDP in 2006.

Additionally, in Purchasing Power Parity (PPP) terms with the price level in India being about a third of the USA, the adverse economic impacts of inadequate sanitation in India is US$161 billion, or US$144 per person. Of the Rs. 2.4 trillion lost, about Rs. 1.1 trillion signifies the loss of flow of economic value of 2006, and the balance Rs. 1.3 trillion, the present value of future losses owing to the human capital lost in 2006.

In the same article, another reader pointed out an error in the last paragraph that read: “…by 2017 the country will be declared free from open defecation.” The reader said the Government had revised the year to 2022. The reader is right.