The big clean up

India

Up to 150,000 Indians die from water-related diseases every year

Luke Harding reports on the struggle to make water work.

For most people in Britain, going to the toilet is a solitary experience. But for the residents of Bells Colony, a slum in southern India, it is a daily battle. The main enemy is the pig. The colony has no latrines, and so every morning the slum-dwellers troop off into the dense green thorn bushes to relieve themselves. This is not a pleasant experience. The pigs flourish amid the excrement, and have been known to attack small children. Then there are the snakes. "There are lots of them lurking in the bushes. You have to make sure they don't bite you," one slum-dweller, Mrs Valli, explained.

Finally, there is the problem of floods. During the rainy season even getting to the thorn bushes is tricky. "We have to wade through waist-high water. There are holes in the ground. One old woman recently fell in. Fortunately people go to the bushes in groups. We managed to pull her out," she says.

The problems of Bells Colony - an illegal urban slum next to the railway line in the pleasant temple town of Tiruchirapalli - are by no means unique. Across India, some 690 million people face a similar daily battle. They do not have access to proper sanitation. Instead, they are forced to improvise: defecating in fields, thorn bushes, and sometimes along the tracks of India's vast railway network - an arrangement that led the writer Paul Theroux in The Great Railway Bazaar to coin the phrase "the turd world".

And yet open defecation is no joke. Under India's ancient caste system, the so-called "untouchables" have traditionally been responsible for disposing of night soil. This barbaric practice, known as "manual scavenging", was made illegal in most Indian states three years ago. And yet it persists. In some urban and rural areas, Dalit ("untouchable") villagers - fearful of retribution from higher caste landowners - continue to dispose of human waste.

The residents of Bells Colony, who migrated there several decades ago and live in neat mud houses thatched with coconut leaves, are aware of the dangers of poor sanitation. "We want to change our lifestyle. We just need help," Valli adds.

In other respects, the community exudes self-respect. The women recently formed their own self-help committee. Every morning, they decorate their porches with kolam, an auspicious geometric pattern made from white powder. Their alleyways are fastidiously clean. And like many women in south India, they wear fresh jasmine flowers in their hair. They have only one complaint: "We have no facilities," Mrs Vijay Lakshmi says.

The lack of proper sanitation means that the slum-dwellers are often ill. They suffer from diarrhoea, dysentery, malaria, typhoid and brain fever. In the evenings, a dark crescent of mosquitoes hovers above the undergrowth kingdom of the pigs. Five slum-dwellers recently contracted elephantiasis, a vicious disease spread by mosquito (the medical name is lymphatic filariasis) where the patient's limbs and testicles swell up. When we turned up to inspect the slum, with its somnolent buffaloes and brightly decorated Hindu temple, one child, suffering from diarrhoea, had just died.

Across India it is the same grim story. Some 150,000 people perish every year from water-related diseases. The overwhelming majority are children aged three or under.

This bleak statistic is hardly surprising when you consider that in urban areas of India only about 40% of the population has access to proper latrines. In slums such as Bells Colony the figure drops to just 15%. The answer to the slum-dwellers' problems can be found on the other side of Tiruchirapalli, next to a large banana warehouse where dozens of men swarm under a humid sky over bundles of green fruit. And it costs a mere £600 to build.

The British charity WaterAid has come up with an ingenious solution to the hygiene problems in developing world slums - a community toilet. Two years ago, the slum-dwellers of Kalmandhai knocked down their old municipal latrine, which had fallen into disuse. The locals had reverted to their bad old ways: defecating not in, but around, the broken-down toilets. With a grant from WaterAid, they built two new yellow-painted latrine blocks for men and women. They also constructed a special communal toilet for children - India's first. Most crucially, the local women who had previously had to disappear into the bushes before sunrise or after sunset managed the latrine themselves. They charged customers 50 paise (less than 1p) to use the facilities. They kept the blocks scrupulously clean. They provided soap. Soon, about 1,000 slum-dwellers a day started visiting the new latrine, and the women found they were making a modest profit.

"Our aim is sanitation for all. If we get that, we will be happy," the toilet committee's manager, Mrs AC Ilangium, explains. Round the back, they excavated several tonnes of excrement and planted a herb garden, full of flowering gourds. They opened up a shower block as well, charging the labourers working next door three rupees to have a shower.

Once the block was up and running, the women started experimenting with other entrepreneurial schemes. They bought some red worms from the neighbouring state of Kerala and began making their own compost. They lent money to women from a neighbouring slum so that they could build another revenue-generating latrine block. And they employed a night watchman to stop drunks from clambering over the wall.

Last month, the women's endeavours earned them a mention in Indian newspapers when Kalmandhai became the country's first "100% sanitised slum". The locals had stopped defecating in the open, for India nothing short of a miracle. Other habits changed too. "In the past it was the job of lower castes to collect the night soil. But the ladies who run this latrine come from lots of different castes. Everybody does it," Mrs Ilangium, a formidable matriarch in a canary yellow sari, explains, sitting next to the toilet's entrance where the daily tallies of customers are written in a ledger.

Even with unlimited resources, the problems of sanitation in India are not going to be solved quickly. It would take a generation. But WaterAid, which has been working in India since the late 80s, is good at establishing virtuous models, run by local communities, where there is the added incentive of making a bit of money. The results from Kalmandhai, meanwhile, have been dramatic. During the past two years the number of cases of diarrhoea among children has fallen from 73% to 10%. Among adults, the figure has gone down from 20% to 10%. Families who used to spend one-third of their £30 monthly income on medicines suddenly found that they were better off.

"I used to go to the toilet in the ditches," Martin, a 12-year-old boy from the slum, explains. "Now I use the children's latrine. I like the animals painted on the wall. I have only ever seen a lion in the circus."

But the enormity of the problem facing India - a vast country in the grip of rapid and chaotic urbanisation - is hard to exaggerate. A few miles away on the banks of the sluggish Cauvery River, the inhabitants of Kosameda slum have no access to proper sanitation. Instead, they defecate on the river's rubbish-strewn upper terraces. A few feet away, down in the bathing ghat, women wash their clothes in the same water. In the far distance, beyond the shimmering dragonflies, local youths splash in the river against a serene backdrop of palm trees. The setting is idyllic - but the reality is squalid.

"There are scarcely any fish left in the river now because of the pollution," one woman, Vasantha, complains. "We did catch two crocodiles two weeks ago, though. We gave them to the police."

And the problems in India go beyond the mere provision of proper sanitation. The issue of water has become intensely political in a country of a billion-plus people. A historic dispute between the state of Tamil Nadu, where Tiruchirapalli is situated, and neighbouring Karnataka erupted bitterly a few months ago. Tamil Nadu's chief minister Jayalalithaa, accused her opposite number, S M Krishna, of deliberately withholding water from the Cauvery River, which flows through both states. Krishna refused her request for more water, and said his farmers needed it. The row has provoked numerous demonstrations in both regions, a ban by Tamil cable television operators of all channels from Karnataka, and a nine-hour hunger strike by a Tamil film star, Rajnikath. One Karnataka farmer even committed suicide. India's central government has grudgingly tried to broker peace between both sides.

Very little water, meanwhile, is reaching Tamil Nadu. The Cauvery at Tiruchirapalli is little more than a looping trickle between gleaming mountainous sand banks. This water war follows several disastrous monsoons in India - the probable result, campaigners argue, of global warming.

Either way, the worsening drought in India makes life even more difficult for the country's poor, some 170 million of whom don't have access to safe water. WaterAid now hopes to extend its operations from the southern states of Tamil Nadu, Andhra Pradesh, Maharashtra, Orissa and Karnataka to northern India, where the problems are - if anything - even more acute. It works with more than 70 partner organisations, including, in Tiruchirapalli, the impressive Indian charity Gramalaya, which operates in 25 urban slums.

Back in Bells Colony, the slum-dwellers are waiting for change. The pigs are still king. "We are trying to improve our slum scenario," Mrs Valli says. "We just hope someone will help us."