The quantum of importance of sanitation in human life can be easily deduced from the commitment by the World Community to halve by 2015 the proportion of people without safe sanitation in September 2002 at the World Summit on Sustainable development in Johannesburg. Hygienic behaviour in humans reflects the dignity of society as a whole, status and well-being of every individual irrespective of the place they dwell in (rural area, small towns and metropolitan cities) and their economic strata. The Government of India back in 2014 formulated indicators for monitoring the cleanliness under the Mahatma Gandhi Swachchhata Mission and named it as Sanitation Index.

Despite this on-going project which did bring positive changes in the sanitation and hygiene behaviour of citizens as it reduced open defecation by 40%1, yet India ranks low on the international fronts concerning sanitation and “is placed at the sixth position among the top 10 nations working to reduce open defecation”2.

The global pandemic caused by the corona virus has compelled the human race to vocalize the sanitation issue profoundly at least in the countries worst hit by the virus. Since India stands at the 12th place in the list of countries worsened by this outbreak, it becomes very crucial to address the sanitation issue properly and take measures to improve it. It is also important because as of now there are no vaccines available to control its spread and sanitation and physical distancing are the only solutions in hand.


The UNICEF’s report on sanitation in health care facilities precisely declaimed against the low level of sanitation this sector in which the following observations were made3:

  • 18 Countries and 1 SDG region had adequate data to figure out reporting of basic sanitation services in health care facilities. Fortunately, India falls into this category.
  • 9% of the hospitals and 20% of the other health care facilities had no sanitation services.
  • 16% of the government health care facilities and 36% of the non-government facilities had no sanitation services.

The observations make it very clear that the desired level of sanitation is far away. Intrinsically, the countries which account with the miserable degree of sanitation are densely populated putting the life of billions of people at stake.

In the past 20 days the rate of COVID infected patients has risen three fold. Considering the size of population, the outbreak is harder to contain, yet a significant step of nationwide lockdown is appreciable. The other side of the lockdown which is resulting in economic slowdown, unemployment, migration of the labour eventually with nothing to eat and so on cannot be ignored.

Source: Rural Health Statistics, 2018.

Fig. 1. Percentage of sub-centres, PHCs and CHCs without staff toilets. 

The fact that even after five years of Swachchha Bharat Mission, 38% of the government health centres do not staff toilets and nearly 61% of the government health centres do not have separate toilets for women speak tonnes abouts the sanitation facility in India.


Apparently, most of the private health care centres provide better sanitation facilities beside charging a huge sum of money whereas the government health care centres lack in providing these facilities. One of the major challenges which the Indian health care centre faces is poor organisational infrastructure giving pathetic laxation substructure. This inadequacy is also visible in insufficient ward rooms in hospital to accommodate the patients. The graphs relate to the sanitation services in India post COVID when it was merely marked as a target to achieve but during this pandemic sanitation is the only resort to curb the spread.


Experience has shown that sustained improvements in access to sanitation and sustained changes in hygienic behaviour requires an appropriate enabling environment in policy, organisations, finance, management and accountability.4  The following are the enumerated policies suggested to the government to adopt and implement and also the corrective measures to be taken by the non-government bodies which will effectively contribute to check the transmission of this virus.

  1. National Government
  • With everything going digital, it is advisable that the patients are facilitated to consult with their medical practitioners so that in nonfatal cases they won’t have to leave their homes.
  • During the recent times of this pandemic, migration of the labour class who majorly lack immunity and will be easily prone to the virus, attracts immediate attention. Government can turn the public schools and other such buildings where man movement has been apparently prohibited into relief camps.
  • The organisations willing to join or initiate any sanitation programme should be allowed to do so.
  • Government can allocate special funds to hygiene promotion and sanitation so that new technological equipment such as robot sanitizers can be installed in health care centres at the minimum.
  • The products such as soaps and hand sanitizers should be made available to every individual at lower rates similar to the supply of various other essentials.
  1. District/Local Government
  • Due to the nationwide lockdown, the economy is facing a sharp sudden downfall therefore, it is of the essence that each penny so allocated for the said purpose will be utilised appropriately. The Local Government is entitled to take this charge and implement the policies which have been framed till now.
  • The local government needs to ensure that there is at least one toilet dedicated for staff, one sex-separated toilet to maintain menstrual hygiene and at least one toilet for people with limited mobility in one health care centre.
  • The proper disposal of human waste of affected and suspects of the COVID is of due consideration.
  • Radical redevelopment of institutional structure is indeed required to accommodate the increasing number of infected patients maintaining the physical distance as well.
Source: Rural Health Statistics, 2018.

Fig. 2. Percentage of government health centres without separate toilets for women.

In light of the abovementioned suggestions, the judgement made by the Hon’ble Supreme Court of India can be relied upon if authorities lack in providing any of the required services. In Municipal Council, Ratlam v. Vardhichand5, it was ruled that a responsible municipal council constituted for the precise purpose of preserving public health and providing better finances cannot run away from its principal duty by pleading financial inability.

Therefore, even financial incapacity cannot be taken as a plea by any authority if they fail to fulfil their duty.

  1. International Agencies
  • Deduct the rate of interest on debt accrued to international bodies of worst hit countries.

Sanitation can only ensure that patients and other medical staff do not fall sick again with other diseases owing to lack of hygiene in health care centres. Also the separate toilets for medical staff will help them to be more focused on their work which otherwise would be hampered by physical inconvenience of waiting for their turn to respond to nature’s call.


The outbreak of COVID 19 pandemic is an unprecedented incident; it requires extraordinary efforts, solution and massive support of the public at large to recover from the exigency. Sanitation services have never been satisfactory in India, but the increase in the number of corona infected patients at an alarming rate does call for the society to come together and fight against it by merely keeping up hygienic behaviour and sanitation around themselves. It is a wake up call for the government to make some stringent efforts in this regard as the lockdown cannot be extended for years. Life has to be brought to normalcy defeating the coronavirus pandemic. A strong will is required to fight against it and India being a country which could eradicate the polio virus will survive this pandemic too.


1.’’ (accessed on 14th May 2020)

  1.’(accessed on 14th May 2020)
  2. ‘’ (accessed on 14th May 2020)
  3. ‘’ (accessed on 13th May 2020)
  4. AIR 1980 SC 622.
Written by-

Shivani Pandey


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