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Radha, 13, is the oldest of four siblings. She lives in a “non-notified” slum (one unrecognized by municipal authorities) in Wadala East, north of Mumbai, with no basic water and sanitation services—and no land security either. The government could claim the area at any time, and so Radha, her family, and others who live in the community are not motivated to invest their scarce resources in their homes or in any sort of public infrastructure.

Critically, Radha, like 63 million other adolescent Indian girls, does not have access to a private toilet.1 In fact, she does not even have reliable access to a community toilet. There is only one “restroom” within walking distance of her house, located in a neighboring slum, across a busy road. The facility is always dirty, used sanitary napkins rot in the stalls, there is no electricity or water connection, and of the 16 seats that were originally built for women only 3 still function.2

Faced with such untenable options, Radha, like most residents in her community, uses the vacant land adjoining the slum for her toileting needs, despite acknowledging that there are many real disadvantages to open defecation. In Indian cities, it is so common to see someone squatting beside the road to relieve himself that most people living there wouldn’t even look twice. For the majority of middle- and upper-class Indians, the country’s poor sanitation infrastructure is a blind spot, even though more than half of India’s population lacks access to a toilet.3 Studies have found that 67 percent of rural households and 13 percent of urban households defecate in the open.4

The poor state of sanitation in India has a negative impact on the economy and on development indicators in sectors such as health, education, and gender equality. Ultimately, however, it is girls like Radha who are disproportionately affected. In urban slums and rural villages, when girls relieve themselves outside, or when they try to make their way to a public facility, they face intense embarrassment, catcalls, fear of peeping toms, the danger of being attacked by stray animals, sexual harassment, and even the risk of rape.5

To limit this harrowing experience as much as possible, girls often restrict consumption of food and water during the day. They tend to hold their bladders for an average of 13 hours, raising the likelihood of urinary infections, constipation, and mental stress.6 Is it any wonder that these practices are often cited as having a cumulative negative impact on girls’ productivity and earning potential?

India's government has committed to building 120 million toilets across the country by 2019. (Photo courtesy of Splash) 

Unfortunately, young women also have the least ability within a household to allocate resources to improve sanitation. 7 This finding is echoed by sanitation practitioners in India, who find that adolescent girls desire access to better sanitation, and when they are empowered to advocate for themselves, they can be the biggest motivators for their families to seek change. Research conducted by Dasra for Bank of America has shown the great potential of programs that focus on empowering this sizable, yet often overlooked group.

Involving girls in the design and creation of sanitation infrastructure in schools (as nonprofit Water for People India does, for example) has increased the success of sanitation programs there, and it has also improved attendance rates. Breaking the culture of silence around girls’ bodies by educating their families—especially men—to understand the sanitation needs of their young daughters as they reach puberty (as the nonprofit Vatsalya has done) has also demonstrated success in improving sanitation habits for entire families. It is important to prioritize individual toilets over community toilets, as they offer young girls greater privacy and convenience. “One Home One Toilet,” an initiative of the nonprofit Shelter Associates, has shown that individual toilets can be a practical solution for India’s sanitation crisis, even in congested urban slums.

India’s government has committed to building about 120 million toilets across the country by 2019, and that action has created a renewed interest in sanitation innovation countrywide.8 Private sector support, through corporate social responsibility initiatives, has brought increased rigor to the initiative, as well as a clear focus on results. Leading corporations in India, such as Bank of America, Reckitt Benckiser, and Tata Consultancy Services, have committed financial and professional resources to improving sanitation in India.

These activities hold immense potential. But there is much more to do. One way to accelerate the benefits of India’s focus on sanitation is to support programs designed with the needs and preferences of key demographic groups—such as adolescent girls—in mind. Such a focus is more likely to generate interest and support than a broad call to action.