Ending poverty with food and sanitation

Nutritious mid-day meals keep children healthy and toilets keep girls in school. However, when schools run out of water, health and hygiene are the biggest casualties.

Schools in Madhya Pradesh’s predominantly tribal districts of Dhar and Jhabua — which are home to Bhil, Bhilala and Patlia tribes — have toilets, but most remain unused because they lack water supply, often not even to drink.

The handpump at Gopalpura Middle School in Jhabua’s Rama block ran dry in November. “It works only for three to four months during the monsoons,” principal, Mav Singh Solanki said.

The municipal tanker fills the school tanks twice or thrice a week and when this water is used up, a waterman cycles two kilometres to get water from a handpump, all of which is used for drinking and cooking for 229 students and 10 staff members.

There is no water to spare for the toilet water tanks. “There’s no water and now the villagers have stolen the doors. The children have no choice but to use the fields around the school as toilets,” said Solanki, his hand sweeping the rocky, barren landscape around the school compound.

In Jhabua district’s Thandla block, one working handpump is the source of drinking water for Chainpura Middle School’s 376 students and Chainpura High School’s 228 students, but the toilets remain dry. “There’s no water to clean them. This handpump will also stop working in another month. When needed, the girls leave school to use toilets at the Kasturba Girls Hostel, which is one km away,” said Ratan Singh Damod, principal, Chainpura Middle School.

Local Solutions

In sharp contrast, the Ganganagar Girls Hostel in the neighbouring Dhar district’s Tirla block has taps that don’t run dry, toilets that work and beds with clean bedsheets and mosquito nets.

Even though the days start at 4 am for the 275 tribal girls, they prefer hostel to home. “We get fruits and four meals a day, a clean bed to sleep in and a football to play with even on our days off. At home, I’m cooking, herding goats and working in the fields all day. I don’t like going back,” said Sarita Goyal, 14, a class 8 student, who is part of a school group that goes to Dhar town to lean taekwondo. Unlike the school toilet, the one at her home in the predominantly tribal village of Premnagar is not used.

The woman who brought about the miracle is the school warden, Ranjana Chauhan, who is a champion for hygiene. “When I joined, bedsheets would routinely get stolen to be used as sanitary pads and the toilets were unusable because they were chocked with discarded cloth used for menstruation,” said Chauhan.

Within days, her first two priorities became getting the toilets cleaned and starting water-harvesting projects to ensure there was water 24x7.

“The school handpump is dry so we got the old well cleaned and installed a merry-go-round (carousal) over it. When the children played, it worked the pump and pushed water to the overhead water tanks,” said Chauhan.

The school also has a ‘hygiene club’ that inspects the rooms, beds, clothes and personal hygiene each week and hands before meals. “Now students wash their hands before and after meals and after using the toilet, without being told. We almost never have complaints of diarrhoea and skin infections, which were common some years ago,” said Chauhan, adding, “I’m still struggling to get them to wear slippers all the time, though, but that will come.”

Generational Effect

Almost all students Ganganagar Girls Hostel are still stunted and look younger than their 14 years, but the nutritious meals and the iron and folic acid tablets they get have made them far healthier than their peers out of school.

“Apart from strengthening mother- and newborn-health services, including institutional care and promoting breastfeeding, keeping the mother healthy, preventing early marriage and reducing malnutrition in adolescent girls lowers underweight births and newborn deaths,” said Dr Dileep Mavlankar, director, Indian Institute of Public Health, Gandhinagar.

If the mother is undernourished, providing nutritional support to the baby after birth is doing too little too late.

Adolescent Health

Girls who stay in school are not just healthier but also more likely to delay marriage and pregnancy, which improves child health and survival.

Girls who got married before their 18th birthday in India declined from 47% in 2006 to 27% in 2016, but prevalence remained close to 40% in Bihar, West Bengal and Rajasthan, even as states with good indices reported pockets of disparity concentrated in disadvantaged tribal communities and scheduled castes.

“When a girl is forced to marry as a child, she faces immediate and lifelong consequences. Her odds of finishing school decrease while her odds of being abused by her husband and suffering complications during pregnancy increase. There are also huge societal consequences, and higher risk of intergenerational cycles of poverty,” said Javier Aguilar, chief of child protection, Unicef India.

Globally, there were 25 million fewer child marriages in the past decade, but efforts need to be intensified to meet the target of ending the practice by 2030, as set out in the Sustainable Development Goals, Unicef said earlier this week.

India is driving the change, registering the highest progress worldwide in preventing marriage before 18 for girls and 21 for men. A lot has to do with implementing the law that bans child marriage and keeping girls in school — NHFS data from 2005-06 and 2015-16 shows female literacy increasing from 55% to 68 % and women with 10 or more years of schooling going up from 22% to 36%, but even in the progressive states, there are major intra-state disparities.

“Progress has not been equal and inter-state and intra-state, but higher education, increased public awareness on the negative impact of child marriage and a change in social practices as a result of urbanisation and migration to urban centres is driving change in India,” said Aguilar.