For most of us, going to the toilet is as simple and natural as breathing. However, for many it is a daily nightmare. About 2.3 billion people in the world do not have access to clean, safe and reliable toilets. They have to walk for miles every day to reach a safe spot where they can relieve themselves in the open. Inadequate sanitation is estimated to cause 280,000 deaths worldwide, annually.

In India, about 732 million people do not have access to proper toilets. As much as 90% of the river water is contaminated by faeces. People drink water from the same rivers, bathe and wash their clothes and utensils there, and even cook food with the contaminated water. Pathogens and worms from the faeces spread life-threatening diseases like diarrhoea, cholera, typhoid, schistosomiasis and trachoma.

The risks associated with open defecation in India are not just restricted to diseases. Rapes occur when women and young girls are on their way to fields to defecate at night. Each day, they have to suffer humiliation while squatting near gutters or bushes. Most girls drop out of schools at an early age because of the lack of toilets.

India’s sanitation crisis has, however, started to improve drastically ever since the launch of Prime Minister Narendra Modi’s ‘Swachh Bharat Abhiyan’. The campaign vowed to combat the sanitation crisis within five years by setting a target of building 110 million toilets nationwide—the largest toilet-building programme in the history of mankind. More than 83 million household toilets have already been built in India, and the Indian government must be congratulated for this remarkable feat.

The campaign is similar to the one launched in Singapore post-independence, when open defecation was a common sight in the 1950s-60s. Even sophisticated urban areas had primitive toilet systems where human waste was collected manually in buckets and disposed directly into nearby waterways.

In rural areas, panchayati raj institutions can be used to promote sanitation practices-

Lee Kuan Yew, Singapore’s first prime minister, wanted to build a strong and prosperous country. He understood the power of sanitation, and knew that a sick nation could not be productive. Singapore did not have the time or resources to build an expensive curative health-care system. Yew, therefore, invested in toilet hygiene and clean water as a preventive health strategy, which was much cheaper and far more effective.

Through an aggressive approach, the Singapore River, which was polluted from heavy boat traffic, and untreated animal and human waste, was cleaned up within 10 years. By focussing on providing clean water and sanitation, Singapore created a healthy and productive workforce, ready for international business and commerce by the 2000s.

India can replicate Singapore’s success story. Apart from building more toilets, India needs to address the challenges that prevent it from achieving 100% open defecation free status. The major challenges of sanitation in India arise from puritan religious beliefs. Many people in India view toilets as impure and refrain from installing them within their household premises. Most defecate in the open as it is something they have grown accustomed to since their childhood.

No matter how many toilets the government builds, the country will never be able to become open defecation free until people start using them. So, how can this problem be overcome?

In order to make India 100% open defecation free, it is essential to launch a comprehensive behavioural change strategy similar to Singapore that focuses on changing the mindset of people and eradicating the open defecation habit.

Toilets need to be repositioned as a status symbol that is desired by all. School textbooks should include chapters on sanitation. Both children and adults should be shown films and TV programmes on the subject to help them understand the importance of defecating in toilets. Toilets need to be projected as a trend that people can follow, rather than forcing them as a prescription.

However, merely building new toilets is not going to change the game. India needs to move beyond that and take steps towards efficient faecal sludge management for a safer environment which does not pose any threat to the health of its people. Post construction of toilets, the government should establish a monitoring system that makes sure that the latrines are emptied regularly when they fill up and the waste is decomposed safely, and not into nearby rivers or oceans.

In rural areas, focus needs to be laid upon panchayati raj institutions, which can be used as a platform to promote sustainable sanitation practices and creation of public-supported frameworks of organic disposal and utilisation of human waste.

There is a lot that India can learn from the Singapore sanitation model. We see a need to draw inspirational strategies that can contribute towards the successful completion of Swachh Bharat Abhiyan. Platforms like World Toilet Summit, organized on World Toilet Day in Mumbai, will highlight the importance of faecal sludge management and behavioural change which will help in attracting investments in the sewerage networks that ensure safe transportation of faecal sludge to the treatment units.

After all, it is only through a holistic sanitation model that we can break the open-defecation-disease-expenditure-poverty cycle and make India a progressive and productive nation.

Jack Sim is the founder of World Toilet Organization.