Swachh Bharat Abhiyan: Will It Help Reduce the Incidence of Communicable Diseases?

On Gandhi Jayanti this year, Prime Minister Narendra Modi launched the Swachh Bharat Abhiyan, a somewhat ambitious, but laudable programme of cleaning India by the 150^th anniversary of Gandhiji’s birth in 2019.  This programme has a backing of the President and several celebrities and figures of national importance from various fields.

This is a welcome move in a country where people wouldn’t think twice about throwing the garbage outside their home window.  ‘As long as my house is clean, it does not matter how the roads or the neighbourhood looks’, seems to be the over-riding thought pattern that has taken root in our psyche since ages.  Breaking this familiar pattern is not only going to take time, but also a lot of effort from all the signatories to the campaign.

One measure of cleanliness that is usually overlooked is the prevalence of communicable diseases. There are quite a few infections that are directly linked to lack of cleanliness.  A few of these which are seen in India are:

Those that spread due to food and water contamination

• Diarrhoeal diseases: gastroenteritis, dysentery, rota virus, cholera, hepatitis A and E
• Typhoid and rat bite fever

Those that are spread by insects

• Dengue
• Chikungunya
• Malaria

Dengue, for the record, is caused by a virus.  It is a vector-borne disease; that is, the virus causing the illness is spread through mosquito bites.  Aedes aegypti species of mosquitoes is the culprit here.  This species of mosquito can be easily recognised thanks to the white spots all over its body and legs.

It is also more active during mornings and late afternoons.  It is more in numbers in hot climate or around the monsoon period due to the abundance of standing water, puddles and cesspools.  The larval stage of the mosquito develops under the surface of the water.

Hence it is recommended that larvicidal techniques are better when the mosquito is still under water, rather than when it is terrestrial or air-borne.  This means that sanitizing water-logged areas and keeping the land dry is very important.  It is worthwhile remembering that there is neither an antibiotic which can cure dengue, nor any vaccine which can stop it from spreading.  This again translates to ‘prevention is better than cure’.

In November 2014, the Mumbai Municipal Corporation reported a decline in the number of diagnosed dengue cases.  Was this due to the effect of Swachh Bharat Abhiyaan which was launched in October 2014?  It is too early to say.  The Abhiyan needs at least a year or two before any reduction in the incidence of communicable diseases could be attributed to it.

It was heartening to note that during the Swachh Bharat Saptah (from September 25 to October 2, 2014), the Abhiyan’s manifesto recommended the following activities, among others:

• Involving NGOs and general public through vigorous campaign in print and electronic media
• Repair, maintenance, cleaning and sanitization of public/community toilets
• River/talab side waste cleaning
• Cleaning of toilets in Government buildings/hospitals/schools
• Removal of debris and garbage from public places

This, one hopes, is not confined to the Saptah, and will be an ongoing effort by the State, NGOs and the community.

Community participation is very important for the success of the programme.  The lack of this is evident when we see instances of public spitting and urination.  Roadside stalls regularly sell contaminated food and dirty the pavements on which they are set up.  Manual scavenging without the use of any safety material is still rampant in parts of the country.  All this has to change.

No amount of rule-setting is going to help if the change does not come from within us.  More than anything, the cultivation of an inner feeling of discipline, civic sense and cleanliness is vitally important if the Abhiyan is to be truly successful, and for the communicable diseases to be prevented.