The article examines the challenges of sanitation, menstrual hygiene and unequal access to clean toilets in India. Through personal accounts, community initiatives and policy developments, it highlights caste-based discrimination, poor sanitation infrastructure, menstrual stigma and the need for dignity, gender equality and sustainable sanitation systems.
Modern civilisation has turned unproblematic natural phenomena into insurmountable problems. Changed habitats render disposal of human excreta, for instance, into a tough management issue. In “less evolved” cultures, with ample commons, nature’s call was answered within nature, contributing to compost and soil fertility. Today, such simple circularity has disappeared, replaced by elaborate, expensive systems that carry away human waste to be dealt with elsewhere. Shame and silence around bodily phenomena further complicate the situation. As for menstruation, stigma and misconceptions lead to chronic neglect and untold hardships.
Essential Facilities, in Changing Times
Kamli Devi (51), Sarpanch in Chhindwara district, MP, observes, “Earlier, girls and women would walk out early morning to secluded spots, carrying water. It was our routine. Men went later, to other spots. There was an understanding. But gradually space reduced, especially after the road got built. There was construction, garbage, and also peeping Toms. We no longer felt safe. That’s why, construction of toilets has been high on my agenda as Sarpanch.” Gyanvati (65), of Sabla Sangh, Jahangirpuri, Delhi, recalls, “When we came here, it was wilderness. Women went before dawn to the fields. If you had to go in the day, you had to walk very far— or just control. It was very difficult. We built one room, no toilet. Community latrines were made. They were filthy—no water, maintenance, doors broken. A few hundred people use each latrine block. Girls, women, never went alone, one stood guard while the other was inside. Many residents preferred open defecation. Some constructed toilets at home, but waste matter flowed into open drains. Government brought us here (in 1976), but didn’t provide sewerage. And no workers came to clean the latrines, or drains.
In the early 1980s, Gyanvati co-founded Sabla Sangh, a community-based women’s group. With support from democratic-minded feminists like Sharda behn and Gouri Choudhury, Sabla Sangh members took action for community health. They demanded accountability from the municipality, ensured that staff employed for cleaning actually came, and worked. Cleanliness improved, but latrines remained ill-maintained and dirty, cleaning once or twice a day being insufficient. Sabla Sangh administered neem tablets for deworming, taught people to boil water, treated diarrhoea.
“After many years, new toilets were built—Sulabh Shauchalayas. They were kept clean by full-time workers, and better maintained. Much later, sewage lines were laid. Thereafter, most people made home latrines. Government demolished most of the Sulabh Shauchalayas.” Kamli and Gyanvati’s accounts indicate acute failure of governance. Provision of essential facilities is not charity or munificence. On a research trip in rural Bihar, when I asked to use the toilet in a government school, the teacher took me to a dirty door, unlocked it to reveal a dingy cubicle, reeking of scum, fungus, vermin. She said, “Actually, girls pee just outside this toilet…. Teachers go home.” I had no choice but to copy-cat the schoolgirls’ practice. I felt awful, but for girls who study there, this is daily, gross violation. And, what when they have periods? The answer was pat: “We send the girls home!”
Unequal Access, Negligence and Indignity
Why has the matter of clean toilets been so sorely, inexcusably neglected? Part of the answer lies in deep-seated social inequality. Caste, class, gender, disability, all manifest in unequal access. Ironically those who clean elite toilets cannot use them, as Dalit scholar Suraj Yengde has movingly described—as a child he accompanied his grandmother one day to the house where she worked; needing to pee, he used the facilities, was discovered, and his grandmother punished.
Dry latrines with manual removal of ‘night-soil’ was common until quite recently. On visits to
relatives in Agra, the toilet, in a corner of the courtyard, was clean, mug and water-bucket
conveniently positioned, soap and running water just outside. Beneath the squatting-toilet
hole was a removable pan. A community sweeper cleaned the poop pan once a day, from outside through an opening in the latrine wall, emptied it into a metal pail, and moved on to the next house. He emptied the poop pail into a huge covered metal container. The entire matter was taken by bullock-cart to fields next to the settlement, to be composted. This system changed perhaps twenty-five years ago. Two soakpits were dug behind each house, one used when the other was full. This is in-situ treatment of human waste — eco-friendly, responsible and sustainable.
The Sulabh International Museum of Toilets, Delhi, not only exhibits chamber pots used by kings, and other historical items, but also explains how current large-scale sewerage systems are unscientific, and explains alternatives. Thousands of miles of sewage lines carry millions of tons of faecal matter, only a fraction of which goes into any treatment plant. Human beings clean and clear sewers and septic tanks. Leaking pipelines contaminate drinking water, routinely in many low-income settlements. Even residents of Delhi’s upscale Gulmohar Park fell sick this summer when sewage mixed into drinking water. In Bhagirathpura, Indore, hundreds of people recently fell ill due to contaminated drinking water, and some 35 died.
Sulabh Museum demonstrates a more scientific, humane system. The campus has a public toilet complex, which some 1,000 residents of adjacent settlements use. Waste matter is converted into odourless biogas, used for cooking on-campus; it can also light bulbs. Grey water irrigates the vegetable garden, and flowers beds. Bindeshwar Pathak, inspired by Gandhian constructive action, created the first twinpit, pour-flush, compost toilets in 1969, and worked lifelong to spread these eco-friendly Sulabh toilets. Part of his motivation was– freeing manual scavengers. Didi Contractor, eco-friendly architect, designed homes in Kangra, Himachal Pradesh, where human waste flows into gardens, which flourish; with no mess anywhere.
At a public hearing organised by Safai Karamchari Andolan (SKA) in 2026, women sanitation workers from U.P., M.P., Bihar, Jammu & Kashmir shared testimonies about cleaning human excreta by hand, reiterating caste-based exploitation. Parliamentary figures acknowledge over 500 sanitation workers died due to toxic work conditions during 2019-26. Bezwada Wilson, SKA, notes, “Manual scavenging has reduced, but deaths from sewage work and septic-tank
cleaning continue, and are on the rise.”
Menstruation: Breaking the Silence
For women, lack of safe, clean toilets is complicated by the fact of menstruation. Gyanvati recalls: “Menstruation was handled anyhow. Women contracted infections, but were too ashamed to tell anyone.” Caught within a web of silence and stigma, misconceptions persisted, and infections were frequently left untreated.
Menstrual blood has been vilified as impure and polluting. In a street play written and performed by Sabla Sangh, a young woman, Rukma, is blamed by family members and religious leaders for the death of her sister-in-law’s child: “A menstruating woman killed the child, by touching it!” Her sisterin-law, however, disagrees: “My child died of illness. We women are the ones who give birth! Without menstruation, there would be no birth, none of these people would exist!” Such plays help break silence, open conversations that can be empowering. Elite institutions too need those conversations. During college in Delhi University, we women students drew up a list of demands, including sanitary towels to be stocked in the women’s common room. The college had a hostel only for men. If a woman suddenly had her periods, she had to somehow manage. The principal, phenomenally ignorant, insolently asked
Priya: “Are these items kept where your father teaches?” She replied firmly, “We had sanitary towels kept in my school!” Others corroborated, their schools had stocked STs. The principal learnt a lesson, and sanctioned the required funds. In a low-income area within Warangal, Telangana, a toilet complex was built under Swachh Bharat Abhiyan (in 2017). It had a male caretaker, was unclean, and had no provision for STs. Women refused to use it, and continued with open defecation. After the municipal corporation redesigned the toilets based on women’s suggestions, providing female caretaker, provision for STs, squatting as well as raised seats, women began using it. An audit of municipal public toilets in 2017, by Action Aid, found some men sitting inside women’s toilets, consuming drugs, at prominent spots like Ram Lila Grounds, Delhi. Toilets had semi-transparent doors, absence of latches, non-functioning flushes and lights.
In Mumbai, the municipal corporation outsources ownership and maintenance of public toilets. At a chawl in Mankhurd, Kavita Khomane (42) operates a complex of toilets, 4 for women, 4 for men, 2 for people with disabilities. She has installed an ST pad vending and disposal machine, funded by a private company. The small user fee Khomane charges gets entirely spent on
cleaning, maintenance, water and electricity.
The facility is well-run, due to her sheer commitment. But it is a public good, and the
municipal corporation ought to undertake running costs, or pay her a salary. She wants local corporators to take up the issues of public toilets.
From “Unmentionable” — To Fundamental Right
Kerala’s She Pad program (2017 onwards) requires ST vending and disposal machines
in every school. A study in 2022 recorded the remarkable impact: attendance rate among
Class 7 girls increased by 23%, and dropout rate fell by 24%.
In 2022, Dr Jaya Thakur filed a writ petition in the Supreme Court, seeking free STs for all girl students of Classes 6 to 12, separate toilets, maintenance and awareness programmes. The Court, in a landmark judgment (January 2026) held menstrual hygiene integral to the right to life, and right to education. It noted that menstrual health is tied to dignity, bodily autonomy and equality, and directed all States/UTs to ensure gender-segregated toilets, free sanitary pads, and usable water in all schools.
Nine months after this landmark judgment, implementation remains patchy. Only Chandigarh has reported all its schools provide free STs. Seven States/UTs report compliance in over half their schools. Figures are low for UP, MP, for Andhra Pradesh as low as 5%, for Bihar just 2.6%. The Court has noted that compliance is meaningless if toilets are unusable or water unavailable, and directed District Education Officers to send teams of teachers to carry out surprise checks, covering every school.
It is a long, rocky road ahead. But at least we now speak of these issues, which had earlier
been “unmentionables,” and acknowledge their importance. This arouses hope, we may truly move towards universal health and hygiene, with dignity and social justice.
About the Author:
Dr Deepti Priya Mehrotra is a political scientist, teacher, and consultant with specialization in gender, education and social issues. She writes in English and Hindi, has authored several books including acclaimed biographies of Irom Sharmila, Gulab Bai, stories of single mothers, and a history of street theatre in India.
Clear Cut Child Protection, Gender Desk
New Delhi, UPDATED: November 04, 2026 16:50 IST
Written By: Dr. Deepti Priya Mehrotra
Designation: Deputy General Manager– MLE at Devinsights
