Community and public toilets (CT/PTs) play an essential role in enabling access to sanitation. The Swachh Bharat Mission’s focus on eliminating open defecation led to mass construction of toilets including CT/PTs, however, there have been challenges in ensuring the sustainability of operations and maintenance of the CT/PTs.

The Tamil Nadu Urban Sanitation Support Programme (TNUSSP) has been supporting the Government of Tamil Nadu (GoTN) in achieving total sanitation in the state, and are demonstrating innovations intwo model urban locations – Tiruchirappali Corporation, and Periyanaicken-palayam (PNP) andNarasimhanaicken-palayam (NNP) town panchayats. The Bill and Melinda Gates Foundation (BMGF) is supporting the GoTN through TNUSSP.

This report documents the experiences of the 11 health camps organised over the last three years in Coimbatore district and proposes a way forward to institutionalising regular health camps that specifically address the needs and risks faced by sanitation workers.

The Indian Institute for Human Settlements (IIHS) and its partners along with the Trichy City Corporation (TCC) have collaborated to improve the health, occupational safety and livelihoods of sanitation workers.

TNUSSP has identified and engaged with different types of sanitation workers employed in urban areassuch as Urban Local Body (ULB)-managed workers, school toilet cleaners, public and community toilet cleaners, independent cleaners as daily wage workers, desludging truck operators and cleaners, privately managed solid waste workers, rag-pickers, and railway cleaners.

The initiatives undertaken integrate multiple social, engineering, and behavioural aspects that focus on improving the living and working conditions of this vulnerable section of society. This note provides anoverview of the initiatives.

Sanitation workers are the backbone of the public hygiene and waste management system. Despite providing an essential public service, their work is often unrecognised. A majority of the workers too are unaware of the social security and welfare schemes instituted by both the Central and State governments for their wellbeing, which prevents them from availing the benefits such as pension, differently-abled and education and women welfare assistance, among others. This document furnishes the details of the social security and welfare schemes implemented by the Central and State governments, the eligibility criteria and benefits, and how sanitation workers can access them.

Safe collection, handling and transport of fecal sludge is an integral part of septage management. Limited attention has been paid to the safe collection, transport, disposal and treatment of human excreta from septic tanks. A needs assessment study was conducted in one city in India with an aim to understand: current desludging practices, the underlying reasons for current occupational practices and hazards, relevance and sufficiency of personal protection equipment and to make recommendations for improvement of occupational safety standards. This report presents the findings of the study along with recommendations.

A State-level Stakeholders’ Consultation was organised in November 2015 in Chennai to discuss the need for improvements along the urban sanitation value chain in Tamil Nadu. Representatives from the Municipal Administration and Water Supply (MAWS) department, delegates from the Bill and Melinda Gates Foundation (BMGF) and the staff members from Indian Institute for Human Settlements (IIHS), and consortium partners such as Gramalaya, Keystone Foundation and CDD Society participated in the workshop. The workshop discussed ideas to achieve the overall objective of the Tamil Nadu Sanitation Mission and the possibility of demonstrating innovations in two urban locations. As a result of this consultation, the Tamil Nadu Urban Sanitation Support Programme (TNUSSP) was launched to implement Fecal Sludge Management (FSM) initiatives in two urban locations and use the learnings from these two locations to scale-up and implement FSM in urban areas across the State.

While the role of gender in differential access to sanitation facilities is largely understood and accepted, very few studies have applied a gendered lens through the full cycle of sanitation. This assessment was undertaken to gain insight on the range of gender and social inclusion issues across the full cycle of sanitation in two locations in Tamil Nadu and see how gender perspective could influence programme and policy. The findings from this assessment are presented in this report along with possible strategies for gender and social inclusion at various levels.

To demonstrate an effective and efficient septage management operation, which can be scaled up across the state, a cluster of urban locations comprising of Karunguzhi Town Panchayat (TP) and the adjacent Madhuranthagam Municipality were identified to pilot a septage management project in Tamil Nadu. As a result, a Fecal Sludge Treatment Plant (FSTP) with a capacity to treat 23 KLD of septage, at an estimated cost of Rs 4.93 crore, was set up in Karunguzhi TP.