"Those in power, only they can change the situation," says Pathak, who claims to have helped build a million low-cost latrines across India over the past 40 years. "India can achieve this -if it desires."
In the slums of Mumbai, home to more than half the city's population of 14 million, the yearning for toilets is so great that enterprising residents have built makeshift outhouses on their own.
In Annabhau Sathe Nagar, a raised latrine of corrugated tin empties into a river of sewage that children splash in and adults wade across. The slum in east Mumbai has about 50,000 residents and a single toilet building, with 10 pay toilets for men and eight for women -two of which are broken.
With the wait for those toilets up to an hour even at 5 a.m., and the two-rupee (4-cent) fee too expensive for many, most people either use a field or wait to use the toilets at work, says Santosh Thorat, 32, a community organizer. Nearly 60 percent have developed piles from regularly waiting to defecate, he says.
Conditions are far worse in Rafiq Nagar, a crowded, 15-year-old slum on the lip of a 110-acre garbage dump.
Image: In this Oct. 23, 2010 photo, a migrant laborer, makes a phone call outside his makeshift home at a slum in Mumbai, India.