This thesis assesses sanitation realities experienced by peri-urban slum dwellers in Chennai, India, to investigate whether rapid economic growth translates into pervasive safe sanitation, otherwise a threat to human security. This is in line with the Sustainable Development Goals of ‘leaving no one behind’. The empirical methodology consists of qualitative comparative case studies approached through rapid appraisal. At least 5 interviews at each of the 10 different slum settlement locations within the Chennai Metropolitan area were conducted. Both the locations and the settlers were conveniently sampled. The settlements were chosen as they mostly lay in a rapidly urbanizing area. The selection of interviewee was determined by availability, yet leaning towards women who are more vulnerable when lacking safe sanitation facilities, and who are the primary caregivers in the household. The research found that out of the 10 settlements visited, 5 habitually practiced open defecation, as no sanitation facilities were available. Hence some settlers were restricted in their freedom to be safe from emotional or physical harm: threatened by dangerous pathogens released into the environment, and insecurities due to lack of privacy. Conceptually the thesis applies an understanding of how affecting influences in individual history and living environment impact upon an individual’s conscious mind, connecting the capability approach to consciousness research. The thesis argues how settlers, overlooked by public services, and subjected to the dangerous and humiliating practice of open defecation, are faced with mental health issues and a diminished likelihood to productively engage, and exercise agency for human growth.