A Riverful of Muck

Yamuna, flowing past Delhi, continues to be faecally transformed into a vast stream of flowing slime by the city. The existing clean up strategy has been disastrous; the river is more spent than ever today. Instead of harping on the endless tragedy, it is more important to put in place a strategy that works

by Sunita Narain and S V Suresh Babu

The Yamuna Action Plan (YAP), launched in April 1993 to tackle Yamuna’s pollution, has implemented schemes in 21 towns along the river in three states of Uttar Pradesh, Haryana and Delhi. Since its inception, a lot of money has been spent. Rs 732 crore was sanctioned in the three states in YAP-I plus the extended phase – May 2001 to February 2003. Another Rs 573 crores has been allocated for YAP-II. Till March 2004, YAP’s total expenditure stood at Rs 674 crore.

Not only that Delhi government has invested about Rs 900 crore to 1,200 crore on building sewage and waste treatment facilities. In all, the total expenditure would amount to Rs 1,100 crore to Rs 1,450 crore till date. Once the YAP-II money is spent, the government would have invested Rs 1,400 crore to Rs 1,900 crore just to clean up a tiny 22-km segment.

This expenditure has been on an action plan largely consisting of:

• Building sewage treatment plants to treat domestic sewage
• Building common effluent treatment plants to treat industrial waste
• Repairing city sewage systems and low cost toilets to connect the waste of slums and poor settlements to treatment plants
• Building electric crematoria

On paper this plan works. Unfortunately that is the only place where it works.

The government’s favourite strategy is to construct sewage treatment plants (STPs). The rush began in 1995. The plan was to build and make operational 14 STPs by 1997. By October 2000, Delhi’s then chief secretary reported to the Supreme Court that 9 STPs were functioning against the 16 to be constructed. This he disposed would help solve the problem, as the percentage of untreated sewage discharged into the river would decline from 63 per cent in 2000 to 5 per cent by March 2005.

Today Delhi’s 17 STPs have a treatment capacity of 2,330 million litres per day (mld). But the problem is nobody quite knows how much sewage the city generates. Central Pollution Control Board (CPCB) says that in 2003-2004, 3,853 mld, calculated based on the flow in the river, was discharged into the river form the 22 odd drains that traverse the city. Delhi Jal Board (DJB) on the other hand says 2,934 mld of waste generated (this is based on the water it supplies). There is no consensus on how much wastewater the city generates.

Further the problem is that the city’s existing sewer lines – about 5,600 km long, which include 130 km of trunk sewers – are either silted or settled. Government says that only 15 per cent of the trunk sewers are in order. In October 2000, the chief secretary informed the court that Rs 155 crores had been earmarked for the rehabilitation of the 22 trunk sewers. But the drains were never repaired; only the money was spent. By 2004, the government has accepted that only 30 km of rehabilitation work had been completed.

Moreover, over 40-50 per cent of Delhi’s people live in unauthorised colonies and slums, which are not connected to sewerage system. The government said it would complete sewerage of 490 regularised but unauthorised colonies by March 31, 2003 and the rest by March 31, 2004. However, by 2004, it had managed to complete the internal sewerage of 482 colonies; it aims to connect the rest by December 2005. The problem is even larger because vast numbers of people live in unregularised and unauthorised colonies, where the government has no plans to even introduce sewerage systems. Irrespective that the illegal sewage flows into the river, untreated, through the drains.

The plan also aims to remove poor people living along the river, so that the river can be cleaned up. In 2001, the state chief secretary told the court that out of the 600,000 slum dwellers in the city, roughly 60,000 lived along the river and that they contribute to the pollution. So over the past 10 years, every successive government has worked hard to remove slums of poor people. Nobody has ever asked what is the evidence that these poor people living on the banks of the polluted river are its villain and not its victims.

But even with 17 STPs, drains, pipes, low cost toilets for the illegal residents and thousands displaced in the name of river cleaning there is little impact. The simplest answer is that sewage treatment capacity has not kept in step with population and waste growth. The huge amounts of money invested in the STPs and rehabilitation of drains has gone down the drain as 13 out of the 17 STPs are under utilised; one of them does not receive any sewage. Whatever wastewater is treated at high costs is disposed by mixing with untreated waste, negating the effort, because while constructing the STPs no planning was done for the disposal of treated effluents.

Also, the STPs are built based on the availability of land and not sewage. So they are invariably built in areas where sewage needs to be transported long distances for treatment, adding the costs of transportation.

The fact is that the quantum of waste a city generates is in direct proportion to the water it consumes. CPCB says 80 per cent of the water supplied to a house leaves as waste. But the city planners do not know how much water the city uses. At present, the city’s water demand is about 3,600 mld, has a capacity to treat 2,880 mld of raw water and supplies 3,040 mld raw water. But the water supplied does not reach people. The DJB admits that only 1,730 mld water reaches its consumers. So, it can be assumed that people have to depend on groundwater for their supplies. But how much groundwater is extracted in Delhi is a mystery. Given the water-waste connection there is no way of knowing how much sewage the city generates.

The fact also is that nobody plans for sewage when they plan for water. For instance, the city government plans to supply 250 litres per capita daily (lpcd) to each citizen, creating a water treatment capacity of 3,510 mld, through the Sonia Vihar water treatment plant that will get water from Tehri dam. But there is no planning for the waste that this increased water supply will create.

The fact also is that Yamuna does not have water for virtually nine months of the year. The river ceases to exist at Wazirabad, where all the water is impounded for water needs of the city. This means there is no water available to dilute the waste and hence its assimilative capacity is on the decline.

This current pipe-drains-plant strategy, clearly, is not working. So we need to reinvent the strategy. It will require a shift in thinking so that all sewage generated, is trapped and treated; there is no distinction between legal and illegal sewage. That treated effluent is not allowed to mix with untreated. This will require the government to work on a plan to reuse the treated effluent of each plant. Whatever effluent reaches the river through the drains will have to be further treated before it falls in the river, so that the treated effluent is used to dilute the river water and not pollute it. But all this is possible only if we monitor treated waste and strictly enforce standards.

More than that the strategy has to be linked with the city’s water users, also the waste generators: who flush and forget only to drown in their own excreta and degrade their waterways. It will have to make a new beginning: build a society that learns about its waste so that it can minimise want. A water prudent society that worships the river in the true sense.

CSE/Down to Earth Feature Service
1,341 words

And the World Bank President is…

… Paul Wolfowitz. And you thought you couldn’t be surprised.
by Kevin Rafferty, former managing editor, World Bank

Paul Wolfowitz, deputy US defence secretary, will take over as president of the World Bank (WB) when James Wolfensohn steps down in mid-2005. The ultimate shareholders of the World Bank — the people of the world with their shares held by proxy by their respective governments — deserve better. Wolfowitz has been compared to Robert McNamara, who was a giant of a WB president after his controversial time as a warmongering US defence secretary. But McNamara had important pluses over Wolfowitz: he was full defence secretary, had experience as chief executive of Ford and lived in different times. Even so, he was controversial.

There are compelling reasons for rethinking the global financial edifice. For one, it was devised in the dying days of World War II, and most of today’s economic powers were not involved. More importantly, the gas-guzzling, spendthrift, heavily indebted US is not a good model for global development. Is Wolfowitz’s vision for democracy in Iraq — brought by US guns — a workable system for the world (or the WB)? Surely, the nominee for WB should not be a candidate pursuing George Bush’s lawfully elected agenda, but the leader of a development mission for the world.

The sad fact of life today is that while new multibillionaires are being created in hundreds (though in the US they are often built on flimsily mortgaged paper called the US dollar), several billions are in danger of falling off the edge without the resources to survive. At the same time, China’s tearaway economic growth since Deng Xiaoping opened its doors to the world has challenged conventional economic wisdom. India has also begun to show its potential and should demand a say in a crucial appointment for the world. A WB revamped under a leader of greater stature than Wolfowitz could have been the forum for better action on global development.

Whatever his many faults, Wolfensohn cared — cares — passionately about development and the plight of the poor. Still, after ten years in the job, Wolfensohn’s achievements have been modest. He began dialogues with critical non-governmental organisations and tried to make them partners in his development dream. Wolfensohn refocused the bank to look at its clients, the developing countries, strengthened the country offices and created career opportunities outside the Washington headquarters. In the last two years, not before time, he also spoke out against corruption as a major stumbling block against economic development.

Wolfensohn’s efforts to reform the management structure were more mixed and many of his best ideas were ruined by his volcanic temper and an appalling judgement of people, with some really poor senior appointments. And for all of Wolfensohn’s efforts, the battle against global poverty is far from being won. It needs a general who can understand the issues, preferably a general who knows where the battlefield is.

There are some critics of course who say that the Bank is irrelevant to real development. They cite the example of China. But let’s not forget that even China has benefited from the Bank’s advice and aid. For smaller countries with fewer resources, a WB package might be a vital catalyst to unlocking private capital inflows.

Given that so many major development issues are linked to trade and that stalemate in negotiations under the

World Trade Organization (WTO) is a problem for many developing countries, I am surprised that no one has tried to link the two bodies. This is good opportunity to do so and then let the developing countries choose the WTO head. Someone from Latin America might remind the US that it does not own all of America.

Clean blow

Reliance asked to guarantee Rs 300 crore for new plant
by Nidhi Jamwal

Mumbai based Reliance Energy Limited (REL) is in the soup following a March 19, 2005 order of the Dahanu Taluka Environment Protection Authority (DTEPA) of Dahanu, Maharashtra. REL has to furnish a bank guarantee of Rs 300 crore in favour of the Union ministry of environment and forests (MOEF) within a month to assure that it will establish a flue gas desulphurisation plant (FGD) in its Dahanu Thermal Power Station (DTPS), near Mumbai.

But evidence strongly suggests it has been conspiring to avoid setting up the FGD and the other the order is a big blow to it. DTEPA also said REL has disobeyed the Bombay High Court (HC) and the Supreme Court in delaying the FGD in Dahanu, designated eco-fragile area.

REL’s problem is compounded by the fact that DTPS’s permission to operate expires on April 30, 2005. DTEPA will review the permission on April 26, 2005 but is unlikely to agree to the company’s desire of a five-year extension.

REL informed DTEPA on February 12, 2005 that it had finalised negotiations with Ducon Technologies Inc. to set up the FGD. It refused to reveal further, saying it had "entered into Confidentiality Agreement with Ducon". But REL’s Letter of Intent (LOI) made it clear that the work on the FGD would be delayed.

To understand REL’s motives, on March 4, 2005, Dahanu Taluka Environment Welfare Association (DTEWA), a local non governmental organisation, spoke to two other bidders for the FGD’s installation: Monsanto DMCC Environmental Technical Engineering Limited and Alstom Power. On March 14, 2005, DTEWA told DTEPA that the bidders were unhappy with the bid process. It claimed that REL had told Alstom it wanted to delay the FGD. It also objected to giving Ducon the project, citing lack of experience in FGD technology.

DTEWA counsel Kerban Anklesaria wrote to DTEPA that "Alstom Director said that he had been categorically told by REL that they were being forced to set up a FGD plant, but did not want to set it up and were therefore working on getting an exemption…REL assured Alstom that because of certain legal pressures they wanted to issue a LOI and carry on with the bid process…REL was actually looking for a company that will help them delay the…FGD plant."

Anklesaria also wrote Monsanto’s reaction: "REL has no real intention of placing an order for FGD plant and in an unethical manner (it) obtained details from Monsanto".

DTEPA has also noticed contradictions in the project timetable submitted to it by REL and the one mentioned in the LOI. To settle the matter it invited Ducon to its March meeting. But Ducon’s general manager (operations) South East Asia, Kiran Patil, didn’t turn up, citing "important preoccupation". An angry DTEPA said in its order that REL was purposely delaying the FGD.

REL filed a review petition before the DTEPA, asking it to consider the order. THE DTEPA rejected it, saying it isn’t empowered to review its own order. The only option left for REL is to approach the HC. It may also reopen the debate over the FGD; the state pollution control board’s March 2004 report, prepared at the behest of MOEF’s Rajagopalan Committee, discounted its need. But the two deadlines will make it tough.

CSE/Down to Earth Feature Service
559 words

Dial Rx for telemedicine

Rural patients consult city doctors via satellite link
by Nidhi Jamwal and Deepa Kozhisseri

Living in remote villages or smaller towns can mean being cut off from good medical facilities. One could an occasional trip to city hospitals for a planned surgery or a one-time diagnosis, but consultation on a regular basis is unfeasible.

But with telemedicine, a medical concept where hospitals get linked with patients far away, gaining ground, this is not the case any more. For instance, 60-year-old Nabam Aetum is a patient of throat cancer in Naharlagun, Arunachal Pradesh. Aetum had his throat operated three years ago at the Tata Memorial Hospital (TMH) and consults his doctors via telemedicine. The sessions are conducted at the local general hospital. Senior radio-oncologist R L Balavat and senior surgeon K A Pathak study Aetum’s latest test reports and future course of action.

With hospitals across India getting connected, more people are linking up to the convenience of telemedicine. The network is also growing to include hospitals in neighbouring countries. Kolkata based Asia Heart Foundation (AHF) launched its integrated tele-cardiology and tele-health project in 2001 with hub centres in Narayana Hrudalaya (NH), Bangalore and Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), Kolkata. It has now set up telemedicine centre in Pakistan and Malaysia as well.

The brainchild of Indian Space Research Organisation (ISRO), telemedicine uses satellite to link up rural centres with city hospitals. A typical session needs a computer, a web camera, an advanced scanner, a 21-inch colour television and connectivity through Very Small Aperture Terminal Satellite (VSAT). Patients far away can share medical data/test results through free video conferencing at the nearest health centre.

ISRO has funded now established 100 telemedicine nodes across the country. 22 of these are located in super speciality hospitals like NH, TMH and Apollo Hospital, and 78 in remote rural areas including in the Andaman and Nicobar Islands. ISRO provides VSAT, diagnostic equipment and satellite bandwidth to the hospital, and setting up one such centre costs over Rs eight lakh.

Says S Krishnamurthy, ISRO, "We provide a telemedicine network only if the hospital provides free medical consultation and conducts regular follow-ups. If a private hospital wants to set up such a centre, then it has to provide treatment at government hospital rates. We want to take the telemedicine network first to every district of the country and down to every taluka."

Already used in other branches of medicine, telemedicine is a new step in cancer treatment. The connectivity is a blessing for the seriously ill in rural areas who can neither access highly trained doctors nor speciality treatment options. Earlier, such patients would have to travel across states to access treatment at TMH and NH. Says Rekha Batura, officer-in-charge, telemedicine project, TMH, "One fifth of our patients are Mumbai locals. About one third come from other western states of the country. But a huge chunk of cancer patients come from the northeast, contributing 50,600 patients out of an annual total of 220,000. We estimate that through telemedicine, almost 25-30 per cent of our patients will avail of latest cancer treatment close to their homes."

Isolated areas with a shortage of specialists need telemedicine consultation the most. The NH network connects with 39 secondary centre through VSAT, extending from remote Tinsukia in Assam to Yadgir in north Karnataka. 20-35 per cent of patients may still have to travel to NH for treatment, but 60-65 per cent can be treated locally. Together NH and RTIICS have treated 16,000 patients with the help of telemedicine.

Telemedicine, besides being free, also cuts costs like outstation travel and stay. It can save a minimum of Rs 25,000 per patient visit. Out of the 63 patients TMH treated via telemedicine, only three were advised to come to Mumbai.

Telemedicine also strengthens treatment options available in rural centres. Doctors in far flung outposts lack regular training and exposure to latest medical research. An important advantage of telemedicine, therefore, is judicious consultation. Local doctors can now discuss their cases with specialists and send their patients to town only if surgery is required.

Mari Basar, Aetum’s doctor in Arunachal Pradesh, says, "we often need timely consultation, which we get from senior doctors at TMH. Since there is a rise in cancer incidence in the northeast, many patients from nondescript villages of Arunachal Pradesh, who do not have resources to travel to Mumbai, come to us. In these situations, telemedicine is the saviour."

Yet, as Basar says, "We never get to know the latest advances in medicine. There should be more e-conferences involving doctors from far off centres. If we could also see surgeries being performed, it would really help us."

Telemedicine is trying to push the envelope and do more. Soon, services boosting timely data interpretation, like telepathology (sending pathological slides through the server) and teleradiology (interpreting CT scans and MRI reports), may be possible. TMH has a three-phase plan, from September 2003 to December 2004, 14 centres were collected via telemedicine. Phase II will link four regional cancer centres between January and December 2005. Telepathology services will also be available at eight hospitals, seven of them in the northeast. During the last phase, from January to December 2006, the other centres across the country will also get linked.

Telemedicine is clearly growing. Karnataka’s telemedicine project was launched in 2002, with ISRO, NH and the state government as partners. 20 telemedicine centres for coronary care were set up in 12 districts and the doctors trained. In the second phase, 17 centres are coming up, with the state spending Rs 15-20 lakh per centre.

ISRO is also poised to widen the nation’s network. "We have reduced hardware-transmission costs by 20 per cent in less than three years. It’s a good opportunity to reach space-based applications to the community and extend it to mobile vans, dedicated terminals, high tech service deliveries and telemedicine-trained doctors," said Madhavan Nair, ISRO chairperson, at the recently held Intelemedindia 2005, in Bangalore. The picture for outstation patients can only get brighter.