Urban Update Sep 2014

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Title Code: DELENG18712 ISSN 2349-6266

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Health Unmasking Disparities

SEPTEMBER 2014


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INSIDE

Inside Cover Story

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Unmasking disparities India has potential to provide the best healthcare, but the inequity persists

22 A crack wide open Urban poor are at greater health risk than their rural counterparts 25 Empowering poor for improved health care Civil Society participation crucial for bridging the gap between healthcare, poor 28

When, West flock to East

30

Mind your medical business

32

Is health souring you or the drug?

Tourists flocking to India for world class healthcare at affordable cost

Private landscape is poised to be a key contributor to the healthcare industry

Unregulated medicine market, medical practices put the health of people at risk

centre stage

34

Under the thumb in politics India has 62 women MPs in Lok Sabha this time. Is the political trend changing

Velo-city

36

Vadodara takes challenges head-on A bird eye view of how the city is tackling demographic challenges

One on one

39

Helipads along NH for lifting accident victims Gadkari on govt initiatives on green transport system, streamlining e-rickshaws

vox pop

41

Do you know your ‘SMART’ city? As the govt plans to build Smart Cities, is there a viable solution to execute it?

Urban Agenda

46 The numbers game There is a need for bringing in a data system for delivering optimum governance RegularS

6 Newscan

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44 Events


EDITORIAL

DR JATIN MODI PRESIDENT-AIILSG RANJIT CHAVAN EDITOR-IN-CHIEF & PUBLISHER DIRECTOR GENERAL-AIILSG APRESH C MISHRA

Synergise Community Health

MANAGING EDITOR LOJY THOMAS, AIILSG ASSOCIATE EDITOR PRATHIBA RAJU Assistant editor ABHISHEK PANDEY PRINCIPAL CORRESPONDENT JESSY IYPE DESK EDITOR & REPORTER MEENAKSHI RAJPUT GRAPHIC DESIGNER ANKITA SINGH MARKETING EXECUTIVE AAMINI DOGRA MARKETING EXECUTIVE HEAD OFFICE PLOT NO. 6, F-BLOCK, BANDRA KURLA COMPLEX, TPS ROAD-12, BANDRA-EAST MUMBAI-400051, MAHARASHTRA VOLUME I - ISSUE V FOR FEEDBACK AND INFORMATION WRITE AT info@urbanupdate.in Printed And Published By Ranjit Chavan On Behalf Of All India Institute Of Local Self Government Printed At Cirrus Graphics Pvt Ltd B-61, Sector-67, Noida – 201301 Uttar Pradesh. Published At Plot No. 6, F-Block, Bandra Kurla Complex, Tps Road-12, Bandra-East Mumbai-400051, Maharashtra Despite Careful Selection Of Sources, No Responsibility Can Be Taken For Accuracy. The

N

early one-third of India’s urban population live in slums, informal settings or sidewalk tents, which are characterised by overcrowding, poor hygiene, sanitation, absence of proper civic services and fuelled by basic health infrastructure and healthcare service delivery. To improve the urban health scenario, reformed urban health governance is need of the hour. Statistical data reveals that in developing countries, the best urban governance can help to produce 75 years or more of life expectancy. Seen as a stark reality, even though Indian healthcare has access to world class services, there is a wide gap between the services being provided equally to the masses. Understanding public health needs in urban areas requires a comprehensive conceptual framework. Traditionally, alleviation of poverty is the most important precursor of improving general health. But in urban areas, the marginal increase in income for the poor, in itself, does not assure better living conditions due to wide disparities, which makes decent accommodation, and clean water and air unaffordable. The poor are typically driven to the margins of the urban space, where living conditions are the most degraded and of little economic value. The relative difference in income and wealth is much starker in urban areas. The higher purchasing power of the rich drives up the prices of food and healthcare goods, making them unaffordable to the poor. A good urban health dominion helps ensure that opportunities and advantages are more evenly distributed, and that access to healthcare is fair and affordable. Optimal urban governance helps the health sector, in promoting and planning for hygienic living conditions; building inclusive cities that are accessible and making cities resilient to emergencies like epidemics. A synergy between the urban local bodies, state and central government is needed to engage on quality research to generate and systematise knowledge to address many existing information gaps. The inequities of health disaggregated by intra-urban area; the effectiveness of proactive approaches to deal with health inequity in cities; and the importance of involving all citizens in the decisions that affect their habitat and their health is crucial. Also, it is imperative to maintain this momentum of creating clean, green and healthy cities to live in. Urban health advocates should identify successful models to be shared as menus of policy options and models of good practice. It is therefore imperative that urban health receives due attention and is accompanied by coordinated actions from all stakeholders and more importantly, a strong political commitment for addressing the growing problems of the urban poor.

Magazine Assumes No Liability Or Responsibility Of Any Kind In Connection With The Information Thereof. All Right Reserved. Reproduction In Whole Or In Part Is Strictly Prohibited Without Written Permission From The Publisher.

Ranjit Chavan dgaiilsg@gmail.com

www.urbanupdate.in | September 2014

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Rejuvenating Rivers, Improving Lives The multi-crore Kshipra-Narmada Simhastha Link Project has rejuvenated the dying Kshipra river and solved the water problem of the Malwa region. To upkeep the sanctity of the Kshipra river, the Indore Municipal Corporation now focuses to clean Khan river Team Urban Update

INDORE: One river link project has given a multi-faceted benefit to the Malwa region. The Kshipra-Narmada Simhastha Link Project has improved ground water level situation and provided adequate potable water in the region. The state government undertook the Kshipra-Narmada Simhastha Link Project to connect Narmada with Kshipra with huge pipes. Indore Mayor, Krishna Kumar Moghe told Urban Update that the project has benefitted the people of Malwa region in many ways. It has solved the irrigation problem and made the Ujjaini village a tourism spot. It would give employment to the youth.“The most remarkable benefits of the project is that water requirements for holy bathing of lakhs of devotees will be fulfilled during Simhastha held at Ujjain after every 12 years,” he said.

Increase in water table

Due to the availability of potable water, the price of the agricultural

land and residential plots in the nearby villages has gone up by 50 to 100 percent. Now, drinking water is supplied to Dewas, Ujjain and villages on the banks of Kshipra river and industries in the area also get adequate water paving way for other major projects in future. According to government reports, Narmada water flowing into Kshipra River would provide potable water to 70 towns and 3000 villages. Apart from this, it would provide additional irrigation facilities in a 16-lakh hectare area. The scheme would also ensure availability of water in Ujjain during the Simhast 2016—a religious gathering that takes place every 12th year. Release of Narmada water into Kshipra River will recharge and increase groundwater table in the region. As a result, ample water will be available in wells, tube-wells and ponds. Power consumption on lifting water will come down when water level goes up. Under this project, water from the Narmada River would be lifted from the Sisliya pond in Khargone district

Salient features of Narmada-Kshipra Simhastha Link Project

Quantity of water through lift irrigation

500 MLD

Total length of rising main

49 Kilometres

Total height of lift irrigation

348 Metres

Electric pumps Four-stage pumping Project’s administrative sanction

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Rs 432 Crore

and brought to Kshipra’s source from where it would be released into the Kshipra river. From here, the water would flow to a distance of 115 km to reach Ujjain where Simhast (Kumbh) mela is held. According to preliminary estimates, water is lifted up to 348 meter during its 49 kilometre long course. For this, lift irrigation pumps will be installed at four places. Madhya Pradesh CM Shivraj Singh Chauhan said that after the successful completion of NarmadaKshipra Link Project, Betwa and Ken rivers will also be linked under riverlinking project.

Clean Khan to upkeep Kshipra

Moghe also said that the cleaning of Khan river is equally important for the success of Kshipra-Narmada link project as the polluted water of Khan and Saraswati river is mixed with the Khsipra River. “I met Union Water Resources Minister Uma Bharti and elborated the need to clean Khan river. She has assured me that she would help me in providing resources and funds for improving the quality of water in rivers,” said Moghe. The city has laid a new sewerage line under Jawaharlal Nehru National Urban Renewal Mission (JnNURM) and new water treatment plant to treat 200 MLD sewage water. The municipal corporation is setting up industrial and sewage water treatment plant to ensure the rivers are not polluted.


PIN POINT

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India is a youthful nation. We want to give importance to skill development. Be it quality, zero defect and discipline Narendra Modi, Prime Minister while addressing business leaders on his visit to Japan

Urban planning and administration is the biggest challenge. There is a need for changes in town planning rules for setting up integrated self-contained townships. At present creating the infrastructure of metro, mono-rail or BRT would be done but this centralisation of population at the heart of the city has to be avoided. Instead, self contained integrated townships in a decentralized manner is need of the hour

Takehiko Nakao President of the Manila-based Asian Development Bank (ADB), on Smart Cities

‘ ‘ ‘

Prithviraj Chavan, Maharashtra Chief Minister while underlining the growing urbanisation in the state

Aung San Suu Kyi Chairperson NLDB at UNAIDS Global Advocate on Zero Discrimination

Cycles are not merely a means of commuting, it is a tool for empowerment and an economic opportunity for the poor. The govt should increase the ownership of cycles by distributing it free to school children or subidising it

‘ ‘

Pawan Munjal MD, HERO Cycles on economic aspects of cycling

Open up and reach out for change. Everyone has a right to live a full and productive life with dignity. Join us in calling for global transformation for Zero Discrimination

It is important to be smart but it is also important to have sufficient supply of power. ADB can support smart cities because we are doing a lot of work in urban development area. Many foreign IT and power companies would be interested in this idea. They can be realistic

Singapore’s expertise in smart cities, urban planning and water management strategies offer a valuable learning experience for India. We shall work for setting up greenfield smart cities and for urban rejuvenation. Our experts shall identify the priorities and we shall coordinate its timely delivery Sushma Swaraj, External Affairs Minister, on Singapore projects in skills development and rejuvenation of Indian cities

www.urbanupdate.in | September 2014

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Homeless women to get night shelters

NEW DELHI: Exclusive night shelters for homeless women will be built in the national capital before this winter season, Lt Governor Najeeb Jung’s office said in a statement.The decision was taken after a meeting at the governor’s residence, the district commissioners submitted a field report to Jung on the city’s night shelters, water and power supply, de-silting of drains, removal of encroachments, and inspection of hospitals and schools. “The review of night shelters revealed low or no occupancy when it comes to homeless women of the city. The Lt Governor has instructed that separate night shelters, with adequate attention to safety and security, be established by Delhi Urban Shelter Improvement Board (DUSIB) before the onset of winter,” the statement said.

Egypt to dig new waterway near Suez Canal CAIRO: The Egyptian government has launched a Suez Canal Corridor project. Under this new project, a new 72-km waterway will be dug alongside the original Suez Canal. The new canal, once completed, will help in reduce passing ships waiting time from 11 hours to as three hours. So far Cairo has not consulted any foreign country over the new canal. The current 164 km-long Suez Canal is an artificial sea-level waterway in the country. It connects the Mediterranean Sea and the Red Sea, with its northern terminus at Port Said and the southern terminus Port Tawfiq in the city of Suez.

SAP powers BMC’s e-gov project Bhopal civic agency deployed an e-governance project in association with SAP to automate and centralize public service offerings.

Mumbai in A list of Nat Geo Mumbai got into the A-list of National Geographic’s “smart cities”, a catalog that includes familiar metropolises.

Music in buses The transport committee in Nagpur decided to install music system in city buses for entertainment of travellers and to increase its revenue.

E-vans for jobless in Hyderabad GHMC started a fleet of employment vans which would move around the city to help job seekers find a job on the basis of their qualification.

Technology for clean water & sanitation: Nitin Gadkari at inauguration of the National Workshop on Technology for water quality and sanitation in rural India, in New Delhi

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TRAI may charge usage fee on WhatsApp, Viber

NEW DELHI: The rise of instant messaging apps like WhatsApp, Viber and others, tele companies have started to make noise against the rampant adoption of the services. In April, the Telecom Regulatory Authority of India (TRAI) had disclosed to be working on discussion paper that would oversee the impact of Over-The-Top (OTT) players such as messaging apps. TRAI is on its way to find a solution by putting a fee on such apps. Several telcos including Bharti Airtel, Vodafone India and Idea Cellular, reportedly want app providers to pay a connectivity charge to make up for the losses in revenue, since many apps replace core revenue streams such as SMSes or phone calls.

Builders land under CCI scanner MUMBAI: Keeping in view an evidence on a possible fraud likely by some builders, the Competition Commission of India (CCI) has asked 20 leading builders, including Tata Housing, K Raheja, Unitech, Ansal Properties and Purvankara, to respond to findings by its investigation arm that they engaged in unfair trade practices such as one-sided contracts with inadequate disclosure. The anti-monopoly watchdog has found that the builders did not disclose crucial information about the built-up area and often reserved the right to increase or decrease apartment sizes, an official said.

200 railway stations to have solar power plants NEW DELHI: The Indian Railways have proposed to install solar power plants of about 8.8 Mega Watt (MW)-capacity at railway stations, railway office buildings and level crossing gates, the parliament was informed. The provisions include of 10 KWp solar PV modules each at 200 stations under various Zonal Railways, provision of total 4.05 MWp Solar Photo Voltaic (SPV) at roof top of 21 railway office buildings and provision of total 1.3 MWp capacity Solar Photo Voltaic (SPV) plants at 2000 Level Crossing gates, Minister of State for Railways, Manoj Sinha said in the Lok Sabha.


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SUNITA- mission to end tobacco fatalities

NEW DELHI: Keeping in view a serious case of tobacco use of a lady called Sunita, who is battling her life after being diagnosed with cancer, the Ministry of Health has unfurled “Sunita”, a testimonial campaign highlighting the devastating effect of smokeless tobacco (‘gutka’, ‘zarda’, ‘khaini’) especially on women. Union Minister for Health, Dr Harsh Vardhan, inaugurated a resource website www. ntcptobaccocontrolpsa.in that will host health spots and tobacco use disclaimers in high resolution for use in films and television shows.

‘Aware to alleviate handloom weavers’ NEW DELHI: The country’s art and culture is mirrored through the exquisite works of our artisans, weavers and handloom craftsmen, the Government of India is aware that handloom weavers and their cooperative societies are facing hardships due to availability of cheaper imported fabric mainly from China. To address the accumulated debt issue, the Government of India, in November, 2011, has approved Revival, Reform and Restructuring (RRR) package for waiver of overdue loan (100% principal and 25% of interest), the Minister of State (Independent Charge) in the Ministry of Textiles, Santosh Kumar Gangwar informed the Lok Sabha.

Over 600 crisis, response centres for women safety NEW DELHI: In order to help the women affected by violence, the government is setting up 660 crisis and response centres in various states to provide adequate medical and legal assistance, informed Minister of Women and Child Development, Maneka Sanjay Gandhi in the parliament. “The centres will be adequately equipped to assist and support women affected by violence at 660 locations across the country. The centres are expected to facilitate medical aid, police assistance, legal counselling/court case management, psycho-social counselling and temporary shelter, if required,” the Minister said.

AIIMS avails new dental facilities: The Union Minister for Health and Family Welfare, Dr Harsh Vardhan after inaugurating the Dental Centre and other facilities at CDER, AIIMS in New Delhi

PMC to install LED streetlights Patna Municipal Corporation board would install 50 LED lights in each ward before Durga Puja. Each ward will get a sum of Rs 4 lakh.

Web based GIS for roads, bridges in TN Tamil Nadu Highways Department introduced a web-based GIS system to provide information on road, bridges and ongoing projects.

Parks, toilets under flyovers in Guwahati To utilize unused space under flyovers, Guwahati Municipal Corporation would build parks, parking lots and toilets under the flyovers.

Cameras in parks Bengaluru civic agency installed CCTV cameras in parks to “keep a watch on public display of affection and reduce social menace”. The pilot project began in June.

20,000 MW power by 2020 to be generated HYDERABAD: In order to combat the power crisis in various states, the Adani Group will generate 20,000 MW electricity by 2020, which will help to power supply to needy states, informed, Gautam Adani, chairman of the Adani Group of companies. In a meeting with Telangana Chief Minister K. Chandrashekar Rao, Adani explained the group’s profile and activities being taken up, one of which would be 20,000 MW electricity by 2020.

‘Renewable energy needs to be promoted’ NEW DELHI: The renewable energy has huge potential and it needs to be promoted, and using 80 percent of our fossil to meet our power needs is “not a very happy situation”, said UD Minister, M Venkaiah Naidu. Inaugurating the new, solar power generated lights in Dwarka Metro Station, a first-of its kind initiative by the DMRC, he said, “We need to increase the power generation in the country”.

Mobile midwife saves Ghana mothers GHANA: The country is slowly regaining in providing essential medical services through a system called Mobile Midwife. The expecting mothers also receive regular messages with individually-tailored information on everything from eating properly to when to give up manual labour to important treatment and vaccination advice and community health. www.urbanupdate.in | September 2014

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Energy generated by body to replace batteries?

CALIFORNIA: In a new finding, it has emerged that energy harvested from body heat, motion and ambient light could be used in medical implants, monitoring sensors and disposable medical patches. Yogesh Ramadass, lead design engineer at Texas Instruments: “Energy harvested from the body and environment is in the microwatt range, so it can’t be used for smartwatches or fitness trackers, which draw milliwatts of energy.” Smartwatches have displays and software that can drain batteries, while energy harvesters are better for wearables that collect and transmit bits of data at specific intervals. The researchers said that energy harvesting technologies could be relevant in smoke detectors, alarm sensors, smart meters and remote controls.

Jet fuel from tobacco NEW YORK: Ever thought of what smoking out an airplane through tobacco could confer? Well there is a new technological advancement that has been innovated to assure sustainable aviation from bio-fuel. The new tobacco plant will make smoke but the kind that comes from the exhaust of an aeroplane. Boeing and South African Airways (SAA) are collaborating to make sustainable aviation bio-fuel from a new type of tobacco plant. Known as solaris, the hybrid plant is a nicotine-free alternative to traditional tobacco. Test farming has started in South Africa and bio-fuel production is expected in the next few years, said Boeing. Initially, oil from the plant’s seeds will be converted into jet fuel.

Nashik to become first solar city in MH By making solar panels mandatory in buildings with over 10 flats, the state govt proposed to make Nashik, the first solar city.

BMC to adopt zonebased ad model Bhubaneswar Municipal Corporation decided to adopt a zone-based advertisement model to streamline and boost its revenue generation.

Real time integration of civic amenities Surat civic agency will start a pilot project by December for real time integration of basic infrastructural sectors like water supply, sewerage, and SWM.

LRTS for Trivandrum, Kozhikode Kerala Monorail Corporation Ltd. proposed light metro for Trivandrum and Kozhikode.

Cities to become cycle friendly in UP

LUCKNOW: In order to boost cycling, the Uttar Pradesh government decided to develop Noida, Lucknow and Agra cities as cycle friendly, with separate cycle tracks, along with cycle stands on important routes and ‘cycle on rent’, an official said. All future development of Noida and Greater Noida will be cycle friendly. A decision has been taken to construct cycle stands and cycle shelters where people can avail the facilities of “cycles on rent”. CM Akhilesh Yadav said, “Foreigners always give priority to the use of cycles thereby making it imperative that the Taj City is developed as a cycle-friendly city. Lucknow would also be developed as a cycle-friendly city.”

Saraswati river to be revived: Uma Bharti NEW DELHI: Saraswati, the river known for great splendour in ancient India, which has been dwindled and dried up will be revived, assured Union Minister for Water Resources, River Development and Ganga Rejuvenation, Uma Bharti in the parliament. “The centre is committed to the revival of the ancient Saraswati river,” she said while replying to a Calling Attention motion in the Lok Sabha, on the need to set up the Saraswati Research Institute. “We have enough scientific evidences on the presence of the river Saraswati in some parts of the country, through which it flowed about five to six thousand years ago. The Central Ground Water Board (CGWB) has been directed to test the water of a well located inside Allahabad fort in this connection,” the minister added.

PM promises Rs 8000cr for J&K road connectivity

Boosting Renewable energy: The Minister of State for Home Affairs, Kiren Rijiju unveiled a plaque and inaugurated the 200kWp Rooftop SPV Power Plant in Chandigarh

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NEW DELHI: Prime Minister Narendra Modi has promised Rs 8000 crores for road connectivity in Jammu and Kashmir and informed the government is committed to the development of the region. Attending a public rally at the Polo Ground in Ladakh, Modi said, “I assure you that in the union cabinet meeting we will soon approve an ambitious road connectivity project of Rs.8,000 crores for four major road building projects in J&K.”


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Municipal bodies, DDA map your land, says Naidu NEW DELHI: All the municipal bodies of the national capital and Delhi Development Authority (DDA) should get their respective lands mapped properly using GIS and Information Technology, instructed, Urban Development Minister M Venkiah Naidu. The

The country’s slum population has seen a rise of over 130 lakhs in ten years. Maharashtra followed by undivided Andhra Pradesh host the largest chunks of slum population, Urban Development minister, M Venkaiah Naidu informed the parliament. “Slum population has increased by over 130 lakhs between 2001 and 2011. Number of towns that reported slum dwellers increased from 1,743 to 2,613 during the same period,” Naidu said in Lok Sabha. Maharashtra tops the list with a slum population of over 118 lakhs, “Arunachal Pradesh, HP, Mizoram, Nagaland and Sikkim who had reported no slums in 2001 census reported marginal slum dwellers in 2011,” Naidu added.

of the land should be made available in the public domain and all MPs, MLAs, corporators and general public should provide necessary information in this regard to respective agencies so that the problem of encroachment can be addressed. He also suggested that DDA should submit full details of various pending court cases in respect of its land and launch a campaign for eviction from its encroached land. “A institutional framework will be put in place for creation of a separate agency for maintenance of public toilets in Delhi on PPP basis,” the minsiter said in a statement. Naidu also directed that a concept paper be prepared within 15 days for a fresh look at regularisation of all unauthorised colonies in Delhi.

UP ranks high in Babycare kits from ‘Amma’ In line with Amma-branded housing shortage CHENNAI: subsidised salt, agricultral seeds, medicines,

Civil Defence to be taught in schools

minister reviewed issues relating to urbanisation and development of National Captial Region (NCR) with Members of Parliament from Delhi, Mayors and Chief Executives of municipal bodies including New Delhi Municipal Council (NDMC) and DDA. Naidu also instructed that details

‘Steep rise in country’s slum population’

NEW DELHI: Uttar Pradesh is among the worst states when it comes to urban housing shortage. About 30 lakh units of total housing shortage is in the state, which is followed by Maharashtra when it comes to low housing stock, the parliament was informed. According to the HUPA ministry, Uttar Pradesh tops the list with urban housing shortage of 30 lakh units followed by Maharashtra (19 lakh units). Minister of HUPA, M Venkaiah Naidu in a written reply to the Rajya Sabha said, “The urban housing shortage is 187.80 dwelling units in urban areas. The houses which has been built in urban areas during the last three years are 2,20,741 houses.”

water bottle canteen and others, the Tamil Nadu government is trying to woo the newborn babies with ‘Amma’ babycare kits across the state to extend caring hands to mothers in state-run hospitals. The government would spend over Rs 67 crore which would benefit over 6.7 lakh babies this year alone, Chief Minister Jayalalithaa said, making a suo motu statement in the Assembly.The kit worth Rs 1,000 would be gifted to the new born with 16 items which includes a towel, baby dress, baby bed, protection net, napkin, 100 ml baby oil bottle, 60 ml shampoo, sachet, a soap box, a soap, a nail clipper, toy, a rattle, a 250 ml handwash liquid and a 100 gram soap for mother, she said, amidst thumping of benches by legislators. The announcement comes close on the heels of the government launching ‘Amma’ seeds to provide farmers with quality seeds at a reasonable price, ‘Amma’ ‘Amudam Supermarkets’, ‘Amma Pharmacies’ and subsidised ‘Amma Salt’ recently. The ‘Amma Canteens’ and ‘Amma Mineral Water’, both low-cost initiatives, have been well received by a large section of the people.

New Delhi: The role of Civil Defence and the knowledge of lifesaving skills need to be emphasised to youngsters. The Home Ministry will take the initiative to introduce civil defence as a subject in school curriculum and text books. Speaking at an event, Home Minister Rajnath Singh said that his ministry will write to the Human Resource Development (HRD) ministry to include civil defence in school curriculum. “I will take this initiative from my ministry’s side. The role of civil defence in the country is important. The children need to know the importance of such life saving skills,” Singh said. The minister also unveiled a scheme called ‘Mainstreaming Civil Defence in Disaster Risk Reduction’, which will be implemented in various states and Union Territories during the 12th Five Year Plan. Recently, Union Home Minister has sanctioned a new Rs 290.89 crore scheme for civil defence works. www.urbanupdate.in | September 2014

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Digital literacy in slums NEW DELHI: In a nobel cause to impart 100 percent digital education in the urban slums across the country, the Digital Empowerment Foundation (DEF), a NGO, has taken initiative of teaching urban poor about technology. The foundation will open community resource centers in slums in urban areas for educating the poor, especially the youth. The NGO based in Delhi has recently started a pilot project in Yamuna Nagar slum, Pune where people has shown keen interest and even offered their community centre to be operated as Community Information Resource Centre (CIRC). The main objective of these centers is to ensure 100 percent digital literacy particularly among urban and rural poor.

Pave way to GPS traffic signs inside vehicles NEW DELHI: Adopting the suitable nuances of the information technology at its best, a group of researchers paved way to a new technology that will allow a dashboard screen inside the car to display traffic signs and alert the drivers to act accordingly. Researchers at the Virginia Tech Transportation Institute are developing an idea to move stop and yield signs, among other posted traffic, from the side of the road into the car itself. “The idea is there would be no physical stop or yield signs on the side of the road, but they would be inside the vehicle,” said Alexandria Noble of Newark, Delaware, a master’s student with the Virginia Tech Charles E Via Jr Department of Civil and Environmental Engineering.

Bus wash automated

‘e-health care service’ for rural India

CM Jayalalitha announced renovation of the Kodaikanal Lake at a cost of Rs 87cr. The project would include removal of silt, hyacinth and water plants.

NEW DELHI: To intensify health awareness in rural India, an online health care service would be initiated soon across the country, a health official said. “The health minsitry has already prepared the white paper of the ‘e-health care service’ which will be a boost to raise awareness among the people, who remain completely deprived of the health services initiated by the government,” Jagdish Prasad, director general (DG) health services, Ministry of Health and Family Welfare said. Prasad said the e-health care system, which basically will be a web portal, will help the government to address the people about every health-related programme and the various schemes that enable them to get free medical treatment.

‘Road doctor’ for potholed roads

Now, pesticides found in tea too

GHMC adopted ‘Road Doctor’— the infrared road repair system that quickly repairs badlydamaged roads and does away with the need for frequent pothole filling.

MUMBAI: Greenpeace India has found pesticide residues in the tea of leading national and international brands. The environment think tank has come out with a report ‘Trouble Brewing’ in which they have exposed the presence of pesticides residue in 46 samples of packaged tea of leading national and international tea brands, considered highly and moderately hazardous by the World Health Organization (WHO). “Indian tea is a national pride, and it should not be linked to toxic chemicals with serious environmental and health risks,” said Neha Saigal of Greenpeace India.

Puducherry Road Transport Corporation launched an automatic bus washing machine to cut down the time taken to clean buses and save water. The project cost is Rs four lakh.

Lake renovation

Intelligent Transport Odisha govt set up an Intelligent Transport System in Bhubaneswar to streamline traffic in the state capital.

‘Indians are top investors in central London’

Banking scheme for all: Minister of State for Statistics and Programme Implementation (Independent Charge), Rao Inderjit Singh at the launch of ‘Pradhan Mantri Jan Dhan Yojana’ at Karnal

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LONDON: Investment of nearly $400 million (Rs.2451 crore) make Indians the largest buyers of land among overseas investors in central London, it accounts for a 55 percent share in the second quarter of this year, informed a leading commercial realty services group. One of the largest deal by an overseas investor was struck by an Indian entity, India Bulls, which purchased a property in upmarket Hanover Square in Mayfair, close to Oxford Circus, for $260 million (Rs.1593 crore), says the report prepared by CBRE South Asia.


NEWSCAN

‘Focus on leveraging IT to build Smart Cities’

NEW DELHI: With an aim to ensure that the country reaps the fruits of technological innovations, Dr Arvind Gupta, national head, information and technology, said that there is need to focus on leveraging Information and Technology to build Smart Cities. While addressing the Urban Matters at the SAP Forum for Public Services in the national capital Gupta said, “Today, citizens want effective delivery of services, improved governance and transparency in the functioning of big, complex and constantly changing cities.

Bhopal introduces first ‘City App’

Awards for corporate governance: Union Minister for Finance, Corporate Affairs and Defence Arun Jaitley at the 13th ICSI National Awards for Excellence in Corporate Governance in Kolkata

Solar panels in Gurgaon buildings

NEW DELHI: In a a vision to improve the quality of life through better administration and citizen services, Bhopal’s civic agency has sought viable solutions to automate public service offerings through a ‘City App’. While announcing the panacea, that will be bilingual and be available in Hindi, at the SAP Forum Delhi, Tejaswi Nayak, commissioner of Bhopal Municipal Corporation (BMC), informed that the application will help streamline day-to-day functions and help upgrade the underprivileged. The app intends to simplify the citizen’s interaction with the cooperation on the mobile platform of their choice. “This is an exciting time for India and the wider region,” said Vivek Puthucode, vice president Public Services in Asia Pacific Japan, SAP.

Municipal Corporation of Gurgaon proposed changes in its rulebook and link the installation of solar panels to building plan approvals.

Tata Nano to become a ‘Smart City Car’

Tree committee in Kolhapur rejected proposals to cut 615 trees last year owing to the declining green cover.

AHMEDABAD: Tata Nano will be revamped next year and launched as a ‘Smart City Car’, said Girish Wagh, senior vice-president, Tata Motors. He added, “We are carrying out multiple interventions to improve the product as well as its image to ensure that the Nano lives up to its promise.” The much hyped product by the Tata had received a blow due to dip in its sales. The company also found that there were significant number of cases where people would test-drive, book their Nano and then, drop out owing to negativity around the brand.

NDMC to open gyms in all wards North Delhi Municipal Corporation would start green gyms in its parks. The cost of setting a green gym is around Rs six lakh.

Tree committee saves 615 trees

Wi-fi in markets Lucknow civic agency to install Wi-Fi poles in city markets. The project will be started in Patrakarpuram Chouraha, Gole market, Lekhraj market, Hazratganj, Alambagh, etc.

World Bank to give $50m to Laos VIENTIANE: The World Bank Group and the government of Lao People’s Democratic Republic (PDR) signed agreements worth 50 million USD for the socio-economic development and environment sustainability of the Southeast Asian nation. The agreement would financially assist the government of Laos in executing its National Socio-Economic Development Plan and support small and medium scale industries. “The project will provide long term credit to the small firms, with the view to helping them expand job creation and productive activities,” said H E Mme Thipphakone Chanthavongsa, Vice Minister of Finance of the Laos.

‘Live App Testing’ tool for mobile developers NEW DELHI: E-commerce giant Amazon introduced a new tool that facilitates mobile application developers to test their apps on a customised set of testers before submitting them to app stores such as Amazon Appstore for Android and Google Play. Developers can choose to test their app against all Android and Amazon devices, including the Fire TV and Fire phone. The new Live App Testing tool ensures to give developers a chance to correct some bugs, errors or unexpected crashing of apps before making it available in app stores. “This allows developers to gather feedback, improve quality, increase stability and optimize the experience before they push app live for all customers to download,” stated Amazon’s Paul Cutsinger. www.urbanupdate.in | September 2014

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NEWSCAN

Guidelines framed to ensure safety of tourists

NEW DELHI: Top priority will be given to the safety and security of tourists, especially women, by the government. The Tourism Ministry is framing guidelines for state governments to ensure this, said Union Minister of Culture and Tourism Shripad Yesso Naik. Speaking at a inaugural session of a day-long “State Tourism Ministers Conference”, Naik said in-bound tourism has shown growth since June 2014 and foreign tourist arrivals grew by 9 percent. “With increasing visitors, the Ministry of Tourism has prepared a road map to ensure improvement in travel conditions and services. We are coming out with a set of guidelines, includes tips for travellers and also safety guidelines for adventure activities. ,” the Minister said.

‘Exempt income tax for road safety programs’ NEW DELHI: The Road transport, highways minister Nitin Gadkari has asked the finance ministry to extend 100 percent income tax exemption for road safety programs organised by various industries, corporate houses, NGO’s, individuals and media. In a letter to Finance Minister, Arun Jaitley, Gadkari said “During the Union budget the government had allowed income tax exemption on 50 percent of the amount that people and entities contribute for road safety activities. Extending 100 percent exemption will further help motivate people to donate generously for such road safety measures and associate leaders from the industry towards various activities.”

ITS in A’bad Zero-Sum ITS with Nagoya Electric Works of Japan would implement the pilot Intelligent Traffic System (ITS) in Ahmedabad on the 132 feet road near IIM. The project cost is $ 1 million.

New names for corps Owing to confusion in nomenclature of NDMC, the municipal corporations of Delhi will be called MCD North, South and East.

Laws for better waste management Pune Municipal Corporation framed public health and sanitation bye-laws-2014 for better segregation and disposal of waste.

MH grades corps Maharashtra govt reclassified 26 municipal corporations based on various parameters. The Municipal Corporation of Mumbai is the only one with an ‘A+’ grade.

Handshake with Japanese: The Prime Minister, Narendra Modi interacting with the people during his visit to the Kinkaku-ji Temple, Kyoto, Japan

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September 2014 | www.urbanupdate.in

Country’s first fish hospital to come up in Bengal KOLKATA: In first of its kind a hospital for fish will come up in West Bengal next year, which is funded by the Indian Council of Agricultural Research (ICAR), Under the Union Ministry of Agriculture. The main focus of this hospital is to increase fish production in Bengal by improving management practices of fish production, said T.J. Abraham, fish microbiologist at West Bengal University of Animal and Fishery Sciences.

Rajasthan stalls 4,000 Mw solar project for birds

RAJASTHAN: As the central government vouching to implement solar energy programme across the states, the Rajasthan government is likely to cancel the 4,000Mw solar UMPP, which was to come up near Sambhar Lake. The state government has cited ecological and environmental impact on the migratory birds if the plant is established at the prescribed site. The UMPP, a massive scaling up of solar power said to be launched in September. It was supposed to be a joint venture of five public sector units – Bharat Heavy Electricals Ltd, Power Grid Corporation of India, Solar Energy Corporation of India, Hindustan Salts Limited and Rajasthan Electronics and Instruments Limited. The estimated cost of the project was calculated at Rs 7,500 crore.

Jan Dhan Yojana to uplift common man

NEW DELHI: Rolling out ambitious financial inclusion programme, the Pradhan Mantri Jan Dhan Yojana (PMJDY) People Welfare Scheme, Prime Minister Narendra Modi’s pet project promises a bank account for every Indian household. The programme led to the opening of an astounding 1.5 crore bank accounts on a single day. The project aims at tackling poverty. Modi said, “If we want to get rid of poverty, we have to get rid of financial untouchability. We have to connect every person with the financial system.” The programme will cover 60 percent of the population who does not have a banking account.


WORKSHOP NEWSCAN

Municipal Bodies should equip for disasters Keeping in mind the state of unpreparedness during cities among the city administrators, planners, it is very crucial for the government to pull their socks. Urban local bodies should be well-equipped to tackle disasters whether it is manmade or natural, besides sound infrastructure, building resilient with proper disaster management is necessary Team Urban Update

“The civic agencies should be well-equipped to any kind of disasters, for example the location and construction of Vadodara city is such that it has never faced the effects of earthquake. However, it is necessary to maintain a disaster mitigation plan, particularly man-made, which are faced with the development of industrialisation,” said SK Nanda, Additional Home Secretary, Gujarat while inaugurating a workshop on disaster preparedness and management at city level. He also highlighted that during such mishaps, the duty of the concerned government bodies is to prevent the rumours that may create panic amongst the affected people. “Proper message at proper time should be provided to the citizens so they can be aware to face and handle the disaster at individual level. In case the disaster is unmanageable, immediately concerned expertise in managing and mitigating the disasters within the shortest possible

Dr SK Nanda, Additional Chief Secretary, inaugurating the Workshop and releasing the Indian quarterly magazine published by National Fire Academy, AIILSG, Vadodara on the dais

time should be approached,” he said. Giving suggestion on disaster management, the Gujarat home secretary, said, “During monsoon, the district disaster management cell and fire control room should make effective use of modern technology like GPS system, so that location of time, place and person can be known.” Emergency equipments like oxygen cylinder, cranes with proper capacity, JCB machine, oxygen cutter, concrete cutter, jackets having lights etc. should be readily available for rescue operations with the team responsible for disaster management, while keeping in mind all the probable factors and risks while carrying out search and rescue operations immediately after a disaster, he stated. Highlighting few preventive measures which should adopted by the civic agnecies, JV Modi, president, All India Institute of Local Self Government (AIILSG) said,”With the increasing urbanisation and industrialisation in the city, incidents of fire related accidents and disasters are increasing, and the local governments have the responsibility to adopt preventive measures to protect the city from man-made disasters and be prepared to minimise the impact of natural disasters in and around the city of Vadodara.” As per fire and emergency services officials compared to other months, summers reported a rise of 20 to 25 percent rise in fire calls. A major reason they sighted is the short circuits due to high power load.

Dr Hitendra Patel, Chairman, Standing Committee, Vadodara Maha Nagar Seva Sadan, inaugurating the Workshop on Disaster Preparedness and Management at City Level by lighting the lamp on the dais. He is flanked by Dr Jatin Modi, President, AIILSG & Former Mayor of Vadodara

Manish Bharadwaj, Municipal Commissioner of Vadodara Mahanagar Sevasadan, lauded the efficiency and preparedness of the employees of fire and emergency services who take minimum time to respond any fire incidents with all the available resources. The workshop also had various experts emphasising view on the disaster mitigation. Balkrushna Shukla, former MP and mayor of Vadodara, urged the need for proper training of the rescue personnel and appreciated the constructive role played by the AIILSG for organising workshops and programmes, which is seen as an eyeopener for many city managers. “A public–private partnership for joint operations during the time of disasters is crucial, as it will help in positive and speedy results to mitigate the genuine grievances of the affected people,” Shukla added. www.urbanupdate.in | September 2014

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COVER STORY

T

he effect on health in urban sectors is doubleedged. While cities can bring employment opportunities, education, better healthcare options unlike the rural areas; they also bring challenges of various health hazards. Right from substandard housing, contaminated drinking water, population growth, open defecation, inadequate sanitation, improper solid waste disposal services, and industrial effluents in water bodies, air pollution, and lifestyle disorders are few important factors. Cities are afflicted by various communicable diseases like HIV/AIDS, TB, pneumonia, diarrhoeal diseases, cholera; and non-communicable disease like asthma, heart disease, cancer, hyper tension and diabetes. The WHO states that the health situation in India is a sad story of deprivation. In select urban centres you have the five star deluxe facility hospitals with hi-tech medical care, and state-of-the-art medical technologies. On the flipside there are overcrowded government hospitals, primary health centres, with serpentine queues of patients jostling for check-up and many lying on the floor. In the WHO ranking of the world’s health systems, India falls lowly on the 112th position, where neighbouring countries like Sri Lanka is in 76th and Bangladesh is in 88th position.

but we are not able to give the basic infrastructure like sewage to the public,” Rita Bahuguna Joshi MLA, Lucknow Cantt constituency, Uttar Pradesh told Urban Update. “The rapid pace of urbanisation, population growth does not match the facilities provided. I think the city management is yet to run efficiently, they don’t have enough power. More focus should be given on primary healthcare basic facilities like sewage, drainage, toilet facilities, clean drinking water,” Joshi added. The UNICEF states that more children under the age of five die in India than anywhere else in the world. That’s 1.7 million children – over 4,650 child deaths a day. Main cause of the death is diarrhoea, a disease, which can be easily be prevented by ensuring clean drinking water among the slum dwellers, particularly in non-regularised colonies where most of the migrants live. “Overcrowding, poor sanitation, open defecation increases the risk of communicable diseases like diarrhoea, typhoid and other water/food borne diseases such as cholera, under nutrition, pneumonia, typhoid and

Urban Health

Urbanisation creating sick cities

Unplanned urbanisation and increase in population in cities, is turning out to be a burden and it is creating a huge impact in healthcare scenario of the metropolis, say experts. “The biggest problem faced by every city is sanitation. Nearly 40 percent of the cities have open toilets. The city like Lucknow doesn’t have enough toilets. The municipality builds a toilet but they don’t maintain it. Sixty to 70 percent of the cities do not have a proper sewage system, due to which diseases upsurge. As a representative of an urban constituency, I feel ashamed that in so many years, we tend to build, parks, high rise malls 16

September 2014 | www.urbanupdate.in

Rita Bahuguna Joshi MLA Lucknow Cantt constituency, Uttar Pradesh

The biggest problem faced by every city is sanitation. Nearly 40 percent of the cities have open toilets...I feel ashamed that in so many years, we tend to build, parks, high rise malls but we are not able to give the basic infrastructure like sewage to the public

Unmas dispar

Healthcare in cities seems to be a m challenges ahead are a wide disparit accurate dissemination of informatio immediate check as cities are gra Prathiba Raju,


COVER STORY vector borne diseases like malaria, dengue, chikunguniya. Respiratory diseases like tuberculosis are most common in the poorer section of the society. Poverty leads to malnourishment, stunting in many children in slums. While coming to the middle and the rich class, most of them suffer from cardio vascular diseases, diabetes, hyper tension, which is non- communicable,” Dr Priya Balasubramanian, Senior Public Health Specialist, Public Health Foundation of India (PHFI) told Urban Update. Spread of such communicable diseases can be controlled by using technology, said Puneet Gupta of SAP Labs India Pvt Ltd. “A nationwide tracking, monitoring and treatment of every reported person through integrated communicable disease surveillance system are necessary for communicable disease. As a nation, India has the experience of running hugely successful programs like Pulse polio, to eradicate Polio and there is no reason for us not being able to run similar awareness and outreach programs to combat communicable diseases when the technology for treatment is available,” he said.

sking rities

mix of inequity and dismal. Intriguing ty in quality, unaffordable costs, and on. This daunting scenario needs an appling with various health issues Assistant Editor

Dr Priya Balasubramanian Senior Public Health Specialist, PHFI

Overcrowding, poor sanitation, open defecation, under nutrition, typhoid increases the risk of communicable diseases.Middle and the rich class suffer from noncommunicable disease like cardio vascular disease and diabetes

Malnutrition: An invisible crisis

Malnutrition is not a rocket science and can be tackled with simple measures. It is not the question of food intake, but the basic health and sanitation that plays a vital role, inform health care experts. “The fast pace of urbanisation poses a significant challenge to children living in urban slums; especially newborns and infants whose health entirely depends on the availability of the mother to breastfeed, the ability of the care taker and household to provide nutritious meals, the quality of the public healthcare system and overall community support. There is an urgent need to strengthen government mechanisms and to ensure access to these services to curb the ever growing menace of malnutrition,” Jaya Singh, Child Rights and You (CRY), NGO said while sharing a report on malnutrition. Under-nutrition among the urban poor is 1.5 times higher as compared to the remaining urban population. Nearly 54 percent of children aged under five are chronically undernourished among the poorest urban quartile, as per the recent NFHS. In a survey by an NGO, the children in slums take less than 10 kg cereal and one kg vegetable a month. If we analyse their dietary plan one would be surprise how the children survive with such low calorie food. Many anganwadi centres are not enough equipped to meet the dietary requirements of the children. Only one third (33 percent) Indian children receive any service from an anganwadi centre, less than 25 percent receive supplementary foods through Integrated Child Development Scheme (ICDS) and only 18 percent have their weights measured in an anganwadi centres.

Lifestyle disorder - emerging issue

Sedentary lifestyle, junk food, alcohol, and inactive lifestyle are leading factors which are slowly killing a major populace of the city. Increasing lifestyle disorders leads to excess body weight, which is associated with a series of non-communicable disease like www.urbanupdate.in | September 2014

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COVER STORY

Kousalya Periasamy Founder Positive Women Network

With rising migrant population in cities, a dedicated AIDS cell is necessary. Apart from truck drivers, migrants are considered high-risk groups. Every corporation must have a AIDS cell

blood pressure, diabetes, and cardiovascular ailments. Nearly, 53 percent of deaths in India occur due to noncommunicable diseases, the leading cause of mortality in India is cardiovascular diseases, chronic respiratory diseases, cancer and diabetes. “Non communicable diseases like cardiovascular, diabetes are correlated with obesity, which has grown drastically in India. These are primarily caused by the lifestyle and eating habits of the population. People are not aware of the importance of healthy eating and lifestyle habits to control its spread. Obesity and lifestyle disorders are usually developed owing to lack of workout/ exercises, for example increase intake of fibre rich food grains like bajra, wheat atta with fibre, seasonal vegetables which are not rich in trans-fat. Consumption of fast food (chowmein and momos) has also gained popularity in lower income/ slum communities which has also played part in increasing life style diseases and obesity, including among children and youth,” Siddharth Aggarwal, Director, Urban Health Resource Centre (UHRC) told Urban Update. As per the doctors the fat is usually deposited around the abdomen, where it interferes with insulin and increases sugar levels in the blood, causing diabetes in people with a low body mass index. “The populations which was 18

September 2014 | www.urbanupdate.in

under-nutrition for a long time are now exposed to the over-nutrition of the modern world through globalisation. The bad fat nutritional history of the developing world, the epidemic is exploding in developing countries. In order to address this, a study will help to explore various modalities and therapeutic interventions,” said Dr Deep Goel, Director, Department of Bariatric Surgery, BLK Hospital. Doctors term that diabetes and obesity, condition called diabesity, a double barred menace, mostly seen in the middle and upper-middle class urban dwellers. “The prevalence of diabetes is higher among people who engage in light-grade physical activity (17 percent), compared to those with either moderate (10 percent) or heavy-grade physical activities (5 percent). Indeed, the single strongest driver of the diabetes epidemic is a marked decrease in levels of physical activity, particularly in urban areas,” Gupta said. India currently leads the world with an estimated 67 million people with diabetes in 2013; and by 2030 India will have the highest number of diabetes cases in the world, states International Diabetes Federation (IDF). The diabetes epidemic is more pronounced in urban areas in India, where rates of diabetes are roughly double those in rural areas.

Awareness can reduce cancer and HIV/AIDS

Cost-effective long-term strategy, awareness,effective policies can help reduce the number of cancer death in the country. Some five lakh deaths occur annually in India due to cancer. As per the WHO report, the estimated cancer deaths in India are projected to increase to seven lakh by 2015. “Many patients worry unnecessarily, they think if one gets cancer he will not survive. More awareness is needed in various cancer and their symptoms. Apart from awareness programs, the government should take a stern step to control the high costs of drugs, as it gets tougher for patients to complete lengthy therapy. We need an universal health insurance, like many western

countries, with so many life threating disease insurance can helps many ailing people, particularly elders,” said Indra Jasuja, Director (Delhi), Health Services, Indian Cancer Society. In a latest UN study, it is indicated that there is a correlation between HIV/AIDS and population density, and the prevalence of the infection is fast-growing in country like India. “There is strong evidence that HIV and AIDS prevalence tends to be positively correlated with population density, which will increase in India,” the study by the UNAIDS says. This rate was 27.7 percent in India in 2000. By 2030, it is expected to rise to 41.5 percent. The UNAIDS also applauded that last decade India has registered a 50 percent reduction in the number of new infections. But it needs to concentrate more in containing transmission of HIV from mother to child. “With rising migrant population in metropolis like Mumbai, Delhi, Pune, Bangalore, Chennai, Hyderabad we need a dedicated AIDS cell in city which conducts awareness programme, helps victims. Apart from truck drivers, children of sex workers, migrants are considered high-risk groups,” said Kousalya Periasamy, the first woman in India who declared she is HIV-positive. Starting Positive Women Network (PWN) NGO Kousalya informed that NACO has stopped the city based program which was run by three municipal corporations Chennai, Mumbai and Ahmedabad, stating that the activities carried by the cor-

Our programme are wellstructured and we have different programs and some of them are dedicated for the migrants and truckers. We also co-ordinate with various civic agencies

Subhash Chandra Deputy Secretary, NACO


COVER STORY poration are duplication of State Aids Control Organisation (SACO) “We want every corporation to set up a AIDS cell, which will help vulnerable section like migrants, rickshaw pullers, truck drivers,” Kousalya added. Talking to Urban Update on measures taken by NACO Subhash Chandra, Deputy Secretary, NACO, said, “Our programme are well-structured and we have different programs and some of them are dedicated for the migrants and truckers. We also coordinate with various civic agencies.”

Heavy dose of investment needed

The urban healthcare system, with wide demand-supply mismatch and a low spending on public health, is in

Siddharth Aggarwal Director, UHRC

People are not aware of the importance of healthy eating and lifestyle habits to control its spread. Obesity and lifestyle disorders are usually developed owing to lack of workout/ exercises

Proper lifestyle for a healthy heart Healthy diet and lifestyle are the best weapons to prevent cardiovascular disease. Although, we can boast that every third person of the country is young, we cannot assert that they are healthy, as many suffer from lifestyle disorders taking health to a back seat. There has been a disturbing shift in the age group were the number of young cardiac patients is constantly on the rise. Though this is a global development, India has a large number of such young patients. With different kinds of food-habits and only a handful of the population performing daily exercises, more focus should be given on the preventive aspect of cardiac ailments. For example, obesity is an increasingly prevalent metabolic disorder, which increases the risk of developing heart diseases. Many fall prey to the easily available processed, high calorie and oversized food portions, which increase the chances of becoming overweight/ obese in turn increasing the risk of developing cardio vascular disease. Leading a sedentary lifestyle like late working hours, high stress levels, and addiction to alcohol and increase in consumption of packaged, processed and ready-to-eat meals, which are high in salt, cholesterol and oil content and regular consumption leads to weight gain and obesity in turn leads to hypertension. Hypertension which puts stress on the heart and blood vessels is silent killer as its symptoms rarely show, and most of the cases go undiagnosed. Diabetes is another impending risk for heart disease, which leads to stroke. Choosing a nutritious diet with proper calorie, routine exercise, maintaining body weight as per age, avoiding stress, regular and health checkup for blood pressure, diabetes and high cholesterol can help solve many of these deadly diseases. Low sodium, low sugar and high potassium diet along with weight loss solutions can help in control hyper tension; moreover a tension free life can Dr Kandarp Patel help attain a healthy heart. MD, FACC, Cardiologist

ICU. It needs a high dose of investment. Although the government has proposed to increase its total health expenditure to 2.5 percent of the GDP by the end of the 12th Five Year Plan, many feel it is not sufficient, as huge number of patients slip into poverty each year, trying to meet the cost of treatment from their own resources. “Healthcare should be made a priority sector as this is one of the fundamental sectors that have a large effect on the common man. There should be an intersectoral policy for health. Ministries like water and sanitation, environment should work in coordination. In the health ministry level there is lot of dialogue is going in universal health coverage, which would focus on primary health care, which is cityspecific,” Balasubramanian said. On pilot basis in cities with different population size, segments a health program needs to be implemented through municipal bodies to know how the benefits of well intended government health programs reaches the needy citizens, Aggarwal said. “These lead programs results will help the government to evolve the working systems of collaborative program delivery which should then be adapted and replicated in all cities of the country.” The schemes implemented should be monitored, many a times a large portion of the funds and medicines never reach the intended beneficiaries, adds Gupta. “The funds meant for public healthcare programs get diverted and never reach the beneficiaries resulting in reduced effectiveness of the programs. This makes it difficult for the beneficiary to avail the intended benefits for the services designed for them and increases the overall cost of healthcare,” he said. The schemes implemented by the government should be monitored, many a times large portion of the funds and medicines never reach the beneficiaries, Gupta added.

Direct your queries to

prathiba@urbanupdate.in

www.urbanupdate.in | September 2014

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COVER STORY

Crunch in basic healthcare Beds per 1000 population Kerala 3.07 30,000 Doctors from 181 govt hospital

Delhi 2.33

Bihar 0.33

UP 0.38

Maharashtra 1.08 220,000 Doctors shortfall

206 Pvt medical colleges

Doctor-population ratio 2020 4 lakh doctors needed to 1:1000

Out-of-pocket health expenses - compulsion for urban dwellers India 78 %

China 61 %

Sri Lanka 53 %

Thailand 31 %

The statistics on urban health showcases the severity of ill-health the citizens are undergoing. It highlights that a pragmatic decsion along with immediate attention is needed on the healthcare sector. Optimum healthcare services at an affordable cost is required to eradicate the inequity in the sector

Bhutan 29 %

Maldives 14 %

Pakistan 82.5 %

Supersized India 73 % Urban Indians are obese 28-38 yrs Maximum risk age 3/4 Indians are overweight

Health 20 September 2014 | www.urbanupdate.in


COVER STORY

Chubby states Punjab

Kerala

Goa

Tamil Nadu

Andhra Pradesh

XL children 40 % Eat out

70 % Chips

38 % Burgers

48 % Pizzas

40 % French fries

60 % Noodles, aerated drinks (Once in a week)

Spiralling cancer cases

Cancer in metro women

City Men Women

City

Mumbai Delhi Chennai Bangalore Ahmedabad Kolkata Kollam Pune Trivandrum Nagpur

15,745 13,720 7,392 5,645 6,615 4,611 4,656 4,047 2,851 2,668

17,485 12,613 7,866 6,979 5,229 4,427 4,374 4,547 2,904 2,754

72 % 2011

19 29 30 41

67 Million 2014

70 Million 2025

HIV/AIDS in age North 22%

6% 0-14 yrs

21 % 15-21 yrs

73 % 25 yrs

Predicted growth of healthcare

Healthcare market 54 % 2009

27 29 21 22

40 Million 2007

Andhra Pradesh West Bengal Maharashtra Gujarat Karnataka Bihar Tamil Nadu Uttar Pradesh

51 % 2008

Breast cancer Cervix cancer

Diabetes

Factfile of HIV/AIDS South 55%

Mumbai Delhi Bangalore Chennai

38 % 2012

65 % 2010

5.5 % 2009

8% 2012

$280 billion 2020

Top 5 causes of death Causes of Death

Cardio Vascular Disease Respiratory Disease Tuberculosis Malignant and other tumors Ill defined conditions

Male

26 10 11.4 7.8 4.8

Female 22 10.4 8.3 11.8 6

Hazards www.urbanupdate.in | September 2014

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COVER STORY

Urban Poor & Health Care

A CRACK T WIDE OPEN

Average urban health indicators are deceptive. Urban poor are at greater health risk than their rural counterparts. As rural poor benefit from low population density and better environment that confer a form of natural protection against some communicable diseases Abhishek Pandey, Principal Correspondent

22 September 2014 | www.urbanupdate.in

he upward trend of migration towards urban centres suggests that more poor people from rural areas are migrating to urban centres with a hope of living a better life but most of them end up living in unhygienic conditions in illegal slums. The demographic transformation has had profound implications on the health of urban poor. There is an instant need to acknowledge and address the social and economic diversity of urban poor population whose health environments differ from those of rural poor. Anil Kumar of National Forum for Housing Rights (NFHR) says: “Urban poor constitute 35-65 per cent population in cities, but hardly occupy a tenth of the land in cities.” Gita Pillai, Director of Urban Health Initiative (UHI), said: “The country is rapidly urbanising. In most cases, rural poor leave their families in villages and come to cities where they don’t have social networks. If they have some medical emergency, they have to handle everything on their own without any social support. “Another problem is: urban system has begun developing now and they are not well coordinated while the country has good rural systems. It makes, sometimes, harder for urban poor to access health services.” The situation in cities throws up a major challenge for the government and authorities to build a health care system that benefits urban poor, especially the migrants. Pillai underlines that many of these poor remain invisible to system as


COVER STORY they live in illegal settlements and they are not reflected in government surveys. She adds that urban poor do not feel powerful enough to ask for services they are entitled to. Some are not aware of health services available and others feel if they reveal their identity to the government officials, it may result in their eviction from their illegal settlements.

Urban Vs Rural

The common belief is that healthcare system in urban areas is generally better than rural areas as it is supported by good number of scientific evidences, surveys and studies. If one looks at health indicators such as child mortality, percentage of delivery in hospitals, prenatal and postnatal care, spread of communicable diseases, etc., urban healthcare system appears for better than rural one. However, averages can be deceptive. Urban health averages covers wide socioeconomic differentials. When these are disaggregated, it becomes clear that urban poor often face health risks that are more severe as those of their rural counterparts. The situation on ground suggests that health policies for urban centres cannot be based on averages alone. Disaggregation is quite essential if policies and health programmes are to be properly formed targeted to those most in need. Urbanites in general enjoy an advantage in healthcare system available to them relative to rural populace. With private hospitals having state-of-the-art facilities providing all sort of heathcare services in cities and the availability of public hospitals run by municipality, State and Central governments, healthcare system in cities provides a lot of choices to urbanites to choose where to go for heathcare. The availability of options have improved health services for middle and high income groups but nothing much has changed for the poor in cities. Urban poor without cash on hand find themselves unable to gain entry into the modern private

Dr Gita Pillai Director, Urban Health Initiative

The country is rapidly urbanising. In most cases, rural poor leave their families in villages and come to cities where they don’t have social networks. Urban system has begun developing now and they are not well coordinated while the country has good rural systems. It makes sometimes harder for urban poor to access health services

hospitals and clinics. Even public health infrastructure is miles away from being equitably distributed; the urban poor are notably ill-served in comparison with other urban households. Geographic targeting could be an effective health strategy for reaching urban poor living in slums, but other methods will need to be devised to meet the needs of the poor who live outside slums. The newly proposed National Urban Health Mission considers these hurdles in improving health care in urban areas and addresses these critical issues. Dr Ajay Khare, Joint Convener and the Member of National Coordination Committee of Jan Swasthya Abhiyan (JSA), says: “Poor urbanites live in close proximity without the protections of safe drinking water and adequate sanitation; they face elevated risks from water, air, and food-borne diseases.” Khare further explained, however, rural households have even less access to water and sanitation services than poor urban households, but

they benefit to an extent from lower population densities. Such conditions confer a form of natural protection against some communicable diseases. Recently, the government initiated National Urban Sanitation Policy (NUSP), 2008 and it aims to make cities community-driven, totally sanitised, healthy and liveable. It intends making cities 100 percent open defecation-free and 100 percent safe disposal of human excreta and liquid wastes.

The Way Ahead

In one of the reports on urban health system in India, the Associated Chambers of Commerce and Industry of India (ASSOCHAM) estimated that an investment of Rs. 7 billion is required to provide basic living and health facilities to poor urbandwellers. Many reports and surveys including this one suggest that urban poor in every city are in the most disadvantaged position with respect of almost all health indicators. Since poor population live in illegal colonies and unregistered households, it is necessary to formulate more inclusive policy that extends services to all poor people in addition to slum dwellers. Healthcare system for urban poor has not been given due importance as the major focus has been on improving rural healthcare system. In general, urban healthcare has improved but it did not cover each and every one. Recently in January 2014, Union government launched the NUHM that is a sub-mission under National Heath Mission (NHM). The NUHM has several provisions to deal with the challenges of heath care services in cities. The most important being is setting up Urban Primary Heath Care Centres (UPHC) focusing to provide heath services to slum and non slum poor population of cities. The mission is being implemented in 779 cities and towns with a population of 50,000 or more. The mission is expected to cover over 7.75 crore people nationwide. The initial www.urbanupdate.in | September 2014

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COVER STORY budgetary allocation for the mission is Rs 22,507-crore. The mission is to facilitate equitable access to quality health care through a revamped primary public health care system, targeted outreach services and involvement of the community and urban local bodies. The mission is on the lines of the Health and Family Welfare Ministry’s flagship National Rural Health Mission (NRHM) launched in 2005 to address the health challenges of rural India. The interventions under this submission has set goals to reduce the Infant Mortality Rate (IMR), the Maternal Mortality Ratio (MMR), universal access to reproductive health care and the convergence of all health-related interventions. Another ongoing scheme by Union government--Rashtriya Swasthya Bima Yojana (RSBY--is designed to protect patients from the ‘catastrophic’ impact of out-of pocket expenses incurred on hospital care. It is

Ajay Khare Joint Convener of Jan Swasthya Abhiyan (JSA)

Poor urbanites live in close proximity without the protections of safe drinking water and adequate sanitation; they face elevated risks from water, air and food-borne diseases. Rural households benefit to an extent from lower population densities.

modelled on ‘Rajiv Arogyasri Scheme’ running in Andhra Pradesh. The

Indian Population Rural 68.84%

Urban Urban Poor 31.16%

27 % of urban population

Urbanisation 2001 27.81% 2011 31.16%

Rural Population Declined 72.1% to 68.84%

2001 2011 Difference

India 102.9 121.0 + 18.1 Rural 74.3 83.3 + 9.0 Urban 28.6 37.7 + 9.1 Source: Census 2011

24 September 2014 | www.urbanupdate.in

scheme enables urban poor to avail medical services in any accredited public or private hospitals and major financing comes from central or state government funds. Khare further says that the NUHM and RSBY targetes to improve health care services for urban population, particularly for the poor and disadvantaged sections. However, the scheme does not provide comprehensive health care. Beneficiaries are insured against a couple of ailments that require hospitalization. He adds that India has one of the best public healthcare system in the world that has many provision to help the poor. There are many heath schemes that could benefit the poor urban populace but there is a lack of information about them. Poor implementation of the schemes and medical staff crunch in hospitals are also responsible for poor healthcare condiions. He added that the schemes like the NUHM and the proposed Right to Health will definitely help the urban poor if these schemes are allotted enough funds. The scheme also exclude almost all infectious diseases that are treated in out-patient settings, such as tuberculosis that requires prolonged treatment, most chronic diseases such as diabetes, hypertension and heart diseases, or cancer treatment that does not call for hospitalization. A review of health system in India done by Jan Swasthya Abhiyan (JSA) —a non government organisation— recommends a couple of measure to improve health care. It suggests that the current Clinical Establishments Registration and Regulation Act should be implemented in all states and it should be broadened since it does not mention the principles of patients’ rights or ensuring public health obligations of private providers. The review report also suggests that such reformulation should be based on a consultative process, to take into account the concerns of various stakeholders including health rights organisations and patients groups.


COVER STORY

Participation of Civil Society Organisations in Indian health care system is crucial as they play a catalyst role and bridge the gap between government, private health providers and the beneficiaries, particularly the urban slum dwellers

Civil Society

Empowering poor for improved health care

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overnment lacking fitting infrastructure and manpower in making heath care available to urban poor living in diverse environments. Civil Society Organisations (CSO) are pitching in with volunteers, medical experts, and funds to improve health care delivery. Delivering health care to over 1.2 billion population is a challenging task. The government has numerous health care schemes to benefit the poor but does not have an infallible delivery system that could ensure ideal implementation of health programs and reach-ability to the last poor. Globally, CSO, NGO and local community groups have been instrumental in improving health care situation. However, owing to poor medical infrastructure and facilities available in rural India, the major focus of the international and national NGOs in India has been villages. These organisations are working with their volunteers and member institutions to help governments to implement health care schemes effectively, provide medical facilities, and spread aware-

ness on hazardous diseases among poor living in urban slums or on the streets of metropolitan cities. Mukesh Sharma, Programme Manager Urban Health Initiative (UHI) says, “there are largely three kinds of works CSOs are doing in India for improving health care—model creation for ideal health care system, advocacy to reform health policies, and training and treatment.” Ajay Khare of Jan Swasthya Abhi-

Mukesh Sharma Programme Manager Urban Health Initiative (UHI)

Three kinds of works CSOs are doing in India for improving health care—model creation for ideal health care system, advocacy to reform health policies, training and treatment

yan further explains, “the Guttmacher Institute—a research institute for advancing sexual and reproductive health created a Home Based Neonatal Care model that enabled heath department in Maharashtra to reduce the child mortality by 20 percent in Ghadchiroli district.” Similarly there are other organisations such as JSA, the Catholic Health Association of India, CRY, Child Fund, Save the Children, The Hunger Project and others. They have been demanding drastic reforms in health policies and more budgetary allocation for health sector. WHO, the international health organisation working closely with CSOs and NGOs to improve public health in India and other countries, created the Civil Society Initiative in 2001 to foster better understanding of community groups and civil society. According to the WHO India, the interactions with NGOs have been varied, dynamic and long-standing; they could benefit from more recognition and systematic integration into the core priorities of the WHO. Exhaustive and long campaign against Polio that made India a polio www.urbanupdate.in | September 2014

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COVER STORY

Health Scenario The World Health Organisation (WHO), CARE India and many other CSOs are executing many heath related projects in close collaboration with governments and community groups to ensure better maternal and child health in the marginalised communities in cities. SAKSHAM in Andhra Pradesh

The key objective of the project is to enhance capacities of NGOs and CSOs to ensure community mobilisation strategies for reducing risk of HIV/AIDS and STD contraction amongst marginalised populations. AXSHYA in MP, JH, Chhattisgarh

AXSHYA works to address identified challenges in the treatment of Tuber-

free country is an idle success story of collaboration between NGOs and health department. During these large-scale drives, thousands of volunteers of Rotary India Foundation joined health workers to vaccinate every child under age five against polio on national immunization days. According to the WHO, over 100,000 volunteers of the organisation were involved in spreading awareness and immunizing children. Talking about the involvement of civil society and government in improving health situation in the country, Deepak Kapur, the chairman of the Rotary International’s India National PolioPlus Committee since 2002, writes in a post on Rotary India Foundation website: “the National Polio Surveillance Committee and W.H.O. are utilizing the infrastructure to improve routine immunizations. We are asking all Rotarians in India to focus on routine immunizations and alongside polio, focus on promoting other diseases. The polio model will be in vogue towards the end of this decade for a host of other diseases and social needs.” Sumit Mazumdar of Institute for Human Development (IHD) said that the 26 September 2014 | www.urbanupdate.in

culosis (TB). It also targets to scale-up care and management of Drug Resistant -TB in 35 States/Union Territories of India resulting in the initiation of treatment of 55,350 additional cases by 2015. Family Health Initiative in Bihar

The Family Health Initiative, with support from the Bill and Melinda Gates Foundation, catalyses a dynamic process of developing innovative solutions that transform family health services. SWASTH in Bihar

As part of Sector Wide Approach to Strengthen Health (SWASTH), CARE India is providing technical assistance support to Bihar govt. to develop a comprehensive health sector reform, a nutrition policy and capacity building.

Sumit Mazumdar Sr Researcher, Institute for Human Development

Role of civil society and local groups was vital in making health care system accessible for urban poor. Strong local groups in cities can make sure government schemes reach the urban poor

role of civil society and local groups was vital in making health care system accessible for urban poor which has varied characteristics. Mazumdar added that sanitation and lack of public toilets in slums and poor habitats in cities is a major concern and strong local groups in cities can make sure government schemes reach the poor and urban dwellers are well informed about their entitlements, rights and responsibilities. Understanding the need of sanita-

Urban Health Initiative in UP

The Urban Reproductive Health Initiative in Uttar Pradesh is designed to contribute to India’s efforts to achieve the Millennium Development Goals, especially its target to achieve universal access to reproductive health (RH) by 2015. IMPACT in West Bengal

The objective of IMPACT (Initiative to Manage People Centred Alliances in Control of TB) is to support the Revised National Tuberculosis Control Programme (RNTCP) to decrease the morbidity and mortality caused by Tuberculosis (TB). Other initiatives

EMPHASIS in Delhi, UP, and WB, SEHAT in MP, CHAI in Telangana, Andhra Pradesh, CHCMI in WB, etc.

tion in urban habitats, the South East Regional Office of WHO (SEARO) joined hands with NGOs and the local municipal government ten years ago to provide low-cost toilets and safe water for 150,000 people in 12 urban slums in Delhi. The Population Services International (PSI) and Sulabh International Social Service Organization executed the project and helped municipal body to improve hygienic conditions in Delhi slums. During the project, the PSI and Sulabh trained over 6000 residents of Delhi slums on hygiene and sanitation related issues and identified 1500 volunteers among the residents to communicate health and environment message to people. It is apparently clear that people form the core of health systems and CSOs and NGOs are playing a key role in making people empowered enough to demand for services and building awareness of community needs among them.

Direct your queries to

abhishek@urbanupdate.in



COVER STORY

Medical Tourism

When, West

flocks to the East India is heaven for those who can’t payhuge sum for life saving treatment. That’s why medical tourism in our nation is on boom. India offers cost effective healthcare without compromising on its quality Jessy Iype, Desk Editor & Reporter

I

ndian hospitals attract more foreigners than Taj Mahal does. India has tens of thousands of well qualified doctors and skilled nurses. Delhi, Mumbai, Kolkata, Chennai, Hyderabad, Bangalore, Vellore are top cities that are providing such facilities. Over the last two decades, the economic boom led to the building of medical facilities and infrastructure that rival the very best that western medical care has to offer. While some small countries may be viable as alternatives for minor surgical procedures, India is the only mainstream option that offers a comprehensive solution for any and all medical needs, and does this with the highest levels of service, facilities, and professional skills. Fifty-three percent of total foreign patients comes for different kind of surgeries like Cardiac Surgery, Colon and Rectal Surgery, Breast Health Surgery, Neurosurgery, Orthopedic Surgery, Plastic and Reconstructive Surgery, Surgical Oncology and so on, 18 percent comes for wellness and spa service, 18 percent for surrogacy, and rest 14 percent for dental surgeries. 28 September 2014 | www.urbanupdate.in

Upward dosage

India’s medical tourism sector is expected to experience an annual growth rate of 30 percent, making it a $2 billion industry by 2015. A complex transplant or bypass procedure can be achieved for a tiny fraction of the cost for the same procedure in the US. Not only do tourists benefit, but local hospitals do as well. Said Parvez Dewan, secretary, Ministry of Tourism India: “The growth of medical tourism in India has led to the enhancement of better and advanced medical facilities in the country.” Dr AP Singh, Jt Secretary, Delhi Medical Association, speaking on the boom in medical tourism told Urban Update, “Earlier we used to go out to the west for optimum healthcare facilities, now the tables have turned and India is equally at par in providing five star healthcare.” Chief cardiothoracic and vascular surgeon at the Fortis Group of Hospitals Vivek Javali said the medical tourism sector a would only mature as time goes by and India would continue to attract patients from Europe and the USA, because of cost effective and qualitative healthcare available here.

Role of states

While the country benefits from the popular medical services, it is essential that the government ensure that the tourists have adequate accommodation during the stay, have ease travelling option. Janavignana Vedika, the largest people’s science movement in Andhra Pradesh, whose secretary general Dr V Brahma Reddy had ensured that the state authorities provide diversified facilities across and not confine to one particular place.

Dr AP Singh Hon Jt Secretary Delhi Medical Association

Earlier we used to go out to the west for optimum healthcare facilities, now the tables have turned and India is equally at par in providing five star healthcare


COVER STORY

This apart, measures should be taken to offer advanced medical treatment to the general public within their limited budgets, he had appealed. Indian Medical Association, Andhra Pradesh president, P. Venkateswarlu said there was a need to have international airports with night landing, helicopter ambulance services in the country. Many state governments have put medical tourism on top priority. Newest state Telangana’s chief minister K Chandrashekar Rao said, “Hyderabad can take a lead in medical tourism and the best example has been shown by Apollo Hospitals Group, which attracts patients from 150 countries.” With a view to boost the image of Hyderabad globally, Rao hinted at corporate hospitals to capitalise on their expertise and infrastructure in order to tap patients around the world.

Competitors boost

According to experts, we have both US and Indian based staff of specialists who focus on Medical Tourism, and stay abreast of all current developments in their respective fields. These specialists work closely with the leisure travel specialists and are able to coordinate explorations of India’s (and other Asian countries) major tourism attractions. These can be facilitated for a vacation for the patient and their travelling companion. This kind tourism in the country will continue to boom despite attempts by US administration to curb the flow of American patients to India and other Asian Countries as US president Barack Obama earlier had said that he would change the US healthcare system to discourage Americans from seeking medical treatment in India.

Factfile

♦♦ Anand District of Gujarat is considered as the World surrogacy Capital. From past few years many couples paid million of rupees to poor women of Anand district to fulfill their dream to have children. ♦♦ India has world’s best guided regimens of Aryuveda, Yoga, and Meditation, which speeds healing of ailments and brings the mind and body together as one

But it seems India remains one of the best option. Dr Ajay Sharma, Founder and Chief Medical Director, Eye-Q Super Speciality Eye Hospitals, Gurgaon told Urban Update: “Better technology can change the healthcare behavior of the population and improve skill in healthcare delivery. Our focus is not just on meeting the needs but to make available superlative care.” www.urbanupdate.in | September 2014

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COVER STORY

Corporate Health

Mind your Medical business Urbanisation in today’s world is an ongoing process that has a profound impact on people’s living conditions and health status. The driving forces behind this process are the globalisation of markets, and new information technologies. Investment from both the public and private sector is required to moderate the impacts of urbanisation, ensuring the expansion of healthy and inclusive urban communities

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here is a critical need for better inter-sectoral coordination between the health sector and other sectors such as housing and planning, in preventing negative health impacts associated with rapid urbanisation in the future. Unplanned urbanisation is not a new threat to environmental sustainability. The continued gwroth of cities today is partly due to rural to urban migration and partly dute to an influx of migrants from other countries. In 1950, 30 percent of the world’s population lived in urban centres. Unprecedented urban growth saw 30 September 2014 | www.urbanupdate.in

this number increase to 50 percent and, today, this trend shows no signs of slowing.

Root cause ignored?

Migrants relocate to urban centres in search of employment opportunities and improved access to social services, including healthcare and education. The positive social impacts of urbanisation are many; however, such benefits are not consistently available to every migrant. Moreover, they do not offset the negative consequences overcrowded and under-resourced urban areas pose to the community’s health. Says Dr Ajay Lekhi, member

of Delhi Medical Association, “The middle class is the most deprived as they depend on the doctor’s verdict for any ailment and have to rely on the poor government hospital services. They do not have access to better services due to economical disparity that is generated due to private health centres.”

Status quo

Achieving good health is one of the major concerns in modern societies. Whilst attention is more directed towards post-genome research, we should not forget that our genes are influenced by environmental exposure


COVER STORY

Thirty-two percent of the national bed strength is in the 150 plus private corporate hospitals. There is an estimated demand of another 80,000 beds per year in next five years

Anil Mehra, MD India Aeromedical Services Pvt Ltd

and lifestyle. The challenge of future epidemiological research would therefore be to decipher how different genetic make-ups may modify the effect of various environmental factors. The healthcare sector is made up of many different industries – from pharmaceuticals and devices to health insurers and hospitals – and each has different dynamics. Investments in this sector are affected by many variables, including positive trends related to demographics and negative trends related to reimbursement. Feels Kaberi Niyogi, of Indian Medical Holiday, “Even though the government hospital services are good in India and are allocated funds, suitable services are not provided.” The role of private hospitals is crucial as they provide affordable healthcare services, but there is a considerable disparity in not providing a wholesome one to the urban poor, she added.

Privatisation boom

Anil Mehra, Medical Director, India Aeromedical Services Pvt. Ltd says, “Thirty-two percent of the national bed strength is in the 150 plus private corporate hospitals.” “Tatas, Apollo, Wockhardt, Escorts,

Max India, Fortis, Piramal, Ispat, Duncan,Escorts etc. have been the major contributors. There is an estimated demand of another 80,000 beds per year in next five years.” Influx of patients into India from other developing countries for stateof –the –art medical and surgical care, is booming every year and medical tourism, is seen as an incentive for further investment and involvement of the private sector in the healthcare industry. According to an ASSOCHAM study, the private sector accounts for 80 percent of India’s healthcare delivery market which is higher for India than in any other country in the world. Out of pocket spending by Indians constitutes 94 percent of total spend in the private

hospital chains not only in urban cities but also in innovative rural models, we expect this large investor appetite to contribute significantly to the increase of private healthcare establishments, D S Rawat Secretary General Assocham, said. Innovative infrastructure financing models will reduce incubation periods stimulating increased investor interest. Large corporations have also begun venturing into this highly lucrative business and we expect to see continuity in this trend, he added. The private sector has emerged as a vibrant force in India’s healthcare industry, lending it both national and international repute. The sector’s share in healthcare delivery is expected to increase from 66 per cent in 2005 to 81

Government Initiatives The Planning Commission has allocated US$ 55 billion under the 12th Five-Year Plan to the Ministry of Health and Family Welfare, and focuses on providing universal healthcare, strengthening healthcare infrastructure, promoting research and development (R&D) and enacting strong regulations for the healthcare sector. Some of the major initiatives: ♦♦ All India Institute of Medical Sciences (AIIMS) spends at least Rs 2 million (US$ 33,271.51) annually on each faculty member, according to a study by the institute’s hospital administration ♦♦ Sikkim has become India’s first state with 100 per cent sanitation coverage, according to a report of the drinking water and sanitation ministry ♦♦ India and Maldives have signed three agreements after delegation level talks between Mr Abdulla Yameen Abdul Gayoom, President, Maldives, and former Indian PM Dr Manmohan on January 2, 2014. The pacts include a Memorandum of Understanding (MoU) on health cooperation ♦♦ The Union Cabinet has approved the proposal for setting up of National Cancer Institute (NCI) at a cost of Rs 2,035 crore (US$ 338.51 million). NCI will be set up in the Jhajjar campus (Haryana) of All India Institute of Medical Sciences (AIIMS), New Delhi. The project is estimated to be completed in 45 months ♦♦ Sis Ram Ola, Union Minister of Labour and Employment, Government of India, has inaugurated the state-of-the-art ESIC Model Hospital at Jaipur, Rajasthan

health industry. India attracts patients mostly from Africa, Gulf and SAARC nations, Pakistan, Bangladesh and Myanmar, who come mainly for organ transplant, treatment of orthopedic, cardiac and oncology problems, adds the study. The private healthcare landscape is poised to be a key contributor to the healthcare industry. With substantial private equity investments in private

per cent by 2015. The private sector’s share in hospitals and hospital beds is estimated at 74 percent and 40 per cent, respectively. According to data released by the Department of Industrial Policy and Promotion (DIPP), hospital and diagnostic centres attracted foreign direct investment (FDI) worth Rs 11,272.32 crore (US$ 1.87 billion) between April 2000 and February 2014. www.urbanupdate.in | September 2014

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COVER STORY

Bitter pills

Is health souring you or the drug?

The unregulated medicine market and unethical medical practices in India has put the health of people at risk. It is the government’s imperative to ensure the ethical practises are followed in the pharmaceutical industry and the people need not pay exorbitant prices

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eteriorating health conditions, owing to urban pollution and change in lifestyle, compel us to pop pills. But has the dependency on drugs made us vulnerable to be victimised of the over-exorbitant prices of them? Is the government turning a blind eye to the most crucial sector per say. We see that even a normal consultation fee is overcharged to the limit that a common man has difficulty to afford. The absence of a well thought out policy framework for strengthening the health system is the most important issue facing the health sector in India. In the government,

32 September 2014 | www.urbanupdate.in

there is no clarity on what the nation’s health system should be 10 years hence, says K Sujatha Rao, former Secretary, Ministry of Health and Family Welfare.

Financial aspect

Medical is considered as a noble profession. The foremost aim of medical profession is to provide service to humanity. Financial profit is a subordinate consideration. But it has been observed globally that medical practitioners in conjunction with pharmaceutical companies are prescribing and thereby promoting unnecessary drugs just for the sake of monetary gains. The unethical

relationship between doctors and drugs companies and its future consequences has been continuously raised by many media and social activist. But this topic got the most coverage when Bollywood actor Amir Khan raised this issue in is TV show Satyamev Jayate. One of its episode of the show threw light on the frail health care system prevalent in the country. How corrupt hospital management and some doctors cost the life of a patient to raise their bank balance. Doctors suggest that a medicine which cost too much in the market has same compositions of drugs that are available in a govt. shop. They never prescribe generic medicines that


COVER STORY are available at affordable cost and are in no way inferior to the branded medicines produced by celebrated pharmaceutical companies.

Unethical practice prevalent

Recently a news channel named “News Nation” in its sting operation “Operation Jonk” showed the ease with which some doctors have exposed as collecting 30-50 percent commissions on magnetic resonance imaging (MRI), CT Scans, ultra sound, routine pathological tests, etc., the footage was captured through surreptitiously filmed conversations. Some reputed diagnostic centres of Delhi, including its oldest standing one, were shown as involved in this nefarious racket. In response to that expose Union Health and Family Welfare Minister Dr. Harsh Vardhan clearly said :“Ministry does not accept the alleged medical fraud findings of the television channel News Nation achieved through its “Operation Jonk” expose. “The Ministry of Health and Family Welfare does not accept a broad-brush depiction of the medical community as

guilty of such malpractices. However, it is felt that some individuals who are indulging in such unethical conduct should be identified and disqualified from practicing the noble profession of the physician,” Dr. Harsh Vardhan said. The interaction between doctors and medical representatives is almost an age old practice. The basic role of a medical representative is to inform the doctor about his company’s products including the drugs. There is nothing wrong in that as long as the ultimate beneficiary of this information is the patient. After all, continued professional development is an essential component of a good healthcare system. Even the Medical Council of India expects that every registered medical practitioner should try to upgrade his knowledge and skill for the betterment of his patients. Unfortunately, there is often a conflict between the interests of the patient and doctors as far as the drug promotion is concern. The drug-companies interact with doctors in order to promote their medicines. They reach out to almost all concerned doctors to attain their goals. The doctors are compensated

Highlights ♦♦ Healthcare expenditure in India expected to increase by 12% per ♦♦ annum between 2011-15 ♦♦ Foreign Direct Investment in the country has increased to USD 1,183.04 million in hospitals and diagnostic centers and USD 9,170.24 million in drugs and pharmaceutical space ♦♦ Recent, large number of acquisitions of domestic pharmaceutical companies by foreign majors ♦♦ Increasing Government expenditure on public healthcare expected ♦♦ The industry’s growth forecast is defined by rising incomes of the urban middleclass in particular, leading to greater affordability of private healthcare facilities, a growing aged segment of the population, and increasing risks from changing disease patterns and large population of lifestyle diseases like Diabetes, Cancer, and so on Challenges The Government has made/proposed a lot of policy changes to control the rate of takeovers of domestic pharmaceutical companies by large MNCs, in order to control the price of medicines ♦♦ The threat of controlled licenses being awarded to companies to manufacture patented drugs at cheaper rates ♦♦ Major companies are facing several patent related issues which have major impact on their exclusive revenue streams – this is giving rise to the need for organizations to find cost- cutting solution

K Sujatha Rao former Secretary, Ministry of Health and Family Welfare

In the government, there is no clarity on what the nation’s health system should be 10 years hence

adequately in the form of gifts and other incentives by drug companies. Consequentially, both the parties are benefited from this interaction with potential consequences for patients.

Ape the west?

Should India have a public sector dominated system like Brazil or China; or a regulated private-led like the US; or one where both sectors function but have only one payer as in the UK is an opinion to be debated about. In Japan, delivery is private but the government sets the prices. Each option has its costs, benefits, tradeoffs and systems to ensure control on costs and quality. India has a unique laissez faire model with a private sector-led health system that is unregulated and has no rules of the game spelt out, not even as minimal as those laid down for opening a liquor shop. And so, one can set up a nursing home in a residential colony; throw infectious waste anywhere, charge any amount that the market allows and have no systems of oversight to assure quality, says Rao. The private sector is further incentivised by excise duty waivers, subsidised loans for establishing hospitals, tax breaks and a liberalised health insurance market with tax exemptions for the premium.

Direct your queries to

Jessy@urbanupdate.in

www.urbanupdate.in | September 2014

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CENTRE STAGE

Under the thumb in Politics

“ Persistent efforts are made to push the one-third reservation for women in various legal bodies including parliament, but when it comes to politics-the hall of the power, women still seem to be under the thumb Prathiba Raju, Assistant editor

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he stature of women in India has been changing over the times, but there participation in politics seems to be the same. The gender gap in politics is wide, as the women legislators in the country remain to be a handful and there seems to be a qualm to raise the number. As per Inter-Parliamentary Union (IPU), an international organisation, which works closely with the United Nations, says India is placed as lowly at 111th position out of 189 countries in a list that ranks nations on the number of women representatives in parliament.

Less in number

In India, there are only 62 women parliamentarians sitting in the Lok Sabha (lower house), the total share of women in the 16th Lok Sabha is 11.2 percent compared to 89 percent men. Out of total 7828 representatives to Lok Sabha, men comprise 93 percent of them and women seven percent, it stated. When compared 34 September 2014 | www.urbanupdate.in

to the neighboring countries, Indian women in politics seem to be miniscule. Over 20 percent of the lower houses of Pakistan, Nepal and China’s are women; five to six percent of the national legislative bodies of Myanmar, Bangladesh and Sri Lanka are female. “We cannot compare our country with neighboring countries like Bangladesh, Sri Lanka or Pakistan. Our country is much bigger and widespread. Women have been actively participating in politics, how much ever the representation of the women folk is, it is strong and vocal,” Moon Moon Sen, MP from Bankura, told Urban Update. Butta Renuka, MP, Kurnool (Andhra Pradesh) said, “India is a country where women have been revered as goddesses from time immemorial. Women are considered as life givers, as family makers, but women are not shining in every arena in India. Unfortunately, the percentage of women in politics in India is low.” “Women should participate more

Moon Moon Sen MP from Bankura

We cannot compare our country with neighboring countries like Bangladesh, Sri Lanka or Pakistan. Our country is much bigger and widespread. Women have been actively participating in politics, how much ever the representation of the women folk is, it is strong and vocal

in politics as they are endowed with patience, and have a more focused thinking and will be a good decision maker,” Renuka added.

Progress seen

Informing that the women participation in political arena is progressing, Mamtaz Sanghamita, MP from Bardhaman-Durgapur, said: “The women participation in the political fraternity is building up slowly. For example, the 16th Lok Sabha has 62 women members with more women representation, issues concerning women will be taken up. The passage of the women’s reservation bill also seems to be possible with such huge support.” “Although women representatives at rural level in the Panchayati Raj are increasing. Certain states are leading in it,” Sangahmita added. States like Madhya Pradesh, Himachal Pradesh, Bihar and Uttarkhand have increased the reservation percentage to 50 percent from 33 percent.


CENTRE STAGE Beating the odds

The Women Reservation Bill, which would provide 33 percent reservation to women in parliament and state legislatures, was passed by the Rajya Sabha on March 9, 2010, but blocked in the Lok Sabha during the UPA’s tenure. It lapsed in the 15th Lok Sabha ahead of the April-May general elections. If the eighteen year old bill was cleared, it would have set aside 390 and 2,060 seats in parliament and the state assemblies respectively for women in this election. First introduced in 1996, it could not make headway in the Lok Sabha because of opposition from parties like the Samajwadi Party (SP) and the Rashtriya Lok Dal (RLD) which demanded a sub-quota for scheduled castes/scheduled tribes and other backward classes within the women’s quota. The bill has been hanging out since then. “With just 63 women out of the 543 MPs, still we are far less than onethird in the house. We need to bring in Women Reservation Bill, but whoever is the ruling party should make sure it’s passed. It has been hanging around for as it will help the nation as a whole,” P K Sreemathi, Communist Party of India (Marxist) CPI (M) said. The ruling government should take a step to bring in the long pending bill, she added.

Meenakshi Lekhi Spokesperson BJP

People talk about empowerment of women and do nothing about it. When it comes to women in politics some of the issues are respect, decency, safety and protection

Sadhavi Niranjan Jyoti, a BJP MP from Fatehpur (Uttar Pradesh), informed that BJP is committed to pass the women reservation bill in the next session of the parliament. “I strongly support women’s reservation bill, that will ensure active participation of women in policy making. Women are mamta ki murat (idol of motherhood) and they would be able to perform better in politics. The country cannot prosper if the half of the population is not empowered. Regional parties such as JD (U), Samajwadi Party believe that their parties will be marginalised if the women reservation bill is passed, which makes the delay,” Jyoti added.

The problem persists

There are many issues faced by women in politics shared Julie Thekkudan, Lead Specialist, Gender Justice, Oxfam India told Urban Update, “Women in politics face specific violence that men do not face, particularly the first generation women politicians face sexual harassment, character assassination, like the Australian PM Julia Guliard faced during a campaign. For women Mps, networking with their constituency becomes difficult and puts them at risk of facing violence unlike the male politicians. Many women politicians are largely connected to political families for whom the entry is easier.” The main hindrance for women politicians they are not be able to raise resources that are required for contesting elections like their male counterparts, which is why women are not given tickets for contesting. She also added that they have been given softer portfolios which restrict their active participation and they are able to reach only to a limit, though this too may be changing gradually.

Respect, regard us

Stating that more respect is needed for women politicians, Meenakshi Lekhi, spokesperson BJP said, “People talk about empowerment of women and do nothing about it. When it comes to women in politics some of

Sadhavi Niranjan Jyoti a BJP MP from Fatehpur (Uttar Pradesh)

Women are mamta ki murat (idol of motherhood) and they would be able to perform better in politics. The country cannot prosper if the half of the population is not empowered

the issues are respect, decency, and safety. Rest the women politicians are capable to handle. Quality of a person not depends on gender but capability.” Oxfam India Programme, an NGO which encourage more women to take part in politics and boost the capacity of women to contest election inform that many women do participate in panchayat election in rural areas. “In the past 20 years, women have gained confidence, and able to make the difference on their own in panchayat elections, that is testimony to the fact that women won 50 percent of the seats in some states before that was formalised. This also paves the way for women to contest in state and national levels but political parties should come forward to give them tickets to gain the experience.” Almost 49 percent of India’s population being women, their needs are not necessarily the same as men, with more women in politics the chances are that their needs would get better articulation and treatment for resolution, voice many MPs. “As a democratic society politics should be a domain which is open to both sexes, in the initial stages some special process might be needed which can after a period decided by the legislature can be removed. But give women the chance to break the stereotype of ‘being from elite political families’,” Thekkudan added. www.urbanupdate.in | September 2014

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VELO-CITY The physical growth of city is induced by development of residential and industrial activity around the city from time to time. Industrial and commercial activities have developed along the major arterial roads running North-South and EastWest of Vadodara city. Initially, the development took place along the four axis of Mandvi, later spread outwards West and North Western direction. Consequently, there was increase in the administrative limits.

Water supply

Vadodara takes challenges head-on

It is inspiring to observe through a bird eye view on how Vadodara city’s infrastructure and service delivery system is able to tackle the demographic challenges Team Urban Update

T

he rapid urbanisation poses an unprecedented managerial and policy challenges to Vadodara—the garden city and one of the frontrunner cities in India when it comes to infrastructure and service delivery. But it is yet to see that the city designed by the administration of Maharaja SayajiRao Gaekawad is competent enough to cope up with massive influx of population by increasing the capacity of the existing infrastructure.

The Garden City

Vadodara is located in the most developed region of Gujarat, popularly known as “Golden Corridor”. The region has undergone dramatic changes in the land use pattern due to speedy industrialisation. Massive multi-core national projects like Koyali 36 September 2014 | www.urbanupdate.in

refinery, Indian Petro Chemicals Ltd. and Gujarat State Fertilizer Plant have been set up. During 1980’s the city saw the development of specific industrial estates like Makarpura, Sardar Estate & Nandesri developed by the Gujarat Industrial Development Corporation with in the immediate urban area and industrial area of Savli, Vaghodia and Por on the outskirts of the present urban limits of Vadodara. Expanding private sector provided additional white and blue collared jobs to thousands of people. It helped in building a wide and highly diversified modern industrial base. The post librealisation period have seen spurt in the growth and establishment of global giants around the Vadodara urban area like General Motors (Halol), Larson & Tubro (Nandesri), GE Plastic (Bajwa) etc.

The city depends on two major water sources—the Ajwa reservoir and the French wells in Mahi at Fajalpur—for its 900 lakh gallons water requirement everyday. Another major source that is coming up is the water works at Khanpur where there is a plan for drawing water from a Narmada project canal and purifying it for supply to the city’s western parts. But the project is yet to take off. According to the Vadodara Municipal Corporation (VMC) officials, the consumption for water increases in summers but the city does not fail to fulfil the citizens’ requirement of water. Additionally, the Vadodara Mahanagar Seva Sadan (VMSS) supplies non-potable industrial grade water to Nandesari Industries Association. The city has received national award under JnNURM ‘Best City for Improvement in Water Supply and Waste Water Sector’ in 2009-10 for its various initiatives.

Waste management

The city is one of the few cities of India that has advantage of having an underground drainage system that was constructed over a century ago in 1894. The sewage in the city is collected through this underground drainage network and then processed at a treatment plant before being eventually disposed into the nearby rivers. The Gujarat Pollution Control Board has established certain standards for waste disposal to reduce any potential for hazards. The VMC has assigned three


VELO-CITY drainage zones for the sewerage system based on the physical features of the city. Each of these has its own treatment plant. The effluents of the first two zones are discarded into the Ruparel Kaans, while that from the third is discharged into the River Vishwamitri. The three zones are thus delineated as Tarwali, Gajrawadi and Atladra. A further sewerage plant has been established at Rajiv Nagar this year at the cost of Rs 72.26 crore. It aims to take care of the drainage concerns of the Ajwa Road and Karelibagh areas. There are initiatives to utilise the bi-products from the treatment of the sewage water. Solid bio-organic wastes are collected in drying beds and then sold as fertilizers. In 2014, the Vadodara Municipal Corporation initiated an ‘e-waste collection drive’ in the city. Under this system, the vendor company would provide rewards to citizens for recycling their old electronic equipments such as TV, mobile phones, gaming consoles, etc. The vendor company would proceed to contribute 14 percent of this total to the government authorities and the waste would be disposed as per the state’s standards.

Housing and real estate

VMC has initiated projects for constructing houses for people belonging to Economically Weaker Section (EWS) and Low Income Groups (LIG) houses. A total of 3,500 LIG houses would be constructed in Manjalpur, Sami, Karelibagh, Tandalja road and other areas. While 372 and 360 EWS apartment will come up in Vasna and Sayajipur respectively. Both projects will cost approximately Rs 23 crore each. The developer could use 10 percent of the floor space at both locations for commercial purpose. In April 2013, reports showed that the price of real estate, particularly affordable housing had decreased by 15 to 20 percent. One of the main reasons cited for this is the interruption in land transactions due to stricter

rules on sale of agricultural land, thus restricting the land availability. The change in prices was thought to benefit especially the middle class and encourage greater investments from the citizens. Experts speculate that flyover projects such as that at Fatehgunj will help further support the real estate market to a considerable extent. These projects would help to resolve traffic issues and thus boost the popularity of the area. Vadodara’s real estate market, further, offers a large variety including residential buildings, bungalows, farm houses as well as complexes for commercial and retail use. Some significant developments that the city boasts of include hotels, integrated townships-particularly those involved in the finance sector, gated communities and IT corridors.

Transportation

Vadodora is connected to the rest of the country via National Highway-8 (NH-8). The city also has an airport that provides access to Delhi and Mumbai. In terms of transport for locals, auto-rickshaws and taxis are the most popular modes of transport apart from the state-run buses. The VMC along with Centre for Green Mobility (CGM), a non-profit organisation, has initiated ‘cycle sharing’—another alternative to public transport. It has been designed to reduce pollution as well as ease and improve connectivity from various public transport stations, along the lines of other cities, such as Paris, New York and even Bengaluru. Under this system, users will be registered with a smart card which will enable them to rent cycles from their nearest stations and they can return these at the next station on completion of their journey. The recently inaugurated bus terminal of Vadodara, known as the ‘Sardar Vallabhai Patel Central Bus Station’ has been endorsed as the best in the country, and is considered to be on par with its international counterparts. The unique design of the building was inspired from the

structure of a banyan tree and is being constructed through a public-private partnership, costing around Rs 110 crore. The terminal offers airport-like facilities and includes shopping malls, supermarkets and commercial office complexes.

Challenges Ahead

According to the estimates of the VMC, the water supply of the city is likely to fluctuate in the years to come due to an expanding population density and lack of service and operations. Changes in the frequency and timing of the water supply may also occur. Further as the treatment plants are prone to silt formation, this may lead to untreated sewage entering the rivers. With regard to lack of an appropriate storm drainage system, flooding in the entire upstream network becomes a concern. As part of the drainage area is being utilised by slum dwellers and for the disposal of garbage, section of the Bhukhi drain downstream has been reduced. Water logging also has subsequently led to epidemics such as malaria, cholera, etc. Further problems have risen consequently from increase in the population of the city, as this has in turn led to rise in demand for more housing and transportation. Vadodara was once known the ‘City of Gardens’ as it had 62 gardens. However, the cityscape is fast changing with the green space disappearing and officials are concerned that this may disrupt the quality of life index for the city. Obstacles also remain in the execution of the town planning schemes by the VMC, as only six out of the twenty have been so far realised. Such schemes are of vital importance to the city as these not only concern the infrastructure but also housing facilities for the poor. The authorities are thus working towards adapting to the ever increasing urbanisation rates and simultaneously preserving an ecological balance, as Vadodara continues to grow into a city of national importance. www.urbanupdate.in | September 2014

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VELO-CITY

Maharaja etched in memories

M

aharaja Sayajirao Gaekawad led the city to a new path with his initiatives for education of his subjects, uplifting of the downtrodden, judicial, agricultural and social reforms, building a network of railways to connect areas of his dispersed territories. He is etched on the memories of his successors and residents of Baroda for his welfare and development works. His educational and social reforms included ban on child marriage, legislation of divorce, removal of untouchability, spread of education, development of Sanskrit and ideological studies, religious education, encouragement of fine arts. The Maharaja played a key role in the development of textile

industry of Baroda. Says his great grandson Samarjitsingh Gaekawad; “He created rich library which became the nucleus of today’s Central Library of Baroda with a network of libraries in all the towns and villages in his state.” He was the first Indian ruler to introduce compulsory and free primary education in his state, placing his territory far in advance of contemporary British India, he told Urban Update.

Public Works

It was during his reign that a large narrow gauge railway network was set up in Baroda State which even today is the largest narrow gauge railway network in the world with Dabhoi at its focal point. Sayajirao envisioned a water supply scheme for Baroda in 1892 at Ajwa which would supply

Samarjitsingh Gaekawad Great Grandson of Maharaja Sayajirao Gaekawad

drinking water to the people of Baroda by gravity. To this day a large portion of Vadodara city gets its drinking water from the source.

Parks and universities

He created rich library which became the nucleus of today’s Central Library of Baroda with a network of libraries in all the towns and villages in his state

38 September 2014 | www.urbanupdate.in

Maharaja Sayajirao Gaekawad

The large public park originally called Kamati Baug and now called Sayaji Baug was his gift to the city of Baroda. On the occasion of his Diamond jubilee of accession to the throne, he set apart large funds out of his personal as well as the state funds for setting up a university in Baroda for the benefit of students from the rural areas of the state.


ONE ON ONE

The Environment Ministry has approved three projects and finalised terms of reference (ToR) for two others to be built on the Delhi-Mumbai Industrial Corridor (DMIC). The Dholera investment region in Gujarat, Manesar-Bawal investment region in Haryana, and KhuskheraBhiwadi-Neemrana investment region in Rajasthan were cleared on July 30. The Dholera investment region plans to build electronics, pharmaceuticals, automobile general manufacturing, agro and food processing and tourism sectors. The Manesar-Bawal region will take up projects related to engineering, technology, future technology, consumer products and service sectors. The Khushkhera-BhiwadiNeemrana investment region will deal with metal products and other consumer-oriented sectors. The project aims to develop industrial zones between Delhi and Mumbai covering 1,483 kilometres through six states--UP, NCR of Delhi,

Haryana, Rajasthan, Gujarat and Maharashtra. The end terminals will be at Dadri in the National Capital Region of Delhi and Jawaharlal Nehru Port near Mumbai. This Dedicated Freight Corridor offers high-speed connectivity for High Axle Load Wagons (25 Tonne) of Double Stacked Container Trains supported by high power locomotives. The Delhi-Mumbai leg of the Golden Quadrilateral National Highway also runs almost parallel to the Freight Corridor. The ministry’s statutory appraisal panel finalised the ToR for the construction of the Dighi Port industrial area in Maharashtra and the development of the PithampurDhar-Mhow investment region in Madhya Pradesh. All these are on the dedicated freight corridor (DFC) that is part of the DMIC.

Union Budget has allotted about Rs 37,000 crore for road development. How can the ministry expedite the works of the projects?

I am glad that the Union Finance Minister Arun Jaitley has allocated Rs. 37,000 crore for the road development in the country. You must be aware that the Cabinet, in a major policy decision, has empowered the Ministry of Road Transport and Highways to amend the Model Concession Agreement (MCA) and the mode of delivery of projects as per local requirements. This will expedite the process of constructing highways. Against the ambitious target of 9,500 kms of road length for the financial year 2012-13, only 1,116 kms

Temporary registration of the vehicles (e-rickshaw) would be done, 13 special counters would be opened by the state transport department to issue commercial licences to those who will drive them

What is the current status of the Delhi-Mumbai Industrial Corridor (DMIC)?

could be awarded during the year by the National Highways Authority of India and 1,436 kms against the target of 4,030 kms for 2013-14. This shortfall was primarily attributed to an overall economic slowdown resulting in lack of availability of debt and equity in the market. It is also attributed to policy issues pertaining to environment and forest clearances, provisions regarding loans to concessionaires and procedural complexities. The 2009 report of the BK Chaturvedi Committee had prescribed a framework to decide the mode of delivery and changes in the MCA through an institutional mechanism of the Inter Ministerial Group. According to recommendations of the Committee, further amendments to the MCA where necessary, and the mode of delivery of any specific

Part two of one-one-one series with Urban Update, Union Minister for Road, Transport and Highways Nitin Gadkari shares his views on green projects, e-rickshaw, and Delhi-Mumbai Industrial Corridor (DMIC)

Helipads along NH for lifting accident victims www.urbanupdate.in | September 2014

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ONE ON ONE Synopsis ♦♦

♦♦

♦♦

The government has set 2019 as the deadline to deliver the first three smart cities, all of which will be built as part of the Delhi-Mumbai Industrial Corridor (DMIC). The DMIC is a project the government aims to build as a ‘global manufacturing and trading hub’. These smart cities are Dholera, Shendra-Bidkin and Global City. Overall, seven smart cities will be set up between Delhi and Mumbai under the DMIC project, which is being built in partnership with the government of Japan The high court on July 31 had ordered a ban on plying of e-rickshaws in the national capital, saying they are illegally running on Delhi roads and “prima facie a hazard to other traffic as well citizens” Shanawaz Khan, on whose petition the e-rickshaws were banned, alleged that e-rickshaws, which are operated with power output of 650 to 850 Watt and are designed to ferry only four people, including the driver, were carrying more than eight people at a time, endangering their lives

project in case the project is found unviable on Build, Operate Transfer (BOT) (Toll) and/or BOT (Annuity), is to be considered, examined and approved by the IMG. In case there is no unanimity in the IMG, the same was required to be placed before the Empowered Group of Ministers (EGoM) with the approval of the minister for road transport and highways. Since this EGoM was disbanded in 2012, such proposals had to be put up before the Cabinet/ Cabinet Committee on Economic Affairs (CCEA) for approval. The cabinet felt that these issues were putting unnecessary burden on the Cabinet.

Do you think there are adequate medical facilities along the national highways? Will any exclusive measures be taken?

Every possible effort will be made to provide necessary medical facilities along national highways. Helipads will be built on highways for emergency lifting of accident victims. This will assure optimum road safety.

40 September 2014 | www.urbanupdate.in

On the recent ban on the e-rickshaw, which will be made to ply after regulations are ready, what is your opinion? Do you think that the non-motorised vehicles are posing a threat? The government has proposed measures to regulate plying of e-rickshaws during the interregnum between now and when the rules will be framed under the Motor Vehicle Act. The interim guidelines submitted by the ministry says that municipal corporations would demarcate the roads, like high-speed roads, where e-rickshaws cannot ply, while the Delhi Police will ensure that they do not carry more than four passengers and over 50kg weight at one time. The guidelines also said temporary registration of the vehicles would be done by providing numbers to e-rickshaws and added that 13 special counters would be opened by the state transport department to issue commercial licences to those who will drive them. This could bring about the desired safety in traportation.

Recently ethanol buses were inaugurated in Nagpur. Public transport on ethanol buses is a cost-effective way to reduce several environmental problems. Your comments? What more ecological friendly initiatives is the government planning to deliver?

You are absolutely right. India’s first pilot project to test ethanol-run environment-friendly public buses has been launched in Nagpur. This green project was my dream. I call it a green project because the carbon-dioxide emissions from the bus will be as low as 75 percent to 90 percent--depending on the purity of ethanol. The emissions will be monitored for the next three months by the Nagpur Municipal Corporation, the state and the central governments. The entire automotive industry moves onto indigenous fuels. Ethanol can be produced here in large quantities, and it will reduce our dependence on traditional fossil fuels. If we use ethanol we can reduce the fiscal deficit and reduce our oil imports by Rs 200,000 crore.


VOX-POP

T

he new government has conceptualised the Smart Cities and sought it as a catchphrase while groundwork for the ambitious programme is aimed at setting up 100 such urban settlements nationwide. Modi’s vision for advanced cities that benefit from the latest technology has finally begun to take shape with the Ministry of Urban Development identifying almost all the locations where they will be built as well as existing cities that are to be remodelled on these lines. The ministry has asked the 22 states where the programme will be implemented to send detailed project reports so a final blueprint can be outlined. Describing the scheme, officials of the urban development ministry say they plan to set up seven smart cities each in Gujarat, Kerala, Rajasthan and Karnataka. Across the world, the stride of migration from rural to urban areas is increasing. By 2050, about 70 per cent of the population will be living in cities,

and India is no exception. It will need about 500 new cities to accommodate the influx. Interestingly, urbanisation in India has for the longest time been viewed as a by-product of failed regional planning. Though it is inevitable, and will only change when the benefits of urbanisation overtake the costs involved, it is an opportunity for achieving faster growth. The recent smart city summit held in Mumbai was an eye-opener in validating experts, stakeholder and government official viewpoint of executing the concept in India.

Defining the concept

The concept of smart cities originated at the time when the entire world was facing one of the worst economic crises. In 2008, IBM began work on a ‘smarter cities’ concept as part of its Smarter Planet initiative. By the beginning of 2009, the concept had captivated the imagination of various nations across the globe. Countries like South Korea, UAE and China began to invest heavily into

their research and formation. Today, a number of excellent precedents exist that India can emulate, such as those in Vienna, Aarhus, Amsterdam, Cairo, Lyon, Málaga, Malta, the Songdo International Business District near Seoul, Verona etc. In India the cities with ongoing or proposed smart cities include Kochi in Kerala, Ahmedabad in Gujarat, Aurangabad in Maharashtra, Manesar in Delhi NCR, Khushkera in Rajasthan, Krishnapatnam in Andhra Pradesh, Ponneri in Tamil Nadu and Tumkur in Karnataka. Describing the smart city concept in India, SK Nanda, Addntl Home Secretary, Gujarat said that the state has found three cities that is Ahemdabad, Vadodara and Surat as smart cities. We need to understand the need of smart cities, which means using resources and infrastructure. You need adequate parking space, solid waste management, waste disposal system, adequate roads, market places and most important thing health and education, Ramnath Sonawne, Municipal Commissioner, Kalyan Development

Do you know your ‘smart’ city? Even though the government has sought out plans to venture its notion of 100 smart cities all over the country, the question remains how viable is this concept in India and whether we are literate in knowing ‘Smart Cities’ Team Urban Update

www.urbanupdate.in | September 2014

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VOX-POP

Ramnath Sonawne Municipal Commissioner, KDMC

SK Nanda Addntl Home Secretary, Gujarat

Dr Sudhir Krishna Former Secretary of Ministry of Urban Development

“We need to understand the need of smart cities. You need adequate parking space, roads, markets, solid waste management, and health and education”

“A smart city means slum development, Wi-Fi connectivity to ensure that social infrastructure like health and education is for the growing population”

“There is a paradigm shift required for procuring the viable projects. They must be notified and statutory issues must be analysed. A proper planning is required”

Municipal Corporation told Urban Update. “A city which works at overall development, adequate shelter and services, this is what mean by a smart city,” he added. Describing the concept in Indian context further, Nanda said: “A smart city means providing facilities such as Wifi and developing slums into colonies to see that social infrastructure like health and education is adequate for the growing population.” Smart cities should see quicker quality of life, he said.

Money speak

During the summit, while the notion and concepts were being discussed at length, what went missing is throwing light on procuring infrastructure and mostly importantly suitable financial options. On being asked a prominent question on financial viability to be undertaken by each city, by our managing editor, Apresh Mishra; Dr Sudhir Khrishna, Former secretary of Ministry of Urban Development said: “There is a paradigm shift required for procuring the viable projects. They must be notified and statutory issues must be analysed. A proper planning is needed as there has been a neglecting attitude for decades.” 42 September 2014 | www.urbanupdate.in

Aamer Azeemi, Mananging Director, CISCO said, “There is a ardent need to understand the indigenous model and needs in a particular city rather than aping something from the west that is not suited to the country.” “The concept will be successful through thorough planning on infrastructure viability in each city,” he said.”

Role of private players

Speaking on the role of private players, the summit saw how many private companies are helping build the basic necessities to help enhance the cities into a smart one. Enlightening on this, Nanda told Urban Update: “Japan has been a partner and JICA had even given a grant to the Indian govt. It had partnered in vibrant Gujarat campaign.” JICA has given funds to dole out for developing satellites and corridors and procuring waste management in cities, he said. “We are planning to connect cities through broadband width, like the capacity 2 MB with companies like Idea, Airtel and Vodafone.” Rajesh Ramachandran, Chief Technical Officer, ROLTA, said: “ To attract investors it is vital for administrators to study the financial resources needed the physical infrastructure required

Aamer Azeemi Mananging Director, CISCO

“There is a ardent need to understand the indigenous model and needs in a particular city rather than aping something from the west that is not suited to the country”

in transport, education and many others to help build an optimum smart city.”

Planning, design

While systems need to be placed, the most vital component to build smart city is its design. Shared Biju Kadapurath, Managing Consultant, PwC India, “Planning is crucial as we do not have a baseline infrastructure in a traditional sense and there is a need to upgrade and update the infrastructure to assure best services to the people. There should be integration of ICT for urban development.” Ajay Poddar, MD of Synergy Environ told Urban Update: “Existing cities should be made smarter as there are many habitats living there already. While ICT integration is necessary, it must also be seen that whether the technology is required in that arena, for example, green building technology is not always required in all buildings. Automation is costly and we should be aware of what is the best option for every city. Mahender Vasandani, president, MSquare shared his views on urban design during the summit. He said that there is a need to educate policy makers on how to design a city. He opined that even though resources are


VOX-POP

Biju Kadapurath Managing Consultant PwC India

“The planning is crucial as we do not have a baseline infrastructure. There is a need to upgrade the infrastructure to assure best services to the people”

Ajay Poddar MD of Synergy Environ

Mahender Vasandani President, MSquare

Madhav Pai Director of EMBARQ

“Existing cities should be made smarter. While ICT integration is necessary, viable tehnology should be used e.g. green building technology is not always required in all buildings”

“The there is a need to educate policy makers on how to design a city. Even though resources are there, our needs are different. The infrastructure should suit our needs”

“Hardest thing is to improve walking and cycling in cities. For this, remove parking and no free parking on streets. We should create more public spaces, we have density”

there, our needs are different and the infrastructure should be made in accordance to suitabilities.

ICT integration

Smart cities means providing service to the populace in a smart way. And what better path to enhance it through optimum usage of technological innovations to make citizen centric incentives. Nanda feels that smaller cities need to be developed as the infrastructure are there since its inception and it only needs to be enhanced through suitable technologies like the sensors and the big data Mindset is also crucial, people are a lot in numbers and are demanding it, he added. Citizen centric services are useful when people start demanding then only the application will be put to use, Nanda said. Social and physical infrastructure that are part of futuristic smart cities have been declared like autos have been changed from petrol to gases, safety of women, and so on, he stressed. According to Ramachandran, information is available for people. ICT solutions like, big data analysis, huge amount of information, IT infrastructure can be used for availing

cyber security. Technology driven solution have been necessary in all cities and is a biggest change for example, in Abudhabi the jurisdiction before pronouncing a verdict actually go through the criminal’s record and database, he informed. “It is very important to adopt indigenous model as in India problems are very different in terms of water management, other infrastructure virtues.”

Smart mobility, utilities

Madhav Pai, Director of EMBARQ told Urban Update: “Hardest thing is to improve walking and cycling. For this remove parking, no free parking on streets. We should create more public spaces, we have density.” Speaking about adopting transit transport system Pai said that BRT is the most cost effective. Asked about the awareness on mobility in cities he said: “No I think a lot of new thinking has come about, this is very different how transport was taught earlier... there are some missionary leaders mostly in Latin America like Michael Bloomberg. They are a few best practices, but the main fight is with construction industry, and getting income to build smart mobility for people.” In his view Ahemdabad is going on right path and Surat also, and the worst city adopting mobility is Delhi

due to the increasing sprawl. Speaking about the updation of the Motor Vehicle Act, Pai informed: “The act is going on for years, but it was until the recent death of Gopinath Munde, which was a special interest for the government, that is being brought up. It involves elements of safety, permits, public transport, among others.” On new technological advances for transport, Pai suggested the use of Transport Open Data card as useful. Usually administered by bank, used by various types of transport, the card is an open standard, payment getaway, in which transactions can happen.

Is Smart city viable?

The concept is not without challenges, especially in India. For instance, the success of such a city depends on residents, entrepreneurs and visitors becoming actively involved in energy saving and implementation of new technologies. There are many ways to make residential, commercial and public spaces sustainable by ways of technology, but a high percentage of the total energy use is still in the hands of end users and their behaviour. Also, there is the time factor — such cities can potentially take anything between 20 and 30 years to build. www.urbanupdate.in | September 2014

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EVENTS

October Events Tech Indiia Expo October 4-6, Pragati Maidan, New Delhi Cities For All XI Metropolis World Congress October 7-10, Hyderabad Metropolis World Congress October 7-10 , Hyderabad International Convention Center Global SME Business Summit October 8, India Habitat Centre, New Delhi IFAT India October 9-11, Bombay Exhibition & Convention Center, Mumbai

Smart cities, smart concept While there are numerous discussions, debate held on the concept of ‘smart cities’, what is required to understand is the concept of how to procure one through optimum utilisation of available resources. In lieu of the notion, ASAPP in association with Centre for Sustainable Development had recently organised a Smart Cities Summit-2014, which was seen as a platform for multiple public and private sectors to meet, network and discuss a cohesive approach to achieve sustainable urban development. In present times urbanisation poses a great challenge to the development of sustainable infrastructure and

to achieve a smart & sustainable outcome, it is crucial to initiate work at the grassroots level. The summit aimed to aware government and private policy makers to deliberate on the opportunities, challenges and solutions of a Smart City through initiating on topics including Urban Planning, Smart Buildings, Mobility, Utilities, Energy, Safety and Security, Governance and Economic Development. Cities are now relying on intelligent structures and well networked supply systems for smartening the urban systems realising it the new government had proposed to develop 100 Smart Cities in the country.

Smart Card Expo October 15-17, New Delhi Exhibition-Energy Efficient Lighting October 16, New Delhi Cyber Securitiy and Cyber Governance October 16-17, Oberoi Hotel Infrastructure Conference on Sustainable Civil Infrastructure October 17-18, Hyderabad CII Tamil Nadu Water Summit October 18, Tamil Nadu Sustainable Urban Development October 18-19, Mumbai Resources India Expo October 18-20, Mumbai Energy Efficiency Summit October 29, Hyderabad Hydrology and Watershed Management October 29-1 Nov, Hyderabad

44 September 2014 | www.urbanupdate.in

AIILSG president Jatin Modi with other dignataries from different quarters of the industry - stakeholders and experts, who had culminated at the Smart Cities Summit 2014 in Mumbai

‘Digital India is skilled India’ Stating that the government is assertive on improving the digital connectivity in the country, Minister of Communication and IT, Ravi Shankar Prasad said that the NDA government is planning on numerous initiatives that will enhance the sector. “There is a great need among Indians to connect; this is creating a different India. The government feels that a digital India is a skilled one,” he said while addressing a conference called i-Bharat held at FICCI in New Delhi. The government has allocated a handsome sum to the sector and would focus on expediting the National Optical Fibre connectivity, which will reach 5000 gram panchayats,

said the minister. The government has also opted in introducing GUNgovernment user network and is keen to bring broadband to almost all schools in the country. The minister said that the current import of the technology product is 1000 billion and by the next year it will be 4000 billion. The urban area’s mobile network connectivity is 140 percent and 43 percent in rural areas, he said. “The electronic manufacturing sector can generate employment to three crore people,” the minister said. The government had also allocated Rs 100 crore for development of Technology Development Fund.


EVENTS

‘Empower local bodies for vibrant city’ Cities are the epicenter of urban productivity and socio-economic growth, in order to enhance it the Urban Local Bodies (ULB), which deals with city governance, needs to be strengthened. The state and central government should not forget that mayors are the guarantors of services in local life. It is necessary that we get adequate financial and administrative powers, voiced Mayors of different cities at annual session of All India Council of Mayors (AICM) forum, held in Dehradun. Highlighting the reform of ULBs, Uma Shankar Gupta, higher education minister, Madhya Pradesh told Urban Update, “The basic principal of the 74th Amendment is that local bodies should be given priority when it comes to city governance, they can make better plans for the city. If the amendment is implemented, the municipal corporation will be strengthened and it would provide better civic services.” Sharing of responsibilities between state and local bodies should be made clear so that the blame game do not happen if some work is not done, he added.

Monitor spurting urbanisation

“Growing urbanisation is a big challenge and thus, there must be proper co-ordination among the centre, state governments and local bodies for the development of cities,” said Anil Sole, mayor of Nagpur Municipal Corporation (Maharashtra). Talking about Ahmedabad one of the prime city of Gujarat and its infrastructure growth, Meenaxi Patel, mayor of the city said: “We have set an example on how the state and urban local bodies should run in a cohesive manner. All the initiatives taken by the city management are well appreciated by the state government.” Patel also informed that many new projects are in pipeline already like the

“We need to restructure local bodies so that they can work for the betterment of the city on the basis of priorities of different cities” Vinod Chamoli, Mayor of Dehradun and the chairman of AICM sai first phase of Metro Rail, construction of toilets in very household (about Rs 8000 per toilet). Treated water from Narmada River’s and smart water meters connection, affordable houses for EWS, LIG and MIG. Meanwhile, Dr Satya Pandy, Gorakhpur Mayor, informed that Gorakhpur has not developed in a planned way. He said to empower such cities the municipal corporation should be empowered as per the 74th amendment and development authorities should come under the municipal corporation for better management of cities. “The city has lot of potential to grow into a planned city. We have proposed plans for improving drainage system and expansion of main roads of the city. The city infrastructure has to be developed in such a way that attracts national and international tourists. As a city manager I have lot of development plans for my city, but I need finance and decision making power to execute them,” Pandy said.

Why we require the act

Stressing on implementation of 74th amendment by the new union government, Vinod Chamoli, mayor of Dehradun and the chairman of AICM said, “We are hopeful that the new government will take actions to empower municipal bodies to run cities properly. Local bodies do not have financial, administrative powers and we need such powers for smooth functioning. There is a lot of interference from the governance. We have to go to state and central

government for permission before initiating any project for cities.” He also added that amendment has not been implemented; only elections are being held as per the amendment. “It should be implemented. We also need to restructure local bodies so that they can work for the betterment of the city on the basis of priorities of different cities,” he added. The UD Minister, M Venkaiah Naidu recently informed that the urban local bodies across various states had not been empowered as required, they are financially constrained and lack capacity to discharge functions as per the Constitution (74th Amendment) Act, 1992. Most of the states have not met the requirements of the 74th amendment in respect of devolution of powers and responsibilities to municipal bodies, he said. As per the UD ministry, the 12th Schedule of the 74th Constitutional Amendment Act of India, defines tasks in the functional domain of the Urban Local Bodies. It illustrates about the ULBs role, power, function health, sanitation conservancy. Challenged with population boom, increasing urbanisation, migrants in flow to develop a robust megalopolis good city managers are necessary, and for this we need to develop Indian Municipal Services (IMS) on the line of IAS that will help in managing cities better, Gupta informed. “States should also have Municipal Cadre for effective implementing municipal projects. Madhya Pradesh has done it and other states shall follow the suite,” he added. www.urbanupdate.in | September 2014

45


URBAN AGENDA

The Number Game Apresh Chandra Mishra Managing Editor apresh@urbanupdate.in

I

n a country like India there is little data available on the basic amenities the citizens have access to. The data on lack provision for water, sanitation, drainage, health care and possibly even schools have been not touched upon. One of the most profound forms of exclusion for communities is the fact that they are never consulted about their needs and priorities. There are no accurate maps or surveys assessing needs of urban population making it impossible to plan adequately for improving or extending provisions. It is virtually hard to understand why city managers and other stakeholders continue to overlook this ardent fact.

Not surveyed enough

Each and every forum in the world has been advocating about indicators to use to measure and monitor infrastructure and governance in cities. But the discussion on how to gather data has been neglected 46 September 2014 | www.urbanupdate.in

Governments and international agencies use national sample surveys to gather data. But there are limitations in what data are currently gathered, from whom they are gathered and to whom they are available and useful. Any commitment to ensuring safe, sufficient, affordable provision must be supported by a commitment to generate the data on which housing units and streets are unnerved. Censuses should provide data down to this level, but they are expensive and generally done only every ten years. In many cases the data col-

lected are not available to local governments in a form that allows them to identify the needs. Also, censuses and other household surveys do not always include households in informal settlements, for which there may be no maps, no street names, no house addresses or numbers and no information on households — not to mention reluctance on the part of those collecting the data sometimes to go into these settlements.

Data revolution

We therefore need a data revolution, one that informs local action and that draws on the knowledge and capacity of the urban poor as collectors and users of information. What we really need is more detailed data from each urban centre that describes the deprivations that low-income people face. This must include data on housing conditions, infrastructure and service provision to each street and community. Local governments need to engage with representative organisations in collecting the data as these organisations not only provide the information they lack and need in order to act, but also empower these communities to engage with governments in both planning and implementing actions that can improve the lives of the poorest of citizens.



MUMBAI METROPOLITAN REGION DEVELOPMENT AUTHORITY Transforming Mumbai Into A World Class City

MMRDA EASES

Mobility

PROJECTS THAT PROVIDE RELIEF FROM TRAFFIC WOES Versova-Andheri-Ghatkopar Metro Corridor – 11.4 km – 2,356 crore ♦♦ Journey time reduced from 70 minutes to 20 minutes ♦♦ Has provided East-West connectivity ♦♦ 4-coach Metro carries 1,178 commuters ♦♦ MMRDA intends to develop a 150-km Metro network Chembur-Wadala-Gadge Maharaj Chowk Mono Corridor – 20 km – 2,460 crore ♦♦ 9-km Chembur to Wadala corridor successfully launched ♦♦ Journey time reduced from 50 minutes to 20 minutes ♦♦ 4-coach Mono carries 600 commuters ♦♦ The second phase from Wadala to Gadge Maharaj Chowk will be completed next year

Roads completed under MUTP Jogeshwari-Vikhroli Link Road, Santacruz-Chembur Link Road Roads completed under MUIP Eastern Express Highway, Western Express Highway, Swami Vivekanand Marg, Lal Bahadur shastri Marg, Main Link Road, Andheri-Kurla Link Road (Saki Naka to Kurla), Sahar Elevated Road, N.S.Phadke Marg, SakiVihar Road, Marol-Maroshi Road, Mahakali Caves Road, B.D.Sawant Road (Dhaku Road), Goregaon-Mulund Link Road (Extended), Sion-Dharavi Road Flyovers completed under MUIP Dahisar ROB, Thakur Complex, Times of India, Dindoshi, Santacruz airport, Barfiwala Lane, Suman Nagar, Navghar, Sion Hospital, King’s Circle, Hindamata, Lalbaug, Milan ROB, Amar Junction Flyovers completed under Extended MUIP Waghbil, Manpada, Patlipada, Panvel, Kapurbawdi-2

Eastern Freeway – 16.4 km – 1,464 crore ♦♦ The Freeway connects Southern Mumbai with Eastern suburbs ♦♦ Runs from Orange Gate to GhatkoparMankhurd Link Road ♦♦ Journey time reduced from 90 minutes to 25 minutes ♦♦ The Freeway has been providing quicker connectivity to Thane, Nasik, Pune, Goa sahar Elevated Road – 2 km – 400 crore ♦♦ The Elevated Road is a boon for International Commuters ♦♦ From WEH to International Airport within five minutes ♦♦ The signal-free road provides 3 lanes for up and down traffic ♦♦ The beautiful Palm trees and shrubs offers enjoyable driving experience


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