Urban Update July 2017

ISSN 2349-6266 RNI No DELENG/2014/57384

Setting The Agenda For Tomorrow’s Cities

UrbanUpdate Volume IV, Issue III

JUly 2017

Rs 100

Leaderspeak

Get well soon, cities!

Health

In Our Cities

Rapid and relentless urbanisation or the deluge of population into urban centres has amplified the public health challenge in Indian cities

The project is funded by the European Union.

The project is implemented by the AIILSG.

Magazines & Journals

Energy Efficiency

AMRUT Knowledge Management

Seminars

Project Management Customised Training

Sustainable Development Goals

Policy Research

Advisory Services

Swachh Bharat Mission

ECBC

Smart City Mission Capacity Building

Skill Development

All India Institute of Local Self-Government No. 6, F-Block, Bandra Kurla Complex, TPS Road-12, Bandra-East, Mumbai-400051, Maharashtra Tel.No.: +91-22-26571713, 26571714, 61805600, Fax: +91-22-26572115, Email: contact@aiilsg.org

Quality is just one of our strengths

AIILSG has begun skill development programmes in Rajasthan and Jharkhand. The institute with its 90 years of experience in the field of capacity building would impart training to youth living in rural areas of these two states to make them employable in various emerging sectorsApparel, Beauty & Wellness, Electronics, Healthcare, IT-ITEs, and Renewable Energy.

As per Mou singed, AIILSG will train 16,000 youngsters.

AIILSG is committed to build empowered India with skilled human workforce For Details, email at delhi@aiilsg.org

UrbanUpdate A monthly magazine published by the AIILSG — a project funded by European Union’s ‘Equi-City’ programme for India.

Ranjit Chavan President-AIILSG Ashish Deosthali Editor-In-Chief Director General-AIILSG Ashok Wankhade Managing Editor Abhishek Pandey Editor Ravi Ranjan Guru Executive Editor

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The project is funded by the European Union.

The project is implemented by the AIILSG.

The views expressed in this publication do not necessarily reflect the views of the European Commission.

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July 2017 | www.urbanupdate.in

EDITORIAL

Not so healthy challenges for cities

Q

uite obviously, our health or physical well-being is determined by how we live. But it could also be determined by where we live. Some cities may provide greater opportunity for residents by way of better access to parks, green spaces and recreation, better waste management and sanitation, healthy food options, clean air and water, sustainable public transport, and access to affordable, quality healthcare. Such cities are ahead of others in supporting and promoting healthy living and thus healthy citizens.

Urbanization has brought about significant changes not only in the built space and urban form but in the lifestyles and habits of urban residents. On the physical side, cities face challenges with respect to water and air quality, housing, traffic congestion and waste management. The efficacy of response of urban local bodies to these challenges has great bearing on urban health issues. At the same time the phenomenon of urbanization has brought about several lifestyle changes – eating habits, physical exercise or the lack of it, working couples, longer working hours, late night leisure activities, etc. - all of which affect the urban resident’s health.

The health aspects of certain categories of residents, for example women and children are of particular importance considering their vulnerabilities. The National Family Health Survey-4 (2015-16) has some uncomfortable findings. For example, take percentage of children 12-23 months fully immunized. The national average is just 62%. The figure for urban India (63.9) is only marginally better than for rural India (61.3). Or take the ‘reported prevalence of diarrhoea in the last two weeks preceding the survey (age under 5 years)’. This indicator is relevant as the disease is related to the access to clean, safe drinking water and sanitation facilities. At the national level this figure alarmingly went up in NFHS-4 (9.2%) compared to NFHS-3 (9.0%). Urban 8.2% and rural 9.6%. The picture with respect to undernourishment in children under 5 is not favourable too. Nationally the percentage increased from 19.8 (NFHS3) to 21 (NFHS-4). Again urban is high

at 20%. Often, there is a tendency to link economic development levels with these health outcomes. But closer scrutiny reveals otherwise. In terms of undernourished children, relatively lower per capita income states like Bihar and Madhya Pradesh show a reduction in percentage of such children across the two surveys compared to higher income states Gujarat and Maharashtra which show an increase.

Therefore policy interventions can also impact health outcomes.

Urban local bodies need to incorporate public health issues in all aspects relating to the design and administration of cities envisaged by them. These could relate to both, the physical as well as the social aspects of city life. Adequate green spaces, sustainable public transport, coverage of piped water supply, waste handling and ambient air quality are all areas where appropriate policy choices can impact health outcomes greatly. Efficient public healthcare infrastructure facilities are absolutely necessary given the often difficult access to private healthcare due to affordability. In addition there is great need to mobilize community involvement as well as the private sector and other nongovernment actors in this health mission.

An intersectoral approach that goes beyond players in the health sector will be able to address the direct as well as indirect determinants of health in cities.

In this issue of Urban Update we cover many of the relevant aspects of urban health.

We have a story on the ongoing Mohalla clinics experiment in Delhi which appears to be well received. Another piece tells us about the difficult lives of safai karmacharis in our cities. Plus of course all our regular features. We at Urban Update have among other matters, been covering a range of issues that affect the well-being of our cities and citizens. We hope that this issue will also make a contribution to the cause.

Urban local bodies need to incorporate public health issues in all aspects relating to the design and administration of cities envisaged by them. These could relate to both, the physical as well as the social aspects of city life

Ashish Deosthali Editor-In-Chief dg@aiilsg.org

www.urbanupdate.in | July 2017

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Quotes

PIN POINT BUZZ

Citizen engagement is our priority in Pune’s Smart City project.

We set up our projects only after several deliberations with the residents of this city.

What came across on top of everyone’s list were water and transport and accordingly we prioritised our projects, thus, the first project was 24x7 water supply

To argue Area Based Development under Smart City Mission benefits the people of that area only is a huge distortion.

It will certainly benefit other citizens as well in several ways

Prerna Deshbhratar Additional Municipal Commissioner (Spl) Pune Municipal Corporation

M Venkaiah Naidu Union Minister of Urban Development

Nicolas ROCHE @nicolasroche61

Smart cities a great idea, but also sponge cities for water cycle in the cities

World Bank Transport @WBG_Transport

Economic growth, transit & land use can be managed more efficiently if planned together

Piyush Goyal @PiyushGoyal

Urge all of you to use http://meritindia. in to monitor DISCOM power procurement. All our apps are available at

Information Technology must be embedded into Pollution Control Regime; need to clear the Pollution of Corruption from the system

Dr Harsh Vardhan Union Minister of Environment, Forest & Climate Change, Science & Technology and Earth Sciences

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July 2017 | www.urbanupdate.in

Many developing nations are attempting to collect, organise and analyse large, varied data sets to uncover patterns and trends to help address poverty

Paul Szyarto Head of the Big Data program Rutgers University

PBSC Urban Solutions @LovePublicBike

Proper docking stations are the solution to the sustainability of a bikesharing system

Inside

Volume 4, Issue 3

Inside July 2017

Article

34

Dirty Lives of Cleaners

38

Urbanisation hits slums hard

They wake up at three in the morning, leave their homes for work. They go down the drains to remove silt and clean choked drains without any safety gear.

They are sanitation workers. They are ill equipped. Are we providing adequate apparatus and fair working conditions to sanitation warriors to win this war for cleanliness?

Rapid urbanisation in developing countries like India has caused mushrooming of slums that is affecting health of their inhabitants adversely

one on one

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Cities need to adapt to changing urban dynamics

34 Cover story

24

Yumiko Noda, Head of PwC’s Cities Solution Centre (Tokyo) and former deputy mayor of Yokohama City, speaks to Abhishek Pandey, Editor, Urban Update on changing urban dynamics and what cities need to do to face evolving challenges

Velo-city

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The Jewel of the East Coast With sea on one side and mountain on the other, Vizag symbolizes beauty at its best. The city is known by many names, from ‘Jewel of the East Coast’ to ‘City of Destiny’ and ‘City of Future’. No wonder, The city is among the top hundred fastest growing cities in the world

RegularS

6 Pin Point 8 Equi-City 10 Newscan 44,45 Events

15 28 46

City Images Numerographs Urban Agenda

Health in our Cities

The G20 2017 Summit in July 2017 will include a Health track in its Agenda; for the first time ever. The top nations of the world will discuss global health as part of the development agenda in addition to political, economic and environmental issues.Ahead of the Summit, health ministers of the G20 countries met on May 1920 in Berlin to discuss and create the framework for their leaders’ meeting in July. This marks the recognition of health as among the central issues in the world today coming as it does with fresh challenges and the need for collaborative and coordinated action

LEADerspeak

30

Get well soon, cities!

Cities are not the healthiest places to live in. This has become a general perception and researches second it. Congested living spaces, increasing pollution in urban environment, fast paced urban lifestyle, lowering quality of civic services, crumbling infrastructure and lack of green spaces are among a factors to blame for making cities ‘ill’ and unhealthy living spaces

opinion

32

When antibiotics themselves become sick Antibiotics revolutionized the world of medicine and health. But today antibiotic itself has become sick. Antibiotic resistance infections are rising. Experts are warning that situation is as grim as global warming

www.urbanupdate.in | July 2017

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feature | Equi-City

Equi-City develops equality framework for Nagpur The framework would ensure equitable access to civic services by all with special focus on marginalized groups living in the city of Nagpur. This will provide a platform where citizens and local governments can engage with each other to ensure no one is unlawfully discriminated against

T

he framework uses a wider definition of equality— “An equal society protects and promotes equal, real freedom and opportunity to live in the way people value and would choose, so that everyone can flourish. An equal society recognizes people’s different needs, situations and goals, and removes the barriers that limit what people can do and be.” This definition is more aspirational than the formal legal definitions of equality. It is about what we can do to create a fair society by recognizing the needs of different people.

This definition includes the groups that are protected by discrimination law. Local authorities will therefore need to continue to consider the impact that race, disability, age, sexual orientation and religion or belief may have on the life chances of members of their communities. But it will also encourage councils to understand the relationship between these characteristics and socio-economic status and the experience of other vulnerable groups like looked after children and white working class boys with poor educational attainment.

The definition of equality in the Framework is close to the way inequality and vulnerability is defined by the Audit Commission(which) and other inspectorates for the purposes of the CAA(which CAA, is it 74th).

Effective local public services tar-

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July 2017 | www.urbanupdate.in

get effort where improvement is most needed to tackle inequalities within and between communities. This may include focusing on the particular needs of people who are disadvantaged or discriminated against age, disability, race, gender or transgender, religion or belief and sexual orientation. It may also include efforts to reduce child poverty or other inequalities within communities.

The project team will consider how well local partners know and understand the nature and extent of inequality and disadvantage within their communities and how effectively they are working to reduce or eliminate discrimination.

Objectives

The main objective of Equality Framework for Local Government is to: ♦♦ Identify and eradicate the unlawful discrimination and provide equal opportunities for the people ♦♦ Identify, assess and sensitize the roles and responsibilities, between and within the stakeholders of the system ♦♦ Review and improve the performance of the services for the people

Key Performance Areas

Equality Framework for Local Government comprises of five performance areas—Knowing your communities, Leadership, partnership and organi-

sational commitment, Involving your communities, Responsive services and customer care, A skilled and committed workforce, Knowing your communities It includes three elements within the framework ♦♦ Collecting Information ♦♦ Analysing and using information ♦♦ Sharing information between stakeholders.

Knowing your communities section helps to identify on-ground experiences of existing issues, difficulties and challenges faced by individual and the community. Equality analysis enables the authorities to benchmark the level of services in accordance with the experience of the people especially in the key areas of life such as health, education, community safety, housing quality, access to work and so on. Equality analysis is about identifying where the outcomes and opportunities gaps are for different communities, including those sharing the protected characteristics. It enables the authorities to stratify their policy along with line of action in accordance with on-ground evidences and research. In short it eradicates the analysis of data based on assumptions.

1. Leadership, partnership and organisational commitment It plays a vital role in order to direct strategies along the course of set objectives of the framework. It establishes the transparency between the stakeholders with a clear and strong vision

of equality. Local councilors play a vital role for ensuring strong vision and public commitment towards the equality for the public services. It also emphasises the importance of working in collaboration with local partners as health, fire, police and rescue services which promotes safe and secure society. Leadership, partnership and organisational commitment within the framework comprise seven main elements: ♦♦ Leadership ♦♦ Local vision and priorities ♦♦ Equality objectives ♦♦ Monitoring and scrutiny ♦♦ Effective communication ♦♦ Commissioning and procuring services ♦♦ Fostering good relations 2. Involving your communities Participation of local communities proves to be effective for evaluating and developing new policies and strategies for the community. The promotion for community participation is done through seminars, workshops, advertisements and social media. Involvement of local agencies also facilitates the participation of people. The framework also emphasises the participation of people from the various disciplines in order to extract effective results.

Greater community involvement delivers effective stratified data. This is one of the major components of Equi-City project being implemented.

3. Responsive services and customer care Public services must meet the needs of a diverse range of local communities and individuals. The framework emphasises on proactive approach for responsive services rather than reactive approach. A proactive approach focuses on eliminating problems before they have a chance to appear and a reactive approach is based on responding to events after they have happened. The proactive approach requires a strong understanding about people, activities, services and their inter-relation of the community for delivering good equality outcomes. Responsive services and customer care’ within the framework comprises five main elements: ♦♦ Equality analysis/ impact

assessment ♦♦ Integration into business planning and delivery ♦♦ Service level procurement ♦♦ Accessible services ♦♦ Human rights 4. A skilled and committed workforce As part of their work to promote equality and diversity, local authorities need to ensure that they reflect these aspirations in their role as an employer as well as in their role as a service provider. This means that not only should all their human resources (HR) policies and procedures reflect good practice in equality and diversity, but also that anyone who applies to the organisation or who works for it feels confident that they are treated fairly. A modern and diverse workforce’ comprises 10 main elements within the framework: ♦♦ Workforce diversity ♦♦ Workforce strategy ♦♦ Workforce monitoring ♦♦ Equality analysis/impact assessment ♦♦ Staff engagement ♦♦ Promoting an inclusive working environment ♦♦ Equal pay ♦♦ Harassment and bullying, Appraisal ♦♦ Learning and development.

All these are followed by Equi-City at City level. Various theme areas of Capacity Building workshops which have

been planned for the next phase of project are as follows:♦♦ Municipal Finance Management and Distribution ♦♦ Innovative Teaching Techniques Education ♦♦ Administrative efficiency and Sustainable practices ♦♦ Quality Control ♦♦ Water Management ♦♦ Sanitation/Solid waste Management/ Public Health ♦♦ Town Planning/Citizen Participation in delivery of Municipal Services ♦♦ Disaster Training Program ♦♦ Contract Management and Building Infrastructure ♦♦ Information and Communication Technology (ICT)

Equality Outcomes through Framework

♦♦ Improves the quality of services by making sure they are suitable and accessible to everyone ♦♦ Identifies any possible discrimination which may exist and means of overcoming it ♦♦ To develop a better understanding of our community ♦♦ Targets resources efficiently and achieving best value ♦♦ Promotes equal opportunities and good relations

Achieveand Reviewequality outcomes

Collect quality information,data, consult,assess

Monitor Andevaluate

Setequality Prioritiesand objectives

www.urbanupdate.in | July 2017

9

NEWSCAN

Smart Cities Mission

Centre announces 30 new Smart Cities Central Government recently announces the addition of 30 new names to the Smart Cities Mission (SCM) list for development thus taking the number up to 90 cities so far since the mission was launched in June, 2015. Thiruvananthapuram tops the list and capitals of many states have been selected, while 20 more cities will be competing for inclusion in the remaining 10 New Delhi: Under the Smart Cities Mission, central government recently announced list of 30 new smart cities at the National Workshop on Urban Transformation. Minister of Urban Development and Housing & Urban Poverty Alleviation, M Venkaiah Naidu said that 45 cities contested for 40 available smart city slots but only 30 were selected to ensure feasible and workable plans that match the aspirations of the citizens as directed

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July 2017 | www.urbanupdate.in

by Prime Minister Narendra Modi while launching the mission.

He said there will be no compromise in selection of cities and quality of smart city plans. “The concept of smart cities has refined the urban discourse in our country like no other idea and initiative. In one single stroke, the Prime Minister has fired the imagination of the people by proposing to develop 100 smart cities and he has already told us, these 100 smart cities are going to act

All India Institute of Local self-Government (AIILSG) has made the smart city plan of Bilaspur by engaging citizens of the city. AIILSG is also developing smart city plans for state smart cities, Rajnandgaon and Korba

like light houses to inspire other cities to follow suit�, he added.

For the 30 new smart cities, total investment of Rs 57,393 crore under the smart city plan is envisaged, Naidu announced. This includes Rs 46,879 crore for ensuring core infrastructure in the areas identified by citizens for area based development and Rs 10,514 crore for technology based solutions for improving governance, service delivery and utilisation of infrastructure. With this the total investment approved under the smart city plans of 90 cities has gone up to Rs 1,91,155 crore.

Naidu said that 20 cities will be contesting for the remaining 10 slots under smart cities mission. These are; Itanagar (Arunachal Pradesh),

NEWSCAN

Biharsharif (Bihar), Diu (Daman & Diu), Silvassa (Dadra and Nagar Haveli), Kavaratti (Lakshadweep), Navi Mumbai, Greater Mumbai and Amravati (Maharashtra), Imphal (Manipur), Shillong (Meghalaya), Dindigul and Erode (Tamil Nadu), Bidhannagar, Durgapur and Haldia (West Bengal), Meerut, Rai Bareilly, Ghaziabad, Saharanpur and Rampur (UP). Selection of cities for smart city development is running ahead of schedule and the remaining cities would submit revised smart city plans for filling up the vacant slots, he added.

For the next three years, incentive funds of Rs 10,000 crore are approved for recognising the efforts by states in urban transformation, Naidu said.

Besides this, the Housing and Land Rights networks (HLRN), a global coalition calls for an

‘inclusive and sustainable approach to development’ of smart cities, including environmental impacts and human rights. Shivani Chaudhry, Excutive Director, HLRN said, “There is an urgent need to ensure that the government immediately develops human rights indicators to guarantee that the trajectory of development in these cities and their surrounding areas emphasises inclusion, social justice, equality, nondiscrimination, and the progressive realisation of human rights of all city residents, especially the most marginalised.” Naidu addressed the National Workshop on Urban Transformation held in the national capital on completion of two years of the SCM, Atal Mission for Rejuvenation and Urban Transformation (AMRUT) and Housing for all (Urban).

S.No City State/UT 1. Thiruvananthapuram Kerala 2. Naya Raipur Chhattisgarh 3. Rajkot Gujarat 4. Amaravati Andhra Pradesh 5. Patna Bihar 6. Karimnagar Telangana 7. Muzaffarpur Bihar 8. Puducherry Puducherry 9. Gandhinagar Gujarat 10. Srinagar Jammu & Kashmir 11. Sagar Madhya Pradesh 12. Karnal Haryana 13. Satna Madhya Pradesh 14. Bengaluru Karnataka 15. Shimla Himachal Pradesh 16. Dehradun Uttarakhand 17. Tiruppur Tamil Nadu 18. Pimpri Chinchwad Maharashtra 19. Bilaspur Chhattisgarh 20. Pasighat Arunachal Pradesh 21. Jammu Jammu & Kashmir 22. Dahod Gujarat 23. Tirunelveli Tamil Nadu 24. Thootukkudi Tamil Nadu 25. Tiruchirapalli Tamil Nadu 26. Jhansi Uttar Pradesh 27. Aizawl Mizoram 28. Allahabad Uttar Pradesh 29. Aligarh Uttar Pradesh 30. Gangtok Sikkim

Liveability scorecard for Indian cities Ministry of Urban Development (MoUD) recently launches the ‘City Liveability Index’ for measuring the quality of living in 116 major Indian cities including smart cities, capital cities and cities with population of above one million each. At the National Workshop on Urban transformation, Minister of Urban Development, M Venkaiah Naidu said while launching the initiative, “Time has now come to measure life quality in cities and rank them accordingly”. It is a first-of-its-kind index to be introduced in the country where cities will know where they stand in terms of quality of life.

Cities will be assessed on a comprehensive set of 79 parameters to capture the extent and quality of infrastructure including availability of roads, education and health care, mobility, employment opportunities, emergency response, grievance redressal, pollution, availability of open and green spaces, and cultural and entertainment opportunities. In the coming month, agencies will be selected for undertaking the assessment and thereafter the data collection will be completed in next six months.

As an incentive, Rs. 500 crore was distributed by urban development ministry to 16 states that performed well in implementing urban reforms during 2016-2017. The progress was measured in respect of e-governance, audit of accounts, tax revision policies and extent of tax revenue collection, energy and water audit, establishing state level financial intermediaries for resource mobilization, credit rating etc.

Former Urban Development Secretary, Rajiv Gauba said that reform incentive fund for the next three financial years will be increased from the present allocation of Rs 900 cr to Rs 10,000 cr to promote next generation reforms that would make a substantial difference to urban governance and service delivery and resource mobilisation by urban local bodies.

www.urbanupdate.in | July 2017

11

BRIEFS

Uttarakhand, Haryana declared ODF states Under the Swachh Bharat Mission Gramin (SBM-G), rural Uttarakhand and rural Haryana have declared themselves as the 4th and 5th Open Defecation Free (ODF) states. The two join the league of Sikkim, Himachal Pradesh and Kerala, the first three ODF states. Nationally, the sanitation coverage has increased from 42% to over 64% since the launch of SBM. Uttarakhand has 13 districts, 95 blocks, 7256 gram panchayats and 15751 villages while Haryana has 21 districts, 124 blocks, and 6083 gram panchayats - all of which have declared themselves as ODF in formal declarations in Dehradun and Chandigarh, respectively. With the total number of ODF states now rising to 5, more than 2 Lakh villages and 147 districts have also been declared ODF across the country.

MCDs to get mechanical sweepers by July 15

Three municipal corporations in Delhi are expected get mechanical sweepers, which control dust pollution, by July 15, officials told Delhi Lt. Governor Anil Baijal. The New Delhi Municipal Council already has five mechanical sweepers.

Principal Secretary, PWD, Ashwani Kumar, told the Lt. Governor that the government has also hired six mechanical sweepers and a global tender has been floated for six additional machines which are expected to be delivered by September 2017.

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July 2017 | www.urbanupdate.in

NEWSCAN

PMC raises municipal bonds of Rs 200 cr Pune: Pune Municipal Corporation (PMC) recently raises municipal bonds of Rs 200 crore after 14 years. Munibonds were last sold by Ahmedabad Municipal Corporation (AMC) in 1998.

Nearly two years after the Securities and Exchange Board of India (Sebi) issues new norms for municipal bonds, PMC becomes the first civic body to raise funds through selling bonds.

Speaking on the occasion Minister of Urban Development Venkaiah Naidu said, “Today’s striking of ‘Gong’ at Bombay Stock Exchange has far wider implications than many of us can think of. I would like to capture the significance of this event in one sentence and that being - This sound of Gong is an echo of urban revival happening in our country now” The bonds issues raised at a coupon of 7.59 per cent and oversubscribed six times, will be used for a water project of Rs 2300 crore under Smart Cities Mission (SCM). Kunal Kumar, commissioner of PMC, said that the issue was subscribed six times and clutch of investors including banks, insurance companies and pension funds participated in the offering. He added that with AA+ rating, highest for municipal bonds, PMC has managed to raise funds at a competitive rate. “We were confident on our back-

end system. We have improved our financials, we have taken active steps on improving our governance structure and overall we had a very sound project to bring to the market.”

PMC issued bonds through Bombay Stock Exchange (BSE) BOND platform.

Ashish kumar Chauhan, CEO & MD BSE Ltd said, “I am delighted that Pune Municipal Corporation (PMC) is able to raise Rs 200 crore successfully using BSE BOND platform, a market leading platform for bond raising in India. PMC is the first municipality to raise funds in last several years. I am sure, the smart city framework as envisaged by PM Narendra Modi is taking shape very fast.

BSE is delighted to play a significant role in raising funds for the smart cities. We invite all the municipalities to raise the funds and follow PMC’s successful bond issuance. BSE firmly believes that Indian bond markets are poised for a substantial growth and India can use its domestic savings to fund its infrastructure needs in a substantial manner.”

After Pune, New Delhi Municipal Corporation (NDMC) is likely to float municipal bonds of Rs 500 crores. The civic body plans to use these funds on the projects of Smart Cities Mission (SCM) which includes smart schools, parking and health care centres.

Launch of India’s largest Municipal Bonds at Bombay Stock Exchange (BSE)

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BRIEFS

Smart redevelopment at 10 Indian railway stations

Ten railway stations have been identified to roll out redevelopment of stations on self-financing basis through land monetisation in synergy with the Smart Cities Mission of the Ministry of Urban Development.

A MoU was signed for smart redevelopment of Delhi Sarai Rohilla, Lucknow, Gomtinagar, Kota, Tirupati, Nellore, Ernakulam, Puducherry, Madgaon and Thane New stations. Speaking on the occasion, Naidu said, redevelopment of railway stations further enhances the smartness of cities by addressing congestion and sanitation at stations which are visited by a large number of people.

AMC to appoint 500 personnel, check open defecation The civic body of Aurangabad decides to appoint 500 people to check the practice of open defecation in the city. As a part of Swachh Bharat Abhiyan, Aurangabad Municipal Corporation (AMC) was to construct 7000 toilets to end open defecation in the city.

Municipal Commissioner, D M Mugalikar said 28 teams have been formed, which will move around the affected areas to reason with people to avoid open defecation and construct toilets on their premises. The staff would also guide people on how to avail of the government scheme under which Rs 12,000 is provided for construction of toilets.

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July 2017 | www.urbanupdate.in

NEWSCAN

Yoga healing in KMC health clinics Kolkata: Civic body of Kolkata run health clinics may have their own yoga instructors and yoga mat besides the doctor’s room for ailment of the people visiting these clinics. When Kolkata Municipal Corporation (KMC) floated the proposal to set up yoga clinic in the city to promote the conventional courses of the treatment, the state health department not only endorsed it, but has also written to the Union Health ministry to approve the project and provide funds.

A meeting was also attended by state health department in the month of May and participated in an interactive session with health ministry officials on the necessity of setting up yoga clinics in Kolkata.

If the proposal is approved, civic body of Kolkata is to set up yoga clinics attached to the exiting health ward units, which are located all over the city. KMC will further recruit yoga trainers based on their qualification and experience. A board of eminent yoga practitioners will keep an eye on the module and methods of such alternative modes of healing at KMC’s clinics.

A patient visiting KMC clinics with a

problem will first be diagnosed by the medical officer. Depending on the problem and its scope of treatment with Yoga, the medical officer may refer the patient to see yoga expert. “We have devised a plan to set up yoga clinics as an alternative healing for patients who badly need it. Today, we can’t ignore the usefulness of yoga and should extend its benefits to patients who can’t afford individual trainers,” said Atin Ghosh, the MMiC overseeing KMC’s health department.

KMC health department adviser, T K Mukherjee said the proposal had been sent to the Union Health ministry under the National Urban Health Mission (NUHM).

According to Mukherjee, available funds would be utilised for setting up yoga treatment centres to treat, mainly, lifestyle diseases.

‘Mayor Express’ service at Re 1 in Bhopal Bhopal: ‘Bhopal Plus’ application is set to have a ‘Mayor Express’ service, through which the citizens of Bhopal can get services of plumber, carpenter, electrician, gardener, and alike at their door-step, all for rupee one till June 25.

In all 19 wards of Municipal Corporation, service providers would reach residents in blue and yellow dress. Rs 1 crore has been allocated for Mayor Express (plumber and electrician helpline) in the current civic body budget. “We are in beta testing mode and are looking for valuable inputs from citizens. The services with a new helpline number 155304 would go live from June 25,” said Neeraj Alia, whose company has been entrusted with operating the smart city citizen service.

Operations of ‘Mayor Express’ are being

done from Chunna Bhatti and MP Nagar.

Given the increased number of calls from areas like Ashoka Garden and walled city, another base station is likely to be opened in the Old City soon. As per BMC’s new plan, the services would cost about Rs 200 as a home visit charge. Basic issues would be resolved in the call period for a fixed charge. Above and beyond the service call, charges would vary. However, during the beta testing of the service, the company will only charge Re 1 as token amount.

Mayor Express was first launched by BMC mayor Alok Sharma in February 2016. The service, which then functioned out of BMC office at Mata Mandir, has been offloaded to a private operator. BMC officials expect the service to be more professional under the new operator.

CITY IMAGES

Rock Garden, Chandigarh

Best from waste

Chandigarh rock garden which is constructed by using industrial and urban waste is an embodiment of creativity and innovation. The sculptures in the garden are made by using a variety of different discarded waste materials like broken crockery, iron foundry clinker, electric plug moulds, fluorescent tubes, bicycle frames, bottles, glass bangles, shells, and cooking pots and smashed up bathroom fittings. The Rock Garden covers an area of around 40 acres and contains more than 2000 statues. It is like an open air exhibition with an open air theatre, a large waterfall, a canal and a miniature village which have become interactive spaces for cultural activities.

www.urbanupdate.in | July 2017

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BRIEFS

Durga Shankar Mishra, new UD Secretary

Central Government appoints Durga Shankar Mishra as new Urban Development (UD) Secretary replacing Rajiv Gauba.

Mishra is IAS officer of 1984 batch who was earlier appointed as the additional secretary.

The government hasrecently appointed 16 secretaries including Rajiv Gauba as the home secretary-designate and Subhash C Garg as economic affairs secretary.

India’s busiest port to be powered by RE India’s largest seaport Kandla located in the Western Indian state of Gujarat is all set to be powered by renewable energy, the Minister for Shipping and Transport Nitin Gadkari recently stated. Minister Gadkari stated that “the solar-wind energy park could be commissioned over an area of 150,000 acres with a total installed capacity of around 200 megawatts”. Gadkari stated that “solar power tariffs have crashed in India over the last few months, and the port could use the surplus land to develop largescale renewable energy projects.”

Since February this year four major solar power auctions have taken place in India with the lowest tariff bids falling by as much as 26% between the first and the latest auction. The race to lower tariff bids has been fuelled primarily by the crash in solar module prices, regulatory support from the government and perhaps, the promise and hope of cheap debt finance”.

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July 2017 | www.urbanupdate.in

NEWSCAN

National Mission on Cultural Mapping of India launches in Mathura Mathura: In a block level mega talent hunt programme “Sanskritik Pratibha Khoj Samaroh”, Dr Mahesh Sharma, Minister of State (Independent Charge) for Culture & Tourism launched the implementation of the ‘National Mission on Cultural Mapping of India’ at Goverdhan Block, Mathura, Uttar Pradesh.

Srikant Sharma, Energy Minister of Uttar Pradesh, Ministry’s senior officials and various renowned artists including Padma, Sangeet Natak Akademi and State Awardees were present. This Mission is part of the ‘Ek Bharat Shreshtha Bharat’ umbrella.

Artistes in large number participated in this Block level event where a stage was provided to the registered artists for performance and displaying their talent.

A panel of renowned artists was invited for judging the participants in different art forms. Registration was directly on the portal culturalmappingofindia.nic.in.

Any person who claims to be an artist can register at the initial level.

In his address on the occasion, Dr Mahesh Sharma said that paving the way for the ‘Ek Bharat, Shreshtha Bharat’ programme led by the Prime Minister

Narendra Modi, the mission aims at converting the vast and widespread cultural canvas of India into an objective cultural map, designing a mechanism to fulfil the aspirations of the whole artist community of the nation and preserving the rich cultural heritage of this country in the form of a cultural repository of artists and art forms.

This Mission encompasses data mapping, demography building formalising the processes and bringing all the cultural activities under one web based umbrella for better results.

The Ministry of Culture has planned to hold talent hunt competitions with various rounds from Block level to National level. The scheme is set to cover all the Blocks of the Country, involving a total of 6.40 Lakh villages over the span of next 3 years.

N K Sinha, Secretary, Ministry of Culture said, “The Cultural Mapping of India portal will serve as a repository/ consolidated database of information about cultural assets and resources i.e. a cultural inventory at one place for essential planning, sustainable economic development and for preserving the scattered and near extinct art forms.”

NEWSCAN

GST to impact real estate sector

Calling the GST, a major structural reform, Shrikant Paranjape, President, Confederation of Real Estate Developers Association of India (CREDAI) Pune Metro said, “Steps like RERA and GST will increase transparency in the segment”

New Delhi: In a statement, CREDAI said it believed that real estate developers will pass on tax credit to the customer. “However, the extent of benefit that can be passed on to the customer will depend on various parameters, such as the stage of project, land value embedded in price, total sales made, the cost of the house already paid by the customer to the developer,” CREDAI said.

Holding forth on the factors that will play important role in making the GST related calculations, Paranjape said, “It is important to assess the quantum of corresponding benefit that will be passed on by suppliers, vendors and

service providers of developers. It is expected that the benefit will be passed on to developers so that overall cost of developer does not go up. If the cost does not increase then the entire input credit benefit can be passed on by developers to buyers.”

CREDAI said it must also be borne in mind that a lot of vendors of the sectors like steel, cement, and sand have tendencies to cartel. “The cement and steel prices soar without warnings.

Sand is always in short supply and not available in monsoon. It is likely that these industries may not pass on entire benefit of tax credit. Only time will test it.”

Another factor that will determine the passing of the benefit to purchaser is the price tag of the real estate. “The prices of real estate depend on land value. Land is a major raw material in any real estate… It is pertinent to note that there is no GST on land. Obviously, no input credit is available in respect of the major raw material. If no input credit is available for 80 per cent of the incurred cost, overall percentage of input credit of the tax collected will be negligible and virtually no benefit may be passed on to the purchaser…”, it said.

Considering the GST a positive

change, realtors’ body NAREDCO President Parveen Jain said “The enactment of this law will singlehandedly solve many of the challenges faced by the real estate sector and help in pulling the sluggish sector out of its long slumber. Heavy taxes that are being paid currently by the developers will automatically go down by a considerable percentage.

Construction costs would be reduced to some extent and this benefit can be passed on to the customers, thereby spurring home buying, he added.

“This bill has been long awaited by the industry. This is a major tax reform for our economy, which will transform India into a single market.

Once implemented, it is likely to have a positive impact on the real estate sector, which has linkages with over 250 ancillary industries,” said Anshuman Magazine, Chairman - India and SouthEast Asia, CBRE. “The passage of Goods and Services Tax (GST) Bill is the biggest indirect taxation reform in the country. It would be a harbinger of change for the real estate sector which is currently plagued with a myriad of indirect tax issues both at the center and state level,” Neha Hiranandani, Director, House of Hiranandani, said in a statement.

www.urbanupdate.in | July 2017

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BRIEFS

AMC to use bio-mining at Pirana dumping site Often catching fire, Pirana dumping site is set on bio-mining as a way to flatten the dumping mount formed by Ahmedabad Municipal Corporation (AMC).

For more than two decades, it was a reason for spreading toxins into the city and often caught fire, making it uncomfortable for the nearby residents. AMC resolved to appoint a consultant to prepare a detailed project report (DPR) for the process.

First desalination water project in Thane Municipal Corporation of Thane is set to launch Mumbai Metropolitan Region’s (MMR) first creek water desalination pilot project to tackle the water scarcity in the city. It will convert 20 million litres of brackish creek water into potable drinking water on daily basis. Civic chief Sanjeev Jaiswal on functionalities of the project said, “During my visit to Israel’s Tel Aviv, I noticed that the city’s total 480 MLD drinking water supply was sourced by purifying sea water using desalination system. However, our city which is surrounded by a creek and a river is dependent on dams.”

‘Hum versus Dengue’ campaign in Gurugram Haryana health department launches ‘Hum versus Dengue’ campaign to fight vector borne diseases in the city. Under this campaign, children studying in government schools in Gurugram would be provided with free insurance cover up to Rs 20,000 for treatment in cases diagnosed with vector-borne diseases. Municipal Corporation of Gurgaon has also launched helpline number 1800-180-1817 for fogging in vulnerable areas.

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July 2017 | www.urbanupdate.in

NEWSCAN

‘Nation Committed to Achieve Land Degradation Neutrality by 2030’ New Delhi: Emphasising that the current Government is committed to achieve Land Degradation Neutrality by the year 2030, Environment Minister Dr Harsh Vardhan has said that India’s new National Action Programme (NAP) will be finalised after a series of regional consultations and workshops with all relevant stakeholders, keeping in mind our national circumstances and development priorities. In a statement on the eve of World Day to Combat Desertification, the Minister said that India is focusing on sustainable land and resource management for livelihood generation at community level for making the local lands healthier and productive for providing a better homeland and

a better future to its inhabitants. He emphasised this year’s slogan, “Our Land.

Our Home. Our Future”, underlines the central role that productive land can play in turning the growing tide of migrants abandoning their unproductive land into communities and nations that are stable, secure and sustainable in future.

Vardhan said that initiatives like the Soil Health Card Scheme have been launched by the Government to help farmers improve productivity through judicious use of inputs. He added that the Scheme was allotted Rs 840.52 crore over the last three years, which is 30 times more than the funds devoted to soil research and analysis in the preceding years.

Shimla gets new Mayor, Deputy Mayor Shimla: “Kusum Sadrate recently emerged as the new Mayor of Himachal Pradesh’s capital. Rakesh Kumar took charge of the Deputy Mayor position.

Water supply, sanitation, allocating parking space, sewage management and constructing parks will be Kusum’s priorities. While water crisis and sanitation is her main concern, “We will sit together and find out solutions to these problems”, she said.

After 31 years, Bhartiya Janata Party won in Shimla defeating the Congress.

Sadrate is a first time councillor who won by defeating Congress former Mayor Jaini Prem by a margins of 299 votes.

There were 19 BJP supported candidates while 14 Congress supporters, including independents. Sadrate polled 19 votes while the Congress candidate Simi Nanda bagged 13 votes. On the day of judgment, Shaily Sharma abstained from the election while 33 out of the total councillors remained present. BJP rebel, Rakesh Kumar was elected as the new Deputy Mayor of Shimla Municipal Corporation.

Both the Mayor and Deputy Mayor

Newly elected Shimla mayor Kusum Sadrate performing ‘havan’ on her first day in office

promised to work in close coordination with eachother as well as with the councillors.” I contested the election independently to stop Congress from winning”, Rakesh Kumar said.

The Mayor was briefed on various development projects, money allocation and governance projects under the centrally-funded JNNURM by Municipal Commissioner G C Negi.

Mayor Sadrate also hopes that the reelected councillors will help her formulate welfare plans. The Mayor promised to restore the beauty of the city and develop it as an ideal tourist place.

NEWSCAN

Energy Conservation

New Energy Conservation Building Code launched New Delhi: Piyush Goyal, Minister of State (IC) for Power, Coal, New and Renewable Energy and Mines launched the Energy Conservation Building Code 2017 (ECBC 2017).Developed

by Ministry of Power and Bureau of Energy Efficiency (BEE), ECBC 2017 prescribes the energy performance standards for new commercial buildings to be constructed across India.

The updated version of ECBC provides current as well as futuristic advancements in building technology to further reduce building energy consumption and promote low-carbon growth. ECBC 2017 sets parameters for builders, designers and architects to integrate renewable energy sources in building design with the inclusion of passive design strategies. The code aims to optimise energy savings with the comfort levels for occupants, and prefers life-cycle cost effectiveness to achieve energy neutrality in commercial buildings.

In his address, Goyal, said, “I would like to dedicate today ECBC Code 2017 to all the young children of India to the future of India for whose sake, it is incumbent on all of us to efficiently utilize every bit of resource, ensure implement such progressive and forward looking programmes of Government very diligently and ensure that we will leave behind for next generation a better world then what we inherited.”

Pradeep Kumar Pujari, Secretary, Power, stated that ECBC 2017 will give clear direction and have criteria for new buildings to be Super ECBC: “The new code reflects current and futuristic advancements in building technology, market changes, and energy demand scenario of the country, setting the

The new code reflects current and futuristic advancements in building technology, market changes, and energy demand scenario of the country, setting the benchmark for Indian buildings to be amongst some of the most efficient globally benchmark for Indian buildings to be amongst some of the most efficient globally.”

In order for a building to be considered ECBC-compliant, it would need to demonstrate minimum energy savings of 25%. Additional improvements in energy efficiency performance would enable the new buildings to achieve higher grades like ECBC Plus or Super ECBC status leading to further energy savings of 35% and 50%, respectively.

With the adoption of ECBC 2017 for new commercial building construction throughout the country, it is estimated to achieve a 50% reduction in energy use by 2030. This will translate to energy savings of about 300 billion units by

2030 and peak demand reduction of over 15 GW in a year. This will be equivalent to expenditure savings of Rs 35,000 crore and 250 million tonnes of CO2 reduction. ECBC 2017 was developed

by BEE with technical support from United States Agency for International Development (USAID) under the U.S.India bilateral Partnership to Advance Clean Energy – Deployment Technical Assistance (PACE-D TA) Program.

The launch event was attended by senior officers of ministries, state governments, technical bodies, public utilities, multilateral agencies, international funding bodies, academicians and industry experts and consultants from across the building, infrastructure, real estate, energy and construction sectors. The event also featured a video on the ECBC, as well as a technical session that highlighted the salient features of ECBC 2017, international best practices in the building sector, as well as the presentation of case studies on energy efficient buildings.

www.urbanupdate.in | July 2017

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BRIEFS

Disabled friendly park to open in Hyderabad

Greater Hyderabad Municipal Corporation (GHMC) is set to open a disabled friendly park in Hyderabad made over 1.03 acres.

The park is specially designed for visually and hearing impaired people as well as for physically and mentally challenged ones.

It has a recreational zone with rides and gardens, also acquired a statue of Lois Braille, the inventor of Braille. GHMC has fixed an investment of Rs 28.20 lakh annually for maintenance, of which 25% will come by donations.

Teams to combat vector-borne diseases in Gurugram In their efforts to combat Chikungunya and Dengue and to make Haryana malaria free, the Municipal Corporation Gurugram (MCG) recently forms 20 teams to create awareness and help reduce larvae breeding of mosquitoes causing vector borne diseases at source. The teams will get training from the health department officials regarding Dengue and other vector borne diseases. The identified 20 teams will be creating door to door awareness and will also scan through the houses to spot any larvae breeding.

20 July 2017 | www.urbanupdate.in

NEWSCAN

SIDBI, AIILSG train municipalities to improve energy efficiency Nagpur: Small Industries Development Bank of India (SIDBI) along with All India Institute of Local Self-Government (AIILSG) and the World Bank recently facilitated a half-day workshop on energy efficiency improvements in municipalities in Nagpur. It consisted of 40-45 municipal officials mostly from Nagpur Municipal Corporation and from nearby civic bodies like Amravati, Chandrapur, Katol, Umred and Narkhed.

Apart from this there were participants from Maharashtra Housing and Area Development Authority (MHADA) and Nagpur Improvement Trust (NIT).

At present, municipalities are spending large amounts of their revenue on paying energy bills for municipally owned buildings such as schools and hospitals, providing local public services such as street lighting, water supply and others.

It has been estimated that municipal water supply system can save up to 25 to 40% and usage of efficient lighting infrastructure could help reduce the energy usage between 25-60%, while opting for energy efficient street lighting can save upto 50% annually.

SIDBI is implementing a project titled “Partial Risk Sharing for Energy Efficiency (PRSF)� with the support of World Bank, Global Environment Facility (GEF) and Clean Technology Fund (CTF) with an objective of transforming the Energy Efficiency (EE) market in India by promoting increased level of

EE investments, particularly through Energy Service Performance Contracting (ESPC) delivered through energy service companies.

With the same purpose, it was proposed to conduct a sensitization workshop, which was inaugurated Nanda Jichkar, Mayor of Nagpur and AshwinMudgal, Municipal Commissioner of Nagpur.

Jichkar spoke about the importance of energy efficiency in municipalities and benefits of such practices in Nagpur. She also emphasised upon the practice of changing conventional energy consuming street lights with LED street lights in the city. While Mudgal put forward the various schemes being implemented in Nagpur for improvement of energy efficiency in municipality owned buildings and infrastructure.

He concluded with examples of energy efficient appliances and solar panels being used in infrastructure owned by Nagpur Municipal Corporation and their benefits. The theme address was delivered by Shankar Haldar, Lead Technical Expert, Energy Efficiency Centre, SIDBI. The workshop also included presentations by various experts in the field of energy efficiency.

A session summary, an interactive discussion session and a questionnaire exchanged between the experts and participants were the concluding events of the workshop.

NEWSCAN

Connaught Place 9 most expensive office market in the world th

New Delhi: The nation’s financial capital continues to slip on office rentals as Connaught Place in the heart of the national capital continues to remain the most expensive market in the country and the 9th costliest in the world, says a report.

According to the bi-annual global prime office occupancy costs survey by realty consultant CBRE Group, New Delhi’s central business district of Connaught Place is the 9th most expensive office market in the world with an occupancy cost of USD 153.89 per sqft per annum. This makes Connaught Place costlier than Dubai, downtown Boston and Shanghai.

As against this Mumbai’s BandraKurla Complex (BKC) is ranked 20th while the CBD of Nariman Point is ranked 33 on the list of the top 50 most expensive office markets around the world, says the CBRE report.

CBRE India & Southeast Asia Chairman Anshuman Magazine said “despite Connaught Place having limited supply

of prime office space, its location in the heart of the national capital, coupled with great infrastructure and connectivity to other parts of the city, makes it to be an ideal location for any business to be in.”

According to the report, Central in Hong Kong and West End in London remain the two most expensive markets in the world, while the top 10 list remains largely consistent.

Central in Hong Kong is the world’s highest-priced office market with an overall occupancy cost of USD 302.51 per sqft per annum and with seven of the most expensive cities, Asia continues to dominate the list of the world’s most expensive office locations, according to the survey. Hong Kong (West Kowloon) (USD190.02 per sqft) and Beijing (CBD) (USD183.10 per sqft) also feature among the top five most expensive markets this year.

Of the top 50 most expensive markets, 18 were in Asia-Pacific, 20 in Europe and the Middle East and Africa (EMEA), and 12 in the Americas.

12,000 flats on offer under new DDA scheme NEW DELHI: The Delhi Development Authority’s (DDA) housing scheme with 12,000 flats on offer was launched by Union Urban Development Minister M Venkaiah Naidu. The scheme has been linked with the Pradhan Mantri Aawas Yojna as “the vision of our government is to provide affordable housing by 2022”, Naidu said. Most of the flats are in Rohini, Dwarka, Narela, Vasant Kunj, Jasola, Pitampura and Paschim Vihar. Officials said all the flats have been constructed using environmentfriendly technologies. Some 10,000 unoccupied flats are from the DDA’s 2014 housing scheme; 2,000 flats have been lying vacant.

To apply for the flats, people will have to pay Rs 1 lakh for LIG and Rs 2

lakh for MIG and HIG flats as earnest money. No penalty will be levied on the earnest money if an applicant withdraws before the draw of lots. “But they will have to forfeit 25% of the amount if they surrender the flats within 90 days after the draw of lots,” said Aggarwal.

If a person surrenders within three months of issue of the demand letter, then they will lose 50% of the earnest money. “After this, there would be no exemption,” he said. The banks are Axis Bank, Yes Bank, IDBI, Bank of Baroda, Central Bank, State Bank of India (SBI), Kotak Mahindra, HDFC, ICICI and Canara Bank. The DDA had set mid-June as the target date for the launch of the scheme, which was earlier scheduled to be announced by February.

YMC marks 4,000 streetlights The Yamunanagar Municipal Corporation (YMC) has decided to mark 4000 streetlights following the complaints by residents regarding the same.

The problem arising due to unmarked lights was that it was difficult for residents to file complaints on the new mobile application launched by the YMC. Of the total 22,000 streetlights within the MC limits, 18,000 have already been marked. However, MC commissioner Girish Arora denied having any such problems with the marking of streetlights.

SDMC to map areas to manage waste

For effective collection of waste, the South Delhi Municipal Corporation (SDMC) has decided to conduct geo-mapping of areas. This initiative will help to study the data from different geographical locations and will give information about inhabitants residing in various colonies, apartments and unauthorized colonies.

“This exercise is necessary to effectively plan waste collection and disposal. The corporation could streamline its efforts better if it had an exact idea of the number of hotels, hospitals, restaurants, residential areas and commercial centres where waste was generated,” SDMC mayor Kamaljeet Sehrawat said.

www.urbanupdate.in | July 2017

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news feature | Child Care

A strike against pneumonia

I JP Nadda Union Minister Ministry of Health and Family Welfare

22 July 2017 | www.urbanupdate.in

n 2014, this government made a promise to the people of India, to safeguard their health, to provide the men, women, and children of this country the best chance to survive and thrive. One of the key initiatives was to protect as many of our children against as many diseases as possible, with the introduction of new vaccines into the Universal Immunization Programme (UIP), as well as by ensuring these reach the unreached. This was one of the most significant policy decisions in public health arena taken because of the visionary leadership of Shri

Narendra Modi Ji. Today, I can say that promise is well on its way to being fulfilled.

For decades, our children have died from diseases that could be prevented.

Introduction of new vaccines is key to reducing childhood and infant mortality and morbidity in the country. In the last two years, through the UIP, we saw the introduction of the Inactivated Polio Vaccine (IPV), Rotavirus vaccine (RVV) against diarrhoea, and the measles-rubella (MR) vaccine, to protect against both measles and rubella. The latest weapon in the arsenal being introduced is

pneumococcal conjugate vaccine (PCV). More than 130 countries worldwide have introduced PCV as part of their childhood immunization programmes, in line with World Health Organization (WHO) global recommendations.

This vaccine provides protection against one of the most common causes of pneumonia—a bacterium called pneumococcus. This bacterium also causes other diseases such as ear infections, meningitis and blood infections, with some of these resulting in death or serious disabilities.

This vaccine has long been available in the private sector in India, so children of wealthy families who could afford it could be protected. But today, by introducing it in the UIP, we are ensuring that this vaccine reaches all children, especially those who need it the most, the underprivileged and underserved. The availability of life-saving vaccines should not be limited to only those who can afford it. It is through vaccines like PCV that we can give the citizens of this country a shot at an equitable future and achieve the vision of an India in which every citizen lives a healthy and productive life.

Many people ask, “Why immunize?”

Previous generations, the argument goes, suffered from diseases like diarrhoea, measles, and pneumonia; why is it essential for us to immunize our children against it? By the time you finish reading this article, one child in India would have died from pneumonia. One child every three

By the time you finish reading this article, one child in India would have died from pneumonia. One child every three minutes – that is the tragic toll pneumonia claims in this country. We need to protect and save those children

minutes – that is the tragic toll pneumonia claims in this country.

We need to protect and save those children.

The decision to introduce a vaccine in the UIP is a well-regulated and carefully thought-out process that takes into account the need, the safety and the efficacy of the vaccine. For a new vaccine to be introduced in the country, the National Technical Advisory Group on Immunisation (NTAGI) reviews disease burden and epidemiology of a particular vaccine preventable disease and vaccine availability along with its cost effectiveness before making recommendations for any new vaccine introduction. NTAGI is an independent body of experts with repute and experience in the field.

The Ministry introduces new vaccines only when NTAGI recommendations are subsequently approved by the empowered programme committee and Mission Steering Group (MSG).

All new vaccines, including the PCV, have been included in the UIP at the recommendation of NTAGI and following this procedure. PCV helps protect against the bacterium that causes the maximum number of child pneumonia deaths worldwide and in India. We are starting by introducing it in parts of Bihar, parts of Uttar Pradesh and Himachal Pradesh, but the plan is to soon cover all of India. It is an expensive vaccine, but it will now be available to our citizens for free.

The cost to the government exchequer is offset by the additional economic benefits of having a healthier society.

With close to 1.8 lakh deaths and over 20 lakh cases annually, child pneumonia poses a significant financial burden on India. The costs of treating a case of pneumonia perpetuates the cycle of poverty. Parents of children who contract pneumonia have to pay expensive hospital bills, which can cost them several months in wages.

To add to this, they have to take time off and stay home to care for sick children, negatively impacting India’s economy. Healthier children enjoy better cognitive development, are

better in school, missing fewer days, and in the long run, when they join the workforce, they tend to be more productive and earn more. Health thus creates wealth. There are several global examples where healthier populations grow their incomes and escape from poverty quicker, making PCV an investment into India’s progress towards becoming an economically developed nation. India leads the world in pneumonia deaths but, with the launch of PCV, we have definite chance at changing that statistic and making a serious dent in our contribution to the global burden of the disease.

In the past, vaccines have greatly contributed in reducing death and disease. Ailments like smallpox no longer plague us and India is now free of polio and maternal and neonatal tetanus. The government’s investment and commitment to India’s UIP has contributed to this progress. Today, the UIP provides Indian children with vaccines for 11 deadly and debilitating diseases; the introduction of PCV will increase that number to 12. Recently released National Family Health Survey (NFHS-4) data shows that India’s full immunization coverage stands at 62%, up from 43.5% just a decade ago. More vaccines and higher coverage have helped to drastically reduce our infant and child deaths. To accelerate that momentum, Mission Indradhanush was launched in 2014 to reach the most vulnerable and ensure 90% of India’s children have access to life-saving vaccines by 2020. This project now has attained top speed with our Honourable Prime Minister rescheduling the target to 2018, emphasizing that no child should be left behind.

It is our duty to deliver on the promise and save the lives of tens of thousands of children in this country who don’t live to see their fifth birthday due to preventable diseases. To achieve these ambitious targets, we cannot afford to slow down. Let us immunize and give our children the protection they need to fight off deadly diseases and reach their full potential.

www.urbanupdate.in | July 2017

23

COVER STORY | Urban Health

COVER STORY | Urban Health

24 July 2017 | www.urbanupdate.in

Health

In Our Cities

The G20 2017 Summit in July 2017 will include a Health track in its Agenda; for the first time ever. The top nations of the world will discuss global health as part of the development agenda in addition to political, economic and environmental issues.

Ahead of the Summit, health ministers of the G20 countries met on May 19-20 in Berlin to discuss and create the framework for their leaders’ meeting in July. This marks the recognition of health as among the central issues in the world today coming as it does with fresh challenges and the need for collaborative and coordinated action

V Vijaykumar Sr Advisor, AIILSG

A

s we write, Director General Dr Tedros Adhanom Ghebreyesus leads the World Health Organization delegation participating in the G20 Summit taking place on 7–8 July 2017, in Hamburg, Germany. An Ethiopian, Dr Tedros who took office on July 1 this year, is the first WHO Director General from Africa in the organization’s nearly 70 year

history. He will participate in all the sessions of the G20 Summit including priorities for health, economic growth, sustainable development as well as women’s empowerment. During his meetings with heads of state and government, and leaders of various international organizations, Dr Tedros is expected to advance global health goals for universal health coverage, health security, health impacts of climate change and combating antimicrobial resistance.

Public healthcare is now more than a sympathetic concern for people, especially the disadvantaged and vulnerable. Adequate and effective investments in healthcare go towards building a healthy, diseasefree population thus contributing to economic growth. A healthy community enables its members participate fully in the development process and partake of the benefits of economic growth thereby realizing one’s full potential. Beyond individual

Rapid and relentless urbanization or the deluge of population into urban centres has amplified the public health challenge in Indian cities and indeed the entire developing world. Lack of safe housing leading to proliferation of slums, poor sanitation, nonaccess to safe piped water and environmental degradation are the more visible manifestations of sub-optimal urban life and are direct causes of poor personal and community health

achievement, a healthy population enables faster economic growth and overall development at the national level. Thus effective and efficient public healthcare can go towards meeting

www.urbanupdate.in | July 2017

25

COVER STORY | Urban Health

overall national goals while enabling more just, fair and equitable societies.

Rapid and relentless urbanization or the deluge of population into urban centres has amplified the public health challenge in Indian cities and indeed the entire developing world. Lack of safe housing leading to proliferation of slums, poor sanitation, non-access to safe piped water and environmental degradation are the more visible manifestations of sub-optimal urban life and are direct causes of poor personal and community health. Dangerous air quality and substance abuse issues especially among the poorer sections are others. And then there is the near absence of an effective and efficient public healthcare system to take care of complications arising out of these poor urban living conditions.

Healthcare in India

The large dependence on private health care in India, in both urban and rural settings, indicates the lack of adequate public healthcare options. Nearly 70 and 65 percent of population, urban and rural respectively, depend on private healthcare.

These high figures are accompanied by very low levels of insurance coverage, just about 20 percent by some estimates.

Moreover insurance coverage is usually limited to hospitalization expenses leaving all out-patient consultation, medicines and diagnostic expenses to be met out-of-pocket. High healthcare costs can have a debilitating effect on family finances, often crowding out other essentials such as good nutrition and education.

Healthcare in urban India is also marked by less than noble practices of some healthcare professionals.

Government has frequently had to rein in errant participants including pricing through the Drug Price Control Order and the like. The recent public spat involving cardiac stent manufacturers is a case in point. Doctors and other practitioners are often known for irrational drug prescribing and uncalled for interventions requiring a patient to spend well more than would otherwise be required.

26 July 2017 | www.urbanupdate.in

ASHA & MAS ASHA is a key initiative under the National Health Mission, both Urban and Rural. Accredited Social Health Activist (ASHA) plays a crucial role in improving health outcomes in the urban setting by increasing the reach of health care services to vulnerable groups among the urban poor including the homeless / pavement dwellers, beggars, street children, women working as commercial sex workers, construction workers, rag pickers, rickshaw pullers, elderly poor, disabled people and people with mental illness. An ASHA usually works to strengthen community processes in 1000-2500 populationgroup.

Alongside is the MahilaArogyaSamiti (MAS) which comprises women living in a cluster at the level of 50-100 household viz population of 250-500.

Therefore every ASHA works over agroup of upto five MAS. An ASHA performs a mix of tasks in order to facilitate access to health care services, build awareness about health care entitlements especially amongst the poor and marginalized, promote healthy behaviours and mobilizing for collective action for better health outcomes and meet curative care needs as appropriate to the organization of service delivery in that area and compatible with her training and skills.

Some key elements of her role are

♦♦ To create awareness on social determinants and entitlements related to health and other related public services especially among vulnerable groups ♦♦ Counsel women, families and adolescents on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections among others ♦♦ Provide community level curative care for ailments such

♦♦

♦♦

♦♦

♦♦

as diarrhoea, fevers, childhood illnesses, first aid, etc.

Measure blood pressure and blood and urine sugar and hold stock of essential health products like iron and folic acid pills, chloroquine, condoms, oral contraceptives, sanitary napkins, etc.

Facilitate people’s access to health services available at the AWC/ Primary Urban Health Centres/ urban secondary and tertiary health centres, for institutional delivery, Immunization, Ante Natal Check-up (ANC), Post Natal Check Assist the MahilaArogyaSamiti to promote and increase access of vulnerable groups for various public services including action on- gender based violence, alcohol –drug abuse, mental health issues,and education regarding irrational drug use, exploitative practices of private health practitioners.

Provide information to the Urban Primary Health Centre on the births and deaths in her area and any unusual health problems/ disease outbreaks

The key activities of ASHA include

♦♦ Home Visits: For up to two hours every day, for at least four or five days a week ♦♦ Attending the Urban Health and Nutrition Day (UHND) and supporting outreach activities ♦♦ Visits to the health facility by accompanying a pregnant woman, sick child, or some member of the community needing facility based care ♦♦ Promotion of Mahila Arogya Samitis. She will be the member secretary of the two-five Mahila Arogya Samitisin her designated area ♦♦ Maintain records

On the path towards a more healthy society, one realizes that healthcare is too precious to be left to free market economics. Demand and supply forces cannot be expected to provide a level playing field; largely because the buyer of healthcare services (patient) is largely ignorant of the technicalities-his illness, the standard treatment protocols and general costs, and can be subjected to arbitrary treatment education, nutrition, social and gender inequalities, cultural practices, etc.”

Way forward

Public healthcare

India’s National Health Mission seeks to address healthcare issues in the nation both urban and rural. Two separate sub missions, viz., urban and rural have been created for the purpose.

The mission is intended to guide states towards ensuring the achievement of universal access to health care through strengthening of health systems, institutions and capabilities.

The NUHM seeks to establish Urban Primary Health Centres (U-PHC) and Urban Community Health Centres (U-CHC) under urban local bodies. The government is committed to providing all necessary inputs including necessary budgetary allocation (Rs 47353 crores for 2017-18) in to support the twin programmes.

The need for and the role of a strong public healthcare system is vital especially in the context of

the poor and the vulnerable. The Reconstituted Task Group on Public Private Partnership under NRHM says “There are many reasons for advocating a large public sector in health. Firstly, it is less expensive than private health care. Secondly, it is often much more equitous, both geographically and socially. Thirdly, it is an opportunity for rational drug use and use of standard treatment protocols. Fourthly, it helps to keep the balance right between preventive, promotive and curative care. Fifthly, it insulates the poor against market led promotion of drugs and diagnostics. Sixthly, it allows the state an opportunity to face up to unfair markets for drugs, diagnostics and other health services. Seventhly, it allows a greater possibility for convergent action, given the wide diversity of determinants of health – water, sanitation, women’s empowerment,

On the path towards a more healthy society, one realizes that healthcare is too precious to be left to free market economics. Demand and supply forces cannot be expected to provide a level playing field; largely because the buyer of healthcare services (patient) is largely ignorant of the technicalitieshis illness, the standard treatment protocols and general costs, and can be subjected to arbitrary treatment.

There is therefore need for a rights based approach similar to the right for food and the right to education.

This needs to be enacted into law to enable accountable and responsive functioning of all stakeholders, possibly overseen by a regulator with enough powers to enforce. Budgetary allocation needs to be supported by mandatory contributions akin to provident funds rather than through voluntary insurance policy purchases; and the final cost to the patient at the point of delivery should be zero or near zero. Parallel private facilities for those who can afford it need to be well regulated.

We need to do all the above and possibly more if we are to achieve Sustainable Development Goal 3-Ensure healthy lives and promote well-being for all at all ages.

www.urbanupdate.in | July 2017

27

Numerographs | Urban Health Before 15 years of age Male

Before 15 years of age Female

Before 70 years of age Male

Before 70 years of age Female

Between ages 15 and 49 due to maternal causes Female

Between ages 30 and 70,from 4 major non communicable diseases(NCDs)* Both Sexes

Probability of dying Before 15 years of age (Male)

Before 15 years of age (Female)

Before 70 years of age (Male)

Before 70 years of age (Female)

Between ages 15 and 49 due to maternal causes (Female)

Between ages 30 and 70, from 4 major non communicable diseases(NCDs)* (Both Sexes)

69%

60%

Note: *Cancers, cardiovascular diseases, chronic respiratory diseases and diabetes 46%

69%

38%

36%

60%

32% 27%

26% 22%

22%

46% 14%

12%

38%

7% 4%

27%

3%

3%

32%

1%

2%

6% 36%

5% 1%

0%

United States of America

United Kingdom

China

India

22%

Stroke

22%

26%

22%

19%

Major causes of deaths Ischaemic heart disease 14%

12%

Communicable diseases and maternal, prenatal and nutrition conditions

Stroke

Ischaemic heart disease

%

22%

19%

1%

7% 3%

6%

1%

0% Communicable diseases and maternal, prenatal and nutrition conditions United States of America

24%

United Kingdom

5%

28%

2%

China

28%

India

24% 15%

15%

14%

12% 15%

14%

8%

9%

7%

6%

5%

9%

8% 5%

15% 12% 5%

7%

6%

5%

United States of America

United Kingdom

China

Unitedof Kingdom China Calculation Human Development Index

ited States of America

DIMENSIONS

Long and healthy life

INDICATORS

Life expectancy at birth

DIMENSION INDEX

Life expectancy index

India

India

Knowledge

A decent standard of living

Expected years Mean years of schooling of schooling

GNI per capita (PPP $)

Education index

GNI index

Human Development Index(HDI)

HDI ranks World Rank

Country

1 Norway 10 USA 16 UK 21 France 90 China 131 India 147 Pakistan 188 CAR#

World Note: #Central African Republic

28 July 2017 | www.urbanupdate.in

HDI

Life expectancy at birth

Health Expenditure

0.949 0.92 0.909 0..897 0.738 0.624 0.55 0.352 0.717

81.7 years 79.2 years 80.8 years 82.4 years 76 years 68.3 years 66.4 years 51.5 years 71.6 years

9.7% of GDP 17.1% of GDP 9.1% of GDP 11.5% of GDP 5.5% of GDP 4.7% of GDP 2.6% of GDP 4.2% of GDP 9.9% of GDP

Source: WHO, UNDP & CIA World Factbook

United States of America

United Kingdom

China

Access to sanitation

India

Healthcare infrastructure United States of America

100% 100%

100% 99%

United Kingdom States of America China

United India Kingdom

100% 99% 4

87%

4

77% 3 3

64%

63%

3 3

3 3 2

40% 29%

1

Rural

Total

United Kingdom

China

7%

1

1

1

5%

Deaths caused by Hospital beds communicable diseases available(per

Hospital beds available(per 1000 inhabitants)

1000 inhabitants)

Access to sanitation facilities(% of total) United States of America

2

28% 6%

Urban

3 3

United States of America

India

Doctors available(per 1000 inhabitants) United Kingdom

Doctors available(per 1000 inhabitants)

China

India

4

Urban Immunity Needs A Boost 3 3

100% 99%

3 3

2

77%

%

1

1

40%

29%

28% 6% Total

7%

Hospital beds available(per 1000 inhabitants)

5%

Doctors available(per 1000 inhabitants)

Deaths caused by communicable diseases

o sanitation facilities(% of total)

Top-10 causes of deaths

Ischaemic h

Chronic obs

12%

Stroke

11%

42%

Diarrhoeal d

9%

Preterm birt

6% 2% 3% 3% 3% 4%

Lower respi

5%

Tuberculos Self-harm Falls

Ischaemic heart disease

Road injury

Chronic obstructive pulmonary disease

12%

Stroke

11%

42%

Diarrhoeal diseases

9% 2% 3% 3% 3% Urban health is fast becoming an extremely important factor of measuring a country’s level of development. With this in mind, the Indian Govt., along with the civic agencies of the country, is trying its best to maintain healthy standards of living for its citizens

6% 4%

5%

Lower respiratory infections Preterm birth complications Tuberculosis Self-harm Falls Road injury Others

Team UrbanUpdate

www.urbanupdate.in | July 2017

29

Others

Leaderspeak | Healthcare in Cities

Ranjit S Chavan President, AIILSG

Get well soon, cities!

Cities are not the healthiest places to live in. This has become a general perception and researches second it. Congested living spaces, increasing pollution in urban environment, fast paced urban lifestyle, lowering quality of civic services, crumbling infrastructure and lack of green spaces are among the factors to blame for making cities ‘ill’ and unhealthy living spaces

C

ities may boast for state-ofthe-art health facilities and the most talented doctors to cure almost any disease ever discovered. Yet there is no denying the fact that the present functioning of cities is causing many of these diseases among urban dwellers. And, the spread of any disease is much faster in cities than in rural settings because of close proximity of human settlements, especially in low income colonies and slums. Most of the people cannot afford to access modern health facilities available in expensive hospitals.

The poor in urban settings are more vulnerable in absence of any kind of community support since many of them are migrants and rarely know someone who can help them during a medical emergency. The poor become more vulnerable to health hazards. Even if we put the best available health system in

30 July 2017 | www.urbanupdate.in

place, the problem will be halfsolved unless we address the real issues of the poor in cities: adequate housing, sanitation facilities, and proper urban environment. Without solving these issues, we cannot claim to have a healthcare system but sick-care system. The ideal system is in place when diseases are not just cured but when diseases are prevented.

New perception on remaining healthy

The basic requirement of being healthy is not just having access to world class healthcare but not falling sick in the first place. As the old saying goes prevention is better than cure. This is a matter of deliberation to find out what is the solution to make our cities healthy. Should we improvise the way cities are run and managed? Should we change urban priorities while planning and designing cities to ensure we conserve urban environment and maintain harmony with nature? Or,

should we just invest hugely in improving health services and employing more doctors and health experts in hospitals? I think we need an integrated approach. None of it will work in isolation.

Bill Davenhall, a Health and human services expert, has endorsed that where people live impact their heath conditions.

He underlines one of his public lectures that physicians’ diagnostic techniques can be improved by collecting each patient’s geographic and environmental data, and merging it with their medical records. He strongly believes that the environment where people spend their life years is as important as their genetics and life style details. He wants to improve physicians’ diagnostic techniques by collecting each patient’s geographic and environmental data, and merging it with their medical records.

Chief Minister of Delhi Arvind Kejriwal had posted a picture comparing the medical

conditions of two pairs of lungs.

One pair belonged to a Delhi citizen and another was of a person living in a hilly village of Himachal Pradesh. Both of them led nearly identical lifestyles. The person from Himachal clearly had healthier lungs. All of us know that Delhi air is becoming deadlier by the day because of increasing air pollution compounded by several reasons such as crop burning, vehicular emission and industrial activities. The observation depicts how important it is to conserve urban environment and clean urban air before it becomes irreversible. The aforementioned research by Davenhall holds significance by this example. The time is not far when people have to fill out the details of the places where they spent their life years in their medical records. And, it does seem important.

Ignorance is not bliss

Standard of living condition is considered much better in cities than in villages, at least for middle income and high income groups. People have access to

the best services in all spheres of life such as health, education, entertainment, etc. Yet the side effects of urban lifestyle are worrisome and they are making urban habitants physically and mentally ill. According to a medical survey conducted

by Metropolis Healthcare, lifestyle diseases like diabetes and high cholesterol are now hitting more young men in metropolitan cities of India.

Despite rising awareness, more than half of the men in major cities like Delhi, Mumbai, Ahmedabad and Chennai suffer from diabetes. Of the 38,966 samples screened, 56.81 per cent reported high diabetes levels. High diabetes levels are usually associated with age, but other factors like body mass index, stress, family history of the disease, lack of physical activity etc. also significantly add to the problem.

Several other reports in the media have elaborated on the alarming rise in cardiovascular disease, diabetes, hypertension, asthma and respiratory diseases as well as cancers. I don’t doubt that a good healthcare system can help in curing the

Mental healthcare has got least attention from the governments in our cities. According to World Bank, nearly 450 million people are affected by mental illness worldwide. Vikram Patel, a mental healthcare advocate, says that in wealthy nations, just half receive appropriate care, but in developing countries, close to 90 percent go untreated because psychiatrists are in such short supply

patients and help them live long. But are these health conditions not impacting the quality of life lived? Of course, improving the life expectancy of citizens cannot be the criterion to decide a functioning and smart health care system. Quality of life lived by citizens should be factored in to ensure the efficiency of a health system in a city or a country.

Mental healthcare is another area that has got least attention from the governments in our cities.

According to World Bank data, nearly 450 million people are affected by mental illness worldwide, placing mental disorders among the leading causes of ill-health and disability. One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Vikram Patel, a mental healthcare advocate, says that in wealthy nations, just half receive appropriate care, but in developing countries, close to 90 percent go untreated because psychiatrists are in such short supply. Patel comes out with a brilliant idea of building an army of community members to reach out to people who do not have access or cannot afford mental healthcare.

City governments which are closest to the community can help in upscaling such initiatives and help build a healthier society.

www.urbanupdate.in | July 2017

31

Article | Super Bug

“

The time may come when penicillin can be bought by anyone in the shops. There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.”

- Alexander Fleming at his 1945 Nobel Prize lecture The world of medical science was revolutionized by the discovery of Penicillin in 1928 by Alexander Fleming. Before that, for centuries human species died of even minor infections. Even a small cut caused by a sharp object could lead to amputation.

But, after its discovery, doctors could

cure any infection acquired even during surgeries with small dose of antibiotics. Indeed, it was a turning point in medical science that has saved millions of lives over the years.

But as Alexander Fleming had predicted and had cautioned against, its overuse came to the fore in 2010.

It was in the year 2010, a study published in the prestigious medical journal Lancet took India by storm. A study done by Chennai microbiologist Karthikeyan Kumarasamy along with a British researcher caused a medical uproar when he reported that patients returning from India after treatment were diagnosed with infections. They named this deadly bacterial gene New

Delhi metallo-beta-lactamase (NDM1). They said, in their study, that NDM-1 makes a bacteria resistant to all antibiotics including Carbapenem, known as the last resort in health sector to treat infection. Indian health industry cried foul and a war of words began. It was called a motivated and alarmist attack to damage India’s booming medical tourism industry. But the picture is actually grim because the figures are startling.

A sign of the times: According to a report of Center for Disease Dynamics, Economics & Policy (CDDEP), in India, one million infants die in the first four weeks of life every year. Over 190,000 deaths occur due to bacteria in the

When antibiotics

themselves become sick Antibiotics revolutionized the world of medicine and health. But today antibiotic itself has become sick. Antibiotic resistance infections are rising. Experts are warning that situation is as grim as global warming Kumar Dhananjay Consulting Editor

32 July 2017 | www.urbanupdate.in

blood. And 30 per cent of babies die of ABR. The problem is that nobody can predict what germ is present in someone’s body waiting to erupt. From high fever to swollen glands to rashes filled with pus, if antibiotics are not working on you within forty eight hours you know that bacteria has become resistant. It becomes more dangerous if it invades your blood streams even threatening your life. Alarming cases are coming out from across the country.

Neonatals death in the first four weeks caused by antibiotic resistance(ABR); Tuberculosis patients not responding to antibiotics especially in metros; ABR infections are rising in hospitals;even tap water and drains are infected with these killer germs in big cities. Surveys have shown that even people without history of any disease are showing signs of resistance to antibiotics. Experts are warning that the situation is as grim as global warming and needs immediate redressal. Microbiologist Dr Chand Wattal along with his colleagues have studied about eighty thousand patients since 2002. Their study has shown an alarming rise in ABR. Between 2002 and 2012 their study showed a jump from 2.4 percent to 52 percent in ABR. The findings and the cases that have come up have baffled the medical community. From metropolis like Mumbai, Delhi and Chennai to a small town in Uttar Pradesh,Bijnor, doctors are confronted with the cases they have never seen before. In Bijnor, for nearly two years between 2009 and 2011 several babies were brought to hospital with unusual infection and during treatment showed resistance to antibiotics. Similar is the case of a police constable in Mumbai who had to spend three months in ICU after he hit a wooden structure. A businessman in Delhi was unconscious for thirty five days because he would not respond to antibiotics or a housewife in Kolkata who was coughing blood and doctors would keep raising her antibiotics dose but nothing would work. These are not isolated cases but a just few case studies to drive home the seriousness of the situation.

The problem is that our attitude to

Immunity in Danger ♦♦ ♦♦ ♦♦ ♦♦

50 percent antibiotics are overused and misused by physicians and patients globally.

70 percent ICU patients surveyed in India carry bacteria immune to multiple antibiotics.

30 percent infants die in India each year from germs that do not respond to antibiotics.

95 percent rise in pneumonia, blood and wound infections in last 10 years in India; cannot be cured by last-resort drugs.

antibiotics is too casual. It is cheap, easily available, and can be bought without prescription. A survey done

by World Health Organization in 2010 revealed that ♦♦ Fifty three percent of Delhi citizens self prescribe antibiotics ♦♦ One in every four skips the course once they start feeling better ♦♦ Eighteen percent physicians prescribe antibiotics for common cold Study after study in recent years has thrown similar results without any aberration. In 2011, a study done by Dr Anita Kotwani, pharmacologist with VP Chest Institute, Delhi University found that of all the drugs sold in the city, antibiotics constitute 3943 per cent. Also, even for common infections, powerful antibiotics were prescribed which were meant only for hospital use.

A study done by researchers at Princeton University a couple of years back that analysed global trend in antibiotic consumption puts India at the number one spot in the world. It analysed the data between 2000 and 2010. In the year 2010 alone they estimated that India consumed about thirteen billion pills in comparison to ten billion in China and about seven billion in the United States.

While it recorded that consumption of antibiotics has gone up worldwide, India has left the world far behind. In the first decade of this century, while globally it was thirty six percent, in India it was sixty two percent, from eight billion pills in 2001 to thirteen billion in 2010.

Have we woken up to the crisis

After the storm of 2010, several organisations and medical bodies came together to evolve a plan to deal with the crisis. They formulated a five year plan which came to be known as Chennai Declaration to control the misuse and overuse of antibiotics.

Their recommendations that aim to restrict easy access to the powerful antibioticshave been accepted by many hospitals.

They also shared their recommendation with the government to draft an antibiotics policy. Five years down the line this year, in March, Indian Council of Medical Research issued fresh guidelines on the usage of antibiotics.KaminiWalia, deputy director, ICMR said “the idea of issuing these guidelines is to bring about a change in the way antibiotics are prescribed.

Doctors’ education on antibiotic use has so far been limited to what medical representatives of pharmaceutical companies told them. Some hospitals have prescription guidelines, but most don’t.”

Though ABR has emerged as a global phenomenon, India has emerged as its epicenter. Experts and medical practitioners are already warning that all is almost lost and we are already living in post antibiotic age. They are worried that with increasing drug resistant bacteria, forget about organ transplant or chemotherapy, even to perform small surgeries would become difficult. The prophetic words of its inventor have come true faster than he might have expected.

www.urbanupdate.in | July 2017

33

Article | Health of Sanitation Workers

Dirty Lives of Cleaners

They wake up at three in the morning, leave their homes for work. They go down the drains to remove silt and clean choked drains without any safety gear. They are sanitation workers. They are ill equipped. They just have a bamboo stick, a bucket and a shovel. In the times when the nation is going gaga about Swachh Bharat, are we providing adequate apparatus and fair working conditions to sanitation warriors to win this war for cleanliness? An analytical report to gauge the on ground situation.

Arzoo Arora of Urban Update goes on the field to interact with sanitation workers who are working in high danger situation with low wages

S

wachh Bharat Mission is on a cleanliness spree in India; but our government does not seem much concerned about the heroes of the movement. The Swachhta Senanis (Sanitation workers) in India are living a life of sheer neglect.

They perform their task without any gloves in hands or mask on face. Their bare hands are the tools for picking up the garbage from roads or sometimes a cardboard sheet, if lucky to find one.

From a sweeper on a railway station to a manhole cleaner, all of them lack safety, security and most importantly respect during work. No one wants to sit, talk to or eat with them. On condition of anonymity, a manhole cleaner from

34 July 2017 | www.urbanupdate.in

New Delhi says, “Even if I take bath twice a day, my body stinks of filth. I don’t feel like having food with the same hands, but I have to eat and get back to work, so that I can feed my family.” At New Delhi railway station, government hired Safaikaramcharis work in brown colored dresses while the contractor hired workers are seen in green dresses.

More than 50% of the workers work in green. All sanitation workers in India are working with many disadvantages, but a contract based worker suffers more. They are being paid lesser with almost no benefits. A contractor hired worker from the same station says, “We are given only a Jhadu and a single set of uniform to work, we are not allowed to take any leaves or else they will cut

from the salary. Our salary is a mere sum of 9000 rupees with no other benefits.”

On asking for any health benefits like health campaigns, ESI and provident fund, he says, “I am not aware if any such thing exists. They don’t put up any health checkup campaigns.” That is the reaction of each worker on the same station working under any contractor.

However, when the same contractor (Telecon Company) was interviewed, he denied it and says that the sanitation workers are being paid Rs 15,000 with provident fund and ESI facility. At NDLS, 200 workers are working under this contractor. Though he was not sure of what tools his company provides to the workers, gloves and mask were not in his list.

Drain-hole Cleaners

In Hong Kong, a manhole cleaner needs 15 licenses, an instruction manual, a bunny suit with boots, gloves, a helmet with light and most importantly oxygen cylinders, before entering into those deep dark holes. In some countries, a big fan is also provided outside to reduce the suffocation inside the drains.

Why these people need such safety preparations? The garbage which they (manhole workers) face contains many types of hazardous substances from pesticides to medical syringes, from battery to bleach. These substances have the potential to injure, infect, poison, burn or can possibly damagethe respiratory system. The trash is often filled with pests like rats and mice, cockroaches. Contact with these pests can result in bites, rabies and other diseases, even the dead ones can cause rat-bite fever and skin lesions. These things can hurt them, pests can bite and the gases formed in the sewer lines can make them unconscious.

The sewer system has a mixture of inorganic gases namely hydrogen sulphide, ammonia, carbon dioxide, methane, nitrogen and hydrogen, which is also known as ‘Sewer gas’. Over exposure to this can cause olfactory fatigue- inability to detect its odour.

Some gases known as asphyxiants affect the flow of oxygen supply to the brain and lead to unconsciousness and death by suffocation. More than

Thousands of crores have been likely spent on laying or relaying pipes and drains in 2002 under JNNURM, but no investment on the safety and health of sanitation workers till date. The Jawaharlal Nehru National Urban Renewal Mission (JNNURM) has spent Rs 1,20,536 crore over seven years on urban local bodies. Of this, 40 per cent was allotted to drainage and sewerage work. The rights of sanitation workers are in utter neglect by the government. They are working in an unsafe environment, they are descending to death

100 ppm of hydrogen sulphide can result in instantaneous suppression of respiration and less than 10 ppm, can cause conjunctivitis and headaches.

Indian scenario

However, in India a drain cleaner is provided with a Jhadu and a light neon shade half-jacket to reduce the risk of accidents at night. Here, a manhole cleaner enters wearing half-pants or a langot and is given a long stick (khapchi). After a number of deaths in manholes were reported in our country, a ‘safety belt’ was ensured to be provided to the cleaner who enters in it. The funny thing here: a ‘safety belt’ is a belt attached with a rope and the worker standing outside holds the other end of the rope. This kind of safety system does not save the cleaners from any pests or poisonous gases in the drain. This is it, no bunny suits, no safety mask for the cleaners. In 2006, a body representing sanitation workers of Brihanmumbai Municipal Corporation (BMC), Safai Kamgar Vikas Sangh sought the data of deaths of sanitation workers and found more than 250 deaths occurring every year, which is just the data of Mumbai, capital of Maharashtra, not of the whole country.

In some countries the workers are equipped with a Manhole gas detector machine while entering into sewer lines. Another machine named Manhole Odour Eliminator (MOE) is used to release poisonous gases from the manholes and reduce suffocation.

Since Indian workers do not have sewer gas detectors or odour eliminator, they use basic tricks to save their lives.

Lighting a matchstick before entering the manhole can detect methane, an explosive gas or waiting for the cockroaches to come out also helps. If they don’t come out it is supposed that they are dead and poisonous gases are inside the manhole.

Rights, laws and wages

Workers are often given a contract of seven months that is exactly 210 days and they are made to sign a new contract after every seven months with a new company name. This dirty

trick benefits the contractor of these labourers with respect to the Industrial Disputes Act, 1947 which allows all contract workers the right to demand a permanent position if they have worked continuously in a particular job for 240 days. The Contract Labour Act, 1970 which specifically provides labour rights to contract workers, is applicable only to establishments that employ more than 20 workmen.

The Supreme Court in 2014 announced that the families of those who died while working in sewers since 1993 should be given around one lakh rupees as compensation. Most of the families are not aware of such government initiatives. The authorities which could not even provide them a safety suit are not expected to provide any compensation.

In some nations, a sewerage worker, equipped with safety tools earns $1000 (65,000 INR) a month or more along with Health Insurance. Sometimes the health insurance is more than their wages. Indian labourers earn 300 rupee-a-day, of which Rs 50 is used for buying lunch for himself. For mere amount 250 rupee s/he puts his life at stake every day. Another controversy is that if the worker does not die inside a manhole, the civic body does not offer any monetary compensation for illness/ deaths owing to occupational deaths.

Well, Delhi civic body gives Rs 50 as ‘risk allowance’ to a permanent worker, in some states it has risenuptoRs 200.

Changemakers

Ananth Narayanan, a man from Chennai makes a move by drafting a PIL in Madras High Court against the Chennai Corporation that hires people to clean sewages manually without any protective equipment. He says, that at the time when we are planning smart cities and so much technology is available, why are we letting our own men to die in sewages. Manual cleaning should be banned, instead machines should be used, the PIL demands. Sewer workers of Chandigarh recently got 10 sets of safety equipment provided by the civic body worth Rs 21.11 lakh for the whole city.

www.urbanupdate.in | July 2017

35

Article | Domestic Breeding Checkers

The decaying backbone Shruti Gupta| Editorial Assistant

T

he DBCs could be considered as the ‘backbone’ of the vector borne disease control programmes. They are required to conduct the inspection of households (door to door), public premises and corporate buildings to check if there is any mosquito breeding; in case breeding is found S anti larval activities are performed in the presence of DBCs. They perform a three-fold duty also known as IEC i.e.

Inform, Educate, and Communicate.

The DBC workers are trained by their zonal entomologists.

Staff Crunch

The DBCs are supervised by malaria inspectors and assistant malaria inspectors. Each inspector has to monitor 14 DBCs. Of the 755 sanctioned posts of malaria inspectors and assistant malaria inspectors in the north and east civic bodies, nearly 531 are vacant.

In the North Delhi Municipal Corporation, 129 posts of ‘Malaria Inspectors’ are sanctioned; the civic body has only about 50. There is just a single epidemiologist as against the requirement of six. “There are only

50-60 DBC workers, where the actual requirement is of 100”, said an assistant malaria inspector on the condition of anonymity.

A 42-year-old DBC worker and a member of the DBC union (North Delhi), Sanjay Kumar tells Urban Update that the reward received in return of DBC workers’ hard work around the year sums up to be a memo (warning), transfer or termination. Sanjay leaves for work at 10 am everyday and covers about 30-40 houses in the course of the day. There is absolutely no facility of vehicles or even a vehicle allowance. “I work for not less than 7-8 hours a day. I have to walk several kilometers, climb stairs, work for hours in heat and in the presence of fumigants which are not less than slow poison”, he says.

“Most DBC workers do not survive till retirement”, added another DBC worker who did not wish to be named.

“Apart from the work that we are supposed to do, we are sent to collect house tax, arrange furniture during elections, do field work and fumigations”, says Sanjay. In spite of performing countless number of duties, the amount of salary of a DBC worker working on contractual basis ranges between Rs 9000–13000.

No regularisation If it is for the people of Delhi, I am ready to work even more than my body can tolerate, but such a meager salary is nothing less than an insult Sanjay, DBC worker 36 July 2017 | www.urbanupdate.in

In September 2016, during a massive outbreak of Dengue and Chikungunya, more than half of the domestic breeding checkers under MCD went on a strike.The major demand being regularisation of their posts. There is no regular post for DBC workers. No DBC worker becomes permanent even till the time of his retirement.

Sanjay was a part of the protest.

He tells Urban Update that the strike went on for three days and was called off only after the then additional commissioner of North

Delhi Municipal Corporation assured them of necessary action. “We are not permanent. They can terminate us at any minor mistake. We always have the sword of termination hanging over our heads.We have no health insurance or medical facilities”, says Sanjay. The case has worsened to such an extent that even if a DBC worker dies on duty, he receives no compensation.

Delhi’s most vulnerable areas still left unchecked

According to the data released by the municipal corporation in 2016, of the 1,158 cases of dengue reported in the Capital, over 255 patients of the vectorborne disease are from the South zone.

The north and east zone reported 105 and 70 cases of dengue respectively.

The most vulnerable areas were Shaheen Bagh, Mohan Garden and Sangam Vihar among others.

“The DCB workers visited our area once, since January. They checked the coolers, refrigerator and water tank.

They also, gave us anti-larva medicines to put in stagnant water, but I know many areas where checking has not been done even once”, says Karan Kr, a resident of Hauz Khas, South Delhi.

The SDMC boasts of a major pilot project whereby about 200 Domestic Breeding Checkers (DBCs) have been equipped with tablets to record the data collected after the inspection of various households and feed it to the central control room at the same time.

But, as they say, sound policies need sound execution.

The medical health officer (North Delhi) about the regularization of DBC workers, he said that the case has already been forwarded to the MCD. The SDMC Mayor Kamaljeet Sehrawat’s office informed us that the mayor was on leave. On the other hand, no response was received from the North Delhi Municipal Corporation.

Article | Indian Slums

Urbanisation hits slums hard

Rapid urbanisation in developing countries like India has caused mushrooming of slums that is affecting health of their inhabitants adversely Akash Mandyal | Editorial Assistant

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ccording to Census of India, (2011), ‘Slums’ are usually a cluster of hutments with dilapidated and infirm structures having common or no toilet facilities, suffering from lack of basic amenities, inadequate arrangements for drainage and for disposal of solid wastes and garbage. These inadequacies make the living conditions in slums extremely suboptimal, unhygienic and result in higher incidence of air and water borne diseases for the dwellers.

When it comes to slums especially in India, a picture of densely located homes with no toilets, no water supply and garbage all around comes in our mind. These dwellings don’t have proper sewage to dispose of the waste.

As cities are growing, slum population is also increasing. The important issue

38 July 2017 | www.urbanupdate.in

which today India and its developing cities are facing is living conditions in slums causing health hazards.As per Government of India, ministry of Health and Family Welfare, the total health expenditure is only 1.2 percent of the total expenditure. The urban health infrastructure is not appropriate in Indian cities and leads to many health issues in slums.

As per a report published by UN Habitat, the number of slum dwellers in urban areas has increased from 760 million in 2000 to 863 million in 2012 globally. As far as India is concerned the urban population of slum dwellers has increased from 52 million in 2001 to 65 million in 2011. One part of the urban population is enjoying all the benefits of urban living while on the other hand the urban slum dwellers are living in worse conditions than their

rural counterparts. Even though the urban areas have government hospitals and other health facilities, the slum dwellers have limited access to them.

According to the National Family Health Survey (NFHS-3), when asked about using services of government hospitals, slum dwellers complained about distance being an impediment to accessing the facilities.

Major health problems in slums

Some of the major health issues in Indian slums are child malnutrition, anemia among children, diarrhea, parasitic infection and fecal epidemics, teenager fertility and maternal care.

Due to the lack of sanitation in slums, they are vulnerable to many diseases.

Teenage pregnancy and motherhood is very much prevalent in the slums

which leads to a high risk of pregnancy complications negatively affecting maternal and infant health. These kinds of teenage pregnancies leave women with deteriorated health for their life time. A study on urban health which focus on reproductive and child health in urban areas shows that there were huge differences in Antenatal Care (ANC) Coverage between slum and non-slum areas. 74 percent of women in non-slum areas received three or more antenatal care check-ups while in slums only 55 percent received antenatal check-ups. The report also shows that there is a huge health status difference between recognized and unrecognized slums.

According to the Urban Health Resource Centre (UHRC), India, one in every ten children in slums do not live to see their fifth birthday. Only 42 percent of slum children receive all the recommended vaccinations. Over 56 percent of child births take place at home in slums putting the life of both the mother and the new born to serious risk. Two-thirds of urban poor households do not have access to toilets and 40 percent do not have piped water supply at home.

Poor water quality is one of the major causes of all the dreaded diseases in

the slums. Many infections causing diseases such as cholera and hepatitis which even lead to death are all associated with the contaminated.

Bathing with infected water also leads to scabies and bacterial skin infections.

According to the Urban Health Resource Centre (UHRC), India, one in every ten children in slums do not live to see their fifth birthday. Only 42 percent of slum children receive all the recommended vaccinations.

Over 56 percent of child births take place at home in slums putting the life of both the mother and the new born to serious risk. Two-thirds of urban poor households do not have access to toilets and 40 percent do not have piped water supply at home

Urgent need to take major steps

In order to address the challenging health issues in slums, government needs to establish health clinics within the slum communities. There is a need to ensure a safe environment that is not prone to disease. A specific department could look after informal residential status in the communities and inform the government. Innovative programs like school based vaccination or outreach via churches, temples and mosques, can improve the access to health services. Government has launched several initiatives like Jawaharlal Nehru National Urban Renewal Mission (2005-14), Rajiv Awas Yojana, National Urban Sanitation Policy 2008, State Sanitation Strategies, City Sanitation Plans, National Sanitation Rating and Service Level Benchmarking, Swachh Bharat Mission (Urban) 2014-19 and Community Toilet Complexes as a Response to the Slum Sanitation Deficit.

Some non-government organisations have also taken initiatives with government bodies to improve access to basic amenities in the slum areas. Public Private Partnership (PPP) can be helpful in achieving the target set by government to improve health conditions of slum dwellers and others living in low-income colonies.

A recent example of such public private partnership is “Samajik Suvidha Sangam” also known as National Capital Territory of Delhi’s (GNCTP) Mission Convergence programme. This USAID funded programme is an innovative PPP with participation by local community organisations to improve the health and well-being of urban poor of Delhi.

Public health particularly of the urban poor is challenging and thus calls for multi-pronged innovative interventions. Government at the national level has signaled its resolve by stepping up budgetary allocations for healthcare including support to states.

There is need for dedicated, motivated actors both from the government and non-government spheres as well as the slum community members themselves to work jointly to address this challenge if we are to realize the vision of ‘Health for All’.

www.urbanupdate.in | July 2017

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one on one | Yumiko Noda, Former Deputy Mayor, Tokyo

Yumiko Noda served as the deputy mayor of Yokohama city between 2007 and 2009. She has been a senior fellow at Japan Research Centre in Tsinghua University, Beijing, as well as a project finance banker working in Tokyo, London and New York. She also leads PwC Cities Solution Centre in Japan.

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Cities need to ad changing urban d

Yumiko Noda, Head of PwC’s Cities Solution Centre (Tokyo) and former deputy mayor of Yokohama City, speaks to Abhishek Pandey, Editor, UrbanUpdate on changing urban dynamics and what cities need to do to face evolving challenges You have worn many hats in the area of urban development. From a deputy mayor of Yokohama city to heading various projects in Asia and Europe for improving living conditions in cities.

What are the major problems cities are grappling with, and how local leaders can help resolve them?

I have been involved in many urban development projects especially Public Private Partnership projects in Asia, Africa and Europe in various capacities for over 25 years. I helped the central governments, local governments and private players as a consultant. While I was the deputy mayor of Yokohama city that is the second largest Japanese city with 3.7 million population, I tried to improve livability of the city

40 July 2017 | www.urbanupdate.in

by engaging different stakeholders.

Yokohama city is recognised as a smart city in Japan and has won many awards including the Eco2 City (Ecological Cities as Economic Cities) Award from the World Bank in 2009. The award is for urban development strategy to aim at the making of sustainable city by balancing economy with ecology.

Cities are facing problems in many areas especially providing tailor-made services to all sections of society.

Japan is among the few nations that have cities which have set examples for handling urban issues. In my view, public participation is must. Most of the solutions can come from local experts.

Engagement of local leadership with citizens is the key.

You are called the pioneer of bringing in PPP/PFI concept in Japan. Since you have worked in many cities around the world, do you think it is feasible to upscale the similar concept in other Asian cities?

PPP is easy to say but difficult to implement because there are different motives, mission and behaviours of private and government sector.

Aligning the two sectors to meet the demand is a challenging thing. Public sector can bring long term perspective to make cities more valuable and livable. It protects citizens’ interest especially of poor people and provides universal access to civic services. On the other hand, private sector can bring innovation, technology and efficiency

dapt to dynamics in many areas. Private sector may cream skim to maximize the profits. They may just focus on providing services to the high-end users and may ignore the interests of people at the bottom of the pyramid. Under PPP, we need to bring the best of both sectors.

There are four main ingredients for the success of any PPP projects—output specifications, lifecycle approach, performance monitoring and optimized risk allocation. The clear specifications on roles and responsibilities of both the sectors can help in improving the quality of any project.

Have PPP projects borne results?

What has been your experience in this regard?

In Japan, we have over 500 PPP projects.

You will be surprised to know that one of the successful sectors is prison. In the prison projects, public sector carried out core custodian services while private sector designed, constructed, maintained and refurbished facilities.

What private sector proposed for reducing maintenance cost was very interesting. They got rid of thick and high walls in prisons and placed electric fencing and CCTV cameras. This has reduced cost drastically. They are also providing training to prisoners so they can get employment after their jail terms are over. City governments can find out a range of areas where private players can be involved for reducing cost and increasing efficiency.

Elderly population is growing in many Japanese cities. What are the steps local governments have taken to address the issue?

Japan is among the most aged nations in the world. Almost 27 per cent population of the nation is above 65. Mobility is a major challenge for elderly population in cities as we have witnessed many fatal accidents by elderly drivers. It is becoming a serious social issue. It is dangerous to have a car-oriented society in a city where a major population is of senior citizens.

We need to build public transport oriented walkable cities. My mother is 83 years old and she needs to go to only three places—hospital, grocery store and bank. Providing such services at walkable distance is important.

Another concern is that if the city has elderly population then tax revenue shrinks as the population is not spending or contributing to city’s economy.

Toyama city is a good example. I was special advisor to the city. The city is considered as model city for aging society. The city revitalised public transport and encouraged relocation of residences and businesses along the public transportation system. They also revitalised city center which were increasingly becoming deserted places. The city government came up with an innovative idea to attract elderly people to come to city center and engage in rec-

reational activities and spend money.

They launched a travel pass in which they have to pay only one dollar if they were going to city center but if they get down before city center then they had to pay normal fare.

Which are the areas cities in the developing countries of Asia need to focus on to compete with global cities?

Cities should be inclusive and must have space for all sections of society with provision of adequate civic amenities for everyone.

Traffic and air pollution are key concerns in many cities because public transport is not popular and vehicular population is on the rise. What is the scenario in Japanese cities?

Focus on improving public transport systems can be of great help. In one of the PPP projects in Japan, Airport Terminal Project, a consortium was created in which two rail companies were also involved. It was a successful project; it has provided convenience to commuters and passengers. When you exit from the train, you can reach the check-in counter in just one minute. It is most probably the shortest distance form a train station to airport check-in counter. If we can provide commuters with a convenient option to private vehicles, I am sure that people will opt for public transport. Such efforts would help in solving traffic and pollution problem in our ever-increasing cities.

Tell us how innovation can help in achieving Sustainable Development Goals (SDGs) and objectives mentioned in Habitat III declarations.

How important is the role of cities?

Technology can play a crucial role in many sectors. City governments can make their service efficient and sustainable by applying technological innovations. World leaders have underlined that cities would need to play an important role if SDGs have to be achieved within time frame.

Capacity building of local government officials and knowledge sharing among cities would also help.

www.urbanupdate.in | July 2017

41

VELO-CITY | Vizag

The Jewel of the East Coast

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Kumar Dhananjay Consulting Editor

42 July 2017 | www.urbanupdate.in

he port city of Vizag is known by many names.

From the ‘Jewel of the East Coast’ to the ‘City of Destiny and the ‘City of Future’, this city has earned many sobriquets over the years. You call it by any name, the fact remains that the city attracts you by its picturesque and serene beauty. If you visit the city once you will certainly like to visit it over and over again. The words of legendary chief Justice, late PV Rajamannar actually define the city and capture its character: “Nestled between the sea on one side and a mountain on the other, the city is unlike any other. The sea stands for dynamism, change and adventure and the mountain stands for permanence, tradition and values.

A dialectical process is taking place in this beautiful city, shaping its destiny over the years.”

Visakhapatnam is a port city and industrial center in Andhra Pradesh,

on the Bay of Bengal. The city is known for its many beaches which are clean and pristine. The Ramakrishna Mission beach is a particular centre of attraction for being home to preserved submarine Kursura turned into a museum. Not far are the famous Kali temple and Visakha museum and an old Dutch bungalow that houses local maritime and historical exhibits. It is often called the best tourism destination in Andhra Pradesh. Visakhapatnam has the natural beauty that any city can crave for. Lakes, beaches, hill ranges, caves and valleys, you name it and the city has it. The district has many tourism spots that represent the Culture and Heritage of the true India. The city is the administrative headquarters of Visakhapatnam district and is also home to of the Eastern Naval Command of the Indian Navy.

The History

The city is named after the god of

valor-Visakha. Under the rule of Great Ashoka in 260 BC it was part of Kalinga Kingdom. Later on it became part of various dynasties from Pallava, Chola and Ganga dynasties. In the 15th century it became part of Vijayanagara Empire. It was conquered by the Mughals in the 16th century. Later even Europeans descended on the city and it remained under French rule till the end of the eighteenth century. In 1804 it came under British rule and remained so until India’s independence in 1947. But the formation of the ‘City of Destiny’ goes way back to 1844.

Sir Arthur Cotton, British General spent two years in the city while he was recovering from an illness.

During that period he developed the groynes in the sea that help break the waves and control erosion. He was also instrumental in redesigning and rebuilding St John’s Church and for the first time drew plans to make a port in the city.

The term ‘City of Destiny’ was coined in 1930 by Dr C R Reddy, the former Vice Chancellor of Andhra University.

He facilitated shifting of Andhra University from Bejawada to this port city, a little known fishermen village then called Waltair. This was an unusual decision because at that time other old towns like Bejawada, Rajamundry and others were much more accomplished centres of education and culture. A

Vizag ranks among the hundred fastest growing cities in the world with a GDP of twenty six billion dollars. The city is fast becoming an IT hub which is boosting the local economy. In the last couple of years IT industry turnover has jumped almost four hundred percent. It recorded a turnover of 840 million dollars in 201617 compared to 230 million dollars in 2013-14. Today more than 34,000 employees are working in about 350 firms

Prasanna Kumar, Director of Center of Policy Studies says that “Dr CR Reddy took the bold decision because he believed this was the city of the future. However, his vision of the city was very different from the burgeoning industrial hub and megapolis that it is on course to become. He envisaged that this fisherman’s village would become the intellectual capital of the state.”

Kumar adds that it was Dr Abid Hussain, former ambassador to the USA who later popularized the phrase ‘City of Destiny’. He believed that it’s not going to take long before Vizag would become one of the best cities in India. He says that Vizag has the distinction of perhaps being the only city in India which has had no history of communal or caste clashes. The citizens are broad minded. It welcomes outsiders and allows them to merge with local populace.

Its economy is soaring as its oceans

The local pride

Personal Touch

You talk to the local citizens and they will proudly tell you that for them Vizag is synonym of beauty and arguably one of the best places to live. They say that you realise it when you come and live here from any other city in India. For them Vizag offers everything that one lives for. They will tell you to come and watch the Sun rise from the ocean and set somewhere behind the hills and that is the best thing for them. If you have good appetite for local food hot dosas and idlis sold by bandis will simply sway your taste buds. Also the hygiene levels of these roadside stalls are much better. The city attaches a lot of importance to cleanliness and roads and public premises are kept neat and clean(no wonder the city is ranked one of the cleanest in the country). Life in the city is quite laid back. Nobody seems to be in a hurry to reach office because even if they start late they know they will make it on time because there is nothing called traffic jams. Surprising in such a vibrant and growing city night life is missing. Some bars are crowded on weekends but not for too long. Even the beach road is open to public only till mid night. That is the only sore point in the city

Vizag ranks among the hundred fastest growing cities in the world with a GDP of twenty six billion dollars. The city is fast becoming an IT hub which is boosting the local economy. In the last couple of years IT industry turnover has jumped almost four hundred percent. It recorded a turnover of 840 million dollars in 2016-17 compared to 230 million dollars in 2013-14.

Today more than 34,000 employees are working in about 350 firms. That is one of the reasons why the city is also chosen to be developed as a smart one.

The city has already completed two phases of its plan. The third phase of smart city plan is going to focus mainly on five areas. They are, upgrading of BRTS, redevelopment of RTC complex, electric buses, emergency response system and water management.

While travelling in a taxi I asked the driver, as it was my first visit to the city, whether the city has always been like this. And his answer was no, and then he came out with a fascinating story. He told me that Hudhud cyclone that left the city ravaged was the turning point.

The city picked itself up and rebuilt itself and turned it into what you see today within three years. A classic example of how a calamity was turned into an opportunity to transform itself.

The city has got laurels and recognition in every field. Be it education, music, acting, art, sculpture and last but not the least its booming economy. A lot of people have come here and made it big in this ‘City of Destiny’. Nothing sums it up better than the words of music director Ramana Gogula.

He says “For me, the city is about the ocean and it has sown all the seeds of my creativity and it has taught me to dare to be different. There is so much diversity in the city that it allows people to be themselves. I remember many afternoons when I was down and out I would go and sit on the beach for a couple of hours and life would be okay again.”

www.urbanupdate.in | July 2017

43

Event | AIILSG Activities

IIM-A, AIILSG organises training for city managers

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ll India Institute of Local Self-Government (AIILSG) and Indian Institute of Management Ahmedabad jointly organised a three-day residential training on Corporate Governance to train municipal commissioners, deputy commissioners, Chief Executive Officers (CEO)s and Managing Directors from many cities selected under Smart Cities Mission. A total of 35 city representatives attended the training held between July 4-6, 2017.

The training program had nine interactive sessions where eminent urban planning and development experts from around the country gave lectures on smart city concept and requisite efforts for effective implementation. The panel of speakers comprised professors from IIM Ahmedabad and domain experts— Ajay Pandey, Bimal Patel, Pashim Tiwari and Sebastian Morris.

The key managerial officers of Special Purpose Vehicles (SPVs) had lively discussion with the panel of experts.

On the first day of the event, Ravi Ranjan Guru, Sr Executive Director, AIILSG, interacted with the panelists and the participants. He said that AIILSG has been working in the domain of local governance since 1926 and it is a moment of pride that the institute is playing a pro-active role in urban transformation by engaging in various missions of Government of India. He said that the efforts will bear good results

A lesson in corporate governance

and the urban scene would change soon.

“The vision behind the programme lies in helping the Ministry of Housing and Urban Afffairs in increasing the capacity of CEOs of smart cities in delivering urban renewal of cities through integrated development whilst utilizing a combination of grants and innovations which would be a paradigm shift from the existing sectoral implementation and grant based financing framework”, says Pashim Tiwari, Technical Director, AIILSG. Addressing the participants during the training, Tiwari further said, “‘Smart cities’ is a relatively new concept. There is no universally accepted definition of a smart city on which the whole idea can function. Smart cities are planned and

The training offered an excellent insight into the ideas and processes that can transform an SPV of a Smart city, a corporate body, into a highly effective organization to meet all challenges. The programme broadly covered the following aspects: ♦♦ ♦♦ ♦♦

Corporate Law that includes corporate separateness, corporate purpose, corporate finance and limited liability, rethinking of corporate boards, fiduciary duties etc.; Company Structure that includes Power of Directors, how to exercise independent judgment, how to exercise reasonable care, skill and diligence, how to avoid conflicts in the company etc.; Roles and responsibilities of Directors including duties, ways to exercise duties, ways to avoid conflicts, how to build capacities of entire workforce, how to keep high ethical standards etc.

44 July 2017 | www.urbanupdate.in

executed by Special Purpose Vehicles, also known as, SPVs. The traditional way of operations of a municipal corporation is entirely different from how a Special Purpose Vehicle functions. This serves as the reason why there is an immense need to train the existing managerial personnel of the SPVs of smart cities in India.”

The second day of the programme witnessed sessions by Prof Ajay Pandey on creation of a smart city and the participation of the private sector in building and maintaining smart cities which was followed by Prof Morris elaborating on PPP’s and their treatment of sewage and water.

Dr Bimal Patel, Chairman of the Board of Governors of the School of Planning and Architecture, Bhopal, leader of HCP Design Planning and Management Pvt. Ltd., a leading architecture, planning and project management firm, was the guest speaker for the third day of the event.

The final day of the event concluded with Dr. Patel sharing meaningful insights about the perspective behind a smart city.

Funded by the Government of India, the three-day long event was helpful not only in finding out the basic idea behind a smart city but also in recognizing the issues and challenges that it faces in implementation.

AIILSG Activities | EVENT

Swedish Parliament Roundtable discusses AIILSG ICEQUI-T work among nomadic tribals Nomadic tribals not just in India but elsewhere too face extreme vulnerabilities including access to education, healthcare, and social stigma. Their women are in addition, victims of the worst gender inequality. AIILSG IC EQUI-T’s work among this community has drawn notable recognition

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wedish Parliament Roundtable invited Prof Dr Mukesh Kanaskar, Deputy Director GeneralAIILSG and DirectorAIILSG’s International Center of EQUI-T (AIILSG- ICEQUI-T) as the Speaker at a which was specifically organised to discuss the global policy implications of AIILSG ICEQUI-T team’s innovations regarding “the nomadic tribals and vulnerability of nomadic tribal children & women”.

The round-table titled “Innovative Risk Reduction for Women and Children of Nomadic Tribal Communities” took place on 4th May 2017 at Conference Room: 2-10 in the Swedish Parliament.

Organizers of the round-table were Amineh Kakabaveh (Member of Parliament, Swedish Parliament) and Elinor Brunnberg, Professor in Social Work, Mälardalen University while Mehrdad Darvishpour (Associate Professor in Social Work, Mälardalen University) was the Commentator.

Prof Dr Kanaskar had visited the Parliament in May 2016 also to share global innovations of the AIILSG’s ICEQUI-T team vis-à- vis extremely disadvantaged populations and its global policy implications on with respect to the Sustainable Development Goals. At the recent roundtable, Prof Dr Kanaskar put forth the world-wide significance of the AIILSG’s innovations vis-à-vis disadvantaged populations, and need to have a global policy focus on the plight of nomadic tribals, especially children & women. He elucidated the holistic development approach adoptedby AIILSG encompassing education,

Against the backdrop of the Swedish Parliament Hall, Prof Dr Kanaskar with Amineh Kakabaveh (Member of Parliament, Swedish Parliament), Veronica Lindholm (Member of Parliament Swedish Parliament), Hans Arrvidson, ex-Finance Secretary with Government of Sweden, who is currently an advisor and Mehrdad Darvishpour, Associate Professor in Social Work, Mälardalen University

health, livelihoods, basic services, etc. and linking with the government services.

He emphasized that the plight of the nomadic tribals is not just an Indiaspecific phenomenonbut the situation is almost same in all the countries.

The exact numbers of the nomadic tribals are not known in most of the countries. In India itself, they are about 110 million which is more than the respective country population in 202 countries of the total 214 countries whose population is enumerated. The nomadic tribals all over the world are relatively less developed, marginalized and face social stigma such as being branded as criminals. He added that it was double whammy for the nomadic tribal women. Nomadic tribal communities have among the worst gender inequalities in the world, and are more rigidly patriarchal than sedentary agrarian communities. Thus nomadic tribal women face discrimination from outside and within their communities.

AIILSG’s efforts for empowerment

of the nomadic tribal women were pitched against the backdrop of these extremely challenging conditions which are further aggravated by strong exploitative grip of respective nomadic tribal caste councils.

He also informed the gathering about two recent global felicitations of the work of AIILSG-ICEQUI- T team: 1) Risk Award 2015 which is a joint initiative of United Nations Office for Disaster Risk Reduction(UNISDR), Munich Re Foundation- Germany (MRF) and Global Risk Forum- Davos (GRF), 2) Government of Canada’s Grand Challenges Canada Award (2017). He explained how the AIILSGICEQUI- T innovations recognized through these awards (of community self-assessment and planning, and centre-staging role of disadvantaged women in decision making) are relevant to most of the contexts of deprivations.

He concluded by requesting support for global policy advocacy and upscaling of AIILSG’s work with the nomadic tribals and other disadvantaged populations.

www.urbanupdate.in | July 2017

45

URBAN AGENDA | Healthcare Services

Are we serious about our health?

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ife expectancy in India has grown in the last two decades by more than 10 years, but the per capita expenditure on health has had negligible rise in the same period. Health infrastructure in India is poor, lacking adequate modern facilities and doctors. As per World Health Organisation (WHO) data, India has 1.3 beds per 1000 people, significantly lower than the guidelines of 3.5 beds. The country needs additional 1.5 million beds and three million doctors by 2034.

Countries like the UK, Canada, Japan, Australia, France and Germany spent more than 10 per cent of their Gross Domestic Product (GDP) in 2014 on health services, as per World Bank. The United States of America allocated 17.1 per cent; it is the highest share of GDP any nation spends on healthcare. India spent just 4.7 per cent of its GDP, quite low in comparison to developing countries’ health budgets. The nation’s health expenditure has increased merely 0.7 per cent since 1990.

India does have a robust public healthcare system providing treatment at each level but the quality of healthcare facilities at municipal or state-run hospitals are not up to the mark for various reasons including staff crunch and crumbling old-aged infrastructure facilities. Private hospitals at city level have better medical facilities and that is why these hospitals have remained the first choice for 70 per cent of urban households, as per the National Family Health Survey-3. But these private hospitals are not affordable for all sections of society.

In the USA, it is mandatory for every citizen to have health insurance. Besides that, employers are supposed to provide health insurance to their employees. Government of Canada runs National Health Insurance (NHI) policy covering the entire population.

Patients do not chase for reimbursement, it is a direct process from government to health care providers. National Health System

46 July 2017 | www.urbanupdate.in

(NHS) in the UK, which is among five largest employers in the world, provides almost free services to every British citizen. Majorly funded by general taxation and national insurance, NHS receives only 1.2 per cent funds from the patients charges. There is a need to bring such health reforms in India.

Some of the states including Chhattisgarh have introduced health cards for the poor to ensure better healthcare facilities. In India, insurance system is majorly a private stakeholder’s market, though it is cheaper than the USA, but it does not cover every aspect of all diseases.

Fifteen years after the last health policy was introduced in 2002, a National Health Policy (NHP) 2017, emphasizing on provision of quality health facilities to every Indian citizen and investment in preventive care for health security in the country has been formulated. This policy prioritizes the role of government, with private sector as a strategic partner, for shaping the health system. For better accessibility of the services to people, the policy proposes free drugs, free diagnostics and free emergency care services in all public hospitals with an increment of 2.5 per cent of GDP on health expenditure. It also ensures accessibility of 2 beds per 1000 people. After the approval of National Health Policy, 2017, the Indian government is approaching towards making Health, a fundamental right. The proposed National Health Rights Act makes ‘denial of health’ an offence.

Like Canada and the UK, our cities need a centrally funded or single-pay health care system, serving all the sections of the society, which works on physical, mental and social wellbeing of the people in India. Good health of the citizens is the key for social and economical development of a city and hence the city prospers. As once said by former British Prime Minister, Benjamin Disraeli, “The health of people is the foundation upon which all their happiness and all their powers as a state depend.”

Ashok Wankhade Managing Editor bhau1008@gmail.com

AIILSG has a footprint across the value chain in urban transformation.

Our areas of functioning involve creating and appraising DPRs, monitoring & evaluation and capacity building under Atal Mission for Rejuvenation and Urban Transformation (AMRUT) The institute is active in

1560

200 cities of 11 states

In 2016-17 training workshops Municipal officials/employees trained

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All India Institute of Local Self-Government (AIILSG) whole heartedly supports Swachh Bharat Mission and is committed to play a proactive role to realise its objectives.

The institute is organising regular orientation workshops on SBM to augment the capacity of ULBs and also generating public awareness on cleanliness

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