The family of Somesh Manikpuri of Amasivani colony in Raipur is still in shock of his sudden demise from jaundice in May this year. Six similar deaths have been reported from Raipur since April 2018. Memsingh Chandrakar, a resident of Naharpara, another locality in Raipur, was also affected by jaundice in May. He says, “We did not have an epidemic like this in Naharpara till a decade ago. The quality of drinking water was far better then than it is now and we lived a healthy life. But since the year 2014, the drinking water quality has deteriorated to such an extent that epidemics like jaundice, diarrhoea and typhoid have become very common. More than 100 residents in Naharpara alone have been affected by jaundice in the last few months.” 

On May 1, the high court termed jaundice at Naharpara locality a “disaster” and directed the Raipur Municipal Corporation (RMC) to shift the entire population of the area to makeshift camps within 48 hours till sanitation was restored. “But RMC appealed and assured to fix the issue and the court withheld its order,” says the mayor of RMC, Pramod Dubey. 

Jaundice-related deaths on the rise

As per the data provided by Raipur district health authorities, in the last five years, more than 70 deaths have been registered in Raipur government hospitals due to jaundice alone. The most affected area in Raipur is Mowa. As per Dr I. Rehman, senior consultant and physician, more than 50 positive cases were identified from Mowa area in March. The elected member (ward parshad) from Mowa area, Anwar Hussain says that the old, faulty pipeline network is the primary reason for the rise in the epidemic in the city. Many leading newspapers in the area also reported that the primary cause of the epidemic was the faulty pipeline and the piped water distribution system. 

Status of Jaundice deaths in Raipur city government hospitals

Source: Data compiled from Raipur district hospital inpatient records from 2014-2018 and AIIMS-Raipur

According to water expert and coordinator of the Chhattisgarh Action Research Team (CART), a leading NGO in Raipur working on water sector issues, Gautam Bandhopadhya, the defective pipeline is not the only reason for the continuous rise in the epidemic. “The more significant problem in Raipur is the contamination of the overall water resources from untreated sewage network,” he says. 

The primary source of drinking water in Raipur is Kharun river and the groundwater. The stand posts and hand pumps in most of the areas are located very close to the open drains, causing contamination of drinking water, says a study conducted by non-profit organisation Ecosan Services Foundation (ESF) in April. According to the study, only 11 percent of the urban poor in Raipur is connected to the city sewer network while the remaining 89 percent resorts to open drains or open areas for wastewater disposal. At the city level, about 43 percent of the population lacks any system of disposal of the sewage generated. It goes on to say that the existing sewage treatment system in Raipur consisting of seven oxidation ponds is defunct and the total sewage generated in the city is untreated. The ESF has now been empanelled as a Key Resource Centre (KRC) and a leading knowledge hub in sustainable sanitation and water management by the Ministry of Drinking Water and Sanitation (MDWS). 

The study also reports that roughly 54 percent of the properties in Raipur is connected to unscientifically designed septic tanks which do not adhere to the Central Public Health and Environmental Engineering Organisation (CPHEEO) guidelines and therefore overflow into the open drainage channels ultimately draining into natural water bodies and polluting the groundwater.

As per senior RMC officials who do not want to be named, the domestic sewage network of Raipur is linked to the Kharun river through eight big canals and almost all the sewage flows directly into the river without any treatment being done. Before supplying drinking water to the residents, the RMC officials say that though the water is treated, bacterial and viral contamination cannot be ruled out completely.

“We had conducted an independent survey of the condition of slums in Raipur in 2014 in collaboration with the Youth for Unity and Voluntary Action (YUVA), Mumbai and Oxfam India, the non-profit organisations working in the development and water sector,” says Bandhopadhaya. The study found that out of the 8151 houses surveyed, only three percent of temporary houses, 30 percent of the semi-permanent houses and 67 percent of the permanent houses had toilet facilities. Four percent of the temporary houses, 24 percent of the semi-permanent houses and 72 percent of the permanent houses had drinking water facilities. In the last four years, on the ground, the condition of water and sanitation has improved only negligibly. More than 35 percent of the households living in slums still defecate in the open and are exposed to various health hazards due to poor maintenance of toilets and lack of water facilities. 

In just two decades, a self-sustaining city like Raipur that once had more than 100 lakes and a clean river has become one of the most polluted hubs in the state, and it has adversely affected the overall public health of the city. "Everybody agrees that our living condition should improve, but none of the individuals, politicians or officers have done anything significant to improve basic services in our area,” says 55-year-old Rohit Vishwakarma of Shivaji Nagar slum in Raipur.

If the district administration and the government had taken adequate measures to restore the lakes and the Kharun river, the residents of Raipur could have led a healthier life. The restoration of water bodies is limited to beautification.  

So far, there hasn’t been any significant effort from the government towards containing the epidemic in the area though Dubey says that they have been “organising health camps since April 2018 for the patients and have been continuously working on changing the defective pipelines”. 

Better infrastructure as solution

The basic cause of the epidemic in Raipur is the lack of proper infrastructure like functional sewage treatment plants, machinery for cleaning water bodies, etc. There is also a need for better research in the area and manpower in RMC. “Just monitoring the water quality and health status of the people will not help the RMC to address the problem fully. The broader issues of public health could only be addressed when we deploy people and fill the gap in the infrastructure and trained manpower. We also have to design and ensure proper monitoring mechanisms to keep a check on the quality of water resources, water distribution network and other basic services like health, hygiene and sanitation that need urgent attention,” says Dr Kamlesh Jain, a senior urban health consultant and public health expert. 

There is a need to simplify government procedures for fixing basic services like water and sanitation at the ground level. “For example, more than 50 percent of the water supply pipelines run through the drainage lines. It takes RMC months to act on a problem due to the lengthy procedure involved. Similar is the case with other departments like Public Health Engineering (PHE) and town and country planning department of Raipur. If we can simplify the government processes, then it would become easier for the staff to fix the problems at the earliest,” says Anurag Gupta, state head of WaterAid, a non-profit organisation.