HEALTH AND ENVIRONMENT

General protection of the environment

Due to an increase in unplanned urbanization and industrialization, the environment has deteriorated significantly. Pollution from a wide variety of emissions, such as from automobiles and industrial activities, has reached critical levels in many urban and industrial areas, causing respiratory, ocular and other health problems. Monitoring of the urban environment in selected cities in recent years by the pollution control authority has identified 21 critically polluted areas in the country.

Agricultural activities including widespread use of fertilizers, pesticides and weed killers also alter the environment and create health hazards. Water stagnation and the consequent multiplication of vectors has increased the risk of vector-borne diseases. The risk associated with disposal of hospital wastes has added to the overall unhealthy situation.

India is a party to the UN Conference on Environment and Development (UNCED) held in 1992. In the same year, a national conservation strategy and a policy statement on environment were formulated. The policy addresses issues related to sustainable development including health. Thrust has also been given to management of hazardous waste, adoption of clean technologies by industries, establishment of effluent treatment plants, criteria for environmentally friendly products, phasing out of ozone depleting substances, and creating mass awareness programmes.

A very far-reaching notification by the Ministry of Environment and Forests gazetted in 1994 makes it obligatory for almost all development projects to conduct an environmental impact assessment study which has to be evaluated by an impact assessment agency. A Government constituted group at the highest level has identified six priority programme areas, namely urban low cost sanitation, urban waste water management, urban solid waste management including hospital waste management, rural environmental sanitation, industrial waste management and air pollution control, and strengthening of health surveillance and support services. These areas have been addressed in the Dayal Committee Report that forms the basis for a comprehensive national programme on sanitation and environmental hygiene.

There are many constitutional provisions and laws pertaining to the environment and its protection and improvement. However, the level of enforcement has been extremely poor. Besides, there is no comprehensive legislation on environment and health. In view of the current situation and the Dayal Committee Report, it was proposed that action be taken by the concerned ministries/departments to prioritize the areas and activities that should be included in the 9th plan. During the 9th FYP the Ministry has proposed the following actions:

¨ Strengthen environmental health and health risk assessment in the country. A division of environmental health will be established in the Department of Health for this purpose.

¨ Establish a hospital waste management programme.

¨ Initiate drinking water quality surveillance as a part of disease surveillance.

¨ Water supply and sanitation  

The proportion of the population with safe drinking water available at home or with reasonable access was 92.6% in 1998/99 for urban areas and 72.3% for rural areas. The proportion of the population with adequate excreta disposal facilities was 80.7% in 1998/99 in urban areas and 18.9 in rural areas.

At the time of formulation of the 8th plan, it was estimated that with regard to water there were about 3000 hard-core 'no source' villages out of a list of 'problem' villages numbering 162,000. Besides this, about 150,000 villages were only partially covered. Regarding urban water supply, the service levels are far below desired norms. During the mid 90s, an accelerated urban water supply programme was initiated for towns having less than 20,000 population. The provision of hygienic sanitation facilities through conventional sewage and on-site low cost sanitation has not been given priority. Though the 8th plan envisaged conversion of all existing dry latrines, the final result is nowhere near the target.

The main constraints with regard to water supply are inadequate maintenance of rural water systems, lack of finances and poor community involvement. Most municipalities do not have any system for monitoring the quality of water, with contamination causing episodes of water-borne diseases even in metro cities like Delhi and Calcutta. Most of the people in rural areas are not aware of the health and environmental benefits of improved sanitation. Future actions include phasing of the rural water supply programme, more financial support from the state finance commissions, more responsibilities given to local bodies and village panchayats, water supply and sanitation agencies to have full autonomy in declaring tariffs, improving manpower and equipment support to municipal authorities, and creating public awareness regarding safe water and sanitation.