How many children must die in places some of us may never visit before we realise that too many have died? At last count, 290 babies, mostly newborns, had died at the Baba Raghav Das (BRD) Medical College in Gorakhpur in the month of August alone. Even in a war zone, these numbers would spark outrage and action, says a friend, a medical doctor, who has traversed the world on humanitarian work. Anger and outrage, there have been plenty. Action? Of sorts. Investigations are on; a few people have been suspended.
What systemic changes are being put in place to ensure that there is no repeat? Ah, that is the tricky one and that is where we run into the default template of “alibi searching” and “scapegoating”, which comes into play, and not just in Gorakhpur.
Everywhere, every time, faced with a catastrophe, the standard response from those elected to govern us is the same — it has happened before; it has happened elsewhere; it has happened when another chief minister, another Prime Minister, another political party was at the helm of affairs. The circular arguments begin and end with this formula.
Even if you have not been personally affected, it can be utterly exhausting and disempowering to read about and watch heartrending images from the sites of these catastrophes. Baby deaths in Gorakhpur year after year, baby deaths in Jharkhand, Banswara, the list goes on and on. Devastating floods in Mumbai bring back memories of the similar inundation in 2005 and the deaths and disease outbreaks that followed, even as floods drown Gujarat, Bihar, Assam, Tripura, West Bengal. Buildings collapse in Delhi, Mumbai, and elsewhere. A waste mountain 10 storeys tall collapses in Delhi, killing two and injuring several.
When deaths, devastation and disease happen with a monotonous regularity, they lose their sting. We all know, we have all read about what needs to be done, but little has changed. We rage, we rationalise, we gloss over or criticise the acts of omission and commission of the “guilty”, according to our ideological moorings.
As the catalogue of catastrophes grow longer and the suffering is beamed into our living rooms through television and the Internet, you can expect a more vigorous display of the politics of compensations and a search for scapegoats — a word which aptly has its origins in the Book of Leviticus. In the story it tells, all the sins of Israel are put on the head of a goat, which is then ritualistically driven out. Here too, those who are driven out are almost as innocent as the goat.
This is how you “normalise” a catastrophe. Preventable deaths, preventable building collapses, preventable devastation and train derailments are the new normal. We show our spirit of jugaad and survive. But survival is not living.
What will it take to change the scenario? Many things. But in each of the disasters that I have listed, the possible mitigating mechanisms and solutions have been known and discussed endlessly. Everyone who waded through knee-deep dirty water in Mumbai, for example, knows what has to be done — the capacity of the megacity’s drainage system has to be expanded, drains have to be kept clean, Mumbai has to stop killing its rivers and mangrove forests. Climate change has made disasters much more severe and likely, and there is really no option but to take preventive measures.
But though we all know what needs to be done in each case, it does not happen because the “communities” that are the most affected and most vulnerable are not organised, do not demand to have their say and make accountability a political issue.
Every time, there is a catastrophe or a massacre, as is happening in the case of newborn deaths in many parts of the country, platitudes and promises are trotted out. Compensation is announced and it is back to normal.
But communities can have a say and make things happen. During a recent visit to neighbouring Thailand, I happened to be speaking to Dr Carl Middleton, who teaches development studies at Bangkok’s Chulalongkorn University. Dr Middleton spoke about how Thailand was trying to operationalise accountability.
One important way is health impact assessment (HIA), which has gained traction. Dr Middleton — who has co-authored a chapter on this in a forthcoming book, Water Governance and Collective Action: Multi-scale Challenges — says that since the late 1980s, Thai community movements and civil society groups have managed to resist new large power plants, with high-profile protests against projects like the Pak Mun hydropower dam and the Mae Moh coal-fired power station. The civil society groups talk not only about the environmental impact of development projects but also the health consequences of changes in the physical and biological environment. It helps a lot that in Thailand, since 2000, HIA has been legislated into the Constitution and there is a National Health Act (2007). While it is not compulsory, a community-led HIA can be requested under this law.
That is something to think about in India. We have mandatory environmental impact assessments (EIA) but consequent critiques showing how badly they are done, how public consultation about a new project is often turned into a farce. A mandatory community-led EIA and HIA would act as checks and balances on the official monitoring mechanisms, not just for new projects but also for proper maintenance of everyday things like health centres, hospitals, drains and garbage dumps as well as railway lines. Living in a building that is about to collapse is injurious to health. For whatever reason, why should anybody have to do that?
Those living in a Gorakhpur slum know that they or their children are likely to get a host of infectious diseases because they live in filthy surroundings that breed mosquitoes, nobody removes garbage or keeps the hospital premises clean. Hospitals are ill-equipped and ill-managed. Their babies die like flies. Who do they complain to? The municipal authorities say they don’t have money; and the state government is too distant.
Community-led monitoring and impact assessments on health and environment would be empowering tools.
But nothing will work unless, we, as individuals, make common cause on issues that affect us, our children, demand such tools, use them, and settle for nothing else but accountability.
