Padma Prakash: Bijli, sadak, pani may be bad for your health

The health effects of large infrastructure projects need to be researched

in recent years. With huge investments flowing into these areas, the stage is set for rapid growth in the sector.

There can hardly be any dispute that such projects, regardless of the benefits, not only affect the ecology of the area but also the socio-economy of the area, lifestyles, welfare and health status of the population. But who is keeping track of all this?

How do we know what the multiple and complex impact of these projects will be? And if we don't know the possible outcomes, how is the success of these projects to be evaluated?

In 1946, the Health Survey and Development Committee (popularly known as the Bhore Committee), whose recommendations formed the basis of independent India's health system, had directed that all irrigation projects be subject to a health impact assessment.

And indeed, in the early years there was representation from the public health department in these project design bodies. Today, the health, welfare and social impact of a large development project becomes important only when there has been a disaster "" or a near-disaster.

Until now infrastructure growth has been slow and since the gestation period of, say, a power plant, a road or an irrigation project has been long, their social and economic impact, too, has been dispersed over time, allowing for better adjustments to be made.

But now larger investments demand greater efficiency and quicker yields and, therefore, shorter gestation periods. Also, projects are far more numerous than before.

Take for instance, the power sector "" generating systems and the spread of distribution networks with kilometre upon kilometre of high-tension cables across the country.

In the 1980s, research in the US pointed to the negative health impact of electromagnetic radiation around these cables on the health profiles of nearby populations.

There have been many studies linking childhood leukaemia clusters with low-level electromagnetic radiation. A web search yields over a thousand references and studies, but not one is in India or south Asia.

In 1994, however, a case was filed in the Supreme Court of Pakistan by a group of citizens, led by the environmentalist Tarik Banuri, opposing the setting up of a power plant. The petitioners cited several studies in the US, Sweden and the UK to support their petition that the plant was likely to have a health impact on the people in the dhobi ghat near the plant.

The expert in the case reviewing the studies concluded that there was no outstanding evidence to show possible harm, but nor was there enough data to rule out such an impact.

The Supreme Court recommended the setting up of a commission that would not only look at the case but also consider the institution of a provision for public debate before such projects were set up.

The power industry has consistently refuted research findings on the impact of electromagnetic radiation from high-tension cables, but there has been continuing academic interest in this area.

Regulations in the US, Europe and the UK today ensure that high-tension power cables do not cross or pass near residential areas or schools. The concern there has shifted to the impact of electromagnetic radiation on wildlife and so on. But these early findings are important to us.

Anyone driving on the Eastern Expressway connecting Mumbai to south-eastern parts of the country will have noticed new residential complexes coming up at almost touching distance from these power cables.

And, of course, these cables straddle slums and villages across the country. Has any thought been given to the possible effect of this on the health of those over which these cables pass?

This neglect of impact monitoring and assessment makes it possible for vested interests and power lobbies to effectively reverse pro-people decisions.

The recent attempt by the Andhra Pradesh government to seek a lifting of the ban on chrysalides (asbestos) mining is a case in point. Had the decision to ban been accompanied by serious research and review of the damaging effects of asbestos, appropriate measures would have been set in place to develop alternatives.

Also, plans evolved to absorb those whose livelihoods depended on the mining and manufacture of asbestos products, the pressure to revive an industry best left dead, would not have arisen.

It is absurd to allow a possibly health-damaging activity even while investing in care facilities to manage the damage. The newly proposed tobacco cess rests on the logic that those who cause the damage should pay for the repair. The principle could be applied to other areas as well.

That the spread of malaria closely follows irrigation projects is acknowledged and is certainly nowhere as controversial as in the case of asbestos or tobacco consumption.

It is also well known that large bodies of stagnant water, such as are created in large construction sites, act as breeding grounds for mosquitoes.

But no attempt has been made to tie up a public health monitoring component with irrigation projects, nor evolve and enforce stringent building regulations that take note of these aspects. Perhaps a cess on construction projects that neglect mosquito control measures will be an effective measure.

We seem to be giving little thought to studying the impact of technology or technological interventions on the social and welfare status of the affected population.

This is not simply for academic reasons, to satisfy a curiosity "" although even for that reason alone it would be worthwhile "" but a necessary process that will lead to better designs. The introduction of water taps in villages for instance, led to drastic changes in the quality of water, and cut down on the time taken to collect water.

But it also meant, researchers found, that women lost the space and time for legitimate and socially sanctioned leisure time and social bonding that was available to them at the village well or the river bank. A change in the layout of public taps in the village was the outcome of this bit of project-associated field research.

Take another instance. There are several studies on the health impact of railways in parts of Africa that point to the consequent spread of certain diseases. One hasn't come across similar studies in India, or on what changes are affected when rural roads are built.

There are anecdotal references to new roads as a factor in, say, migration studies or health seeking behaviour or changes in educational profiles or even voting behaviour.

But does the appearance of village roads and, consequently, transport lead to more children, especially girls, continuing to the secondary level schooling? Would it mean that more at-risk pregnancies would reach hospitals? Or would it also lead to a greater spread of STDs and HIV?

A Russian study examining thyroid cancers among those exposed to the Chernobyl accident found a surprising relationship between proximity to roads and railways and such cancers rather than any association with radionuclides in the environment or soil. We know nothing at all about the impact of roads on our lives.

We need systematic and well-designed inquiries integrated with the design and execution of large projects. It is here that ministries concerned should play an active role in funding and encouraging such research.

All this is not to pose a Luddite argument against development and technology. And it is more than possible that new technologies and large projects have only benign impact on society.

The point, however, is to ensure that their impact is tracked and mid-course corrections applied if and when necessary. This is even more imperative when the state is no longer the sole or even the main authority in designing and controlling these developments.

This is where regulation and monitoring, and a mandatory research and evaluation component are necessary and where the state can play a role in ensuring that those who are affected have some role in keeping track.