On a warm Friday afternoon in the slums of Madhukam, in the heart of Ranchi, India, a middle-aged man arrived at a public water station with two 20-liter containers to fill. The water station - directly adjacent to an open sewage drain - was really just a concerete wall with four pink spigots protruding from its barren surface. On top perched two large, seemingly empty holding tanks of water. The man placed one of his containers under the first spigot and turned the handle. A small flow of water came out. Within a minute, the flow turned into a trickle, and the trickle quickly became nothing. The man moved to the next spigot, and then the next, only to have all four repeat the same pattern. In the end, the man left carrying only six ounces of water in his two 20-liter containers.
Let’s say we are both girls born on farms in remote villages at the foothills of mountains, but you were born at the foothills of the Himalayas and I, somewhere at the foothills of the Swiss Alps. You are the first of five children and I have only one younger sister. What do you suppose our lives growing up would be like?
I have access to a road that leads me to school every day and to hospitals when I need it. I have electricity so that I can do my homework in the evenings and my mother can cook using a clean stove. We have heat. I even have telecommunication services for when I want to talk to my uncle who lives in Nova Friburgo, Brazil. And my bathroom is indoors because it separates us from our waste.
I was intrigued by Kerala's Akshaya program. Kerala is uniquely, a most decentralized state, the only one of 17 in India to enact the Right to Public Services and, to open citizen service centers called Akshaya, run under the oversight of panchayats, 3-tier local self-governments, in 14 districts set within a 2 km radius of households. Akshaya was designed in its first phase in 2003 by the Kerala IT Mission to improve e-literacy in underserved areas and, in its second phase to provide a platform for government to citizen services through a public-private partnership. Over 60% of Kerala's 33 million citizens have been served by 2070+ Akshaya centers run by private entrepreneurs who collectively earn 30 million INR a month, creating employment for over 20,000 individuals. (For more details, see Akshaya Overview and UNDP Report on Akshaya).
A common notion in public policy is that policy-making and implementation are divorced from each other, in the sense that politics surrounds decision-making activities (to be carried out by the elected political leadership) while implementation is an administrative activity (to be handled by bureaucracies). However, researchers have found that such distinctions are not helpful in understanding policy implementation in developing countries.
The broad objective of the World Bank’s India Country Partnership Strategy Report (CPS) for the period 2013-2017 is to support poverty reduction and shared prosperity in India. The Report states that between 2005 and 2010, India’s share of global GDP increased from 1.8 to 2.7% and 53 million people were lifted out of poverty. But it also states that with population growth, it has proved difficult to reduce the absolute number of poor at a rapid pace and 400 million Indians still live in poverty. Each of the seven low income states (Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Odisha, Rajasthan; Uttar Pradesh) and seven special category states (Assam, Himachal Pradesh, Manipur, Meghalaya, Mizoram, Sikkim, Uttrakhand) have poverty rates that are higher than that of the more advanced states. The low income states, where a large majority of the poorest 200 million Indians reside, are a priority for the World Bank Country Strategy funding during 2013-2017 (estimated to be $ 5 billion annually with 60 percent lending through direct financing of state projects of which half will go to low income and special category states).
India, both in the above mentioned and its advanced states (e.g. Punjab, Haryana, Kerala) is undergoing a massive rural- urban transformation- one of the largest in the 21st century. For the first time since independence, India has seen a greater absolute growth in urban population. The number of towns has increased from about 5000 in 2001 to 8,000 in 2011 and some 53 cities have a population exceeding one million. Today 30.1 percent of the population lives in urban areas and the share is expected to rise to 50% in the next 20 years (with urban India expected to generate 70% of its GDP by 2030). Though villages vastly outnumber towns in India (660,000 villages as per Census 2011), the construct of these villages is changing as the economy grows.
When it comes to primary education, there are many reasons to be optimistic. Enrollment has jumped across the world, and more children are in school than ever before. In the last decade, the number of out-of-school children has fallen by half, from 102 million in 2000 to 57 million in 2011.
But is showing up to school enough?
According to UNESCO’s Education for All Global Monitoring Report, almost one quarter of the youth in the developing world cannot read a sentence. In countries with large youth populations, this can leave behind a crippling ‘legacy of illiteracy’. Despite almost universal primary enrollment in India – 97 percent – half of second grade students cannot read a full sentence, and almost a quarter cannot even recognize letters.
Reading is a foundational skill. Children who do not learn to read in the primary grades are less likely to benefit from further schooling. Poor readers struggle to develop writing skills and absorb content in other areas. More worryingly, learning gaps hit disadvantaged populations the hardest, limiting their economic opportunities. In Bangladesh, only one in three of the poorest quartile is literate, compared to almost nine out of ten in the richest.
A good friend of mine recently returned from her mother’s funeral in Germany. She had died of lung cancer after spending the last eight years of her life in a slum in New Delhi where she taught orphaned children.
I can’t help but wonder if breathing the dirty indoor and outdoor pollution in New Delhi contributed to her cancer. My friend has the same question.
In new estimates released March 25, the World Health Organization (WHO) reports that in 2012, about 7 million people died - one in eight of total global deaths – as a result of air pollution. Indoor air pollution was linked to 4.3 million deaths in households that cook over coal, wood and biomass stoves. Outdoor air pollution was linked to 3.7 million deaths from urban and rural sources worldwide. (As many people are exposed to both indoor and outdoor air pollution, mortality attributed to the two sources cannot simply be added together.)
South and East Asia had the largest number of deaths linked to indoor air pollution.
The WHO finding more than doubles previous estimates and confirms that air pollution is now the world’s single largest environmental health risk. In particular, the new data reveal a stronger link between both indoor and outdoor air pollution exposure and cardiovascular diseases, such as strokes and ischemic heart disease, as well as between air pollution and cancer. In the case of both indoor and outdoor air pollution related deaths, 6 percent were attributed to cancer.
Thinking that my friend’s mother perished as result of pollution may not be so far-fetched.