1. Problems and Issues Facing India

2.  Overpopulation  1 billion & climbing.  Economic development.  Hindu-Muslim tensions.  Gender issues  dowry killings.  Caste bias  discrimination against untouchables continues.  The Kashmir dispute and nuclear weapons.  Political assassinations. Major problems & Issues in India today

3. India and the Subcontinent Conflict over Kashmir – India & Pakistan –Irrigation –Pride Nuclear Weapons – India & Pakistan Flood control – India & Bangladesh Humanitarian Aid – India & Bangladesh

4. Urbanization and Poverty

5. Cities Two largest cities— Mumbai (Bombay) and Kolkata (Calcutta) Bangalore and Mumbai— universities, research centers, and high-tech businesses Most people struggle to earn a living in the cities. Villages Most Indians live in rural areas. Most villagers work as farmers and live with an extended family. Paved roads and electricity have only recently reached many Indian villages. Daily life in India is centered around cities, villages, and religion. Religion Plays a key role in Indian daily life Most practice Hinduism. Many follow other religions (Islam, Buddhism, etc.). Millions practice Sikhism and Jainism. Religious celebrations are important.

6. Daily Life About 7 out of 10 Indians live in villages and farm for a living. Houses belonging to more prosperous families in a village are made of better materials than those of poorer villagers, most of which include only a charpoy, or wooden bed frame with knotted string in place of a mattress. For religious and economic reasons, Indians follow a mostly vegetarian diet, and most Indians eat some form of rice every day. 2

7. 70% Rural 600,000 villages

8. 2 Economic Improvements Farming methods have improved, but few families own enough land to support themselves. Many farmers have set up cottage industries to add to their income. India is a leading industrial nation, and advances have been made there in technology and consumer industries. The growing middle class forms the market for consumer goods.

9. Poverty Abounds

10. Four of every ten people in India struggle to live on the equivalent of less than $1.25 /day

11. % Arable Land Pop. Density /km GDP PPP % Literate Life Exp. Poverty Rate India49% 392$2,80061%70 yrs25% Pakistan24% 199$2,60050% 65 yrs24% Nepal16% 226$1,70049%65 yrs31% Bangladesh55%1165$1,50043%60 yrs45% Comparative Statistics for Selected Countries in South Asia

12. Poverty is a tremendous problem in South Asia

13. Consider these indicators of poverty for the countries of South Asia

14. Today India faces many challenges, including a growing population and economic development. Population India is the world’s second most populous country. India’s huge population places a strain on India’s environment and resources. Urbanization is taking place. Urbanization is the increase in the percentage of people who live in cities.

15. Urbanization Many of India’s people live in small or medium-sized towns, which are larger and livelier than rural villages. India’s cities are very densely populated, as evidenced by Mumbai’s population density of 714,000 inhabitants per square mile. Despite the extreme crowding and poverty, cities offer more opportunities for work and education than do rural areas. 2

16. Urbanization trends in India Year 1800 1950 2000 2008 2030 2% 30% 47% ~50% ~ 60% Source: UN, Urbanization prospects, the 1999 revision Total population 360 1027 140 1160 In million Urban Population 2050 16

17. Urbanization Growth If India does grow rapidly, one would expect about 75% of India’s population would be urbanized by 2050 Urban population in 2050 = 75% of 1.6 billion = 1.2 billion Urban population today = 28% of 1.002 billion = 280 million Urban population would increase by 920 million by 2050 (almost 20 million new urban residents a year) Can India cope with such rapid urbanization, or will it stymie India’s growth?

18. Urbanization: Trends and Patterns- 2 286 million people in India live in urban areas (around 28% of the population) * The proportion of urban population in India is increasing consistently over the years  From 11% in 1901 to 26% in 1991 and 28% in 2001 Estimated to increase to 357 million in 2011 and to 432 million in 2021 * After independence 3 times growth - Total population 5 times growth - Urban population* * Census of India 2001 18

19. INDIA: URBAN GEOGRAPHY In 2003, India was one of the least urbanized of the large in population countries of the world, given that only 28 percent of the country's population resided in urban areas. Although the proportion classified as urban is small, in absolute numbers India had 299,208,000 people residing in urban centers. Mumbai (formerly Bombay), with 11,914,398 people, is the largest city of India in terms of population. Delhi ranks second with 9,817,439 followed by Kolkata (formerly Calcutta) with 4,580,544. 11 Indian cities have populations in excess of one million inhabitants. The largest metropolitan area populations of India are: –Mumbai 16,368,084 –Kolkata 13,216,546 –Delhi 12,791,458

20. Dharavi is the largest ‘slum’ in Asia Location: Mumbai, India

21. How would they describe Dharavi to a tourist?

22. Dharavi is described as a “slum of hope” Dharavi is described as a “slum of despair”

24. Demographics in South Asia Mumbai- 16 million Kolkatta- 13 million Delhi- 13 million Dhaka- 13 million 70% of South Asians live in rural areas, in villages, yet South Asia has some of the world’s largest cities:

25. INDIA: URBAN GEOGRAPHY Indian urbanization is accelerating, and urban India is today growing more than twice as rapidly as the country's overall population. Attendant problems include poor sanitation, street dwellers, and riots. In 1984, riots between Hindu and Moslems in Mumbai left hundreds dead. Reasons for migration to cities (internal migration): –Loosening of ties between poor peasants and their villages. –Widespread establishment of village men or "caste brothers" who encourage friends and relatives to move to the cities.

26. Reasons for migration to cities: Higher salaries Business opportunities Anonymity and individualism Rise in caste status Agricultural modernization (reduces rural incomes and jobs) Population pressures Refugees of drought or flooding

27. Migration-causes Increased family size-limited agricultural property -Land use Pattern -Irrigation facilities Better income prospects Better educational facilities Better “Life style” Basic amenities – health, transport,water, electricity. Victims of natural/manmade calamities-Refugees 27

28. Urbanization Many of India’s people live in small or medium-sized towns, which are larger and livelier than rural villages. India’s cities are very densely populated, as evidenced by Mumbai’s population density of 714,000 inhabitants per square mile. Despite the extreme crowding and poverty, cities offer more opportunities for work and education than do rural areas. 2

30. INDIA: URBAN GEOGRAPHY Population densities in urban centers are very high. Kolkata (Calcutta) averages 13,900 persons per sq km (36,000 persons per sq mi) for its entire area of 1036 sq km (400 sq mi). By comparison, New York City averages 1544 persons per sq km (4,000 persons per sq mi). In Kolkata (Calcutta), an estimated 200,000 residents are known as street people and sleep under bridges, railway overpasses, in doorways or wherever they can find a spot. Slightly better off are the residents of the bustees, hovels made of cardboard, burlap, or other scrap material. An estimated 2,000,000 people live in bustees.

31. INDIA: URBAN GEOGRAPHY Indian urbanization reveals several regional patterns: –The northern heartland, the west (wheat growing area) is more urbanized than the east (where rice forms the main staple crop). –In the west urbanization may be as much as 40%; in the east only about 10% of the population resides in urban centers. India's larger cities (more than 100,000) are concentrated in three regions: (1) the northern plains from Punjab to the Ganges Delta (2) the Bombay-Ahmadabad area (3) the southern end of the peninsula, which includes Madras and Bangalore Large cities(more than one million) outside these regions include centrally positioned Nagpur and Hyderabad (capital of Andhra Pradesh).

33. Cities of India Mumbai, on India’s west coast, is the country’s busiest port and its financial center, while Chennai and Kolkata are major centers of commerce and shipping on the east coast. New Delhi is the country’s capital and center of government. Varanasi, on the banks of the Ganges, is regarded by Hindus as their holiest city, and devout Hindus hope to visit the city at least once within their lifetime to wash in the sacred Ganges River.

35. Migration-consequences Overcrowding Mushrooming of slums Unemployment Poverty Physical & mental stress Family structure-Nuclear families -Single males 35

36. Migration-cobweb Migration Stretching of overburdened systems Stretching of overburdened systems Overcrowding Unemployment Crimes Poverty Illiteracy Communicable diseases Communicable diseases Unhygienic conditions Unhygienic conditions Slums Injuries Mental illness Mental illness Stress Life style modification Life style modification Non-Communicable diseases Non-Communicable diseases 36

37. A scene which makes every Indian feel shameful… 37

38. Slums of India In the last decades, the total urban population in India’s 3 largest metropolitan areas has increased to nearly 400 million people. In 2011, India’s slum population was estimated to be 90 million. T his rapid urbanization has brought unique challenges to those calling India’s cities home. Planning practices left over from Colonial times have created city structures characterized by unequal distribution of public services, especially access to clean water and sanitary waste disposal. Government agencies, as well as Non-Governmental Organizations, are working to provide access to clean water and sanitation for India’s slum dwellers through crisis intervention, infrastructure construction, and education on water quality standards and women’s issues 1,2

39. Slums Under section 3 of the Slum Area and Improvement Act (Improvement and Clearance Act) (Act No.96, 1956) an area is legally considered a slum if competent authority reports that any areas are: a)In any respect unfit for human habitation; or b) are by reason of dilapidation, overcrowding, faulty arrangement and design of such buildings, narrowness or faulty arrangement of streets, lack of ventilation, light, sanitation facilities or any combination of these factors which are detrimental to safety, health and morals More males than females Vast majority is part of the working age group (15-59) Caste System continues to play defining role

40. Factors Affecting Health in Slums * Economic conditions Social conditions Living environment Access and use of public health care services Hidden/Unlisted slums Rapid mobility * Agarwal S, Satyavada A, Kaushik S, Kumar R. Urbanization, Urban Poverty and Health of the Urban Poor: Status, Challenges and the Way Forward. Demography India. 2007; 36(1): 121-134 40

41. Double Burden of Diseases Overcrowding and related health issues Rapid growth of urban centers has led to substandard housing on marginal land and overcrowding Outbreaks of diseases transmitted through respiratory and faeco-oral route due to increased population density It exacerbates health risks related to insufficient and poor water supply and poor sanitation systems Lack of privacy leading to depression, anxiety, stress etc 41

42. Double Burden of Diseases Upsurge of Non-communicable diseases The rising trends of non-communicable diseases are a consequence of the demographic and dietary transition Decreases in activity combined with access to processed food high in calories and low in nutrition have played a key role Urbanization is an example of social change that has a remarkable effect on diet in the developing world 42

43. Double Burden of Diseases Traditional staples are often more expensive in urban areas than in rural areas, whereas processed foods are less expensive This favors the consumption of new processed foods This places the urban population at increased risk of NCDs In India, chronic diseases are estimated to account for 53% of all deaths and 44% of disability-adjusted life- years (DALYs) lost in 2005 43

44. Increased burden of diseases associated with overcrowding, poor sanitation and hygiene Diseases associated with air and water pollution Lifestyle and stress related diseases, accidents/violence, substance abuse Diseases of nutrition Various administrative units with little coordination. Districts and zones not clear Lack of grass root level structures like PRI’s Inequitable distribution of health facilities Multiple agencies/bodies providing health care Lack of Standardization and standard treatment protocols Lack of integrated HMIS and databases Large segment of urban poor In migration and floating populations Diverse social and cultural backgrounds Greater vulnerability of the migrating populations Socio Demographic Operational Dual burden of diseases Administrative KEY CHALLENGES TO URBAN HEALTH SERVICES 44

45. Operational Challenges Lack of standards for – Provision of safe water and sanitation facilities – Housing and waste disposal systems No public health bill for setting up and regulating these standards Lack of understanding of recent demands of urban health care delivery and poor planning/implementation 45

46. Operational Challenges Lack of infrastructure for setting up of primary health care facilities Many slums are not having even a single primary health care facility in their vicinity Multiple health care facilities/bodies but without coordination Lack of community level organizations/slum level organizations and lack of adequate support to them 46

47. Infrastructure Issues

48. Disparate Taxation Only 35 million people pay income tax to the federal government. – Formal Sector Over 1 billion pay NO federal taxes! – Informal Sector – Largely agricultural or village based

49. Lacking Infrastructure Major cities are not connected at this point by a highway system. Golden Quadrilateral Highway Project will eventually connect New Delhi-Mumbai- Bangalore-Chennai-Kolkata. - $12 billion Currently only 3,700 miles of highways!!! 40% of farm produce goes to waste as a result of poor transportation

50. Infrastructure Issues Irrigation & Water Pollution – Narmada Valley Project – Building of 30 major & 3,000 minor dams – Electric power will be created Bhopal Accident – American chemical plant accident, killed 2,000 Modernizing vs. Environmental Protection

51. Scheduled Improvements New $430 million Bangalore International Airport to be completed by April 2008. (European built and operated) – Roads to the airport are uncertain Vallapardam Ship Terminal in Kochi (southwest coast of Kerala) to be completed by Dubai’s DP World at a cost of $555 million

52. Population Issues How To Handle Them

53. INDIA: POPULATION GEOGRAPHY India had 1,068,600,000 people in 2003 (17% of the world total), the world's second largest country in population after China. India has a rate of natural increase of 1.7% (compared to a 1.3% world rate) and a projected population of 1,363,000,000 by 2025. At this rate, it is only a matter of time before India becomes the world's most populous country. The largest clusters of the Indian population are found in the Gangetic plains in the north and the coastal areas of the country. These are the most fertile parts of India.

55. South Asia is one of the most densely populated areas on earth. 5 India has a population growth rate of 1.6 percent, which will lead to the doubling of the nation’s population in 36 years.

56. INDIA: POPULATION GEOGRAPHY In India, population arithmetic density (in 2003) was 325 persons per sq km (842 persons per sq mi); physiological density (in 2000) was at 557 persons per square kilometer (1442 persons per square mile). In neighboring Bangladesh the arithmetic density is approximately 2.5 times as high, 1,040 persons per sq km (2,639 persons per sq mi).

57. India’s natural increase rate: 1.5% (2009 est) China’s natural increase rate: 0.6% More than one-third of India’s population is under the age of 15 years old. India’s population is expected to exceed China’s by 2020.

58. Each year India adds 18 million people. To accommodate this, each year India would have to add: 127,000 new village schools 373,000 new teachers (at 50 students per teacher) 2.5 million new homes (with 7 people per home) 4 million new jobs 180 million new bushels of grain and vegetables

59. CASE STUDY: Slowing Population Growth in India For over 50 years, India has tried to control its population growth with only modest success. Two factors help account for larger families in India. –Most poor couples believe they need several children to work and care for them in old age. –The strong cultural preference for male children means that some couples keep having children until they produce one or more boys. The result: even though 9/10 Indian couples have access to at least one modern birth control method, only 48% actually use one.

60. Family Planning as National Policy In 1952, the Indian government adopted family planning as a national policy. –By 1961, there were 4,165 family planning clinics. –As a part of the government campaign to limit the number of children, the government has put up billboards with the following slogan: "four is a family, five is a crowd." In 1976, a national population policy was adopted including: –the increase of the age of marriage for females to 18 years and for males to 21, –tying financial grants from the federal government to the state governments to their performance in limiting births, –provision of sex education in schools, –expansion of compensation for voluntary sterilization, –and use of incentives by governments to encourage people to limit their family size. In 1977, this policy was made voluntary following the collapse of the Indira Gandhi government. Only 8% of federal assistance was tied to performance on birth control by states.

61. India began its population programs in 1952. mid-1960s: they opened camps for mass insertions of IUDs. 1970s: “Vasectomy camps” 10 million men were coerced into sterilized by vasectomies during the “Emergency Drive” for family planning in the 1970s. Backlash against family planning and distrust of gov’t 1998: the Indian government abandoned targets for sterilizations and contraception. Focus on education. South Asia has been trying to reduce births since 1952.

62. Family planning poster from India

63. “Why only a boy?” family planning poster from India

64. How is it that population continues to boom even with declines in fertility? Significant part of population is in early reproductive years Poor, rural, uneducated people see children as their only source of wealth. Because there is little access to healthcare, infant mortality rates are high (67/1,000 live births). View sons as more beneficial than daughters.

65. Pollution Issues

66. Pollution  “ All the ills of urban development exist in this one city, [New Delhi].”  “The environmental problems of developing countries are not the side effects of excessive industrialization but reflect the inadequacy of development” (Gandhi)  Indira Gandhi 1968: UN pollution conference

67. Double Burden of Diseases Air pollution and its consequences Due to increase in the numbers of motorized vehicles and industries in the cities of the developing world Problems of noise and air pollution Air pollution can affect our health in many ways with both short-term and long-term effects Short-term air pollution can aggravate medical conditions like asthma and emphysema Long-term health effects can include chronic respiratory disease, lung cancer, heart disease, and even damage to other vital organs 67

68. Indoor Air Pollution  Fuel wood, animal dung and crop residues = fuel (Smith 2000).  Arsenic & other toxins  560 villages arsenic-affected  More than a million people are drinking arsenic contaminated water  200,000 people are suffer from arsenic-related diseases  Result: chronic obstructive pulmonary disease and acute respiratory infections. –Most common COD for children under 5 in India (WHO) –Low birth weight, increased infant and prenatal mortality, pulmonary tuberculosis, nasopharyngeal and laryngeal cancer, cataract, and, specifically in respect of the use of coal, with lung cancer and asthma.

69. Waste Disposal  Increase in MSW (municipal solid waste) Rapid population growth Modernization  Mumbai population grew from 8.2 million in 1981 to 12.3 million in 1991  MSW 3200 tons per day to 5 355 tons per day  Municipality competition  Land scarcity for dumping sites  Burning: Most common = CFC emissions  Recycling difficult to implement

70. Access sanitation Only 33% can get rid of there garbage others can’t. So that leaves them with nasty garbage to live with. So they have to find a way to get rid of all that garbage.

71. This is what has happened in India Water conservation can help solve this problem Water conservation can help solve this problem

72. The problem in India India has the world’s second largest population The population in India is too big. This is part of why India is in a water crisis. Some of the diseases are being spread because, many people cannot wash their hands correctly with such little water. Disease is also spread through drinking-water.

73. Water India has 86% improved water sources that leaves 14% with dirty water. India has 86% improved water sources that leaves 14% with dirty water.

74. Water Pollution  3.7 Million depend on basic well system  hydrocarbons, phenols, cyanide, pesticides, major inorganic species, and bacteria.  Yamuna River can no longer support life  Garbage cascades down its banks, giving off a fetid stench. And half of the city's raw sewage flows into its waters.  "The river is dead, it just has not been officially cremated"  Govt. spending: $500 million  River pollution has doubled since 1993  Unplanned Communities  80% pollution due to raw sewage  -4% GDP due to lost productivity (Gupta)  Technology can improve “nullahs”

75. Double Burden of Diseases Water and sanitation problems Due to increasing urbanization coupled with existing un-sustainability factors and conventional urban water management Nealy 1.1 billion people worldwide who do not have access to clean drinking water and 2.6 billion people i.e. over 400 million people, lack even a simple improved latrine Can lead to increased episodes of diarrhea and economic burden 75