Studying a river

Despite being perceived as eternal, the Ganga has changed massively

A new book by an American architect maps the history of the river from its source in the Himalayas down to the ancient city of Varanasi.

Comprising maps, satellite photographs and pictures of specific parts of the river over solar cycles, Anthony Acciavatti’s 400-page The Ganges Water Machine shows a deep understanding of the river basin in its upper half. It is a strong critique of the narrow prism through which policymakers have viewed the river over a century and a half.

Anthony Acciavatti teaches urban design at the Graduate School of Architecture, Planning, and Preservation at Columbia University in New York City. He is also a founding partner of Somatic Collaborative and Manifest: A Journal of American Architecture and Urbanism.

Can you tell us what made you so interested in the Ganges that you devoted 10 years to this project?
It was a combination of factors actually. I had lived in New Orleans and Rome, two cities that are intimately connected to rivers, so I was interested in that relationship of cities and rivers. When I applied for a [J William] Fulbright fellowship I was constrained to applying to only one country. The Ganges is one of the few rivers that largely flows in one country. I also realised that it had not been mapped in 60 years. I was also fascinated by the fact that the Gangetic plain is one of the most densely populated and agriculturally productive regions on earth. I was curious to understand how this worked.

 You have chosen a curious name for your book. Why Ganges Water Machine?
This was the name of a paper written in 1975 by Roger Revelle and V Lakshminarayana in Science, although they did not use the term in the rest of the paper. But they were basically visualising the river and the groundwater as one “machine”. The Ganges is one of the most engineered rivers in the world. Beginning from 1854, the work done on the river has been relentless. It has the longest canal system in the world, stretching upwards of 12,000 kilometres. By the 1870s, people were already referring to it as a system, like a steam engine. This has not changed post-independence. It is a hyper-inhabited region, and has millions of tubewells alongside it.

There is this belief that the river is eternal, never-changing, because of the sacred beliefs associated with it, but the reality is that it has changed massively over the last century and a half.

You mention 1854, and that brings us to the impact of the British in India. There is a section in your book titled Drain where you discuss this topic. Could you elaborate?
The chapter looks at how key Indian commentators showed how the British empire was an imperial drain on the Indian economy. One of the ways that this happened was because of the focus on railways rather than canals. In fact, as I write in my book, British liberals like the journalist William Digby showed how the focus on railways actually drove prices up during the famine of 1876-'77. Initially, the British government subsidised the canals, so that the makers made a 5% profit. Local labour and others also profited. The import of technology for railways changed all that. The canals were no longer subsidised, and local needs suffered.

Do you see the relevance of focusing on infrastructure today?
Yes, very much so. There is often this focus on large, engineering solutions that will use infrastructure to impose order on the landscape, and the people living there. This technology is often sourced from abroad and provides little financial benefit to the people living there. Moreover, large projects imposed from above often do not work in the way that they are intended to, or have other consequences if they do not align with local conditions. For example, the creation of long canals has also led to seepages, creating perfect breeding ground for disease-bearing mosquitoes. Many people do not see the Ganges as a flow of water, but only see the area that they are familiar with, which is part of their sacred geography.

How do you hope that your book will help?
This is an important moment when it comes to the Ganges. The World Bank has just extended a $1.5 billion loan to the Indian government to clean the Ganges. We can continue to work in a narrow manner, but it might be more useful if we look at the geography of the Ganges as a laminated geography.

Could you explain what you mean by that?
The landscape is not mono-functional. It is not merely about farming or shops. It is about both of these things, and more, but we treat them as separate. So a canal is built and agriculture will align along the canal, but shops will align along a major road, such as the Grand Trunk Road. We should be thinking of all that together, otherwise we will only be solving part of a problem, and possibly creating counter-productive results.

Will you remain engaged in this region?
I would like to. This began as a one-year Fulbright fellowship. I did not expect it to turn into a 10-year project.


The Ganga at Sangam, Allahabad, over a year. (Image by Anthony Acciavatti)


This article was originally published on thethirdpole.net.

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Removing the layers of complexity that weigh down mental health in rural India

Patients in rural areas of the country face several obstacles to get to treatment.

Two individuals, with sombre faces, are immersed in conversation in a sunlit classroom. This image is the theme across WHO’s 2017 campaign ‘Depression: let’s talk’ that aims to encourage people suffering from depression or anxiety to seek help and get assistance. The fact that depression is the theme of World Health Day 2017 indicates the growing global awareness of mental health. This intensification of the discourse on mental health unfortunately coincides with the global rise in mental illness. According to the latest estimates from WHO, more than 300 million people across the globe are suffering from depression, an increase of 18% between 2005 and 2015.

In India, the National Mental Health Survey of India, 2015-16, conducted by the National Institute of Mental Health and Neurosciences (NIMHANS) revealed the prevalence of mental disorders in 13.7% of the surveyed population. The survey also highlighted that common mental disorders including depression, anxiety disorders and substance use disorders affect nearly 10% of the population, with 1 in 20 people in India suffering from depression. Perhaps the most crucial finding from this survey is the disclosure of a huge treatment gap that remains very high in our country and even worse in rural areas.

According to the National Mental Health Programme, basic psychiatric care is mandated to be provided in every primary health centre – the state run rural healthcare clinics that are the most basic units of India’s public health system. The government provides basic training for all primary health centre doctors, and pays for psychiatric medication to be stocked and available to patients. Despite this mandate, the implementation of mental health services in rural parts of the country continues to be riddled with difficulties:

Attitudinal barriers

In some rural parts of the country, a heavy social stigma exists against mental illness – this has been documented in many studies including the NIMHANS study mentioned earlier. Mental illness is considered to be the “possession of an evil spirit in an individual”. To rid the individual of this evil spirit, patients or family members rely on traditional healers or religious practitioners. Lack of awareness on mental disorders has led to further strengthening of this stigma. Most families refuse to acknowledge the presence of a mental disorder to save themselves from the discrimination in the community.

Lack of healthcare services

The average national deficit of trained psychiatrists in India is estimated to be 77% (0.2 psychiatrists per 1,00,000 population) – this shows the scale of the problem across rural and urban India. The absence of mental healthcare infrastructure compounds the public health problem as many individuals living with mental disorders remain untreated.

Economic burden

The scarcity of healthcare services also means that poor families have to travel great distances to get good mental healthcare. They are often unable to afford the cost of transportation to medical centres that provide treatment.

After focussed efforts towards awareness building on mental health in India, The Live Love Laugh Foundation (TLLLF), founded by Deepika Padukone, is steering its cause towards understanding mental health of rural India. TLLLF has joined forces with The Association of People with Disability (APD), a non-governmental organisation working in the field of disability for the last 57 years to work towards ensuring quality treatment for the rural population living with mental disorders.

APD’s intervention strategy starts with surveys to identify individuals suffering from mental illnesses. The identified individuals and families are then directed to the local Primary Healthcare Centres. In the background, APD capacity building programs work simultaneously to create awareness about mental illnesses amongst community workers (ASHA workers, Village Rehabilitation Workers and General Physicians) in the area. The whole complex process involves creating the social acceptance of mental health conditions and motivating them to approach healthcare specialists.

Participants of the program.
Participants of the program.

When mental health patients are finally free of social barriers and seeking help, APD also mobilises its network to make treatments accessible and affordable. The organisation coordinates psychiatrists’ visits to camps and local healthcare centres and ensures that the necessary medicines are well stocked and free medicines are available to the patients.

We spent a lot of money for treatment and travel. We visited Shivamogha Manasa and Dharwad Hospital for getting treatment. We were not able to continue the treatment for long as we are poor. We suffered economic burden because of the long- distance travel required for the treatment. Now we are getting quality psychiatric service near our village. We are getting free medication in taluk and Primary Healthcare Centres resulting in less economic stress.

— A parent's experience at an APD treatment camp.

In the two years TLLLF has partnered with APD, 892 and individuals with mental health concerns have been treated in the districts of Kolar, Davangere, Chikkaballapur and Bijapur in Karnataka. Over 4620 students participated in awareness building sessions. TLLLF and APD have also secured the participation of 810 community health workers including ASHA workers in the mental health awareness projects - a crucial victory as these workers play an important role in spreading awareness about health. Post treatment, 155 patients have resumed their previous occupations.

To mark World Mental Health Day, 2017, a team from TLLLF lead by Deepika Padukone visited program participants in the Davengere district.

Sessions on World Mental Health Day, 2017.
Sessions on World Mental Health Day, 2017.

In the face of a mental health crisis, it is essential to overcome the treatment gap present across the country, rural and urban. While awareness campaigns attempt to destigmatise mental disorders, policymakers need to make treatment accessible and cost effective. Until then, organisations like TLLLF and APD are doing what they can to create an environment that acknowledges and supports people who live with mental disorders. To know more, see here.

This article was produced by the Scroll marketing team on behalf of The Live Love Laugh Foundation and not by the Scroll editorial team.