Health hazards

In a garbage-infested village outside Delhi, fevers have been claiming lives this monsoon

But the district health administration refutes claims of a 'mystery virus'. The causes of death were different in each case, they say.

Just 10 minutes of rain in Sarfabad village caused floods in its bylanes. The village is in Noida, a township in Uttar Pradesh that is part of the National Capital Region and just outside Delhi. Children in Sarfabad who decided that it was time to play ended up wading in blackish sewage water in the streets. The roads are lined with mounds of garbage. On Friday, civic authorities had removed silt from the gutters that were then piled up in black heaps near the gutters. That silt was washed away again by the next round of rain.

In this village, there have been ten deaths just in the month of August. Residents claim that most of the deceased had suffered fever and body pain for a few days before they died. Public health authorities in Noida investigating the deaths have said that the the causes of death were different in each case including. Some died of heart attacks, they said. There was no outbreak of any disease, they claimed.

Despite this, television reports have started talking about a mystery virus afflicting the area's residents.

Villagers walk through water that has accumulated after about 10 minutes of rain. Photo: Menaka Rao
Villagers walk through water that has accumulated after about 10 minutes of rain. Photo: Menaka Rao

Ten deaths with no pattern 

Twenty two-year-old Vipin Sharma was preparing for a test in a law college on August 15, when he said he was feeling feverish. The next morning at around 7, he complained that he was cold. He was shivering. His family took him to the nearby District Government Hospital at Noida's Sector 30, but say they were sent back. Sharma died at home at around 8.30 am.

“Only two youths have died, among the 10," said Dr VD Verma, the chief medical officer, Gautam Buddha Nagar district which covers Noida. "Another youth who died had a problem of convulsions. Most others were either between 50-60 years of age.”

Verma listed a litany of medical complaints that affected the victims.

“One died of heart attack, one of paralysis, one had acute liver failure, one had pancreatitis, one had chronic obstructive pulmonary disease,” he said. "All of them have died of different reasons."

Sukhpal Yadav, 60, was “perfectly healthy” before he was struck with fever, according to his family. “He was in hospital for ten days," said his son Moolchand, who works as a driver. "We got all the tests done, but nothing came out positive.”

Sarfabad village is contained within a three-kilometer radius and has about 10,000 to 15,000 inhabitants. “If there are 10 deaths in two weeks time associated with fever there is clearly an outbreak,"said Dr Rajib Dasgupta, from the community medicine department of Jawaharlal Nehru University, Delhi. "It is most certainly an unusual event though we cannot comment on what has really happened.”

The district administration did about five rapid malaria tests, and tested a few people for dengue, all of which have turned up negative. While admitting to the lack of sanitation in the area, the administration has denied finding any disease-carrying organisms like the dengue-causing Aedes mosquito.

No primary health centre nearby

Nevertheless, the district administration has also held a medical camp in the area to treat patients who have fever. The camp has been running since August 25, and will continue for some time, said Verma.

Even though temporary, this is the first government facility within the village that Sarfabad residents are getting access to. There is no primary health care centre nearby. It is little wonder that patients were excited about the free medicines available in the camp.

The villagers usually rely on jholachap or quacks in the area, or doctors with Ayurveda degrees. There is not a single MBBS doctor in the village.

Veer Singh, who has a Ayurveda medicine degree, with his patients. Photo: Menaka Rao
Veer Singh, who has a Ayurveda medicine degree, with his patients. Photo: Menaka Rao

Scroll.in visited two doctors who claimed to a have degree in Ayurvedic medicine. Both were receiving many patients with symptoms of fever, cold and cough.

“Many of my patients complain of pain in the leg and fever," said Dr Veer Singh, whose desk was strewn with different formulations of injections. "Some of their blood tests are showing that they have a drop in platelets. We get about 200-250 patients a day, mostly with fever.”

As he spoke, Singh was tending to to a man complaining of knee pain. The doctored administered and injection to the patient through his shirt, without exposing the skin of his arm – a method that could possible infect the site of the injection.

The sanitation problem

Whether this round of sickness in Sarfabad is connected to its filth or not, it's evident that the village has a huge sanitation problem, the root of which lies in politics.

Last year, the Uttar Pradesh government decided against having panchayat elections in the villages of Gautam Buddha Nagar. The farmers had then complained that in the absence of an elected body, no one could be held responsible for the development of rural areas and protection of the rights of the villagers, the Times of India reported at the time.

Now, everyone in Sarfabad complains bitterly that the Noida Authority has not taken care of the village's sanitation.

A derelict structure used as a garbage dump at Sarfabad village. Photo: Menaka Rao
A derelict structure used as a garbage dump at Sarfabad village. Photo: Menaka Rao

“Earlier, we had a pradhan [elected sarpanch] who would ensure that the village is kept clean," said Sukhvir Pehelwan, a social worker in the area. "It was running better then. Dabav rehta hai." There are pressures in living in the same society.

Residents complained that municipal workers now come only twice a week.

This is the first monsoon without a panchayat system. The authority has started a cleanliness drive in Sarfabad, a few more villages nearby till September 15.

Risks in peri-urban landscapes

Villages like Sarfabad are peculiar in nature. These peri-urban habitations on the fringes of cities are just one turn off a four-lane highway on a lanes that lead to hamlet-like enlosures where people still live in havelis or kothis.

“In developing countries they are often called ‘peri-urban interfaces’," said Dasgupta. "It is a zone of interaction between urban and rural socioeconomic systems, a transition zone between fully urbanized land in cities and areas in predominantly agricultural use. It is characterised as zone of rapid economic and social structural change. These have implications for urban governance.”

Many people in Sarfabad, like Moolchand, have sold their ancestral land. Just outside the core of the village, where the original village dwellers live, there are buildings and farm houses that are have come up. Some are using their land to build small cemented hutments in which the construction workers live.

There are people who are involved in the construction business, like Bhirampal Yadav, who supplies land mowers. His 62-year old father, Bhimpal Yadav, died of after fever on April 24. The district administration maintains he suffered from pancreatitis.

There is also an influx of migrant populations who work in Noida and rent in Sarfabad village, the villagers said.

“Urban health systems are weak in India, deficient in core public health functions. Peri urban typically falls between two stools, lacking in services provided by either the rural health services or excluded by the municipal system,” said Dasgupta. This, he added, increases the risk of such infections.

The villagers, in the meanwhile, feel the administration is only trying to push things under the carpet. By all the different account the number of deaths in Sarfabad in August varies between 13 and 35. Residents maintain that one or two people have been dying every day for the past three weeks.

Prajwala Sharma, the mother of the 22-year-old Sharma wants the village to be cleaned better. “ I do not want any other mother in this village to cry over a dead son,” she said.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

Making two-wheelers less polluting to combat air pollution in India

Innovations focusing on two-wheelers can make a difference in facing the challenges brought about by climate change.

Two-wheelers are the lifeline of urban Asia, where they account for more than half of the vehicles owned in some countries. This trend is amply evident in India, where sales in the sub-category of mopeds alone rose 23% in 2016-17. In fact, one survey estimates that today one in every three Indian households owns a two-wheeler.

What explains the enduring popularity of two-wheelers? In one of the fastest growing economies in the world, two-wheeler ownership is a practical aspiration in small towns and rural areas, and a tactic to deal with choked roads in the bigger cities. Two-wheelers have also allowed more women to commute independently with the advent of gearless scooters and mopeds. Together, these factors have led to phenomenal growth in overall two-wheeler sales, which rose by 27.5% in the past five years, according to the Society of Indian Automobile Manufacturers (SIAM). Indeed, the ICE 2016 360 survey says that two-wheelers are used by 37% of metropolitan commuters to reach work, and are owned by half the households in India’s bigger cities and developed rural areas.

Amid this exponential growth, experts have cautioned about two-wheelers’ role in compounding the impact of pollution. Largely ignored in measures to control vehicular pollution, experts say two-wheelers too need to be brought in the ambit of pollution control as they contribute across most factors determining vehicular pollution - engine technology, total number of vehicles, structure and age of vehicles and fuel quality. In fact, in major Indian cities, two-thirds of pollution load is due to two-wheelers. They give out 30% of the particulate matter load, 10 percentage points more than the contribution from cars. Additionally, 75% - 80% of the two-wheelers on the roads in some of the Asian cities have two-stroke engines which are more polluting.

The Bharat Stage (BS) emissions standards are set by the Indian government to regulate pollutants emitted by vehicles fitted with combustion engines. In April 2017, India’s ban of BS III certified vehicles in favour of the higher BS IV emission standards came into effect. By April 2020, India aims to leapfrog to the BS VI standards, being a signatory to Conference of Parties protocol on combating climate change. Over and above the BS VI norms target, the energy department has shown a clear commitment to move to an electric-only future for automobiles by 2030 with the announcement of the FAME scheme (Faster Adoption and Manufacturing of Hybrid and Electric Vehicles in India).

The struggles of on-ground execution, though, remain herculean for automakers who are scrambling to upgrade engine technology in time to meet the deadlines for the next BS norms update. As compliance with BS VI would require changes in the engine system itself, it is being seen as one of the most mammoth R&D projects undertaken by the Indian automotive industry in recent times. Relative to BS IV, BS VI norms mandate a reduction of particulate matter by 82% and of oxides of nitrogen (NOx) by 68%.

Emission control in fuel based two-wheelers can be tackled on several fronts. Amongst post-emission solutions, catalytic converters are highly effective. Catalytic converters transform exhaust emissions into less harmful compounds. They can be especially effective in removing hydrocarbons, nitrous oxides and carbon monoxide from the exhaust.

At the engine level itself, engine oil additives are helpful in reducing emissions. Anti-wear additives, friction modifiers, high performance fuel additives and more lead to better performance, improved combustion and a longer engine life. The improvement in the engine’s efficiency as a result directly correlates to lesser emissions over time. Fuel economy of a vehicle is yet another factor that helps determine emissions. It can be optimised by light weighting, which lessens fuel consumption itself. Light weighting a vehicle by 10 pounds can result in a 10-15-pound reduction of carbon dioxide emissions each year. Polymer systems that can bear a lot of stress have emerged as reliable replacements for metals in automotive construction.

BASF, the pioneer of the first catalytic converter for automobiles, has been at the forefront of developing technology to help automakers comply with advancing emission norms while retaining vehicle performance and cost-efficiency. Its new state-of-the-art manufacturing facility at Mahindra World City near Chennai is equipped to develop a range of catalysts for diverse requirements, from high performance and recreational bikes to economy-oriented basic transportation. BASF also leverages its additives expertise to provide compounded lubricant solutions, such as antioxidants, anti-wear additives and corrosion inhibitors and more. At the manufacturing level, BASF’s R&D in engineered material systems has led to the development of innovative materials that are much lighter than metals, yet just as durable and strong. These can be used to manufacture mirror brackets, intake pipes, step holders, clutch covers, etc.

With innovative solutions on all fronts of automobile production, BASF has been successfully collaborating with various companies in making their vehicles emission compliant in the most cost-effective way. You can read more about BASF’s innovations in two-wheeler emission control here, lubricant solutions here and light weighting solutions here.

This article was produced by the Scroll marketing team on behalf of BASF and not by the Scroll editorial team.