Malignant growth: The Sardar Sarovar dam and its impact on public health

ENVIRON IMPACT ASSESS REV 1994;14:349-358 3 4 9

MALIGNANT GROWTH: THE SARDAR SAROVAR DAM AND ITS IMPACT ON PUBLIC HEALTH

Amita Baviskar Delhi School of Economics, India

A r u n K u m a r S ingh The Other Media, New Delhi, India

Large projects associated with industrial and economic growth in most lesser or newly industrialized countries have generally resulted in wide-ranging impacts on local populations. The effects may be direct, due to changes in the physical environment, or indirect, as populations are displaced and traditional lifestyles disrupted. Adverse health effects represent an important dimension, although this is often not reflected in the assessments undertaken during the planning o f such projects. This article discusses the impacts o f an ongoing massive river project in India on the health and welfare of affected indigenous populations.

The Sardar Sarovar Project

The controversial Sardar Sarovar Project (SSP) on the river Narmada in central India is one of the largest and most expensive multipurpose river projects ever to be initiated. At an estimated cost of more than $8 billion, it is claimed that the dam will irrigate 1.8 million hectares of land and supply drinking water to 40 million people in the drought-prone state of Gujarat, and have an installed capacity of 1450 MW of power over the next 30 years (Raj 1992:11). However, all these claims have been questioned on the grounds of feasibility. The SSP has also been opposed by local people and other groups all over the world and has

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350 AMITA BAVISKAR AND ARUN KUMAR SINGH

been described as "the world's largest planned ecological disaster." About a million people will be displaced and affected--by direct submergence, building of canals, weirs, dykes, and the project colony, by catchment area treatment and compensatory afforestation, and due to secondary displacement and effects downstream of the dam. Independent critiques of the SSP have questioned the overall viability of the project itself, challenging the government's claims that Sardar Sarovar will "drought proof" Gujarat (Ram 1993).

Proposals for damming the Narmada, India's fifth longest fiver, were first floated by the British. However it was only during the time of Jawaharlal Nehru, independent India's first prime minister who initiated a massive program of state-sponsored industrialization, that harnessing the river was seriously considered. In 1961, Nehru inaugurated work at the site in Kevadia for Sardar Sarovar--another "temple of modem India." However, construction of the "temple" ran into trouble when the three riparian states involved--Gujarat, Maharashtra, and Madhya Pradesh--could not agree about the sharing of river water and the distribution of costs and benefits. In 1969, the Government of India appointed the Narmada Water Disputes Tribunal to resolve the differences among the states. The Tribunal handed down its decision in 1979, establishing the main design parameters of the Sardar Sarovar dam and other upstream dams and setting out guidelines for resettlement of people who would be displaced. After the Tribunal Award, work on the SSP started in earnest.

Even several years after construction had begun, people living in the designated submergence zone of the dam did not know anything about the project or its implications for their lives. Despite the plans that would drastically alter the lives of large numbers of people, the government did not consult or even inform the affected people about their fate. In some of the villages, the first information about the dam came from the Central Water Commission surveyors who came to place stone markers to indicate the reservoir level. No one from the government has told people when their land and houses are likely to be submerged. Despite the large numbers of people affected and despite the enormity of the change in their lives, there is no government system of information that respects people's fight to know. Residents glean scarce facts from informal conversations with the patvari (revenue official) or similar officials when they meet on other business. Villagers have not been apprised of their rights under the terms of the Narmada Water Disputes Tribunal Award. The planning and implementation process of the project has not included participation by the affected population and violates their rights to information, cultural autonomy, and choice.

The first stirrings of protest against the SSP started in 1979 in the Nimar region in Madhya Pradesh soon after the Narmada Water Disputes Tribunal gave its award. People mobilized around the issue of displacement in what came to be known as the Nimar Bachao Andolan (Movement to Save Nimar). However, the movement collapsed after a year. The second attempt at organizing the opposition to the project occurred around 1985, when Medha Patkar, a social scientist from

THE SARDAR SAROVAR DAM 351

the Tata Institute for Social Studies in Bombay, who had become involved in community mobilization, started working in the SSP submergence zone villages in Maharashtra, and went on to build the valley-wide Narmada Bachao Andolan (Movement to Save the Narmada). Popular mobilization in the valley has been supplemented by cooperation with city-based non-governmental organizations (NGOs) and rural-based mass organizations within India. The Andolan also receives help from Western NGOs that are pressuring the international financial community to withdraw their support from the project. Initially, the Andolan did not challenge the overall validity of the SSP; the early intent was to organize people to agitate for adequate rehabilitation. However, when it became apparent that it was impossible for the states to properly resettle all the project-affected people, and moreover that the project was questionable on other grounds, the Andolan changed its position to a total rejection of the project, voiced in the slogan Koi nahin hatega, t Baandh nahin banega, t (No one will move! The dam will not be built!).

Due to the Narmada Bachao Andolan and its supporters, the SSP has earned such notoriety that even the World Bank was embarrassed into disassociating itself from it midway. In 1985, the World Bank had entered into credit and loan agreements for $450 million with India and the state governments of Gujarat, Maharashtra, and Madhya Pradesh to assist in the construction of the Sardar Sarovar dam and canal. In 1989, three U.S.-based environmental NGOsmthe Environmental Defense Fund, the Environmental Policy Institute, and the National Wildlife Federation--urged the United States' Congress to compel the World Bank to stop funding the SSP. In 1991, the Bank constituted an independent review of the Bank's involvement with the project. Such a step was unprecedented in that no lending or aid institution had ever before accepted that its decisions and procedures be submitted to this kind of public scrutiny. The independent review roundly criticized the project as fundamentally flawed on the grounds of its environmental and social impact, leading the Bank to impose stringent timebound conditions regarding rehabilitation and environmental redress that the Indian government could not fulfill (Morse and Berger 1992). The Indian government subsequently terminated its loan arrangement with the Bank in March 1993.

Despite a serious financial crunch, the dam construction continues. In February 1994, in clear violation of the stipulations laid down by the Ministry of Environment and Forests (MoEF), project authorities closed the temporary sluice gates in the dam wall, facilitating further construction. This will result in the submergence of more than 2000 houses in over 20 villages during the coming rainy season. The struggle against the project continues.

Health Policy and SSP

A low profile, though everpresent, concern in the public debate about the project has been its possible impact on health. The public health risks associated with


large-scale hydroelectric and irrigation developments are generally well-known. Any such development drastically alters the existing environment: the water

impounded in the reservoir and flowing through the canals seeps into the surrounding soil, raising the water table. Providing irrigation and drinking water may bring health benefits but may also make communities vulnerable to water-borne diseases with well-documented dangers. Epidemic levels of malaria, schistosomiasis, and other water-related diseases have been experienced in a number of hydro projects around the world. In India, the term "engineer-made malaria" was used as early as 1938 to describe the proliferation of vectors due to ill-planned development (Russell, quoted in Morse and Berger 1992:323). The significance of such risk in the Indian context can be gauged from the fact that the country loses 73 million person-days a year as a consequence of water-borne diseases (D'Souza 1981).

Although there has been no attempt to make it mandatory for all project plans to include a "health impact assessment" that systematically appraises risks and remedies in the manner of an environmental impact assessment, the institutional framework for addressing public health risks is well established in India. In 1980, the Ministry of Irrigation included public health aspects in its guidelines, which were similar to the guidelines given by the MoEF in 1978. The Central Board of Irrigation and Power also issued guidelines regarding health in 1986. Despite these provisions, the first substantial consideration of public health hazards of the SSP occurred only in 1983--22 years after construction began on the project. Objections to the project on grounds of its public health impact were first raised by the MoEF which strongly opposed the SSP. However, in June 1987, the Ministry was pressured into granting conditional clearance. The clearance noted that studies and detailed action plans were to be made available by 1989; in 1994, the Ministry is still waiting to receive them.

Despite repeated urging to prepare public health plans to deal with all the disease risks, both during implementation and later during operations, the government has done little beyond recommending that studies be done and mitigative measures designed, even with construction of Sardar Sarovar well underway. Thousands of workers from all over India have been assembled at the dam site. Infrastructural development in the workers' and engineers' colony at KeVadia has been extensive; major works have been started on the rock-filled dykes, and work on the main canal has been progressing. Villages are being affected by creation of pools of stagnant water. Yet, even in 1992, the World Bank noted that "no measures have been planned so far [to minimize the risk of water-related diseases]. The Government of Gujarat needs to examine and prepare a comprehensive scheme to tackle malaria and other water-borne

diseases as a priority" (Morse and Berger 1992:327, emphasis added).


The Risk of Malaria

The Bank's alarm was based on a detailed study by N.L. Kalra of the National Malaria Eradication Programme, which made disturbing reading. Kalra found that:

• the project had been planned, designed, and executed without incorporating health safeguards;

• the vector control measures had "become blunt because of injudicious use" and the killer variety of malaria had shown resistance to chloroquine;

• the project area and villages in its vicinity had a high level of malaria with the killer type (P.falciparum) exceeding 30%; and

• deaths from malaria had been reported since 1990.

The report noted that with the onset of peak construction, the rate of fever increased two and a half times, malaria increased by six times, and incidence of P.falciparum also increased by two and a half-fold. The occurrence of the disease at the Sardar Sarovar dam and the adjacent villages was nearly double that of the other villages served by the local health center. Two deaths due to malaria were recorded in 1990, rising to three deaths for 1991. Kalra said that"there was a total collapse of the vector control measures." The indoor vector density was over 10 times the level considered to be risky. Kalra characterized conditions at the construction sites as an encounter between the "ignition wire" of construction- related stagnant water and the "gunpowder" of immigrant labor, creating"an explosion of malaria" (Kalra, quoted in Morse and Berger 1992:323).

RISKS IN THE COMMAND AREA. Whereas the previous observations pertain to conditions at the dam site, Kalra's study also examined the engineering aspects of the SSP and considered the malaria-inducing features. According to the study, construction of the rock-filled dykes has "created tremendous potential" for increase in malarial mosquito populations. There is also a likelihood that the ponds would lead to a high incidence of Japanese encephalitis in the coming 15 to 20 years. Canal-related drainage works have created more stagnant ponds, "taking malaria to the doorsteps of villagers." The report also identified some of the malarial risks that will arise with future construction at Sardar Sarovar. The periphery of the reservoir will increase humidity over distances of three to five kilometers, which will in turn increase the lifespan of mosquitoes and facilitate a longer transmission period for malaria. Especially alarming is the finding that over 900,000 hectares or more than half the area proposed for irrigation is susceptible to waterlogging and salinization (Ram 1993). The implications of this change for the proliferation of vectors have not been adequately studied. The absence of data on health has not impeded work on the project, however. In spite of the warning bells being sounded by public health experts, the juggernaut of construction roils along heedless of present or future risks to health.


The Risk of Schistosomiasis

Besides malaria and filaria, schistosomiasis has been identified as a source of health risk from the SSP. Two studies on schistosomiasis were carried out by the National Institute of Communicable Diseases in 1985. This was followed by an investigation by a team led by the chief of the World Health Organization's schistosomiasis division. These studies all concluded that the disease posed no threat in the area of the project. Yet, a 1985 Aide-Memoire of the World Bank stated that the potential for schistosomiasis to develop in the project must be viewed very seriously. It went on to say that if schistosomiasis were to get a foothold "all of the Gujarat and Madhya Pradesh populations would either have to avoid exposure to the reservoirs and irrigation water for all time, which is practically impossible to accomplish, or most of the people in the areas would be subject to schistosmiasis from childhood onward" (Goodland, quoted in Morse and Berger 1992:325). A report by the Government of Maharashtra indicates that the danger of spreading schistosomiasis is indeed present in the submergence zone; the disease has been reported in one of the 33 Maharashtra villages that will be displaced by the project (NCA 1987).

Nothing has been done, however, to investigate the implications of these risks. The construction of reservoirs and the resulting creation of submergence zones

in tropical latitudes has often resulted in increased incidence of diseases caused by vectors with an aquatic phase in their lifecycle. The possibility of an increase in malaria around the SSP reservoir, as noted, is very high. In earlier documents, however, this possibility had been dismissed by the project authorities with the assertion that there will be no rise in malaria because in the summer the reservoir level will fall, stranding the larvae, while in the monsoons the reservoir level will rise, drowning the larvae (MSU 1983). This argument was maintained by the authorities for at least six years in meetings of the Narmada Control Authority Environment Sub-Group; it was only in 1991 that a study was initiated to investigate the possible increase in incidence of malaria. The possibility of increase in malaria has now been confirmed for both the reservoir and the command area. The casual manner in which the incidence of water-borne diseases is being treated seems to be symptomatic of the government's attitude toward consideration of the health risks that could affect people in the submergence zone of the project.

Health Effects of Displacement There has been no comprehensive study of the health status of communities that will be displaced, and there is little systematic monitoring of the changes in health that resettlement entails. There has also been no effort to relate health to other aspects of a community's well-being such as its access to productive resources or its ability to generate a sustainable and adequate livelihood. Nor has there been any attempt to examine systems of health from the point of view of local


knowledge and control. These aspects acquire great significance in the context of Sardar Sarovar because tribal communities constitute the majority of the population to be displaced (see Table 1).

During the course of two years, living in a tribal village in the submergence zone, and working with Khedut Mazdoor Chetna Sangath (a trade union of tribal peasants and farmers), Baviskar (1992) found that local conceptions of health were strikingly different from the piecemeal approach of the government. Although tribal people in the Nimar plains in the submergence zone of Madhya Pradesh have been largely assimilated into the Hindu caste hierarchy and lead lives that are, for the most part, culturally undistinguishable from their Hindu neighbors, all other tribal people in the submergence zone have a distinct identity and way of life that sets them apart from the people of the plains. The adivasis (tribal people) of the hills of Gujarat, Maharashtra, and Madhya Pradesh belong to the Bhil, Bhilala, and Tadvi tribes. They are mainly farmers who cultivate land that has been cleared from the forest. The forest continues to be central to the local economy; besides being a source of fuel, fodder, and timber it provides people with fruit, edible gum, and other products that they consume or sell. Adivasis also depend on the river for fish. Livestock is very important in their lives as a source of meat, an offering to the gods, and as a store of wealth.

Adivasi communities tend to be highly close-knit; most villages can trace their ancestry to a common patriarch. The village as a community is defined by a set of kin in relation to land. All the men of the lineage living in a village have title to, or have claims to inherit, cultivable land in the village. The adivasi village is remarkably egalitarian in terms of land ownership; all proprietors of land are its actual cultivators. There is no landlessness or wage labor. Besides defining itself in relation to land, the community also comes together to labor. All labor-intensive tasks that exceed the capacity of the individual household are performed collectively in a form of work-sharing called laah. If there is grain to be brought from the fields to the house, a field to be harvested, or a house to be built, a family will call upon all households so that each one sends a member to their aid. In return, the family gives a feast for its helpers and, in turn, reciprocates with its own gift of labor. Thus the system within the village comes close to realizing the ideal of cooperation usually thought of as only an abstraction, too good to be true.

Poverty persuades people in the hills to pool their resources such that the ethic of sharing is central to the maintenance of health and economic security. If people do not help kin in their hour of need, who will come to their aid? This philosophy extends beyond the family in the village to the larger network of affines and agnates in other villages, constructing a web of favors and obligations in the currency of labor and kind. When a family's grain stocks run low, or their bullock falls sick, relatives usually help out. The lineage of a village survives over time because of its relationship with other villages. Members of the lineage sometimes settle elsewhere, in villages of their kin where they may be offered more land or

356 AM1TA BAVISKAR AND ARUN KUMAR SINGH

TABLE 1. Size and Number of Tribal People Affected by Sardar Sarovar

State Estimated Size Estimated No. of Affected Population of Tribals Affected

Gujarat 71,000 48,400 Maharashtra 13,500 12,825 Madhya Pradesh 115,000 56,350

Total 199,500 117,575

some other amenity. More significantly, the community replenishes itself through marriage with people of other clans from other villages. Kinship ties are kept alive through constant working of the web of reciprocity that extends from routine labor-sharing to emergency aid in times of crisis (Baviskar 1992).

A community's sense of identity is closely related to its physical rootedness in a particular location--its ancestors' spirits and its gods inhabit that space; its sense of security derives from its familiarity with local geography, people, and resources. The creation myth of the Bhilalas who live along the river describes the Narmada as the source of all life; the myth is sung during all important festivals of the agricultural calendar. Besides cosmology, secular systems of knowledge are also locally rooted; young children who take livestock into the forest to graze can identify more than 80 different tree species and their uses. Thus the tribal economy is largely defined by dependence on local natural resources and by the kinship network around which production and distribution are organized.

Most adivasi communities are extremely poor and suffer from chronic malnutrition. Forty-six years of tribal welfare programs have not improved their conditions of poverty or their health. The hardships that adivasis continue to face stem from the fact that they do not control or have a right to the natural resources upon which their livelihood depends. They do not have legal title to much of the land that they cultivate and what they grow goes to non-adivasi traders and money-lenders. Poverty prevents adivasis from improving their land and making fanning more productive. They have no legal access to the forest; for fuel and fodder, as well as for collecting forest produce for sale, adivasis have to deal with the demands of the (often corrupt) government bureaucracy. Government resources allocated for tribal welfare rarely reach the villages in the hills that are regarded as "remote" and "inaccessible;" schools and health services are conspicuously absent.

The adivasi system of medicine, which is based on the use of locally available plants, is under siege due to the depletion of the forest. This system of knowledge is more self-reliant, accessible, and democratic than the allopathic expertise vended by the government. Under such circumstances, the well-being of the community depends more on its political strength and its economic ability to sustain its own way of life than on the provision of services by the government. Such a predicament of tribal communities forms the basis of the organizing being


done by Khedut Mazdoor Chema Sangath, a trade union of adivasi peasants and laborers that has been working in the Madhya Pradesh submergence zone for the last 10 years.

So far, the experience of resettlement has shown that displacement brings about a drastic deterioration in an adivasi community's sense of well-being. The families from Madhya Pradesh who agreed to move have been resettled in the plains of Gujarat, far from the forest and the river, in predominantly Hindu villages. For these people (as well as for people from the Gujarat villages who have had to move) the village community, as they knew it, has ceased to exist. Gujarat's 19 affected villages have been scattered over 175 different locations. The dispersal of villages in such a fashion has led to a breakdown of kinship ties that regulate marriage and other social relations. The psychological impacts of this loss of community and sense of place have been tremendous, especially for women because they rely more than men on the kinship network for economic and emotional sustenance. Displacement from the hills to the plains has profoundly altered the community economic life. Adivasi institutions of mutual aid and labor-sharing can no longer operate. Instead of using familiar resources and relationships, people have to negotiate their way through an alien system of capital-intensive farming, buying commercial inputs like fertilizers and pesti- cides, and hiring laborers. Very few adivasis have the financial resources or the confidence to deal with a system that devalues their technology, knowledge, and skills, and that is run by high-caste Hindus who regard adivasis as untouchable. If they need help they have no one to turn to. The very fabric of adivasi life--the

source of physical and emotional security--is being tom apart by displacement. Resettlement has also impinged directly on health. Difficulty in finding fodder

has led to a reduction in livestock numbers, which has decreased protein availability in people's diet. Among project-affected population in Gujarat, a decline in milk consumption has been recorded (TISS 1993:1711). Other nutritional changes have also occurred as a consequence of displacement. Along with the disappearance of meat and fish from the diet, the variety of fruit and vegetables collected from the forest are also no longer available. Because access to the forest has been completely cut off, the system of indigenous medicine is destroyed, and highly detailed, finely tuned knowledge is lost forever. This loss further impoverishes the adivasis and makes them even more dependent on the state. The breakdown of indigenous medicine has not been compensated for by greater provision of government health services. The official monitoring and evaluation agency for the displaced from Maharashtra, Tata Institute o f Social Sciences (TISS), has noted that the Primary Health Centers at the resettlement sites were poorly equipped and were usually too far away to be accessible to most people (TISS 1993:1713). Thus the claims of project authorities that resettlement in the plains makes modem health facilities available to villagers are not borne out in actual experience. In effect, villagers are left in the lurch with neither indigenous nor allopathic medicine coming their way.


The worst case of deterioration in health after resettlement was experienced at Parveta, one of the many resettlement sites in Gujarat. According to TISS, the first batch of displaced people faced "serious health problems due to nutritional deficiency and lack of proper health care. In 1988, 17 deaths (a number of them children less than five years old) were recorded out of a total of 350 people in this settlement" (TISS 1993:1713). Although conditions at Parveta have improved subsequently as a result of the public outcry caused by the anti-dam movement, the possibility of similar disasters is ever-present. Even when such dramatic instances of mortality and morbidity do not occur, the overall experience of resettlement is still extremely traumatic from the point of view of health (Baviskar 1992).

In a context where even government-mandated studies on the risk of specific diseases have not been carded out, there is small likelihood that project authorities will show sensitivity to the complex relationship between adivasi culture and health. These issues emerge only within the space created by the political struggle of the adivasis for the right to life. Thus the Narmada Bachao Andolan has come to represent not merely the fight against a dam, but the aspirations of an entire generation of adivasis in the Narmada valley.

References

Baviskar, A. i 992. Development, nature and resistance: The case of Bhilala Tribals in the Narmada Valley. Ph.D. dissertation. Ithaca, NY: Corneli University.

D'Souza, L.A. 1981. UN water decade: A program for survival. In International Drinking Water Supply and Sanitation Decade: India 1981-1990. India: UNDP.

Morse, B., and Berger, T. 1992. Sardar Sarovar: The Report of the Independent Review. Ottawa: Resource Futures International.

MSU (Maharaj Sayajirao University). 1983. The Sardar Sarovar Narmada Project Studies on Ecology and Environment. Department of Botany, MSU, Baroda. Sponsored by Narmada Planning Group, Government of Gujarat.

Narmada Control Authority (NCA). 1987. Government of Maharashtra: Action Plan for Public Health on Environmental Aspects o f Sardar Sarovar Project.

Raj, P.A. 1992. Sardar Sarovar Project: What it is and what it is not. Gujarat: Sardar Sarovar Narmada Nigam Limited.

Ram, R.N. 1993. Muddy Waters: A Critical Assessment of the Benefits o f the Sardar Sarovar Project. New Delhi: Kalpavriksh.

Tata Institute of Social Sciences (TISS). 1993. Sardar Sarovar Project: Review of resettlement and rehabilitation in Maharashtra. Economic and Political Weekly 28:34.

Malignant growth: The Sardar Sarovar dam and its impact on public health

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