Health Woes in Times of Urban Floods
On Aug 29th, the monsoon fury unleashed on Mumbai, India’s financial city, brought it to a grinding halt. Two toddlers were among 14 people killed in the floods. It received nearly a month’s average rainfall in a single day – that halted the transit lifeline of train services and led to several flight cancellations. It continued for two more days until subsiding. This is touted to be the worst flooding since 2005 that saw death of more than 500 people.
Over the last month, several other Indian cities witnessed above average rainfall. On the morning of Aug 21, Chandigarh, the joint capital of Punjab and Haryana had received 112 mm of rainfall, 23 times the city’s average daily monsoon rainfall. Similarly, on August 15, Bengaluru received 37 times, and on August 11-12 Agartala received more than 11 times its average daily monsoon rainfall of the last five years.
Vimal Mishra, a meteorologist and assistant professor at the IIT Gandhinagar revealed in his research work that extreme rains are going to increase over the current century. Specifically, he found that one-to-five-day extreme rains, at levels found once in about 500 years, can increase by about 20-30% over the next century if global warming goes unchecked.  This prognosis does not augur well for a sizable population of poor and migrant community in these cities.
So, who actually bears the brunt? It’s the Urban Poor.
Peculiar to Indian cities, a large number of rural folks migrate to these cities in search of work and livelihood. Many of them earn daily wages and end up sheltering in temporary squatter settlements or claustrophobic slum settlements. The city corporation have not been successful in providing basic amenities to them or even extend public infrastructural services like drainage, drinking water or sanitation disposal facility. Rapid urbanization and population growth has made the situation worse. With increasing occurrence of extreme events, the adverse impact on health has compounded. A field study conducted in Mumbai by S. Kumar Karn and H. Harada from Nagaoka University of Technology, Japan found that at least 30% of all morbidity can be accounted for by water-related infections.  Such intermittent urban floods further aggravate the morbidity caused by water-borne diseases in the community. The children are especially vulnerable to water-borne diseases. Clogged drainage in sewage system carrying both storm-water and human waste poses grave health risk. A sudden outpour inundates their homes with contaminated water exposing them to lethal faecal-oral diseases. They have no other way to go but stay.
Also, due to lack of ‘legal access’ to drinking water, many of the slum residents are forced to illegally tap into city water pipes out of desperation or access surface water bodies like lakes & rivulets. However, the water-bodies gets contaminated owing to flooding which becomes breeding ground for deadly pathogens. Diseases like cholera, diarrhoea in slum-dwelling children is mainly due to such source-point contamination.  And unfortunately, the parents aren’t even aware of it.
When hospitals need help.
In times of urban disaster or natural crisis, public hospitals project image of chaos and confusion. Most of the public hospitals are situated close to low-lying urban settlements for ease of access and ironically floods throw up challenges of their own kind. At times, the public health infrastructure gets incapacitated due to rains and flooding into the premises. In one of the cases in a hospital in Chennai, the flooding of its power units led to failure of ventilators imminently led to death of 18 patients.  Such instances cannot be overlooked. Moreover, the logistical interruption by floods cause delay in supply of critical medicines and health instruments that can prove to be expensive at such times. At times, it also restricts the movement of medical personnel in attending to the patients. Another challenge is disposal of medical waste. The floods have high probability of carrying hazardous chemicals and infections to nearby population and further spread them.
Almost all of these challenges can be managed, provided civic authorities are foresighted to make the urban land-scape resilient to climate change events and are adequately prepared for any disaster. The various agencies need to coordinate swiftly in terms with a city-wise disaster management framework that alleviate confusion and foster cooperation. The natural flood protection systems like urban wetlands and rivers need to be preserved and maintained sustainably. They provide a cushion to absorb excess flood water. Ironically, it is the nature itself that can actually safeguard the city-dwellers from nature’s fury.