The latest book by
Shankar Aiyyar is a searing
indictment on the failures of the Indian state in providing the following essential services to its citizens:-
- Piped drinking water
- Power supply
- Health care
- Education
- Internal Security
Heavy on data , Aiyyar
paints a stark picture on the failures by the Central governments in succession. He dwells on the repeated tall and grand promises made, terming it 'announcement approach', the failures in implementation, and the States dismal record in ensuring last mile connectivity.
Aiyyar does not touch upon the even more appalling failures of the government in eradicating grinding
poverty from the nation, with 250 million of its citizenry still mired in
abject poverty, or providing meaningful employment opportunities to its teeming unemployed millions, crumbling infrastructure state of cities etc. That is another
depressing story.
The book is a
statement of facts and at times brings about comparisons with other countries
to underline how innovative solutions have been found in places where the
baseline was similar to India a few years/decades ago.
The dream for piped water
Nehru at least had the priorities
right it would appear. The Bhakra-Nangal
Canal project began in 1954 and was completed in 1963. It helped to irrigate large
portions of Punjab and Rajasthan and Nehru called the project something ‘tremendous,
something stupendous, and something which shakes you up when you see it.
Bhakra, the new temple of resurgent India, is the symbol of India's progress’.
It enabled the generation of
electricity and ramped up irrigation - gross irrigated area increased from 22
million hectares to 36 million hectares between 1950 and 1970. But all the dams and reservoirs put
together were not enough for populous and far-flung India. It wasn't just
enough to create storage but also to make water available to people,
particularly those in the rural areas.
Inspite of all his good intentions,
towards the fag end of Nehru’s rule in 1961, of the 5,67,000 villages in India,
only 1.9 per cent or 11,000 villages had piped water.
Things did not improve a decade
later either. In 1971, barely 17,000 or 3 per cent of India's villages were getting
drinking water.
Aiyyar terms the path adopted by politicians, whenever public pressure mounted to provide water to households, the ‘Announcement approach’. A national programme called the ‘Accelerated
Rural Water Supply Programme’ was kicked off in 1973. Nothing much happened and
in 1986, Rajiv Gandhi declared the programme would be on 'mission mode’ and
launched the Technology Mission on Drinking Water. The Narasimha Rao regime further
renamed it as the Rajiv Gandhi National Drinking Water Mission.
The glacial progress
continued. In 1981, barely 38 per cent of the population and only 26.5
percent of rural Indians, had access to safe drinking water.
In 1989, barely 16 per
cent of rural Indians had access to tap water.
To compound the dismal
state of affairs, studies showed contamination across a wide distribution of
areas throughout India with groundwater containing levels of uranium exceeding
30 ug/L, far above the WHO provisional standard.
In addition about two-thirds
of sewage all across India is flowing untreated into the ground, lakes and
rivers. In February 2019, the CPCB (Central Pollution control board) reported
that there are 351 polluted river
stretches on 323 rivers spread over twenty-nine states and two union
territories.
In spite of Modi
making it an electoral pitch to clean up the Ganga, not much change is visible
in the ground. Three years after its launch, in December 2017, the CAG found Namami
Gange wracked by administrative delays, poor contract management and lack of
monitoring with the audit revealing staggering sloth.
No major Indian city has a 24-hour supply of water, with four to five hours of supply per day being the norm, as against the nineteen hours per day supply across the Asian-Pacific region.
Piped water status as in 2019
As of 2019, only one
in five Indian households have piped water in their homes. Over 78.6 per cent
do not have access to piped water in their homes. Every second home depends on
water from wells, tube wells, unprotected water bodies, hand pumps or tanker
water. Over 42 per cent must trek between 0.5 and 1.5 km to fetch water.
Contrast the state of
affairs with Israel. In 2000, The Sea of Galilee was rapidly depleting and its
bed risked being severely damaged. The government imposed restrictions on water
usage and inducted a comprehensive strategy. In 2015, one of the driest years
in its history, Israel had surplus water. Thanks to the policy push, it now
'manufactures' 62 per cent of its water requirement through recycling and
desalination and natural water accounts for just 38 per cent of its
consumption. Indeed, the country produces 660 billion litres each year from desalination
and 290 billion litres through recycling of water. What's more, Israel now
exports 150 billion litres of water every year.
India is ranked a dismal 120
among 122 countries in the water quality index.
Healthcare
In 2018, the Global
Burden of Disease and Healthcare Access Quality Index report published by
Lancet ranked India 145th out of 195 countries, trailing Countries with large populations, such as China, and countries with
smaller economies and per capita incomes, like Sri Lanka, Bhutan and
Bangladesh.
A few instances cited by the author, captures the malaise that afflicts the Indian Health care system. In August 2017, in just
twenty-four hours, twenty-three infants died in Gorakhpur's Baba Raghav Das
Medical College Hospital. In a five-day period, over seventy infants admitted
to the hospital's neo-natal ward for treatment of Japanese encephalitis died due to lack of oxygen
supply. The hospital did not have the required number of oxygen cylinders
because the oxygen supplier had not been paid his dues.
The national average however
camouflages regional disparities. The NITI Aayog in its study rated Kerala, as the topper in healthcare provision, with 76.55 points ,
while Uttar Pradesh scores 33.69; Bihar with 38.46 is at the bottom of the
pile. While under-five
mortality rates in Kerala are at thirteen per 1,000 births, they are at
sixty-one in Assam and at fifty-one in Uttar Pradesh. Similarly, maternal
mortality is six per 1,000 births in Kerala while it's thirty-five in Odisha.
Every second baby's birth in Uttar Pradesh and four of ten births in Bihar are
not under medical care, whereas 92 per cent of the births in Kerala and 85
percent in Maharashtra are at a health care centre.
As per the National
Health Profile 2019, India has a ratio of 1 doctor per 1456 personnel as
against the WHO norms of 1 doctor per 1000 persons.
India's rural
healthcare system is a three tiered pyramid- the sub centres cater to
habitations of 3000 to 5000, primary health centres to between 20,000 and
30,000 people and community centres are for populations up to one lakh.
Of the 1,58,417 sub-centres,
26,360 are without a water connection, 39,122 are without electricity and
15,623 lack approach roads.
The next tier, the primary health centres should be open round the clock. Only
9,492 of the 25,743 primary health centres function 24x7. 55 per cent function with just one doctor - that's one doctor per 30,000 persons. An
unbelievable 1,494 primary health centres, meant to cumulatively cater to
nearly 45 million persons, don't have doctors on the premises.
The community health
centres require 22,496 specialists but only 4,074 are present. Effectively, the community
health centres only have one-fifth of what they need.
Modi announced the National
Health Protection Scheme in 2018. Popularized as
Ayushman Bharat and tagged as the Pradhan Mantri Jan Arogya Yojana (PMJAY), it
promises 100 million families- roughly 500 million persons a coverage of Rs 5
lakh per family. The government proposed to pay around Rs 1,100 per family as
premium.
The design of Ayushman
Bharat on who is eligible raises problematic questions of who is poor and
therefore who can be left out. Ayushman Bharat suffers from poor capacity and dependence on private
hospitals. For instance, a scheme that must cover 500 million persons had, in
February 2019, only 16,000 hospitals empanelled to deliver services.
Unsurprisingly, across
India, in rural and urban areas, over 42 per cent of Indians are opting for
private doctors for outpatient treatment and 55 per cent are going to private
hospitals for hospitalization even though the costs are as much of a killer as
the disease for both poor and middle-class people.
Meanwhile, government
expenditure on health is barely 1.8 per cent of GDP, which is worse even in comparison to India's neighbours and even low-income countries.
Education
Copying is an endemic
problem in states like UP and Bihar even today. The reasons are not hard to find.
A quarter of a century earlier, UP government led by Kalyan Singh had tried to
crack down on mass copying. Rajnath Singh, then education minister in UP, had
promulgated via an ordinance the Anti-Copying Act, 1992. That year, the passing
percentage dipped to 14 per cent; barely one of seven students who appeared for
the Class X exam passed. The opposition of that time Samajwadi Party led by
Mulayam Singh Yadav and Bahujan Samaj Party led by Mayawati – deployed it as an
election issue, with Mulayam promising to abolish the anti- copying law. In
December 1993, the BJP lost the polls and the SP-BSP alliance came to power.
When Mulayam was sworn in as chief minister, one of his first acts was to scrap
the Anti-Copying Act. The pass percentage in the following years went up to
over 85 per cent.
Ironically, both
Mayawati and Mulayam, before they embarked on their political careers, had been
teachers. The BJP made mass copying an election issue in 2017 and upon coming
to power in the state, initiated this crackdown on mass copying.
Comparison to countries which started with a similar baseline is telling. India and Indonesia
had similar levels of literacy of sub 20 per cent in 1950. By 1990, Indonesia
boasted of 81 per cent literacy while India was stuck at 52 per cent. The scale
of India's population is cited as a reason for its many failings. China would
have faced the issue too, but between 1950 and 2000, China ramped up literacy
from around 30 per cent to over 95 per cent. India in 2019, in terms of
literacy, is where China was in 1990.
Adult literacy in
Indonesia is at 95 per cent while a fourth of India's populace is classified as
not literate. In 2018, of the 750 million persons in the world who are not
literate, 37 per cent or over 287 million resided in India.
The Organization for
Economic Cooperation and Development evaluates global education systems through
the Programme for International Student Assessment (PISA) tests. In 2012, over
half a million students participated for reading and understanding of science
and mathematical abilities. Chinese students from Shanghai topped the tests in
reading, science and mathematics. India came second from the bottom, just above
Kyrgyzstan. India pulled out of PISA tests the following year.
Electricity
In 2019, nearly 40 per cent of the schools in the
country in India do not have electricity. Similar story for the heath care
centres also with one in four sub-centres, functioning without electricity.
Pace of electrification
At the end of the
first plan in 1957, Only 7,294 of 5.7 lakh villages had electricity. By 1961, the number of villages
electrified rose to 21,754, the pace of electrfication being appallingly slow..
In the sixth five year plan,
in 1980, it was recorded that over half the 5.7 lakh villages in the country
continued to be without electricity and only 14 per cent of all households had
electricity.
Of the total 247
million households in India, eighty-two million urban and rural households
spent the time after sunset in complete darkness as they did not have access to
electricity. This translates to over 400 million people living without any
power.
In 2018, all inhabited villages had been
electrified. Of 177.3 million rural households, 152.2 million (85.84 per cent)
households were electrified. This meant that 25.1 million households in rural
India (roughly one in seven households) did not have access to electricity.
As of 15 September 2018,
only 1,425 villages across the country could boast of 100 per cent electrified
households. Only six states and one union
territory - Gujarat, Andhra Pradesh, Tamil Nadu, Kerala, Punjab, Goa and
Puducherry - could claim 100 per cent household electrification.
On 8 January 2019,
Power Minister R.K. Singh informed Parliament that SEBS were unable to recover
costs on one-fifth of the power supplied. SEBS could not collect any money on
21.42 per cent of the power generated due to transmission and
distribution (T&D) loss. Globally, T&D
losses average between 2 per cent and 8 per cent. T&D losses are 5.5 per
cent in China. At 21.42 per cent, India does worse than Pakistan, Sri Lanka and
Bangladesh .
Security
In early 2019, Delhi
Police released some statistics - every day, five women are raped and eight are
molested in Delhi. In 2016, nationwide cases of theft, dacoity and burglary recorded were 4.94 lakh. The
maximum cases were from Delhi, followed by Maharashtra and Uttar Pradesh.
On average, around
ninety banks are looted every month across the country. Shockingly, rape of
foreign women is high enough to be a data classification category for the NCRB. NCRB records show that
on average, nearly 100 women are raped every day, with four rapes every hour.
A UN study suggests
that the median is 303.3 police officers per 100,000 population.On paper, the national
average of police per lakh population is 193. In reality, it is barely 151 per lakh
population. Fourteen of the most populous states are below the
UN-stipulated ratio. Bihar, one
of the most backward, has seventy-four police personnel per lakh population.
Uttar Pradesh, with a population of over 230 million, has ninety police persons
per lakh people. West Bengal, which is the hotbed of political violence, has
102 police persons per lakh population.
The title chosen by
the author ‘The Gated Republic’, reflects the phenomenon of mass exit, of millions of
Indians disinvesting from faith in government delivery of services. There is a mass
exit towards and into gated solutions, each a republic of its own. Millions of
Indians are disinvesting from hope in the government's promises and adopting
alternatives in the wake of such glaring public policy failures.
The world over, the
migration to private paid-for services is driven by rising income levels. In
India, the migration of taxpaying citizens entitled to public services is
driven by falling levels of service. The dilution and decimation in
accountability propels the exit of even those who cannot afford to do so. Over six of ten students in the poor and
populous state of Uttar Pradesh attend private schools. Indians meet as much as
64 per cent of healthcare costs out of their own pockets. Nearly 730 million
people – more than twice the population of the US – are living without access
to piped water.
The earlier book by Aiyyar, Accidental India, had somewhat stuck an optimistic and upbeat note about India. For all its sluggishness and policy ambiguities, the Indian state seemed to find a way to stumble onto the correct path somehow, and the road to prosperity and progress seemed to be a possibility in the not too far future.
Not this book however. The book presents a bleak and dark outlook. There seems to be no solutions to the mess India seems to be in for the foreseeable future.
