My life, your life

12.04.2020

I presume the lock down in Mumbai/India is because we as a people care for life and would not like to see people dying or incapacitated. Logically speaking, shouldn’t that concern extend to many other areas of the city’s day to day functioning where thousands of lives are lost annually? But is that so?

The lock down perplexes me as someone who has spent a lifetime being involved with numerous environmental, civic and governance issues. At the heart of those efforts have been arguments, which invite concern and need for urgent action towards the life and well being of the citizens of Mumbai. Resolving any of those issues would not require anything as severe as the lock down and many more lives would be saved on an ongoing basis.

What explains this imbalance in approach? I will take one such issue to elaborate on. There could easily be a dozen such case studies, from housing conditions, to quality of air, safety in transport, flooding, tuberculosis and more.

In any given year in the past three decades a minimum of 2000 people have died every year in what is called as the lifeline of Mumbai – the Mumbai Suburban Railway System (MSRS) – that is 2000 people dead every year for 30 years. The total comes to 60,000 people dead. A jaw dropping number by any scale of comparison – a genocide as some would describe. Then there are those who have been grievously injured but not died, and from that subset there must be people who would be better off dead than living.

A significant number die because they just happen to fall off from trains which are packed beyond imagination during peak hour. One moment they are holding on to the grab pole or any other part of the train which they can lay their hand on, next moment they have fallen off from a speeding train resulting in immediate death or grievous injury. In some cases, someone’s head has smashed against the signal poles because they are part of the dangerous bulge out. Others died because in the Mumbai that has grown post-independence the Indian administrators for long did not bother to provide adequate infrastructure for the crossing of railway tracks.

I took up an investigation into those deaths in a detailed manner exactly a decade back as Research Fellow at the Observer Research Foundation, Mumbai. That concluded in co-authoring the report Killer Tracks with Dhaval Desai and Deepa Dinesh.

The lock down happened in a matter of a week or ten days of calculation and the concern arising during that duration. And it is seen as the absolutely right thing to do if we are to avoid thousands of deaths. We have done what has never ever happened before in the history of the city, not during World War II, not during the Spanish flu and not even post the Babri Masjid riots though we are close. We have locked down the city for 21 days and may extend it for a few more weeks, all in the interest of saving lives. A city which is the hub of economic activity, the business hub of the country, overnight seeing its functioning being pulverised.

The Prime Minister and many Chief Ministers and bureaucrats are being lauded as guardians of the health and life of citizens. What explains the differences in concern shown by these guardians? Why such a swift response in case of one danger to life and why no resolution even 30 years into the ‘genocide’ on the railway system and many other such issues of concern?

The same offices of Prime Minister and Chief Ministers and bureaucrats and institutions oversee both the issues and have so for decades. In many cases it is the same individuals who have also held influence and only grown in power – the current Maharashtra Chief Minister being only one such example.

I believe it is the democratic nature of the virus – that the virus goes after the most entitled and the most marginalised equally – which has got India worried and locked up and not a value system which has concern for life at its foundation. The ruling elite in India rarely face the consequences that India suffers as a result of their villainy, ineptitude and selfishness. Invocations and stories about karma and justice populate Indian daily discourse and imagination but none of which sees proof in real life just like the case with most Indian laws.

In a rare occasion the ruling elite are faced with no small threat and have acted swiftly. And again, to their considerable advantage while transferring the disadvantage and hardship to the marginalised or those who may be elite but not ruling. Without the lock down the virus could well be taking a toll of the ruling elite. That elite does not face threat by falling off trains or dying in the corridors of public hospitals for want of ICU beds or from tuberculosis as a result of living in inhuman dwellings or as pedestrians crossing roads or railway tracks. Now they have built a new moat for themselves.

Had the virus been something which would have spared them and left only the vulnerable sections affected and dealing with the overwhelmed public health system chances are we would not have been locked down. There would have been hue and cry and a lot of posturing and politics but no lock down. Life would have continued in the corridors of power and elsewhere while televisions showed heart rendering footage and the usual howling and shouting. It is because we the people can suddenly become transmitters of this virus, which can then hurt them that Covid 19 has become a problem worth attending to.

In case of the MSRS deaths there has been 30 years to plan the cities land use and transportation systems in a way that the train system does not see such dangerous crowding levels; people may be inconvenienced and face crowds but will not die while undertaking a daily commute critical to earn their livelihood. All of the knowledge is available and ready for use. That same elite has given grandiose illusions of making the city into a Singapore first and then a Shanghai.

30 years is a long period of time. It is also a period of time from teenage onwards when I have had my deep engagement with numerous civic and environmental issues of the city of Mumbai, which has been the only city I have stayed in, all my adult life. I have seen the evolution of new institutions and policy instruments, partnerships and budgets and five Chief Ministers of Maharashtra pass by during the duration. I have through various permutations and combinations, been part of numerous advocacy efforts to save those lives.

To be correct the system has seen an order of magnitude of improvements during this decade. It is almost unrecognizable from what it was in the last century. And yet the deaths continue. I will not even touch upon the stress levels and the usual user experience benchmarks.

Rapid economic growth through the 90s and 00s and consequent dynamic and rapid changes in housing along a number of new and existing nodes has meant that as capacity increases it has mostly helped ease legacy pressure but has then faced additional pressure from new commuters being added. The same government framework, which has successfully locked down the city is also the one, which decides on this dynamic nature of the city; where additional housing should develop, how it can be affordable, where offices should develop, transport policy, how much people should commute and whether to show concern and compassion for life in taking these decisions or not.

The ruling elite have in this case chosen to enrich themselves in the past three decades at the cost of the welfare of the citizens whose votes and taxes provide them with the power and heft. Instead of judiciously using the land stock in the city the same has become a playground for the most brazen of desperadoes who have carved out and leveraged that land for unimaginable bounties. The 10th century attacks on Indian temples from Central Asian horse mounted raiders has a very evocative touch and feel relatability to any Indian and I can invoke that as an example. This same political and business class has behaved in no less brutal and violent a manner in looting the citizens of Mumbai from what was rightfully theirs and left death, bloodshed, misery in trail with an added insult of intimidation for any protest or efforts to counter their butchery.

And this is the same ruling elite, which over the same past three decades has supported and liberally funded the Ram Mandir campaign. A ruling elite, which cannot provide the right kind of governance will plunder one city and go build a temple in another city, which is nowhere even close on the aspiration list of the same elite for their leisure and business and partying trips and translocation if need be.

This framework – the ruling elite – has in its power to shape the public health system (in Mumbai or elsewhere) which currently is a metaphor for the word third class. It is the lack of such a public health system, which has been a big deciding factor in the lock down checklist. The ruling elite does not have to suffer the consequences of this broken-down public health system.

Now for the irony. Those killed in the Mumbai Suburban Railway System are all in the prime of their age, the demographic dividend of which we (again “we”? Or is it the Indian elite propaganda machinery?) are proud as a brahmastra in the race for global dominion and economic opportunities. They are earning members of their families, are consumers, paying EMIs or repatriating funds to dependents in their villages. In comparison those most vulnerable to the COVID 2019 virus are the elderly and those with weak immune systems or severe comorbidity – existing patients suffering from diabetes, heart disease or cancer. Not exactly the most productive elements of the society. And while we should show compassion for the elderly and the ailing but then why is our balance of favour so skewed?

I could speak at length about many other issues which I have been involved with where sanctity of life is central to the arguments and where we have only been losing to this kleptocracy and brutal ruling elite. I could flag two issues – the brutal relocation of the poor and marginalized through government rehabilitation schemes in Mankhurd and Mahul. Living hells which have introduced the residents to life threatening exposure to tuberculosis and chemical pollution.

In Mumbai, at the least the lock down should help save the number of lives that are lost to the MSRS annually, at best it would be equal to the decadal number of 20,000. 20,000 lives saved after pulverising other aspects of life. People will argue that if there was no lock down then the casualty would be too large to explain for. Maybe one lakh people dead, maybe two lakhs. We do not have that many hospital beds or ventilators to handle the backlash. I would say please wake up. Please direct that energy towards making your MPs and institutions accountable.

[Co-author of the report Killer Tracks by ORF Mumbai 2015, Member of Committee formed the same year by then Minister of Railways Mr. Suresh Prabhu.
Long association with transport and governance improvements in Mumbai as an activist and campaigner.
Founder and Director of Mumbai Sustainability Center]

First visit to KEM

Amidst the slowdown, I am reminded of my first visit to KEM Hospital – one of the oldest and largest public hospitals in Mumbai run by the municipal corporation. A senior friend had developed serious complications and had to be admitted to the ICU section. The photos below are from December 2018.

There are talks currently of supporting the government, to not be critical, that no government could handle such a situation, that citizens are not doing their bit, that the poor and uneducated should follow rules.

The below commentary is for the well fed citizenry making this commentary. I am not interested in bring critical of Modi or of the government. I have better things to do than waste my time with them. But this is just to provide perspective for those who are saying that the government cannot do anything in such situations. The time to add more ICU beds and ventilators and testing capacity is during non-epidemic times when the temple is the priority.

The conditions in the ICU section were heart rendering. To imagine that the doctors go through this every single day left me sympathising.

There were a total of 15 (yes 15) ICU beds and there was a steady stream of patients pouring in. It was about 9pm that we had reached and in a poorly lit corridor I could see patients being stabilised on the floor of the corridor, on beds, in arms. Through influence of his family members my friend was able to jump the queue and be provided with a bed but not without final mile challenges in that corridor.

Poor families crowded the corridor, everyone of them shouting out for doctors to attend to their family member, at times pulling at a doctor who was already attending to someone else, leading to heated exchanges and security having to step in.

I could realise that some of those brought in would possibly be taking their last breath on the floor of the corridor awaiting help.

In the reception a large portrait of the founder of Shiv Sena the Late Bal Thackeray and his wife adorned. The political party he founded, Shiv Sena has been in control of the Mumbai municipal corporation since 1995 and under whom this public hospital comes. They and other Hindu right wing party BJP have been in coalition since till only recently.

Outside the hospital were political banners where more pressing were attended to – the Shiv Sena putting the BJP on the mat over the Ram Mandir issue and posturing that they were not hungry for power but deeply felt for an early construction of the temple over their coalition with the BJP.

That coalition had till then been in the saddle for three years at the State government level and 20 years in the municipal corporation running the KEM Hospital. And they could not bring the ICU bed tally to a respectable 100 also. Pehle Mandir, phir sarkar. First temple, then government. ICU beds and adequate ventilators would be way bottom in the list.

Inside patients gasped, doctors overstretched. Overstretched seems mild to describe. I am not sure how they could they be having the frame of mind to make an accurate diagnosis and then administer the right course of action. But miraculously they were. During my short visit (Over following 2-3 days) I could see happy recovering patients in the ICU section including my friend.

The hygiene levels were alarming and a health crisis on their own. Toilet facilities inadequate and repulsive.

The ICU bed equipment had paan spit at the bottom. Though air conditioned, I was not sure of the air quality.

After a few days my friend was shifted to the general ward. That was another experience all together.

The architecture and campuses and the very idea of having so much space in a central part of the city devoted for an essential public service makes me happy.

The highlight of the general ward really was one of the toilets. I could just take the photo from the outside for this particular toilet. Inside on the left the condition of the toilet was beyond nauseating. It just left me without any sensation.

I am used to take photos of garbage and bad sanitary conditions but I have never seen anything like that. It was like somebody had taken a spray gun and filled its container with excreta and just sprayed the whole toilet finely with the shit. The shit was all over. People must have come in a state of diarrhea or desperation and just shat on previous piles of shit and whenever they could make place. This was a government toilet facility of a government running Swachh Bharat Abhiyan.