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The World Health Organisation introduced the Healthy City
Project in India
in the early 1990s, beginning with a few seminars and workshops for advocacy
and awareness for professionals who would in future take up Healthy City
Projects. This was the first stage of Healthy
City activities in India.
Subsequently in 1998-99 the project was introduced in the
four metropolitan cities of Bangalore,
Kolkata, Mumbai and Delhi for
research, training, development of information systems and IEC materials and
location-specific “settings” activities such as solid waste management,
cleaning of markets, etc. The settings approach, as known, is a WHO concept
for local action and can be used when resources are limited or the magnitude
of the task demands piecemeal or gradual development or management. A
“setting” is a defined area with specific characteristics that enables easy
handling of developmental work. Hence, there could be several settings within
a city. At the same time, a city could be a setting in a regional context. In
a country like India
this approach is appropriate, as municipalities suffer from shortages of
resources, often resulting from poor collection of taxes, especially the property
tax, rates of which have not been revised for many years. In addition, many
training programmes were organised in different cities of the country for
capacity building of officials, municipal personnel and the
community/grassroots workers to promote the development of Healthy Cities.
In the same biennium of 1998-99 a pilot project was
undertaken with the support of the Government of India and the sponsorship of
the WHO. Kottayam, a small town in Kerala was selected for detailed Healthy
City activities like formulation
of Healthy City Plans, institutional arrangements for city/neighbourhood
management through community participation, Healthy Setting competitions and
so on. The Kottayam activities were highly successful.
In the biennium of 2000-2001, Nagpur
and Bhubaneshwar were selected for advocacy, while Hyderabad,
Mirzapur and
Vrindavan were selected for the formulation of action plans. While Hyderabad
did not respond for want of an elected representative, Vrindavan worked out a
Healthy City Plan that could not be funded because of shortage of resources.
It was only Mirzapur, a small city in the State of Uttar
Pradesh in India
that took up the work in right earnest. However, the path to success is
fraught with difficulties.
 The Mirzapur Healthy City Project
 Mirzapur
is a small city with a population of around 200,000. The city is located on
the banks of the River Ganga, which is considered to be a sacred river, with
the renowned temple of Vindhyachal
situated on its bank to the northwest of the city, dating back to prehistoric
times. The city of Mirzapur has,
therefore, been a centre of attraction from time immemorial. It is also a
large carpet-weaving centre in northern India.
The Mirzapur Healthy City Project was launched with the
objective of preparing a Healthy City Plan with the help of the local
government and the community. A two-day Brainstorming workshop was conducted
in December 2000, followed by a Local Taskforce in February 2001. The idea
was to begin the project by assessing present conditions and identifying
needs. The departmental heads of the Local Government were requested to write
the status papers of the different sectors of city development in order to
identify the future needs. This took some time.
However, the identified gaps still require further
analysis, before action plans can be made for implementation. The main
difficulty of the municipal officials was lack of experience in project
formulation and documentation. It was, therefore,
felt that there is need to include training on project formulation and
documentation for Healthy City
development. This would be done in the subsequent stages of the Healthy City
Project. However, the overall status of the city infrastructure is known.
The Mirzapur Nagar Palika Parishad (the local government)
has extensive GIS information from a previous community development project,
on the basis of which a Guide Atlas has been brought out for planning for a Healthy
City. This Guide Atlas is the
first of its kind in the development of Healthy Cites. It is a unique
contribution of a multi-level planning process, which can be adopted globally
for the planning and development of Healthy Cities. The Guide Atlas is
divided into four parts. Part one narrates the Healthy
City concept and its principles.
Part two explains how infrastructure planning can be done for a city
vis-à-vis the population distribution. Part three synthesizes the spatial
distribution of infrastructure and illnesses to indicate gaps in service
provision for further development within the city. The fourth and the final
part indicates how neighborhood planning can be done
with the help of GIS. This part also shows how information on properties can
be maintained.
 Since
a complete picture of the city’s disease burden was absent, a household survey
was done to get an idea of the prevailing illnesses. The data analyzed and
included in the Atlas are therefore that of self-reported illnesses. This
data was used to highlight the cause and effect relationship between diseases
and the available utility infrastructure. However, today in Mirzapur,
municipal management takes the help of the computerized data stored in the
municipality’s computers, especially for property tax billing and for
identification and inspection of properties.
Meanwhile, advocacy for making a city healthy had begun
through a citywide election rally. This was followed by school campaigns and
display of banners on occasions. Posters were pasted all over the city to
disseminate knowledge of the Healthy City Project. Since awareness creation
is quite time consuming, each section of the society has to be informed at a
different level. However, today the citizens of Mirzapur are aware of a
Healthy City Project that aims to make the city clean and environmentally
sound.
The need for action at the grassroots level is all what
community participation is about. The local government should initiate such
participation. This is taking time. The local government has so far not
contributed any resource. Hence more efforts will have to be made to make the
citizens understand that their city will have to be looked after by
themselves and not by others. Some kind of public-private partnership should
be introduced for city development. Mirzapur is known for its carpet
industry. Hence, the business community should collaborate with the local
government to improve the city. After all, the business community is drawing
benefits from the city’s infrastructure.
 The
“settings” approach for development has also been adopted for a few
developmental activities. Toilets in a few schools were upgraded; tree guards
put for a few recently planted trees and two closets for changing clothes
after bathing in the river (which is the culture of the place as the river is
considered to be holy) have been set up for women.
With the expansion of the project to the district, in the
biennium 2002-2003, which includes both rural and urban, twelve
underprivileged villages (one in each administrative block) have been
selected for improvement. From the city one slum has also been selected for
pilot activities. These are illustrative villages from where the entire
district will learn. The villages are part of U. P. Government’s programme of
helping under-privileged villages called “Ambedkar” villages. Efforts are
being made to converge development programmes, so as
to help each other and to economize on resources. Health camps were organized
to make people aware of the Healthy District Project and to get an idea of
the nature of problems prevailing in these villages. Sample surveys have also
been conducted to do “need assessments” for these villages, so as to learn
about the health problems and the shortage of utility infrastructure in the
twelve villages and the city slum.
The purpose of carrying out these activities is to make
people aware of environmental hygiene and to elicit their participation in
planning for basic infrastructure development and maintenance. A step-by-step
process has been adopted. The different stages of Healthy
City development will be as
follows:
 Assessment of the existing status of utility
infrastructure and land use
Sample survey of households for collecting
primary data on self-reported illnesses, income and education
Analysis of the spatial distribution of
illnesses vis-à-vis population density and existing infrastructure
Drafting of thematic maps for situational
analysis
Developing a Guide Atlas for Healthy City
Feedback to the Local government for
improvement in infrastructure.
Alongside the formulation of the Atlas, advocacy campaigns
were carried out in the city and in schools, followed by health camps and
need assessment surveys. Students were made to do the survey, so that they
get initiated into the Healthy City
concept. The issue is of changing the mind-set of the people to get involved
in the planning of the city, as well as its upkeep. The focus is to involve
the community at all levels. Apart from an overall consciousness for every
citizen, students are being targeted as the future citizens. Only then will
the process be sustainable.
In working out the Healthy City/District activities, the
support of the Local and the State governments is essential. All the work is
being done in close association with the two governments, as it requires
multi-sectoral and multi-level planning. However, private participation is
yet to be solicited.
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