The matter of stunting in the Ganges Plains
Larry H. Bernstein, MD, FCAP, Curator
LPBI
Nicholas Kristof wrote had an excellent Op-Ed in the Oct 15, 2015 NY Times. There is some relevant background on tranthyretin and protein-energy malnutrition that I have previously posted relevant to the discussion, and there are also specific religious beliefs as well as climate change and pollution factors that can’t be ignored.
Water and Climate in the Himalayas
The mountainous states of India, and the nations of Nepal and Bhutan share one of the world’s greatest freshwater resources — water from the snows of the Himalayas and the monsoons which the mountains create. More than 1.4 billion people depend on water from the rivers of the Himalaya, with the eastern rivers like the Ganges much more dependent on rain and groundwater than on direct flow from glaciers. Glacier melt is only 4 percent of the annual 220,000 billion cubic meters of flow for the rivers of Nepal, which feed the Ganges, as estimated in a recent report. One of these rivers is the Trisuli, in this photograph flowing down past Betrawati from the Langtang region of central Nepal.
On a recent journey to Uttarakhand, India, and Nepal, with support from the Karuna Foundation US, the use of water and its abundance, scarcity and quality as our climate changes was crucial everywhere we went. The photos and research presented here were made through the gracious cooperation of the Uttarakhand Environmental Education Center (UEEC), World Wildlife Fund – Nepal (WWF), and The Mountain Institute. Additional information is from International Centre for Integrated Mountain Development (ICIMOD) reports, other NGOs and press reports.
http://www.worldviewofglobalwarming.org/himalaya_1/02NepalKathmanduVishnumatiRPolluted2613.jpg
Water flowing down from the Himalaya is mostly abused and polluted as it flows through the cities, even though the water is needed for human use. In Kathmandu, rivers like the Bagmati and its tributary the Vishnumati (also called Bishnumati), seen here, are public and industrial dumps of every kind of waste, despite frequent public awareness campaigns and periodic clean up attempts. As the Nepal Times put it, “The Bagmati River is an open sewer.” Nevertheless, people use the water for washing, household use, rituals, and for funeral ceremonies at ghats, including at the holy Hindu temple of Pashupati. The Bagmati is a snow- and rain-fed, not glacial river, and the Vishnumati, only 18 km long, is entirely supplied by rain and groundwater.
Nepal is extremely rich with water, with more than 6,000 rivers and the rains of the monsoon. Yet, according to a report by the International Water Management Institute, more than a quarter of the 29 million population has no access to safe drinking water and “little consideration is given to environmental requirements.” In the Himalayan foothills, where rivers and groundwater are much less polluted than in the cities and valley, seasonal water shortages and lack of safe in-home water supply nevertheless affect most people. We saw families and mothers stooped over to fill bottles, jugs and pans with water leaking from pipes that were snaking down dirt streets in the village of Kalikistan, Rusuwa, Nepal. The pipes supply the village of Jibjibe, but leaks spurted and dripped along the 2 km route, part of which was temporarily suspended across a raw landslide scar (see the Landslides photo set for more about this).
Gesturing broadly up to the surrounding mountains, primary school teacher Dessli Rai of the village of Torke Maimajhuwa, Nepal, tells us there are now no long-lasting snows after winter and thus much less water in the spring pre-monsoon season. The 50-year-old said the change has been noticeable for more than a decade but seems to be increasing. Small streams flowing down from the hills in this area north of Ilam now are drying up, “completely finished, day by day,” in March instead of flowing for two more months. His observations were commonly repeated by others we met in the region: It used to snow heavily at around 2400 m and below, up to a meter in depth and the snow would remain to provide meltwater over several months. In the neighboring Indian state of Uttarakhand, “it never snows in Almora anymore,” said Anuradha Pande of the UEEC. Recent studies reported by ICIMOD found that it has not snowed in Almora, eleveation 1600 m, for 3 to four years and that the lack of snow at medium elevation locations removed “an important source of water for agriculture.” Farmers reported “delayed and erratic rainfall during the rainy season followed by prolonged dry periods.”
In the dawn, four women carry water containers from a spring into the village of Chausali, near Almora, Uttarakhand, India. Women are particularly affected by climate changes due to their daily work which includes getting water, collecting forest wood and fodder, and working in dangerous landslide areas near villages. Researchers of the Indi-German Environment Programme found that, “In the fragile ecological zone in the hilly areas of Uttarakhand, human activities, including agriculture, cause extensive land degradation which, in turn, adversely affect water retention and recharge. The problem of water shortage, exacerbated by extreme weather events such as erratic rainfall, cloudbursts, unpredictable temperatures, etc. leads to detrimental effects on agriculture, forestry” and even manufacturing.
More than 15 women wait as a very slow flow from another spring in Chausali, India, fills their water containers. Several springs in this area have dried up, causing the community to change the traditional division among castes. Women here are limited to filling one container a day. Previously different castes used separate springs, but now upper and lower castes are using the same water sources. Across similar Himalayan foothills areas, inhabitants told ICIMOD researchers in 2011 that local drinking water sources seemed to be drying up; and “on average, they reported a 50 percent decrease in drinking water sources.”
The last of the water from a cistern in Chausali village is drawn up by Bhem Singh Latwal and his wife Kamla Latwal in early March — a time when late winter rains would be expected to have at least partially refilled the underground tank. But in recent years winter rain is scarce, they said. This cistern, fed from rain falling on roofs of the family buildings, was built in 1952 to supply livestock and irrigate the garden. Recent aid from the Indo-German Environment Program through UEEC in the Almora area has helped build new water-conservation facilities like erosion control dams, rooftop rainwater harvesting systems, rejuvenation of springs and catchment areas. The goals of this and other UEEC work include increased availability of drinking and agricultural water, increased soil moisture, and reduced health impacts of drought.
Throughout the Himalayas, most people in villages do not have piped in water but must rely for household use on public roadside taps from springs or catchments. Many community water sources are drying up in the foothills and mountainous regions of Nepal at the same time that regional temperatures are rising at a rapid rate. Studies published in 2011 showed that the “region is one of the world’s hotspots in terms of warming trends.” An ICIMOD report on water in the Himalaya said that the mean maximum temperature in Nepal increased by 0.06 degrees C per year between 1977 and 2000 — equivalent to more than a degree F per decade. In Nepal just as in India, there are already signs of changes in the dates of the onset and retreat of the monsoon as well as the number and frequency of extreme precipitation events, according to scientific research published by ICIMOD.
In the Nepalese village of Jibjibe, a Village Development Committee of Rasuwa District, the family and neighbors of farmer Bhawanath Paudel fill a hand-dug water storage pond. Jibjibe is a village of about 4,000 people which like many mountain hamlets spreads down a steep hillside notched by agricultural terraces above the Phalankhu River. Over the years the townspeople have dealt with uncertain water supplies by building three reservoirs, the water from which runs down past houses in small pipes but is rationed during droughts. When water is flowing, farmers irrigate their vegetable crops like onions, peas, tomatoes, mustard and cabbage and fill small ponds to save the water. Locally-run programs in farmer education, climate change education, and water management have advanced with advice and encouragement of the World Wildlife Fund.
The Ganga’s main stem and tributaries drain more than one million square kilometers of China, Nepal, India and Bangladesh. The Ganga basin in India, which includes the Yamuna sub-basin, covers one fourth of India’s geographical area. From the confluences of the Bhagirathi and the Alaknanda tributaries in the Himalayas, the river Ganga gains additional flow from Nepal’s tributaries, glacial snowmelt and monsoon rainfall. Now the basin’s sediment loads, which are integral to the river system, are driven by the deforestation of the Gangetic plains and construction across the Himalayan regions. For at least two and a half millennia, the river Ganga has nourished human civilizations and great dynasties, and Hindu and Buddhist pilgrimage places have grown up along the riverbanks. By the 4th century BCE, Pataliputra (now near Patna, the capital of the state of Bihar) was one of ten ancient capital cities of India. At the headwaters of the Ganga in the Himalayas, sacred shrines at Gangotri, Kedarnath and Badrinath establish the sources of the river’s sacred power in the Hindu traditions. The temples of Kedarnath and Badrinath rest at the snouts of Himalayan glaciers. Farther downstream in the sacred towns of Uttarkashi and Rishikesh and along the plains at Haridwar, Allahabad (Prayag), Banaras, Vindhyachal, Nadia and Kalighat people worship Ganga’s waters through rituals of purification. The Ganga has been worshipped as a river goddess by Hindus across India and the world. According to the Hindu view, sacred spaces are not detached from ecology and the built environment but are embedded in them; Hindu texts and rituals explain this conjunction of divine power and the physical world. In this integrated view, Ganga is a goddess who absolves worldly impurities and rejuvenates the cosmos with her purificatory power. She is also a mother who cleans up human sin and mess with loving forgiveness. Hindus show their respect to her in oil lamp rituals (arati) performed on the riverbank and in temple worship (puja). Most importantly, devotees seek spiritual purification by doing ritual ablutions (snan) in the river.
Today more than 800 million people reside in the Ganga basin. From the Himalayas to the Bay of Bengal, the Ganga passes by more than 30 major cities of 300,000 or more residents and borders many smaller towns and agricultural tracts. The Ganga provides municipal and industrial water for these cities and they return polluted wastewater to the river system in great quantities.(see Central Pollution Control Board http://cpcb.nic.in/water.php) The Upper Ganga plain in the state of Uttar Pradesh is home to sugar factories, leather tanneries, textile industries of cotton, wool, jute and silk, food processing industries related with rice, dal and edible oils, paper and pulp industries, heavy chemical factories, and fertilizer and rubber manufacturing units. Industrial wastewater is discharged by all these industries and contains hazardous chemicals and pathogens. Four major thermal power plants depend upon water from the Ganga.
Water quality in river streams affects and is also affected by ground water tables that are depleted by over-pumping for agriculture. When surface water is polluted and rendered unusable for human purposes, residents turn to groundwater for domestic, municipal, agricultural and industrial needs and this leads to further depletion. The groundwater supply also needs to be recharged by river flows. When hydroelectric dams and canals divert water to needy urban centers they affect this recharge rate. In the warming climate, more rapid and extensive glacial melt may bring more water into the river system at some times of the year but this increase in volume and change in the timing of melting can lead to flash floods especially in riverbeds that have become disembedded from ecological and hydrological systems by dams and diversions. Increased rainfall and glacial melt may help to recharge groundwater and dilute river pollution but they may also lead to dangerous and deadly flooding.
J Environ Qual. 2001 Mar-Apr;30(2):356-68.
Effect on water resources from upstream water diversion in the Ganges basin.
Adel MM1.
Abstract
Bangladesh faces at least 30 upstream water diversion constructions of which Farakka Barrage is the major one. The effects of Farakka Barrage on water resources, socioeconomy, and culture have been investigated downstream in the basins of the Ganges and its distributaries. A diversion of up to 60% of the Ganges water over 25 yr has caused (i) reduction of water in surface water resources, (ii) increased dependence on ground water, (iii) destruction of the breeding and raising grounds for 109 species of Gangetic fishes and other aquatic species and amphibians, (iv) increased malnutrition, (v) deficiency in soil organic matter content, (vi) change in the agricultural practices, (vii) eradication of inland navigable routes, (viii) outbreak of waterborne diseases, (ix) loss of professions, and (x) obstruction to religious observances and pastimes. Further, arsenopyrites buried in the prebarrage water table have come in contact with air and formed water-soluble compounds of arsenic. Inadequate recharging of ground water hinders the natural cleansing of arsenic, and threatens about 75,000,000 lives who are likely to use water contaminated with up to 2 mg/L of arsenic. Furthermore, the depletion of surface water resources has caused environmental heating and cooling effects. Apart from these effects, sudden releases of water by the barrage during the flood season cause devestating floods. In consideration of such a heavy toll for the areas downstream, strict international rules have to be laid down to preserve the riparian ecosystems.
Environ Int. 2006 Aug;32(6):831-49. Epub 2006 Jun 16.
Ecological and toxicological effects of inorganic nitrogen pollution in aquatic ecosystems: A global assessment.
Abstract
We provide a global assessment, with detailed multi-scale data, of the ecological and toxicological effects generated by inorganic nitrogen pollution in aquatic ecosystems. Our synthesis of the published scientific literature shows three major environmental problems: (1) it can increase the concentration of hydrogen ions in freshwater ecosystems without much acid-neutralizing capacity, resulting in acidification of those systems; (2) it can stimulate or enhance the development, maintenance and proliferation of primary producers, resulting in eutrophication of aquatic ecosystems; (3) it can reach toxic levels that impair the ability of aquatic animals to survive, grow and reproduce. Inorganic nitrogen pollution of ground and surface waters can also induce adverse effects on human health and economy. Because reductions in SO2 emissions have reduced the atmospheric deposition of H2SO4 across large portions of North America and Europe, while emissions of NOx have gone unchecked, HNO3 is now playing an increasing role in the acidification of freshwater ecosystems. This acidification process has caused several adverse effects on primary and secondary producers, with significant biotic impoverishments, particularly concerning invertebrates and fishes, in many atmospherically acidified lakes and streams. The cultural eutrophication of freshwater, estuarine, and coastal marine ecosystems can cause ecological and toxicological effects that are either directly or indirectly related to the proliferation of primary producers. Extensive kills of both invertebrates and fishes are probably the most dramatic manifestation of hypoxia (or anoxia) in eutrophic and hypereutrophic aquatic ecosystems with low water turnover rates. The decline in dissolved oxygen concentrations can also promote the formation of reduced compounds, such as hydrogen sulphide, resulting in higher adverse (toxic) effects on aquatic animals. Additionally, the occurrence of toxic algae can significantly contribute to the extensive kills of aquatic animals. Cyanobacteria, dinoflagellates and diatoms appear to be major responsible that may be stimulated by inorganic nitrogen pollution. Among the different inorganic nitrogenous compounds (NH4+, NH3, NO2-, HNO2NO3-) that aquatic animals can take up directly from the ambient water, unionized ammonia is the most toxic, while ammonium and nitrate ions are the least toxic. In general, seawater animals seem to be more tolerant to the toxicity of inorganic nitrogenous compounds than freshwater animals, probably because of the ameliorating effect of water salinity (sodium, chloride, calcium and other ions) on the tolerance of aquatic animals. Ingested nitrites and nitrates from polluted drinking waters can induce methemoglobinemia in humans, particularly in young infants, by blocking the oxygen-carrying capacity of hemoglobin. Ingested nitrites and nitrates also have a potential role in developing cancers of the digestive tract through their contribution to the formation of nitrosamines. In addition, some scientific evidences suggest that ingested nitrites and nitrates might result in mutagenicity, teratogenicity and birth defects, contribute to the risks of non-Hodgkin’s lymphoma and bladder and ovarian cancers, play a role in the etiology of insulin-dependent diabetes mellitus and in the development of thyroid hypertrophy, or cause spontaneous abortions and respiratory tract infections. Indirect health hazards can occur as a consequence of algal toxins, causing nausea, vomiting, diarrhoea, pneumonia, gastroenteritis, hepatoenteritis, muscular cramps, and several poisoning syndromes (paralytic shellfish poisoning, neurotoxic shellfish poisoning, amnesic shellfish poisoning). Other indirect health hazards can also come from the potential relationship between inorganic nitrogen pollution and human infectious diseases (malaria, cholera). Human sickness and death, extensive kills of aquatic animals, and other negative effects, can have elevated costs on human economy, with the recreation and tourism industry suffering the most important economic impacts, at least locally. It is concluded that levels of total nitrogen lower than 0.5-1.0 mg TN/L could prevent aquatic ecosystems (excluding those ecosystems with naturally high N levels) from developing acidification and eutrophication, at least by inorganic nitrogen pollution. Those relatively low TN levels could also protect aquatic animals against the toxicity of inorganic nitrogenous compounds since, in the absence of eutrophication, surface waters usually present relatively high concentrations of dissolved oxygen, most inorganic reactive nitrogen being in the form of nitrate. Additionally, human health and economy would be safer from the adverse effects of inorganic nitrogen pollution.
Dirty Water
India and China share a grave environmental problem—extreme water pollution
BY SHARON GUYNUP
The hazy dawn knits river to sky on the banks of the holy Ganges river in Varanasi. Even at sunrise, the city’s 4.5-mile waterfront bustles. Bathers brush their teeth, soap themselves, and scrub their children. Legions wash laundry, gather water, and scour dishes. Men swim and lounge on ghats (steps that descend into the Ganges). Black noses and curving horns betray the presence of submerged water buffalo.
Women in bright saris gather in groups or with their families at the water’s edge. Up to 60,000 pilgrims journey to this sacred, 3,000-year-old city from across India each day. They sculpt altars in slick, gray mud, making offerings of flowers and candles. They pour Ganges water, pray, take a sacramental sip and immerse themselves in the turbid river for spiritual healing.
At the “burning ghats,” flames consume the bodies of the dead: Hindus believe casting their remains into the Ganges guides their souls to heaven. To them, this river is the mother goddess, Ganga Ma, who washes away humanity’s sins.
Four hundred million people rely on the Ganges watershed for drinking water, including Varanasi’s 1.6 million residents. But along its 1,560-mile journey from the Himalayas to the Bay of Bengal, the river absorbs raw sewage from 116 cities. Waste has turned these waters into a highway for viruses and bacteria, including deadly, dysentery-causing microbes like E. coli O157 and Shigella, and those that cause cholera, hepatitis A, and typhoid fever. Last year, the Indian government pledged $4 billion for river cleanup to stem the tide of waterborne disease.
But the problem of environmental water pollution extends far beyond the Ganges. Municipal waste, pesticides, and industrial chemicals foul waterways and drinking water across the globe, with the worst pollution concentrated in developing countries. If India’s waterways are the dubious poster children for sewage, then China’s waters take that role for toxic chemicals. Municipal waste is also a severe problem in China, but three decades of meteoric industrial growth have laced lakes and rivers with a witches’ brew of chemicals. Some Chinese waters are now among the most polluted on Earth.
There are few statistics on global health impacts from waterborne chemical exposures, but there is data on fecal contamination. Diarrhea is the second-largest killer of children under five, causing about 1.5 million deaths annually, says Eric Mintz, an epidemiologist at the U.S. Centers for Disease Control and Prevention. India tops that list. Mintz notes that the younger the child, the greater their risk of life-threatening dehydration. Unsafe drinking water, sanitation, and poor hygiene are almost always to blame. In 2006, nearly one billion people lacked access to “improved” drinking water (from a municipal water supply or a deep-dug well), according to the World Health Organization (WHO). Another 2.5 billion lived in homes without a toilet.
Problems on a holy river
Year round, children stream through the emergency room at Varanasi’s Sir Sundar Lal Hospital with illnesses that can be directly attributed to use of contaminated water, says Dr. Ashok Kumar, a pediatrician. They are treated—and quickly re-infected. “As a result, most of these children also have concomitant malnutrition, which further weakens their immunity and makes them vulnerable to more frequent and severe episodes of diarrhea,” he says. They also carry waterborne intestinal parasites like cryptosporidium and giardia, which further stunt their growth and development. For many families, costs are prohibitive, so children don’t get proper medical care—or come too late.
One of the Ganges’s most vocal protectors is Veer Bhadra Mishra, a 70-year-old Brahmin civil engineer and priest of Varanasi’s second-largest temple. In 1982, he founded the Sankat Mochan Foundation (SMF; Sankat Mochan means “deliverer from troubles”) with colleagues from Banaras Hindu University. Their goal was to foster awareness about the causes of Ganges pollution—and to act as guardians, technical advisers and activists to spark river cleanup.
Varanasi generates over 80 million gallons of sewage daily. “The whole city’s nightsoil is coming to the river,” says Mishra. Output continues to rise with the burgeoning population and many of the 33 outflows along the city waterfront are adjacent to the busiest ghats. “If public health is the issue, point-source pollution from untreated sewage is over 90 percent of the problem,” he says.
A lab run by SMF has monitored river water quality since 1993. Downriver, concentrations of bacteria that indicate fecal contamination sometimes top 1.5 million in a 100-milliliter test tube of water. In the U.S., beaches are closed when concentrations reach 200.
Sarai Mohana, one of many “unplanned villages” downstream, is ground zero for Varanasi’s sewage crisis. It lies at the confluence of the Varuna River, where black, stinking water pours into the Ganges and methane bubbles rise from the sediment. No pilgrims come here: the village is home to some of Varanasi’s poorest citizens and the river is utilitarian. Makeshift housing and crop fields dot the shoreline where cows and buffaloes graze or bathe. Fishermen cast their nets nearby, one of them, 35-year-old Nakharu Sahani lives in Sarai Mohana. His family eats fish every day, but they don’t drink from the Ganges. “How could we drink this water?” he asks.
He and other residents lack both sewerage and a piped, treated drinking water supply. They draw foul-smelling, discolored water that sometimes squirms with thread-like worms from hand-pumped wells.
Sarai Mohana was included in the only published study on public use of the Ganges and health. Steve Hamner, a microbiologist from Montana State University, interviewed 104 families at four locations along the river in 2004. “Though it was a small sampling, this study demonstrated a very high incidence of waterborne disease,” he says.
Socio-economic factors influence infection rates. At more affluent sites upstream where people have indoor plumbing, the waterborne illness rate over the previous year was 38 percent. Sarai Mohana had a 90 percent illness rate.
Moves toward cleanup
Mishra has been trying to bring cheap, algae-based sewage treatment to India since 1994. This “advanced integrated wastewater pond system” (AIWPS), developed by University of California Berkeley engineers William Oswald and Bailey Green, has been used in California for 44 years. Treated water meets stringent state standards for irrigation, discharge into a river, or for processing into clean drinking water.
Over 45 days, sewage cycles through an engineered natural system that mimics how nature deals with waste, says Green. In a series of four ponds, bacteria, algae, and sunlight ferment and break down sludge and purify the water, removing 99.999 percent of fecal coliform bacteria.
In February 2009, Prime Minister Manmohan Singh named Ganges cleanup a nation-wide priority, creating the new National Ganga River Basin Authority. The government committed $4 billion to stop the flow of waste into the Ganges by 2020, including a $1 billion World Bank loan. Some of that money will explore alternative technologies. Funding has been approved for a small-scale demonstration AIWPS plant capable of handling 10 million gallons of waste per day. Green’s company, California-based GO2 Water, Inc., and SMF submitted a detailed project design to the government in February. The plant could be up and running by 2011, Green says.
If approved, it would take another five years to design and build a second, larger AIWPS plant just below the city. This energy-efficient plant will be fed by a new sealed, gravity-driven interceptor sewer system that flows downhill, requiring less electricity. It could handle the entire city’s sewage flow.
In 1985, Mishra’s battle to clean up the Ganges helped attract the attention of Rajiv Gandhi, who launched the Ganga Action Plan (GAP). As part of that initiative, the government built a traditional wastewater treatment for Varanasi using what Green considers “conventional, energy-intensive technology developed for cold climates.” The system is ill-suited to the tropics: it requires continuous electricity in a country plagued by constant outages—and when monsoon rains overwhelm pumping stations, sewage never reaches the treatment facility and gushes into the Ganges. The plant treats less than a quarter of the current sewage output.
Most importantly, the process fails to remove pathogenic organisms that end up back in the river. Local farmers also use “treated” effluent to irrigate crop fields, contaminating nearby shallow tube wells.
According to a government audit report, GAP spent an estimated $200 million (901 crore rupees) between 1991 and 2000. For years, officials argued they had met GAP objectives despite empirical evidence that the Ganges grows ever-more polluted. “To put it simply, the plan failed,” Mishra says. “The river has never been close to healthy.”
In 1997, SMF’s proposal for construction of an algae pond system and gravity interceptor sewers was unanimously approved by the city. After the state government scuttled the plan, a subsequent lawsuit languished in the highest court for over a decade.
Until new infrastructure is built, the 40 percent of India’s population that lives in the Ganges river basin will be exposed to waterborne pathogens. Many will get sick; some will die. In-home solutions like water filters, single-dose chlorination and UV disinfection could act as temporary band-aids to purify drinking water. But the only way to curb the transmission of waterborne disease is through effective sewage treatment and access to clean drinking water, says Mishra. “We have landed on the moon and cannot do this?” he asks.
The Red-Brown Yellow River
Northwest across Asia lies another dirty “Mother River,” the Yellow River that once cradled Chinese civilization and remains the country’s spiritual home today. It snakes through 3,000 miles of mountains, plains, and farmland, past dams, factories and cities before emptying into the Bohai Sea. Some years, the mouth of the river runs dry. Though 140 million rely on it for water, certain sections run brown or red, and three-fifths of the river is too toxic for human contact. And no wonder: as of four years ago, over half of China’s 21,000 chemical plants sat on the banks of the Yellow and Yangtze rivers.
In Liangjiawan, a small, blue-collar and farming community, residents unknowingly drank untreated Yellow River water for a few years. Their water treatment plant had malfunctioned and pollutants concentrated when a new dam was built nearby. Villagers were dying of myriad cancers: pancreatic, brain, stomach, and liver. Public outcry led by Green Camel Bell, a local NGO, has sparked construction of new treatment facilities.
Across the country, three decades of double-digit economic growth have drained rivers at the same time flooding them with noxious chemicals. Unbridled rapid industrial development often has serious environmental consequences, including carcinogens in the water, said Hisashi Ogawa, the WHO’s Western Pacific regional adviser on environmental health. Despite billions of dollars spent on cleanup, lax enforcement has left 40 percent of China’s rivers undrinkable, according to a 2006 State Environmental Protection Agency (SEPA) report.
But last February, the government unveiled new data. With long-ignored agricultural chemicals factored in, water quality was twice as bad as previously reported.
Some 90 million Chinese—one in 14—must drink, bathe in, or cook with water so noxious that the World Bank warns of potential “catastrophic consequences for future generations.” Hundreds of so-called “cancer villages” cluster on polluted shorelines. Some communities suffer staggering rates of spontaneous abortion, birth defects, diminished IQs, and other maladies, says Elizabeth Economy, director of Asia Studies at the U.S. Council on Foreign Relations.
The statistics make grim reading. The WHO estimates that 22 percent of deaths in China stem from environmental causes. A 2007 government report blamed alarming jumps in cancer incidence on air and water pollution: 19 percent in cities and 23 percent in the industrialized countryside. Last year, a Fudan University study noted a serious public health risk from lead, mercury, chromium, cadmium, and arsenic. However, there is little hard data on health impacts. “No systematic epidemiological studies have been conducted proving links between industrial pollution and disease,” says Yok-shiu Lee, a University of Hong Kong urban planning professor.
Fighting back
With high medical costs and few practitioners in rural areas, many patients don’t get care or are buried in debt. The government is currently in the midst of health reform.
Citizens are becoming acutely aware of the growing health crisis. Headlines chronicle frequent industrial accidents, new cancer villages, hundreds of lead poisoning cases, and more. Beginning in 1997 the State Council pushed the mostly-state-owned media to report on environmental issues. But information-gathering is often hampered by local officials with entrenched economic interests, and there is very little oversight and massive corruption, says a health researcher who requested anonymity.
Information now spreads over the Internet, on blogs and in chat rooms, though many people are still hesitant to speak openly. In 2006, former journalist Ma Jun built an online water pollution map now consisting of 58,000 records on more than 30,000 domestic and foreign companies. His Bejing-based Institute of Public and Environmental Affairs compiles official statistics and grassroots monitoring into a searchable database. This data has shamed a few multinationals into leaning on their polluting Chinese suppliers.
About 3,000 registered environmental organizations have sprung up since the first was formed over a decade ago. Today, NGOs are activist groups that bring government and public attention to environmental issues, though they still must operate carefully within political constraints. Some educate the public about their rights. Some press for government action. Others file lawsuits against polluting industries. Without media attention or support, most pollution victims, many of whom are poor and uneducated, have little recourse.
Green Anhui is one of these activist groups. They fight for the Huai River Basin, which ranks with the Yellow, Ao, and the Yangtze as among China’s most polluted. The “ugly river” and its tributaries are riddled with factories—and health problems. Over two and a half years, 53 people from Quigang—a village of 2,000 people—died of cancer, including a toddler. Children who attended a riverside school were vomiting and suffered from nosebleeds, dizziness and diarrhea. Water quality tests were sabotaged and villagers who spoke out were beaten, according to a Woodrow Wilson Center China Environment Forum (CEF) report.
Green Anhui stepped in, focusing press and government attention on three chemical plants in nearby Bengbu. The plants were dumping benzene and other toxics into the Huai’s Baojiagou tributary in alarming quantities. It took two years to shut them down. This model is now being used in other locations, says Xiu Min Li, co-director of Pacific Environment’s China Program, Green Anhui’s California-based partner.
Even skin contact with benzene can trigger anemia, nervous system or reproductive damage, leukemia and other ills. Over a hundred tons of benzene, aniline and nitrobenzene spilled into the Songhua River when a petrochemical plant exploded in Jilin Province in November 2005. Since the river straddles the Russian border, the ensuing government cover-up caused international embarrassment and internal scandal. Xie Zhenhua, then-head of China’s environmental protection agency stepped down and a vice-mayor, Wang Wei, committed suicide.
The disaster focused public attention on the magnitude of the nation’s water pollution crisis. “The Chinese government now sees water as their most important environmental issue,” says CEF director Jennifer Turner. Laws have become more progressive, she says. She ticks off a list of gains: stronger environmental impact assessment laws, mandatory reporting of industrial pollution levels, greater public access to environmental information, and growing citizen protests. China Daily reported that roughly 50,000 environmental protests broke out in 2005; uprisings have continued.
Companies and government officials can now be brought up on criminal charges for water pollution violations. Fines and penalties are higher. “People are being told they have the right to complain, to take cases to court, and the laws are making it easier to do so,” says Turner.
Although more cases are being tried, there are few victories for pollution victims. But last year, in a landmark ruling, the head of Biaoxin Chemical Co. Ltd. was sentenced to 11 years in prison for “spreading poison.”
Implementation remains scarce. A Greenpeace China report found that few large companies were disclosing pollution data and government agencies fail to enforce the disclosure requirement.
Great distance remains between the laws on the books and enforcement on the ground, says Vermont Law School professor Jingjing Liu. Turner agrees, but she’s optimistic. She believes that the health impacts from deadly pollutants, water scarcity and growing public pressure will catalyze stronger environmental governance.
With rising populations in China, India, and the developing world, the old adage that “the solution to pollution is dilution” no longer holds true. “When you combine multi-point pollution, chemical industrial runoff, lack of infrastructure to clean the water at all, and poverty, you have a recipe for a health crisis as great as any pandemic in our history,” says Maude Barlow, U.N. senior adviser on water.
Mishra couches it differently. “The Mother is sick and needs our help,” he says.
Photo: Banks of the holy Ganges river in Varanasi / © Sharon Guynup
Water for growth and development in the Ganges, Brahmaputra, and Meghna basins: an economic perspective
Intl J River Basin Management 2015; Volume 13, Issue 3, 387-400 |
http://dx.doi.org:/10.1080/15715124.2015.1012518
The Ganges, Brahmaputra, and Meghna (GBM) river system flows through five countries – Bangladesh, Bhutan, China, India, and Nepal – characterized by large population, limited land resources, and frequent floods and natural hazards. Although the GBM region is well endowed with water sources, this is one of the poorest regions in the world. Its economy and human and environmental health depend on water, and water is thus at the heart of sustainable development, economic growth, and poverty reduction. This paper examines the opportunities for, and potential socio-economic benefits of, water resource management in the GBM region in the face of changing climate. It argues that water can be an entry point for addressing challenges common to the region, particularly through multi-purpose river projects that store monsoon water, mitigate the effects of floods and droughts, augment dry season river flows, expand irrigation and navigation facilities, generate hydropower, and enhance energy and environmental security. The paper emphasizes the importance of effective regional cooperation in water management to achieve these benefits. Upstream–downstream interdependencies necessitate development of a shared river system in an integrated and collaborative manner.
Transthyretin and Lean Body Mass in Stable and Stressed State
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A Second Look at the Transthyretin Nutrition Inflammatory Conundrum
Voluntary and Involuntary S- Insufficiency
Writer and Curator: Larry H Bernstein, MD, FCAP
http://pharmaceuticalintelligence.com/2015/03/07/transthyretin-and-the-stressful-condition/
Malnutrition in India, high newborn death rate and stunting of children age under five years
Larry H Bernstein, MD, FCAP, Reviewer and Curator
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