ORLD COMMISSION ON DAMS
Item
- Title
- ORLD COMMISSION ON DAMS
- extracted text
-
RF_DM_8_SUDHA
Pong 1
”7
Main identity
From:
To:
"arnol” <amol_p@vsnl.com>
‘ Soman Ravindra” <rssoman@hotmaii com>: "Narayan Ravi" <sochara@vsni.com>; "Burte
Aruna / Prakash" <burte@bom7.vsn!.net.in>; "Burte Poornima"
<poornimaburte@hotmail.com>: "SarkarPK" <fha@cal.vsnl.net.in>: "Prachi Patankar"
<prach i noor@y ahoo. com >
Monday, January 26, 2004 3:36 PM
Successful Thiyya !
Sent:
Subject:
Th© Successful Thiyya Andolsn !
A few days ago we nad posted an appeal for support for a Thiyya Andolan (indefinite Sit In’ ) of the Pani
Sangharsh Chalwal which started on the 19th of January in front of the Maharashtra Krishna Valley
Development Corporation (MKVDC) Office here in Pune
A 'Thiyya Andolan Sahayya Samiti' consisting of most of the ieft and progressive organizations and
unions was set up in Pune. However, since most of the leaders and activists from the ieft wing organisations
were involved in the WSF not much support could be organised by these organisations. Much of the support
therefore came from the remaining handful of activists who put pressure on the Pune Municipal Corporation to
make arrangements for water supply and other basic amenities. The staff co-operated, thanks to the humanist
appeal of the Thiyya Andolan and the influence of the Pune Municipal Kamamgar Union. A few articles in the
Marathi press and news coverage heiped io take the issue to a very wide circle of citizens. A good street piay
prepared by about a dozen motivated students of the Karve institute of Social Service did its rounds in
various colleges and youth hostels to raise consciousness about the drought issue and about the Thiyya.
About 7000 people from the drought affected and dam affected areas of West
Maharashtra participated in this struggle. This Thiyya Andolan was the largest indefinite 'Sit In' of the rural
toilers in Maharashtra in many aecaaes. it was also one of the most disciplined ones. People strictly followed
the decision of not interfering with the working of the MKVDC office here in Pune. There was no violence or
any untoward incident through the entire two days. For Punekars and especially the media it was a novel
experience to see thousands of people eating and sleeping in the open on the roads.
it was quite a task to make arrangements for food for such a large number of agitators. Since the
organisations in Pune could not undertake this responsibility the agitating organisations decided to make the
food arrangements themselves. A team from Sangola taluka ( Solapur district) took the responsibility of
making about 30,000 chapatis and more than a quintal of sabji twice a day for the agitators! Leaders of some
of the unions and organisations of the toilers in Pune like the LIC Union, Pune Municipal Kamgar Sanghatana,
Molkareen Sanghatana (Organisation of the domestic workers), and state level leaders like N D Patil
addressed the agitating farmers and pledged support for the Thiyya Andolan.
II
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Page 1 pf 4
Main identity
"amol" <amol_p@vsnl.com>
“Soman Ravindra" <rssorrian@hotmaii.com>; "Narayan Ravi" csochara@vsni.com>: “Burte
From:
To:
Aruna / Prakash” <burte@bom7.vsnl.net.in>; ”Burte Poornima”
<poornimaburte@hotmail.com>; "Sarkar PK" <fha@cal vsnl.net.in>: "Prachi Patankar”
<prachinoor@yahoo.com>
Sent:
Subject:
Tuesday, January 13, 2004 9:55 AM
appeal I
Support the ‘Thiyya Andolan’ of the Drought and Dam Affected
in the Krishna Valley!
This is an appeal to support the indefinite sit-in' (Thiyya Andolan} organised by the Pani
Sangharsh Chalwal (a movement active in South Maharashtra) and Maharashtra Rajya Dharan va
Prakalpgrast Parishad. About 20,000 people would be coming from 13 talukas of the drought and
dam affected areas of Sangli, Satara, Solapur and Kolhapur districts to demand ’water for
livelihoods*. This Thiyya Andolan3 has been planned in front of the Sinchan Bhavan on Barne Road
in Mangalwar Peth in Pune.
The main demands of the Thiyya andolan are
Immediate release of funds for eradication of drought
Change in the priority allocation of water from industry to agriculture
Equitable distribution of water- in proportion to the population
Rehabilitation of the Dam affected
Maharashtra state is reeling under a severe drought, which is worse than the one that occurred in
1972. Apart from the stray news reports on the current drought in Maharashtra, the main reminders
for the middle class have been when there was the news of artificial rains and when Pune’s water
quota was to be given to the drought affected Solapur. Almost 70 talukas in Maharashtra are
affected by this drought. Thousands of cattle are being butchered because there is no fodder or
water to keep them alive. If no serious programme is taken up to ameliorate the situation, then
thousands of people-men women and children will be forced to leave their homes in search of
livelihood- perhaps never to return homel
Amidst this fight for survival, people are forced to wage a struggle to force the government to act
The last one-year has seen such struggles in Sangli, Satara, Solapur, Kolhapur districts where
people have come on the streets in large numbers to demand water for livelihoods. What a paradox
this is! The toilers continue to toil for their survival and also wage a battle for the ‘greater common
good’- in this case measures for eradication of drought that in a few more years would engulf all of
us in the cities too
1/13/04
The Pani Sangharsh Chalwal
According to the Pani Sangharsh Chalwal priority must be given to harvesting local water
1/13/04
Page 2 of 4
through watershed development. However the movement also argues that unless this local
water is supplemented by 'exogenous’ water from the dams, the drought prone areas in
Maharashtra would remain deprived of water. This has to be done by taking into account, the
average amount of dependable rainfall, nature of soil, terrain and population density. The movement
also says, based on reliable infonnation, that there is sufficient water in the existing dams to make
this supplementary water available to all the drought-prone villages. However the main bottleneck
according to the 'Pani Sangharsh’ movement is the lack of a canal network. Much of the water
remains unutilised today simply because of the incomplete canal work. The race to dam the Krishna
waters to establish Maharashtra’s right over the quota has meant that the state coffers are emptied
on damming, leaving little or no resources for completing the canal work. The movement takes a
position that if priority is given to the completion of this canal work and if water is distributed in an
equitable manner a long-term solution to address the drought situation would emerge.
For over a decade, in the 13 drought-prone talukas in these 4 districts, the ’Pani Sangharsh
Chalwal’ and the ‘Dharangrast Parishad’ have been struggling for rights over water for all, including
the landless. Over the last few years the movement has gained some unprecedented successes
and is involved in significant struggles, which however have not been significantly reported In the
state-level media. One of the significant contributions of this movement is that of joining together the
interests of two groups, which are traditionally considered to be at loggerheads with each other- the
dam affected and the drought affected-a situation the state exploits to its advantage.
in the last couple of months the movement waged successful struggles in Tasgaon and Mann
talukas of Sangli district. Here the people launched indefinite ‘sit Ins’ which lasted for a period of 6
and 14 days respectively. Their main demands were for equity in distribution of water. The
people withdrew their struggle only after getting written assurances from the government.
All these struggles have been able to achieve the demands partially or fully. However the
movement realises the limitations of location-specific struggles and hence it decided to launch a
massive struggle from the 19th of January 2004 which would demand to review the current water
policy and specifically the water allocations within the Krishna basin to ensure equity in the basin
and eradication of drought. Their slogan is 'Water for livelihood’ (Jagnyasathi Pani) and 'Eradication
of drought’ (Dushkal Bimod)
' Rehabilitation first, dam construction later1 has been one of the major demands of the
different successful struggles launched over the last few years. During January 2002 and 2003,
more than three thousand dam-affected had launched an indefinite ‘Thiyya Andolan' in Satara for
twenty days. The dam-affected withdrew the agitation only after getting written acceptance of their
demands by the then Chief Minister. But even these written assurances have not been fully
honoured, that is why they are joining this ‘Thiyya Andolan'.
In the last few months, apart from South-West Maharashtra, there have been struggles in other
parts as well- in Pavana, Malvandi, Panshet, and by people affected by the Tata dam, Narmada,
Ujani, Vainganga projects, etc . All these struggles point to the growing discontent across the state
which needs to be addressed in a much more holistic manner
The ‘Thiyya Andolan' planned from the 19th of January 2004 in a way is the culmination of
these various struggles
•
E-mail a letter of support to the Chief Minister of Maharashtra State at the following id
chiefmlnlster@maharashtra.gov.ln
Or phone him at the following numbers (Off) 22025151, 22025222 (Res) 23630408, 23634950
• As individuals and as organisations support the movement- send support letters, write articles,
spread word etc. Support letters could be sent to any of the following addresses and they would be
reached at the site of the thiyya andolan
amol_p@vsnl.com; joynagmans@vsnl.net; abhayseema@vsnl.com;
1/13/04
Page 3 of 4
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• Support by giving financial donations either in cash or in kind. You could contact anyone of the
numbers given below or the addresses mentioned above and get more details for donations.
Contact: Joy and Mani 3422505473, Seoma Kulkami- 020- 25465336, Anant Phadke- 020- 25460038
(Panl Sangharsh Samarthan Gat Pune)
A Thiyya Andolan Sahayya Samiti has been formed in Pune and consists of -
Hamal Panchayat. Sarva Shramik Sangh, CITU, Shramik Mahila Morcha, IFTU, Pune
Mahanagarpalika Union, Kagad Kach Patra Sanghatana, Maharashtra Rajya Karmachari Union,
Maharashtra Rajya Nurses Federation Pune, All India Democratic Women's Association, Ayurvima
Karmachari sanghatana, National Railway Majdoor Union, Rashtra Seva Dal, PUCL, Pani
Panchayat, Masum, Chowkashya,
Communist Patty of India (M), Communist Patty of India, Lal Nishan Patty (L), Peasants
Workers Patty, Samajwadi Jan Parishad, Shramik Mukti Dal.
A************
WISH YOU A MEANINGFUL, PEACEFUL NEW YEAR I
Anant & Sandhya Phadke,
8, Arney Ashish Co-op. housing society,
Near Kokan Express hotel, off Karve Road,
Kothrud, Pune 411029.
phone no. - 020 5460038
To,
The Chief Minister
Maharashtra State
Dear Sir,
As you are well aware Maharashtra has been severely affected by drought this year. In the light of
this situation, the question of equitable distribution of the existing surface water gains significance.
In the last few years the state has constructed a number of dams particularly in the Krishna basin.
However this has not been supported by the construction of canals that would actually take this
water to the fields. In fact the cavalier attitude of the state in this regard has meant that water just
remains unutilised.
Pani Sangharsh Chalwal, a people’s movement active in South Maharashtra takes the position that
if the government takes up the work of the canal network on a war footing and ensures that water is
distributed equitably (i.e. at least 3000rn3/household/year), long term solutions to eradicate drought
would emerge. The movement makes a demand that ail the necessary financial allocation for this
must be made readily available. This has been a long-standing demand of the movement and it has
led several successful local struggles on this.
1/13/04
Page 4 of 4
i ne movement once again comes on the streets ot Hune trom the 19“ .or January with this very
demand. 'We extend our support to the movement.
Cattie camps, employment guarantee scheme (EGS), provision of water tankers although
necessary, are only temporary measures for mitigating drought and cannot be justified in isolation.
The movement, based on a rapid assessment, shows that long term solutions to eradicate drought
could emerge at a cost less than that incurred by the state on provision of tankers, EGS works etc.
Technological and social analyses have shown that failure of rains need not necessarily lead to a
drought. However despite this we see that every failure of rains triggers a drought. This has largely
been a result of the flawed policies with regard to water consen/ation and storage and use and
distribution. Inequity in water distribution and policies that are leading to ecological crisis need to
change. A pro- people policy in this regard has to be introduced. This too is one of our demands.
' Rehabilitation first, dam construction later* has been one of the major demands of the different
successful struggles launched over the last few years. The Rehabilitation Act of 1978 was an
outcome of these struggles. However due to the callousness of the state many of the demands of
the dam affected still remain unaddressed. The last few years is marked with several struggles of
the dam affected in different parts of Maharashtra. There have been some gains, however lack of
funds is cited as the main cause for not honouring the assurances that the then Chief Minister
himself made.
The dam affected are also therefore joining the Thiyya Andolan starting from the 19th of
January 2004. We extend our support to them too.
We appeal to you to accept the demands of this thiyya andolan immediately and to implement
them at the earliest.
Yours
1/13/04
8J
7
J
‘I
Social Issues
1
Human Health and Dams
Draft Final Report
November 1999
Prepared for the WCD by:
World Health Organisation - Geneva
G O Al
o
£
I
I
World Commission on Dams Secretariat
P.O. Box 16002, Vlaeberg, Cape Town 8018, Sou th Africa
Phone: 27 21 426 4000 Fax: 27 21 426 0036.
Website: htlp.7/www.dams.org E-mail: info@dains.org
This is a . draft
working7 paper
of the World Commission
.
---------- on Dams. The report published herein was prepared for
the Commission as part of Us informalion-gathering activity. The views, conclusions, and recommendations are not intended to
represent the views of the Commission.
’ T'-’V
TF
I
World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
ii
Ifi
DAMS AND HUMAN HEALTH - EXECUTIVE SUMMARY
Bi
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1. Recommendations
The World Health Organization welcomes the independent inquiry by the World Cor"m^^
DaJlWCD) and .he opportunity <0 contribute positively to the debate on datua. It offers the
following recommendations for consideration by the Commission.
. Health impact assessment (HIA)
.
There is an overwhelming need to include health impact assessment (HIA) as an integral component
7 '
*; on the
Assessment, Social Impact
t, and the need to incorporate HIA in any
tional legislation on dams.
international conventions and in national
HI
Bi
• Capacity building
both within
within the
and community health management needs to
to be
be built
built both
me
Appropriate capacity in HIA
health sector and in the sectors primarily responsible for dams.
inter-institutional arrangements and staff in all relevant
conducive
policy
framework,
effective
i
A
hiSned inZ'skm^n^toral communication and collaboration are three essential
institutions tiamw. m
------------------. rUelements that need to be addressed by national capacity building activities.
Ii
framework for the health impact assessment of large,
development projects.
. Documentation of successes and efficacy of current practices
An information and education oriented data base should be compiled.
I
J
(a) describing the limited number of health success stories based on careful dam design and
i1
operation, and explaining the key management processes in detail.
(b) »i.h am .ssccmcnt of the efficacy of .heady implemented health risk m.n.gement techniques.
ii
^3
; t qn good practicejnjlw^dgsign and R
This submission points out that there is scattered infonnation
^ThTknoud^^
______
# health issues Kj
operation for health. It provldeTa^oSrse^lrafScfenzafion
c.
•
. The number of successful integrated health risk management^
associated with dam projects. The number of
-----------. •
i relatively iar«A
large Hndv
body nf
of evidence of singular®^
singuhr^,
experiences in dam projects is limited, but there is a r
,
ipidemiological
;
eco-epidemiological
M
methods of good practice which have been proven to be effective under specific
health issues determined by environmental factors.
pd
conditions, with an emphasis on 1.—---- -------1
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USESXZ
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rescarchand inunprove
"is,ingb '‘I®p'”"rf “comm
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1
projects in order to strengthen
existing taudedge base,
„„i.”ltl
|t
Models for reservoir management and dam operation to reduce healin
gW
and a number of en.honmenial management concepts for vector control require testing of tag.S
l
views of (he Commission.
gj
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b<
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I
■ I
World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
Disclaimer
This is a working paper of the World Commission on Dams - the report published herein
was prepared for the Commission as part of its information gathering activity. The views,
conclusions, and recommendations are not intended to represent the views of the
Commission. The Commission's views, conclusions, and recommendations will be set forth
in the Commission's own report.
World Commission on Dams
5lh Floor, Hycastle House
58 Loop Street
PO Box 16002
Vlaeberg, Cape Town
8018, SOUTH AFRICA
Telephone: +27 21 426 4000
Fax: +27 21 426 0036
Email: info@dams.org
http://www.dams.org
iS
1
II
I
X
i
1
II
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for
the Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to
represent the views of the Commission.
TTBSISHTHF ’ VI' ■ riMwi
•
I
Is
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■>
World Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
(:
iii
feasibility and effectiveness. Comprehensive documentation of the economic aspects will be crucial
for successfully transferring tested methods to routine management and operations.
• Budgeting for health
A he^h^cqmporient shqujd be negotiated as a budgeted_item for all project loans in order to
safeguard and enhancenealth.
! j
Any health budget allocated in the context of a dam project should be used primarily for preventative
actions, and secondarily for strengthening of health services, with the optimal balance decided on a
case by case basis. Such an investment in health should not be considered a substitute for the existing
health care system.
• Prioritising the health issues
It is important that the health priorities are not pre-judged but allowed to emerge from the health
impact analysis and community consultation.
Development agencies may have a limited or biased understanding of the health issues associated
with a dam project in a given location. Priority setting therefore has to rely on a comprehensive and
independent HIA complemented by an expression of the risk perceptions of affected communities.
This will not only promote a correct focus on key health issues, but also enhance community
ownership of the risk management measures.
• Prioritising dam projects for impact assessment
Screening procedures for HIA needs must be the minimum requirement for all dam projects.
A robust screening procedure, preferably anchored in legislation, will ensure that limited financial
and human resources for HIA are used to their maximum capacity.
The cumulative effect on health of many small dams should be dealt with through strategic
assessment of representative cases.
I ‘
I i’
• Transparency
The health impact assessment and planning process should be open to scrutiny by all stakeholders and
communities.
All components of the planning process, including HIA, benefit from the inclusion of all stakeholders
at all stages of the process.
2. GENERAL CONSIDERATIONS
As dams, large and small, continue to be planned, constructed and operated with the aim of achieving
important socio-economic development objectives, their potential to alleviate poverty can, and in
many cases will, contribute significantly to the improvement of the human health status.
It is, however, the issue ofj^piityj»jy)£jhat is at the root of the adverse health impacts of dams.
Benefits of dams are not disputed, but it is the uneven distribution of the benefits, including the health
benefits, and of the health risks that needs to be addressed in their planning, construction and
operation. A simple health accounting is not satisfactory: itJ_s_jiot acceptable to simply balance out
theJ]£^tb^ajr[S_of^on£part of the population against the health losses of another, to arrive at a net
health benefitoFdamsT^Fis tlwTncfeased risks foFVulnerable groups that need to be identified at an
early stage and managed as an integral part of dam design and operation. The protection and
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This is a draft working paper of the World Commission on Darns. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent the
views of the Commission.
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Social Issues - Human Health and Dams, Draft, November, 1999
iv .
promotion of human health in the context of dam projects can only be ensured if all potentially J
affected communities have an opportunity
•
•
to consider how dam construction and operation will affect their own health, and
to participate fully in the planning, assessment and decision making process
- J^eSat^ve ^^j^jlll^ct^fdamsjepmsen£a^^
health sector. Taking human health
into consideration atTie planning stage makes good economic sense. Not only does it allow to keep
the additional burden on the health sector limited to a minimum, but it also permits an optimal use of
"win-win" opportunities for the dam operators and public health. Many of the health safeguards that
should be considered good practice can be incorporated into dam projects at minimal additional costs,
because^they imply desigivchanges that pemiit a more flexible operation. Changes in environmental
and social determinants of health, resulting from a dam project, will also provide an incentive for the
health sector to review the delivery of its services and improve performance and efficiency.
Three requirements are essential in order to effectively protect and promote health in relation to dam
projects: (1) a supportive policy, (2) an acceptable procedure and (3) a usable method of risk
assessment.
The lack of an appropriate policy framework means:
• lack of assessment of policies, programmes and projects for health impacts;
• greater than necessary adverse impacts of development on health;
• the tendency of vertical disease control programmes to ignore environment and
• development links;
• lack of funds for research in health impact assessment.
Environmental Impact Assessment (EIA) is an testablished policy and procedure in many countries
and development agencies, but EIAs normally make limited reference to health. The health issue
most commonly included is poisoning due to pollution; in the case of dams, filariasis, malaria and
schistosomiasis,, are also often cited. Other important health aspects are often neglected.
In many cases, health is addressed in a strictly ‘medical’ sense rather than through a wider crosscutting
This tends to produce recommendations for strengthening health
services which, although important, often do not lead to broad improvements in the identification,
characterization and management of community health risks.
Some health issues have physical environmental determinants, others have primarily social
determinants that will be brought to light only by a social impact assessment (SIA). Health, therefore,
has a stake in both EIA and SIA, with a number of unique features that distinguish it from either of
these. The solution favoured by WHO is to create a separate and parallel procedure for health
impact assessment (HIA). The middle way is to plan for integration while maintaining a separate
profile for health. The state-of-the-art of HIA methodology and procedures is presented in detail in
the WHO submission. Critical action required in any dam project includes:
C
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Adding specific references to health to the Terms of Reference provided to the consultants
undertaking an impact assessment and indicating the method of health impact assessment to be
used.
Providing quality assurance mechanisms through appraising or evaluating the health component
of completed impact assessments.
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This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent the
views of the Commission.
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Social Issues - Human Health and Dams, Draft, November, 1999
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The health issues associated with dams can be conveniently represented in six major categories:
communicable diseases, non-communicable diseases, injury, malnutrition, psychosocial disorder, and
lack of social well-being. The existing knowledge bases concerning the impact of dam construction
and operation vary for the different categories.
c
3. OPTIONS FOR PREVENTATIVE AND HEALTH PROMOTIONAL ACTION
Many of the adverse health outcomes associated with dams and associated infrastructure
developments (e.g. irrigation schemes) can be prevented or mitigated if a broader and more holistic
view of project construction and operation is taken. Along with a range of insightful engineering
approaches should come a recognition for the need to take an integrated, multi-disciplinary approach
to environmental, social and health management. This new understanding can lead to the /
implementation of a range of innovative design and operational features for water infrastructure
projects^ Such changes may be cost effective and provide the desired health outcomes that formally
were considered controllable only through medical intervention or by more drastic environmental
control procedures.
There are a number of fully or partially validated options which can mitigate the adverse effects on
human health of dam construction. These planning options fall into a number of categories including
engineering design considerations, operational water management, social and community planning.
Recommendations and suggestions for good management practice are listed in table 1. A number of
general observations need to be made first:
■ Preventative and health promotional measures tend t£_be_sil^specific. They are linked to the
geographic variation in health conditions associated with dams^aF^vell as to the relative
effectiveness of measures in different ecological and epidemiological settings.
■ The secondary effects of measures need to be taken into account and trade-offs will have to be
found to come to a final decision.
■ Whatever the technical merit of “good practice” interventions, they will only be effective and^7
sustainable if the process of their design and implementation is transparent and participatory.
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This is a draft working paper of the World Commission on Dams. The report published herein wns prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent the
views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, DraR, November, 1999
Mgs
Tabic 1. Examples of techniques and good practices for mana ging health risks
safeguard
Poverty reduction
Voveb, reduction empowers and oo.bk. P'.°P'= “
“
themselves and their families from many environmental haza-----------------
Zooprophylaxis
---- ------- ’
■
ectKtiitv of using livestock as diversionary hosts to
In specific settings, there is a possibility ot us g
protect people from malaria
———•
«.t some mostooT^W^^
>"
Wetting and drying of
floodplains or streams
agriculture such as flood recession cultivation
Health centres
and balding capacity and capability of health personnel-------------------- ----------------
I®
'M
________________ _____
bcfore dam construct1011’
HI
water supphes
Water
supply
sanitation
and
May be appropriate for certain arboviruses_______________________ ___________
Vaccination
moribund
Handling
animals
should be protected from contamination by flood waters.-------- -------------- ------------ -
Control of Rift Valley Fever
•’ h”“"
Canal or river nushing
waste, clearing drains or flushing away mosquito larv
----------- ------ ------------------
be.lll,------------------------
■"1 .eJud»Bn.TOl.My
lno...sta8
H
111
3
Community control
- -------------
Communication
-------------
Dam design
~sw.tu,« to q»M. ^»l« “""-1 »r °7”»lto"1 -1” toe----------------
pi
Minimlslns low 0o» «o»ss » prevent vector breertaE
Irrigation
channel
design and improved
hydraulic structures
Dam siting
Retoto or conuet peferor w.R, co-.to.ted w.te,
r
--------------
; dlcptoore^
:
" Siting new settlements away from vector breeding sites--------------
Settlement planning
Adequate design of community water supply and sanitation,
including careful
fel
management of wastes
----------Culturally sensitive community planning
Irrigation management
------------------------------Catchment management to minimise floodjndpolhdio^----------------------------Upstream management
In-flow forecasting
Early warning of floods--------------- - -------------------------------------------' To erto.ee Itotpl.lrr protoM) ...dtoeeototo------------------------------------
Water release schemes
--------
Reservoir management
wHhi
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17,------------------------Sensitive management for hcbdal stidveotor control--------------------------------------Floodplain
herein wns prepared for the
xommendations are not intended to represent the
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views of the Commission.
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World Commission on Dams
Sotfial Issues - Human Health and Dams, Draft, November, 1999
Good operation
maintenance
and
vii
Delivering a reliable and cost-effective service
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lids is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its informalion-gathering activity. The views, conclusions, and recommendations are not intended to represent the
views of the Commission.
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viii
Social Issues - Human Health and Dams, Draft, November, 1999
Table of contents
1.
Background
1
1.1
1.2
1.3
1.4
1.5
1.6
Human Health in Environment and Development
..........
Equity and health.....................................................................
The economic perspective
Policy
.
Legislation
.
Integration of HIA with Environmental Impact Assessment
1
2
3
4
5
5
2.
Human health issues related to dam construction and operation
2.1
2.2
2.3
Categories of health issues
Regional differences
Differentiation on the basis of dam size and purpose
3.
Options for preventative or health promotional action
3.1
3.2
3.3
3.4
General considerations
.
Good Practice - the Planning Framework
Good Practice - Design and operation options
..................
Good Practice - Off site management and environmental protection
4.
Recommendations for improving health outcomes
.
14
4.1
4.2
4.3
4.4
4.5
4.6
4.7
Health impact assessment (HIA)
.
Documentation of successes and efficacy of cunent practices
Action oriented research...........................................................
Budgeting for health..................................................................
Prioritising the health issues
Prioritising dam projects for impact assessment
Transparency..............................................................................
14
•
Health impact assessment (HIA)
.211
5.
Introduction
5.1
5.2 HIA Procedures
Timing
5.2.1
Screening
5.2.2
Steering committee
5.2.3
5.2.4
Scoping and agreeing Terms of Reference
Choosing an Assessor
5.2.5
Spatial boundaries
5.2.6
Temporal boundaries
5.2.7
Appraisal and dissemination
5.2.8
Negotiation
5.2.9
Implementation and monitoring
5.2.10
5.3 HIA Methods
Stakeholders
5.3.1
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11
23
23
23
23
24
24
26
27
28
.29
.29
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This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commission.
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Social Issues-Human Health and Dams, Draft, November, 1999
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5.3,2
5.3.3
5.3.4
30
32
33
Health determinants
Weight of Evidence............................................
Management of health risks and enhancements
6.
Acknowledgements
36
7.
Bibliography
37
8.
References
38
I
This Is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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Social Issues - Human Health and Dams, Draft, November, 1999
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Tables, figures and boxes
Table 1. f
' ’ ' categories of health issues and the
Principal
extent of existing knowledge about their 1
association with dam projects
..8 1
Table 2. Examples of regional variation in health conditions
...9 J
Table 3. Examples of health outcomes from dam construction and management'.’.'
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Table 4. Might range of insect vectors
•26 C™■
Table 5. Typology of human circulation
26
Table 6. Examples of association of health issues with timing
27 J
Table 7. Examples of the association of health issues with different project stages
28
Table 8. Examn
| OCf,S‘akeholder communities and important health issues..
30
Table 9. Examples of health determinants and their classification
32
Table 10 Examples of techniques for managing health risks
33
1
III
Figure 1. Procedures and methods used in health impact assessment
Figure 2. Spatial boundaries of dam health assessment
Box 1.
Box 2.
Box 3.
Box 4.
Box 5.
Box 6.
E
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H0eXonCniC(dirr tiOnSu,fthe World Heal,h Or8anisation, September 1999
Health Opportunities in Water Resources Development
Flushing canals for malaria control in Sri Lanka
F™mWiater ^an°’’actenal toxins ~ an emerging dam-related health issue....
Examples of health impacts from India
The compounded malaria impact of microdams in Ethiopia
..2
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
1
1. Background
1.1 Human Health in Environment and Development
Throughout the world, especially the developing world, dams and related water infrastructure
projects continue to be planned, constructed and operated to meet human needs through energy
generation, agricultural production and the supply of drinking water. For most countries, dams are
a crucial part of economic and social development and, as such, they aim to achieve important
socio-economic development objectives. Through their potential to alleviate poverty they can
contribute significantly to the enhancement of human health.
e intended development objectives of dams, including poverty reduction, are invariably
accompanied by a range of unintended impacts on the natural environment en on human
communities. These communities may be affected in quite different ways and, as well as
beneficiaries, there are potential losers. It is this observation of health benefit inequity that forms a
central theme in the present submission. Informed action can protect vulnerable groups against
increased health risks and ensure a more equitable distribution of benefits, including health
benefits.
WHO welcomes the independent inquiry by the World Commission on Dams
(WCD) and
and the
Dams (WCD)
the
opportunity to contribute positively to the debate. WHO has long been concerned about the effect
of dams and other water resources development projects on human health and has catalogued their
health impacts, particularly on a range of communicable tropical diseases. The present WHO
contribution to the WCD advocates that health considerations should always be included along
side economic, environmental and social issues in decision making on dams. Furthermore, it
provides an analytic framework for the incorporation of such considerations into dam planning
construction, operation, rehabilitation and disaster preparedness.
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Bearing in mind a target audience of mainly non-health specialists, this paper uses the broadest
socio-environmental definition of human health. As envisaged by the founders of WHO health is
considered to be:
’
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...a state of complete physical, mental and social well-being, and not merely the absence of
disease and infirmity”.
The preservation of human health can only be ensured if all potentially affected communities have
an opportunity:
•
to consider how dam construction and operation will affect their own health, and
to participate fully in the planning, assessment and decision making process
p'
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At times, this submission makes a distinction between recommended actions that are practical - in
the sense that they are readily achievable through realistic and feasible modifications to current
practices and planning procedures - and those actions that should be undertaken in an ideal world.
It is understood that the WCD is interested in both, as is certainly the WHO.
L-’
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At different times in the past, WHO’s concern over health in development has been expressed with
different emphases. The 1986 World Health Assembly Technical Discussions on Inter-sectoral
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This Is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
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theTiews'of the Cornmission0^31'00 8athCr'n8 aCtivlly* ThC V’CWS’ conc,usions- and recommendations are not intended to represent
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Social Issues - Human Health and Dams, Draft, November, 1999
2
A.Cll°" f°r 1 ea 11 and lhc review of the imPact of development policies on health (Cooper-Weil et
n/ 199°) are two of several examples. Currently, the WHO Global Cabinet has defined four
strategic directions, two of which address different aspects of the environment-developmenthuman health continuum (see Box 1 in bold). Along similar lines, the World Bank recently
defined one of its comparative advantages in the Roll Back Malaria initiative as its capacity to
include health concerns in infrastructure projects for which it provides loans.
1
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Box 1. Four strategic directions of the World Health Organisation, September 1999
'i
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Reducing the burden of excess mortality and disability, especially that suffered by poor
and marginalised populations
Reducing the risk factors associated with major causes of disease and the key threats to
human health that arise from environmental, economic, social and behavioural causes
•
Developing health systems which are imanaged*to
___________
__
ensure equitable
health outcomes and
cost-effectiveness; responsiveness to people’s legitimate ^needs;
j .. r .
. .
- -o-------- -------; are financially and
procedurally fair; and, encourage public involvement
•
Promoting an effective health dimension to social, economic and development policy.
In addition to an international health policy framework, WHO has provided technical guidance to
its Member States in the form of guidelines for the resolution of these problems including:
■ Guidelines for forecasting the vector-borne disease implications of water resources
development (Birley 1991);
Parasitic diseases in water resources development (Hunter et al. 1993).
It has also been instrumental, through its Collaborating Centre arrangements with the Liverpool
School of Tropical Medicine, in stimulating a wider debate, including the publication of:
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1 he Health Impact Assessment of Development Projects (Birley 1995);
WHO and its Collaborating Centres the Danish Bilharziasis Laboratory and the Liverpool School
o Tropical Medicine have a long-term commitment to building national managerial capacities in
inter-sectoral planning of development projects and including health considerations. Together,
they have developed and tested a task oriented problem-based learning course entitled Health
opportunities in Water Resources Development, and the next phase will be course implementation
and institutionalisation in Africa.
1.2 Equity and health
As already noted, the development and economic objectives of dams are often not fully
compatible with an equitable distribution of the benefits and stresses between different stakeholder
and community groups. For example, with dams for hydropower generation or drinking water
Ilns is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Comnuss.on as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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Social Issues - Human Health and Dams, Draft, November, 1999
3
supply, the beneficiaries may be hundreds of kilometres away in urban centres, while the local and
downstream communities may suffer from the adverse health effects of environmental change and
social disruption. In irrigation schemes, those living in the tail end of the system and relying on
water from canals to meet their domestic needs may be exposed to increased levels of pesticide
residues. Additionally, if proper drainage is lacking, they may be exposed to increased
transmission of vector-borne diseases. Downstream impacts on water availability and quality,
agricultural production, livestock and fisheries may lead to persistent malnutrition and communal
violence.
■
$
Clearly, improved health is inherent to the general poverty reduction objectives of dams, but it is
the issue of equity gaps that is at (he root of the adverse health impacts of dams. For this reason, a
simple health accounting is not satisfactory. In other words, it is not acceptable to simply balance
out the health gains of one part of the population against the losses of another, to arrive at a net
health benefit, as one might do in an economic or financial analysis.
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It is very important that this point is accepted by all involved in the dam planning and evaluation
process. Benefits of dams, also for health, are not disputed. It is the risks to health, however,
resulting from inequity, that need to be identified at an early stage and managed as an integral part
of dam design, construction and operation.
ft
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1.3 The economic perspective
I
The economic arguments in favour of including health concerns in dam projects are clear.
Most developing countries and most development agencies spend about 5% of their budget
on the health sector, and most of this health budget is spent on the delivery of health
services. A considerably larger part of the national budget or of development loans is
spent on the development and management of infrastructure projects, including dams.
Decisions on infrastructure development that may be critical to people’s health status are,
however, made without proper consultation of health authorities and experts.
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When negative health impacts occur, they represent a hidden cost of the project that is transferred
to t ic health sector without adequate provision for alleviation. They also represent an increase in
pain, suffering, and loss of education achievement and of productivity for the affected community,
mproving the health status of the community through preventative action by other sectors is an
efficient way to help to reduce the burden on the health sector. It is assumed to also have a
multiplier effect by ensuring that relatively small investments for health protection and promotion
at the construction phase will produce substantial health improvements.
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There are three main requirements needed in order to protect and promote health: (i) a supportive
P° lcY, 00 an acceptable procedure, and (iii) a usable method of assessment. None of these is
su ficient in itself. Good policy supports good planning and management. It also enables laws to
be enacted that establish requirements and regulations to conserve human health. Good planning
depends on good procedures for assuring quality and inclusive debate. Good assessment methods
enable the health risks and benefits of different options to be analysed and compared.
••'5
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1.4 Policy
1
The international development aid policy of many industrialised nations aims to reduce poverty
and improve the quality of life of poor communities. The aid Hows through many bilateral and
This is a draft working paper of the World Commission on T
~
~
Dams. The report published herein was prepared Tor the
o^ cXJXnm,iOn-ga,hcr^
1I”
rccomnSdons
•
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World Commission on Dams
Social Issues - Human Health and Dams, D,
'raft, November, 1999
4
oo,n,„„„ifc,. l’lo7mi“sVrocedX'ri,‘X'evo|,^a^L7L’e‘’'COn0m,‘!'"''‘r°,‘,ne,’‘,’r'U’k',“’,d':r
-- orproleora,
limited.
■’ S'eVeuT" "T8"7 "dV'rS' 'mPac's
f°r l"a"” i"””C,S;
progr-mmes (known as verto.l
_
lack of funds for research in health impact assessment
’
ris-o2/
environmental and health impact assessment (UN 199D 7 °Pment PoIicies a"d recommends
and the Amsterdam Treaty, 1999 require that the FC h i? EurOpe’ the Maastricht Treaty, 19
1992,
adverse impact on health^r create condit ons h t H
‘hat Pr°P0SalS d° not
J an
Policy for Health advocates muMsectma "
k". TT* heaHh PrOmOtion' The Eu™pean
both internal and foreign policies (WHO 1998) TheV
1 °r-fh health lmpact assessment for
and Health recognises the need for health imnart
uroPean barter on Transport, Environment
has published a White Paper on Public HeTlE anT™
government
policies for the assessment of health impacts of all 3 reP°rt °n health inequalities that establish
Secretary of State for Health 1999).
P
government policies (Acheson et al. 1998;
—
°n,Madr"
countries where health impact assessment polieiec h
u
dfVelopment (OAU 1997).
Other
et al. 1992), Canada (Kwiatkowski 1996) New^l
’nC1Ude Australia (Ewan
Philippines (Philippine Environmental Health 9 ' ea a"d (Publlc HeaIth Commission 1995),
(Koivusalo et a,
P^^iT’TlZ?"
initiatives.
U utiers iyysj. ulere are> no
many o(her
Many civic society groups cite health risks
,
, aS 3 princiPal concern when they object to dams or
other development projects. Pnr.
J ' jmTT e|mb°Ut 60% of submissions received by WCD from civic
society groups explicitly cited hu
- -Jman health concerns (WCD, pers. comm.)
Development projects r*particular places or benefit specific communities'. 1
projects in
ext™,
groundwater for
for taigation
wilSta^h^"'
extract groundwater
irrigation with
the result that “T 'tm ”’y be 6i,en s“l»Wi“ “
drinking water from the . ..
nlsning supply. Dams may sometimes be located in remote
regions in order to establish
vuuuu group
group into
t0 encoura8e migration of a
majority ethnic
into an areainhabiterbvVm3
include the award of high value construction co J 't"0"17
8r°UP' °ther motivations may
into a neighbouring country In these examnle
3 deC1SIOn to contro1 downstream flows
ntry.
these examples, pohey changes are required to ensure coherence.
“s.l,,at rvidc 'prTe’ince,,tives to site
that health be added"tothnS iX’XaTmu^^^
of and not detrimental to health, andZXZlnities.^
“ ‘b*
t0 reconimend
SUPP°rtiVe
rWl
fed
BS
Commission as part of its infonn’Xn’g^
the views of the Commission.
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report published herein was prepared for lhe
concIus’ons, and recommendations
---- j arc not intended to represent
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and DamS’ Dra". November, l999
5
1.5 Legislation
►
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With environmental laws. There are also 7series Tf im
support health,
protection.
►
SUCh 3S those a«ociateS
ISO9„00, „
project. The World Commis!i„® „n”ams'a“S,re8“‘rded in “»
of development
eon.ent.on. or nation., legislalio„ for tlle “
?' d''"l»i»”"l »r intents’on.l
expltett st.tement
hej||h
. “d »P'™"0" »f d.tn.,
WHO »„n|d |ike
1.6 integration of HiA with Environnrentai lmpact Assessment
•nd de„«"d P™**™ in many c„u„lrtes
_
people to large rursHam
“!0c”,ed
proje™.""1
lin'i,ed teferenoe to human he.hh
£8kF',dn®^
^^^sx'hX^^e^
*' movement of
-dr
cross-cutting view of community health status
than throu8h a wider
strengthening of health services which a thouH
?
reSU'tS
Commendations for
management of eommunlV health r,sks f p,oje8, deX'Z’oXta""5
profile in EnX«°A.'^mem'■"h™1”01 assess'"'"> “ to give health a slr„„ger
hat distinguish it from either of these An alternV
!" SIA’ Wlth 3 number of unique features
procedure for health impact ..Se..mo„t mu
r ff mto
‘ «d»«e’.ul p.^M
■““.ment dten it „.y be
“ J™’. Jfff111’ '”“l»omed in environmental or
e ’Pm'"' ”f
-nd practice of he.hh imp.^X^mZL 1““^ in,eSMd "
fetch. 1995;So„,tX“’"I" ;79« ■“-men,
profile for health. If
r«9mr,„gseparate
ihe
Health
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World ConiniissiOI1 on Dams
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assessment and indicate the method of health i-— to the consultants
impact assessment to be
Provide a quality assurance mechanisms
component of completed impact assessments. through appraising or evaluating the health
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
7
2. Human health issues related to dam construction and
operation
2.1 Categories of health issues
9
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The health issues associated with dams can be conveniently represented in six major categories.
The existing knowledge bases concerning the impact of dam construction and operation vary for
the different categories. Table 1 provides an overview. Each knowledge base has been described
according to the volume of knowledge (large or limited), the reliability of that knowledge, the
transferability between projects or regions and the quantifiability of the knowledge in terms of
epidemiological statistics. The basis for characterisation of the knowledge bases was a limited
amount of expert opinion and further refinement is desirable.
A method is required to attribute these risks to particular dam project components. This is
provided by health impact assessment (HIA), which is described below.
It is difficult to provide a measure of the size of the problem. The total annual global mortality
from floods is probably relatively small (perhaps 100,000 -Miller, 1997). Such deaths are vivid
because they affect large groups of people simultaneously, have an element of dread, are outside
the control of the individual and are not part of everyday life. In contrast, communicable diseases
such as malaria and diarrhoea kill far larger numbers of people and especially children (World
Bank, 1993). Transport injury rates are also very high and there is widespread malnutrition
associated with protein-energy deficit or diet. There is a substantial difference between the
perception of risk and the statistical measurement of risk. It is thus usually the case that familiar
voluntary risks (e.g. drowning during normal recreational swimming) are not given the same
weight as unfamiliar, often dramatic, involuntary ones (e.g. drowning during a once-in-a-hundred
years flood event). The choice of priority is a matter for the community.
df-'
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Ibis is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
Table 1.
8
f
• ‘ ‘ categories of health issues and the extent of existing knowledge about their
Principal
J
association with dam projects
Health Issue
Examples
Knowledge base
Communicable
disease
vector-borne, water-borne,
sexually transmitted, zoonoses,
other parasitic
large, reliable, ecosystem specific,
some quantification
Non-communicable
disease
poisoning by minerals, biological
toxins, pesticide residues,
industrial effluent
Geographically limited, reliable,
generalisable, and frequently well
quantified
Injury
drowning, construction injuries,
communal and domestic violence,
catastrophic failures, seismic
activity, traffic injury
limited, reliable, transferable, some
statistics
lack of protein, carbohydrate or
essential elements
limited and controversial, limited
transferability, reasonably
quantified, limited reliability
Nutrition
Psychosocial disorder
stress, suicide, substance abuse,
social disruption, unrest violence,
decreased tolerance
low volume, of poor reliability with
little quantification and cultural
variation
Social well-being
quality of life, social cohesion
and support structures, selfdetermination, human rights,
equity
low volume, of variable reliability
and quantification and considerable
cultural variation
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There is a considerable body of evidence about the global burden of disease and a measurement j
unit has been constructed to compare pain, suffering, disability and loss of productivity from
different illnesses. This unit is known as the disability-adjusted life year, or DALY. It is designed
to assist in the allocation of scarce resources within the health sector (World Bank 1993). While
useful in evaluating the relative burden of many diseases and illnesses, further research is needed
before it can be used to analyse the health issues associated with dam projects and serve as a basis
for the selection of health safeguards.
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2.2 Regional differences
There is regional variation in the prevalence rate of certain health conditions. This variation is
most obvious when the condition depends on ecological factors such as the presence of insect
vectors, which in turn depends on environmental determinants such as vegetation type or rainfall.
Clear differences are observed between hot tropical climates and cooler temperate climates in the
transmission of many vector-borne diseases, or in the occurrence of toxic cyanobacterial blooms,
for example. Some of the more generalisable regional differences in health conditions throughout
the world are described in .
Ki
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
■v ■
V
• World Commission on Dams
SoC'al lssues “ Human Health and Dams, Draft, November, 1999
9
Table 3. Examples of regional variation in health conditions
Warm v cold
climates
Various communicable diseases depend on a pathogen lifecycle
which has a stage in the environment and transmission is then
temperature, rainfall and water cycle dependent, e.g. malaria,
schistosomiasis and cholera. Toxic algal blooms more prevalent in
warmer climates.
Africa v Asia
Communicable diseases such as yellow fever, rift valley fever,
onchocerciasis, trypanosomiasis are not found in Asia.
Schistosomiasis has a very limited distribution in Asia but a wide
istnbution in Africa. The malaria vectors of Asia have different
habits to those m Africa. Communicable diseases such as Japanese
encephalitis and dengue fever are found in the Asian region.
S E Asia
Opistorchiasis is an example of a parasitic disease that is most
common here. Schistosomiasis is restricted to a belt of China,
Philippines, a valley in Sulawesi and a small section of the Mekong
river. I he habits of the snail host are considerably different to
Africa and S America. The malaria vectors tend to be associated
with the forest fringe.
America
i
Malaria is sometimes associated with forests but there are many
different habitats, schistosomiasis is focal, zoonoses include Chagas
disease and leishmaniasis.
!’
2.3 Differentiation on the basis of dam size and purpose
Because many health concerns are associated with the interface between land and water the health
equal total volume This id*
lhe impact of a few large dams of
volume For examnl^'b
inCreased ratio of overa11 shoreline to water storage
ZaTd FC’r,eXa i ple’ bJeedlng s'tes for mosquitoes tend to be in shallow backwaters Hence
small dams should not be ignored in a regional health context, particularly where significant
numbers ofsuch dams exist or are planned.
7
significant
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The purpose of a dam will be reflected in the infrastructure associated with it and in its operation
Uns will have spec.fic consequences for its impact on environment and health ReseZirs S
JZthaUheT SUPP Y haVe 311 imPaCt °n the landscaPe and ecol°gy of‘he agricultural production
electrS V aene V’ COn‘raSt hydroelectric dams- TyPicaI da™ functions include: irrigation,
y g ration, water supply, flood control, recreation, inland navigation and fish breeding.
Each will havej a range of positive and negative health impacts on a range of stakeholder
communities.
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The report published herein was prepared for the
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
1
10
3. Options for preventative or health promotional action
3.1 General considerations
I
The minimum requirement for any development project should be that it does not adversely affect
the health of local communities. Unfortunately this largely remains a distant objective. The health
impacts can be difficult to quantify but they can be categorised as an increase, decrease or no
change in the risk of disease and in opportunities and enhancements for health. The ideal
objective is that the health of all communities should be enhanced and promoted by the project. In
the search for procedures, methods and technical solutions that assist in achieving these objectives,
many technical solutions can be found to the problems of negative impacts of dam construction good practices as Table 4 and illustrate.
Table 4. Examples of health outcomes from dam construction and management
Successful
Panama Canal
Health was accepted as an integral objective of the river
Authority
basin development and the most important problem,
malaria, was quickly controlled around dam sites. The
Tennessee Valley
success of carefully planned engineering measures has
Authority
been sustained for almost a century along the Panama
Canal and half a century in Tennessee.
Mushandike
Irrigation Scheme,
Zimbabwe
Not
successful
Senegal Valley
Authority (OMVS)
Rehabilitation of this scheme in the 1980s included
health concerns into the planning, design, construction
and management. It included the development of new,
self draining hydraulic structures, improved canal
infrastructure with optimal gradients and reduced risks
of seepage, and the provision of ventilated improved pit
latrines in the fields, deployed according to a grid
pattern.
Health was not accepted as an integral part of planning
for the Diama and Manantali dams. An epidemic of Rift
Valley Fever occurred when the dams were filled,
schistosomiasis prevalence rates reached record levels
and riverside inhabitants experienced diarrhoeal disease,
malnutrition and malaria.
Recommendations for good management practice are listed below,
observations need to be made:
•
•
!
First, a number of general
II
I
Preventative and health promotional measures tend to be site specific. They are linked to the
geographic variation in health conditions associated with dams as well as to the relative
effectiveness of measures in different ecological and epidemiological settings.
The secondary effects of measures need to be taken into account and trade-offs will have to be
found to come to a final decision. The reliance on swamp drainage for malaria vector control,
This Is a draft working paper of the World Commission on Dams.
The report published herein
was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc
not intended to represent
the views of the Commission.
I®
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-Huvumuusswn on Dams
3nd D-=. Draft, November, I999
11
for example, which was
,
the 1920s and 1930s
unacceptable in many instances b
Whatever the technical i™n. Of "good p„clice.. inte„end JX
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3.2 Good Practice - the Planning Framework
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health outcomes associated with dams and associated8’ fr10"’ Fortunately- ma”y of the adverse
take an >ntegrateTmdHXCfplineaXlnaeerin8 |Pproaches should come r
This new understanding can fead m the™30 . enVlronmental- s°c>alrecognition
and healthfor the need to
management.
operational features for water infra
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innovative
provide tte desired heal”
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remedial medical interventions.
formally were considered controllable
- : only through i
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As already noted, the key process driving n • ■
Impact Assessment (HIA). In the content of '"CreaSed understand‘ng >s the integrated Health
important that the HIA is implemented as en
h 0Ve[a" .dam Planning framework, it is verv
of the HIA, such as the gathering of base!/ aS P°SS'b e ln the Panning cycle. Certain aspects
complete than other aspects of the overall environmlmCl a^31*
reqU‘re m°re time to
be collected across different seasons because of tlCe shonP™0655' Often this data must
Product,™ ind .ctivity, „ m|, „
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It is also very important that the HIA is nnrt w i
WHO or by national health organisations a'nd exne?8 ^d™3' tmethodolo8ies a* outlined by
regulatory backing (See section 5 for details) In addftio '
,Wlth proper institutional and/or
be identified between the HIA and environmental feco?’
3pS and ^gies will be usually
From a health perspective, it will usually bTaXa ent ^T30
^Ocial i^ assessments,
!,na
environmental impacts, also lead to clear! identic W u
°f ,he identified social and
specialist(s) carrying out the HIA may not be f ’’r'
? lmpacts' Because the health
outcomes, such post-analysis and integration is ess^fV 7“^
environmental or social
opportunities are to be identified and addressed duriS^^^
^adnnrsr,e is the need to h- a>* < •
sections of the stakeholder
■merest in or be affected by the construction f
t0 mea" any°ne wbo ma>' have a'«
Pr°CeSS’ and gCneraIly in a" aSp- relating to^m^ZX'^ttn.
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Social Issues - Human Health and Dams, Draft, November, 1999
1
12
3.3 Good Practice - Design and operation options
There are a number of fully or partially validated options, which can mitigate the adverse effects
on human health of, dam construction. These planning options fall into a number of categories
including engineering design considerations, operational water management, social and
community planning. Some examples are:
n
Multiple depth off-takes which allow release of first flush inflows that may contain
high levels of contaminants and nutrients, and allow a high control of variation in
operational water level (which can be advantageous in the control of disease vectors
such as snails and mosquitoes).
■ Minimising low flow zones in artificial channel networks to minimise habitats for
development of disease vectors.
■ Siting dams in areas that require minimal population displacement.
■ At all potential sites, ensuring careful examination of reservoir bathymetry so as to avoid dam
sites that have extensive shallow areas conducive for insect and snail breeding. While shallow
margins can never be totally avoided, catchment topographies that give rise to large reservoirs
of low average depth (and therefore large wetted perimeter) should be avoided (such
reservoirs will also be undesirable from an evaporative loss point of view).
■ Provision of simple infrastructure at critical places along the reservoir shore to reduce water
contact for specific target groups (fishermen, women, and children).
■ In-reservoir management to prevent eutrophication and excessive growth of problematic
organisms such as toxic cyanobacteria and aquatic weeds. The, development of massive
blooms of toxic cyanobacteria is an area of increasing concern, especially in poorer countries
where safe drinking water treatment is less common or absent, and where exposure to toxic
blooms may go unmanaged or unreported (see text Box 4).
■ Careful settlement planning that ensures that, whereever possible, and in balance with other
planning and social needs, population settlement occurs away from areas of impounded and
slow flowing water. This will minimise human exposure to disease carrying vectors (see table
4 for more information).
■ Adequate planning for, and design of, community water supply and sanitation, including
careful management of sewage and waste.
This will reduce the rate of reservoir
eutrophication and the occurrence and severity of toxic cyanobacterial blooms, as well as
generally reducing water pollution.
■ Management of cropping systems to maintain seasonal wetting and drying cycles (while
ensuring efficiency in water use), crop diversification and synchronisation of cropping
patterns. In particular, there should be no agricultural advocacy or economic analysis carried
out that encourages excessive multiple cropping within a single production year. Extended
crop drying periods are important controls on the development of water borne insect disease
vectors in irrigation areas.
■ Staged and planned controls over population movement into and out of the affected region e.g.
planned community infrastructure construction, culturally sensitive community planning.
■ Well formulated dam environmental management plans that will support sustainable fisheries
practices, enhance the growth of natural predators of animal disease vectors, and minimise
excessive growth of aquatic weeds and animal pest species.
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Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the vlcwi of the Cotnntlsalun.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
13
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3.4 Good Practice - Off site management and environmental ]BMprotection
Rl
The spatial boundaries of the health impact of dams generally extend beyond the confines of the
reservoir and the immediate downstream area. Therefore a number of offsite environmental
management measures may also be considered.
■
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Catchment management to minimise negative impacts on fthe impoundment including
population and agricultural growth in the upper catchment and pollutant in-flow
Adequate in-flow forecasting for disaster prevention because of increased settlement on the
downstream floodplain and heavy dependence of livelihood on the new production system
Water release regimes that minimise impacts on ('downstream ecology and productivity
especially in regions where there is a significant nutritional reliance on the downstream river
production
Management plans for irrigation areas that minimise long term salinisation and water logging
and therefore impact on community nutrition and viability
Sensitive management of flood plain wetlands and water resources to ensure wetland
protection, but at the same time minimising excessive growth of water borne diseases vectors.
As with irrigation cropping developments, natural seasonal wetting and drying cycles will be
an important management tool. Traditional irrigation and drainage practices often lead to
permanent inundation and wetting of previously ephemeral wetlands. The outcome of this is
both the degradation of the wetland and an increase in the growth of disease vectors.
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This is a draft working paper of the World Commission on Danis. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commission.
•A
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
14
4. Recommendations for improving health outcomes
4.1 Health impact assessment (HIA)
V'
There is an overwhelming need to include health impact assessment (HIA) as an integral
component in the planning of dams and other major water infrastructure projects
HIA is an instrument for safeguarding the health of stakeholder communities. Prospective health
impact assessment provides a mechanism for scrutinising and comparing the health outcomes of
different project plans. Changes may then be included in the plans and operations so as to
safeguard and promote human health. This recommendation is seminal and is discussed in detail
in the next section.
Ideally HIA should be integrated with Environmental Impact Assessment (EIA) and Social Impact
Assessment (SIA) as much as possible, while at the same time ensuring that the importance of
human health as an assessment parameter is not lost in the integration process.
Furthermore, the HIA should be commissioned as early in the project planning cycle as possible,
when alternative designs are being discussed. This will allow a comparative assessment to be
made of the health impacts of each design, and importantly, it will allow time for baseline data to
be collected throughout a full annual climatic cycle (see sec. 3.2).
The imperative need for HIA should be incorporated in any future international conventions and in
national legislation on dams.
I
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Capacity building
Appropriate capacity in HIA and community health management needs to be built both within the
health sector and in the sectors primarily responsible for dams.
I
National authorities cannot use instruments such as HIA to their full potential until there is a
significant body of trained personnel, and this is clearly lacking throughout the world at the
present time. Health sector personnel will benefit from training in impact assessment procedures
and methods, and will be better placed to appreciate the concerns of other sectors. In turn, other
important sectors, in particular the dam design and construction (engineering) sector, should work
towards the development of an understanding of the association between their decisions and
human health.
Where lacking, all groups should develop skills and training in inter-sectoral communication and
collaboration. This training should include an appreciation of the principles of health impact
assessment. These are generic skills that apply equally to all development policies, programmes
and projects, training courses need to be self-sustaining and widely available in all countries and
regions as optional components of post-graduate degrees as well as free standing short courses.
The participants of such courses need to be empowered by their managers to implement the skills
that they acquire. This includes career rewards for engaging in inter-sectoral activity that may go
beyond their original job specifications. Wherever possible, this new expertise should be
established and maintained local to the project. Orientation courses are also required for different
stake holders, especially policy makers and elected members of local administrative bodies (See
Box 2 for more details).
Ibis is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Comnussion as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
15
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'''
Institutional support is required to foster these training programmes and provide quality assurance
mechanisms. The World Health Organisation could be one institution to provide that support
through its headquarters, Regional Offices and country representations. It can also provide the
international framework for health impact assessment of large development projects, as a service i
to the World Bank, Regional Development Banks and bilateral agencies,
-----A programme of s
training and re-orientation is then needed within WHO to build its own capacity
(
to undertake such J
functions. On a longer term a self-sustaining financial mechanism as well a local institutional
basis should be found to support this framework and the associated activities.
'
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Box 2. Health Opportunities in Water Resources Development
Capacity and skills to break through the barriers that exist between public sectors are
critically important for health to be considered effectively in the planning, design and
implementation of infrastructure projects. Formal secondary and tertiary education generally
aims at the formation of specialists. Adult learning is most effective when it is problem
based and allows participants to learn from each other rather than through passive information
transfer such as formal lectures. The World Health Organisation, the Danish Bilharziasis
Laboratory and the Liverpool School of Tropical Medicine have developed and tested a threeweek training course for mid-level managers in ministries and other public authorities. In the
context of water resources development -fully documented real projects are used- the
participants work, in inter-sectoral groups, through a series of tasks representing crucial
decision making moments in the project cycle. To a large extent, these tasks revolve around
HIA. Evaluations of five courses (three in Africa, one each in the Americas and Asia)
suggest high levels of acceptability, effectiveness and efficiency. The value of such training
efforts is highly enhanced when simultaneously policy reform is promoted allowing for the
trained staff to effectively engage in inter-sectoral collaboration (Birley et al. 1996)
4.2 Documentation
practices
of
successes
and
efficacy
of
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An information and education oriented data base should be compiled:
■
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describing the limited number of health success stories based on careful dam design and
operation, and explaining the key management processes in detail.
with an assessment of the efficacy of already implemented health risk management
techniques.
improvement in the existing health management
This information will lead to a considerable
<
knowledge base and will streamline health-sensitive dam planning
...............
Examples of good health planning in dam and water infrastructure construction include: Panama
Canal, Tennessee Valley Authority, Owens Falls in Uganda, Puerto Rico small dams,
simplification of the Gorgol irrigation project in Mauritania, and remedial action on the Dez
Project in Iran and the Mushandike Irrigation Scheme in Zimbabwe. There are also dams that
have included engineering measures for safeguarding health that have not been evaluated. These
include water supply reservoirs in Katsina and Kaduna States, Nigeria, the Ghazi-Barotha Power
Canal in Pakistan, Manantali reservoir in Mali.
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
16
os construction evaluations of dam projects should routinely include a retrospective health
assessment as well as a prospective health impact assessment that takes into account the long-term
(50-100 years) temporal boundaries (also see section 5 for more details).
4.3 Action oriented research
Special funding should be directed towards action oriented research in existing and planned dam
construction projects in order to strengthen existing knowledgebases and improve health outcomes
There are a number of well-documented health problems associated with dams that require
remedial action, with examples including dams in the Senegal, Blue Nile and Volta river
basins. There is good reason to believe that the adverse health, social and environmental
impacts could be alleviated by changes in dam operation. Such projects should be given
priority attention for funding and implementation of health management strategies.
Similarly, there are a number of incompletely tested ideas for environmental management
methods for vector control. One example involves fluctuating reservoir outflows. There is
a shortage of funds to support such research because it falls between environmental and
health budgets.
i
Box 3. Flushing canals for malaria control in Sri Lanka
.1
The synergistic potential of multidisciplinary research on malaria in a specific
specific ecological
ecological
setting was recently demonstrated by the work done in the Huruluwewa watershed,
Anuradhapura District, Sri Lanka. The joint efforts of Peradeniya University and the
International Water Management Institute (IWMI) focused on a strategic assessment of the
local ecology of malaria vector mosquitoes and a water balance estimation/flow measurement
in the irrigation scheme. The primary vector species in Sri Lanka is Anopheles culicifacies,
known to use stream and riverbed pools as its main breeding sites. The water management
options suggested by the research include flushing of streams and irrigation canals at critical
times to reduce mosquito densities and malaria transmission. Routinely applied, this will
require new decision making criteria for irrigation water management, and further feasibility
studies involving both government institutions and farmers. The availability of existing
reservoirs to manage water levels in streams/canals, and the capacity to recapture the released
water downstream are important factors contributing to the feasibility of the proposed water
management regime. Further testing of different options for flushing regimes can provide an
optimal combination with both health and agricultural benefits (van der Hoek el al. 1998*
Matsuno et al. 1999).
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4.4 Budgeting for health
A health component should be negotiated as a budgeted item for all project loans in order to
safeguard and enhance health.
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Economic assessments of dam projects that do not include the consideration of health
issues tend to transfer a hidden cost to the health sector. That is, the cost of providing
health and medical support to communities for illnesses that arise because of unforeseen
(though avoidable) consequences of dam construction. The health budget, which is not
This is a draft working paper of the World Commission on Dams. The report published herein was prepared Tor the
lheTiews'ordu
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Ormat,on'Bal*lcr’n8 activity. I he views, conclusions, and recommendations are not intended to represent
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
17
necessarily administered by the medical sub-sector, should be used primarily for
preventative rather than curative actions, with the optimal balance decided on a case by
case basis. It should complement the existing general health infrastructure and should not
be considered as a substitute for the existing health care system.
4.5 Prioritising the health issues
It is important that the health priorities are not pre-judged but allowed to emerge from the health
impact analysis and community consultation.
tw!
The IIIA will identify a wide range of health changes attributable to the project. Many of these
positive health enhancements, while others will be negative health impacts that have to be ‘
prioritised for preventative action. Table 1 (sec. 2.1) indicated the range of health issues that may i
be affected by a dam project. Development agencies are often aware of one or two major issues examples include schistosomiasis and AIDS - and assume that these have over-riding priority,
sometimes to the neglect of other potentially very important health issues.
Boxes 4 and 5
highlight some important health risks that do not always receive the attention they deserve in
health assessment procedures for dam construction.
Box 4. Freshwater cyanobacterial toxins
an emerging dam-related health issue
In tropical, sub-tropical and arid regions of the world it is almost inevitable that new dams
will become eutrophied (nutrient enriched) rather quickly, often within the first few years
of filling and operation. Eutrophication brings with it problems of excessive aquatic weed
growth or ‘blooms’ of toxic cyanobacteria (cyanobacteria are a type of microscopic algae).
Arid zones of the world are particularly at risk, where the artificial impoundment of water
in the hot climate creates the perfect ecological environment for the growth of toxic
cyanobacteria. Added to this natural climatic effect is the enhanced rate of nutrient
pollution that accompanies the growth of towns and agriculture in the catchment around a
dam, often with inadequate effluent collection and treatment facilities.
Blooms of freshwater algae and cyanobacteria have always occurred in eutrophied
waterways, but the toxicity of these organisms has only been elucidated in recent years.
There are several types of cyanobacterial toxins found throughout the world, all of which
are potentially dangerous to humans and animals if consumed in sufficient quantities.
Additionally, some cyanobacterial toxins can promote liver cancer during chronic low
level exposure, and most cyanobacteria can cause a range of gastrointestinal and allergenic
illnesses in humans exposed to toxins in drinking water, food or during swimming (Chorus
and Bartram (WHO), 1999). A drinking water guideline concentration for the common
cyanobacterial toxin microcystin has recently been developed by the WHO.
The most severe and well-documented case of human poisoning due to cyanobacterial
toxins occurred in the Brazilian city of Curaru in 1996. Inadequately treated water from a
local reservoir was used for patients in a local kidney dialysis clinic. As a consequence,
more than 50 people died due to direct exposure of the cyanobacterial toxin to their blood
stream during dialysis. Elsewhere in South America, in 1988, more than 80 deaths and
2,000 illnesses due to severe gastroenteritis have also been linked with toxic cyanobacteria
in a newly constructed dam. In China, a high incidence of primary liver cancer has been
linked to the presence of cyanobacterial toxins in drinking water (Chorus and Bartram
(WHO), 1999).
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
18
In addition, there are often differences in perception of risk between subject experts (health
specialists) and affected communities. Such differences in opinion can not simply dismissed out
of hand as subjective or emotive. There are various approaches to establishing priorities,
including the following:
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estimating the frequency, severity and probability of health impacts;
conducting an economic analysis that compares the cost of all health outcomes;
determining the subjective perception of risk expressed by the stakeholder community;
negotiation of opportunities for mutual gain;
comparison with standards;
reducing health inequalities.
Box 5. Examples of health impacts from India
Downstream: monsoon dryness
When dams obstruct a river, the protection provided to aquifers and soil by the outward
freshwater flow disappears, and tidal surges may invade the rivers and cause flooding. This
is already evident along Western state of Gujarat’s long Saurashtra coast. Reports by
independent experts, including a World Bank-instituted independent review expressed
similar fears regarding the Narmada (Anon, 1982)
Water pollution
The impounding of river water in reservoirs has dramatically reduced flow in many rivers,
rendering them incapable of diluting effluents or sustaining much of their natural fauna and
flora. The diversion of the river Yamuna's water into Upper and Lower Yamuna Canal at
the Tajewale barrage at the Himalayan baseline constricts the downstream flow. Industries
and towns in the North Indian state of Haryana's and later Delhi itself seriously pollutes the
remaining insubstantial flow. The health of downstream communities is placed at risk
because of the high levels of toxic pollutants and pathogenic micro-organisms (Anon.
1997).
1
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Fluorosis
S3
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Large reservoirs and the inigation they bring in command areas elevate sub-soil water,
changing the levels of calcium and trace metals, and can increase fluorosis. The Nagar
Junasagar dam in South Indian Andhra Pradesh triggered a crippling syndrome of knock
knees {Genu valgum) among villagers in the command area. According to Hyderabad's
National Institute of Nutrition, seepage from the reservoir and canals increased the level of
sub-soil water. This in turn elevated the molybdenum uptake of sorghum plants, and
augmented soil alkalinity. Genu valgum has been found in villages in Coimbatore district,
situated within a radius of 30 km from the Parambikulam-Aliyar dam, and from villages
near Karnataka's Hospet dam (Anon. 1982).
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Illis is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commission.
□I I [if ■
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
19
tel
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4.6 Prioritising dam projects for impact assessment
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Screening procedures for HIA needs must be the minimum requirement for all dam projects.
There are often more projects that require health assessment than there are resources
available. Typical screening criteria include number of people affected, location in
sensitive sites, and use of unusual technologies and procedures. Multiple screening
procedures can be used and these are equivalent to rapid health assessments. Several of the
largest dams in the world have serious health impacts. Because of their unique size and
nature, such dams should be evaluated as a special category.
The cumulative effect of many small dams may be more important than the effect of one large
dam. It is impractical to conduct separate assessments for each small dam. A preferred approach
is to conduct a strategic assessment of the small dam construction programme.
f<i
Box 6. The compounded malaria impact of microdams in Ethiopia
p
Recent studies in Ethiopia using community based incidence surveys revealed a 7.3 fold
increase of malaria incidence associated with the presence of microdams. The study sites
were all at altitudes where malaria transmission is seasonal (in association with the rains).
The increase was more pronounced for dams below 1900 meters of altitude, and less above
that altitude. In addition, observed trends in incidence suggest that dams increase the
established pattern of transmission throughout the year, which leads to greatly increased
levels of malaria at the end of the transmission season (Ghebreyesus 1999).
H
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4.7 Transparency
The health impact assessment and planning process should be open to scrutiny by all stakeholders
and communities.
As with all forms of impact assessment, and indeed the entire planning process, it is crucial to
include all stakeholders at all stages of the process. This is good practice for all kinds of
assessment and development activities, not just HIA. Health concerns simply provide a specific
example. In addition, the community is the critical source and repository of health knowledge and
information.
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This is a draft working paper of the World Commission on Danis. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
20
5. Health impact assessment (HIA)
J
5.1 Introduction
I
Much of the preceding discussion points to the need to include health impact assessment (HIA)
when dam projects are designed or changed. HIA is an instrument for safeguarding the health of
stakeholder communities. A recent broad definition of HIA is the estimation of the effects of
specified actions on the health of defined populations (Scott-Samuel et al, 1998).
For the purpose of this paper WHO prefers a more operational definition: a health impact is a
change in health risk reasonably attributable to a project, programme or policy. A health risk is
the likelihood of a health hazard affecting a particular community at a particular time.
Assessments can be retrospective or prospective. The retrospective kind is the business of normal
science and serves to enlarge our knowledge base. It measures and records what has happened.
The prospective kind is part of the development planning and project assessment procedure. It
projects the likely consequences of a future project based on available evidence. The health
impacts themselves may be positive or negative. It is expected that most development projects
have mostly positive impacts and these include reductions in health risks as well as positive health
enhancements.
The various components of health impact assessment have been debated over the past 15 years
especially in the context of water resource development. They can broadly be classified as policy,
procedure and method. The policy context was described earlier in this document. The distinction
between procedure and method is important. At the early stages of HIA development
methodological questions were considered more important. Experience proved otherwise. The
problem is not so much technical as knowing when and where to conduct the assessment. This
section of the document starts by providing a summary of the procedure so that each stakeholder is
informed of the framework in which the assessment should be carried out. See Figure 1.
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5.2 HIA Procedures
J
The procedure that is describe here and in Figure 1 will be familiar to anyone who is already
informed about impact assessment, such as environmental assessment specialists. It may not be
familiar to many members of the health community who wish to have a role in future assessments.
In addition, there should be community participation by involving stakeholder representatives in
all stages of the procedure. The main components of procedure are as follows.
1. Timing
2. Screening
3.
Establishing a steering committee
4.
5.
Agreeing Terms of Reference
6. Choosing an assessor
Scoping
7. Undertaking an assessment (see method)
8.
9.
Disseminating
10. Negotiating
11. Agreeing actions
12. Implementing
!
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Appraising
13. Monitoring and evaluating
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
21
■H
Figure 1. Procedures and methods used in health impact assessment
Procedures
Methods
?i Apply, screening^
^criteria toiselecR;
^project-oir ‘ policy,?-;
>s
r;-. .
• -r
;i,.; Profiling .of^
Si-’<’25
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IntQn/ipY^^
^m^pf^ference;
^forassessment:^
if Select assessor:?' I
MSB
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stakeholders’ and I
key: informant^, I
Identify health
determinants
affected
Collect.evidence ||
from previous I
reports.
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<
~~T~^
.
w
Assess
evidence
■
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R
s'T. v .J,l ..a,
f'^'Negoliate;^?^
<<;?x
tel
;f^Establishv^;
priority iippacts'.
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Recommend and
justify options for
*'r: . action
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monitor; ':’••
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? 7 Eva I ua t e a nd/i^
•\:?y.‘;docunient'
aJ-s:
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
W T W T* W
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- World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999 ’
22
. ;.u'
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5.2.1 Timing
R
liming - when to commence the MIA - is crucial because of the frequent observation that impact
assessments are commissioned too late, sometimes even when the first concrete has already been
poured. They should be commissioned when alternative designs are being discussed so that a
comparative assessment can be made of the health impacts of each design. The timing should also
allow the health assessor to interact with other members of the design and assessment team.
Additionally, time should be allowed for seasonal differences in baseline community health
conditions to observed and recorded (see also sec. 3.2).
A
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5.2.2 Screening
Screening procedures are used to decide which projects should receive a particular level of HIA,
or whether indeed a HIA is necessary at all (as discussed in sec. 4.7). However, it is difficult to
conceive of any large dam project for which a health assessment would prove unnecessary.
Individual small dam projects may not, upon initial consideration, seem likely to require an HIA.
However, as already noted, small dam developments need to be examined strategically and in a
regional context. In particular whether several other such dams already exist in an area whose
cumulative health impact may be similar to or even worse than that of a large dam of identical
total storage capacity.
I
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5.2.3 Steering committee
S'
Following screening a multidisciplinary Steering Group should be established to determine the
scope and Terms of Reference of the assessment and to provide advice and support as it develops.
Its membership should include representatives of the commissioners of the HIA, the assessors
carrying it out, the proponents (i.e. those developing, planning or working on the dam project),
affected communities, and other stakeholders as appropriate. Members should ideally be able to
take decisions on behalf of those that they represent. A single committee that takes charge of all
assessment and feasibility studies is the preferred option. This broad committee should include a
specialist health representative.
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5.2.4 Scoping and agreeing Terms of Reference
The outcome of the screening procedure should be the starting point for scoping and the
formulation of Terms of Reference (TOR). Scoping serves to define the health issues that should
be considered in detail (generically listed in Table 1), the stakeholders, and the boundaries of the
assessment in time and space. Based on the scoping exercise, TOR are formulated.
The purpose of the TOR is to provide a basis for a quality assurance procedure for the
work being undertaken. The TOR is project specific, but should include the following
elements.
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Steering Group membership should be listed in the TOR, together with members’ roles,
including those of Chair and Secretary.
The nature and frequency of feedback to the Steering Group should be specified.
1 he methods to be used in the assessment should be described in adequate detail.
I he 1OR should outline the form and content of the policy, programme or project’s outputs,
and any conditions associated with their production and publication. Issues associated with
publication of outputs include ownership, confidentiality and copyright.
The scope of the work should be outlined - what is to be included and excluded, and the
boundaries of the HIA in time and space. Positive as well as negative health impacts should
be included in the assessment (see sec. 2.1, table 1).
This is a draft working paper of the World Commission on T
’
.
.
Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations
----------- , —.......
arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
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23
An outline programme - including any deadlines - should be provided.
The budget and source(s) of funding should be specified.
The TOR is a crucial element of the HIA procedure, with the quality of the assessment being
determined in part by the quality of the TOR. In the case of dam projects, it should be written by
an expert with experience/ expertise in community health and/or environmental sciences and with
definite experience in working with displaced people. It will need to be agreed by the Steering
Committee. It is important that the TOR has a broad view of health issues as outlined in Table 1.
When the assessment report is complete, it is appraised by the Steering Group to determine
whether it satisfies the TOR.
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5.2.5 Choosing an Assessor
work on health impacts are frequently unclear about
Project proponents who are commissioning
(
the kind of person that they should commission to carry out the HIA. This is made more difficult
2._.lack of availability
\
‘ ‘ training
* ' j or expertise. In an ideal world, a team
by the general
of' special
WWUIU
u.v
---------- i
encompassing all the requisite skills and knowledgec would
undertake the
assessment, but
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The
following
list
is
provided
for
guidance,
reality, some compromise will usually be necessary.
The person or team
t---- contracted
------------ to undertake the HIA should ideally have the following
qualifications, education and experience:
■ Experience with prospective health/ environment / environmental health impact assessment.
■ Training in public health, environmental health or equivalent.
■ Familiarity with both environmental and social determinants of health
■ Able to adopt a holistic perspective of health issues (see Table 1).
■ A record of publication or experience linking environmental change and health issues.
■ Able to carry out key informant interviews and produce an analytic report that cites sources and Bi
8
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indicates assumptions.
■ An understanding of water resource development issues.
■ Familiarity with disease ecology, for example the ecology of vectors associated with the
floodplain.
An involvement with field based health research such as epidemiology or human ecology.
B
A number of training courses have now been pilot tested in both developing and develop.. >
countries (Birley et al. 1996; Birley et al. in prep). But they have not yet been w.dely
disseminated or institutionalised (see for more details sec. 4.2, Box 2).
1
5.2.6 Spatial
boundaries
. ..
that administrative, ecological and hydrological boundaries do not coincide. Rivers ||
It is common tnu*.
------ - -j
«-*
_
,
may flow through several countries, regions and local government districts. The boundaries used
in different kinds of impact assessment need to be integrated. Health impacts are sometimes |g
associated with boundary problems and confusions over jurisdiction.
Kj
Figure 2 illustrates the various geographical boundaries and components of dam projects.
include reservoir, upper catchment, irrigation scheme, floodplain, estuary, urban slums, and coa^M
The health impacts cover the whole river basin both upstream and downstream of the dam wall>
and ultimately, it is the extent of human movement that determines the lateral extent of the zone o
interest rather
rather than
than any
any particular
particular biogeographic
biogeographic zones (e.g. catchment boundaries). This inclu es
interest
I
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for the H'-l
I his is a draft workine Paper of the World Commission on Dams. The report published herein was prepared
|
p..l on., foroJ.lion.gMhcring ac.ivi.y. The
The view,,
conclusion,, and
and recommendation,
.0 rcpre^S.
f
views, conclusions,
recommendations are no. .mended"■■■
the vlowi of the Commliilon.
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‘ World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
24
seasonal movement by pastoralists, displacement to urban slums, and circulation between river
basins by fishing folk. Communities displaced by reservoirs may migrate to the upper catchments
and change the local land use. Others will be formally resettled in newly designed and constructed
villages, with all the difficulties that this entails. Increased deforestation in the upper catchment
area to increase water yields into the reservoir may also have local health impacts, as well as
negative impacts on water quality in the dam itself due to increased sediment and nutrient run-off,
hence contributing to the risk of toxic algal bloo:>ms. The displaced communities also migrate to
distant cities where they swell the peri-urban slums.
K
100 kms
catchment
resettlement
1
circulation
rrlgatlon
displacement,
circulation,
migration
■t
it
flood
recession
floodplain
human
circulation
i
i
estuary
coastal plain
sea
Figure 2. Spatial boundaries of dam health assessment
The association between human circulation and health issues is illustrated in Table 5. At a smaller
scale and depending on the specific river system, the river floodplain includes a flood recession
zone that may extend 50 km and the reservoir has a draw-down zone that may extend 5 km
laterally around the perimeter of the dam. At an even smaller scale, the local flight range of insect
II
This Is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
25
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vectors between breeding and feeding sites ranges from 0.1-10 km as Table 5 indicates. Longer
migratory flights or long-range transport of insects by prevailing winds imply that if a project
creates new insect breeding sites then sooner or later they will be colonised.
■
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Table 5. Flight range of insect vectors
Vector
Local movement
(km)
Migration (kin)
Simuliid blackflies
4-10
400
Anopheline mosquitoes
1.5-2.0
50
Culicine mosquitoes
0.1-8.0
50
Tsetse flies
2-4
1
1
1
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Table 6. Typology of human circulation
Migration
Circulation
Regular
:;O
-------------Resettlement'g^^g
Daily
Periodic
Seasonal
Long-term
Irregular
Rural/rural
Cultivating^
Hunting^
PastoralismM
Labouringl»2
Nomadismi >2
Rural/urban
Commuting*
Urban/rural
Cultivating*
Trading*
Labouring*
Trading *»2
Refugees *>2>3
Retirement*
Urban/urban
Commuting*
Trading *3
Tradingl
Relocation^
Refugees^
3
3
Trading* »2,3
Labouring*
Labouring *»2»
Drought* >23
3
3
1 communicable disease (e.g. vector-borne diseases, STDs)
malnutrition/injury
3 psychosocial (e.g. alcoholism, stress, depression, violence)
-------- ;----Labouring*^.
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(after Birley 1995)
5.2.7 Temporal boundaries
■
The temporal boundaries consist of the stages of the project
design,
construction,,
----- -- cycle: tplanning,
------------------- o,---------O-,............................................
of
dams
the
complete
time-span
may be
operation, rehabilitation, decommissioning. In the case (
Some
health
problems
are
50-100 years and the health impacts will differ in each stage. 1
immediate, rapid or acute in onset while others are slow, delayed or chronic. See Fable 7 and
Table 8 for more details. The baseline conditions, before construction, usually only provide a
partial basis for an accurate forecast of later conditions because of the environmental and
demographic change that occurs. The experience of similar projects in comparable eco-settings is
a more reliable basis for forecasts.
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5.2.8 Appraisal and dissemination
The completed HIA report must be appraised by the steering committee to ensure its quality.
Before final acceptance the report should also be disseminated to all major stakeholder
communities and their feedback should be incorporated. The appraisal includes both technical and
__________________ -»
Hi
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This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commiiilon.
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World Commission on Dams
Social Issues-Human Health and Dams, Drafi, November, 1999
t
Procedural assessment Ps c^eS with o
haS been used-
The
Terms of Reference and the extent to wWch'th O^aS’|problems of timing- ‘he adequacy of the
scrutiny of the conclusions of the HIA
tb
135
met FolIowing a satisfactory
technical feasibility, social acceptance and eco^miclZTs^
their
I1
The accep°ed7eZrt^^
rejection or requirements for report modification.
- - ■
P IS cleerneo to have met a quality standard and that standard and the content of
the final HIA report should be agreed to by all stakeholders as the basis for further nefio“
whether or not it represents a consensus opinion.
I
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Table 7. Examples of association of health issues with timing
Acute or rapid onset
Chronic or delayed onset
Communicable disease
Malaria
Non-communicable
disease
acute poisoning such as during
pesticide
application,
algal
toxins
Injury
drowning, trauma
hearing
workers
Nutrition
wasting
stunting
Psychosocial disorder /
social well-being
communal violence
depression
schistosomiasis
chronic poisoning such as dustinduced lung disease, algal toxins
loss
of
i
construction
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™S iS 3 drart "'orking paper of the World Commission on f
- -----------------------
the v^:^h7crm0LiS,:ionR>rn,’,i0n'8a,heri"8 aC,iVi,y- The Vi‘WS’
, and recommendations
••-••3 ore not intended to represent
Dams.
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The report published herein was prepared for the
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World Commission on Dams
27
Social Issues - Human Health and Dams, Draft, November, 1999
Table 8. Examples of the association of health issues with different project stages
Communicable
disease
Non
communic
able disease
Injury
Nutrition
la.
M
Psychosocial
disorder/
social well
being
Stress, fear,
anxiety
Planning
Construction
STD’s, malaria
Dust-induced
respiratory
tract problems
construction
related
Loss of
subsistence
uncertainty
and
disempower
ment
Early
operation
schistosomiasis,
diarrhoea,
malaria,
zoonoses
toxic algal
blooms
disputes
between
communities
drowning
loss of
subsistence
crops and
grazing
displaced •
communities
lose
coherence
Late operation
schistosomiasis,
diarrhoeal
diseases,
malaria,
onchocerciasis
contamination
of drinking
water, mineral
variation of
soils
drowning
loss of
agricultural
lands
drowning
loss of
irrigation
Decommissioning
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depression
fl
5.2.9 Negotiation
The usefulness of the assessment lies in the weight that it provides to the commissioners of the
HIA during the period of negotiation with the project proponents to ensure that health is
safeguarded and/or enhanced. The negotiators will seek to argue that the predicted health impacts
and the recommendations for mitigating risk and safeguarding health are, indeed, realistic. They
will also agree priorities.
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Once a HIA has been carried out, the consideration of alternative options (or the undertaking of a
• - does
...the process. g
ven w
hen tthere
here appear
formal option appraisal)
not conclude
Even
when
appear to
to be
be clear
clear
................................................................................................................. ■
messages regarding the best way forward, it cannot be assumed that these will automatically be
the Steering Group may ultimately
adopted. Political imperatives, either within or beyond
1
(equalities between
different stakeholder
----- outcome.
------- .... Disagreements
------- ------or- power inc^__".:__
:
..................
determine the
■________ U---------- *1------------ -F
factions may be similarly important. In these and other
such cases, the quality of leadership
shown by the Steering Group Chair and members can prove crucial. Achieving agreement on
options for mitigating or enhancing predicted health impacts might require skilful negotiation on 1
the part of those involved.
few
El
The outcome of negotiation will be a budget and an intersectoral agreement for implementation of
recommended risk management measures.
M
This is a draft working paper of the World Commission on Dams. The report published herein was prepared Tor the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
; f
the views of the Commission.
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
28
5.2.10 Implementation and monitoring
a
unforeseen health effects It is likely to be l/6 d
often well placed to Scrutinis tLs 'indicator
Monitoring provide,
a8,reed and t0 detect the occurrence of any
affeCted co—ities are
example, they can report whether do
t
Prov'd>ng that they are empowered to do so. For
insect bites are more numerous^OmeSt.ic Water suPPlies and health centres are functioning,
the sense of well-being is improved Th^T'f'8 enhanCed’ fear of injur>es decreased, and whether
some of their concerns Part of 2
’7 °J " eCt'°n °f com™nity >^ers can capture
community infrastructure and salaries for !are proves 0U'd
aVa’lable
maintenance of
5.3 HIA Methods
^usistsPonnfe^^ngc^^ng^ in^e^kh^
and that could affect each stakeholdeJ co
taken together, Produ^he^^
Td
aC‘UaI aSSeSSment can take Placc. It
‘ a'6 reaSOnably attributable to the project
The changes,
minimum of three ranks’ nn
■
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1
These are expressed in a
Quantification is generally difficult ebb "T35^ h®al‘h rlsk- Increased health enhancement,
known functional refcht be^
data “ ,aCkin8 °r because there are no
exception, because the dose responsTmodT
d
needed ».he PX» SXLS
I
-I
and lamination are an
“ *’
The best forecast of what will happen is the history of what has happened on
comparable regmns. Reviews are an important tool and a number Previews similar projects in
are available (e.g.
Cooper Weil et al. 1990; Birley 1995; Jobin, 1999).
ZZars'pHort1? f655™"1 W0U'd
iI
by ColleCting baseline data over a period of at least
Ii
By contrast, the objective is to present evidence, infer changes and
recommend actions to
feguard mitigate and enhance human health. The inferences n
may not always be founded on
and'beT
r’ /
mUSt
persuasive- 7116 argument is based
J on the precautionary principle
and best practice (see section below on Evidence).
5.3.1
i1
Stakeholders
c“"i,y ■nd,i,s r“'ur'
po™*
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the views of the Commission.
g
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*’c v,cws. conclusions, and recommendations ore not
Ip
was prepared Tor Hie
intended to represent
J
World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
29
it
....
5.3.2 Health determinants
Health determinants are the factors that are known or postulated to be causally related to states of
health. Health determinants can be listed and classified. The direction of change of health
determinants associated with a project can be inferred. They can be divided into those that can be
managed, such as housing, and those that cannot be managed, such as age. Some health
determinants are listed and classified in this paper but the list is not yet complete. The causal
relationship between determinants and health outcomes is well demonstrated in some cases but
further work is required in other cases. The relationship is clear in some cases while in others it is
multifactorial and complex. In the past there has often been a tendency to focus on the bio
physical environment using a life-cycle model of disease and to ignore social determinants such as
poverty and loss of health culture.
Table 11 indicates examples of health determinants. Some of these will be changed by the project.
The change may be positive or negative in terms of their likely health outcomes. It is not always
possible to associate a change in health determinants with a change in health outcome. Generally,
the risk of a change in health requires several health determinants to act together. For example,
numerous mosquitoes only increase the incidence of disease if people do not protect themselves
from the bites, immunity is low and the health services fail to provide vector control, prompt
diagnosis and treatment. Similarly, the spread of HIV-AIDS may be mitigated substantially
through local education on safe sex practices, distribution of condoms to construction and site
workers and empowerment of local communities to manage the influx of temporary workers.
Personal protection depends on poverty, housing design, knowledge, attitude and belief,
occupation. In seasonal climates vector-borne diseases often have seasonal changes in incidence.
The artificial flood may extend or reduce the transmission season.
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This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues-Human Health and Dams, DraQ, November, 1999
30
Table 10. rExamples of local stakeholder communities and important health issues
Communicable
NonInjury
Nutrition
Psychosocial
disease
communlcStakeholders
disorder /
able
well-being
disease
Construction
SIDs, lung
deafness
occupational
workers
alcoholism
diseases, vectorinjury
bome diseases
Camp
?TDs,
communal
followers
alcoholism
diarrhoeal
violence
disease
Settlers
vector-bome
pesticide
communal
Transitional
dis
diseases
poisoning,
violence,
malnutrition,
empowerment
algal toxins agricultural
food entitle
and
injury
ment
uncertainty
problems in
household
Displaced
diarrhoeal
communal
stress,
disease
violence
depression,
suicide, loss
of tolerance,
violence,
divorce,
school drop
outs
Recipient
communal
Decreased
Loss of
communities of
violence
access to
the displaced
tolerance and
natural
increase in
resources
hostilities and
violence over
a period of
time.
Peripheral
algal toxins
Decreased
communities
access to
natural
resources
Downstream
poisoning
drowning
loss of
floodplain
from
subsistence
dependent
contaminate
communities
d water
Fishing folk
schistosomiasis, algal toxins drowning
other vector
dome diseases
Nomadic
zoonoses
communal
oss of
stress
lerders
violence
grazing
Professional
vector-bome
groups
diseases
associated with
project
management
Rroject
Improved water
deduced air Reduced fire
' mproved
Improved
beneficiaries,
supply
pollution
risks
cooking fuels quality of life
such as
electricity
consumers
Service staff
vector-borne
such as
alienation
diseases
Tills is a ('
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
such as
teachers
diseases
Seasonal
labourers
STDs, vcctorbome diseases
pesticide
poisoning
31
agricultural
and transport
injury
Table 11. Examples of health determinants and their classification
Principal
categories
Individual/family
Environmental
Institutional
Fields
Examples of health determinants
Biological
Genetics, age, senses, gender, immunity, nutritional status
Behavioural/Lifestyle
Risk acceptance and behaviour, occupation, education
Circumstantial
Poverty, empowerment, family structure
Physical
Air, water and soil media, infrastructure, vectors, housing,
energy, land use, pollution, crops and foods, traffic
Social
Community structure, culture, crime, discrimination, social
cohesion
Economic/Financial
Unemployment rate, investment rate, interest rate, inflation
rate
Health services
Primary care, specialist services, access, drug supply
Other services
Police, transport, public works, municipal authorities, local
government, project sector ministry, local community
organisations, NGOs, emergency services, access
Public policy
Regulations, jurisdictions, laws, goals, thresholds, priorities,
standards, targets
pt
of
5.3.3 Weight of Evidence
The HIA assembles evidence from many sources about the changes in health determinants. The
1p
evidence may be qualitative and based on key informants and community opinion. It will often be
incomplete, inconclusive, imprecise, and will usually be probabilistic rather than absolute. At first
it may not seem totally credible to bio-medical scientists and engineers who are used to working
with hard facts and numbers. Because of the uncertainties and difficulty of dealing with large and
highly variable human populations, the type of information that will be gathered has more in
common with legal evidence than scientific evidence.
fl
............................................ *1
Nonetheless, the analysis seeks to establish a chain of inference between the project, the health
determinants and health outcomes. Assumptions have to be made, but if these are explicit, readers
can make their own judgements about the chain of inference. The priorities assigned to the
changes in health outcomes and the associated perceptions of risk are a political matter and outside
the judgement of the assessor.
HI
■
H
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
? I
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# World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
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33
Table 13. Examples of techniques for managing health risks
Poverty reduction
Poverty reduction empowers and enables people to make choices and to
safeguard themselves and their families from many environmental hazards
Zooprophylaxis
There is a possibility of using livestock as diversionary hosts to protect
people from malaria
Wetting and drying of Controls some mosquito species
floodplains or streams
and
Water supply
sanitation
Reduces diarrhoea, intestinal parasites and schistosomiasis. Domestic water
supplies should be protected from contamination by flood waters.
May be appropriate for certain arboviruses
Vaccination
Handling
animals
h
*
*health
’ * centres; are equipped and functional before dam
Ensuring that
construction, and building capacity and capability of health personnel
Health centres
moribund I Control of Rift Valley Fever
Canal or river flushing I Floods have a flushing effect on stagnant waters, removing pollutants such as
I human waste, clearing drains or flushing away mosquito larvae.
Community control
Increasing empowerment and reducing uncertainty enhance health
Communication
Early warning of critical events such as floods, health promotion
Dam design
Dam off-takes that release first flush inflows with high levels of pollutants
fa
if!
Structures that enable extensive control of operational water levels
Irrigation
design
channel I Minimising low flow zones to prevent vector breeding
Dam siting
Siting dams in areas that require minimum population and livestock
displacement
Settlement planning
Siting new settlements away from vector breeding sites
Adequate design of community water supply and sanitation, including
careful management of wastes
___
Staged resettlement linked to infrastructure development
_
Culturally sensitive community planning
Management of cropping systems to enable wetting and drying cycles and to
use water efficiently
Irrigation
management
Minimise long term salinisation, siltation and water logging
Upstream
management
Catchment management to minimise flood and pollution risks
In-flow forecasting
Early warning of floods
Water
schemes
release
Reservoir
management
M
M
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I’/' .
To enhance floodplain productivity and hence nutrition
Prevent excessive growth of aquatic weeds and toxic cyanobacteria
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
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5.3.4 Management of health risks and enhancements
The final stage of the assessment is to recommend and budget socially acceptable measures to
safeguard, rmtigate and promote human health. These measures are designed to influence the
direction of change of some of the health determinants. The budget can be negotiated as part of
t e project oan agreement. Decisions about which recommendations to implement are then an
outcome of the negotiating stage.
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The most important principle for health promotion is dialogue between project proponents, health
professionals and stakeholder communities at the planning stage. The technical recommendations
tor managing health risks are diverse. A broad classification is:
•
•
•
•
•
•
•
•
IX'
I
I
Appropriate health regulations and enforcement^
Modifications to project plans and operations;
Improved management and maintenance;
Supportive infrastructure such as domestic water supply;
Timely provision of accessible health care including diagnosis and treatment;
Special disease control operations;
Individual protective measures;
Redistribution of risk through insurance schemes.
¥
i
Some general principles for managing health risks include poverty reduction, community
empowerment, removal of uncertainties, multiple barriers to safeguard health, accessible and
functional primary health centres and a series of environmental measures. Projects that deliver a
reliable and cost-effective service are likely to be health enhancing. The environmental measures
used to mitigate health risks include manipulation of the timing and duration of the flood to flush
vector breeding sites; the movement of domestic animals so as to avoid zoonoses or to provide
diversionary hosts; management of catchment effluents and pollution to minimise the water
quality degradation (see for more details). Many environmental measures are site specific. It is
inappropriate to rely exclusively on curative medicine or pesticides as the mitigating measure.
Drugs and pesticides are expensive and resistance seems inevitable.
The most appropriate safeguards improve the project outcome as well as improving human health
- the win-win solution”. In some cases this can be achieved without additional project costs by
simply improving communication between stakeholders during the early planning stages.
Recommendations to change individual behaviour are unrealistic. They are also based on a model
of individual responsibility for health. Health determinants are multi-factorial; public policy and
social norms are of equal importance to individual behaviour. Education is valuable because it is
empowering and increases choice. Accessible medical care is very important, but only as an
additional protective barrier rather than as an alternative to preventative community health.
Projects may often provide too little health care and too late. For example, in one dam
resettlement project in S.E. Asia, the health centre was constructed more than a year after the
community was already resettled, and was then built much smaller than planned because of cost
overruns. Health centres should be operational, accessible and stocked with drugs before
important events take place, not afterwards. They should be of an appropriate size for the
projected population and staffed and equipped accordingly.
'i
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21.
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This is a draft working paper of the World Commission on T
Dams. ’
The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions,
and--------------------recommendationsj are not intended to represent
--------- ,---the views of the Commission.
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World Commission on Dams
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Social Issues-Human Health and Dams, Draft, November, 1999
34
Maintain shallow de-weeded reservoir margins near settlements
Floodplain
Sensitive management for habitat and vector control
Good operation and
maintenance
Delivering a reliable and cost-effective service
I
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This is a (draft
’
working paper of the World Commission c„ D„,.„.
on Dams.
Commission
the views o?^ crmmils“on'bnna,iOn’Ealherin8 aC‘iVi,y'
7„c rcpon
The report published herein was prepared for the
Vi'WS- CO"C,USio"S, and recommendations
----- -------------- arc not intended to represent
i I
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* World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
Ir
35
6. Acknowledgements
The World Health Organisation wishes to acknowledge and to express its appreciation in the
preparation of this submission to the World Commission on Dams for the contributions and efforts
of:
■I
I
Dr M.H. Birley, Liverpool School of Tropical Medicine, Liverpool, UK
Dr M. Diop, Planification environnementale TROPICA, Dakar, Senegal
Dr G. Jones, CSIRO Land and Water, Brisbane, Australia
Dr P.V. Unnikrishnan, OXFAM, Delhi, India
Dr R. Zimmerman, Consultant, Gainesville, Florida, USA
Also, the support and inputs provided by Dr J. Bartram (WHO), Dr G. Bergkamp (IUCN), Mr R.
Bos (WHO), Mr P. Furu (DBL), Mr P. Murchie (USEPA), Professor S. Parasuraman (WCD), Dr
T. Satoh (WHO), Dr J. Vapnek (FAO), Dr Y. Von Schirnding (WHO) are gratefully
acknowledged.
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commission.
. •• • TTiisyj' r. • -•
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World Commission on Dams
Social Issues - Human Health and Dams, Draft, November, 1999
't
36
7. Bibliography
1
General website for health impact assessment: wwvvJiv.ac.uk/~mhb.
There are a number of books and reports on the health impacts of dams stretching back many
years. In addition to the references below, recent texts include the following.
■i J
Kay, B. H., Ed. (1999). Water resources: health, environment and development. London and
New York, E and F N Spon and Routledge.
Oomen, J. M. V., J. de Wolf and W. R. Jobin (1988). Health and Irrigation. Incorporation of
disease control measures in irrigation, a multi-faceted task in design, construction, operation Volume 2.
Wageningen, Netherlands, International Institute for Land Reclamation and
Improvement.
Jobins, W. R. (1998). Sustainable management for dams and waters. Lewis Press, boca Raton,
Florida.
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its informalion-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
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World Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
4*
37
8. References
Acheson, D., D. Barker, et al. (1998). Independent inquiry into inequalities in health report.
London, The Stationery Office.Anon (1982) State of India’s Environment: The First Citizens"
Report, Centre for Science and Environment, New Delhi.
Anon (1997) Central Pollution Control Board's (CPCB) 1997 Report, India.
Bercnsson, K. (1998). “Focusing on health in the political arena.” Eurohcalth 4(3): 3437.
Birley, M. H. (1991). Guidelines for forecasting the vector-bome disease implications of
water resources development. Geneva, World Health Organisation.
Birley, M. H. (1995). The health impact assessment of development projects. London
HMSO.
Birley, M. H., A. Boland et al. (1998). Health and environmental impact assessment: an
intcgrated approach. London, Earthscan / British Medical Association.
Birley, M. H., R. Bos et al. (1996). “A multi-sectoral task-based course: Health
opportunities in water resources development.” Education for Health: Change in Training
and Practice 91:71-83.
Birley, M. H., M. Gomes et al. (1997). Health aspects of environmental assessment.
Washington DC, Environmental Division,The World Bank.
Birley, M. H. and G. L. Peralta (1995). The health impact assessment of development
projects. Environmental and Social Impact Assessment. F. Vanclay and D. A.
Bronstein. New York, Wiley.
Birley, M. H., A. Scott-Samuel et al. (in prep). Report of the first UK training course in
health impact assessment. Liverpool, University of Liverpool.
Chorus, I. And J. Bartram (1999) Toxic Cyanobacteria in Water: A Guide to their Public
Health Consequences, Monitoring and Management, World Health Organisation, E & FN
Spon
Cooper Weil, D. E. C., A. P. Alicbusan et al. (1990). The Impact of Development
Policies on Health: A Review of the Literature. Geneva, World Health Organisation.
Department for International Development (1999). DFID environmental guide. London,
Department for International Development.
>
■1
Ewan, C., A. Young et al. (1992). National Framework for Health Impact Assessment in
Environmental Impact Assessment.
Volume 1: Executive Summary and
Recommendations and Volume 2: Background Document, University of Wollongong.
r
Illis is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended Io represent
the views of the Commission.
V
World Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
38
Ghebrcycsus, 1. A., M. Haile, cl al. (1999). “Incidence of malaria among children living
near dams in northern Ethiopia: community based incidence survey.” British Medical
Journal 319: 663-666.
Hunter, J. M., L. Rey et al. (1993). Parasitic diseases in water resources development.
Geneva, WHO.
»<■
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Jobin, W. R. (1999). Dams and Disease. London, Routledge.
Koivusalo, M., P. Santalahti, et al.
Eurohealth 43: 32-34.
(1998).
“Healthy public policies in Finland.”
Kwiatkowski, R. (1996). The role of health professionals in environmental assessment,
consolidated workshop proceedings. Ottawa, Environmental Health Centre, Health
Canada.
Matsuno, Y., F. Konradsen, M. Tasumi, W. van der Hoek, F.P. Amerasinghe and P.H.
Amerasinghe (1999). Control of malaria mosquito breeding through irrigation water
management. Water Resources Development 15: 93-105
Miller, J. B. (1997). Floods: people at risk, strategies for prevention. New York, United
Nations.
Oomen, J.M.V., J. de Wolf and W.R. Jobin (1990). Health and Irrigation. Incoproation of
disease control measures in irrigation, a multifaceted task in design, construction,
operation. ILRI publication 45, International Institute for Land Reclamation and
Improvement, Wageningen, the Netherlands
Organisation of African Unity (1997). Harare Declaration on Malaria Prevention and
Control in the context of African economic recovery and development. Harare,
Organisation of African Unity Assembly of Heads of State and Government.
Philippine Environmental Health Services (1997). National Framework and Guidelines for
Environmental Health Impact Assessment. Manila, Department of Health.
Public Health Commission, N. Z. (1995). A Guide to Health Impact Assessment.
Wellington, Public Health Commission, Rangapu Hauora Tumatanui, New Zealand.
Putters, K. (1998). “Health impact screening, the administrative function of a health
policy instrument.” Eurohealth 43: 29-31.
Scott-Samuel, A., M. H. Birley et al. (1998). The Merseyside guidelines for health
impact assessment. Liverpool, The University of Liverpool.
Secretary of State for Health (1999). Saving lives: our healthier nation. London, The
Stationary Office.
This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations are not intended to represent
the views of the Commission.
few?
WO
F mJ
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ijrVorld Commission on Dams
Social Issues-Human Health and Dams, Draft, November, 1999
-v!.'i
. 39
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I
Secretary of State for International Development (1997). Eliminating World Poverty: A
Challenge for the 21st Century, White Paper■ on International Development. London,
Department for International Development.
UN (1993). The Global Partnership for Environment and Development a guide to Agenda
21 Post Rio edition. New York, United Nations.
Van der Hoek, W., F.P. Amerasinghe, F. Konradsen and P.H. Amerasinghe (1998).
Characteristics of malaria vector breeding habitats in Sri Lanka: relevance for
environmental management. Southeast Asian J, Trop. Med, Public Health 29: 168-172
WHO (1982). Manual on Environmental Management for Mosquito Control, with special
emphasis on malaria vectors. WHO Offset Publication no. 66, World Health Organization,
Geneva
WHO (1998). Health 21 - health for all in the 21st century, an introduction. World Health
Organisation, Europe.
i
I
'i
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WHO (1999). Draft charter on transport, environment and health. Copenhagen, World
Health Organisation: 32.
*
World Bank (1991a). Environmental Assessment Sourcebook, Volume I - Policies,
Procedures, and Cross-Sectoral Issues.
Washington, The International Bank for
Reconstruction and Development/The World Bank.
World Bank (1991b). Environmental Assessment Sourcebook, Volume II - Sectoral
Guidelines. Washington, The International Bank for Reconstruction and Development/The
World Bank.
*
I'
WorldBank (1991c). Environmental Assessment Sourcebook, Volume III - Guidelines for
Environmental Assessment of Energy and Industry Projects.
Washington, The
International Bank for Reconstruction and Development/The World Bank.
World Bank (1993).
Press.
World development report 1993. New York, Oxford University
I
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This is a draft working paper of the World Commission on Dams. The report published herein was prepared for the
Commission as part of its information-gathering activity. The views, conclusions, and recommendations arc not intended to represent
the views of the Commission.
• III
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'7". •
EXECUTIVE SUMMARY
8 I
1. Recommendations
The World Health Organization welcomes the independent inquiry by the World
Commission on Dams (WCD) and the opportunity to contribute positively to the debate on
dams. It offers the following recommendations for consideration by the Commission:
i.
Health impact assessment (HIA)
There is an overwhelming need to include health impact assessment (HIA) as an integral
component tn the planning ofdams and other major water infrastructure projects
In this submission the state-of-the-art of HIA is covered extensively, with special emphasis
on the method and procedures, the links between Environmental Impact Assessment,
Social Impact Assessment and Health Impact Assessment, and the need to incorporate HIA
in any future international conventions and in national legislation on dams.
ii.
Capacity building
Appropriate capacity in HIA and community health management needs to be built both
within the health sector and in the sectors primarily responsible for dams.
A conducive policy framework, effective inter-institutional arrangements and staff in all
relevant institutions trained in the skills of intersectoral communication and collaboration
are three essential elements that need to be addressed by national capacity building
activities.
At the international level, the World Health Organization is the indicated agency to
provide a framework for the health impact assessment of large, often transboundary dam
and river basin development projects.
iii.
Documentation of successes and efficacy of current practices
An information and education oriented data base should be compiled:
(a) describing the limited number ofhealth success stories based on careful dam design
and operation, and explaining the key management processes in detail.
(b) with an assessment of the effectiveness ofalready implemented health risk
management methods and techniques.
This submission points out that there is scattered information on good practice in dam
design and operation for health. It provides a coarse characterization of the knowledge
bases of the health issues associated with dam projects. The number of successful
integrated health risk management experiences in dam projects is limited, but there is a
relatively large body of evidence of singular methods of good practice which have been
proven to be effective under specific eco-epidemiological conditions, with an emphasis on
health issues determined by environmental factors.
ii
iv.
Action oriented research
Specialfunding should be directed towards action research in existing dam construction
projects in order to strengthen existing knowledge bases, to improve health outcomes and
to establish the effectiveness ofhealth risk management techniques
Models for reservoir management and dam operation to reduce health risks of affected
communities and a number of environmental management concepts for vector control
require testing of their feasibility and effectiveness. Comprehensive documentation of the
economic aspects will be crucial for successfully transferring tested methods to routine
management and operations.
v.
Budgeting for health
A health component should be negotiated as a budgeted item for allproject loans in order
to safeguard and enhance health.
Any health budget allocated in the context of a dam project should be used primarily for
preventative actions, and secondarily for strengthening of health services, with the optimal
balance decided on a case by case basis. Such an investment in health should not be
considered a substitute for the existing health care system.
vt
Prioritising the health issues
It is important that the health priorities are not pre-judged but allowed to emerge from the
health impact analysis and community consultation.
Development agencies may have a limited or biased understanding of the health issues
associated with a dam project in a given location. Priority setting therefore has to rely on
a comprehensive and independent HIA complemented by an expression of the risk
perceptions of affected communities. This will not only promote a correct focus on key
health issues, but also enhance community ownership of the risk management measures.
vii.
Prioritising dam projects for impact assessment
Screening procedures for HIA must be the minimum requirementfor all dam projects.
A robust screening procedure, preferably anchored in legislation, will ensure that limited
financial and human resources for HIA are used to their maximum capacity.
The cumulative effect on health of many small dams should be dealt with through strategic
assessment of representative cases.
viii.
Transparency
The health impact assessment andplanning process should be open to scrutiny by all
stakeholders and communities.
All components of the planning process, including HIA, benefit from the inclusion of all
stakeholders at all stages of the process.
I
Ill
2. GENERAL CONSIDERATIONS
As dams, large and small, continue to be planned, constructed and operated with the aim of
achieving important socio-economic development objectives, their potential to alleviate
poverty can, and in many cases will, contribute significantly to the improvement of the
human health status.
It is, however, the issue of equity gaps that is at the root of the adverse health impacts of
dams. Benefits of dams are not disputed, but it is the uneven distribution of the benefits,
including the health benefits, and of the health risks that needs to be addressed in their
planning, construction and operation. A simple health accounting is not satisfactory: it is
not acceptable to simply balance out the health gains of one part of the population against
the health losses of another, to arrive al a net health benefit of dams. It is the increased
risks for vulnerable groups that need to be identified at an early stage and managed as an
integral part of dam design and operation. The protection and promotion of human health
in the context of dam projects can only be ensured if all potentially affected communities
have an opportunity
■
■
to consider how dam construction and operation will affect their owrn health, and
to participate fully in the planning, assessment and decision making process
Negative health impacts of dams represent a hidden cost to the health sector. Taking
human health into consideration at the planning stage makes good economic sense. (Tiffen
1991; Phillips et al. 1993). Not only does it allow to keep the additional burden on the
health sector limited to a minimum, but it also permits an optimal use of ’'win-win”
opportunities for the dam operators and public health. Many of the health safeguards that
should be considered good practice can be incorporated into dam projects at minimal
- additional costs, because they imply design changes that permit a more flexible operation*
(WHO, 1986). Changes in environmental and social determinants of health, resulting from
a dam project, will also provide an incentive for the health sector to review the delivery of
its services and improve performance and efficiency.
Three requirements are essential in order to effectively protect and promote health in
relation to dam projects: (1) a supportive policy, (2) an acceptable procedure and (3) a
usable method of risk assessment.
The lack of an appropriate policy framework means:
■
■
■
•
lack of assessment of policies, programmes and projects for health impacts:
greater than necessary adverse impacts of development on health;
the tendency of vertical disease control programmes to ignore environment and
development links;
lack of funds for research in health impact assessment.
Environmental Impact Assessment (EIA) is an established policy and procedure in many
countries and development agencies, but EIAs normally make limited reference to health.
The health issue most commonly included is poisoning due to pollution; in the case of
dams, filariasis, malaria and schistosomiasis, are also often cited. Other important health
aspects are often neglected.
In many cases, health is addressed in a strictly ‘medical’ sense rather than through a wider
cross-cutting view of community health. This tends to produce recommendations for
strengthening health sendees which, although important, often do not lead to broad
improvements in the identification, characterization and management of community health
risks.
iv
Some health issues have physical environmental determinants, others have primarily social
determinants that will be brought to light only by a social impact assessment (SIA).
Health, therefore, has a stake in both EIA and SIA, with a number of unique features that
distinguish it from either of these. The solution favoured by WHO is to create a separate
and parallel procedure for health impact assessment (HIA). The middle way is to plan
for integration while maintaining a separate profile for health. The state-of-the-art of
HIA methodology and procedures is presented in detail in the WHO submission. Critical
action required in any dam project includes:
Adding specific references to health to the Terms of Reference provided to the
consultants undertaking an impact assessment and indicating the method of health
impact assessment to be used.
■ Providing quality assurance mechanisms through appraising or evaluating the health
component of completed impact assessments.
■
The health issues associated with dams can be conveniently represented in six major
categories, communicable diseases, non-communicable diseases, injury, malnutrition,
psychosocial disorder, and lack of social well-being. The existing knowledge bases
concerning the impact of dam construction and operation vaiy for the different categories.
3. OPTIONS FOR PREVENTATIVE AND HEALTH PROMOTIONAL ACTION
Many of the adverse health outcomes associated with dams and associated infrastructure
developments (e.g. irrigation schemes) can be prevented or mitigated if a broader and more
holistic view of project construction and operation is taken. Along with a range of
insightfill engineering approaches should come a recognition for the need to take an
integrated, multi-disciplinary approach to environmental, social and health management.
This new understanding can lead to the implementation of a range of innovative design and
operational features for water infrastructure projects. Such changes may be cost effective
and provide the desired health outcomes that formally were considered controllable only
through medical intervention or by more drastic environmental control procedures.
There are a number of fully or partially validated options which can mitigate the adverse
effects on human health of dam construction. These planning options fall into a number
of categories including engineering design considerations, operational water management,
social and community planning. Recommendations and suggestions for good management
practice are listed in table 1. A number of general observations need to be made first:
■ Preventative and health promotional measures tend to be site specific. They are linked
to the geographic variation in health conditions associated with dams as well as to the
relative effectiveness of measures in different ecological and epidemiological settings.
■ The secondarv effects of measures need to be taken into account and trade-offs will
have to be found to come to a final decision.
■ Whatever the technical merit of good practice” interventions, they will only be
effective and sustainable if the process of their design and implementation is transparent
and participatory.
Table 1. Examples of techniques and good practices for managing health risks
Poverty reduction
Poverty reduction empowers and enables people to make choices and to safeguard
themselves and their families from many environmental hazards
Zooprophylaxis
In specific settings, there is a possibility of using livestock as diversionary hosts to
protect people from malaria
Wetting and drying of
floodplains or streams
Controls some mosquito species, addresses nutritional issues related to traditional
agriculture such as flood recession cultivation
Health centres
Ensuring that health centres are equipped and functional before dam construction,
and building capacity and capability of health personnel
Water supply and
sanitation
Reduces diarrhoea, intestinal parasites and schistosomiasis. Domestic water supplies
should be protected from contamination by flood waters.
Vaccination
May be appropriate for certain arboviruses
Handling moribund
animals
Control of Rift Valley Fever
Canal or river flushing
Floods have a flushing effect on stagnant waters, removing pollutants such as human
waste, clearing drains or flushing away mosquito larvae.
Community control
Increasing empowerment and reducing uncertainty enhance health
Communication
Early warning of critical events such as floods, health promotion
Dam design
Dam off-takes that release first flush inflows with liigh levels of pollutants
Structures that enable extensive control of operational water levels
Irrigation channel
design and improved
hydraulic structures
Minimising low flow zones to prevent vector breeding
Dam siting
Siting dams in areas that require minimum population and livestock displacement
Settlement planning
Siting new settlements away from vector breeding sites
Reduction of contact patterns with contaminated water (schistosomiasis)
Adequate design of community water supply and sanitation, including carefill
management of wastes
Staged resettlement linked to infrastructure development
Culturally sensitive community planning
Irrigation management
Management of cropping systems to enable wetting and drying cycles and to use
water efficiently (aimed at mosquito vectors breeding in flooded rice fields)
Minimise long term saiinisation, siltation and water logging
Upstream management
Catchment management to minimise flood and pollution risks
In-flow forecasting
Early warning of floods
Water release schemes
To enhance floodplain productivity and hence nutrition
Reservoir management
Prevent excessive growth of aquatic weeds and toxic cyanobacteria
Maintain shallow de-weeded reservoir margins near settlements
Floodplain
Sensitive management for habitat and vector control
Good operation and
maintenance
Delivering a reliable and cost-effective service
STRATEGIC ASSESSMENT
Definition
1.
Strategic Assessment (SA) aims to facilitate early
comparison of impacts of development options, well in
advance of project level impact assessment; consequently,
it operates at the policy and programme level, in a crosssectoral context. It is a process of integrating
sustainability into strategic decision-making.
SA links the needs of economic development effectiveness
to the needs of achieving optimal sustainability. The
initiative and guidance for the SA process must, therefore,
be the responsibility of national governments, shared by
the highest authorities mandated to cover macro-economic
development and environmental protection, respectively.
The scope of SAs will depend on the natural resource
under consideration, either determined by geophysical
boundaries (eg a river basin), or in a cumulative fashion
(eg scattered mineral resources). The outcome should be
the adjustment of the policy framework within which
sectoral ministries implement their development activities.
Responsibility
Scope
SA of the Water Resources sector must be a mandatory
activity prior to consideration of individual projects. The
multi-purpose nature of water resources development
makes the formulation of a national water policy and
strategy a first imperative.
Enabling conditionfor
SA in the water sector
2.
SA must take into account the following principles:
Principles
• compatibility with the existing development policy
frameworks
• opportunities and constraints analysis
• development needs and alternatives to meet those needs
• economic evaluation (eg costs and benefits)
• equitable distribution of benefits and risks
• social and cultural conditions, which determine the nature
of the process and the potential scope of mitigation
• public awareness, involvement and acceptabflity, including
prior informed consent
• the capacity of all partners to effectively participate in and
contribute to the impact assessment process
•z
SA attributes
3.
.
SA must be revisited at appropriate intervals with periodic
“state-of-the-sector” reporting; important variables
determining the frequency and intensity of this on-going
process include developments in the economy, in
technology, in demography and in public opinion.
SA must apply to new development projects and the
1
rehabilitation of projects that are already operational. The
SA process must be a transparent, involving stakeholder
representation both interested and affected parties), and the
results of the SA must be widely disseminated. Review of
SA reports at the highest level of governance (eg
Parhament) is a desirable procedure.
SA outcomes must provide a decision support system with
clear policy directions for the selection of
4.
SA outcomes and their
attributes
•
•
•
•
•
types of projects
size of projects
timing of projects
ownership and financing of projects
regional location of projects
The SA report must recognise the nature and magnitude of
risks and rights of stakeholder groups, as well as
opportunities offered to these groups by different
development options.
5.
The SA process and outcomes must be reviewed
independently by a Panel of Experts, who are leading
professionals in their field, designated in their personal
capacity. The results of the SA and its review must
subsequently be made public. In addition to the review of
process and output indicators, this Panel should also
identify possible synergies in the application of SA
outcomes on different natural resources or for different
sectors.
6.
No individual project can be considered (for study and
implementation) unless a direct link with SA outcomes can
be shown.
Independent review
Conditionality ofSA for
project impact assessments
Strategic Assessment Parameters
1.
2.
3.
4.
5.
6.
7.
multi-criteria decision making
macro approach (eg river basin scale)
cumulative assessment
identification of vulnerable groups and habitats
ranking of alternatives
Prior informed consent
others in accordance with local priorities
2
PROJECT ASSESSMENT
1.
Definition
Comprehensiveness
Outcome
Impact assessment is a comprehensive planning tool which
entails a process of identifying, predicting and evaluating
the effects of development projects, with a view to
preventing adverse effects, minimising risks, mitigating
impacts that are not preventable and promoting additional
development opportunities.
Impact assessment addresses both new development
projects and plans for the rehabiUtation/modernisation of
existing ones; its outcomes include a risk management
plan (for mitigating action during the detailed design,
construction and operational phases, with measurable
targets in a realistic time frame) and a Resettlement Action
Plan (RAP).
Definitions
Environment in its broadest sense refers to biophysical, social,
institutional, economic and health components of the world around us.
Under this "umbrella" three types of impact assessment are
conventionally distinguished.
Environmental Assessment (EA) or Environmental Impact Assessment
the process of identifying, predicting, evaluating and providing a basis
for the management of the biophysical, social, health and other relevar
effects of development proposals before major decisions are taken and
commitments made. As typically institutionalised, EA is applied
primarily to minimise adverse effects that large scale development
projects may have on natural resources and ecosystems. EA has
developed into a broadly based planning tool to maximise developmer
opportunities and options, ensuring that these are adjusted to
environmental potentials and capacities.
Social Impact Assessment is the equivalent of EA on the human side,
with a focus on the social and cultural effects of development initiative
and decisions and their consequences for human populations,
communities and individuals. Ideally, it should be oriented toward
ensuring development meets the needs and priorities of people, with ar
emphasis on their participation and inclusion. In the context of dams,
resettlement issues occupy a prominent place in SIA, resulting in a
Resettlement Action Plan (RAP).
Health Impact Assessment measures changes in health risks attributabl
to a project, programme or policy. A health risk is the likelihood of a
health hazard affecting a particular community at a particular time. El
which has health on its standard checklist, often results in a sector
limited, rather than a cross-cutting consideration of health status
(recommendations would typically address strengthening of health
services). Frequently, health is part of SIA In fact, however, the heal'
status of communities results from both environmental and social
determinants and HIA should therefore have a separate status,
overlapping in method, procedure and outcome with EA and SIA The
outcome is a Health Protection and Promotion Plan.
3
2.
Large dams, as per de definition of WCD, should always
be subject to a project specific impact assessment; the
impact of small dams should be measured in a cumulative
way under a Strategic Assessment.
3.
A generic approach to impact assessment methodology and
procedure will facilitate the integration of Environmental
Assessment (EA), Health Impact Assessment (HIA) and
Social Impact Assessment (SIA) in the context of specific
projects (See box previous page). The decision on die
profile, relative weight and level of integration of the three
components must be made at the scoping phase, based on
clear criteria.
4.
Scoping is the first step in the assessment procedure, and
aims to:
Dam size
Components
• establish the spatial and temporal boundaries for the
assessment
• distinguish the key issues to be addressed in the
assessment from die second-order ones
• ensure that the impact assessment proceeds from the
framework provided by the Strategic Assessment
• define the balance between EA, HIA and SLA within the
overall assessment and a mechanism for issues-driven
interaction between the three during the entire process
• determine the composition of the IA team
Scoping: objectives
The outcome of the scoping exercise is a set of detailed
terms of reference for the contents, process and reporting
of the impact assessment.
Scoping: outcomes
5.
Scoping: timing
Immediately upon identification of a project, a scoping
exercise must be carried out. It should involve appropriate
public participation in an iterative process of identifying
affected communities and starting a process of
consultation. This implies that the scoping exercise must
go beyond a desk study.
A Steering Committee (SC), consisting of representatives
of relevant government agencies and operating under the aegis of
the environmental protection authority, guides the Impact
Assessment process and monitors procedural vigour. The IA
process should be further strengthened by the appointment of a
Panel of Experts made up of leading professionals in their field,
designated in their personal capacity. The Panel’s function is to
ensure that basic principles are adhered to, to provide guidance on
assessment method, and verify the technical soundness, efficiency
and social acceptability of recommended action.
6.
Steering Committee
Panel ofExperts
4
Its first task would be to technically review the terms of
„ reference of the IA and the profile of the consultants before
the selection and start of the IA teams.
7.
The outcome of scoping is the basis for the composition of
the Steering Committee: all relevant ministries and other
development partners must be represented. Each ministry
should, as part of an impact assessment capacity building
programme, develop human resources with intersectoral
negotiating and decision making skills. Information
sharing is a crucial function. Other key, minimal functions
include: formulation of TOR based on the scoping
outcome, review of the impact assessment for procedural
vigour, adherence to the TOR and a secretariat role for the
Panel of Experts. The Steering Committee operates in the
policy framework set by SA, and is accountable to the
highest environmental protection authority.
8.
The composition of the Panel of Experts should reflect the
balance of issues considered by the impact assessment as
determined by the scoping exercise. In the case of dams
there should be minimally one impact assessment expert,
one environmental expert, one resettlement expert and one
health expert on the Panel. The Panel’s essential functions
include the technical review of the scoping outcome, of the
TOR and of the impact assessment reports), and the
provision of technical guidance in the implementation of
the environmental management, health protection and
resettlement action plans. The Panel operates
independently, serviced by the Steering Committee. The
Panel reports to the highest environmental protection
authority; thereafter, its reports should be made public.
9.
The Impact Assessment is to be carried out by qualified
consultants, in conformity with the TOR. It includes the
following components:
SC: modus operandi
Panel ofExperts: modus
operandi
Terms ofReference
TOR components
•
•
•
•
•
•
Review of IA reports of similar projects in the same setting
Analysis.©! affected ecosystems
Profiling/characterisation of all affected people and
communities, with identification of vulnerable groups.
Identification of environment, health and social
determinants affected by the project.
Identification of development opportunities offered by the
project in terms of environment and health protection and
promotion, and socio-economic progress.
Analysis of the evidence of impacts and composition of a
summary assessment. Recommend, justify and cost for
action in the framework of environmental, and health
management plans, and socio-economic development
plans.
5
The outcome of the Impact Assessment is a fully
operationalised plan, defining roles and responsibilities of
all partners, fisting measurable products and delineating
accountability. Typical outcomes include an
Environmental Management Plan (EMP), a Health
Protection and Promotion Plan (HPP) and a Resettlement
Action Plan (RAP).
Outcome ofTA
An assessment process that ensures optimal participation
of stakeholders must, in its initial stages, allow for a
comprehensive coverage of all real and /or perceived
issues in the TOR through meetings with interested parties,
engagement of relevant public sector institutions and
public hearings.
10.
Impact assessment
attributes
It must include interviews with stakeholders and key
informants as part of data collection. It must offer
opportunities for review and improvement of the
assessment report by all stakeholders. And, it must
facilitate consultation with government bodies at all levels
to agree on operational and regulatory responsibilities in
the action plan of recommended measures.
A participatory assessment can be promoted with locally
effective mechanisms, such as opening a local office of the
developer or inviting the press to public hearings. The
Steering Committee, which overviews the procedural
rigour, should pay special attention to the participatory
nature of the process. The Panel of Experts may advise on
innovative participatory approaches.
Mechanisms to induce
participation
Formal review of IAs is considered an essential step in the
decision-making process. It ensures the quality control of
impact assessment. Review by competent authorities
under prevailing laws and regulations (or in their absence,
regulations established for this specific purpose) should be
carried out keeping in mind the following criteria.
11.
Review
Review criteria
Biases
•
•
•
•
•
•
independence
objectivity
comprehensiveness
width of the range
participatory process
provision of clear guidance to proponents and decision
makers
Identification of intentional or unintentional biases is a key
component of review/appraisal; such biases may include:
6
I
•
•
•
•
... ▲ ♦. -
12.
Outcome ofreview
•
•
•
Consultants profile and independence (relevance and scope
of expertise; social barriers -gender, language-, potential
conflicts of interest)
Timing (both methodologically -data collection on a
seasonably transmitted disease should take place over a
full 12-month cycle- and procedurally -work schedules of
the various feasibility and impact assessment teams should
be synchronised for optimal exchange of relevant
information-)
Adequacy of the TOR
Adequacy of the resources allocated to the impact
assessment.
The review of the IA documents can result in
outright approval
conditional approval
postponement of approval until differences have been
effectively addressed.
IMPLEMENTATION OF THE PLAN
A legal framework supported by incentives and assurances
is required to facilitate the transition from the impact
assessment to the implementation of action plans aimed at
prevention, mitigation and additional development
opportunities. Instruments could include:
1.
Legalframework and
instruments
■
2.
Operationalise the Environmental Management Plan, the
Health Protection and Promotion Plan and the
Resettlement Action Plan. Firm up required funding,
contractual and institutional arrangements. Establish roles
and responsibilities, and determine the ultimate
responsibility. Since a wide range of organisations will be
included in the implementation tasks, appropriate
coordination and management structures and procedures
should be in place.
3.
The principles of project implementation have been laid
down in the attached organization chart.
Start-up action pions
Principles
negotiated contracts
establishment of a trust funds
percentage of power revenues
performance guarantees through bonds
improving the certainty level of the outcome by other
means
4.
7
4
After the decision to proceed with the project has been
made, the correct implementation of the mitigation
management and development plans is of the highest
priority. Funding of these activities must be assured and
the institutional framew ork to implement must be clear and
functional. Implementation includes government, private
and non-governmental parties. It should work towards
measurable indicators and include, whenever possible
capacity building components.
5.
Monitoring and evaluation procedures and arrangements
should be in place. These can include:
internal monitoring and review
external independent monitoring
external independent evaluation
panel of experts
6.
Redress procedures and arrangements should be in place.
These can include:
a multi-level approach,
starting at the project, then through committees to the
courts
Implementation
qvalijyers
Monitoring
Re-dress
•
•
7.
All stakeholders should remain actively involved
throughout the implementation phase.
8.
It must be recognised that the project is never completed.
Stakeholders
Time horizon
i
8
6/16/00 10:41 AN
f2
HUMAN HEALTH AND DAMS,
The World Health Organization's submission to the World
Commission on Dams
Genevo, January 1999
Table of contents
1.4
1.5
1.6
Human Health in Environment and Development
......................
Equity and health
The economic perspective
Policy
Legislation
-............................................
Integration with Environmental Impact Assessment
4
.5
.5
.6
.6
.8
.8
2
2.1
2.2
2.3
Human health issues related to dam construction and operation.
Categories of health issues
Regional differences
Differentiation on the basis of dam size and purpose
10
.10
.11
.11
3
3.1
3.2
3.3
3.4
Options for preventative or health promotional action................ ...12
12
General considerations....................................................................
Good practice - the planning framework......................................... -...13
13
Good practice - design and operation options..................................
15
Good practice - off-site management and environmental protection.
4
4.1
4.2
4.3
4.4
4.5
4.6
4.7
4.8
Recommendations for improving good practice.............................
Health impact assessment
Capacity building
Documentation of successes
Action oriented research
.
Budgeting for health
.
Prioritising the health issues
Prioritising dam projects for impact assessment
Transparency
5
5.1
5.2
5.2.1
5.2.2
5.2.3
5.2.4
5.2.5
5.2.6
5.2.7
5.2.8
5.2.9
5.2.10
Health impact assessment............................................................ ...22
22
Introduction...................................................................................
22
Procedure.......................................................................................
24
Timing.............................................................................................
24
Screening.......................................................................................
24
Steering committee........................................................................
24
Scoping and agreeing Terms of Reference......................................
25
Choosing an Assessor.....................................................................
25
Spatial boundaries..........................................................................
27
Temporal boundaries......................................................................
28
Appraisal and dissemination............................................................
29
Negotiation.....................................................................................
29
Implementation and monitoring.......................................................
HIA methods..................................................................................
29
30
Stakeholders.................................................................................
30
Health determinants......................................................................
Weight of evidence......................................................................... -...32
1
1.1
1.2
1.3
5.3
5.3.1
5.3.2
5.3.3
Background
2
16
.16
.16
.17
.18
.18
.19
.21
.21
5.3.4
Management of health risks and enhancements.
32
6
Acknowledgements
.
37
7
Bibliography.........................................................
37
9 "
References
.................
38
Tables, figures and boxes
Table 1 The principal categories of health issues and the extent of existing knowledge
about their association with dam projects
10
Table 2 Examples of regional variation in health conditions
11
Table 3 Examples of good and bad practice (Jobin 1999)
12
Table 4 Flight range of insect vectors
26
Table 5 Typology of human circulation (Birley 1995)
27
Table 6 Examples of association of health issues with timing
................................ 29
Table 7 Examples of the association of health issues with different project stages
29
Table 8 Examples of local stakeholder communities and some important health issues..33
Table 9 Examples of health determinants and their classification
34
Table 10 Examples of techniques for managing health risks
36
Figure 1 Illustration of some of the components of procedures and methods used in
health impact assessment
Figure 2 Illustration of the spatial boundaries of a health assessment
23
28
Box 1 Four strategic directions of the World Health Organization, September 1999
Box 2 Health Opportunities in Water Resources Development
Box 3 Flushing canals for malaria control in Sri Lanka
Box 4 Freshwater cyanobacterial toxins - an emerging dam related health issue
Box 5 Examples of health impacts form India
Box 6 The compounded malaria impact of microdams in Ethiopia
.17
.18
.19
20
.21
3
..5
1. Background
1.1 Human Health in Environment and Development
Throughout the world, especially the developing world, dams and related water
inn^Tr^ciure prJjecfy carrhnue to de pihrmea*, cunshmcted and operated to meet
human needs through energy generation, agricultural production and the supply of
drinking water. For most countries, dams are a crucial part of economic and social
development and, as such, they aim to achieve important socio-economic development
objectives.
Through their potential to alleviate poverty they can contribute
significantly to the enhancement of human health.
The intended development objectives of dams, including poverty reduction, are invariably
accompanied by a range of unintended impacts on the natural environment and on human
communities. These communities may be affected in quite different ways and, as well as
beneficiaries, there are potential losers. It is this observation of health benefit
inequity that forms a central theme in the present submission. Informed action can
protect vulnerable groups against increased health risks and ensure a more equitable
distribution of benefits, including health benefits.
WHO welcomes the independent inquiry by the World Commission on bams (WCb) and
the opportunity to contribute positively to the debate. WHO has long been concerned
about the effect of dams and other water resources development projects on human
health and has catalogued their health impacts, particularly on a range of communicable
tropical diseases. The present WHO contribution to the WCb advocates that health
considerations should always be included along side economic, environmental and social
issues in decision making on dams. Furthermore, it provides an analytic framework for
the incorporation of such considerations into dam planning, construction, operation,
rehabilitation and disaster preparedness.
Bearing in mind a target audience of mainly non-health specialists, this paper uses the
broadest socio-environmental definition of human health. As envisaged by the founders
of WHO, health is considered to be:
n...a state of complete physical, mental and social well-being, and not merely the absence
of disease and infirmity".
The preservation of human health can only be ensured if all the affected communities
have an opportunity:
■
■
to consider how dam construction and operation will affect their own health, and
to participate fully in the planning, assessment and decision making process.
At times, this submission makes a distinction between recommended actions that are
practical - in the sense that they are readily achievable through realistic and feasible
modifications to current practices and planning procedures - and those actions that
should be undertaken in an ideal world. It is understood that the WCb is interested in
both, as is certainly the WHO.
At different times in the past, WHO's concern over health in development has been
expressed with different emphases. The 1986 World Health Assembly Technical
biscussions on Intersectoral Action for Health and the review of the impact of
development policies on health (Cooper-Weil et al, 1990) are two of several examples.
Currently, the WHO Global Cabinet has defined four strategic directions, two of which
address different aspects of the environment-development-human health continuum (see
4
Box 1 in bold). Along similar lines, the World Bank recently defined one of its
comparative advantages in the Roll Back Malaria initiative as its capacity to include
health concerns in infrastructure projects for which it provides loans.
Box 1 Four strategic directions of the World Health Organization, September 1999
■
Reducing the burden of excess mortality and disability, especially that suffered by
poor and marginalised populations
■
Reducing the risk factors associated with major causes of disease and the key
threats to human health that arise from environmental, economic, social and
behavioural causes
■
Developing health systems which are managed to ensure equitable health outcomes
and cost-effectiveness; responsiveness to people's legitimate needs; are financially
and procedurally fair; and, encourage public involvement
■
Promoting an effective health dimension to social, economic and development
policy.
In addition to an international health policy framework, WHO has provided technical
guidance to its Member States in the form of guidelines for the resolution of these
problems including:
■
■
Guidelines for forecasting the vector-borne disease implications of water resources
development (Birley 1991):
Parasitic diseases in water resources development (Hunter et al. 1993)
It has also been instrumental, through its Collaborating Centre arrangements with the
Liverpool School of Tropical Medicine, in stimulating a wider debate, including:
■
The Health Impact Assessment of Development Projects (Birley 1995);
WHO and its Collaborating Centres the Danish Bilharziasis Laboratory and the Liverpool
School of Tropical Medicine have a long-term commitment to building national
managerial capacities in inter-sectoral planning of development projects and including
health considerations. Together, they have developed and tested a task oriented
problem-based learning course entitled Health opportunities in Water Resources
Development, and the next phase will be course institutionalization in Africa (Birley et
at 1996).
1.2 Equity and health
As already noted, the development and economic objectives of dams are often not fully
comptaible with an equitable distribution of the benefits and stresses between
different stakeholder and community groups. In the case of dams for hydropower
generation or drinking water supply, the beneficiaries may be hundreds of kilometres
away in urban centres, while the local and downstream communities may suffer from the
adverse health effects of environmental change and social disruption. In irrigation
schemes, those living at the tail end of the system and relying on water from canals to
meet their domestic needs may be exposed to increased levels of pesticide residues.
5
.. <
Additionally, if proper drainage is lacking, they may be exposed to increased
transmission of vector-borne diseases. Downstream impacts on water availability and
quality, agricultural production, livestock and fisheries may lead to persistent
malnutrition and communal violence.
Clearly, improved health is inherent to the general poverty reduction objectives of dams,
but it is the issue of equity gaps that is at the root of the adverse health impacts of
dams. For this reason, a simple health accounting is not satisfactory. In other words, it
is not acceptable to simply balance out the health gains of one part of the population
against the losses of another, to arrive at a net health benefit, as one might do in
economic or financial analysis.
It is very important that this point is accepted by all involved in the dam planning and
evaluation process. Benefits of dams, also for health, are not disputed. It is the risks
to health, however, resulting from inequity, that need to be identified at an early stage
and managed as an integral part of dam design, construction and operation.
1.3 The economic perspective
The economic arguments in favour of including health concerns in dam projects are clear.
Most developing countries and most development agencies spend about 5% of their
budget on the health sector and most of this health budget is spent on the delivery of
health services. A considerably larger part of the national budget or of development
loans is spent on the development and management of infrastructure projects, including
dams. Decisions on infrastructure development that may be critical to people's health
status are, however, made without proper consultation of health authorities and
experts.
When negative health impacts occur, they represent a hidden cost of the project that is
transferred to the health sector without adequate provision for alleviation. They also
represent an increase in pain, suffering, and toss of education achievement and of
productivity for the affected community. Improving the health status of the community
through preventative action by other sectors is an efficient way to help to reduce the
burden on the health sector. It is assumed to also have a multiplier effect by ensuring
that relatively small investments for health protection and promotion at the
construction phase will produce substantial health improvements (Ehiri and Prowse
1999).
Three main requirements need to be fulfilled in order to protect and promote health:
(i) a supportive policy, (ii) an acceptable procedure and (iii) a usable method of
assessment. None of these is sufficient in itself. Good policy supports good planning
and management. It also enables laws to be enacted that establish requirements and
regulations to conserve human health. Good planning depends on good procedures for
assuring quality and inclusive debate. Good assessment methods enable the health risks
and benefits of different options to be analysed and compared.
1.4 Policy
The international development aid policy of many industrialised nations is intended to
reduce poverty and improve the quality of life of poor communities. The aid flows
through many bilateral and multilateral channels and transforms the social, physical and
6
economic environment of stakeholder communities. Planning procedures have evolved
that assess economic, environmental and social impacts of projects, programmes and •
policies. Assessment of human health impacts has been limited.
The absence of an appropriate policy framework for impact assessment means:
■
■
■
■
lack of assessment of policies, programmes and projects for health impacts;
greater than necessary adverse impacts of development on health;
the tendency of centrally managed, disease specific control programmes (known as
vertical programmes) to ignore environment and development links;
lack of funds for research in health impact assessment.
Principle one of Agenda 21 (United Nations, 1992) places people at the centre of
development, justifies the inclusion of health concerns in all development policies and
recommends environmental and health impact assessment (UN 1993). In Europe, the
Maastricht Treaty, 1992, and the Amsterdam Treaty, 1999, require that the EC shall
ensure that proposals do not have an adverse impact on health, or create conditions that
undermine health promotion. The European Policy for Health advocates multisectoral
accountability through health impact assessment for both internal and foreign policies
(WHO 1998). The European Charter on Transport, Environment and Health recognises
the need for health impact assessment (WHO 1999). The UK government has published
a White Paper on Public Health and a report on health inequalities that establish policies
for the assessment of health impacts of all government policies (Acheson et al. 1998;
Secretary of State for Health 1999).
The Harare Declaration on Malaria Prevention and Control of the Organisation for
African Unity stresses the need for environmental and health impact assessment in
development (OAU 1997). Other countries where health impact assessment policies
have been developed include Australia (Ewan et al. 1992), Canada (Kwiatkowski 1996),
New Zealand (Public Health Commission 1995), Philippines (Philippine Environmental
Health Services 1997), Sweden (Berensson 1998) Finland (Koivusalo et al 1998) and
Netherlands (Putters 1998). There are, no doubt, many other initiatives.
Many civil society groups cite health risks as a principal concern when they object to
dams or other development projects. For example, about 60% of submissions received
by the WCD from civil society groups explicitly cited human health concerns (WCD, pers.
comm.)
Development projects may contain subsidies that provide "perverse" incentives to site
projects in particular places or benefit particular communities. For example, farmers
may be given subsidies to extract groundwater for irrigation with the result that a
nearby community is paying more to obtain drinking water from the same diminishing
supply. Dams may sometimes be located in remote regions in order to establish a
national presence in a border area or to encourage migration of a majority ethnic group
into an area inhabited by a minority ethnic group. Other motivations may include the
award of high value construction contracts or a decision to control downstream flows
into a neighbouring country. In these examples, policy changes are required to ensure
coherence.
7
WHO would like to see the WCb add its weight to this changing policy climate and to
recommend that health be added to the list of issues that must be addressed to ensure
that dams are supportive of, and not detrimental to health, and for all communities.
1.5 Legislation
Policy can be implemented through a range of instruments. These include international
conventions, national legislation and regulations. Not all the instruments are, however,
legal in nature; they may also include changes in departmental practices, and agreements
with local and regional communities. Existing regulatory mechanisms could be used, such
as those associated with environmental laws. There are also a series of international
standards that could be used to support health. These include 1509000, on quality
assurance, and IS014000, on environmental protection.
At present there is no law requiring human health to be safeguarded in the context of
development projects. The World Commission on Dams may recommend the development
of international conventions or national legislation for the construction and operation of
dams. WHO would like to see explicit statements about health included in such
instruments.
1.6 Integration with Environmental Impact Assessment
Environmental Impact Assessment (EIA) is an established policy and procedure in many
countries and development agencies, but EIAs normally make limited reference to health
(Birley and Peralta 1995; Birley et al. 1998). The health issue most commonly included is
poisoning due to pollution, which partly reflects a bias towards health problems of
industrialised countries. In the case of dams, filariasis, malaria and schistosomiasis, are
frequently cited. Other health aspects are often neglected, such as:
■
■
the increase in incidence of sexually transmitted diseases associated with the
movement of people to large rural dam construction projects.
loss of culture-specific traditional health practices. In many developing countries,
indigenous people depend upon such practices, which are part of their everyday life
and health culture.
EIA guidelines published by many development agencies make little reference to human
health (e.g. World Bank 1991; Department for International Development 1999),
although the World Bank's environmental sourcebook has been updated on the issue of
health (Birley et al. 1997). In most cases, health is addressed in a strictly "medical"
sense rather than a wider cross-cutting view of community health. This then results in
recommendations for the strengthening of health services which, although important,
fail to address opportunities for the management of community health risks in project
design and operation.
One solution to the lack of adequate routine health impact assessment is to give health a
stronger profile in Environmental Impact Assessment. However, not all health issues
have physical environmental determinants; some have primarily social determinants and
require social impact assessment (SIA). Health has a stake in EIA and a stake in SIA,
with a number of unique features that distinguish it from either of these. An
alternative solution is to create a separate and parallel procedure for health impact
assessment (HIA). If health is subsumed in environmental or social assessment then it
8
may be hidden and neglected and the scarce resources invested in the development of
theory and practice of health impact assessment may be lost.
The middle way is to plan for integration while maintaining a separate profile for health.
Health issues can be added to other impact assessment by requiring the following steps
(Birley and Peralta 1995; Seott-Samuel etal 1998): *
*
■
■
Add specific references to health to the Terms of Reference provided to the
consultants undertaking an impact assessment and indicate the method of health
impact assessment to be used.
Provide a quality assurance mechanism through appraising or evaluating the health
component of completed impact assessments.
9
....
2.
Human health issues related to dam construction and
operation
2.1 Categories of health issues
The health issues associated with dams can be conveniently represented in six major
categories. The existing knowledge bases concerning the impact of dam construction
and operation vary for the different categories. Table 1 provides an overview. Each
knowledge base has been described according to the volume of knowledge (large or
limited), the reliability of that knowledge, the transferability between projects or
regions and the quantiflability of the knowledge in terms of epidemiological statistics.
The basis for characterisation of the knowledge bases was a limited amount of expert
opinion and further refinement is desirable.
Table 1 The principal categories of health issues and the extent of existing
knowledge about their association with dam projects
Health Issues
Examples
Knowledge base
Communicable disease
vector-borne, water-borne, sexuatty
transmitted, zoonoses, other parasitic
large, reliable, ecosystem specific, some
quantification
Non-communicable diseases
poisoning by minerals, biological toxins,
pesticide residues, industrial effluent
geographically limited, reliable, generalisable, and
frequently weil quantified
Injury
drowning, construction injuries, communal and
domestic violence, catastrophic failures,
seismic activity, traffic injury
limited, reliable, transferable, some statistics
Ualnutrition
lack of protein, carbohydrate or essential
elements
limited and controversial, limited transferability,
reasonably quantified, limited reliabAty
Psychosocial disorder
stress, suicide, substance abuse, social
disruption, unrest, violence, decreased
tolerance
low volume, of poor reiiaMity with little quantification
and cultural variation
Social well-being
quality of Me, social cohesion and support
structures, sett-determination, human rights,
equity
low volume, of variable reliability and quantification
and considerable cultural variation
A method is required to attribute these risks to particular dam project components.
This is provided by health impact assessment (HIA), which is described below.
It is difficult to provide a measure of the size of the problem. The total annual global
mortality from floods is probably relatively small (perhaps 100,000 -Miller, 1997). Such
deaths are vivid because they affect large groups of people simultaneously, have an
element of dread, are outside the control of the individual and are not part of everyday
life. In contrast, communicable diseases such as malaria and diarrhoea kill far larger
numbers of people and especially children (World Bank, 1993). Transport injury rates
are also very high and there is widespread malnutrition associated with protein-energy
deficit or diet. There is a substantial difference between the perception of risk and
the statistical measurement of risk. It is thus usually the case that familiar voluntary
risks (e.g. drowning during normal recreational swimming) are not given the same weight
as unfamiliar, often dramatic, involuntary ones (e.g. drowning during a once-in-a-hundred
years flood event). The choice of priority is a matter for the community.
There is a considerable body of evidence about the global burden of disease and a
measurement unit has been constructed to compare pain, suffering, disability and toss of
productivity from different illnesses. This unit is known as the disability-adjusted life
10
year, or DALY. It is designed to assist in the allocation of scarce resources within the
health sector (World Bank 1993). While useful in evaluating the relative burden of many
diseases and illnesses, further research is needed before it can be used to analyse the
health issues associated with dam projects and serve as a basis for the selection of
health safeguards.
2.2 Regional differences
There* is regional variation in ffie prevalence rate of certain health conditions.
This
variation is most obvious when the condition depends on ecological factors such as the
presence of insect vectors, which in turn depends on environmental determinants such as
vegetation type or rainfall. Clear differences are observed between hot tropical
climates and cooler temperate climates in the transmission of many vector-borne
diseases, or in the occurrence of toxic czanobacterial blooms, for example. Some of the
more generalisable regional differences in health conditions throughout the world are
described in Table 2.
Table 2 Examples of regional variation in health conditions
Warm v cold climates
Various communicable diseases depend on a pathogen lifecycle which has a stage in the environment
and transmission is then temperature, rainfall and water-cycle dependent. Examples include malaria,
schistosomiasis and cholera. Toxic algal blooms are more prevalent in wanner dimates.
Africa v Asia
Communicable diseases such as yellow fever, rift valley lever, onchocerciasis, trypanosomiasis are not
found in Asia. Schistosomiasis has a very limited distribution in Asia but a wide distributon in Africa. The
malaria vectors of Asia have different habits to those in Africa. Communicable diseases such as Japanese
encephalitis and dengue fever are found in the Asian region.
SEAsia
Opisiorchiasis is an example of a parasitic disease restricted to this region. Schistosomiasis is restricted
to a belt of China, Philippines, a valley in Sulawesi and a small section of the Mekong river. The habits of
the snail host are considerably different to Africa and S America. The malaria vectors tend to be
associated with the forest fringe.
America
Malaria is sometimes associated with forests but there are many different habitats, schistosomiasis is
focal, zoonoses indude Chagas disease and leishmaniasis
2.3 Differentiation on the basis of dam size and purpose
Because many health concerns are associated with the interface between land and
water, the health impacts of many small dams may be equal to or greater than the
impact of a few large dams of equal total volume. This is due in part to the increased
ration of overall shoreline to water storage volume. For example, breeding sites for
mosquitoes tend to be in shallow backwaters. Hence, small dams should not be ignored in
a regional health context, particularly where significant numbers of such dams exist or
are planned.
The purpose of a dam will be reflected in the infrastructure associated with it and in its
operation. This will have specific consequences for its impact on environment and health.
Reservoirs for irrigation water supply have an impact on the landscape and ecology of
the agricultural production area that they serve, in contrast to hydroelectric dams.
Typical dam functions include: irrigation, electricity generation, water supply, flood
control, recreation, inland navigation and fish breeding. Each will have a range of
positive and negative health impacts on a range of stakeholder communities.
Table
8
provides
11
examples.
3. Options for preventative or health promotional action
3.1 General considerations
The minimum requirement for any development project should be that it does not
adversely affect the health of local communities. Unfortunately this largely remains a
distant objective. The health impacts can be difficult to quantify, but they can be
categorised as an increase, decrease or no change in the risk of disease and in
opportunities and enhancements for health. The ideal objective is that the health of all
communities should be enhanced and promoted by the project.
In search for
procedures, methods and technical solutions that assist in achieving these objectives,
many technical solutions can be found to the problem of negative impacts of dam
construction - good practices as Table 3 and Table 10 illustrate.
Table 3 Examples of good and bad practice
Successful
Panama Canal Authority
Tennessee Valley Authority
Not successful
Health was accepted as an integral objective of the river basin
development and the most important problem, malaria, was quickly
controlled around dam sites. The success of carefully planned engineering
measures has been sustained for almost a century along the Panama
Canal and half a century in the Tennessee Valley.
Mushandike Irrigation Scheme,
Zimbabwe
RehabiWabon of the scheme tn the 1980s included health concerns into the
planning, design, construction and management. It included the
development of new, self draining hydraulic structures, improved canal
infrastructure with optimal gradients and reduced risks of seepage, and the
provision of ventilated improved pit latrines in the fields, deployed according
to a grid pattern.
Senegal VaRey Authority
(OMVS)
Health was not accepted as an integral part of planning for the Diama and
Manantali dams. An epidemic of Rift Valley Fever occurred when the dams
were filled, schistosomiasis prevalence rates reached record levels and
riverside inhabitants experienced diarrhoeal disease, malnutrition and
malaria.
Recommendations for good management practice are listed below. First, a number of
general observations need to be made:
Preventative and health promotional measures tend to be site specific. They are
linked to the geographic variation in health conditions associated with dams as well as
to the relative effectiveness of measures in different ecological and epidemiological
settings.
■ The secondary effects of measures need to be taken into account and trade-offs will
have to be found to come to a final decision. The reliance on swamp drainage for
malaria vector control, for example, which was considered good practice in the 1920s
and 1930s, would currently be unacceptable in many instances because of the
importance attached to wetland conservation.
■ Whatever the technical merit of "good practice" interventions, they will only be
effective and sustainable if the process of their design and implementation is
transparent and participatory.
■
There is an extensive though rather scattered literature on good practice (WHO 1982;
Oomen et al. 1988; Jobin 1999).
12
-
3.2 Good practice - the planning framework
Many dams around the world have been associated with significant, and even serious,
health problems. The reasons for this are complex but the fact that dams are normally
designed based largely on hydro-engineering criteria is a contributing factor.
Fortunately, many of the adverse health outcomes linked to dams and associated
infrastructure developments (e.g. irrigation schemes) can be ameliorated if a broader
and more holistic view of project construction and operation is taken.
Along with a range of insightful engineering approaches should come a recognition for
the need to take an integrated, multi-disciplinary approach to environmental, social and
health management. This new understanding can lead to the implementation of a range
of innovative design and operational features for water infrastructure projects. Such
changes may be cost-effective and provide the desired health outcomes that formally
were considered controllable only through remedial medical interventions (Bos, 1991;
Rozendaal 1997).
As already noted, the key process driving this increased understanding is the integrated
Health Impact Assessment (HIA). In he context of the overall dam planning framework,
it is very important that the HIA is implemented as early as possible in the planning
cycle. Certain aspects of the HIA, such as the gathering of baseline human health data,
may require more time to complete than other aspects of the overall environmental
assessment process. Often these data must be collected across different seasons
because of the strong impact of the seasonal cycle on vector reproduction and activity,
as well as the impacts on human and social behaviours.
It is also very important that the HIA is undertaken using formal methodologies as
outlined by WHO or by national health organisations and experts, and with proper
institutional and/or regulatory backing (see section 5 for details). In addition, overlaps
and synergies will usually be identified between the HIA and environmental (ecological)
and social impact assessments. From a health perspective, it will be apparent that many
of the identified social and environmental impacts also lead to clearly identifiable health
impacts. Because the health specialist(s) carrying out the HIA may not be familiar with
these environmental or social outcomes, post-analysis and integration is essential if all
potential health problems and opportunities are to be identified and addressed during
the subsequent dam planning process.
Finally, a key aspect in the planning cycle is the need to have all sections of the
stakeholder community (defined in its broadest and most inclusive sense to mean anyone
who may have an interest in or be affected by the construction of the dam) involved
throughout all aspects of the HIA process, and generally in all aspects relating to dam
construction and operation.
3.3 Good practice - design and operation options
There are a number of fully or partially validated options that can mitigate the adverse
effects on human health of dam construction. These planning options fall into a number
of categories including engineering design considerations, operational water
management, and social and community planning. Some examples are:
■
Multiple depth off-takes which allow the release of first flush inflows that may
contain high levels of contaminants and nutrients, and allow a high level of control of
13
■
■
■
■
■
■
■
■
■
■
■
■
variation in operational water level (which can be advantageous in the control of
disease vectors such as snails and mosquitoes).
Double spillways in areas where onchocerciasis (river blindness) is endemic.
Spillways have been shown to provide an appropriate habitat for the breeding of
blackflies {Simulium ssp}, the vectors of the Onchocerca parasite causing the
disease.
A greater than standard diameter of off-takes will allow the rapid draw-down of
reservoirs, allowing both a rapid drop in shoreline water levels (stranding and killing
mosquito vectors, provided no pool formation occurs) and an artificial flood down
stream that will flush out any vector breeding places in rock pools.
Minimising low flow zones in artificial channel networks to minimise habitats for the
propagation of disease vectors.
Concrete lining of irrigation canals to reduce seepage, save water and prevent pools
of standing water where mosquito vectors propagate.
Siting dams in areas that require minimal population displacement
At all potential sites, ensuring careful examination of reservoir bathymetry so as to
avoid dam sites that have extensive shallow areas conducive to insect and snail
breeding. While shallow margins can never be totally avoided, catchment
topographies that give rise to large reservoirs of low average depth (and therefore
large wetted perimeters) should be avoided. Such reservoirs will also be undesirable
from an evaporative loss point of view.
Provision of simple infrastructure at critical places along the reservoir shore to
reduce water contact for specific target groups (fisherman, women, children).
In-reservoir management to prevent eutrophication and excessive growth of
problematic organisms such as toxic cyanobacteria and aquatic weeds. The
development of massive blooms of toxic cyanobacteria is an area of increasing
concern, especially in poorer countries where drinking water treatment may be less
common or absent, and where exposure to toxic blooms may go unmanaged or
unreported (see box 4).
Careful settlement planning that ensures that, where ever possible, and in balance
with other planning and social needs, population settlement occurs away from areas
of impounded and slow flowing water. This will minimise human exposure to disease
carrying vectors (see table 4 for more information).
Adequate planning for and design of community water supply and sanitation, including
careful management of sewage and waste. This will reduce the rate of reservoir
eutrophication and the occurrence and severity of toxic cyanobacterial blooms, as
well as generally reducing water pollution.
Management of irrigated cropping systems to maintain wetting and drying cycles
(while ensuring efficiency in water use), crop diversification and synchronisation of
cropping patterns. Regular wetting and drying of flooded rice fields provides an
important control of water associated vector-borne diseases such as malaria and
Japanese encephalitis. In particular, there should be no agricultural advocacy or
economic analysis carried out that encourages excessive multiple cropping within a
single production year.
Stages and planned control over population movements into and out of affected
region, e g. planned community infrastructure construction and culturally sensitive
community planning.
14
■
Well formulated dam environmental management plans that will support sustainable
fisheries practices, sustain populations of natural predators of disease vectorsand
minimise excessive growth of aquatic weeds.
3.4 Good practice - off-site management and environmental
protection
The spatial boundaries of the health impact of dams generally extend beyond the
confines of the reservoir and the immediate downstream area. Therefore, a number of
off-site environmental management measures may also be considered.
Catchment management to minimise negative impacts on the impoundment, including
population growth and agricultural development in the upper catchment and pollutants
in-flow.
Adequate in-flow forecasting for disaster prevention because of increased settlement
on the downstream floodplain and heavy livelihood dependence on the new production
system.
Water release regimes that minimise impacts on downstream ecology and productivity
especially in regions where there is a significant nutritional reliance on the downstream
river production.
Management plans for irrigated areas that minimise long term salination and water
logging and therefore impact on food security and scheme viability.
Sensitive management of flood plain wetlands and water resources to ensure wetland
protection, while at the same time minimising excessive propagation of water-borne and
water related vector-borne diseases. As with irrigated agricultural production systems,
natural seasonal wetting and drying cycles will be an important management tool.
Traditional irrigation and drainage practices often lead to permanent inundation and
wetting of previously ephemeral wetlands. The outcome of this is both degradation of
the wetland and increased risks of vector-borne diseases.
15
4. Recommendations for improving good practice
4.1 Health Impact Assessment
There is an overwhelming need to include health impact assessment (MIA) as an integral
component in the planning of dams and other major water infrastructure projects.
HIA is an instrument for safeguarding the health of stakeholder communities.
Prospective health impact assessment provides a mechanism for scrutinising and
comparing the health outcomes of different project plans. Changes may then be
included in the plans and operations so as to safeguard and promote human health. This
recommendation is seminal and is discussed in detail in the next section.
Ideally HIA should be integrated with Environmental Impact Assessment (EIA) and
Social Impact Assessment (SIA) as much as possible, while at the same time ensuring
that the importance of human health as an assessment parameter is not lost in the
integration process.
Furthermore, the HIA should be commissioned as early in the project planning cycle as
possible, when alternative designs are being discussed. This will allow a comparative
assessment to be made of the health impacts of each design and importantly, it will
allow time for baseline data to be collected throughout a full annual climate cycle (see
section 3.2).
The imperative need for HIA should be incorporated in any future international
conventions and in national legislation on dams.
4.2 Capacity building
Appropriate capacity in MIA and community health management needs to be built both
within the health sector and in the sectors primarily responsible for dams.
National authorities cannot use instruments such as health impact assessment to their
full potential until there is a body of trained personnel, and this is clearly lacking
throughout the world at the present time. A favourable policy climate is essential for
this body of trained personnel to function optimally. Health sector personnel will
benefit from training in impact assessment procedures and methods, and it will be
better placed to appreciate the concerns of other sectors. In turn, other important
sectors, in particular the dam design and construction (engineering) sector, should work
towards the development of an understanding of the association between their decisions
and human health.
Where lacking, all groups should develop skills in inter-sectoral communication,
collaboration and community participation. Training should include an appreciation of the
principles of health impact assessment. These are generic skills that apply equally to all
development policies, programmes and projects. Training courses need to be selfsustaining and widely available in all countries and regions as optional components of
post-graduate degrees as well as free standing short courses. The participants of such
courses need to be empowered by their managers to implement the skills that they
acquire. This includes career rewards for engaging in inter-sectoral activity that may go
beyond their original job specifications. Wherever possible, this new expertise should be
established and maintained local to the project. Orientation courses are also required
for different stake holders, especially policy makers and elected members of local
administrative bodies. (See box 2 for more details).
16
Institutional support is required to foster these training programmes and provide quality
assurance mechanisms. The World Health Organisation is one of the indicated
institutions to provide that support through its headquarters, Regional Offices and
country representations.
It can also provide the international framework for health
impact assessments of large development projects, as a service to the World Bank,
Regional bevelopment Banks and bilateral agencies. A programme of training and re
orientation is then needed within WHO to build its own capacity to undertake such
functions.
On a longer term a self-sustaining financial mechanism as well a local
institutional basis should be found to support this framework and the associated
activities.
Box 2 Health Opportunities in Water Resources Development
Capacity and skills to break through the barriers that exist between public sectors are
critically important for health to be considered effectively in the planning, design and
implementation of infrastructure projects. Formal secondary and tertiary education
generally aims at the formation of specialists. Adult learning is most effective when it
is problem-based and allows participants to learn from each other rather than through
passive information transfer such as formal lectures. The World Health Organization,
the Danish Bilharziasis Laboratory and the Liverpool School of Tropical Medicine have
developed and tested a three-week training course for mid-level managers in ministries
and other public authorities. In the context of water resources development -fully
documented real projects are used- the participants work, in intersectoral groups,
through a series of tasks representing crucial decision making moments in the project
cycle. To a large extent, these tasks revolve around HIA. Evaluations of five courses
(three in Africa, one each in the Americas and Asia) suggest high levels of acceptability,
effectiveness and efficiency. The value of such training efforts is higly enhanced when
simultaneously policy reform is promoted allowing for the trained staff to effectively
engage in intersectoral collaboration (Birley etal. 1996)
4.3 Documentation of successes
An information and education oriented data base should be compiled:
•
describing the limited number of health success stories based on careful dam design
and operation, and explaining the key management processes in detail;
•
with an assessment of the effectiveness of already implemented health risk
management methods and techniques.
This information will lead to a considerable improvement in the existing health
management knowledge base and will help streamline health-sensitive dam planning.
Examples of good health planning in dam and water infrastructure construction include:
the Panama Canal, the Tennessee Valley Authority, Owens Falls in Uganda, small dams in
Puerto Rico, simplification of the Gorgol irrigation project in Mauritania and remedial
action on the bez Irrigation Project in Iran and the Mushandike Irrigation Scheme in
Zimbabwe. There are also dams that have included engineering measures for
safeguarding health that have not been evaluated. These include water supply reservoirs
in Katsina and Kaduna States, Nigeria, the Ghazi-Barotha Power Canal in Pakistan and
the Manantali reservoir in Mali.
17
Evaluations of recent dam projects following construction (socalled ex-post evaluations)
should routinely include a retrospective health assessment as well as a prospective
health impact assessment that takes into account the long-term (50-100 years)
temporal boundaries. (See sections 5.2.6 and 5.2.7 on HIA - boundaries).
4.4 Action oriented research
Special funding should be directed towards action oriented research in existing dam
construction projects in order to strengthen existing knowledgebases, to improve health
outcomes and to establish the effectiveness of health risk management techniques.
There are a number of well-documented health problems associated with dams that
require remedial action, with examples including dams in the Senegal, Blue Nile and Volta
river basins. There is good reason to believe that the adverse health, social and
environmental impacts could be alleviated by changes in dam operation. Such projects
should be given priority attention for funding and implementation of health management
strategies. An action oriented research component on health risk management should be
part of any future dam project.
Similarly, there are a number of incompletely tested ideas for environmental
management methods for vector control. One example involves fluctuating reservoir
outflows. There is a shortage of funds to support such research because it falls
between environmental and health budgets.
Box 3 Flushing corrals for malaria control in Sri Lanka
The synergistic potential of multidisciplinary research on malaria in a specific ecological
setting was recently demonstrated by the work done in the Huruluwewa watershed,
Anuradhapura District, Sri Lanka. The joint efforts of the Department of Zoology of
Peradeniya University and of the International Water Management Institute (IWMI)
focused on a strategic assessment of the local ecology of malaria vector mosquitoes and
a water balance estimation/f low measurement in the irrigation scheme. The primary
vector species in Sri Lanka is Anopheles culicifacies, known to use stream and riverbed
pools as its main breeding sites. The water management options suggested by the
research include flushing of streams and irrigation canals at critical moments to reduce
mosquito densities and malaria transmission. Routinely applied, this will require new
decision making criteria for irrigation water management, and further feasibility studies
involving both government institutions and farmers. The availability of existing
reservoirs to manage water levels in streams/canals, and the capacity to recapture the
released water downstream are important factors contributing to the feasibility of the
proposed water management regime. Further testing of different options for flushing
regimes can provide an optimal combination with both health and agricultural benefits
(van der Moek et al. 1998: Matsuno et al. 1999).
4.5 Budgeting for health
A health component should be negotiated as a budgeted item for all project loans in
order to safeguard and enhance health.
Economic assessments of dam projects that do not include the consideration of health
issues tend to transfer a hidden cost to the health sector. This represents the cost of
18
providing health care and medical support to communities for illnesses that arise
because of unforeseen (though avoidable) consequences of dam construction. The health
budget of a dam project, which is not necessarily administered by the medical sub
sector, should be used primarily for preventative rather than curative actions, with the
optimal balance decided on a case by case basis. It should complement the existing
general health infrastructure and should not be considered as a substitute for the
existing health care system.
4.6 Prioritising the health issues
It is important that the health priorities are not pre-judged but allowed to emerge from
the health impact analysis and community consultation.
The HIA will identify a wide range of health changes attributable to the project. Many
are positive health enhancements, while others will be negative health impacts that have
to be prioritised for preventative action. Table 1 indicated the range of health issues
that may be affected by a dam project. Development agencies are often aware of one or
two issues -examples include schistosomiasis and AIDS- and assume that these have
over-riding priority, sometimes to the neglect of other potentially very important health
issues. Boxes 4 and 5 highlight some important health risks that do not always receive
the attention they deserve in health impact assessment procedures for dam
construction.
In addition, there are often differences in perception of risk between subject experts
(health specialists) and affected communities. Such differences in opinion cannot simply
be dismissed out of hand as subjective or emotive. There are various approaches to
establishing priorities, including the following.
•
•
•
estimating the frequency, severity and probability of health impacts;
conducting an economic analysis;
determining the subjective perception of risk expressed by the stakeholder
•
•
•
community;
negotiation of opportunities for mutual gain;
comparison with standards;
reducing health inequalities.
Box 4 Freshwater cyanobacterial toxins - an emerging dam related health issue
In tropical, sub-tropical and arid regions of the world it is inevitable that new dams will
become eutrophied (nutrient enriched) rather quickly, often within the first few years
of filling and operation. Eutrophication brings with it problems of excessive aquatic
weed growth or ‘blooms' of toxic cyanobacteria (cyanobacteria are a type of microscopic
algae). Arid zones of the world are particularly at risk, where the artificial
impoundment of water in the hot climate creates the perfect ecological environment for
the growth of toxic cyanobacteria Added to this natural climatic effect is the
enhanced rate of nutrient input that accompanies the growth of towns and the
development of agriculture in the catchment around a dam, often with inadequate
effluent collection and treatment facilities.
19
Blooms of freshwater algae and cyanobacteria have always occurred in eutrophied
waterways, but the toxicity of these organisms has only been elucidated in recent years.
There are several types of cyanobacteria! toxins found throughout the world, all of
which are potentially lethal to humans and animals if consumed in sufficient quantities.
Additionally, some cyano bacterial toxins can promote live cancer during chronic low level
exposure, and most cyanobacteria can cause a range of gastrointestinal and allergenic
illnesses in humans exposed to toxins in drinking water, food or during swimming (Chorus
and Bartram, 1999).
A norm for drinking water concentrations for the common
cyanobacterial toxin microcystin has recently been developed by the WHO.
The most severe and well documented case of human poisoning due to cyanobacterial
toxins occurred in the Brazilian city of Curaru in 1996. Inadequately treated water
from a local reservoir was used for patients in a local kidney dialysis clinic. As a
consequence, more than 50 people died due to direct exposure of the cyanobacterial
toxin to their blood stream during dialysis. Elsewhere in South America, in 1988, more
than 80 deaths and 2,000 illnesses due to severe gastroenteritis have also been directly
linked with toxic cyanobacteria in a newly constructed dam. In China, a high incidence of
primary liver cancer has been linked to the presence of cyanobacterial toxins in drinking
water (Chorus and Bartram, 1999).
Box 5 Examples of health impacts form India
Downstream: monsoon dryness
When dams obstruct a river, the protection provided to aquifers and soil by the outward
freshwater flow disappears, and tidal surges may invade the rivers and cause flooding.
This is already evident along Western state of Gujarat's long Saurashtra coast. Reports
by independent experts, including a World Bank-instituted independent review,
expressed similar fears regarding the Narmada. (The World Bank, 1992.]
Water pollution
The impoundment of river water in reservoirs has dramatically reduced flow in many
rivers, rendering them incapable of diluting effluents or sustaining much of their natural
fauna and flora. The diversion of the river Yamuna’s water into Upper and Lower Yamuna
Canal at the Tajewale barrage at the Himalayan baseline constricts the downstream
flow. Industries and towns in the North Indian state of Haryana's and, further
downstream, Delhi itself seriously pollute the remaining insubstantial flow. The health
of downstream communities is placed at risk because of the high levels of toxic
pollutants and pathogenic micro-organisms (Anon. 1997),
Fluorosis
Large reservoirs and the irrigation they bring in command areas elevate sub-soil water,
changing the levels of calcium and trace metals, and can increase fluorosis. The Nagar
Junasagar dam in South Indian Andhra Pradesh triggered a crippling syndrome of knock
knees (fienu valgum) among villagers in the command area. According to Hyderabad's
National Institute of Nutrition, seepage from the reservoir and canals increased the
level of sub-soil water. This in turn elevated the molybdenum uptake of sorghum plants,
and augmented soil alkalinity. Genu valgum has been found in villages in Coimbatore
district, situated within a radius of 30 km from the Parambikulam-Aliyar dam, and from
villages near Karnataka's Hospet dam (Anon. 1982).
20
4.7 Prioritising dam projects for impact assessment
Screening procedures for HIA must be a minimum requirement for all dam projects.
There are often more projects that require health assessment than there are resources
available. Typical screening criteria include number of people affected, location in
sensitive sites, and use of unusual technologies and procedures. Multiple screening
procedures can be used and these are equivalent to rapid health assessments. Several
of the largest dams in the world have serious health impacts. Because of their unique
size and nature, such dams should be evaluated as a special category.
The cumulative effect of many small dams may be more important than the effect of
one large dam. It is impractical to conduct separate assessments for each small dam.
A preferred approach is to conduct a strategic assessment of the small dam
construction programme.
Box 6 The compounded malaria impact of microdams in Ethiopia
Recent studies in Ethiopia using community based incidence surveys revealed a 7.3 fold
increase of malaria incidence associated with the presence of microdams. The study
sites were all at altitudes where malaria transmission is seasonal (in association with the
rains). The increase was more pronounced for dams below 1900 meters of altitude, and
less above that altitude. In addition, observed trends in incidence suggest that dams
increase the established pattern of transmission throughout the year, which leads to
greatly increased levels of malaria at the end of the transmission season (Ghebreyesus
1999).
4.8 Transparency
The health impact assessment and planning process should be open to scrutiny by all
stakeholders and communities.
As with ail forms of impact assessment, and indeed the entire planning process, it is
crucial to include all stakeholders at all stages of the process. This is good practice for
all kinds of assessment and development activities, not just MIA. Health concerns
simply provide a specific example. In addition, the community is a critical source and
repository of health knowledge and information.
21
5. Health impact assessment
5.1. Introduction
Much of the preceding discussion points to the need to include health impact assessment
(HIA) when dam projects are designed or changed. HIA is an instrument for
safeguarding the health of stakeholder communities. A recent broad definition of HIA
is the estimation of the effects of specified actions on the health of defined
populations (Scott-Samuel et al 1998).
For the purpose of this paper WHO prefers a more operational definition: a health
impact is a change in health risk reasonably attributable to a project, programme or
policy. A health risk is the likelihood of a health hazard affecting a particular
community at a particular time. Assessments can be retrospective or prospective. The
retrospective kind is the business of normal science and serves to enlarge our knowledge
base. It measures and records what has happened. The prospective kind is part of the
development planning and project assessment procedure. It projects the likely
consequences of a future project based on available evidence. The health impacts
themselves may be positive or negative. It is expected that most development projects
have mainly positive impacts and these include reductions in health risks as well as
imporvement of the health status.
The various components of health impact assessment have been debated over the past
15 years especially in the context of water resource development. They can broadly be
classified as policy, procedure and method. The policy context was described earlier in
this document. The distinction between procedure and method is important. At the early
stages of HIA development methodological questions were considered more important.
Experience proved otherwise. The problem is not so much technical as knowing when and
where to conduct the assessment. This section of the document starts by providing a
summary of the procedure which aims to ensure that each stakeholder is informed of
the framework in which the assessment should be carried out. See Figure 1.
5.2 Procedure
The procedure that is described here and in Figure 1 will be familiar to anyone who is
already informed about impact assessment, such as environmental assessment
specialists. It may not be familiar to many members of the health community who wish
to have a role in future assessments. In addition, there should be community
participation by involving stakeholder representatives in all stages of the procedure. The
main components of procedure are the following:
I.
2. Screening
Timing
3. Establishing a steering committee
4. Scoping
5. Agreeing Terms of Reference
6. Choosing an assessor
7. Undertaking an assessment (see
method)
8. Appraising
9. Disseminating
10. Negotiating
II. Agreeing actions
12. Implementing
13. Monitoring and evaluating
22
Figure 1 Illustration of some of the components of procedures and methods used in
health impact assessment
Procedures
Methods
Apply screening
criteria to select
v protect or octo
Estabbsn steering
group
Agree scope and
terms of reference
, for assessment
Select assessor
Profiling of
conwnunitfes
Jr...
Identify health
determinants
£ $ ? iMMiO
Conduct
assessment
<....................
Collect evidence
from previous
reports
interview
stakeholders and
key informants
zr:
F
Assess
evidence
. t...
Appraise the
assessment
t
I
Negotiate
- f favoured options
Establish
priority impacts
Recommend and I
justify options for I
:
action
I
Imptementand
monitor
±
Evaluate and
document
23
5.2.1 Timing
Timing -when to start and when to complete athe HIA- is crucial because of the
frequent observation that impact assessments are commissioned too late, sometimes
even when the first concrete has already been poured. They should be commissioned
when alternative designs are being discussed, so that a comparative assessment can be
made of the health impacts of each design. The timing should also allow the health
assessor to interact with other members of the design and assessment team. Whenever
feasible, time should be allowed for the observation and recording of seasonal
differences in health risks and baseline community health status. See also sections 3.2
and 5.2.7.
5.2.2 Screening
Screening procedures are used to decide which projects should receive a particular level
of HIA, or whether, inded, an HIA is necessary at all (as discussed in section 4.7). It is,
however, difficult to conceive of any large dam project for which a health assessment
would prove unnecessary.
Individual small dam projects may not, upon initial
consideration, seem likely to require an HIA.
As already noted, however, small dam
developments need to be examined strategically and in a regional context. In particular
in areas where several other such dams already exist, their cumulative health impact
may be similar to or even worse than that of a large dam of identical total storage
capacity.
5.2.3 Steering committee
Following screening, a multidisciplinary Steering Group should be established to
determine the scope and Terms of Reference of the assessment and to provide advice
and support as it develops. Its membership should include representatives of the
commissioners of the HIA, the assessors carrying it out, the proponents (i.e. those
developing, planning or working on the dam project), affected communities and other
stakeholders as appropriate. Members should ideally be able to take decisions on behalf
of those that they represent. A single committee that takes charge of all assessment
and feasibility studies is the preferred option. This broad committee should include a
specialist health representative.
5.2.4 Scoping and agreeing Terms of Reference
The outcome of the screening procedure should be the starting point for scoping and
the formulation of Terms of Reference (TOR).
Scoping serves to define the health
issues that should be considered in detail (generically listed in Table 1), the stakeholders
and the boundaries of the assessment in time and space. Based on the scoping exercise,
TOR are formulated.
The purpose of the TOR is to provide a basis for a quality assurance procedure for the
work being undertaken. The TOR is project specific, but should include the following
elements:
■
Steering Group membership should be listed in the TOR, together with members'
roles, including those of Chair and Secretary.
•
The nature and frequency of feedback to the Steering Group should be specified.
■
The methods to be used in the assessment should be described in adequate detail.
■
The TOR should outline the form and content of the policy, programme or project’s
outputs, and any conditions associated with their production and publication. Issues
24
associated with publication of outputs include ownership, confidentiality and
copyright.
■
The scope of the work should be outlined - what is to be included and excluded, and
the boundaries of the HIA in time and space. Positive as well as negative health
impacts should be included in the assessment. See secion 2.1, table 1.
■
■
An outline programme - including any deadlines - should be provided.
The budget and source(s) of funding should be specified.
The TOR is a crucial element of the HIA procedure, with the quality of the asessment
being determined to a large extent by the quality of the TOR. In the case of dam
projects, it should be written by an expert with experience/expertise in community
health and/or environmental sciences and with definite experience in working with
displaced people. It will need to be agreed by the Steering Committee. It is important
that the TOR has a broad view of health issues as outlined in Table 1. When the
assessment report is complete, it is appraised by the Steering Group to determine
whether it satisf ies the TOR. The quality of the assessment is determined in part by
the quality of the TOR.
5.2.5 Choosing an assessor
Project proponents who are commissioning work on health impacts are frequently unclear
about the kind of person they should commission the HIA from. This is made more
difficult by the general lack of availability of special training or expertise. In an ideal
world, a team that encompasses ail the requisite skills would undertake the assessment.
Tn reality, some compromise will usually be necessary. The following list is provided for
guidance. The person or team contracted to undertake the HIA of dam projects should
ideally have the following qualif ications, education and experience:
■
Experience with prospective health/environmental/environmental health impact
assessment.
■ Training in public health, environmental health or equivalent.
■ Familiarity with both environmental and social determinants of health.
■ Able to adopt a holistic perspective of health issues (see Table 1).
— • A record of publication or experience linking environmental change and health issues.
■
Able to carry out key informant interviews and produce an analytic report that cites
■
sources and indicates assumptions.
An understanding of water resource development issues and issues of dam
■
construction and operation.
Familiarity with disease ecology, for example the ecology of vectors associated with
the floodplain.
An involvement with field based health research such as epidemiology or human
ecology (rather than laboratory, taxonomic or clinical expertise).
■ Familiarity with technical assistance and how this differs from experimental
■
scientific research.
A number of training courses have now been pilot tested in both developing and
developed countries (Birley etaL 1996; Birley eT al. in prep). But they have not yet been
widely disseminated or institutionalised. See section 4.2, Box 2.
5.2.6 Spatial boundaries
25
It is common that administrative, ecological and hydrological boundaries do not coincide.
Rivers may flow through several countries, regions and local government districts. The
boundaries used in different kinds of impact assessments need to be integrated. Health
impacts are sometimes associated with boundary problems and confusions over
jurisdiction.
Figure 2 illustrates the various geographical components of dam projects. They include
reservoir, upper catchment, irrigation scheme, floodplain, estuary, urban slums, coast.
The health impacts cover the whole river basin both upstream and downstream of the
dam wall, and, ultimately, it is the extent of human movement that determines the
lateral extent of the lateral zone of interest rather than any particular biogeographic
zones (e.g. catchment boundaries). This includes seasonal movement of pastoralists,
displacement to (peri-)urban slums, and circulation between river basins by fishing folk.
Communities displaced by reservoirs may migrate to the upper catchments and change
the local land use. Others will be formally resettled in newly designed and constructed
villages, with all the difficulties that this entails. Increased deforestation in the upper
catchment area to increase water yields into the reservoir may also have local health
impacts, as well as negative impacts on water quality in the dam itself due to increased
sediment and nutrient run-off, hence contributing to the risk of toxic algal blooms. The
displaced communities also migrate to distant cities where they swell the peri-urban
slums.
The association between human circulation and health issues is illustrated in Table 5. At
a smaller scale and depending on the specific river system, the river floodplain includes a
flood recession zone that may extend 50 kms and the reservoir has a drawdown zone
that may extend 5 kms laterally around the perimeter of the dam. At an even smaller
scale, the local flight range of insect vectors between breeding and feeding sites ranges
from 0.1-10km as Table 4 indicates. Longer migratory flights or long-range transport of
insects by prevailing winds imply that if a project creates new insect breeding sites then
sooner or later they will be colonised.
Table 4 Flight range of insect vectors
Vector
Local movement (km)
Migration (km)
Simuiiid biackflies
410
400
Anophetine mosquitoes
1.5-2.0
50
Culicine mosquitoes
0.1-B.0
50
Tsetse flies
24
Table 5 Typology of human circulation (Birley 1995)
Circulation
Migration
Dally
Periodic
Seasonal
Long-term
Irregular
Regular
Rural/rural
Cultivating1
Hunting1
Pastorafem1"2
Labouring1-2
Nomadism1-2
Resettlement1-3
Rural/urban
Commuting1
Trading1-2-3
Labouring1
Labouring1-2-3
Drought1-2-3
Labouring1-2-3
Urban/rural
Cultivating'
Trading'
Labouring1
Trading1-2
Refugees'-2-3
Retirement'
Urban/urban
Commuting1
Trading1-3
Trading1
Relocation3
Refugees3
Trading3
1 communicable disease (e.g. vector-borne diseases, STbs)
2 malnutrition/injury
3 psychosocial (e.g. alcoholism, stress, depression, violence)
27
Figure 2 Illustration of the spatial boundaries of a health assessment
i
l\
/%
1
/
100 kms
%
<
1 catchment
1
I
i
I
I
/
I
\
.w"
I%
iI
reservoir
resettlement
circulation
J
.y•F
_^rriqation /
displacement,
circulation,
migration
V/
/
’
..V
/
I
%
%
/
/
f
flood
recession
human
circulation
floodplain
.f
t
•
:
■
X
^^estuary
coastal plain
sea
5.2.7 Temporal boundaries
The temporal boundaries consist of the stages of the project cycle: planning, design,
construction, operation, rehabilitation, decommissioning. In the case of dams the
complete time-span is 50-100 years and the health impacts will differ in each stage.
Some health problems are immediate, rapid or acute in onset while others are slow,
delayed or chronic. See Table 6 and Table 7. The baseline conditions, before
construction, usually only provide a partial basis for an accurate forecast of later
28
conditions because of the environmental and demographic change that occurs. The
experience of similar projects in comparable eco-settings is a more reliable basis for
forecasts.
Table 6 Examples of association of health issues with timing
Acute or rapid onset
Chronic or delayed onset
Communicable disease
malana
schistosomiasis
Non-communicable disease
acute poisoning such as during pesticide
application, algal toxins
chronic poisoning such as dust-induced lung
disease, algal toxins
Injury
drowning, iraurna
hearing loss of construcbon workers
Nutrition
wasting
stunting
Psychosocial disorder I social welL-being
communal violence
depression
Table 7 Examples of the association of health issues with different project stages
Communicable
disease
Non-communicable
disease
Injury
Nutrition
Psychosocial
disorder/ social
well-being
Stress, fear, anxiety
Planning
Construction
STD's, malaria
dust-induced
respiratory tract
problems
construction
related
loss of subsistence
uncertainty and
disempowerment
Early operation
schistosomiasis,
diarrhoea, malaria,
zoonoses
toxic algal blooms
disputes
between
communities,
drowning
loss of subsistence
crops and grazing
displaced
communities lose
coherence
Late operation
schistosomiasis,
drarrhoeal diseases,
malaria,
onchocerciasts
contamination of
drinking water, mineral
variation of soils
drowning
loss of agricultural
lands
drowning
loss of irrigation
DecommlMionlng
depression
5.2.8 Appraisal and dissemination
The completed HIA report must be appraised by the steering committee to ensure its
quality. Before final acceptance the report should also be disseminated to all major
stakeholder communities and their feedback should be incorporated. The appraisal
includes both technical and procedural issues. The appraisal of technical issues is
— concerned with the method of assessment, the knowledge base and the nature of the ‘
evidence and inference that has been used. The procedural assessment is concerned with
sources of bias, problems of timing, the adequacy of the Terms of Reference and the
extent to which the TOR has been met. Following a satisfactory scrutiny of the
conclusions of the HIA report, the recommendations are appraised for their technical
feasibility, social acceptance and economic soundness.
The final outcome of the appraisal is acceptance, rejection or requirements for report
modification. The accepted report is deemed to have met a quality standard and that
standard and the content of the final HIA report should be agreed to by all
29
-
stakeholders as the basis for further negotiation, whether or not it represents a
consensus opinion (which it usually will not).
5.2.9 Negotiation
The usefulness of the assessment lies in the weight of the arguments that it provides to
the commissioners during the period of negotiation with the project proponents to
ensure that health is safeguarded and/or enhanced. The negotiators will seek to argue
that the predicted health impacts and the recommendations for mitigating risk and
safeguarding health are, indeed, realistic. They will also agree priorities.
Once a HIA has been carried out, the consideration of alternative options (or the
undertaking of a formal option appraisal) does not conclude the process. Even when
there appear to be clear messages regarding the best way forward, it cannot be
assumed that these will automatically be adopted. Political imperatives, either within or
beyond the Steering Group, may ultimately determine the outcome. Disagreements or
power inequalities between different stakeholder factions may be similarly important. In
these and other such cases, the quality of leadership shown by the Steering Group Chair
and members can prove crucial. Achieving agreement on options for mitigating or
enhancing predicted health impacts might require skilful negotiation on the part of
those involved.
The outcome of negotiation will be a budget and an intersectoral agreement for
implementation of recommended risk management measures.
5.2.10 Implementation and monitoring
The actions agreed must be implemented at appropriate stages of the project.
Monitoring provides a tool for ensuring that implementation proceeds as agreed and to
detect the occurrence of any unforeseen health effects. It is likely to be based on
indicators and the affected communities are often well placed to scrutinise those
indicators providing that they are empowered to do so. For example, they can report
whether domestic water supplies and health centres are functioning, insect bites are
more numerous, food security is enhanced, fear of injuries decreased, and whether the
sense of well-being is improved. The election or re-election of community leaders can
capture some of their concerns. Part of the agreed budget should be available for
maintenance of community infrastructure and salaries for care providers.
5.3 HIA Methods
When policy and procedure have been established, the actual assessment can take place.
It consists of inferring changes in health determinants that are reasonably attributable
to the project and that could affect each stakeholder community during each stage of
the project. The changes, taken together, produce health outcomes or changes in
health states. These are expressed in a minimum of three ranks: no change, increased
health risk, increased health enhancement. Quantification is generally difficult either
because the data is lacking or because there are no known functional relationships
between cause and effect. Poisoning and contamination are an exception, because the
dose-response model provides a functional relationship. Research is needed to improve
the predictive models for other health concerns.
30
The best forecast of what will happen is the history of what has happened on similar
projects in comparable regions. Reviews are an important tool and a number of reviews
are available (e.g. Cooper Weil et a!. 1990; Birley 1995).
In an ideal world, the assessment would start by collecting baseline data over a period
of at least two years prior to final agreement on dam design. This will provide a profile
of the existing communities, their environment, seasonal changes in health risks (e.g. due
to vector breeding cycles) and the capabilities of their institutions. The data collection
would be repeated after the project was operational and the difference would provide a
record of health impact and its likely causes. The record would add to the available
knowledge base and improve the assessment of future projects.
By contrast, the objective is to present evidence, infer changes and recommend actions
to safeguard, mitigate and enhance human health. The inferences may not always be
founded on extensive data, but they must be persuasive. The argument is based on the
precautionary principle and best practice (see section below on Evidence).
5.3.1 Stakeholders
Health impact assessment differs from environmental impact assessment by placing
the human community first. There are many different stakeholder communities and
Table 8 outlines some health impacts that are largely focused on the local stakeholders.
Settlement location, occupation, age and gender and economic status can serve to
identify local stakeholders. Demographic information about the size of each community
and its future change in size is often poor but may still be important for the analysis.
The assessment compares the health impact of the project on two or more communities
and establishes whether health inequalities are likely to change. It is consistent with
other analyses of distributional effects and with health inequalities research.
5.3.2 Health determinants
Health determinants are the factors that are known or postulated to be causally related
to health status. Health determinants can be listed and classified. The direction of
change of health determinants associated with a project can be inferred. They can be
divided into those that can be managed, such as housing, and those that cannot be
managed, such as age. Some health determinants are listed and classified in this paper
but the list is not yet complete. The causal relationship between determinants and
health outcomes is well demonstrated in some cases but further work is required in
other cases. The relationship is clear in some cases while in others it is multifactorial
and complex. In the past there has often been a tendency to focus on the bio-physical
environment using a life-cycle model of disease and to ignore social determinants such as
poverty and loss of health culture.
Table 9 indicates examples of health determinants. Some of these will be changed by
the project. The change may be positive or negative in terms of their likely health
outcomes. It is not always possible to attribute a change in health outcome to a change
in health determinants. Generally, the risk of a change in health requires several health
determinants to act together. For example, numerous mosquitoes only increase the
incidence of disease if people do not protect themselves from the bites, immunity is low
and the health services fail to provide vector control, prompt diagnosis and treatment.
Similarly, the spread of HIV-AIDS may be mitigated substantially through local
31
I
education on safe sex practices, distribution of condoms to construction and site
workers and empowerment of local communities to manage the influx of temporary
workers. Personal protection depends on poverty, housing design, knowledge, attitude
and belief, and occupation. In seasonal climates vector-borne diseases often have
seasonal changes in incidence. Hydrological changes may extend or reduce the
transmission season.
I
32
Table 8 Examples of local stakeholder communities and some important health
issues
Psychosocial
disorder / well
being
Communicable
disease
Non-communic
able disease
Injury
Construction worirers
STDs, lung
diseases, vectorborne diseases
deafness
occupational
injury
alcoholism
Camp followers
STDs, diarrhoeal
disease
communal
violence
alcoholism
Stakeholders
Settlers
vector-borne
diseases
Displaced
diarrhoeal disease
pesticide
poisoning, algal
toxins
communal
violence,
agricultural
injury
communal
violence
algal toxins
Downstream floodplain
dependent communities
poisoning from
contaminated
water
drowning
algal toxins
drowning
Nomadic herders
zoonoses
Various professional groups
associated with project
management
vector-borne
diseases
Project beneficiaries, such as
electricity consumers
Improved water
supply
Service staff such as teachers
vector-borne
diseases
Seasonal labourers
STDs, vectorborne diseases
Reduced air
pollution
dis-empowerment
and uncertainty
stress, depression,
suicide,, loss of
iolerence and
violence, divorce
rates, drop-out from
schools
decreased
access to
natural
resources
Loss of tolerance
and increase in
hostilities and
violence over a
period of time
decreased
access to
natural
resources
Peripheral communities
schistosomiasis
and other vectorborne diseases
transitional
malnutrition,
problems of
food entitlement
within the
household
communal
violence
Recipient communities of the
displaced
Fishing folk
Nutrition
loss of
subsistence
communal
violence
loss of grazing
stress
Reduced fire
risks
Improved
cooking fuels
Improved quality of
life
alienation
pesticide
poisoning
33
agricultural and
transport injury
Table 9 Examples of health determinants and their classification
Principal categories
Fields
Examples of health determinants
IndMduaVfamity
Biological
Genetics, age, senses, gender, immunity, nutritional status
BehaviouraVLifestyie
Risk acceptance and behaviour, occupation, education
Circumstantial
Poverty, empowerment, family structure
Physical
Air, water and soil media, infrastructure, vectors, housing, energy, land use, pollution, crops
and foods, traffic
Social
Community structure, culture, crime, discrimination, social cohesion
Economic/Financtai
Unemployment rate, investment rate, interest rate, inflation rate
Health services
Primary care, specraiisi services, access, drug supply
Other services
Police, transport, public works, municipal authorities, local government, project sector
ministry, local community organisations. NGOs, emergency services, access
Public policy
Regulations, jurisdictions, laws, goals, thresholds, priorities, standards, targets
Environmental
Institutional
5.3.3 Weight of Evidence
The HIA assembles evidence from many sources about The changes in health
determinants. The evidence may be qualitative and based on key informants and
community opinion. It will often be incomplete, inconclusive, imprecise, and will usually be
probabilistic rather than absolute. It may not seem credible to bio-medical scientists
and engineers who are used to working with hard facts and numbers. Because of the
uncertainties and difficulty of dealing with large and highly variable human populations,
the type of information that will be gathered has more in common with legal evidence
than with scientific evidence.
Nonetheless, the analysis seeks to establish a chain of inference between the project,
the health determinants and health outcomes. Assumptions have to be made, but if
these are explicit readers can make their own judgements about the chain of inference.
The priorities assigned to the changes in health outcomes and the associated
perceptions of risk are a political matter and outside the judgement of the assessor.
5.3.4 Management of health risks and enhancements
The final stage of the assessment is to recommend and budget socially acceptable
measures to safeguard, mitigate and promote human health. These measures are
designed to influence the direction of change of some of the health determinants. The
budget can be negotiated as part of the loan agreement, decisions about which
recommendations to implement are then an outcome of the negotiating stage. The most
important principle for health promotion is dialogue between project proponents, health
professionals and stakeholder communities at the planning stage. The technical
recommendations for managing health risks are diverse. A broad classification is:
■ Appropriate health regulations and enforcement;
■ Modifications to project plans and operations;
■ Improved management and maintenance;
■ Supportive infrastructure such as domestic water supply;
■ Timely provision of accessible health care including diagnosis and treatment;
■ Special disease control operations;
■ Individual protective measures;
■ Redistribution of risk through insurance schemes.
34
>
Some general principles for managing health risks include poverty reduction, community
empowerment, removal of uncertainties, multiple barriers to safeguard health,
accessible and functional primary health centres and a series of environmental measures.
Projects that deliver a reliable and cost-effective service are likely to be health
enhancing. The environmental measures used to mitigate health risks include
manipulation of the timing and duration of the flood to flush vector breeding sites and
the movement of domestic animals so as to avoid zoonoses or to provide diversionary
hosts; management of catchment effluents and pollution to minimise water quality
degradation . See Table 10. Many environmental measures are site specific. It is
inappropriate to rely exclusively on curative medicine or pesticides as the mitigating
measure. Drugs and pesticides are expensive and resistance seems inevitable.
The most appropriate safeguards improve the project outcome as well as improving
human health - the “win-win solution*. In some cases this can be achieved without
additional project costs by simply improving communication between stakeholders during
the early planning stages. Recommendations to change individual behaviour are
unrealistic. They are also based on a model of individual responsibility for health. Health
determinants are multifactorial; public policy and social norms are of equal importance
to individual behaviour. Education is valuable because it is empowering and increases
choice. Accessible health care is very important, but only as a last resort. Projects often
provide too little health care and too late. For example, a dam resettlement project in S.
E. Asia constructed the health centre more than a year after the community was
already resettled and built a much smaller unit than planned because of cost overruns.
Health centres should be operational, accessible and stocked with drugs before
important events take place, not afterwards. They should be of an appropriate size for
the projected population and staffed and equipped accordingly.
The most appropriate safeguards improve the project outcome as well as improving
human health - the “win-win solution". In some cases this can be achieved without
additional project costs by simply improving communication between stakeholders during
the early planning stages.
Recommendations to change individual behaviour are
unrealistic. They are also based on a model of individual responsibility for health.
Health determinants are multi-factorial; public policy and social norms are of equal
importance to individual behaviour. Education is valuable because it is empowering and
increases choice. Accessible medical care is very important, but only as an additional
protective barrier rather than as an alternative to preventative community health.
Projects may often provide too little health care and too late. For example, in one dam
resettlement project in 5.E. Asia, the health centre was constructed more than a year
after the community was already resettled, and was then built much smaller than
planned because of cost overruns. Health centres should be operational, accessible and
stocked with drugs before important events take place, not afterwards. They should be
of an appropriate size for the projected population and staffed and equipped
accordingly.
11
35
Table 10 Examples of techniques for managing health risks
Poverty reduction
Poverty is probably the primary determinant of health. Poverty reduction empowers and enables people to
make choices and to safeguard themselves and their families from many environmental hazards
Zooprophylaxis
There is a possibility at using livestock as diversionary hosts to protect people from malaria
Alternate wetting and drying of
floodplains or streams
Controls some mosquito species
Health centres
Ensuring that health centres are equipped and functional before dam construction and building the
capacity and c^rabifty of health service personnel
Water supply and sanitation
Helps to control diarrhoea, various intestinal parasites and schistosomiasis. Domestic water supplies such
as wells should be protected from contamination by flood waters.
Vaccination
May be appropriate for certain arboviruses
Handling moribund animals
Control of Rift Valley Fever
Canal or river flushing
Floods can have a flushing effect on stagnant waters, removing pollutants such as human waste, clearing
drains or flushing away mosquito lan/ae
Community control
Increasing empowerment and reducing uncertainty are health enhancers in themselves.
Communication
Early warning of critical events such as floods, health promotion
Dam design
MultFpoinlToff-tak^ that r^se first flush inflows that may contain high levels of contaminante
Structures that enable extensive control of operational water levels
Irrigation channel design
Minimising low flow zones to prevent vector breeding
Dam siting
Siting dams in areas that require minimum population and livestock displacement
Settlement planning
Siting new settlements away from vector breeding sites
Adequate design of community water supply and sanitation, including careful management of wastes
Staged resettlement linked to infrastructure development
Culturally sensitive community planning
Irrigation management
Management of cropping systems to enable wetting and drying cycles and to use water efficiently
Minimise long term saiinisation, sHtation and water logging
Upstream management
Catchment management to minimise flood and pollution risks
In-flow forecasting
Early warning of floods
Water release schemes
To enhance floodplain productivity and hence nutrition
Reservoir management
Prevent eutrophication and excessive growth of aquatic weeds and toxic cyanobacteria
Maintain shallow de-weeded reservoir margins near settlements
Floodplain
Sensitive management for habitat and vector control
Good operation and maintenance
Delivering a reliable and cost-effective service
36
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6. Acknowledgements
The World Health Organization wishes to acknowledge and to express its appreciation in
the preparation of this submission to the World Commission on bams for the
contributions and efforts of :
Dr AA.H. Birley, Liverpool School of Tropical Medicine, Liverpool, UK
br M. biop, Planification environnementale TROPICA, bakar, S€ndgal
br 6. Jones, CSIRO Land and Water, Brisbane, Australia
br P.V. Unnikrishnan, OXFAM, belhi, India
br R. Zimmerman, Consultant Vector Biology and Control, Gainesville, Florida, USA
Also, the support and inputs provided by br J. Bartram (WHO), br G. Bergkamp (IUCN),
Mr R. Bos (WHO), Mr P. Furu (bBL), Mr P. Murchie (USEPA), Professor S. Parasuraman
(WCb), br T. Satoh (WHO), br J. Vapnek (FAO), br Y. Von Schirnding (WHO) are
gratefully acknowledged.
7. Bibliography
General website for health impact assessment: www.liv.ac.uk/^tnhb.
There are a number of books and reports on the health impacts of dams stretching back
many years. In addition to the references below, recent texts include the following.
Kay, B. M., Ed. (1999). Water resources: health, environment and development. London
and New York, E and F N Spon and Routledge.
Oomen, J. M. V., J. de Wolf and W. R. Jobin (1988). Health and Irrigation.
Incorporation of disease control measures in irrigation, a multi-faceted task in design,
construction, operation - Volume 2. Wageningen, Netherlands, International Institute
for Land Reclamation and Improvement.
Jobin, W. R. (1998). Sustainable management for dams and waters. Lewis Press, boca
Raton, Florida.
37
8. References
Acheson, C>., D. Barker, etaf (1998). Independent inquiry into inequalities in health
report. London, The Stationery Off ice.
Berensson, K. (1998). "Focusing on health in the political arena." Eurohealth 4(3): 34-37.
Birley, M. H. (1991). Guidelines for forecasting the vector-borne disease implications of
water resources development. Geneva, World Health Organization.
Birley, M. H. (1995). The health impact assessment of development projects. London,
HMSO.
Birley, M. H. and G. L. Peralta (1995). The health impact assessment of development
projects. Environmental and Social Impact Assessment. F. Vanclay and b. A. Bronstein.
New York, Wiley.
Birley, M. H., R. Bos etal (1996). “A multi-sectoral task-based course: Health
opportunities in water resources development." Education for Health: Change in Training
and Practice 91: 71-83.
Birley, M. H., M. Gomes etal. (1997). Health aspects of environmental assessment.
Washington bC, Environmental bivision,The World Bank.
Birley, M. H., A. Boland eta! (1998). Health and environmental impact assessment: an
integrated approach. London, Earthscan / British Medical Association.
Birley, M. H., A. Scott-Samuel eta! (in prep). Report of the first UK training course in
health impact assessment. Liverpool, University of Liverpool.
Bos, R. (1991). Cost-effectiveness of environmental management fo vector control in
water resources development projects. Ann.Soc. beige Med.Trop. 71 (suppl. 1): 243-255
Chorus, I. And J. Bartram (1999) Toxic Cyanobacteria in Water: A Guide to their Public
Health Consequences, Monitoring and Management, World Health Organization, E A FN
Spon
Cooper Weil, b. E. C., A. P. Alicbusan eta! (1990). The Impact of bevelopment Policies on
Health: A Review of the Literature. Geneva, World Health Organization.
bepartment for International bevelopment (1999). bFIb environmental guide. London,
bepartment for International bevelopment.
Ewan, C., A. Young etal. (1992). National Framework for Health Impact Assessment in
Environmental Impact Assessment. Volume 1: Executive Summary and Recommendations
and Volume 2: Background bocument. University of Wollongong.
Ehiri, J.E., and J.M. Prowse (1999). Child health promotion in developing countries: the
case for integration of environmental and social interventions. Health Policy and Planning
14:1-10
Ghebreyesus, T. A., M. Haile, et al. (1999). "Incidence of malaria among children living
near dams in northern Ethiopia: community based incidence survey." British Medical
Journal 319: 663-666.
Hunter, J. M., L. Rey etal. (1993). Parasitic diseases in water resources development.
Geneva, WHO.
Jobin, W. R. (1999). bams and bisease. London, Routledge.
38
Koivusalo, M., P. Santalahti, etal (1998). "Healthy public policies in Finland? Eurohealth
43: 32-34:---------------Kwiatkowski, R. (1996). The role of health professionals in environmental assessment,
consolidated workshop proceedings. Ottawa, Environmental Health Centre, Health
Canada.
Matsuno,
F. Konradsen, M. Tasumi, W. van der Hoek, F.P. Amerasinghe and P.H.
Amerasinghe (1999). Control of malaria mosquito breeding through irrigation water
management. Water Resources Development 15: 93-105
Miller, J. B. (1997). Floods: people at risk, strategies for prevention. New York, United
Nations.
Mills, A. (1991). The economics of malaria control. Waiting for the vaccine, ed. G.
Targett. John Wiley and sons, UK.
Organization of African Unity (1997). Harare Declaration on Malaria Prevention and
Control in the context of African economic recovery and development. Harare,
Organization of African Unity Assembly of Heads of State and Government.
Philippine Environmental Health Services (1997). National Framework and Guidelines for
Environmental Health Impact Assessment. Manila. Department of Health.
Phillips. M., A. Mills and C. bye ((1993). Guidelines for Cost-effectiveness analysis of
vector control. PEEM Guidelines Series no. 3, PEEM Secretariat, World Health
Organization, Geneva
Public Health Commission, N. Z. (1995). A Guide to Health Impact Assessment.
Wellington, Public Health Commission, Rangapu Hauara Tumatanui, New Zealand.
Putters, K. (1998). "Health impact screening, the administrative function of a health
policy instrument." Eurohealth 43: 29-31.
Rosendaal, J.A. 1997. Vector Control. Methods for use by individuals and communities.
World Health Organization, Geneva
Scott-Samuel, A., M. H. Birley etal. (1998). The Merseyside guidelines for health impact
assessment. Liverpool, The University of Liverpool.
Secretary of State for Health (1999). Saving lives: our healthier nation. London, The
Stationary Office.
Secretary of State for Internationa! Development (1997). Eliminating World Poverty: A
Challenge for the 21st Century, White Paper on International Development. London,
Department for International Development.
Tiffen, M. (1991) Guidelines for the Incorporation of Health Safeguards into Irrigation
Projects through Intersectoral Cooperation. PEEM Guidelines Series no. 1, PEEM
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IT
WHO (1982). Manual on Environmental Management for Mosquito Control, with special
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---------------------- - ----------------------
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40
3^
J? ^7 8
TEHR1 DAM :
PROJECT
THAT
I
SPELLS DISASTER
By :
\f. D. Saklani
I
I
COMMUNITY HEALTH CELL
47/1,(First Floor)3... Marks Road
BANGA:,O..l
Published by
The Tehri Bandh Virodhi Sangharsh Samiti
Tehri Garhwal
FORE-WORD
A freedom fighter Sri Virendra Datt Saklani is
well known personality and a leading lawyer in the
Himalayan districts of Tehri Garhwal and Uttarkashi.
He was born on 16th Nov. 1916 in Tehri town and it
is natural that he should have profound attachment
and love for his home town. After passing his B.A.
degree he for some time worked as an honorary
teacher in English language in Gbananand High School
Mussorie, but later on he joined law and passed LL.B,
degrees in the first division. In 1942 he joined the
bar in Saharanpuj judgeship at Dehra Dun. He was
very closely associated with martyr Sri Deo Suman
and was profoundly impressed with his national
activities. When the father of the Nation Mahatma
Gandhi gave the call for “Quit India” movement, Sri
Saklani plunged in the Freedom of India movement.
He was the first person to hoist the congress flag in
Tehri Town on 10th of Sept, 1 y42, where upon he
was immediately arrested and was lodged in Tehri
jail on 12th Set. 1912. During the period of deten
tion he was tortured in many ways. He was for
bidden to get clothes to changej not provided to take
bath, no facilities for cutting hair or shaving were
allowed on account of which long hairs on head and
beard grew. Similar treatment was meted out to
other detenues, e.g. Sri Bansi Lal Pundir, Kushal
( iii )
Singh Rangar, Prem Datt Do1 haJ, Dinesh Chandra
Saklani, Ram Chandra Uniyal and all other who were
arrested during the same peri d Sri Saklani was
detained in jail for 390 days, a d, but for the last 30
days he was all through kept in solitary, confinement
and was tortured beyond des ription. During the
winter, the only blanket given t him was taken away
inspite of the clothes on his oody were in tattered
condition, and he was kept in h avy shakles simply to
demoralize and torture and 1 5 was kept in that
horrible position for 24 days.
These very shakles were If er put upon Sri Deo
Suman who resorted to hunger trike for 84 days and
sacrificed his valuable life at the alter of Independence,
These shakles are preserved in Tehri jail for public
view on Suman day which is a declared holiday
Sri Jawahar Lal Nehru, then al a meeting at Srinagar
Garhwal proclaimed that the ? shri jail shall always
be remembered as a symbol of errorism for all times
to come.
Sri Saklani was released in Oct. 1943 from deten
tion but was kept under he ise arrest for one year
more. After expiry of the p»i od of parole, he joined
the Tehri Bar and started pn jticing law under the
guidance of his father Sri Deve idra Datt Saklani, who
himself was an eminent lawyer
In the year 1948, movemt it to free the princely
state of Tehri Garhwal fr •m feudalism began,
(iv)
Sri Saklani together with Sri Shankar Batt Dobhal led
the revolution Both of them were at once arrested,
kept for one night in Tehri Police Hawalat, and then
together with sixteen other Prajamandal workers were
transferred to Police Hawalat Narendra Nagar, where
they were detained for 18 days. After his release
from detention he and Sri Doval with blessings of late
Sardar Patel, again organized the rebellion against
the feudal system of Government in most peaceful
and non-violent way. The Maharaja was not allowed
to enter the Tehri town, and with great tact, the
armed forces stationed at Tehri together with the
commander of State Military Force Sri Nathu Singh
were arrested and disarmed, all the state officials
stationed at Tehri were arrested and lodged in Tehri
jail. Whole of this movement was surprisingly
peaceful except that at Khtinagar, the state Police
resorted to firing in which Sri Nagendra Batt Saklani
and Molu Singh Bhardari lost their lives. So, ended
the feudal system of Govt, in the princely state of
Tehri Garhwal in 1948. A constituent assembly was
formed and a popular democratic Govt, installed
which functioned tijl the merger of Tehri Garhwal in
Uttar Pradesh.
It is to the credit of Sri Saklani, that inspite of
all persuation and opportunities given, he refused to
join the Govt, or to accept any post of power and
position. He jesumed his practice and took part in
social and development activities. For a number of
years he remained President of the Zila Harijan Sewak
(V)
Sangh and General Secretary of Zila Nagrik Parishad
During his tenure as President of hi; Gaon Sabha and
Chairman of Tehri Nagar Palika h< carried out many
works of public welfare arid during 1 le China aggress
ion and Bharat Pakistan war his eh >rts for the help
of soldiers at the front were highly ppreciated by all
concerned. Though entitled to I -eedom Fighter's
pension, he did not accept it holding that he had only
fulfilled his duty towards his mot lerland and could
not accept compensation for it.
Sri Saklani has been in opposit )n of Tehri dam
from the very beginning. Agitation .gainst the Tehii
d
was going on under the Jeadei hip of Sri Vidya
Sagar Nautiyal. but the main
mphasis was on
rehabilitation of the people to be ou ted by the dam
It
sometimes in January 1i that Sri Saklani
and h is colleagues came to know of ertain facts about
the geological, seismological aspec s of project area
and weak rock formations obtainii § at the dam site.
It startled them and they were con inced that if this
dam is built it is not only going to r dn the h 11 people
but it is bound to fail and resu ; in a catastrophe
unprecedented in the history of ma i. Obviously, if
the dam bursts, the 2.62 million acre ft. water released
from its 45 Sq K.M. lake will wipe < ut all habitations
from Munikireti to Calcutta.
It was then that the Tehri Ba; dh Virodhi Sangharah Samiti was fotmed.
Sri Sa. lani being a non-
party man was elected its president, t ad the presidents
or Chairmens of all National Politici I parties (Distt.
(
VI )
Units, were elected. Vice Presidents of the Samiti.
Representatives of all the concerned Gram Sabhas and
prominent Social workers were elected as member of
the Samiti* Many prominent persons were opted as its
members and the first resolution to oppose the dam
was unanimously passed on 24.1 78.
There after several big demonstrations were held,
representation made to the Union and State Govt,
which all fell on deaf ears. The vested inteiests in
collaboration with the corrupt bureaocracy prevailed
and the Govt, gave a green signal to go ahead with
the project which forced the people to offer Satyagrah.
When the work allotted to the contractors came to a
stand still, the Govt, resorted to force, a large number
of armed police force was called in and the Tehri town
was virtually turned into a police cantonment. Sri
Saklani together with his wife and many others were
arrested on 1.6 78 They were released on the next
day but Sri Saklani was rearrested the same day to
gether with Sri Sawan Chand Ramola and many other
prominent Satyagrahis were also arrested and sent to
prison. There after, Sri Govind Singh Negi M.L A.
together with many other persons specially village
women were arrested and due to paucity of space in
Tehri jail most of them were sent to Bareilly jail.
Amongst the arrested persons were Smt. Nisa Rani
wife of the President Congress (I) and the elder
daughter of Sri Saklani. Smt. Sushila Gairola and thus
after putting many persons behind the bar, the tunnCont on last page.
Tehri Dam :
PROJECT THAT SPELLS C ISASTER
(V. D. Saklani)
9
The Tehri Dai a has become a p oject of fierce
controversy in recen' months, and seri us objections
have been raised to its construction on geological and
ecological, humanitaiian and other groun Is.
The dam is proposed to be const ucted on the
Bhagirathi river near Tehri town in m 1 Himalayas.
It is well known that the Tehri dam s te lies within
isoseismals VII and VIII of Kangra earth uake (1905)
and it is subject to an earth quake whose intensity by
M. M. scale can be up to VIII and xX ialls. It has .
frequently experienced earthquakes of vai dng magn?
tudes in the past. A perusal of the report on seismic
instrumentation for water resources levelopment
projects in Ganga and Yamuna Valley by he Roorkie
University scientists goes to show that seis oic activity
is on the increase in this region in as mucl as before
the year. 1971 While one or two earthqi akes a year
were experienced, at least 5 earthquakes i. the year
1974 and 7 earthquakes in the year 1975 ere experienced and many earthquak es originating fror potential
active features along which big earthquakes could
occur in future remained undected as the sej me logical
(2)
instrumentation for monitoring the complete earthquake
activity was formed to be inadequate and not well dist
ributed over the whole region.
The Bhagirathi follows a weathered course and at
the dam site weak metamorphic formations occur in
the foundations and the river gorge are characterized
by their shale structures as well as by their bent for
intensive weathering and disintegration into separate
blocks. The rock formations are of completely low
strength (150-ICO kg/cm) with completely low factor
of shear resistance of rocks in foundation (0.5-0.6).
Heavy cracking of the rocks have been found on
the exterior zone of the slopes of the river gorge.
Thus the rocks on which the dam is proposed to be
built are highly deformed and are most unlikely to be
able to bear the weight of 2.62 million acre feet of
water to be impounded in the la5'e, and it is weil est
ablished fact that when deformed rocks under stress
can no longer resist fracturing, eaithquai es occur.
The water load of Marora dam reservoir, in
Garhwal, was estimated to be 28 tens cn one square
inch and inspite of the fact that rod s at Marora were
far more competent than the Tehri dam site rocks, the
Marora scheme had to be abandoned due to existence,
of fault zones there. The water load of Tehri reser
voir will be far greater than that of Marora, but
inspite of. the standing directions of the UNESCO to'
'(3;)
that effect, no proper scientific invc ligation has been
carried out to establishe the load bear ng capacity of the
rocks at Tehri The matter does nr end there. The
peculiar feature of the Tehri dam pre ect site is that it
is strewn w th many anajor and minor faults which are
all t active and every sort of shear zones of varying
width exhibiting considerable pinchin ? and swelling in
thickness along their traces and thus roving that they
are active and alive have been fou d to exist in the
project area.
The authorities assume the rive bed fault to be
in-active but the assumption is not s ippor-ted by any
scientific investigation or data. It is in act controverted
ly the project report itself. The assv nption made is
wholly uncalled for and is in disregard o the rule of pru
dence that in such cases, under no circui istances a factor
should be assumed to be favourable unti the assumption
is supported by all available data. 1 is well known
that earthquake arise on fault surfaces v hen they come
under stress. The tectonic peculiarity ; in the Tehri
dam project area are more than one The Dharkot
thrust (Tons thrust) lies at a distance T only about a
furlong from the project area and the main boundry
fracture (thrust) of the Himalayan regio of U. P. state
lies at about 20 K.M. from the Tehri lam site. It is
known as frol thrust, and Nahan th ust, which is a
branch of krol thrust, crosses the dam site itself and
is known to be active. The Shrinagar t rust is located
at a distance of 4 K.M. east of the da i site.’ If has'
(4)
been found to be rejuvinated and activity in it is well
established by displacement of terrace deposits across
the fault and the presence of Nick points in the stream
profiles across the trace of fault. A thrust is a horizo
ntally dipping fracture (fault) along which mountains
get tectonically transported for several miles.
Several tear faults are present in the Tehri dam .
project area for example, the Gadoliya tear fault, Tehri
tear fault, Tehri river bed fault, Dewi tear fault and
many other EW-NW SE-NE-SW trending tear faults are
pi esent A potentially dangerous tear fault is Mahar
tear fault which is exposed 4 km. down stream of the
dam s te It runs parallel -to the Dewal tear and by
virtue of its upstream dip lies at a depth of 7 5 k m.
beneath dam site It is admitted in the project report
that in the event of future earthquat es, if release of
stress takes place along this tear, there may be sudden
fracturing and displacement along this fault. No one
can predict that Please of stress in the event of an
earthqua e cannot and will not take place along this
tear, and if it occurs, as it is most likely to occur, no
one can predict the extent of fracturing and displace
ment caused thereby It may result in wholesale frac
turing causing overwhelming destruction.
The NW-SE, NE-SW tear faults are admittedly
very dangerous from the point of view of seismic acti
vity and according to the renowned geologist.
Dr. K S. Waldia, the recipient of the Shanti Swroop
(5)
Bhatnagar award Head of the Deptt of Geology,
Kumaon University, it is along such tear faults in the
Himalayas that devastating earthquakes ccur. At the
dam site itself a major fault of the wi Ith of 5 metre
has been proved by drill holes and the r ver bed fault
has been found to exist from Tehri to Uppu at least.
Dobata, Dobra and Uppu are respectively at a distance
of about 2.9 and 12 K M from the dan site; In fact,
these sites were also investigated for co istruction of a
high dam but were subsequently abando ied, primarilyon account of the river bed faults there.
Tehri reservoiris to extend upto ab< ut 45 k.m in
Bhagirathi valley, and all these river ed faults from
Tehri to Uppu will come directly under he water load
of the Tehri reservoir. The water loac placed on the
earth's crust by such man made lakes ha been respon
sible for triggering off violent earth< uakes even in
areas wh’ch previous to the lake filling ha 1 been earth
quake free The protagonists of this dam do admit
that subsequent to the construction of a irge dam and
impoundment of huge quantity of wat r in the reser
voir, seismic tremors are felt in the vici: ity Constru
ction of high dams and impounding of irge hydraulic
heads seems to strain the rocks in the! d£ n foundations
and in the reservoir area to a large extei t and a conti
nuous process of settlement is known o be initiated;
They maintain that such tremors are ol low order and
eventually die down. When confronted vith the exte
nsive danage to such engineering structi es in U. S. A.
(6)
Japan etc they vaguely assume and assert that they
have invariably teen related to well mown fault
systems which had an earlier record of movement or
orelation with earthquake focii. This averment of
the dam champions is a blatant lie First they fail to
make distinction between Isostatic and tectonic ea thqua* es and secondly they come to conclusions without
considering the relevant scientific datas.
It is largely agreed now that the several earthqua
kes that occurred in the Koyna dam area (Maharashtra)
were occasioned by water load or that the water load
hastened their advent. The earthquake at Kcyna
which occurred on December 11, 1967 was of 6.7 inte
nsity which caused large scale damage to the dam
structure and immense loss of life and property. Not
a single home was left habitable in Koyana nagar
This happened inspite of the fact that Koyana is loca
ted in a stable and solid b’oek of the Southern penin
sular shield in India, which is a zone of minimum
intensity and had no record of any earlier movement
or any co relation with an earthquake focii.
The report of the International Commission on
large Da ns 1973 on lessons of dam accidents reveals
t tat out of 10,0)0 dam5 constructed in various j arts
of the v/Drld, at least ^66 suffered accidents ar.d of
these 140 were total fail ires The Baldwin resen oir
site was only 300 meters from a fault liae and < niy
minor faults were found cutting the project site.
(7)
The reservoir lasted for 1?. years and collapsed on
December 14. 1963 within a few hour of warning. Due
to seismicity of the region, it wa. made a flexible
structure, but the movement occurr d along the fault
on December 14 when fu 1 pressur of the reservoir
came on the fault surface, and the res rvoir gave way.
The Frayle Arch Dam, Peru a 70 mei ires high struct
ure, suffered a severe accident on A >ril 13, 1961, due
to an earthquake tremor. On January I. 1960 a severe
crac!< developed in it and on its abuti tents. The Vega
Tera Dam, Spain was completed ii 1957-58 but on
January 9, k 59, when the resv rvoir wt ; at its maximum
level for on' y a few days, it collapsec due to an earthqual e shock -ecorded at Coimbra, Por ugal, which was
coincidental vith the failure of the dan
The Sar Fernando earthquake,^ hich occured on
February 9, 1971, destroyed the San Fernando hydra
ulic fill da a completely, causing im nense loss of life
and property. It is said that if the s, ock had lasted
few seconds, longer, the Upper Sai Fernando dam,
would have also failed. The Sheffie ?d earth-fill dan.
in the U. S A. failed due to eartl quake shock of
6.3 magnitude on June 29, 1929, and imilarly severa.;
hydraulicfill dams failed in the U. S.
due to earthqual e shocks, of 6.8 magnitude. A least 331 dams
failed or suffered incidents in the U. ». A. uptil now.
Out of the 54 dams in the U. S. S. R. f ur failed com
pletely and tliree suffered incidents. I Japan 9 dams
(8)
failed completely and 7 suffered accidents and there
are reports of very many dams failures from other
countries of the world. The lower Suit Dam failed
during construction in 1935. The reason for the
failure of St. Francis High Dam on March 12. 1928
was the presence of a fault only 2 meters wide half way
of the abutment. The fault surface got progressively
weakend due to the action of water. The failure
resulted in loss of 500 lives and property worth 10
million dollars.
The Malapasset Dam France,
collapsed, on December 2, 1959. The Dam was well
designed, but a fault zone was present higher upstream
of the dam structure, and movement on it caused the
disaster Four hundred lives were lost and the town
of Frejus was completely washed away.
The claim of the champions of Tehri Dam project
that the lake load of the reservoir leads only to insigni
ficant tremors which eventually die down is wholly
false The presence of a fault one is certainly a sign
of danger and huge engineering structure are not
constructed on fault ones which are alive. No instan
ces can be cited where a dam was constructed knowingly
on an active fault zone. It is obvious that in the case
of Tehri Dam the focus and epicentre of a violent
earthquake can certainly be in the project area itself
when pressure of such huge volume of water is artifici
ally laid on the numerous fault surfaces and weak zones.
It happened so in Kariba dam, Rhodesia. There was
no report of any prior seismic activity in that area,
(9)
but when the reservoir began to fill 1 1968, it was after
six months of the filling that earthc lake shocks began
to be experienced and the great st of 5.8 magnitude
occurred four years after the 1 Hing was complete.
The epicentre of the tremors was i i the dam region
itself, where some minor faults exis ;d.
Several such examples have been cited by J, P.
Rothe (1968) Faults are either ac ve or inactive, there
are no dead faults and it has been f und that even those
faults which have been inactive for thousands of years
can become active by the lubrici ing action of water.
The activity in such fault can t arrested by cement
grouting, etc. but active faults can ever be adequately
treated for the obvious reason tha the extent of future
movement along them can never be precisely predicted.
The faults in the Tehri Dam j roject are in fact all
active, but the project report with >ut any justification
assumes them to be inactive and goes on to say that
the position of the nearest active fault is not known.
If the position of the nearest active fault is not known,
how can a plunge into unknown be made without
locating their position ?
Treatment of faults is done jenerally to prevent
large quantities of water reaching tl r subterranean fire.
It can be done only at the dam site vheie the river bed
can be dried up by diverting the rr jr water elsewhere,
but it is
impossible to treat th faults existing on
the riverbed upstream or down stret n of the dam site.
( 10)
Explorations have established that apart from many
ether shear zones, a shear zone varying in thickness
from 7 in to 20 m is present in the river course R>r a
length of about 9(’0 m. (300 m. down stream z nd 600 m.
upstream) of the dam axi.. The project report admits
that it is part of younger fault systems in the valley
and can not be considered free from adjustment in the
event of future earthquakes in the region. If it so
happens, what will be the fate of this dam ?
It is true that mere seismicity of a region may not
be sufficient ground for not constructing a dam there,
the quastion will always be whether there are geological
faults there and whether the faults are aut.ve or not
and further the rocks are competent or not. The
Nurek Dam, a 1040 ft. high structure, is being constru
cted in a highly seismic region in Central Socialist
Russia, but roc>s there area thousand times more
competent than those of Tehri Dam site. It is being
construcicd for experimental purposes.
It is thus clear that in view of the potential prese
nce of many major and minor faults at the Tehri Dam
site, in its vici.i.ty and along the river bed upstream
md downstream, the ep centre of an earthquake shall
be in th 5 project area tself and the enormous water
Dad art ficially laid over fault surfaces will haste i its
triggering off and then it ran be of any magnitude.
Its in tens ty can be 12 balls by m. m. scale and the
result will be wholesale destruction.
(11)
The project report admits that th< triggering
of a tectonic earthquake by the watt* load of the
Tehri reservoir cannot be ruled out and if that possibility can net be ruled out, th ’re can be io question of
constructing this dam. Even in Indi i distress has
occurred in as many as 41 dams anc more than 14
failed totally. The Kadam d.im failed in 1958, Nanak
sagarin 19o7, Chikahole in 1972, Dar :wala in 1973.
Aran in 197b . The Panchet dam which ailed in 1961
is said to be die biggest dam disasters in this country.
The Hinglo v dim failed in August 19' 3 which led to
the destruct on of hundreds of village ; in Birbhumi,
Bardwan & Murshidabad in West Ben ;al and took a
heavy toll o ' human lives and cattle. r he Morvi dam
disaster of August 1979 is still a-fresh in the memory
of all
The see - age from the Tehri Dam re ervoir even in
to the dam’s roc^fill is bound to be al rming, specifi
cally from the right side abutment w' ere the hillside
is highly fissured and fissile and sh;ai zone cross the
whole widtl. of it from the right ban' of the Bhagirathi to the left bank of the Bhainto i rivulet. The
Tehri Dam project report admits that he weak meta
morphic foi mations occurring in the fundations and
on the sides )f the river gorge are < tiaracierised by
their shale structures as well as by their 1 snt for inten
sive weathering and disintegration into : iparate blocks,
and that under such complicated tec onic geological
characteristics at the site of the Tehr. dam located in
a zone where the seismic effect can n tch V1II-1X by
( 12)
m. m. scale, the problem.,of any type of dam constructi
on of 250 metres, will be very serious and complicated.
Thus the great risk is involved in the project is
made clear, by the project report itself But the project
authors opine that if the fault zone in the river bed
can prove to be not active then while studying and
analysing all the peculiarities of the site in a detailed
way as well as by means of special observations and
model investigation solution of this problem safe and
economical to a sufficient extent can be found.
This is technologists over-optimism.
All the faults and ' thrusts in the Himalayas are
active and alive and it can not be denied that the
river bed fault is not active. Assuming it to be inactive
the project authors give a guarantee of the safety of the
dam ’to a sufficient extent alone, where as in
such a matter a guaranteed security is needed for the
obvious reason that if the dam bursts, it will result in
a catastrophe unprecendented in the history of man.
Whole of the Ganga basin from Munikireti to Calcutta
will be wiped out of existence. And, if the river bed.
fault zone be active, then there can not be even one
percent security of this dam. It is so obvious from the
project report itself.
Sri Y K. Murti Ex. fellow Chairman of the central
water commission of India in his paper read at the
54th Annual Session of the Institute of Engineers -
( 13 )
(India) at Banglore, Nov. 3, 1978 admii ed that the
dam at Tehri would not only be the high< >t structure
of its Kind in-the world but would call or tackling
complex technical problems involved ir a rockfill
dam of such a height for which th re is little
precedence available else where in the v )rld." He
further admitted that “despite thorough ivestigation
and adequate design it is not possible to liminate all
possible hazards......... Despite all advance h technology
and improvement in dam Engineering c 'er the last
decades, the surprises in the course of e: 3cution and
operation of Dams & reservoir cannot b eliminated
altogether’'. The question is can we take this risk by
building such a dam in the Himalayas, and let the
Democles sword hang over the head o the Ganga
basin for all days and nights ?
Henry H Thomas an Engineer of w- rid fame in
his book “Th£ Engineering of large dams’' as advised
that the Engineer should not hesitate ) overrule
academic calculations, however positive they night seem
X
to be if there is any element of doubt abot . the safety
of the reservoir. He is a great protagoni t of large
dams, but frankly admits that we know oi failure, is
undoubtedly true in all phases of life but it i a method
we can not afford to adopt in buildin, of dams,
undue boldness in design might ultima! ly end in
disaster... —............... The statics of failur of dams
are some what alarming...-........ The cost
security
can be ascertained with reasonable accuracy if proper
( 14)
investigation have been done, the cost of failure is
immesureable. Damage to property may be assessable,
damage to environment is less tangible but no less real
but loss of life is a matter of personal suffering. Water
can lubricate clay seams, it can adversely affect the
physical properties of most rocks, it can act as colossal
hydraulic ram, it can erode and corrode, it may induce
earthquakes, and if the dam should fail it will devastate
and destroy..-.
Cost is of vital importance, but
security must always be paramount.
It is thus clear that if guaranteed security of the
dam may not be available, it will be a case for rejection
of the prcposal rather than a case to go ahead with it.
The project report of Tehri Dam does not give any
guarantee of security of the dam. It says that the
safety of the dam can be assured to a sufficient
extent alone and no further, and that too if the
river bed fault be found to be inactive.* The project
champions, assume the river bed fault to be inactive
without any rhyme and reason ignoring the opinions
of Geologists, scientists and all tenats of common-sense.
As I have stated ab..ve, the Tehri Dam site is risk
laden to the extreme The project report itself leaves
no doubt about it. The complicated tectonic and
seismic activ ty of the site, the presence of fault zone
ofwidthofISm in the river bed, completely low
strength of roc., formation, high deformity of the rock
ddfcreuces in the properties of rock formations in the
z
(15)
side of the gorge, compariLively low fac or of shear
resistance of rock in foundation, heavy c acting and
large number of fault zones in the exterioi zone of the
slopes of the river gorge have been well ei :ablished by
exploration apart from other dangerous ti :t onic pecu
liarities found in the whole of the project a ea.
X
While the project report categorically admits that
the lake load of Tehri reservoir can trig er off a tect
onic earthquake, it is amazing that the da a champions
make groundless assumption on the ba; s of unwarr
anted comparisions They maintain that the quantity
of water proposed to be stored in Tc iri reservoir
will transmit to the foundations a load «f nearly 3 2
billion tons and as that will be only 30% c * the Govind
sagar, nearly 6% of lake mead and c ily 40% more
than that of Shivsaga r (Koyana), there ore the water
load of Tehri reservoir will be too sma I to cause any
large scale earthquake. In making tl is ass imption
they conviniently ignore the fact that n two lam site
in the world are the same nor have he rocks same
properties. It is admitted by Sri Y. u. Murti and
even by Henry H. Thomas and it is bvious that no
two dam sites are exactly alike any st ndardisation is
neither desirable nor possible, Th; itensity of the
earthquake always depends on the de; h and distance
of the focus and epicentre, the nature of the roc^s, the
sub-structure and solidity of the structu: i.
Technologist's over optimism ma thin1* to build
a dam over an inconceivable Site, bu common sense
( 16 )
may dictate that it is too risky and unwise to do
so. Universities confer degrees and some persons
become technologists, but common sense is a gift from
God. The common sense of the people of Teton, who
were opposing the vast Teton dam, did prevail over
technocrates assertions, when the Teton dam broke
on 5 June 1975. Three town were completely washed
away and property worth more than Nine bilion dollars
destroyed. There cannot be a standard set of guide
lines for ensuring the safety as problems vary from
project to project and so no two dams have failed in
the same way and that exact evaluation of short term
and long term changes in dam and its foundation
which will pose ultimately a threat to its safety is still
and shall always remain an excercise in the domain
of uncertainty. We can not put an implicit faith on
technology which is basically improvisional. It treats
the symptoms but does not provide any lasting cure.
Technology in fact is becoming itself a problem for
mankind.
There can be no room for any doubt that the chances
of the failure of Tehri dam do exist in abundance, and
it will be unwise to ignore them on the assumption
that it is a bare or remote possibility or that the evil
may possibly be avoided by recourse to remedial
measures. The people have to be guarded against such
risks which no prudent and reasonable man will incur,
even if there may be no absolute certainty of its occuring The rule of prudence demands that we balance
x
( 17)
the magnitude of the evil with the chances its occuring,
and even if there be less imminent probability of it,
the risk can not be taisen for the simple reason that if
the evil does occur at any time, i. e. if the dam bursts
the resultant mischief will be vast and overwhelming.
Tehri dam is an unwarranted attempt to disturb
the fragile eco-system of the Himalayas which is the
youngest mountain chain in the world and which has
not yet attained isostatic equilibrium. A little excercise
of reason can foresee the immense likelyhood and
potential of Tehri Dam ending in a national disaster.
The scientists have been warring mankind of the
dangers involved in such projects, They are warnings
not just of difficulties but of a major disaster.
Must we demand the evidence of catastrophe before
we act ?
References
Tehri Dam Project Report. Vol. I & IV.
J. P. Rothe “Fill A Lake, Start An Earthquake".
W. G. Mile and A. G. Davenport, Earthquake
damages to Earth Dams.
Henry H. Thomas, Engineering of Large Dams.
Arthur Holmes. Principles of Physical Geology.
6 Harsh K. Gupta & B. K. Rastogi. Dams and
earthquakes.
7. Proceedings All India Symposium on the Economic
and Civil engineering aspect of Hydro Electric
schemes Roorkee, April-14/16, 1978.
1.
2.
3.
*
4.
5.
(vii)
Gont. from page vi
elling work of the dam was started under the
protection of helmeted armed police.
Before starting the movememt against the daim
the Samiti decided to file petition in the petition comm
ittee of the Parliament. But, unfortunately due to
the dissolution of the Parliament the petition lapsed,
and a new Govt, formed at the centre. Dialogue is
now going on between Sangharsh Samitee and the
Govt. In the mean time before taking the final and
decisive action, the Samiti resolved to publish in small
booklets all the materials available to create awareness
amongst the people about the evil consequences of
this dam, and the present booklet is one of them.
Sri Saklani has very deeply studied, the Geological,
seismological and ecological aspects of this dam which
if constructed is bound to prove baneful to the Nation.
a
I hope that in this booklet and in many other
booklets, articles and letters written in this respect,
the readers will get a complete idea as to why this
project is being opposed, and I very much hope tnat.
they will make a common cause with the Tehri Bandh
Virodhi Sanghrash Samiti in turning down this project.
Sardar Prem Singh
General Secretary
Tehri Bandh Virodhi Sangharsh Samiti
Pundir Printing Press, Tehri.
1
WHO
FAO
UNEP
JOINT WHO/FAO/UNEP PANEL ir EXPERTS
ON ENVIRONMENTAL MANAGEMENT FO R VECTOR CONTROL
SEVENTH ANNUAL MEETING
Rome, 7-11 September 1987
PEEM/7/87.7
ENGLISH ONLY
EPIDEMIOLOGICAL PATTERNS ASS 3CIATED WITH
AGRICULTURAL ACTIVITIES' IN I IE TROPICS
D.J. Bradley and R. N irayan
The issue of this document does not constitute format
publication.
It should not be reviewed, abstractea
or quoted without the agreement of the participating
organizations. Authors alone are responsible for views
exoressed in sinned articles.
Ce document ne constnue pas une publication. II ne
doit faire I'obiet d'aucun compte rendu ou resume ni
d aucune citation sans I'autorisation des organ.saxions
parttcipantes. Les opinions exprimees dans les articles
signes n enqaqent cue leurs auteurs.
EPIDEMIOLOGICAL PATTERNS ASSOCIATED WITH AGRICULTURAL ACTIVITIES IN
IN THE TROPICS WITH SPECIAL REFERENCE TO VECTOR-BORNE DISEASES.
David Bradley^ and Ravi Na ■ayan^2
Introduction
For most rural populations of the tropics
agriculture is the
normative occupation.
Therefore our picture f the health and diseases of
tropical communities consists of the epidemioL gical patterns associated
with agricultural activities. The patterns ar< complex and diverse.
Tropical peasant agriculture is usually charac erized by a high infant and
child death rate, malnutrition which may be seasonal, acute respiratory
infections and diarrhoea as the main causes of death, particularly of
children, frequent tuberculosis and skin infeclions, trauma and disability,
and infection by a variety of endemic parasil ic worms and protozoa at high
prevalence but showing much regional variation. They will include many
vector-borne diseases among which malaria, filariasis, arbovirus
infections, schistosomiasis and the other humar trematode infections, and
the haemoflagellate infections are of particular importance (Table 2).
Typically, the subsistence farmer will live wit h his family on or near to
his fields and there will be no sharp boundary oetween his occupational and
general health.
To separate the two is neither feasible no: particularly useful, The
person’s health problems are experienced as a w lole and they are the concern
of the Ministy of Health.
Some diseases may >e linked to specific
components of life and of activity and may be o >en to change, but in general
there will be a health care system concerned wi :h all the local diseases and
health problems and the agriculture-related dis sases can only be approached
by observing health changes if the people migra e to a city and nothing else
changes in the environment.
Even then, the mu tiplicity of changes is so
great that to relate all the differences to los of agricultural activity
will be clearly mistaken.
While it is difficult in the subsistence s tuation to separate
agricultural occupational health problems from he remainder of the
community’s health, once changes in agriculture activity take place the
consequent health changes may be more readily i< entified and measured. We
now therefore concentrate on the health consequi nces of changing
agricultural activity. Health problems may get worse or better - too often
different factions of those who study the probit m only focus on one of these
aspects. We first analyse the types of agricullural change and their health
effects, then illustrate the effects of common groupings of changes, and
thirdly review a set of particularly important types of agricultural change
and their epidemiological implications.
We present a broad rather than a detailed picture, both because of
space limitations and also because many of the papers that follow will
describe particular aspects of the problem or specific examples.
Agricultural change tends primarily to invc Lve alterations in the basic
environment, domestic plants and animals, and farming methods (Table 1).
The two main types of environmental modification are the provision of
increased, or more controlled, water for vegetat .on growth and the opening
up of additional land.
1 Director, Ross Institute for Tropical Hygien , London, UK
^Academic visitor, London School of Hygiene an Tropical Medicine,
London, UK
■
PEEM/7/WP/87.7
page 2
Water resource developments
Water resource developments have been muc t studied and may comprise
impoundments of water in artificial lakes, son?times of huge size, and
irrigation systems to bring the water to the fields and plants, The
resulting increase in availability and diversity of surface water both in
area and in duration through the year tends tc lead to increased populations
of still-water vectors, particularly mosquitoes and water snails. The
torrent-breeding Simulium vectors of onchocerlasis may have their habitats
destroyed by inundation. The converse aspect )f water management, drainage
of swamps and waterlogged areas, will reduce breeding of mosquitoes and the
amphibious snail hosts of Schistosoma japonic im. While increased surface
waters with more vector habitats and increased vector populations will tend
usually to more mosquitoes biting man, contact between snail parasites and
man will be dependent on the detailed changes n water availability man/vector contact may even be reduced due to a dilution effect.
Land Use Extension
('
Extension of land use brings different ve tor hazards, chiefly
resulting from man’s intrusion into new ecosys ems with disturbance of
parasite life cycles maintained as zoonoses in the undisturbed environment.
Leishmaniasis provides a clear example, both ii the deforestation on the
Amazon region where agricultural settlers are < xposed to Leishmania
braziliensis causing muco-cutaneous disease am in the southern USSR where
cutaneous leishmaniasis, transmitted by sandfl es between huge populations
of the colonial burrowing gerbil Rhombomys opirus is a major hazard to
farming settlement (Lainson et al. , 1963). Moje lethal problems from
sleeping sickness have resulted from agricultuiul resettlement or patchily
cleared secondary forest in South Busoga, Uganci. Audy has emphasized the
importance of eco-tones in the epidemiology of /ector-borne zoonoses and
land use extension creates extended ecotones, e ige-effects between different
ecosystems (Audy, 1968).
Malaria outbreaks ir Thailand due to Anopheles
dirus (formerly called A. balabacensis), and tc be described by Sornmani ,
are of this type also.
An ecologically comparable situation is wh ;re man enters a habitat for
some form of agricultural activity of a more hu iter-gathering type and
thereby enters a zoonotic life cycle habitat.
'he chewing-gum collectors of
Honduras are exposed to Leishmania mexicana, wh ch mutilates their external
ears, in this way (Garnham, 1971). Another exa iple is Kyasanur Forest
Disease, an arboviral infection in Karnataka St te, South India where
affected men and cattle have previously come in contact with Haemaphysalis
spinigera, a monkey biting hard tick during exc rsions into the forest
(Singh, 1971).
(
Domestic animals and cultivated plants
Changes in plants and animals for domestic use may affect vector-borne
diseases, usually because they require changed cultural practices,
Many of
the high-yielding varieties of rice and wheat, x hich are the key feature of
the "green revolution" have requirements for wai er and fertilizer that
prolong the period of available surface water fcr vector breeding.
The time scale of health impacts on agricu]tural change are both
variable and complex, A common effect of water resource developments is to
decrease seasonal effects. to make irrigation we ter available in the dry
season.
So vector presence changes from seasor il to perennial,
Often the
loss of seasonality will be accompanied by inert ised vector populations, bu t
this is not always soso.
The seasonal malaria of the savannah may be ar
I
PEEM/7/WP/87.7
Page 3
least as harmful as the perennial transmissit n of the forest zone in West
Africa.
The degree of persisting seasonality will depend on small scale
decisions.
For example, with the multiple (topping of irrigated rice the
fields may be planted synchronously, or they may be totally staggered with
the consequence that there will always be ric e present at the particular
growing stage that provides the best habitat for a particular vector.
The loss of seasonality may also remove the ’ hungry period" and its
accompanying seasonal overwork and synchronoi5 malaria transmission that lethal combination which so raises the s2asonal death rate in the
savannah of West Africa and elsewhere.
Some changes will be of a secular type ci a very long timetable. Thus
the eutrophication sequence of lake Volta in 5hana is now settling after
some 15 years, during which there were massiv* increases and now falls in
the submerged macrophytes which acted as habi :ats for the snail intermediate
hosts of urinary schistosomiasis (Bulinus tru icatus rolfsi) (Obeng, 1975).
The trend towards multiple cropping whic 1 depends on both irrigation
and appropriate crop varieties can, in the ca ;e of rice, increase the period
when the ricefields provide breeding habitats threefold in the absence of
However, selection of crop
measures to restrict mosquito larval survival
rotations within the year can reduce the time when free surface water is
present.
Changes in livestock may affect vector-b rne disease patterns in
Increased animal population may direct mosquito biting
complex manner.
activity away from man, especially if the liv stock pens are sited between
the breeding sites and human settlements. On the other hand, the stock may
act as amplifier populations, allowing the gr at proliferation of
arboviruses normally transmitted at a lower 1 vel among wild birds or
mammals.
Subsequently the infection may spi 1 over into the human
population, as may occur with Japanese enceph litis virus, amplified in
domestic pig populations.
Livestock popular ons, by increasing food
supplies for mosquitoes and tsetse, may also < ncourage larger vector
population than otherwise would be the case, 1 ut little quantitative data
are available.
In the case of schistosomias s in East Asia, domestic
animals are susceptible and may play a role ii maintaining the parasite life
cycle in the Philippines and elsewhere.
■
Farming methods
Changes in agricultural methodology, suet as increased mechanization
and the use of pesticides, herbicides and fertilizers, will often affect
vector-borne disease transmission but it is di fficult to generalize about
the precise consequences. For example, insecticides applied for
agricultural purposes may initially also reduc 2 vector insect populations
substantially, they may select insecticide-refLstant strains, and they may
continue to reduce natural populations of othe r invertebrates that limit the
vector breeding success.
The outcome after a time may be more rather than
less disease transmission, but the time scale )f such changes may vary
greatly.
Herbicides may render the irrigatic 1 channel less suitable for
vector breeding (or more so for other species) , they may be lethal to snail
hosts of trematodes, and the medium-term ecosystem changes may influence the
vector populations in complex ways.
Eutrophi :ation from fertilizers may
indirectly increase snail breeding and have co iplex effects on the balance
of aquatic organisms.
Increased mechanization, to be discussed :ully by Service, has both
direct effects through changes in the ricefiel:! or other agricultural
environment that may decrease snail population i by better clearing of
*
page
vegetation from canals, for example, ;and’ indirectly
* '
may lead to larger
fields, better levelling, drainage of marshy areas, and a sharper separation
of land and water which will generally tend t > decrease
vectors of
disease.
Most forms of mechanical equipment will ilso tend to reduce persona)
contact of farm workers and the aquatic envir mnent.
Thus ,
schistosomiasis transmission will be reduced, so
will leptospirosis with its
rodent reservoirs, but no invertebrate vector
Where mechanical means are
used to harvest <crops
---- or cut sugar-cane
_
there will be a decreased risk of
snake-bite (a substantial hazard inl some part of Asia).
Increased
sophistication of methods short of imechanisat on may also reduce
schistosomiasis in those working in water whi e better clothing will
decrease leech bites and insect bites among p antation workers such as
teapluckers.
As agricultural activity and culture metl ods become more
sophisticated and higher yields are systematically sought, a more evenly
cultivated landscape will result,
The ecotoies, patches of waste land and
water will be reduced and imany disease vector* will decrease.
There may
however be larger populations of a few vectors whose ecological preferences
happen to coincide with the spreading pattern )f agriculture.
Changes in people, agents of disease and vectc rs
Types of agricultural change are outlined above,
Either in order to
achieve them or following their introduction, ;ubstantial human population
changes frequently occur.
The most obvious a ■e immigration of farmers to
newly opened up or newly irrigated lands,
>ften they may come from overpopulated hill areas where endemic malaria <and other primarily warm climate
diseases are uncommon.
Such immigrants suffe heavily - "malaria of the
tropical migration of labour" is, for example, a well-known and named
entity.
The malnutrition which often occurs n the first years in a new
site takes its toll and may exacerbate other d
senses.
The immigrants may
precede the provision of health services,
Un lanned immigrants,
especially fishermen invading water resource d<velopments, may suffer
from vector-borne diseases such as schistosomii sis but benefit in
economic terms (Pesigan, 1958).
Even more unjortunate are indigenous
inhabitants displaced by the agricultural inno\ations of the water resource
developments undertaken to provide them, Theii health problems are
compounded by poverty and upheaval.
fResettlemeit is usually inadequate
and a health service to take particular‘ care oc new disease hazards is
unavailable.
the agricultural shift is to cash cr >PS from subsistence, family
n„rT..Where
h.
nutrition usually suffers, at least in the shor : run, from the loss of local
cereals and pulses, rsometimes
*
from increased la tour demand and less time for
child-rearing.
The effect of malnutrition on ector-borne diseases is
complex and agent-specific, they are not always made worse.
Tatterns of settlement often change from s attered homesteads to
compact villages,»
Health care can be made mor <accessible
” ’
but some forms
of disease transmission - hookworm and other ge< helminths,
, the childhood
virus fevers, and other infectious conditions!
---------------- 3 m, y become more frequent.
Comiaon source disease outbreaks will be larger.
Many activities, and their health consequei ces, will tend to become
less seasonal than before, and the "hungry seas< ti" that coincided often with
maximal transmission of vector-borne disease,
me Y become less pronounced.
c
PEEM/7/WP/87.7
page 5
New pathogenic organisms may infect mar: new in the sense that they
were previously unknown in the locality. This may be because of the
environmental changes in agricultural practi :e described above, introduction
by immigrant farm workers, or amplification >f zoonotic viruses by
introduced livestock.
Infections already p resent may become more
prevalent, and in the case of helminthic inf jetions the parasite burden may
be increased, with a resulting risk in overt disease.
Thus the Egyptian
transition from annual flood irrigation to p rennial irrigation in the Nile
valley haa led to a changed balance between chistosome species and a
greater intensity of infection.
Vector populations may increase in numb rs, or in a few cases decrease,
have an extended season of activity and unde go the many complex changes to
be described in subsequent papers at this coi ferenceThe emphasis in the above summary has b< en oo the health effects of
agriculture as mediated by change in the nati ral and biological environment.
But agricultural change has social and econoi ic effects and their effect on
human health may be yet more important.
Efjactive agricultural development
will raise aggregate income, with potential 1 ealth benefits, but it often
also increases disparities of income and the poor, usually landless
labourers, may become yet poorer and margincL farmers become worse off,
with consequences for nutritional status anc access to health services.
Consequential inevitable urbanization of the poorest farmers, with its
different health hazards, may be a consequence of agricultural change.
A further group of indirect health effec :s follow from the various
types of seasonal migration related to agriculture, from the regular
traditional transhumance of mountain pastoral .sts to the much larger scale
seasonal labour requirements for planting and harvest of sugarcane in
Thailand, cotton in the Sudan, and various crips in Asian Turkey,
In the
last case, problems of welfare taxation great y complicated control of
malaria; 1both there and in Thailand, as is of en the case, migrant labour
chiefly suffers from the endemic malaria even though local perception may
be reversed, with the migrants being blamed f r the malaria which they have
in fact contracted only on arrival.
Housin for such temporary migrants
is not only often very bad, but the transient structures may lack proper
walls ans be difficult to spray with residual insecticides against mosquito
vectors.
Permanent agricultural housing ove large tracts of South America
is liable to colonization by reduviid bugs, wl o by their nocturnal blood
feeding on inhabitants
Inhabitants may transmit Chagas'
Chagas’ d sease.
Where livestock shares the farmers’ dweU ing at night, other vectorborne disease problems are locally significant .
Cattle ticks of the genus
Ornithodorus in Tanzania will travel up the be dposts, especially if they are
fixed into the ground, and transmit relapsing fever among the inhabitants.
In areas of sheep herding domestic dogs become important in the transmission
of hydatid disease to man while rabies is a ha sard also.
The patterns of disease observed in diffe rent agricultural communities
will depend upon the specific agricultural var .ables listed in Table 1
together with the local features of climate, d ‘gree of socio-economic
development, and cultural
Certain broad
broad patterns
patterns may
may emerge,
c:
------------- variables.
--------- - —*
Certain
in
different geographical regions, though the vec .or—borne diseases in
particular will tend to show micro—geographica variations in both the types
and prevalences of diseases encountered.
LI
. PEEM/7/WP/87.7
page 6
Implications of agricultural types
Asian rice cultivation will be dominat ?d by malaria, schistosomiasis
and Japanese encephalitis, with smaller cortributions from gastro-intestinal
and hepatic flukes.
But all these diseases are patchily distributed and in
many areas malaria is prevalent but unrelated to agricultural activity. ,
Similar problems occur with irrigated rice elsewhere, though different
arboviruses will replace the Japanese encep lalitis, especially in the
/Xmericas, and the filariases will play a variable role.
The problems of extending cultivable 1ind into forested areas are
likely to include zoonoses such as leishmarLasis, sleeping sickness and some
arbovirus infections while some Asian malar La vectors flourish in such
ecotones as does scrub typhus.
Plantation agriculture has usually followed control of malaria, and
particular health hazards are related to labour-intensive activity in close
contact with trees and shrubs where insect stings, leeches and snakebite may
be frequent. A range of vector—borne disec ses may occur but are more easily
controlled than in the unorganized rural at ricultural sector of contiguous
areas .
e:;
The move to highly mechanized advancer agriculture is accompanied by
massive falls in the farming population, larger plots and more capitalintensive methods than usually tend to redi ze che hazards of vector-borne
disease. Contact with vector snails will tend to fall, even if they are
present in the water bodies, and the main residual problems will be vector
mosquito breeding if rice or similar zrops are grown and health hazards from
seasonal labour migrants where these are nesded for harvesting.
Mechanization and/or sophistication of tect nology are invariably involved
with greater capital intensive production r sducing labour demand and hence
increasing rural unemployment, especially if alternative employment through
rural or urban industrialization cannot keep pace.
This could further
complicate the situation of poverty and dis ease.
Particular issues of agricultural change.
Various Arcadian memories or dreams e?1st concerning healthy
agricultural practices and environments in the past, and hunter-gatherers
seem to often have lighter levels of parasi tic infections that do those in
settled agriculture. The ancient hydraulic agricultural communities of Sri
Lanka were said to have a relatively low ir tidence of vector-borne disease
as a result of having a network of small ui its serving limited populations,
without use of pesticides and fertilizers I it with careful maintenance of
tanks and canals and carefully followed eye les of seasonal flooding and
drying out of the channels»
Similarly, ir more recent times the Sudan
Gezira Board achieved good control of schis tosemiasis and of malaria by a
complex of environmental and behavioural me isures enforced with an iron hand
in the earlier years of that irrigation set ’me.
It is far from clear how
far, in the absence of coercion or very string other incentives it is
possible to have an environmentally and bet iviourally determined relatively
safe agricultural programme in the tropics involving water resource
development but certainly this area needs f irther study.
The practical issues of attempting a r ®turn to this Arcadia are raised
by considerations that have increased since the availability of greater
evaluated experience of ’’the green revoluti on” and the awareness of an
increasing range of detrimental effects tha : have accompanied the increased
food availability - not the least of which ire the pesticide ’’treadmill
effect, pesticide hazards, and the socio-economic effects mentioned earlier.
(
PELM/ / / WP/(5 / . /
page 7
♦
The quest for sustainable agriculture - tha
produces higher yields but
with very limited fertilizer and other mode ’n sector inputs has been gaining
ground through experiments in Japan, India, USA and UK.
This situation may
be good for environmental control of vecto s but little directly relevant
research^ is yet available and needs to be p anned for.
Development strategies involving both gricultural and industrial
interventions are increasingly beginning to focus on those sections of
society who do not adequately participate o benefit from the existing modes
of development.
While environmental and s cio-economic changes in the
community have been adequately documented, nly in some limited specific
cases has data about the health and nutriti n effects of agricultural
development been applied in impact evaluati n. Much more needs to be done.
)
The analysis of health consequences of agricultural change has
predominantly considered one disease at a t me and traced the biological and
Less often, a single change in
behavioural determinants of transmission,
agriculture or a single intervention has be n considered in relation to all
its health consequences, as when the effect of increasing irrigated rice
But the farming family
fields or introducing piped water are consi.ered.
see their health as a whole in relation to hemselves rather than a single
agricultural change or occupational hazard. Moreover the farming community
is essentially a stratified community divid d into different groups by
Agricultural
socio-economic status, land ownership and w ge relations,
change whether single or multidimensional, ffects different groups in
There is a need for
different ways - quantitatively and qualitai ively.
community based epidemiological studies tha; will consider agriculture as
one of the many determining variables for h<; alth and measure its impact on
the stratified agricultural community.
Th s is not only to give a sense of
proportion but also to view the problems ant thus seek solutions from the
viewpoint of the farmer and the agricultura community.
References
Andy, J.R., (1968). Red Mites and Typhus, At: no lone Press, London.
Garnham, P.C.C.,(1971). Bull.Wld.Hlth.Org. M: 521-527
Lainson, R., et al., (1963). Trans .Roy. Soc.rJ top .Med .Hyg. 57; 242
Loevinsohn, M. E., (1987). Lancet, June 13,
1987. pl359.
Obeng, L.E., (1975). In: Man-made Lakes anti Human Health, N.F. Stanley and
M.P. Alpers (Eds), Academic Press, Londor .
I
Pesigan,
I
, et al., (1958). Bull.Wld.Hlth.( -g, L8: 481-578
Singh, K.R.P., (1971). Ind.J.Med.Res . 59: 31’
TABLE 1: Epidemiologically Relevant Aspects of Agricultural Change
New or Qualitatively
Changed
Increased Quantitatively
PRIMARY AGRICULTURAL CHANGES
ENVIRONMENT
Water resources development
Land use extension
ORGANISMS
Plants
Livestock
CULTURAL METHODS
Chemicals
Machinery
JO
00
T.
0)
112
0-.
fl
CL
oc
Reservoirs, dams, Land
drainage.
Irrigation
schemes
Irrigation canals
Clearing, deforestation
Extensive ecotones
New High-yielding varieties
Move to cash crops
Intercropping
Multiple cropping
New breeds
Increased animal husbandry
Pesticides
Herbicides
Mechanization
Fertilizers
SECONDARY EPIDEMIOLOGICAL CHANGES
People
Settlement
Changes in Seasonal Patterns
Nutritional status
immigration
Vectors
Species changes
Population changes
Disease agents
Species changes
New introductions
New hosts acquired
Amplification by
stock
Table 2.
page 9
Major vector-borne diseases that may be related to agriculture
Protozoa
Malaria
Anopheline m squito vector may breed in
standing wat r
Sleeping sickness
Tsetse-borne disease related to extending
land use int< forest
Chagas * ^Disease
Transmitted ly bugs living in walls of
houses, espec ially when livestock there
Visceral leishmaniasis
Sporadic, sonstimes epidemic in semi-arid
regions, sane fly transmitted
Cutaneous leishmaniasis
Rodent reserv >irs disturbed in Asian land use
Muco cutaneous leishmaniasis
Forest zoonos.s <of Amazon forests, to man
during defore ;tation
Trematodes and Cestodes
Schistosomiases
i
Major irrigat on problems spread by
aquatic and a phibious snails
I
Dog tapeworms
harmful to ma
larva usually in sheep,
in sheep-herding areas
i
Other tapeworms
Problems when
concerned
undercooked beef and pore
Other trematodes
Transmitted bj snails through undercooked
freshwater andnals
Hydatid
Nematodes
Guinea-worm
Transmitted th *ough defective water supplies
by water-flea :ype crustacean. Big effect on
agriculture
Filariases
Transmitted by anopheline and culicine
mosquitoes
Oncherciasis
Transmitted by fast-water breeding
Simulium flies
Other microbes
Relapsing fever
Tickborne prob em where stock and man
share accommod tion
Yellow fever
Hazard at fore t edge (and in urban areas)
Dengue
Japanese encephalitis
Other encephalitides
Other arbovirus infections
Viruses transm.l tted by mosquitoes, mainly
culicines, brec ling in irrigated fields and
standing water
Scrub typhus
Mite-borne zoon »sis of the forest edge
Non vector-borne diseases
Leptospirosis
Rabies
Snakebite, leeches
Especially prob em of marshy and irrigated
agriculture
Hazard of pasto al areas where dogs used
Hazard in fores plantation agriculture
i
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i
The Si >cial
and
Environmen tai Effects
of Large Dams
by
Edward Goldsmith an 1 Nicholas Hildyard
Volume One: Overview
A Repoi t to
The European Ecological Ac ion Group (ECOROPA)
107 Rue de la Course, Bon leaux'SSOOO, France
Fach Henbant, Crickhowe I , Powys, Wales, UK
CONTENTS P iGE
Preface
A Ballard of Ecological Awareness
Foreword by Brent Blackwelder
PART I: Introduction
Chapter One.
1.00
1.01
1.02
1.03
1.04
1.05
The Overt Reasons for Building Dams
The Pace of Construction
Plans for the Future: Dam them all?
Glittering Prizes: The claimed benefits if large-scale water development projects
The Lure of Hydro-Power
The Lure of Irrigation
Playing with Water: Playing with Fire?
PART II: Before the Flood
Chapter Two. Dams and Society — The Problems of I esettlement
2.00
2.01
2.02
I
2.03
Chapter Three.
3.00
3.01
3.02
3.03
3.04
3.05
The Scale of Resettlement Programme
A Record of Failure
Government Insensitivity
Lack of Compensation and Inferior Lan
Social and Cultural Destruction
Resistance to Resettlement
Ethnic Differences Ignored
Inappropriate Housing
Housing and the Integrity of Traditional Culture
Is better Planning Possible?
The Road to the Slum
PART ill: After the Flood
Chapter Four. Closing the Dam: Loss of Land and Wild fe Upstream,
Loss of Silt and Fertility Downstream
4.00 Loss of Agricultural Land to Flooding
4.01 Loss of Forests to Flooding
4.02 Loss of Wildlife to Flooding
4.03
4.04
4.05
Chapter Five.
5.00
5.01
5.02
5.03
Chapter Six.
Chapter Seven.
7.00
7.01
7.02
7.03
7.04
7.05
7.06
The Reduction of Fertility Downstream ue to Impoundment
Loss of Silt and Coastal Erosion
Conclusion
1
1
3
5
6
9
13
15
15
16
17
20
27
27
30
32
36
40
46
49
49
51
51
58
59
60
Introduction
Losses to Evaporation
Loss to Transpiration: The Problem of At jatic Weeds
Losses Due to Seepage and Over-Use c water
61
61
61
62
64
The Effects of Perennial Irrigation on Pe t Populations
67
Dams and Disease
72
72
72
80
85
85
87
88
Water Losses: Exceeding Gains
Introduction
Malaria
Schistosomiasis
Filariase
Onchocerciasis — River Blindness
Diseases Introduced as an Indirect Resu : of Water Projects
Efforts to Combat Disease
1 rt-
Chapter Eight.
8.00
8.01
8.02
8.03
Chapter Nine.
9.00
9.01
9.02
Chapter Ten.
The Effects of Large-Scale Water Projects on Fisheries
Short-term Successes: Long-term Failure
Dams and the Destruction of Fisheries
Pesticide Poiiuhon and the Destruction of Fisheries
Dams, Fishing and the Net Loss of Protein
Dams, Failures and Earthquakes
Dam Failures
Earthquakes and Dams
Dams and Earthquakes: Recent Research
103
103
106
111
The Myth of Flood Control
10.00 Flood: An Increasing Menace
10.01 The Failure of a Strategy
10.02 Deforestation. Erosion and Floods
10.03 Building on the Flood Plains
10.04 Other Reasons why Structural Controls Cannot Work
10.05 The Trade-Off between Flood Control, Hydropower and Irrigation
10.06 Dealing with Fiooos: the Ecological Approach
Chapter Eleven.
11.00
11.01
11.02
11.03
11.04
11.05
11.06
92
92
93
97
100
Salting the Earth: The Problem of Salinisation
The Causes of Sahntsabon
I
Irrigation
and Sahntsabon: The Intimate Connection
The Extent of tneProblem
‘
‘Salinisation and Water-Logging be Avoided?
Can
Why No Drainage?
Salinisation. The Htstoncal Experience
Salinity and Downstream Agriculture
120
120
121
124
127
128
130
131
135
135
137
139
143
147
150
155
Chapter Twelve.
Management and Maintenance - Perennial Problems
12.00 Introduction
«’Si Management and Maintenance: A Low Priority Concern
12.02 Bureaucratic Ignorance
12.03 Lac k of Accountabi I rty
12.04 The Problem of Maintenance
12 05 Co-operation and Maintenance
-12.06 The Conflict between Food and Cash-Crops
12.07 The Advantages of Traditional Irrigation Systems
Chapter Thirteen.
Loss of Land and Food to Plantations
13-00 The Cash Crop Economy
13.01 Cash Crops and Irrigation Projects
13.02 Pushing Peasants onto Marginal Lands
13.03 Cash Cr°Ps and tt*6 Degradation of Agricultural Land
13.04 Food for What?
13.05 Cash Crops and Rising Food Prices
Chapter Fourteen.
14.00
14.01
14.02
14.03
14.04
14.05
14.06
14.07
167
167
169
170
172
174
175
177
178
The Loss of Land and Water to Industry and Urbanisation
Introduction
The Loss of Land to Urbanisation and Industrialisation in the USA
Loss of Land to Urbanisation in the United Kingdom
Loss of Land to industrialisation and Urbanisation in Japan
The Failure to Take Land Losses into Account
The Aswan Dam and the Loss of Agricultural Land in Egypt
emS
The united s,ates Experience
181
181
183
188
191
193
193
197
197
198
199
202
202
203
205
208
I
Chapter Fifteen. Dams, Pollution and the Reduction c Food Supplies
15.00 Introduction
15.01 The Export of Hazardous Industries
15.02 The Effect of Pollution on Crop Grov th
15.03 Pollution and the Reduction of Fish ields
214
214
214
219
221
Chapter Sixteen.
Introduction
Sedimentation Rates in Temperate Z' eas
Sedimentation Rates in the Tropics
226
226
226
227
Are These Problems Inevitable?
231
16.00
16.01
16.02
Chapter Seventeen.
Part IV:
Sedimentation: The Way of All Dams
The Politics of Damming
Chapter Eighteen.
Social and Environmental Impact Stu ies
239
Chapter Nineteen.
The Politics of Damming
247
247
250
257
262
19.00 Politics or Oversight?
19.01 The Aswan Experience
19.02 Power-Broking, Pork Barrel and Corn )tion
19.03 States within States
Chapter Twenty.
20.00
20.01
20.02
Part V:
Fudging the Books
Cost-Benefit Studies: The Record of F ilsification
Over-estimating Benefits: Under-estin iting Costs
Conclusion
265
265
271
283
Traditional Irrigation: Learning from the Past
Chapter Twenty-one.
The Qanats of Iran
285
Chapter Twenty-two.
The Traditional Irrigation System of th< Sonjo
291
Chapter Twenty-three.
The Traditional Irrigation System of t e Chagga
297
Chapter Twenty-four.
Traditional Irrigation in the Dry Zone c Sri Lanka
302
302
307
308
308
311
312
314
24.01 Sri Lanka s Tanks
24.01 The Importance of the Tanks
24.02 Irrigation as a Way of Life
24.03 The Sustainability of the Traditional Sys 9m
24.04 Deforestation: Jeopardising the Future
24.05 Land Tenure: Traditional vs. Modern
24.06 The Growth of the State and the Breakc >wn of the Traditional System
1.
4^=
Chapte' Twenty-five. Traditional Irrigation in Mesopotamia
25.00 Minimising the Effects of Salinisation
25.01 The El Shabana
25.02 The Earliest Historical Experience in Mesopotamia
25.03 The Modem Experience
25.04 The Lessons of Mesopotamia
Chapte' Twenty-six.
26.00
26.01
26.02
26.03
26.04
26.05
26.06
26.07
26.08
Part VI
The Lessons of Traditional Irrigation Agriculture; Learning to Live with Nature
Introduction
Size: A Critical Factor?
Why Small is Not Enough
Seasonal vs. Perennial irrigation
The Preservation of Forests
Balancing Water Consumption with Water Availability
Design and Management: Village Elder vs. Distant Bureaucrats
Food for Local Consumption rather than for Export
The Need for a new ‘World View’: The Ecological Approach
316
316
317
319
323
326
329
329
329
331
332
333
335
338
340
341
What Should be Done?
Chaote' Twenty-seven.
Recommendations
APPENDICES
Acoendix One.
Reservoirs with Dams greater than 100 metres high
Aooendix Two.
Distribution of Saline and Alkaline Lands
(Areas in 1000 hectares, based on Soil Map of the World at 1:5 million)
REFERENCES
345
A Ballad of Ecological Awarer ss
The cost of building dams is always under* stimated There's erosion of the delta that the rive r has created,
There’s fertile soil belcw the dam that's Likely to be looted.
And the tangled mat of forest that has got to be uprooted.
There's the breaking up of cultures with c Ld haunts and habits loss.
There's the education program that just de isn't ccme across.
And the wasted fruits of progress that are seldan much enjoyed
By expelled subsistence farmers who are m >an unemployed.
There's disappointing yield of fish, beyor I the first explosion;
There's silting up, and drawing down, and watershed erosion.
Above the dam the water's lost by sheer ev poration;
Belo*, the river scours, and suffers dange ous alteration.
For engineers, hewever good, are likely to be guilty
Of quietly forgetting that a river can be : ilty.
While the irrigation people too are freque tly forgetting
Thar water poured upon the land is likely i d be wetting.
Then the water in the lake, and what the lc <e releases,
Is crawling with infected snails and water- x>me diseases.
There's a hideous locust breeding ground wt 31 water level's low.
And a million ecologic facts we really do r Jt know.
There are benefits, of course, vshich may be countable, but which
Have a tendency to fall into the pockets of the rich,
While the costs are apt to fall upon the sh xilders of the poor.
So cost-benefit analysis is nearly always s ire,
To justify the building of a solid concrete fact.
While the Ecologic Truth is left behind in he Abstract.
Kenneth E. Boulding
(Frcr T. Farvar and J. Milton, The Careless technology, Ttn Stacey,
London, 1973).
"
I
345
Chapter IWent -Seven
Reccnmendat. cns
In the light of today's knowledge, it is clear that the building of
large-scale water development schem is can only be justified to an
electorate and to the world at larc e by systematically covering
up - as governments and their advisers have shewn themselves adept at
doing - their true inplications.
Unpalatable as it must undoubtedly t s to the dam-building industry,
there is clear evidence that building 1 irge dams is not an appropriate
means of feeding the world's hungry
of providing energy, or of
reducing flood damage.
For it to be so. we WDuld have to a cept as largely expendable the
human and non-human population of the w ole area affected by the dam
simply in order to further the politic 1 and financial interests of a
very small minority.
To persuade Third World government 5 to abandon plans to build
water-development schemes, to which the5 are often totally committed,
is a lost cause.
The only way to pr vent their construction is to
appeal directly to donor governments, to development banks and to
international agencies without whose fir incial help such schemes could
not be built.
It is not that the latten are more responsible, only
that they operate in the industrialised orld where public opinion can
be mobilised more readily against the pursuance of their present
policies.
We thereby call upon those organisatic s, herewith, to cut off funds
from all large-scale water-developnent schemes that they may plan to
finance, or are involved in financinc , regardless of how advanced
those schemes might be.
1
346
x i x’c:
vqoi_
uajiujx ei_.e
utl-i-K Ox
a thrSc-tjudi tc-S
fxnisTled <xaiii may iiCTt
provide irrigation water or electricity - but then, nor will it drown
ancient villages, precious forests or stretches of fertile bottomland.
Nor will it uproot tens, if not hundreds, of thousands of rural
people,
condemning them to eke out a miserable existence in the
i
degraded environment to which they will have been fore i bl y ccnsioned.
|
I
Nor will it condemn those inhabiting the irrigated areas to see
their children ravaged by malaria and schistosomiasis to which many of
them must inevitably succumb.
Nor will it systematically transform much of their remd•inino agri
cultural land into a waterlogged and salt—encrusted desert, nor cause
it to be progressively made-over to large plantations geared to the
export of food to foreign lands, or to large factories which manufac
ture goods which the local population cannot conceivably afford.
Nor will it deprive local inhabitants of their water supply in order
i
to satisfy the unquenchable thirst of the plantations, the factories
and the new urban conurbations that dams support.
On the other hand, if the project is ccnpleted and all this destruc
tion is allowed to occur, we will eventually be left with a silted-up
reservoir and the vast concrete hulk of an abandoned dam.
All that we
can then hope for is the ruins of that dan. may serve a salutary
function as a permanent monument to the folly, or to the cynicism, of
those who now direct the organisations which have financed so much
destruction and so much misery throughout the world - a monument set
in a vast muddy wasteland where once the fertile soil nourished happy
and sustainable ccrrmunities.
*
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A Journey Inti the Realm of Bhakra
I
I
l
I
I
OUR JOURNEY INTO THE BHAKRA-LAND BEGAN ’ ITH THIS AWESOME DISPLAY
of the green revolution in its full visual glory. As we ti veiled through Haryana, and then
Punjab, this sight was to be repeated day after day. As e moved through the country, we
heard stories of how the waters had transformed virtual de irts into lush green fields. We saw
the big pucca houses in villages, the large number of trac >rs - and not a single bullock can.
We crossed numerous small and big canals as we drove .1 the excellent road network. The
most spectacular sight of the journey was our first view f the Bhakra dam. It was nothing
short of stunning. Seen coming up the mountain from the < Jwnstream side in the late evening,
the wall of the dam rises iup steeply,
\ suddenly from
the spths of the gorge to a sheer 200
meters,
the
lights
at
the
top
illuminating
it.
As
.
*
o ... ..3 an enc leer, I could only marvel at this
. the skills of our profession. We saw at the dam site exhibition the photos of
testimony to
dignitaries
Ho-Chi-Minh,
Bulganin,
‘visiting
■sociahs?
’,SIndiaarieS like H
°‘Chi'Minh’ Bul
8anin! Khrasc
Kh™sc :v - images from the heydays of
Our physical journey was paralleled by another, a metapl' rical, journey - a journey through
t re tacts and figures, through the documents, through the story, geography, science, politics
o the project. A journey through the minds and memories rf people, a tour that accompaniedthe people on their experiences of the dam, of the agricul ire of the two states. This journev
was equally, if not more, fascinating as the physical journe
The mesmensmg display of the green revolution in thi fields of Haryana and Punjab is
matched by the spectacular statistics of agricultural c rwth. In Punjab, the food«rains
production went up from 3.389 million tons (m tons) in 1' >5-66 to 17.221 m tons in 1985-86
an increase of five times in 20 years, or an annual co pounded growth of 8.47% for '’0
years running! In 1999-2000 it stood at 25.197 million ton 12.1% of the all India production,
n laiyana, in the same penod, foodgrains production incr ised from 1.985 m tons to 8 147 m
tons, a four times increase. In 1999-2000.it stood at 13.065 trillion tons, or 6.2% of All India.
There is an old saying - 1 believe it exists in some form or re other in every language - which
states Appearances can be deceptive". Our journey, our I icinating journey into the realm of
rakra was to prove the truth of this saying many times >ver, in many different ways Our
Wa> a,.d‘SC0rvery of ,his’ of how long held popular sliefs and perceptions were mostly
just that beliefs. It was also a revelation of the hidden, >r not so hidden, but often sweptunder-the-carpet side of the story.
H
The first revelation came with our very first visual encou
As we soon found, the lush green fields from Panipat to
1nis area, along with other large areas in Haryana receiv
Canal (WJC) and have been doing so since over 100 ye
taking off from the Yamuna river near Tajewala. This <
er with Haryana described above.
ansi had little to do with Bhakra7
waters from the Western Jamuna
s. The WJC is a diversion canal
version Js from a weir and not a
Throughout this report, unless the context so indicates, or it is specified
therwise, the term “Bhakra" or “Bhakra
2 Th r?CCl Wl11 refer t° lhe entire Bhakra-Nangal project.
IrT,gatin8 5013,1 ^eas as early as the 16th Century - durin the rule of Akbar. In 1832 it was
remodelled for extensive irrigation.
A Journey into the Realm of Bhakra
xvii
5s>.
xviii
Unravelling Bhakra
I
s orage dam. In fact, the gross command area of Bhakra in Haryana is about 30% of the state
geographical area. In Punjab, the gross commanded area of Bhakra is about 18.6% of the state
area. Punjab and Haryana are much more than Bhakra?
It is often said that before Bhakra, Punjab (and Haryana) were just semi-arid, dry regions with
little irrigation and / or highly problematic agriculture. We found this to be far from the truth.
we lraccd thc history of irrigation in the two states, we had to go back to pre-partition
ndia, the pre-partition Punjab. Pre-partition Punjab included not only the Pakistan part of
unjab, but also today’s Indian states of Punjab and Haryana. Punj (Five) Aab (Waters) - the
land of thc five rivers - Sutluj, Beas, Ravi, Chenab, Jhelum - and of course the mighty Indus
whose tributaries these five are - forms an area endowed with the most lavish water^esources.
While imgation was being used in the Indus basin since the days of Harappa and Mohen-jadaro, it really developed during the 19th Century and by the early 1900s, Punjab4 had an
extensive, highly developed irrigation system based on diversions from the major rivers.
A large part of this system was in what is today Pakistan. But the irrigation developed in the
Indian part was not small or insignificant. The Western Jamuna Canal,5 we have seen, was
sei ving large parts in today’s state of Haryana. The Upper Bari Doab system from Ravi that
serves much of Amritsar and Gurudaspur districts in Punjab was opened in 1859.
5
I
I
The Sirhind Canal, taking off from the Sutluj at Ropar in Punjab, was opened in 1882. It was
irrigating, and still does, large areas of Punjab. Apart from these, there was significant
irrigation from wells.
Overall, the situation iin Punjab (including Haryana6) around 1950 - before the Bhakra project
- was as follows.
In percentage terms, in 1949-1950, Punjab7 had 35.3% of its sown area irrigated and the figure
for PEPSU (Patiala and East Punjab States Union)8 was 42.6%. This was the highest in\he
whole country! Together. PEPSU and Punjab accounted for 13% of the country's irrigated
area, while it had 5.89% of the country's total sown area9. Thus, it was way ahead in irrigation
as compared to the rest of the country - even after losing the lion's share to Pakistan. In
PEPSLJ6
thC arCaS irrigated Were 4,9 mi,,ion acres in Punjab and 2.04 m acres in
Similarly, Punjab at that time was the leading producer of wheat, maize and gram in the
country.
Against this background, the decision to build Bhakra was a very interesting one. As we
explored the planning and decision making process around Bhakra project, we found that the
Note that the gross command area gives the maximum possible reach of the project.
Punjab here means the Pre-partition Punjab. The readers will do well to keep in mind the following. The British
rovmce of Punjab included much of what is today Indian Punjab, Indian Haryana, small part of Indian Himachal
ano the Pakistan Punjab. Some areas that are in Punjab or Haryana today were not in the British province of Punjab
u uere princely states. These included Patiala, Jind, Bhatinda, Faridkot etc. and went by the name PEPSU Paua a and East Punjab States Union. In 1947, the partition created West Punjab (in Pakistan) and East Punjab (in
ndia) later-called simply Punjab. This Indian Punjab (of 1947) included parts of today’s Punjab, today’s Haryai
ina
an some parts of Himachal. In 1956, PEPSU merged with Indian Punjab. In 1966, this combined Punjab was
reorganised into Haryana and Punjab, with a few districts going to Himachal. We will use the following
termmology. Pre-partition Punjab for before 1947, Unified Punjab for Punjab between 1947 and 1966 and simply
Punjab tor post 1966. However, we will use these qualifications only when the context does not make it clear which
runjab we are referring to.
Though not a part of the Indus basin
See footnote 4 on what constituted Punjab during various periods.
Punjab at this time also included Shimla and Kangra districts of Himachal, but these had very limited amount of
!
I
i
iii i^uiion.
See footnote 4
R.L. Anand; Punjab Agriculture Facts and Figures; Economic and Statistical Adviser/o Government of Punjab;
1956 Page 57 Table 20
IT-' n
‘1 .. ..........................................
_
■
(
A Journey into the Realm of Bhakra
xix
were
loir, the reservoir has not filled up
in most of the years.
We found that as in rmost other dam projects, the figures p t forward for
areas to be irrigated
by the Bhakra project were highly exaggerated. Indeed, < ‘
ev< i the areas that it could ultimately
semce it was able to do so by virtually drying up the riv
’ and cutting off areas previously
irrigated. The startling finding was that Bhakra did not add
ny
new areas under irrigation - it
only transferred or shifted the irrigation from one set of.
'eas to another - from areas that
were already irrigated to other areas.
The Bhakra project did not produce any dramatic impact o
the country's foodgrain situation.
mgation from the Bhakra-Nangal project began in 1954 ii
1954, ii reased rapidly, and reached close
to its full potential by 1963. Yet, India’s foodgrain positio.
had continued to deteriorate, and
food imports reached an all time high in 1966. While in
•orts
fell subsequently, they rose
sharply again and in 1975 touched a high once more.
k h“ b“-«” '■»»> f
X“cp^“'S.,nd■* ■”
Independent India’s quest for feeding its millions began w
i a ^conflict
(
of approaches. In the
late 40s and early 50s, there was a lot of focus on land refo
ns10 as a necessary component of
addressing the food problem. Further, there was emph is
on minor irrigation and the
community was seen as both, the vehicle of implementing
irograms on the ground and as a
basis for planning. The sum total was a <
' '
Five Year Phn HQSi
° CentraI p,aCe for a lecentra>ised approach. The First
was deemed a success with
terni^of'foodi’ra'ins production^ th®,f05.US fr°,m agricultu ’t0 industIT and was a disaster in
: F““:
- ~«, s...e
One of the important reasons for this shift was the bias tow
ds interpreting the food problem
demTd h 'T^et defiCitS”’ The mark£t def,cit - the ^Ort
ill
of market supply over market
ernand - has little role to play for the millions who are no
connected to the market for their
, ,
------- > •to be
and hence deficit” also c pends on the price of foodgrains
;. If people do not hav purchasing power, their need to
lie lhTlk StfOmachs WOL1Id not be translated into market demi
d and hence the deficit would be
frc»S th % °CUS °n mar^et deFicit led to an emphasis on
in ceasing the “procurable surplus”
om the farmer to meet the market needs. This approach m<
nt the food problem was defined
hiSTr
t V1Siblc” demand of
who could pay.
shifted to an intensive” and “selective” one, where beth corollary was that the approach
endowed areas would produce
XX1
y-jr-’on *• ™'k"
to the tenant, land
from abolitiot >f
►f zamindari, land to the tiller and land
for tenancy etc. It is also used sometimes to include’landI coSdadom’
reaS°nab,e COndili°nS
•
i-
■■
< >L'i
r*i-Tzi'f
T^YjiV
I
XX
Unravelling Bhakra
higher “surpluses” which could be procured for the market,11 since it was easier to produce
and procure more surplus from smaller, better endowed areas. This meant that inputs would
have to be concentrated there.
I
However, there was another approach. In this, it was argued that the real solution was (1) For
the producers - increase the security of and access to land (land reforms) and increase the
productivity of such lands (2) For the millions of “non-producers” increase their purchasing
power through sustainable employment. It was also realised and argued that the only way in
which the purchasing power of the millions spread all over the country could be increased, and
increased in a non-inflationary manner was if the investments used for (1) were also
supporting (2). In other words, a massive, decentralised program that would make use of the
country’s huge human resources to create infrastructure that would increase the productivity of
vast areas of lands.
In today s discourse, this is essentially a wide-spread, decentralised rainwater-harvesting,
wateished management, soil-water conservation, groundwater recharge program.
It is often said that if India has to feed its millions, there is no alternative but to build huge
dams to “harness” the waters of the rivers. Considerable evidence has now accumulated that a
decentralised rain-water harvesting program can improve dramatically the productivity of land
even in the most scanty rainfall areas. It is argued that this evidence is now available, but at the
time of independence, the efficacy of such an approach was not established and hence this was
not an option at all.
One of the important things we discovered during the course of our study was that such
watershed management, rainwater harvesting programs were not only being carried out in the
country, but that impressive results from these had been noted and proposals to implement
these country wide had been forcefully put forward. For example, the report of the All India
Congress Agrarian Reforms Committee of 1949 had noted the results of the soil-water
conservation works in Bijapur and its objectives, which were to “ keep all the rain-water that
fell on the land as near the place at which it fell” and that such a program “could well be
expanded to all of India.”
Further, from time to time, various experts had proposed precisely the kind of schemes that
today are being undertaken for decentralised rainwater harvesting and watershed management
-to be implemented all over the country7. Significantly, a very important advantage presented
for these schemes was that of generating employment on a huge scale and using India’s wealth
of human resources.
However, for a number of reasons, including the reasons of vested interests in large schemes
and the blocking of land reforms by the rural elite, the policies shifted decisively towards the
strategy of large projects, selectivity and intensification. But we discovered an important thing
- that there were very concrete alternatives being proposed to the large projects-based-strategy
even in the early years of Independence.
’
Around 1967 came the Green Revolution (GR). It must be understood that while the GR
strengthened the intensification, the strategy of intensification and the advent of GR were two
separate phenomena. The GR itself was a virtually unforeseen development. The GR took
place primarily with the advent of a new variety of seeds, called High Yielding Varieties
(HYV). However, they should more appropriately be called High Response Seeds, since their
basic quality was that they could take up and withstand much higher levels of fertilisers than
even the “improved” seeds in use till then.
The HYV demanded, and got, huge increases in the inputs. These included not only chemical
fertilisers, pesticides, but also machinery, cheap credit, minimum support prices and
The Public Distribution System was to be the means for addressing the issue of distribution, especially the needs
of the poor.
i
A Journey into the Realm of Bhakra
xxi
procurement, extension services and of course water. It she Id be emphasised that the
performance of the HYV was critically dependent on this whe ; package. All this involved
huge public subsidies, the cost of which was borne by the nation
The spectacular growth in the foodgrains production in Punjal and Haryana came with the
advent of the HYV. It is Jsometimes argued, conceding that the Bhakra project by itself may
not have increased production in a dramatic manner, that it was ic key in enabling the Green
Revolution. It is also said that the Bhakra project helped inc ase production by allowing
hitherto wasteland being brought into cultivation.
We found the ground realities to be quite different. The only s.
st 'Stantial increase in the areas
cultivated brought about by the Bhakra project lie in the dry b t of Haryana - in the Hissar
tracts. But the contribution of this to the foodgrains production vas limited. Against this, we
need to see the costs - financial, social, ecological and economi
- of the project. Further, the
agriculture of these very areas now faces serious problems - eco -gical and economic.
Irrigation was a crucial c
'
component
of the green revolution. B t Bhakra itself has played a
limited role. We have already seen that Bhakra commanded are
form less than a third of the
area of Haryana and less than a fifth in Punjab. The rest of the c
lal irrigation in these states is
from projects that are over a century old and are based only on d ersion structures.
However, far far more important
i
than the canal irrigation - whe icr from Bhakra or anywhere
else — has been the role of groundwater. There is not < 1
an iota o doubt that it is the explosive
growth in the ground water use - especially with tubewells, that
—t as been the real driving force
behind the green revolution and agricultural productioni in these vo states.
The HYV seeds are highly
1 J ‘ sensitive to the timing and quantity f watering. It is the tubewells
that allowed the farmer to ;achieve this control. Tubewell pro ictivity is documented to be
more than one and half times canal productivity.
The number of lubewells in F
Punjab jumped from 20,066 to c er 450,000 from 1965-66 to
f1975-76. In 1997-98, this figure was 910,000. In .Haryana, th< number of tubewells jumped
from 25,311 in 1965-66 to 204,736 in 1975-76, and in year 200( >tood at 583,705.
The areas iirrigated by wells/tubewells also increased dramatic
irrigated areas equalled andJ soon outstripped canal irrigated ar
tubewell irrigation grew rapidly till it now <
* canal‘ irrigai
equals
tubewell irrigation is the major factor behind the agricultural pre
ly. By the late 60s, tubewell
is in Punjab. In Haryana too,
>n. This enormous growth in
uction in the two states.
It is often argued that the tubewell irrigation L,
in the two states w. made possible by the canals.
It is argued that the waters that the tubewells
; are lifting are e ;entially the waters that have
seeped in from the canal and this is given as a i
major contributic of Bhakra. But this is widely
off the mark. Large part of the v
J
water being drawn out by the ubewells in the two states is
actually water that is being mined - in other words, water that
not being recharged. This is
vsater that has accumulated over generations or even centurk
and is being taken out in a
matter of years. Obviously, this is highly unsustainable.
Our calculations show that in
Punjab 43-46% of all agricu ural production is based' on
un
’
’ ’
S'-^dwater. For Haryana, the figure is 5%.^
;;
This is the production
of the - two states5 that
t
has nothing to do with any canal seepage has nothing to do with canal
irrigation and has n<
nothing to do with groundwater recharged r irmally through rain. In other
words, a sizable part of the “miracle” of Punjab and Har
ma is purely and eminently
unsustainable. And on the verge of collapse as groundwater lev<
s are falling rapidly.
aryana figures for the ear 1998-1999. Punjab figures are for year 1989-9
£
xxii
Unravelling Bhakra
It may be added that the figures for Punjab above are for the year 1989-90, when the canal
irrigated area was 1.467 m ha and tubewell irrigated area 2.44 m ha. By 2001-02 the caml
,|QS8?|e<1fareai,n £Unjab h3d fallen SharpIy t0 °-987 m ha " diat is’ even Iess tha" ^at it was in
34 before the Bhakra project - and tubewell area gone up to 3.068 m ha. This means that the
percentage of production dependent on the mined groundwater should be even higher today.
J
1
This is the shocking reality of the miracle of Punjab and Haryana’s agriculture.
hat is the contribution of Bhakra? The same calculations show that the production that can
be attributable to canal irrigation is about 43% in Punjab- this includes the recharge of
groundwater through canals (17%f. For Haryana, the figure is 48%.
An analysis of the Command area shows that in Punjab, the areas irrigated by Bhakra are very
hmited and the even the figure we saw earlier of the GCA (Gross Commanded Area) for
bhakra is misleading. The areas that were proposed to be irrigated by Bhakra were either areas
that were already irrigated, or were well-endowed areas. Even these planned areas are irrigated
uot so much by canal as by tubewells. Most of the canal irrigated areas in Punjab are in the
Sirhind area or the UBDC area. Out of the 43% of Punjab’s production attributed to canals, we
t lrt ub°Ut H% iS dUe t0 Bhakra canals‘5- In Haryana, since Bhakra canals service about
3U/o oi the total canal irrigated areas, we find that Bhakra is responsible for about 24% of
Haryana s production. These are conservative calculations.
What is equally important to note is that Haryana is the senior partner as far as Bhakra is
concerned (it has much more area irrigated from Bhakra than Punjab), but in terms of food
production Punjab is the senior partner. Punjab’s foodgrains production is double that of
Haryana, even though the cultivable area of the two states is comparable.
In other worrls, in the best analysis, contribution of Bhakra to India’s foodgrains production
and Punjab / Haryana’s agricultural prosperity has been limited, and nowhere near what is the
perception. Bhakra happened to be in the right place, at the right time, and has been given the
credit for things it never did.
However limited the production from Bhakra, the question can be asked - was there any other
W3y t° achieve this? In particular, the areas of Hissar tracts in Haryana, which were dry and
semi-arid area, with much of the groundwater of poor quality - and today boast of lush green
fields - is there any other way that these areas could have been served?
We found that the answers are an emphatic yes - and also that the answers have several
dimensions.
There arc two ways the question could be posed - was taking the waters of Sutluj to Hissar,
birsa, Fatehbad, Jind, Kaithal etc. districts in Haryana the only, or even the most optimal, way
to meet India’s food needs? This is from the point of view of the country. From the point of
view of these areas themselves the question is whether there was any other way to meet their
developmental needs.
About the needs of the areas themselves: purely in technical terms, we found that it would
have been possible for these areas to be irrigated with Sutluj water even without the Bhakra
dam. Indeed, such a scheme had also been proposed in the late 19th Century. In fact, many
pans of these areas were already being irrigated with the WJC.
14
Ian Ji? ua " he puroducl,on altr«butable to the canal irrigated areas is 26%. This is the direct contribution of
m
u°7VCr’ ab?Ul 60% of lhe recharsed groundwater in Punjab is said to come from the recharge due to
canals. We have included this as the indirect contribution of the canals and this works out to be 17% of
is Producl,on- Hence, total contribution of canals - direct and indirect is 43%.
ue to the non-cooperation of lhe Government, we were not given the exact areas irrigated in each of the systems.
Ve have worked out these figures from the district-wise irrigation data.
I
A Journey into the Realm of Bhakra
There is a larger issue here. What is the appropriate (agricu ural) development for this area?
From the Second Irrigation Commission (1972) to the new National Water Policy, planners
espouse that development of an area should be appropriate »its eco-climatic conditions. But
the practice has been to implement the same agricultura model in all zones — growing
sugarcane even in deserts , so to say. So long as sugarcane cultivation pays much more than
say a livestock based economy (which may be more suited I such zones), there is little doubt
that the people will demand water to grow sugarcane. The d cussion on this issue is crucial to
the agi icultuial strategy in the country, but it is clearly be ond the scope of our work. We
would only like to state that in our undertaking, we found ar )le evidence of the desirability of
tailoring development strategies to the eco-climatic and loca ronditions.
As for the first question - was the Bhakra (or similar projec ) the only and optimal strategy to
meet the country s foodgrains needs — it was clear th t there were real and tangible
alternatives, alternatives that could have served the < >untry better. These were the
decentralised wide-spread schemes that were being propoj d, which would have spread the
inputs, resources, investments and the outputs — and put pu basing power in the hands of the
people. Such alternatives had been proposed, we found, but id been ignored.
Choosing these alternatives could have also meant avoi ng many of the serious social,
environmental, financial costs and impacts of the Bhakra iroject. In evaluating the limited
benefits of the Bhakra project, we must not forget this other ide of the balance sheet.
One of the imost serious issues has been the waterloggii ; and salinisation in the Bhakra
command. What
■ is: iimportant is that much of the area in B ikra command that is in Haryana
(and this is the main irrigated1 area of the project) is und fain with saline and bad quality
waters. It is virtually impossible to control waterlogging tnd salinisation in this situation,
unlike in areas wnn
with gooo
good quality water where pumpin. can help. The twin dangers of
watetlogging and salinisation of the lands lead to sharp de line in productivity, even making
ihe lands totally uncukivable. When we visited the- art s affected by waterlogging and
salinisation, we were shocked by the impacts. Farmers to us stories of lands going out of
production and farmers migrating from the village. We aw costly experiments trying to
recover saliniscd lands which are meeting
i
with only limits success. We saw the Master Plan
?rmred by lhe Haryana Government to address the probl n of waterlogging- the costt - Rs.
2000 crores.
Waterlogging has also badly affected the infrastructure. i number of houses have fallen,
buildings have been affected due
—c t_
to differential sinking c foundations. Long stretches of a
National Highway have had to be
lifted- for the same reason
- -------
All evidence available to us j*
shows that the problem of 'aterlogging and salinisation will
continue to become more serious,
---- This is a classic examg : of short-term benefits and longterm disastrous impacts.
There have been severe impacts of the dam itself. The iver downstream of the dam has
become virtually dr}'. We have not been able to estimate It J irripacts of this since it is almost
50 years since this has happened and getting baseline ata has been very difficult. But
meticulous research will be able to get this, and we feel th this will be a very important area
for researchers to explore.
There have been no detailed studies of the environmental npacts of the dam except possibly
e issue of waterlogging. We feel that these would have b m important and should have been
one since Bhakra has been projected so much as a model, lut we came across many pieces of
in ormation which indicate that there have been serious i ipacts of the project. Diversion of
most of the water at Nangal and Ropar has meant serious onsequences downstream. Similar
In Kutch, Gujarat, for example, sugarcane is growing in the semi- arid
reas, while neighbouring villages have
serious problem of even drinking water.
xxiii
xxiv
Unravelling Bhakra
impacts are also seen below Pandoh in Beas basin. The traditional, much sought after fish.
masheer has virtually disappeared from the reservoir, being replaced by the silver caip which
is a low valued fish. There have been several health impacts of the project especially in the
reservoir area. About 10% of the live capacity of the reservoir has been lost to siltation and a
hump formation in the reservoir is preventing the silt from going into the dead storage. Given
the importance attached to the project, it is ver}' important that these be thoroughly
investigated.
° '
By tai (he most poignant moments for us have been when we met the oustees of the project.
Almost fifty years have gone by after their displacement. And yet, they have not been fullysettled. The communities living on the periphery of the reservoir - literally a reservoir of water
- do not have proper supply of drinking water. Those who were settled in the command area
of the project, in district of Hissar far away from their homes and culture, were allotted bad
quality lands, overgrown with bushes and undergrowth. An entire generation spent its life in
backbreaking work to try and make these lands cultivable. Fifty years after displacement their
lives are not yet back on track, and they are still fighting to get themselves properly
established. Many of them have not got titles to their lands or house plots. Many of the house
plots are still under the encroachment of local people. The oustees do not find political
representation as they are in the minority, and their grievances are not properly heard for the
same reasons. They find themselves cut off from their relatives and culture, and feel like aliens
in a strange land even after so many years. They are still dersogatorily called bilaspuriyas (as
they came from Bilaspur district) by the locals. Since large number of them have small land
holdings, they are hard hit by the worsening economy of agriculture.
Their voices still convey the pride they had felt, in the days when the country was just
independent, that they had been called on to serve the country through giving their lands and
watan (homeland). This has been replaced by a deep sense of being betrayed by the nation.
Now (here is another set of people who are being pushed headlong towards displacement economic displacement. These are the farmers of Punjab and Haryana. And therein lies one of
the biggest tragedies of this chronicle.
Wherever we went in Haryana or Punjab, we hardly heard exuberant voices extolling the
virtues of the project. In Punjab this was understandable since the Bhakra project has little in
terms of contribution to the state. In Haryana, we went across the command area of the project.
At places people told us about the transformation brought about by the project. Yet, the voices
were weighed down by distress; the eyes were full of apprehension about the future.
Everywhere we went, people told us that after the first 15-20 years of progress, the problems
begam 1 hey pointed out to us that much of what is being seen around (the houses, the tractors,
the prosperity) is the gift of those early years. And things are crumbling now. There is little
doubt about it - there is a deep crisis in the agriculture in the two states.
Ironically, the roots of the crisis lie in the same factors that brought in the much envied, much
referred to prosperity.
The groundwater that has been the real driving force behind the agriculture growth is declining
rapidly. Farmers with 5 H.P. motors have had to shift to 10 and then 20 H.P. motors, and nowhave to go for submersible pumps. Canal irrigation is leading to large-scale problems of
waterlogging and salinity. Prolonged use of fertilisers and chemicals has dramatically reduced
the fertility of the soil, and higher and higher levels of inputs are needed to get the same
output. The yields have stagnated, and in some cases - like rice - are going down. Pests have
increased, and crops like cotton have been devastated. The two states have been locked into
virtual mono-cropping of rice and wheat. Attempts to change the cropping pattern are not
working due to a combination of economic, ecological and political reasons. The farmer is
caught in a pincer as the costs of inputs are mounting, and the price of the output is not
keeping pace. Indebtedness is rising among the fanners and the small farmers are hardest hit.
i
A Journey into the Realm of Dhakra
xxv
There is pressure on the Government to cut the subsidie that manage to support much of the
system. The crisis is so serious that number of farmers i Punjab have resorted to committing
suicide. Suicides of farmers in the state where farming supposed to be most prosperous in
the country is an indicator of the gravity of the situation a d an omen.
At one village, we asked to talk to the landless families.
people with lands. When we repeated our request — we
1-2 acres of land, and hence are as good as landless. To i
ol the crisis of agriculture than the suicides of farmers an
>Vc were again and again brought to
ere told that these people have only
, there could be no bigger indicators
this.
One would have thought that in states considered o be the pinnacle of agricultural
achievement and prosperity, in the land of Bhakra, agric Iture would be so rich that 1-2 acres
would be enough for a person to live well. But it is not s<
There is little doubt that the agriculture and the farmei of the two states are paying a high
price for the short burst of prosperity. Agriculture in the tate has lost the resilience to take on
new challenges. Both the economic, and ecological oundations of the agriculture have
become shaky. The system has become highly vulnerabl to outside shocks. Ecological shocks
arc already being felt, as are economic. And the WTO s waiting in the wings to administer
blows which will be impossible for this system to take In both states, farmers, analysts and
social activists expressed grave fears that if the mini mm support prices were withdrawn
under the pressure of WTO, and they were forced to ill at market price, lakhs of farmers
would be rendered banknipt.
I his ol course, is a part of (he larger crisis of agricultur Punjab and Haryana are the furthest
down this path to agricultural “prosperity”, and hen< have reached the end of the path
earliest. Others on the same path can but reach the sam< end. But if the “magnificent”'Bhakra
project has not protected the two states against this, ther his is food for thought. Our study has
shown that in this model, there will be a short-lived bur: of prosperity, followed by long-term,
permanent devastation. Somewhat like a supernova.
Unfortunately, at the official level, there seems to be li le understanding of, or willingness to
address the root causes. The Punjab Government set up committee to address the agricultural
crisis in the state which gave its report in the year 200^ It is known after its Chair as the Johl
< ’ommittee. The main thrust of the report is that the pt blem of Punjab is that of plenty. It is
locked into the wheat-rice cycle and produces such < undance that it is difficult to find a
market for it. The proposed solution? State subsidy to ic farmers to stop
stop growing
growing wheat
wheat and
rice on about 1 million ha - to be given even if they do Dt grow anything.
1 he report exposes one of the most important dimer ions of the food problem in India. It
reveals the reason behind the fact that even as we tru pet that we are now self-sufficient in
lood. that we now export food, millions still go hungry i the country. We quote:
“India has accumulated huge stocks of foodgr ns that are not finding market and are
proving to be a heavy drain on the state exch< juer and the government is obliged to
purchase substantial new arrivals at higher an higher prices every season under the
system ot Minimum Support Prices. Althougl as per the nutritional requirements of
the Indian population, these stocks may not I : considered in excess, yet due to the
lack of purchasing power with the poor, suppl; exceeds demand....”
This lack of the purchasing power is the main reason f - the perversity of huge food stocks, of
exports at subsidised prices even as millions go I ngry. And the roots of the lack .'of
purchasing power go deep to the strategy of selectivity intensification and centralisation. The
roots go back to the strategy of the separation of the leans to achieve the two objectives of
increasing production and the subsequent equitable di ribution- the strategy of concentrating
inputs, resources and investments in small areas to inc sase production and then hope that the
rest can buy this production. But buy with what? nee this approach creates purchasing
3KZ
•r<s»>w»eX-»^Kigyir<
xxvi
Unravelling Bhakra
capacity only in pockets. Big dams like Bhakra exemplify (he unfolding of this strategy on the
ground, as they concentrate benefits in selected areas.
Unfortunately, we are not learning from these developments in Punjab; a similar situation is
rapidly developing in the economy in the other sectors. Under the policies of globalisation,
liberalisation and privatisation, we are having high rates of growth - but without growth in
employment. The same mistake - of jobless growth; we should be ready for the same'results.
Fortunately, we also found a number of people in Punjab and Haryana thinking along more
fundamental lines. And therein lies hope. We found groups worrying about the impacts of the
large-scale use of chemicals and pesticides. We found people who are concerned about the soil
degradation due to excessive chemical input and are trying to create a shift to organic
agriculture. We found people trying to document and revive traditional water resources, tanks
and ponds. Villages like Sukho Majri show how local water harvesting, diversity of cropping
and use of organic inputs can lead to high yields and minimum debts for the farmers.
When we travelled in Punjab and Haryana, we heard the desperation in the people’s voices.
Some farmers also told us — when the country needed us, we were there to help the country
produce food. Now that we are in trouble - will the country not help us? Even if our report just
leads to an answer in affirmative to this question, we will feel that our efforts have not been in
vain.
It would be incomplete to end the tale of this journey without a word about the other
discoveries we made - almost as a sort of a by product but probably equally valuable.
The first thing we came across, and something that was a constant all along the way has been
the wonderful, warm and generous hospitality of the people of Punjab, Haryana and Himachal.
And this is not just our friends but everyone. Complete strangers welcomed us into their
homes, fed us jsuperbly, and shared their life experiences with us. The latter especially has
been a privilege.
\Ve discovered why the simple traditional meal of makke-ki-roli sarson-da-saag ranks among
the most wonderful food in the world - even though the tnakka may no longer be growing so
much, replaced by wheat and rice. We realised the true meaning of the lassi and paratha and that what we called by these names back home were poor country cousins.
We found out that music in Punjab is much more than “balle balle” or the more recent "Tunuk
Tunuk ’ as we were introduced to the mellifluous songs of Asa Singh Mastana, Surinder Kaur
and others.
We also came across some not so pleasant facts - the low female: male ratio in Punjab to
name one. Or, the striking absence of women in the markets of the small towns of Haryana an indicator of their role and status.
We found the obsession with ‘‘foreign" in the Doab region to be just as the stories have it.
Almost every family from this region of Punjab seems to have a member abroad. It was also
later given to us as a reason why th& farming families are able to make ends meet here.
Two stops on our journey are particularly memorable. One was at Khatkad Kalan - a brief
stop on the way from Ludhiana to Bhakra, to pay a visit to the birth place and home of Shahid
Bhagat Singh. The other was at the Gurudwara at Anandpur Sahib, where, apart from other
things, the lunch at the langaar reminded us that the generosity and hospitality of the Sikhs is
not restricted to individuals but extends to the community.
All these not only made our journey so much more enjoyable and pleasant, it also offered to us
insights into famous entrepreneurial spirit of the Punjab (and Haryana) fanner, and the culture
and society in which the subject of our study is placed.
A Journey into the Realm of Dhakra
xxvii
Yet, we have come away with a sense of despondency. The c sis we saw in the agriculture is
very real, and deep. And it is not just going to be restricted I the two states, but is likely to
engulf much of the country. No farmer we met was untouche by it, and no one could refrain
from referring to it. Before we embark on the details of t s journey of ours in the next
chapters as a reminder of our mission, of what we found. w< can do no better than end with
two quotes one, from an official, the other from a farmer.
Report of the S.S. Johl Committee, Government of Punjab. Oc 2002:
On the other side, continuous production of wheat ii d rice in annual rotation in the
irrigated aieas of Punjab is having a deleterious effeci )n soil, water, environment and
social fabric of the state. Soils of Punjab have beco ie virtually a laboratory culture
that requires higher and higher doses of fertilisers, micronutrients, insecticides and
pesticides to produce same level of wheat and /or ric< This has resulted in declining
total factor productivity. The situation is becoming 'ery serious day by day which
can very soon [proved to be economically disastrous, j cially untenable and politically
unsustainable, which
’.*.'h:ch can turn into man-made natii mal calamity if not dealt with
judiciously.”
Sardar Gurmail Singh, Village Bada, District Ropar:
“AH that you can see around in PPunjab [the prosperil ] all that you have heard about
it, please do not believe it. Things are not what they ;em. Punjab is on the brink...”
SZE3
UNRAVEL! NG
BHAKRA
ASSESSING THE TEMPLE OF R iSURGENT INDIA
Report of a Study b '
Manthan Adhyayan Ke idra
Badwani (M.P.)
Study Team •
Shripad Dharmadhikary
Swathi Sheshadri
Rehmat
Unravelling Bhakra: Assessing the Temple of Resurgent India
Report of a Study of the Bhakra Nangal Project
Published By:
Manthan Adhyayan Kendra,
Dashera Maidan Road,
Badwani (M.P.) 451 551
Ph: 07290-222 857
Email: manthan_b@sanchamet.in
Study Team:
Shripad Dharmadhikary
Swathi Sheshadri
Rehmat
Layout & Maps:
Reh mat
Photographs:
BBMB» Government of Rajasthan,
Rehmat, Mukesh Jat, Alok Agrawal,
Shripad Dharmadhikary and several others.
Production Support:
Eklavya Bhopal
April 2005:
1000 copies
Suggested Contribution:
Individuals: Rs. 15-0./
Institutions: Rs. 300.00
Printed at Adarsh Printers and Publishers, Bhopal, Phone: 2555442
Unravelling Bhakr
Assessing the Temple of Resur; mt India
Table of Contents
Preface
Evaluating a Legend
vii
• Overview
A Journey into the Realm of Bhakra
XV
Chapter 1
The Indus Basin, Irrigation Development and
hakra Project
1
Chapter 2
Planning the Bhakra Project
15
Chapter 3
Bhakra Project: The Final Project Design and Lelated
Developments
33
Chapter 4
Bhakra Project: An Analysis of the Command
41
Chapter 5
Food Production, Food Security and Bhakra 1 50-1966
Annexure I to Chapter 5
57
87
Chapter 6
Food Production and Bhakra Phase II - The G ;en Revolution
89
Chapter 7
Role of Bhakra in Food Production
101
Chapter 8
Groundwater - the Real Driving Force
Additional Note to Chapter 8
Annexure I to Chapter 8
111
127
131
!
ir
ii
Unravelling bhakra ;
Chapter 9
Without Bhakra!
Chapter 10
A Dream Turns to Nightmare: Crisis in Punjab and Haryana
Agriculture
133
149
Chapter 11
Waterlogging and Salinisation
169
Chapter 12
Environmental Impacts
Additional Note to Chapter 12
191
206
Chapter 13
Displacement, Uprootment, Rehabilitation
The Forgotten People
207
Chapter 14
In Conclusion: Behind Bhakra, Beyond Bhakra
227
References: Main
References from the Net
References: Journals
239
265
271
References
A Journey Into he Realm of Bhakra
I
i
OUR JOURNEY INTO THE BHAKRA-LAND BEGAN WI
H THIS AWESOME DISPLAY
of the green revolution in its full visual glory. As we trav
led through Haryana, and then
Punjab, this sight was to be repeated day after day. As we
noved through the country, we
heard stories of how the waters had transformed virtual desei
; into lush green fields. We saw
the big pucca houses in villages, the large number of tractoi
- and not a single bullock can.
We crossed numerous small and big canals as we drove on
ie excellent road network. The
most spectacular sight of the journey was our first view of
ie Bhakra dam. It was nothing
short of stunning. Seen coming up the mountain from the do\
istream side in the late evening,
the wall of the dam rises up steeply, suddenly from the dej
hs of the gorge to a sheer 200
meters, the lights at the top illuminating it. As an engine
r, I could only marvel at this
testimony to the skills of our profession. We saw at the di
a site exhibition the photos of
visiting dignitaries like Ho-Chi-Minh, Bulganin, Khruschev
- images from the heydays of
“socialist” India.
Our physical journey was paralleled by another, a melaphori*
il, journey - a journey through
the facts and figures, through the documents, through the hist
ry, geography, science, politics
of the project. A journey through the minds and memories of
eople, a tour that accompanied
the people on their experiences of the dam, of-the agriculture
of the two states. This journey
was equally, if not more, fascinating as the physical journey.
4>
I
I
The mesmerising display of the green revolution in the fit
ds of Haryana and Punjab is
matched by the spectacular statistics of agricultural grow
i. In Punjab, the foodgrains
production went up from 3.389 million ttons (m
; tons); in
' 1965- 6 to 17.221
_
17.221 nitons in 1985-86
- an increase of five times in 20 years, or an annual compo nded growth of 8.47% for 20
years running! In 1999-2000 it stood at 25.197 million
x.
tons, 1. 1% of the all India production.
In Haryana, in the same period, foodgrains production increase
from 1.985 m tons to 8.147 m
tons, a four times increase. In 1999-2000,it stood at 13.065 mil
an tons, or 6.2% of All India.
There is an old saying - I believe it exists in j
some form or the < her in every language - which
states “Appearances can be deceptive”. Our journey, our f ’
fascii iting journey into the realm of
Bhakra was toJ prove
piuve the
me truth
truth of
ot this
this saying
saying many
many times
times ove in many different ways Our
journey was a discovery
d’
• of how long held popular belie s and perceptions were mostly
of this,
just that - beliefs.
icts It
It was
was also
also _a revelation of the hidden, or i t so hidden, but often sweet>ef Side
h
under-the-carpet
side nf
of fhr*
the ctAn,
story.
The first revelation came with our very first visual encounter
As we soon found, the lush green
l
- • ■ from
fields
Panipat to Hans
Tins area along with other large areas in Haryana receive wa
anal (WJC) and have been doing so since over 100 years 2
taking off from the Yamuna river
'
near Tajewala. This diver.-
ith Haryana described above.
had little to do with Bhakra\
•rs from the Western Jamuna
he WJC is a diversion canal
anus from1 a weir and not a
-------------
Throughout this report, unless the context so indicates, or
it is specified other se, the term “Bhakra" or “Bhakra
2 The" w7r WllI.refer 10 lhe cntire Bhakra-Nangal project.
remode?!^ "T'g:“'ng srnal1
as earlX as >he 16a Century - during the
r e of Akbar. In 1832 it was
remodelled for extensive irrigation.
A Journey into the Realm of Bhakra
xvii
xviii
Unravelling Bhakra
storage dam. In fact, the gross command area of Bhakra in Haryana is about 30% of the state
geographical area. In Punjab, the gross commanded area of Bhakra is about 18.6% of the state
area. Punjab and Haryana are much more than Bhakra?
. It is often said that before Bhakra, Punjab (and Haryana) were just semi-arid, dry regions with
itt c irrigation and / or highly problematic agriculture. We found this to be far from the truth.
As we traced the history of irrigation in the two states, we had to go back to pre-partition
n ia i ic pre-partition Punjab. Pre-partition Punjab included not only the Pakistan part of
unjab but also today’s Indian states of Punjab and Haryana. Punj (Five) Aab (Waters) - the
land of the live rivers - Sutluj, Beas, Ravi, Chenab, Jhelum - and of course the mighty Indus
whose tributaries these five are - forms an area endowed with the most lavish water resources.
ii e imgation was being used in the Indus basin since the days of Harappa and Mohen-jadaro. it really developed during the 19th Century and by the early 1900s, Punjab4 had an
extensive, highly developed irrigation system based on diversions from the major rivers.
A large part of this system was in what is today Pakistan. But the irrigation developed in the
Indian part was not small or insignificant. The Western Jamuna Canal,5 we have seen was
serving large parts in today’s state of Haryana. The Upper Bari Doab system from Ravi that
serves much of Amritsar and Gurudaspur districts in Punjab was opened in 1859.
I he Sirhind Canal, taking off from the Sutluj at Ropar in Punjab, was opened in 1882. It was
irrigating,
imgating, and still does, large areas of Punjab. Apart from these, there was significant
imgation from wells.
Overall, the situation iin Punjab (including Haryana6) around 1950 - before the Bhakra project
- was as follows.
f'
'n 1949’1950’ Punjab7 had 35.3% of its sown area irrigated and the figure
for [ El SU (Patiala and East Punjab States Union)8 was 42.6%. This was the highest in the
whole country! Together, PEPSU and Punjab accounted for 13% of the country's irrigated
• ■ . aiea. while it had 5.89% of the country's total sown area9. Thus, it was way ahead in irrigation
as compared to the rest of the country - even after losing the lion's share to Pakistan In
PEPSU termS’ lhe areaS ,rrigated Were 4 9 million acres in Punjab and 2.04 m acres in
Similarly, Punjab at that time was the leading producer of wheat, maize and gram in the
country.
Against this background, the decision to build Bhakra was a very interesting one. As we
explored the planning and decision making process around Bhakra project, we found that the
41 oie (hat the gross command area gives the maximum possible reach of lhe project.
Prm mr/nf p CanSkthc Pre-Parlit*on Punjab. The readers will do well to keep in mind the following. The British
and the Pakistlnptniah 9
*S
PUnjab’ Ind*an Hafyana’ srna11 P3* of Ind'an Himachal
buf utJ nr
?
J S’™ are3S lhal
*n Punjab or Haryana loday were n°l
British province of Punjab
Patiala and fX
‘111656 ,ncluded Pat,ala. Jind, Bhatinda, Faridkot etc. and went by the name PEPSU India) - lat^allcdTmnTv PS
/h47’ 0°
WeSl PUnjab (in PakiSl3n) and East Punjab <in
H
■ *
Punjab. This Lnd^n Punjab (of 1947) included parts of today’s Punjab today’s Haryana
reorg3nised^nto°H"«nChalrfIp
PEF’SUr mcrgcd with Indian Punjab-ln 1966, this combined Punjab was
termlnoloirv p H y
"d PunJab’ w,th a few districts going to Himachal. We will use the following
PumLb orpost ,966 Ho"
5 P.X X are referring
Jat>
m f°re ‘947' Unificd Punjab for Punjab bctwec" 1947 a"d 1966 a"d simply
~ does no, nU,ke i, clear
6 Though not a part of the Indus basin
? See footnote 4 on what constituted Punjab during various periods.
Xtion
t,mC aIS° inC1UdCd Shimla and Kangra diStriCtS °f Himacha1’ bul 01656 had VCfy limited’amount of
8 See footnote 4
’ R1956Apage57“TabIe M C“"“re
EC°nOmiC and
AdviSer>t°
p™jab:
!
Bsiaggi^A Journey into the Realm of Chakra
xix
real reasons behind advocating the project had much more I
do with the interstate disputes of
the (then British) provinces of Sind and Punjab and later Ii
lia-Pakistan, than the interests of
taking water to dry areas.
We learnt that the Bhakra dam was an cover designed dam Even after the Sutlui flows were
augmented by the transfer of Beas water to the Bhakra
------ j reser )ir, the reservoir has not filled up
in most of the years.
.1
a
V
We found that as in most other dam projects, the figures pu
by the Bhakra project were highly exaggerated. Indeed, eve
service, it was able to do so by virtually drying up the rive
irrigated. The startling finding was that Bhakra did not add c
only transferred or shifted the irrigation from one set of a
were already irrigated to other areas.
.
J
forward for areas to be irrigated
the areas that it could ultimately
and cutting off areas previously
y new areas under irrigation - it
as to another - from areas that
The Bhakra project did not produce any dramatic impact on
he country's foodgrain situation,
Irrigation from the Bhakra-Nangal project began in 1954 inc
eased rapidly, and reached close
to its full potential by 1963. Yet, India’s foodgrain position
ad continued to deteriorate, and
food imports reached an all time high in 1966. While imi
'rts fell subsequently, they rose
sharply again and in 1975 touched a high once more.
20 years after irrigation deliveries started from a project that
supposed to have brought food
self-sufficiency to India,, we were still importing huge quantit s of food.
One of the more ;absorbing
‘
and educative part of our joun y has been the history of food
policy and programs in Indra.
- --------- J
l"C
°r ,OOC1
Tie in
•'
LnttefnndenH InC’iaXqUeSt f°r feedinS its millions began witl a conflict of approaches. In the
late 40s and early 50s, there was
lot of
of focus
on land
land refon
was aa lot
focus on
reforr ; as a necessary component of
addressing the food problem. Further,
was emphas
—, there
there was
emphas on minor irrigation^and the
basTsTr nlann5 ^Thas
35 both,
b0'h’ the vehicle
Veh‘Cle °
Plementing pP 3)grams
granls on the ground and as a
off im
implementing
oasis tor planning. The sum total was a <central' place
*
for a c centralised approach. The First
Five Year Plan (1951-56) was deemed a success with u
respec to food production. Rationing,
control on interstate movement of foodgrains and all such
_’i rest lints were removed.
The Second Plan (1956-61) shifted the focus from agriculture
o industry' and was a disaster in
terms of foodgrains production. From the Second to Third Pla and beyond, the focus also was
shifting away from the decentralised approach, t..._.^
towards laq i-scale schemes. Land reforms
were not going ahead beyond the abolition of zainindari. The trategy of concentrating inputs
and resources on selected areas to attain higher production wa:
coming into prominence.
dle 'imP°rtant reasons for this shift was the bias towan ; interpreting the food problem
demZ L '"ni61 ?
S” The market deficit ~ the shortfa of market saPP>y over market
food need "SJ 6 ? e play for the mlllions who are not c nnected to the market for their
food needs. Even for those who depend on the market f r food needs, it needs to be
emphasised that market demand, and hence “deficit" also dej nds on the price of foodgrains
and purehasmg power of the millions. If people do not have rrchasing power, their ne^d m
ill their stomachs would not be translated into market demanc and hence the deficit would be
from ?heef US °n marke'
led t0 an emPhasis °n incr ising the “procurable surplus”
from the farmer to meet the market needs. This approach meai f'..
‘
P
the food problem was defined
tenps of the “visible” demand of those who could pay. A )rollary was that the approach
shifted to an “intensive” and “selective” one, where better adowed
areas would produce
to ?hc ^^rnhn^rZ^nCTPx- '‘V
°f measures from ^I'^on
wnindari, land to the tiller and land
for tenanc
°f
the Purity of tenan and ensuring reasonable conditions
ancy etc. it is also used sometimes to include land consolidation.
I
XX
Unravelling Bhakra
I
higher “surpluses” which could be procured for the market,11 since it was easier to produce
and procure more surplus from smaller, better endowed areas. This meant that inputs would
have to be concentrated there.
However, there was another approach. In this, it was argued that the real solution was (1) For
the producers - increase the security of and access to land (land reforms) and increase the
productivity of such lands (2) For the millions of “non-producers” increase their purchasing
power through sustainable employment. It was also realised and argued that the only way in
which the purchasing power of the millions spread all over the country could be increased, and
increased in a non-inflationary manner was if the investments used for (1) were also
supporting (2). In other words, a massive, decentralised program that would make use of the
country’s huge human resources to create infrastructure that would increase the productivity of
vast areas of lands.
1
In today s discourse, this is essentially a wide-spread, decentralised rainwater-harvesting,
wateished management, soil-water conservation, ground water recharge program.
It is often said that if India has to feed its millions, there is no alternative but to build huge
dams to harness” the waters of the rivers. Considerable evidence has now accumulated that a
decentralised rain-water harvesting program can improve dramatically the productivity of land
even in the most scanty rainfall areas. It is argued that this evidence is now available, but at the
time of independence, the efficacy of such an approach was not established and hence this was
not an option at all.
One of the important things we discovered during the course of our study was that sucn
watershed management, rainwater harvesting programs were not only being carried out in (he
country, but that impressive results from these had been noted and proposals to implement
these country wide had been forcefully pul forward. For example, the report of the All India
Congress Agrarian Reforms Committee of 1949 had noted the results of the soil-water
conservation works in Bijapur and its objectives, which were to “ keep all the rain-water that
fell on the land as near the place at which it fell" and that such a program “could well be
expanded to all of India.”
Further, from time to time, various experts had proposed precisely the kind of schemes that
today are being undertaken for decentralised rainwater harvesting and watershed management
- to be implemented all over the country. Significantly, a ver\> important advantage presented
Jot these schemes was that of generating employment on a huge scale and using India's wealth
of human resources.
However, for a number of reasons, including the reasons of vested interests in large schemes
and the blocking of land reforms by the rural elite, the policies shifted decisively towards the
strategy of large projects, selectivity and intensification. But we discovered an important thing
- that there were very concrete alternatives being proposed to the large projects-based-strategy
even in the early years of Independence.
1
Around 1967 came the Green Revolution (GR). It must be understood that while the GR
strengthened the intensification, the strategy of intensification and the advent of GR were two
separate phenomena. The GR itself was a virtually unforeseen development. The GR took
place primarily with the advent of a new variety of seeds, called High Yielding Varieties
(HYV). However, they should more appropriately be called High Response Seeds, since their
basic quality was that they could take up and withstand much higher levels of fertilisers than
even the “improved” seeds in use till then.
The HYV demanded, and got, huge increases in the inputs. These included not only chemical
fertilisers, pesticides, but also machinery, cheap credit, minimum support prices and
The Public Distribution System was to be the means for addressing the issue of distribution, especially the needs
of the poor.
I
assaiaiEr
A Journey into the Realm of Dhakra
xxi
procurement, extension services and of course water. It si iild be emphasised that the
performance of the HYV was critically dependent on this wh le package. All this involved
huge public subsidies, the cost of which was bome by the natioi
The spectacular growth in the foodgrains production in Punji and Haryana came with the
advent of the HYV. It is sometimes argued, conceding that th Bhakra project by itself may
not have increased production in a dramatic manner, that it wa< ;he key in enabling the Green
Revolution. It is also said that the Bhakra project helped in< ease production by allowing
hitherto wasteland being brought into cultivation.
We found the ground realities to be quite different. The only s
cultivated brought about by the Bhakra project lie in the dry t
tracts. But the contribution of this to the foodgrains productior
need to see the costs — financial, social, ecological and economi
agriculture of these very areas now faces serious problems — ecc
jstantial increase in the areas
It of Haryana - in the Hissar
was limited. Against this, we
- of the project. Further, the
)gical and economic.
Irrigation was a crucial component of the green revolution. E it Bhakra itself has played a
limited role. We have already seen that Bhakra commanded are ; form less than a third of the
area of Haryana and less than a fifth in Punjab. The rest of the c lal irrigation in these states is
from projects that are over a century old and are based only on d 'ersion structures.
However, far far more important
i
than the canal irrigation - whe icr from Bhakra or anywhere
else — has been the role of groundwater. There is not an iota
i_l o doubt that it is the explosive
growth in the ground water use - especially
tubewells, —
thatt as been the real driving force
4 ---- j with
-------------------1
behind the green revolution and agricultural production in these /o states.
1 he HYV seeds are 1highly
'
sensitive to the timing and quantity ’watering. It is the tubewells
that allowed the farmer to achieve this control. Tubewell pro< ictivity is documented to be
more than one and half times canal productivity.
The number of tubewells in Punjab jumped from 20,066 to o sr 450,000 from 1965-66 to
1975-76. In 1997-98, this figure was 910,000. In .Haryana, the lumber of tubewells jumped
from 25,311 in 1965-66 to 204,736 in 1975-76, and in year 2000 tood at 583,705.
rhe areas irrigated by wells/tubewells also increased dramaticj y. By the late 60s, tubewell
irrigated areas equalled and soon outstripped canal irrigated arc s in Punjab. In Haryana too,
tubewell irrigation grew rapidly till it now equals canal irrigati n. This enormous growth in
tu ewell irrigation is the major factor behind the agricultural pro^ iction in the two states.
It is often argued that the tubewell irrigation in the two states wa made possible by the canals,
t is argued that the waters that the tubewells are lifting are es mtially the waters that have
s^ped in from the canal and this is given as a major contributioi Df Bhakra. But this is widely
o t c mark. Large part of the water being drawn out by the bewells in the two states is
actually water that is being mined - in other words, water that i not being recharged. This is
water that has accumulated over generations or even centuries and is being taken out in a
matter of years. Obviously, this is highly unsustainable.
Our
— calculations
ccucmauons show
X/iow that
that in
m Punjab
Punjab 43-46%
43-46% of
of all
all agricuh
agricuh ral production is based on
nnsustamably mined groundwater. For Haryana, the figure is J %? This is the production
of
o the
t ie two
two states
states that has nothing to do with any canal seepage, las nothing to do with canal
irrigation and has nothing to do with groundwater recharged nc mally through rain. In other
^or s, a sizable part of the “miracle” of Punjab and Haryt a is
is purely
purely and
and eminently
eminently
unsustainable. And on the verge of collapse as groundwater level are falling rapidly.
The point is not about subsidies per se. This author at least believes that subsic :s will be necessary for agriculture,
n Mie issue here was the concentration of the subsidies in limited areas of the cc itry.
Maryana figures for the Year 1998-1999. Punjab figures are for year 1989-90.
xxii
Unravelling Bhakra
It may be added that the figures for Punjab above are for the year 1989-90, when the canal
irrigated area was 1.467 m ha and tubewell irrigated area 2.44 m ha. By 2001-02, the canal
,r?Sated area in Punjab had fallen sharply to 0.987 m ha - that is, even less than what it was in
1954 before the Bhakra project - and tubewell area gone up to 3.068 m ha. This means that the
percentage of production dependent on the mined groundwater should be even higher today.
1
This is the shocking reality of the miracle of Punjab and Haryana’s agriculture.
What is the contribution of Bhakra? The same calculations show that the production that can
be attributable to canal irrigation is about 43% in Punjab- this includes the recharge of
groundwater through canals
For Haryana, the figure is 48%.
An analysis of the Command area shows that in Punjab, the areas irrigated by Bhakra are very
hmited and the even the figure we saw earlier of the GCA (Gross Commanded Area) for
Bhakra is misleading. The areas that were proposed to be irrigated by Bhakra were either areas
that were already irrigated, or were well-endowed areas. Even these planned areas are irrigated
not so much by canal as by tubewells. Most of the canal irrigated areas in Punjab are in the
ir jn area or the UBDC area. Out of the 43% of Punjab’s production attributed to canals, we
r a?°Ut H% iS dUC t0 Bhakra canals ■ In Haryana, since Bhakra canals service about
5U/o oi the total canal irrigated areas, we find that Bhakra is responsible for about 24% of
Haryana s production. These are conservative calculations.
What is equally important to note is that Haryana is the senior partner as far as Bhakra is
concerned (it has much more area irrigated from Bhakra than Punjab), but in terms of food
production Punjab is the senior partner. Punjab’s foodgrains production is double that of
Haryana, even though the cultivable area of the two states is comparable.
In other word5, in the best analysis, contribution of Bhakra to India’s foodgrains production
and 1 unjab / Haryana’s agricultural prosperity has been limited, and nowhere near what is the
perception Bhakra happened to be in the right place, at the right time, and has been given the
credit for things it never did.
However hmited the production from Bhakra, the question can be asked - was there any other
way to achieve this? In particular, the areas of Hissar tracts in Haryana, which were dry and
semi-and area, with much of the groundwater of poor quality - and today boast of lush green
tields is there any other way that these areas could have been served?
We found that the answers are an emphatic yes - and also that the answers have several ■
dimensions.
There arc two ways the question could be posed - was taking the waters of Sutluj to Hissar
irsa, hatehbad Jind, Kaithal etc. districts in Haryana the only, or even the most optimal, way
o meet India s food needs? This is from the point of view of the country. From the point of
view of these areas themselves the question is whether there was any other way to meet their
developmental needs.
About the needs of the areas themselves: purely in technical terms, we found that it would
have been possible for these <areas to be irrigated with Sutluj water even without the Bhakra
dam. Indeed, such a <scheme
'
had also been proposed in the late, 19th Century. In fact, many
parts of these areas were already being irrigated with the WJC.
^ana^sh^oweve^a^n^/AA^0 a3*ibutab1lc t0 016 canaI ligated areas is 26%. This is the direct contribution of
canals We hive ’
°f the re.charsedgroundwater in Punjab is said to come from the recharge due to
■
e included this as the indirect contribution of the canals and this works out to be 17% of
|5 production. Hence, total contribution of canals - direct and indirect is 43%.
1 C non’cooPerat*on °f the Government, we were not given the exact areas irrigated in each of the systems.
We have worked out these figures from the district-wise irrigation data.
■«1 1
- dim
EU a. - ■..
A Journey into the Realm of Bhakra
xxiii
1 here is a larger issue here. What is the appropriate (agr :ultural) development for this area?
From the Second Irrigation Commission (1972) to the n w National Water Policy, planners
espouse that development of an area should be appropria : to its eco-climatic conditions. But
the practice has been to J mp lenient the same agriculti al model in all zones - growing
sugarcane even in deserts , so to say. So long as sugarc: le cultivation pays much more than
say a livestock based economy (which may be more suite to such zones), there is little doubt
that the people will demand water to grow sugarcane. The discussion on this issue is crucial to
(he agricultural strategy in the country, but it is clearly eyond the scope of our work. We
would only like to state that in our undertaking, we found mple evidence of the desirability of
tailoi ing development strategies to the eco-climatic and Io tl conditions.
As for the first question - was the Bhakra (or similar proj :ts) the only and optimal strategy to
meet the country s foodgrains needs - it was clear tat there were real and tangible
alternatives, alternatives that could have served the country better. These were the
decentralised wide-spread schemes that were being prop sed, which would have spread the
inputs, resources, investments and the outputs - and put j rchasing power in the hands of the
people. Such alternatives had been proposed, we found, bi had been ignored.
Choosing these alternatives could have also meant av ding many of the serious social,
environmental, financial costs and impacts of the Bhakj project. In evaluating the limited
benefits of the Bhakra project, we must not forget this oth< side of the balance sheet.
One of the most serious iissues has ‘been the waterlog^ ng and salinisation in the Bhakra
command. What is important is that much of the area in hakra command that is in Haryana
(and this is the main irrigated area of the project) is ur erlain with saline and bad quality
waters. It is virtually impossible to control waterloggin and salinisation in this situation,
unlike in areas with good quality water where pumpi > can help. The twin dangers of
uatci logging and salinisation of the lands lead to sharp c cline in productivity, even making
the lands totally uncultivable. When we visited the- a tas affected by waterlogging and
salinisation, we were shocked by the impacts. Farmers t d us stories of lands going out of
production and farmers migrating from the village. W saw costly experiments trying to
recover sahnised lands which are meeting with only limit 1 success. We saw the Master Plan
^aD’ana Government to address the prol ;m of waterlogging- the cost - Rs
2000 crores.
a,so bad,y affected the infrastructure A number of houses have fallen,
buildings have been affected due
JLT
—c t_
to differential
sinking f foundations. Long stretches of a
National Highway have had to be
lifted for the SHmc rcsso
— ..--wrw
All evidence available to us «show's
’
'
that
the problem of waterlogging and salinisation will
continue to become more serious. This
is a classic..iexam
-----------------|e of short-term benefits and longterm disastrous impacts. t
There have been severe iimpacts
r
off the dam itself. The river downstream of the dam has
become virtually- dry. We have- —
not ----been------able to---estimate
r
----—~ e _...
impacts
of this since it is almost
2) U '/z^ °
-— — -• ■
50 years since
this •has happened and getting baseline data has been very difficult. But
meticulous research will be able to get this, and we feel tl t this will be a very important area
tor researchers to explore.
There have been no detailed studies of the environmental mpacts of the dam except possibly
the issue of waterlogging. We feel that these would have t en important and should have been
done since Bhakra has been projected so much as a model Jut we came across many pieces of
in ormation which indicate that there have been serious ipacts of the project. Diversion of
most of the water at Nangal and Ropar has meant serious ronsequences downstream. Similar
" «rioTp^
iS Er°Wing in the Semi-
whi,e "^hbouring vi.lages have
>'
■
w»ww»mw,ir..-x:-"~
xxiv
Unravelling Bhakra
impacts arc also seen below Pandoh in Beas basin. The traditional, much sought after fish.
masheer has virtually disappeared from the reservoir, being replaced by the silver carp which
is a low valued fish. There have been several health impacts of the project especially in the
reservoir area. About 10% of the live capacity of the reservoir has been lost to siltation and a
hump formation in the reservoir is preventing the silt from going into the dead storage. Given
the importance attached to the project, it is ver}' important that these be thorou^hlv
investigated.
0 '
By tai the most poignant moments for us have been when we met the oustees of the project.
Almost fifty years have gone by after their displacement. And yet, they have not been fullysettled. 1 he communities living on the periphery of the reservoir - literally a reservoir of water
- do not have proper supply of drinking water. Those who were settled in the command area
of the project, in district of Hissar far away from their homes and culture, were allotted bad
quality lands, overgrown with bushes and undergrowth. An entire generation spent its life in
backbreaking work to try and make these lands cultivable. Fifty years after displacement their
lives are not yet back on track, and they are still fighting to get themselves properly
established. Many of them have not got titles to their lands or house plots. Many of the house
plots are still under the encroachment of local people. The oustees do not find political
representation as they are in the minority, and their grievances are not properly heard for the
same reasons. They find themselves cut off from their relatives and culture, and feel like aliens
in a strange land even after so many years. They are still dersogatorily called bilaspuriyas (as
they came from Bilaspur district) by the locals. Since large number of them have small land
holdings, they are hard hit by the worsening economy of agriculture.
Their voices still convey the pride they had felt, in the days when the country was just
independent, that they had been called on to serve the country through giving their lands and
watan (homeland). This has been replaced by a deep sense of being betrayed by the nation.
Now there is another set of people who are being pushed headlong towards displacement economic displacement. These are the farmers of Punjab and Haryana. And therein lies one of
the biggest tragedies of this chronicle.
Wherever we went in Haryana or Punjab, we hardly heard exuberant voices extolling the
virtues of the project. In Punjab this was understandable since the Bhakra project has little in
terms of contribution to the state. In Haryana, we went across the command area of the project.
At places people told us about the transformation brought about by the project. Yet, the voices
were weighed down by distress; the eyes were full of apprehension about the future.
Everywhere we went, people told us that after the first 15-20 years of progress, the problems
begam 1 hey pointed out to us that much of what is being seen around (the houses, the tractors,
the piosperity) is the gift of those early years. And things are crumbling now. There is little
doubt about it - there is a deep crisis in the agriculture in the two states.
Ironically, the roots of the crisis lie in the same factors that brought in the much envied, much
referred to prosperity.
The groundwater that has been the real driving force behind the agriculture growth is declining
rapidly. Farmers with 5 H.P. motors have had to shift to 10 and then 20 H.P. motors, and now have to go for submersible pumps. Canal irrigation is leading to large-scale problems of
waterlogging and salinity. Prolonged use of fertilisers and chemicals has dramatically reduced
the fertility of the soil, and higher and higher levels of inputs are needed to get the same
output. The yields have stagnated, and in some cases - like rice - are going down. Pests have
increased, and crops like cotton have been devastated. The two states have been locked into
virtual mono-cropping of rice and wheat. Attempts to change the cropping pattern are not
working due to a combination of economic, ecological and political reasons. The farmer is
caught in a pincer as the costs of inputs are mounting, and the price of the output is not
keeping pace. Indebtedness is rising among the fanners and the small farmers are hardest hit.
!
' isi.
A Journey into the Realm of Bhakra
XXV
There is pressure on the Government to cut the subs lies that manage to support much of the
j ’ ‘have
~ resorted’ to committing
system. The crisis is so serious that number of farme
farmc s> ‘in ~
Punjab
suicide. Suicides of farmers in the state where farm g is supposed to be most prosperous in
the country is an indicator of the gravity of the situati i and an omen.
At one village, we asked to talk to the landless fami js. We were again and again brought to
people with lands. When we repeated our request - e were told that these people have only
1-2 acies of land, and hence are as good as landless, j us, there could be no bigger indicators
of the crisis of agriculture than the suicides of farmer and this.
One would have thought that in states considei d to be the pinnacle of agricultural
achievement and prosperity, in the land of Bhakra, a riculture would be so rich that 1-2 acres
would be enough for a person to live well. But it is nc so.
There is little doubt that the agriculture and the far ers of the two states are paying a high
price tor the short burst of prosperity. Agriculture in ic state has lost the resilience to take on
new challenges. Both the economic, and ecologiJ 1 foundations of the agriculture have
become shaky. The system has become highly vulner )le to outside shocks. Ecological shocks
are already being felt, as are economic. And the W D is waiting in the wings to administer
blows which will be impossible for this system to t; :e. In both states, farmers, analysts and
social activists expressed grave fears that if the rr limum support prices were withdrawn
under the pressure of WTO, and they were forced > sell at market price, lakhs of farmers
would be rendered bankrupt.
1 his of course, is a part of the larger crisis of agricul ire. Punjab and Haryana are the furthest
down this path to agricultural “prosperity”, and h ice have reached the end of the path
earliest. Others on the same path can but reach the s: ne end. But if the “magnificent” Bhakra
project has not protected the two states against this, tl n this is food for thought. Our study has
shown that in this model, there will be a short-lived b rst of prosperity, followed by long-term,
permanent devastation. Somewhat like a supernova.
Unfortunately, at the official level, there seems to be ittle understanding of, or willingness to
address the root causes. The Punjab Government set ) a committee to address the agricultural
crisis in the state which gave its report in the year 2C 2. It is known after its Chair as the Johl
( ommittee. The main thrust of the report is that the roblem of Punjab is that of plenty. It is
locked into the wheat-rice cycle and produces sue! abundance that it is difficult to find a
market for it. The proposed solution? State subsidy i the fanners to stop growing wheat and
rice on about 1 million ha - to be given even if they d not grow anything.
1 he report exposes one of the most important dim nsions of the food problem in India. It
icveals the reason behind the fact that even as we tj mpet that we are now self-sufficient in
food, that we now export food, millions still go hungi in the country. We quote:
"India has accumulated huge stocks of food; ains that are not finding market and are
proving to be a heavy drain on the state exc equer and the government is obliged to
purchase substantial new arrivals at higher i id higher prices ever)' season under the
system of Minimum Support Prices. Althou h as per the nutritional requirements of
the Indian population, these stocks may noi je considered in excess, yet due to the
lack of purchasing power with the poor, sup[ / exceeds demand....”
This lack of the purchasing power is the main reason or the perversity of huge food stocks, of
expons at subsidised prices even as millionss go ungry. And the roots of the lack 'of
purchasing power go deep to the strategy of selectivi , intensification and centralisation. The
roots go back to the strategy of the separation of th< means to achieve the two objectives of
increasing production and the subsequent equitable < stribution- the strategy of concentrating
inputs, resources and investments in small areas to ir rease production and then hope that the
rest can buy this production. But buy with what? ;ince this approach creates purchasing
3^1 !S3T'tT^tt
xxvi
Unravelling Bhakra
capacity only in pockets. Big dams like Bhakra exemplify the unfolding of this strategy on the
ground, as they concentrate benefits in selected areas.
Unfortunately, we are not learning from these developments in Punjab; a similar situation is
rapidly developing in the economy in the other sectors. Under the policies of globalisation,
liberalisation and privatisation, we are having high rates of growth - but without growth in
employment. The same mistake - of jobless growth; we should be ready for the same'results.
Fortunately, we also found a number of people in Punjab and Haryana thinking along more
fundamental lines. And therein lies hope. We found groups worrying about the impacts of the
large-scale use of chemicals and pesticides. We found people who are concerned about the soil
degradation due to excessive chemical input and are trying to create a shift to organic
agriculture. We found people trying to document and revive traditional water resources, tanks
and ponds. Villages like Sukho Majri show how local water harvesting, diversity of cropping
and use of organic inputs can lead to high yields and minimum debts for the farmers.
When we travelled in Punjab and Haryana, we heard the desperation in the people’s voices.
Some farmers also told us - when the country needed us, we were there to help the country
produce food. Now that we are in trouble - will the country not help us? Even if our report just
leads to an answer in affirmative to this question, we will feel that our efforts have not been in
vain.
Il would be incomplete to end the tale of this journey without a word about the other
discoveries we made - almost as a sort of a by product but probably equally valuable.
The first thing we came across, and something that was a constant all along the way has been
the wonderful. warm and generous hospitality of the people of Punjab, Haryana and Himachal.
And this is not just our friends but everyone. Complete strangers welcomed us into their
homes, fed us «superbly, and shared their life experiences with us. The latter especially has
been a privilege.
\Ve discovered why the simple traditional meal of makke-ki-roli sarson-da-saag ranks among
the most wonderful food in the world - even though the makka may no longer be growing so
much, replaced by wheat and rice. We realised the true meaning of the lassi and paratha and that what we called by these names back home were poor country cousins.
We found out that music in Punjab is much more than ilballe balle" or the more recent “Timuk
Tunuk ’ as we were introduced to the mellifluous songs of Asa Singh Mastana, Surinder Kaur
and others.
We also came across some not so pleasant facts - the low female: male ratio in Punjab to
name one. Or, the striking absence of women in the markets of the small towns of Haryana an indicator of their role and status.
We found the obsession with "foreign" in the Doab region to be just as the stories have it.
Almost every family from this region of Punjab seems to have a member abroad. It was also
later given to us as a reason why th6 farming families are able to make ends meet here.
Two stops on our journey are particularly memorable. One was at Khatkad Kalan - a brief
stop on the way from Ludhiana to Bhakra, to pay a visit to the birth place and home of Shahid
Bhagat Singh. The other was at the Gurudwara at Anandpur Sahib, where, apart from other
things, the lunch at the langaar reminded us that the generosity and hospitality of the Sikhs is
not restricted to individuals but extends to the community.
All these not only made our journey so much more enjoyable and pleasant, it also offered to us
insights into famous entrepreneurial spirit of the Punjab (and Haryana) farmer, and the culture
and society in which the subject of our study is placed.
A Journey into the Realm of Bhakra
xxvii
Yet, we have come away with a sense of despondency. Tl i crisis we saw in the agriculture is
very real, and deep. And it is not just going to be restrict d to the two states, but is likely to
engulf much of the country. No farmer we met was untou ied by it, and no one could refrain
from referring to it. Before we embark on the details < this journey of ours in the next
chapters, as a reminder of our mission, of what we found we can do no better than end with
two quotes - one. from an official, the other from a farmer
Report of the S.S. Johl Committee, Government of Punjab, Jet. 2002:
On the other side, continuous production of whe t and rice in annual rotation in the
irrigated areas of Punjab is having a deleterious ef •■ct on soil, water, environment and
social fabric of the state. Soils of Punjab have b :ome virtually a laboratory culture
that requires higher and higher doses of fertilise i, micronutrients, insecticides and
pesticides to produce same level of wheat and /or ice. This has resulted in declining
total factor productivity. The situation is becom ig very serious day by day which
can ver)' soon proved to be economically disastroi , socially untenable and politically
unsustainable, which can turn into man-made r tional calamity if not dealt with
judiciously.”
Sardar Gurmail Singh, Village Bada, District Ropar:
All that you can see around in Punjab [the prosp rity] all that you have heard about
it, please do not believe it. Things are not what th / seem. Punjab is on the brink...”
JeZ
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