Another file for Mr Jethmalani

Medical advances, he argues, may not have contributed that much to the control of life-threatening infectious diseases as civic progress has. 8220;Tuberculosis, for example, was in drastic decline long before any effective medical treatment was possible or the bacillus responsible was even identified,8221; Ponting writes. 8220;By the time a vaccination was available, the death ratewas one-sixteenth of that experienced in the 1840s. For water-borne diseases such as cholera the crucial factor was not medical treatment but improved sanitation in cities.8221; Of course, Ponting is relating the experience of the western world, but we must not forget that it took the riots triggered by the 1831 cholera epidemic in Britain, followed by an adjournment of Parliament forced by the horrible stench emanating from the effluent-choked Thames in the summer of 1858, to awaken lawmakers to the logic of sanitation. It was then, more than a century and a quarter ago, Britain woke up to the first axiom of public hygiene: universal access to good sanitation is the best vaccine.

So, even as Parlia-ment was in suspended animation, London got a sewerage system, and cholera never returned. Unfortunately for us, our Parliament is a good half-hour drive away from the Yamuna, or for that matter, from the nearest JJ cluster8217;, which is what they call the worst form of human habitation in the Capital JJ, by theway, is the euphemistic cover for the rather plebeian-sounding jhuggi-jhompri!. Not surprisingly, even as we are on the threshold of the new millennium, a piffling 29 percent of our population has access to adequate sanitation.

That8217;s the average in our villages, a mere 14 percent enjoy this luxury. The percentage figure puts us behind even Bangladesh, our neighbour we like to think of as the basket-case of the world. And the rural percentage places us on a par with war-torn Cambodia. A fitting finale to our golden jubilee?My subject reminds me of a seminar on cholera I had attended some time back at the Indian National Science Academy. In what was meant to be a confluence of scientists, the issue that kept being raised by speaker after speaker was access to sanitation and safe drinking water.

One of them, Amit Ghosh of the Institute of Microbial Technology, Chandigarh, devoted much of his talk to the vaccine he and his colleagues are on the verge of perfecting, to the issue, which is critical to thepublic discourse on people8217;s health. Of the 3,119 cities and towns in the country, Ghosh reminded his audience, just 209 have sewage treatment facilities, which means the rivers and streams where the majority of Indians answer nature8217;s call, bathe, wash clothes and fetch water for the home, are choked with bacteria and virus, somewhat like Thames in the year 1831. And if 200 million litres of untreated sewage are pumped into the Yamuna every day, it is not Delhi8217;s problem alone.

Clearly, then, the nation8217;s health is not the concern of the Health Ministry alone, though bureaucrats who cannot look beyond their files would like it to be that way. Public health is an enterprise that cuts across departmental divisions, which is why the Urban Affairs Ministry must take the lead in making access to sanitation a national campaign.

Now that he8217;s set the cat of transparency among the pigeons of babudom, Urban Affairs Minister Ram Jethmalani will be doing a world of good if he flags off a debureaucratised NationalUrban Renewal Programme on New Year8217;s Day to provide every Indian living in cities easy access to community latrines linked to sewer lines that are not clogged; to cover all open drains that breed mosquitoes and malaria; to revive the post-plague enthusiasm for garbage removal by promoting community participation; and to reverse the current disparity in access to municipal water supply. In Chennai, where municipal water does not reach over 1.7 million people, for every municipal tap, there are 240 people depending entirely on it.Such depressing statistics remind me of Britain when Parliament had to shut shop because Thames stank, but that was a good 140 years ago. Victorian public administrators defined as overcrowded8217; those households where two adults and four children lived without access to their own water supply and sanitation.

Sounds like any JJ cluster8217; in the Capital? Well, the big difference is that we8217;re talking about the last century here, and still, just 16 percent of London householdsqualified for that opprobrious tag. No wonder no one is writing a definitive history of the Indian century. For we still live in the last century, which is why communicable diseases coupled with infant and maternal mortality account for a death rate that is four times that of China and 2.5 times that of the world average. Which brings me back to Ponting8217;s argument. We may have the vaccines and the multi-drug therapies, but we mustn8217;t forget that the western world brought down infectious disease rates much before these gained currency.