Yamuna Pushta resident Arun Kumar Jha sits on a footpath across from Ring Road in Delhi / credit: Parva Dubey
DELHI, India—Rohit Sharma stood on the spot where, more than a fortnight ago, he had a bed in a night shelter. After having traveled more than 650 miles from his home city of Patna, Sharma lived for the past four years in a shelter the Delhi Urban Shelter Improvement Board (DUSIB) had provided.
“I used to get picked up from here for work. I would then come back and sleep here. This was my home,” said Sharma, who works in the tent-fitting industry. “Most of us fix tents or work for caterers for different occasions, like marriage or religious programs.”
Yet, everything changed on the night of March 9. That’s when bulldozers, in the presence of police, demolished temporary shelters, according to homeless people like Sharma. Now, he, along with about 1,200 people who used to live in four night shelters, sit under the sky. The site of the former shelter is close to the interstate bus terminus (ISBT) at Kashmere Gate, the northern entrance to the historic walled city of Old Delhi.
Map of Yamuna River flowing through Delhi National Capital Territory / credit: Google Maps
Displacing the Poor Ahead of G20 Summit
Activists and the affected said current demolitions are part of preparations for the Group of Twenty (G20) Summit that the capital city of New Delhi is preparing to host in September. G20 is an intergovernmental group made up of 19 countries plus the European Union. Altogether, the G20 represents two-thirds of the world’s population. Its stated aim is to address global economic issues. Indian Prime Minister Narendra Modi became its chairman last year.
Past G20 summits had been met with protests from both anti-globalization movements and groups opposing the displacement of society’s poorest to make way for a summit venue. Such was the case in 2010 in Toronto, Canada, and in 2017 in Hamburg, Germany, for example.
Similarly, before Donald Trump visited India in 2020 as the president of the United States, the huts of poor families were demolished around the venue to host him in Gujarat state in western India.
Estimates of 100,000 to more than 300,000 people live in Yamuna Pushta, where India’s largest reported slum developed in flood-prone conditions along the banks of the Yamuna River flowing through Delhi, India’s National Capital Territory (NCT).
Demolished shelter in Yamuna Pushta in Delhi near a crematorium known as Nigam Bodhi Ghat / credit: Parva Dubey
Destroying Livelihoods
Since the demolition drive in Delhi began, poor and working-class people said police have been trying to ensure they do not linger in the area where they normally wait to secure gigs for the day.
“They take us in a bus forcefully and drop us at a distance from here and ask us not to come back,” Sharma said, adding, “We find work at this place. Contractors come here and pick us up from here. Where else would we find work?”
The location to which homeless people must be moved is supposed to be “close to where they are concentrated and close to the work site as far as practicable,” as per Indian Ministry of Housing and Urban Affairs’ Revised Operational Guidelines for Scheme of Shelter for Urban Homeless under Deendayal Antyodaya Yojana-National Urban Livelihood Mission (DAY-NULM).
However, the affected said they will struggle to find work after being forced to move.
“I have been working for the cause of the homeless for more than 20 years now. Governments never rehabilitate any homeless, like they claim to do,” alleged social activist Sunil Kumar Aledia, who is National Convenor for Homeless Housing Rights (NFHHR).
Yamuna Pushta resident Rohit Sharma (standing, in a pink shirt) on the spot where his bed once lay before a night shelter was demolished / credit: Parva Dubey
Bulldozing Homes
Aledia filed a Public Interest Litigation (PIL) in the Supreme Court of India on March 3.
“We approached the Supreme Court as the demolition drive was going on in other places, and we did not want other temporary shelters to be demolished,” Aledia said.
But, before the court could take up the matter, Delhi Urban Shelter Improvement Board (DUSIB) razed the shelters.
“We were sleeping when the authorities came with bulldozers. They did not tell us the reason for demolishing our home,” Sharma told Toward Freedom. “Some of the inhabitants were manhandled by the police.”
Little information is available about the source of the demolition drive. NCT Urban Development Minister Saurabh Bharadwaj wrote to DUSIB on March 16, inquiring under whose direction the action was taken. The letter that the Times of India obtained stated:
“Director DUSIB has given a statement in the social media that the demolition has been carried out on the orders of Govt. of NCT, Delhi. DUSIB may kindly specify who in Delhi Govt. has given these directions? And whether these orders were recorded or merely oral?”
DUSIB remains mum.
“The matter is sub judice in the Supreme Court, and it wouldn’t be appropriate to comment at this stage,” P.K. Jha, an official of DUSIB, told Toward Freedom. Sub judice describes a matter under a court’s consideration and, therefore, official commentary is prohibited.
‘We Only Need Food and a Make-Do Shelter’
“Some big event is going to take place here. That’s why they broke this shelter,” said Arun Kumar Jha, another occupant of the night shelter, sitting on the footpath across the road. He frequents different night shelters in the area.
Dozens of homeless still sit in the place where their shelter was until a few weeks ago. They have always relied on voluntary organizations, temples and individuals for food. Across the road, approximately 300 meters (328 yards) away from the shelter is a revered Hanuman Temple. Hanuman is a Hindu god with the face of a monkey known for his devotion via service. The homeless crowd outside the temple has increased after the demolition. They find it easier to find food and money from worshippers visiting the temple.
“Food is not a problem here, many people come and serve us, that’s why we (homeless) do not want to leave this place. We only need food and a make-do shelter,” Jha told Toward Freedom. “Government takes us in a bus from here, but never provides food.”
Parva Dubey is a freelance writer based in New Delhi. Parva can be followed on Twitter at @ParvaDubey.
A coastal village in the Indian state of Andhra Pradesh. While the poorest of the world will be the hardest hit by climate change, the wealthiest countries struck down at COP26 the possibility of compensating for related losses and damages / credit: Rishika Pardikar
What left many grumbling at the 26th meeting of the Conference of Parties (COP26) held in November in Glasgow was rich countries like the United States and those in the European Union striking down the Glasgow Loss and Damage Facility, a body created to address how to compensate developing countries for climate change-related losses and damages. Wealthy countries have been found to be most responsible for causing the climate crisis and face litigation as well as ensuing liabilities and payouts.
But the demand to recognize loss and damage remains alive. A good indication being many climate-vulnerable developing countries have referenced loss and damage in their Nationally Determined Contributions (NDCs). Under the 2015 Paris Agreement, countries are required to submit NDCs to detail their national action to address global climate change, including steps to adapt to a changing climate and the form of financial assistance needed to undertake such action.
A geotextile tube (engineered coastal defense mechanism) located in the state of Odisha, along India’s eastern coast, to keep out rising sea levels caused by climate change / credit: Rishika Pardikar
Small-Income and Developing Countries Hard Hit
A report published in October, 2021 found one-third of the 250 NDCs that were analyzed explicitly mentioned loss and damage. Most were from small-island developing states and least developed countries in the Asia-Pacific, Latin America and the Caribbean. The report was supported by the European Research Council’s Politics of Climate Change Loss and Damage (CCLAD) project.
“NDCs are political documents and not just technical submissions [under the Paris Agreement],” said Elisa Calliari, a co-author of the report.
Developed countries tend to focus on mitigation action, like the deployment of renewable energy. But that hasn’t been the case for the majority of the world’s states.
“Developing countries have pushed hard for the inclusion of adaptation in NDCs because, for them, this is more of a priority than mitigation,” Calliari pointed out. “So you can see the politics.”
For people living in an island nation like Sri Lanka, “key loss and damage impacts are felt in food systems and other vulnerable sectors, like the coastal and marine sector and water resources. These impacts have already resulted in migration interlinked with or induced by climate change among vulnerable communities,” said Vositha Wijenayake, executive director of the SLYCAN Trust, a non-profit think tank working in Asia, Africa and Europe. Its work focuses on climate change, biodiversity and ecosystems, sustainable development, and social justice.
Sri Lanka is classified as a lower-middle income/developing country. Given that it is also an island, its exposure to climate-related risks is high. These two factors make it extremely vulnerable to climate impacts and the ability to withstand them.
So, Wijenayake added, it is important for countries most vulnerable to climate change that loss and damage is a “key component” in addressing climate change processes, both negotiations and climate action. And this is why Sri Lanka was among the first countries to have a separate section allocated to loss and damage commitments included in its first NDCs submitted in September 2016. Building on this, the updated NDC of Sri Lanka submitted last July includes a separate section on loss and damage.
Interestingly, the report says upper-income countries like Costa Rica, Chile and Uruguay also have cited loss and damage in their NDCs.
And outside of NDCs, many developing countries have explicitly stated loss- and damage-related demands. For instance, consider India’s environment ministry laying out ahead of COP26, “There should be a compensation for expenses incurred, and it should be borne by developed nations.”
An island created by rising sea levels off the coast of Mirissa in Sri Lanka / credit: Youhana Nassif on Unsplash
How to Fund Loss and Damage
A question that usually rears its head with respect to addressing loss and damage is how to “operationalize” it, or what processes and institutions could be set up at the global and national levels to address loss and damage.
“[One way would be] to look at NDCs for a bottom-up approach to understand how countries themselves are looking at loss and damage,” Calliari said.
Of the NDCs that explicitly mention loss and damage, around half specify loss- and damage-related responses and initiatives like data gathering, analysis and assessment, and institutional capacities to address loss and damage. For example, Sri Lanka’s NDC has a whole section on loss and damage. It mentions strengthening its weather and climate forecasting systems, plus improving data management to record loss and damage. Meanwhile, Honduras’ NDC puts forth a “gender-responsive agricultural insurance mechanism for loss and damage.”
Wijenayake also stressed “inclusive and participatory processes,” in which the voices of those vulnerable to climate change are taken into account in the national and international policy-making processes. As is “ground-level implementation,” she added.
And so, country-specific NDCs could potentially be a good starting point to determine how to put mechanisms in place to address loss and damage on a global scale.
The other gap that exists today is how finance can be mobilized to fund efforts that compensate for climate change-related loss and damage. A recent study by the Stockholm Environment Institute offers potential solutions.
The researchers propose finance should be provided based on the following:
Solidarity,
“polluter pays” principle that is based on “historical responsibility,” and
CBDR-RC means that while climate change is a shared concern, rich countries with a history of emitting carbon—like the United States and those in Europe—have a greater responsibility to take climate action than the poorer countries.
The “polluter pays” principle has only been used to hold fossil fuel companies accountable for environmental destruction. It implies more strict liabilities than “historical responsibilities,” which outlines broad principles based on past emissions.
The authors stress a combined approach that deploys the principles of solidarity, polluter pays and historical responsibility, as well as using the framework of CBDR-RC, to finance loss and damage.
A strictly liability-based approach would be “politically infeasible and communities cannot wait for years to prove the liability,” said Zoha Shawoo, an associate scientist at the Stockholm Environment Institute as well as one of the authors of the SEI report.
The research team also looked at methods of recovery and rehabilitation that communities would need after financing efforts to cover losses and damages. Those efforts can include planning the relocation of communities, assisting with migration and providing affected people with alternative livelihoods. Here, too, NDCs could help with granular details like national-level entities and processes that could assist local communities with issues like displacement and loss of livelihood.
Rishika Pardikar is a freelance journalist in Bangalore, India. She had reported for Toward Freedom from COP26 in Glasgow.
Kastura Chougule holding her son’s sledgehammer, which remains his last memory / credit: Sanket Jain
Kastura Chougule couldn’t sleep despite having worked 15 hours in the field.
“I was exhausted, but something didn’t feel right,” she recollected. It was half past midnight. Small, shriveled and in her early 70s, Chougule managed to muster enough strength to stretch her muscles and quickly walk toward the adjoining tin shanty.
Her son, Vijay, was sitting on the floor, covering his entire forehead with his hands.
“What’s wrong, son? What’s bothering you?” she asked in the vernacular Marathi language.
Vijay, in his mid-30s, didn’t reply, nor was he aware she had entered the room. After she asked multiple times, he replied, “Go to sleep. It’s too late.” It was the last his mother would see him. By nine in the morning, family members wondered why Vijay hadn’t woken up yet. By the time they had rushed to the house, Vijay, a stone cutter from the western Indian state of Maharashtra’s Jambhali village, was found hanging inside his shanty.
Climate change impacts such as floods, heat waves, cyclones, landslides and other disasters have made more than 5 million hectares of land (12.3 million acres) unusable, pushing more people into poverty across India / credit: Sanket Jain
Economy Grows, While Poor Left Behind
Vijay was one of 153,052 people who died by suicide in 2020. A year later, this number increased by 7 percent to 164,033 suicides, as per India’s National Crime Records Bureau (NCRB) which releases suicide figures every year. This marked the highest annual count since 1967, the year the NCRB began recording. India also witnessed a 10 percent increase in suicides between 2019 and 2020.
Last month, however, India became the fifth-largest economy, overtaking the United Kingdom. However, a United Nations Development Program (UNDP) report released in the same week found India ranked 132nd out of 191 countries on the Human Development Index. It has slipped to two spots since 2020.
Moreover, for the first time, daily wage laborers comprised more than 25 percent of suicide cases. In 2014, they made up only 12 percent of suicides, which means this portion of the Indian population’s suicides has increased by 113 percent.
Within the first month of India’s nationwide lockdown starting March 2020, 122 million people lost their jobs, estimated the Centre for Monitoring Indian Economy, a private company. Daily wage laborers and small traders comprised roughly 75 percent. A report found that a year of the lockdown pushed 230 million Indians into poverty. By the end of 2020, 15 million workers were still out of jobs, including Vijay.
Shrirang Chougule, holding his son’s photo: “Even today, I can’t believe my son who was so strong and gave all of us hope died by suicide.” / credit: Sanket Jain
‘We Never Imagined Life Would Break Him So Much’
“Ever since the lockdown, he was home most of the time. Moreover, construction work came to a halt in most places, which further affected his work,” says his father, Shrirang, who’s in his early 80s now.
Vijay left behind his sledge hammer, which weighs much more than what Kastura can lift.
“This is my son’s last sign,” she says tearfully. She spends most of the time staring at the ten kilograms (22 pounds) hammer.
“Suicide was the last thing he would contemplate,” she says. “For all of us, he was a support system, and we never imagined life would break him so much.”
Inside a crematorium in Maharashtra’s Kolhapur district in 2021. As per India’s National Crime Records Bureau (NCRB), 164,033 people died by suicide in 2021, a 17-percent increase since 2019 / credit: Sanket Jain
What Drove Vijay to Suicide?
A daily wage earner, he earned roughly 300 Indian Rupees ($3.50) for 10 hours of work breaking stones and boulders. He would hoist his hammer at least 4,000 times a day.
“For 6 to 7 months, he didn’t get enough work, which stressed him tremendously,” said his niece, Manisha, 22. When India lifted its nationwide lockdown after 67 days, Vijay found a few days’ work. “While using a tile cutter machine, he met with an accident and lost one of his fingers,” Manisha said.
This was a major blow as he found it extremely difficult to work now. “The task of breaking boulders using a mere hammer comes with no security, and he ended up permanently injuring one of his fingers a year before,” Shrirang said.
Still, Vijay tried breaking stones but couldn’t work with his previous intensity. Further, local lockdowns brought an end to whatever bare minimum work he got.
To undergo surgery for his fingers, he took out a medical loan of 200,000 Rupees ($2,500). “After this surgery, he wasn’t the same. He rarely spoke,” Manisha said. Two months later, he was diagnosed with severe dengue which permanently broke him.
“A few days before the suicide, he told me, ‘What’s the point of living now?’” Shrirang recounted, adding he tried every possible way to convince Vijay not to give up. “I even told him I would help him start a new business.”
Lawyer Amol Naik (brown shirt) has been unionizing daily wage laborers and farmers in India’s Maharashtra state to press for better policies that protect workers / credit: Sanket Jain
‘A Much Larger Problem’
The World Inequality Report 2022 mentioned the top 10 percent in India hold 57 percent of the national wealth, while the bottom 50 percent merely own 13 percent. “India stands out as a poor and very unequal country, with an affluent elite,” the report remarked.
“The stark inequality talks of a much larger problem,” says Amol Naik, a lawyer who is a member of All India Kisan Sabha, the farmers’ wing of the Communist Party of India (Marxist). “With the rapid increase in privatization, many public schools, hospitals and other important institutions that serve the poor have been completely destroyed. Moreover, with the rising inflation, the daily wage earners are caught in a tremendous debt cycle, with no support system.”
Further, in 2021, climate change impacts such as floods, heat waves, cyclones, landslides and other disasters have made more than 5 million hectares of land (12.3 million acres) unusable, pushing more people into poverty.
Vimal Ugale, in her 70s, does farm work to make ends meet. “Even today, I don’t know why my son thought of suicide.” / credit: Sanket Jain
Inadequate Mental Healthcare
In September 2021, Vishal Ugale told his sister that he wanted to rest for a while, so that he could leave for work in the evening. However, he never went to work.
The Ugale family had gathered to celebrate an auspicious occasion at 5:30 p.m.
“We were all dialing Vishal to start the auspicious ceremony, but he wouldn’t take our calls,” recalled his mother, Vimal Ugale. No one knew what exactly had happened.
“A few hours later, it was found that Vishal died by suicide in a public veterinary hospital,” said his sister, Savita Khondre.
A resident of Jambhali village in Maharashtra’s Kolhapur district, Vishal tended furnaces in factories and textile mills. “This work often affected him so much that he drank alcohol occasionally to forget his stress,” said Savita. “But since COVID, he started drinking quite frequently.”
Ugale, a farmworker in her early 70s, said she never knew the reason behind his suicide.
“Every few weeks, he would frustratingly say, ‘Why was I born in this household? I don’t want to live anymore,’” she recounted.
Ugale often spent hours talking to Vishal, asking what help he needed. But he wouldn’t say a word.
Flood-affected daily-wage laborers and farmworkers protesting against the rapidly rising cost of living and inflation in Maharashtra’s Shirol block / credit: Sanket Jain
The Taboo of Mental-Health Care
Vishal became more stressed after COVID induced lockdowns, said Khondre. Jambhali, which has a population of roughly 5,000 people, reported more than seven suicides in 2021, as per official records from the village sub-center. A sub-center is the first point of public healthcare for community members.
“Mostly people talk to us about physical illnesses,” said medical officer Dr. Vasanti Patil, under whose care this village falls. “They never mention mental-health problems because it is still considered a taboo in the villages.”
During the lockdown, she observed deteriorating mental health among several villagers, especially the ones who owed loans. “There are so many cases of rising debt, and with dwindling work during COVID, many people were stressed, which further affected them,” she said.
For a population of 1.3 billion people, India has 9,000 psychiatrists and 1,000 psychologists, as per research published in the Indian Journal of Psychiatry. That comes to 1 mental-health professional for every 130,000 Indians.
“Many villages don’t have adequate mental healthcare facilities, leaving people alone, further pushing them [to] the brink of suicide,” shared Naik, who has organized several protests in Maharashtra’s Kolhapur district and also accompanied many protests that marched to Mumbai, the country’s financial capital, to draw attention to the plight of farm workers and daily-wage laborers. “During these protests, almost everyone talks of the rising stress and the rapidly increasing cost of living.”
During the first wave of COVID, India witnessed a large-scale reverse migration, whereby workers returned to villages because they either had lost jobs or had no work. Many daily-wage laborers walked hundreds of miles to reach their villages.
“However, there wasn’t much work in the fields, and many people had no option to earn enough, further stressing them. During this time, the cases of substance abuse increased rapidly,” says community healthcare worker Bharti Kamble.
In her Bolakewadi village of Maharashtra, over half of the villagers migrate to India’s financial capital—Mumbai, working as daily-wage laborers. “All of these factors impacted almost everyone’s mental health.”
Ugale still thinks about what affected her son so much. She has spent several hours talking to Vishal’s friends. But, so far, she hasn’t found anything concrete.
“He left us with many questions, to which we won’t be able to find answers in an entire lifetime.”
If you are experiencing suicidal thoughts or know someone who needs help, please call India’s 24-hour, toll-free national mental-health helpline dubbed “Kiran” at 1 (800) 599-0019 or any of these helplines near you. For the United States, dial 988.
Sanket Jain is an independent journalist based in the Kolhapur district of the western Indian state of Maharashtra. He was a 2019 People’s Archive of Rural India fellow, for which he documented vanishing art forms in the Indian countryside. He has written for Baffler, Progressive Magazine, Counterpunch, Byline Times, The National, Popula, Media Co-op, Indian Express and several other publications.
Accredited Social Health Activist (ASHA) worker Kavita Magdum monitors the health of infants and children. Here, she weighs one of twins of Hasina Hajukhan / credit: Sanket Jain
Hasina Hajukhan never imagined that returning to her maternal house would turn into a near-death experience. In April, the 28-year-old was seven months pregnant, and her medical parameters were normal. “I was taking extra care to ensure no complications during childbirth,” she told Toward Freedom.
As is customary in many parts of India, pregnant women return to their parents’ homes to give birth. When Hajukhan first reached her mother’s house in Ganeshwadi village of the western Indian state of Maharashtra, she felt nauseated. “It was April’s final week, and I couldn’t even breathe properly,” she recounted. A heat wave had taken hold. “The climate was the stark opposite of what it was in my husband’s village.” In Ganeshwadi, things kept getting complicated with the rising heat. “Every day, I was breathless and would feel dizzy.”
Using a desk fan at the highest speed didn’t help, as it just circulated more hot air. An air conditioning system was something her family could not afford. The tin sheet roof would get extremely hot. During this crucial time, Hajukhan needed rest. However, she spent most of her day stepping out to gasp for cold air. In May’s final week, things got worse. “I felt as if I was going to die,” she recalled, teary-eyed.
Immediately, her mother dialed Ranjana Gavade, an accredited social health activist (ASHA worker), part of a community of 1 million women healthcare workers appointed for every 1,000 people in India’s villages. ASHAs are responsible for more than 70 healthcare tasks, with a particular focus on maternal and child health.
ASHA worker Shubhangi Kamble spends a significant amount of time each day talking to community women to help them understand the impact of climate change on children / credit: Sanket Jain
“I was worried looking at her rapidly deteriorating health and informed my colleagues.” Upon their instructions, Gavade called a government ambulance and swiftly took her to the district hospital, 33 kilometers (20.5 miles) away. Hajukhan gave birth to underweight twins. Her troubles still hadn’t ended when she was discharged after three days. For a month since then, Hajukhan has been trying to ensure her twins gain weight, but all efforts have failed. As a result, they weren’t administered the necessary Bacillus Calmette–Guérin (BCG vaccine used against tuberculosis), Hepatitis B, and Polio vaccines.
The Kolhapur district, where Hajukhan lives, has been reporting recurring floods, heat waves, incessant rainfall, and hailstorms triggered by climate change. She said everything would have been normal had she not returned to her parents’ home to give birth in the heat waves. “My children wouldn’t have had to live such a dangerous life,” she said.
Like in the village of Ganeshwadi, climate change impacts have been delaying children’s immunization schedules throughout India, making them vulnerable to diseases. Research has found that if a child belonged to a district highly vulnerable to climate change, the odds of stunting rose by 32 percent, low weight by 45 percent, anemia by 63 percent and acute malnutrition by 42 percent. An analysis by global nonprofit Save the Children found that, globally, 774 million children are living in poverty and at a high risk of climate-related disasters. Weather disasters ranging from floods to droughts prevent children from obtaining nourishment, causing low weight, and these disasters put a break on children receiving vaccinations on time. Their weakened immune systems, as a result of a lack of proper nourishment in crisis times, make them vulnerable to other diseases. Being sick can halt the necessary immunizations, and these delays have led to a rise in epidemics and diseases.
ASHA worker Shubhangi Kamble often works beyond her duty to ensure every child completes the universal immunization on time. Here, she speaks to a woman to help her understand how climate change can impact her son’s health / credit: Sanket Jain
How Floods Impact Universal Immunization
Snehal Kamble, 24, a resident of Maharashtra’s flood-prone Arjunwad village, remembers the year 2019 in meticulous detail. “A day before the floods, I was preparing to go to my parent’s house.” Five months pregnant, she was looking for iron folic acid tablets. “Instead, all of us went to a flood relief camp,” she recounted. From there, she moved to another relief camp within a few days, as the water rose further. “During this time, I was worried about my house and belongings,” she said. She fell sick and was away from home for 15 days. “Those were the most difficult days of my life,” she shared. Then in January 2020, she gave birth to a boy named Sangarsh, who has often fallen sick. “When I went to my maternal house, he just couldn’t bear the heat there,” she said. The dehydration and spells of fever he experienced affected his immunization schedule. “His Pentavalent vaccine was delayed by several months because of health ailments,” said ASHA worker Shubhangi Kamble (no relation to Snehal), who has been monitoring this child since birth.
Further, his Measles-Rubella vaccine and Vitamin A dose were also delayed, making him vulnerable to diseases. “Vaccines need to be administered on time,” said Sachin Kamble, a nursing officer at the district women’s hospital in Maharashtra’s Osmanabad district. “Otherwise, it affects a child’s immunity, making them more vulnerable to diseases.”
He pointed out how the lack of vaccinations led to 2,692 cases in 2022 in Maharashtra, which reported the highest measles count in India. That was an eight-fold increase from the previous year. During this time, India reported 12,773 cases. India’s National Family Health Survey (NFHS) said only 31.9 percent of children ages 24 months to 35 months had received a second dose of measles-containing vaccine in 2019-21.
Another healthcare worker, Kavita Magdum, from flood-affected Ganeshwadi village, said that children in her surveying area never fell ill so frequently. She started noticing such stark changes only in the past five years. Upon inspecting this, she found, “Stress caused by the changing climate is leading to this.” For instance, Magdum sees that many children aren’t drinking breast milk, which has impacted their medical parameters. These drastic changes reflect in Indian government statistics, as well. During 2015-16, 58.6 percent of children ages 6 months to 59 months (just under 5 years old) were anemic in India. By 2019-20, this number rose to 67.1 percent. In addition, 32 percent of children nationally remain underweight.
After a year-and-a-half, Snehal’s son started getting better, thanks to Shubhangi’s consistent visits, when she monitored every parameter and ensured the best possible treatment by working hours beyond her duty. “Once the vaccination schedule started falling in place, his health, too, began improving,” Shubhangi shared.
ASHA worker Ranjana Gavade frequently visits Hajukhan’s home to monitor the health of her children / credit: Sanket Jain
Untimely Administration of Vaccines
While climate change is making it difficult for these healthcare workers to complete universal immunization, another challenge is the untimely vaccine administration.
“There are many instances, where vaccines in several villages are just not available,” said Netradipa Patil, leader of more than 3,000 ASHA workers and co-founder of Deep-Maya Foundation, a non-profit that works for women and children. “During such times, it becomes extremely challenging for us healthcare workers to manage everyone.”
Patil has observed that the workload has increased tremendously for all the ASHA workers because of the delay in vaccination. This is because ASHA workers are responsible for immunization, and in case of any discrepancy or error, they are held accountable. Research published in 2016 concluded, “Lack of timely administration of key childhood vaccines, especially DPT3 (the three doses of the Diphtheria, Tetanus and Pertussis vaccine) and MCV (measles-containing vaccine), remains a major challenge in India and likely contributes to the significant burden of vaccine-preventable disease-related morbidity and mortality in children.” Another paper published in 2019 inferred, “The proportion of children with delayed vaccination is high in India.”
In 2021, the World Health Organization found that 25 million children around the world under the age of 1 didn’t receive vaccines, a figure not seen since 2009. “Many children never get the Vitamin A doses on time. These doses are just not available when required,” Patil said, suggesting the Indian government should consult local healthcare workers to arrange vaccination. “We need to reach more and more people, and, currently, looking at the changing climate, we aren’t prepared to do this,” she shared. Patil made simple suggestions like identifying vulnerable children and their locality and monitoring them from the earlier stages, even before the disaster strikes. “Just by proper identification, we can save so many children,” she said.
A woman playing with her child in Maharashtra’s Kolhapur district / credit: Sanket Jain
Rising Undernourishment
Fed up with feeding medications and tonics that didn’t seem to help increase his weight and prevent him from continually falling ill due to the changing weather conditions, Rashi Patil, 23, quit taking her son to the doctor every month after 18 months. “My son just wouldn’t eat anything,” Patil said.
Moreover, the changes in local climatic patterns affected her son’s health, and he often fell sick. Last year, he was hospitalized for a week as his platelets fell and a fever intensified. What followed next were recurring illnesses that delayed his immunization schedule. Because of the fever in March, he wasn’t administered the Pentavalent 1 vaccine (it protects from five life-threatening diseases: Diphtheria, Pertussis, Tetanus, Hepatitis B and Hib [Haemophilus Influenzae Type b]). Her son soon became weak and began recovering only after the vaccine’s administration. All this while, her son struggled with good eating habits. After several trials and errors, Rashi and her husband, Rajkumar, discovered the climate affected their son’s health and eating habits.
“Now, their son makes it a point to eat only outside the house, where he gets some cold air,” says Rashi. “Contrastingly, this was never the case with my elder daughter.”
Toward Freedom reached out to Ganeshwadi’s community health officer, Dr. Prajakta Gurav, regarding what steps her team was taking to deal with delayed immunization. Gurav hasn’t replied as of press time.
The impact of poor diets is more obvious at the national level. For instance, just 11.3 percent of children between the ages of 6 months and 23 months receive an adequate diet. Plus, in 2022, India ranked 107 out of 121 countries on the global hunger index. These numbers further reveal how climate change is exacerbating the existing faultlines.
The problem is not restricted to India. Of the countries at severe risk of being adversely affected by climate change, the report by Save the Children says, “Burundi has the highest rate of stunted children (54 percent), followed by Niger (47 percent), Yemen (46 percent), Papua New Guinea (43 percent), Mozambique (42 percent) and Madagascar (42 percent).”
Research published in PLOS Medicine found that in 22 sub-saharan African countries, drought led to lower chances of completion of BCG (Bacillus Calmette-Guérin), Polio and DPT (diphtheria, tetanus, and pertussis) vaccines. “We took vaccines to the last mile. Now, climate change is eroding progress.”
For Komal Kamble, 30, vaccinating her 2-year-old daughter remains challenging. Her remote mountainous village of Kerle, in Maharashtra’s Kolhapur district, remains inaccessible most of the year.
For the village population of less than 1,100 people, the nearest healthcare facility is 15 kilometers away. Last year, within a week of October rains, the road that connects her village to the nearest hospital was completely under floodwater.
Komal’s daughter couldn’t get proper medical care for two days, worsening her health. Her chest was full of cough, and the fever rose, making things difficult for the agrarian Kamble family. This wasn’t restricted to heavy rainfall, though. Since her birth in 2021, Komal has taken her daughter to a private doctor at least 20 times, spending over Rs 15,000 ($182). Last year, she was feverish and wasn’t given the crucial Japanese encephalitis vaccine, a Vitamin A dose and the Measles-Rubella vaccine. This made her vulnerable to more diseases, challenging the Kamble family.
Healthcare worker Shubhangi Kamble from Arjunwad says that instances of children missing their vaccination are rising rapidly. When she went to find out why this was happening in her village, Arjunwad, she saw that children fell sick during floods and heat waves. “This was the time that coincided with their vaccination schedule, and so many couldn’t get the vaccines,” she shared.
However, a delay in vaccination has caused more problems than she had anticipated.
“Almost every day, at least one parent dials me asking where they should get their children hospitalized,” she said.
Now, every rainfall brings a health issue for Komal’s daughter. “I am tired of going to the healthcare center to hear that my daughter is underweight or sick and can’t be given the vaccine,” Komal said, with frustration in her voice.
Meanwhile, with every climate disaster, it will become increasingly difficult for many families to complete the immunization in time. “I’ve been vaccinating children for over a decade, but things never got this difficult. We took vaccines to the last mile. Now, climate change is eroding progress,” said healthcare worker Kavita Magdum.
Sanket Jain is an independent journalist based in the Kolhapur district of the western Indian state of Maharashtra. He was a 2019 People’s Archive of Rural India fellow, for which he documented vanishing art forms in the Indian countryside. He has written for Baffler, Progressive Magazine, Counterpunch, Byline Times, The National, Popula, Media Co-op, Indian Express and several other publications.