by Abhishek Jha, PRIA
Very recently Government of Bihar, approved the implementation of centrally sponsored Health for Urban Poor program in the State.
Abhishek in the article below is sharing a ‘conversation’ with the urban poor community representative organisation – Settlement Improvement Committee (SIC) regarding the same scheme. PRIA has facilitated constitution of these SICs in various urban poor settlements across the country since 2012.
PRIA Facilitator: So finally you all should be congratulated as you have something to cheer for since the government of Bihar has finally approved the implementation of centrally sponsored health for urban poor scheme.
SIC member- Thank you sir, it is really good news for us that government is concerned about the health of urban poor now.
SICmember (2):It is not so good news, it is a complete hogwash by the government.
Facilitator: What makes you think so?
SIC member :I personally feel it is actually an effort by the government and its agencies to dissolve the burning issue of housing for the urban poor since they have failed to address it predominantly.
Everyone in chorus: Yes it’s true, even we think so; government is trying to fool us by doing so and launching programs like health for urban poor.
The chorus generates a bit of aggression among the people present in the meeting and they say “ if need be we can show it to the government how healthy are we by protesting and fighting against the government, which has failed straightaway to implement housing programs even after completing surveys several times.”
Taking the discussion further, people felt strongly that, even though they often use their hard earned money for addressing health issues, they have always have the options of visiting government hospitals as they live in a city and what the government is overlooking is addressing the root causes which work as catalysts for health issues among the urban poor.
If we diagnose the community discussion further, it is hard to term them wrong. The status of Water, Sanitation and Hygiene which are also termed as core basic services remains pathetic in these urban poverty pockets and undoubtedly these are the major factors which ultimately decides the health of urban poor. Defecating in open, or in unhygienic community toilets, drinking untreatedwater makes people vulnerable to a large extent towards diseases, which obviously needs to be addressed first instead of constructing Primary Health Centres (PHCs) in these settlements.
Apart from this, a sneak-peek in to previous centrally sponsored schemes (specifically addressing urban poverty) in the state will add more metal to the collective reasoning made by the community. Nationally sponsored schemes like BSUP, IHSPDP (under JnNURM) didn’t show very encouraging results in the state and very recent Rajiv AwasYojna (RAY) has failed to take off in the state till date. Unavailability of hindrance free land in the urban areas has been cited as one of the major reasons behind infectivity in implementation of these housing schemes. At the same time this forces us to rethink how government is planning to implement the construction of PHCs (for every 50,000 population in the city) when they see land as unavailable entity.