Here is what I wrote...
Smells from the Slaughterhouse
The epidemic of films, books, television programmes and travel brochures about India can't have gone unnoticed by anyone living in Britain during the past few years. In India, affluent western tourists travel from Agra's beautiful Taj Mahal to the pink city of Jaipur in air-conditioned coaches with smoked-glass windows. They stay in the country's luxury hotels or in the converted palaces of maharajahs, complete with billiard rooms, game trophies and willing servants. Tourists of this ilk, beckoned by the travel agents' counterfeit India, are carefully shielded from the non-marketable reality of poverty and ill health that pervades the lives of most Indian people.
Few tourists catch more than a passing glimpse of rural life, despite the fact that there are more than half a million villages, in which more than 80% of the population lives. Most villages have no electricity. A single well provides more or less polluted water for about a thousand people. Countless hand-moulded cakes of cow dung are plastered onto the walls of houses to dry in the sun. The dry dung fuels smokey stoves on which the villager's meagre food is cooked. Upper respiratory tract health problems are common. Village life is far from idyllic.
The enterprising villager, usually the young father, gets fed up after a while with the problems of rural survival and decides to try his luck in the city. Millions of people migrate to the already overcrowded urban centres of Calcutta, Bombay, Delhi or Madras. Arriving in the cities, they settle either on the pavements or in one of the slums that have become a permanent feature of every major Indian conurbation. Something like three hundred families arrive daily in Bombay. The slums continue to bulge. For a thousand rupees (£70) the local landowner will sell a plot of land 15 feet square. On this a family can erect its 'home' from sheet metal, plaited palm leaves, black polythene and wooden crates. Their new house will be surrounded by similar dwellings, from which it is separated only by an open, and usually full, gutter. The front door opens out onto one of the 'streets' of the slum. Six feet away, across the street, are more houses. In the street are two more open gutters, reservoirs of everything from goat droppings and rotting fruit to cholera and typhoid. Nothing drains away. Drainage, like privacy, does not exist in the slum.
I recently visited Dharavi, in western Bombay, said to be the biggest slum in the whole of Asia. In the 1960s it was the site of Bombay's largest slaughterhouse. The first settlers were either employed at the abbatoir or worked in associated trades as cobblers or tanners. Others busied themselves in the aromatic occupation of making soap from boiled bones and animal fat. The slum grew.Later, the slaughterhouse moved east to Chembur but Dharavi, having gathered momentum, continued to expand. By 1980, 200,000 people were living there in squatter settlements. By 1983, their numbers had doubled, while today the slum is reaching saturation point with more than 600,000 people in an area of one square mile. A small, private, illegal slaughterhouse still operates, its smells mingling with the smells of animal, vegetable and human waste.
Almost everyone who lives at Dharavi is from what the Indian government designates as the 'Scheduled Castes' (harijans or untouchables) or Scheduled Tribes. Many language groups are represented - Maharati, Tamil, Telegu, Gujerati, Kannada, Hindi, Muslims and Hindus share the same scarce amenities with Christians and Neo-Bhuddists. Other identifiable groupings also occur - one colony, for example, houses a community whose members specialise in picking pockets. From the many disturbing statistics relevant to Dharavi, two in particular highlight the chronic shortage of basic services - 330 people share each water tap, 250 each lavatory.
In 1982, a group of medical and social workers from the department of Preventive and Social Medicine at Bombay's Sion Hospital began a project, under the leadership of Dr. Gopa Kothari, to try to improve health and living conditions at Dharavi. Initially, the project focussed on the problem of xerophthalmia or 'blinding malnutrition', a condition caused by a lack of dietary vitamin A. Xerophthalmia accounts for more than 40,000 children becoming permanently blind in India every year. This work on xerophthalmia, sponsored by the Indian branch of the Royal Commonwealth Society for the Blind, resulted in the lowering of the 'xero' incidence at Dharavi to below WHO criteria by early 1984.
The project's work covers some 20,000 of the slum's 600,000 inhabitants. Funds come mostly from private donations, although the Bombay corporation supplies some drugs, while the government makes a small contribution. Activities include health and nutrition education, child weighing, immunisation,de-worming, supplementary feeding of severely malnourished children, treatment of infectious diseases and diarrhoea. Successful womens' groups and youth groups have been formed and schemes designed to generate income for women have been started with loans from the project's funds. Later this year, a group of medical students from Edinburgh university will be carrying out a survey of infant feeding practises at Dharavi, one of the aims of which is to help the resident health team to construct an effective programme to promote breast-feeding.
In the early days of the project problems arose because of peoples' beliefs in home remedies, soothsayers, witch doctors and evil spirits. Already malnourished children who contracted measles were starved; breast-feeding and fluid intake were stopped during bouts of diarrhoea; night blindness, an early sign of xerophthalmia, was thought to be the 'curse of God' rather than a medical condition. Attitudes towards the congenitally blind were callous - parents would try to get rid of the blind child by starvation during infancy.
Some of these obstacles have been overcome and many of the results are encouraging. Fewer children now suffer from Grade III malnutrition, the majority have received vitamin A, immunisation status has improved, 400 people have been supplied with spectacles...But, as Dr. Kothari herself points out, there is a massive amount of work still to be done. Every day a stream of mothers arrives at the project's Urban Health Centre, carrying their listless, undernourished babies to be seen briefly by a handful of overworked doctors and nurses.
Looking out from an upstairs window at the health centre, the closely packed roofs of the slum dominate the view. In a consulting room a small child defecates a thin yellow liquid on the floor while the doctor examines its mother. Another woman walks disconsolately out of the door. She does not know her own age, is unable to read even the simplest words and has recently arrived in Dharavi from a village she can only describe as being two days by bus from New Delhi. She holds the thin arm of her three year old son, his legs bent into such exaggerated curves by ricketts that he can hardly walk unaided.
They return to the humid, suffocating heat outside. The aroma of the slaughterhouse wafts upwards, along with the smells of 600,000 human beings. There are no maharajahs palaces, no fading photographs of the Raj, no tiger skin rugs and no inlaid marble floors. Not even, incredibly, any building except the health centre with more than one storey. Just the desperate reality of life experienced by people still sufferring their colonial inheritance, trapped in the vicious circle of poverty and disease.
That Was Then...
So, that's what I wrote in 1985. Around that time, I had been reading several books about India and about urban health. Firstly, there were the two books by V.S.Naipaul - 'An Area of Darkness' and 'India: A Wounded Civilisation'. These titles, on their own, conveyed something of Naipaul's first visits to the subcontinent. He was shocked to see people shitting at the roadside and did not hesitate to say so. He was dismayed at the filth and squalor he saw on his way into town from the airport, passing, no doubt, not far from Dharavi. Naipaul is a great no-holds-barred observer and, for me, these two short books have a personal significance as they were the first ones I ever read about India. When 'An Area of Darkness' was published, in 1966, it caused quite a stir, such that Naipaul's name was mud among middle class Indians for many years afterwards. He did not increase his popularity when 'India: A Wounded Civilisation' was published in 1977. His third non-fiction book about India, 'India: A Million Mutinies Now' continued in much the same unromanticised vein. Throughout the trilogy he spoke a truth very different from the commercialised, globalised version of India promoted by
those who have a vested interest in a false image of Indian reality.
The great Guardian journalist and writer, James Cameron, in his book 'An Indian Summer', first published in 1974, describes a scene reminiscent of early morning life at Dharavi. He writes "On the empty scrub by the roadside and along the creek were half a dozen squatting figures, concerned with the morning evacuation of their bowels. In half a mile they had become a score, and then hundreds; the further we drove the longer and more densely packed were the lines of citizens on their haunches, dhotis gathered up, rapt and concentrated on the pleasurable business of defecation. It would appear that the urge had come simultaneously to the whole suburban population. Very soon the line of squatters had dragged out for miles, as though assembled to watch some parade. For some it would seem to be a convenient occasion for meditation, or even for forty winks; for others this great communal shitting-time was clearly a social activity, they shuffled sideways to approach one another, chattering and waving limp fingers. It is true they faced the roadway; the spectacle would otherwise have been perhaps even more disturbing."
In the same book, Cameron makes the point that it is difficult to photograph or film very poor people without making their poverty appear attractive. He writes "it was difficult indeed to film anything in India without some element of the strange and beautiful intruding". Referring to a television documentary he made in Calcutta (Kolkata), Cameron also observes that "every square centimetre of the frame was an image of despair, yet it had a compelling, irresistable beauty. It just is a fact that poverty is picturesque..."
Around this time I also read a book by another journalist, Jeremy Seabrook, entitled 'Life and Labour in a Bombay slum'. The book, published in 1987, focussed on the Indiranagar slum and provides an informative account of life there. In particular, Seabrook describes the various kinds of work that the slum dwellers have to carry out in order to survive. More recently, I have read an excellent book called 'Planet of Slums' by Mike Davis. I'd recommend it to anyone interested in an overview of global urbanisation as it affects the poorest people.
I looked up Dharavi on Wikipedia recently. It reminded me that Dharavi was originally a mangrove swamp next to a smelly waterway known as Mahim Creek. The creek flows into the Arabian Sea, taking with it as it does so some of Dharavi's human waste. Some of the statistics seem even worse now than when I was there. One source, for example, estimates that there are now one million people living at Dharavi and that "as of November 2006 there was only one toilet per 1440 residents". It is not hard to see why the squatting figures line the roadside and the creek.
Saving Sight with Pictures
In 1985 I wrote to Dr. (Mrs.) Gopa Kothari at the NAB Fazalbhoy Centre for Eye Care in Bombay. Dr. Kothari was the Honorary Director of the Royal Commonwealth Society for the Blind (RCSB) Dharavi Project. The RCSB is now called 'Sightsavers'. The Dharavi Project was part of the 'Programme for the Prevention of Blinding Malnutrition in Children'.
Through correspondence we agreed that it would be a good idea to try to develop images, visual aids, that could be used by community health workers at Dharavi to help communicate about vitamin A deficiency and its prevention. The notion that sight could be saved with the help of pictures certainly appealed to me, as an artist.
One of the consequences of vitaminb A deficiency is the deterioration of a person's eye health, resulting in a condition called 'xerophthalmia'. The process of deterioration involves a number of recognisable stages. To begin with, the person experiences 'night blindness'. Next comes corneal xerosis or dryness of the cornea. One of the health workers at Dharavi told me that "the lustre is lost" in the sufferer's eyes. Thirdly, tiny dark spots appear in the eye. These are known as 'Bitot spots' and result from the keratinisation of the superficial epithelial cells of the conjunctiva. Up to this point, the xerophthalmia is reversible if the sufferer takes several large doses of vitamin A, in concentrated form, by injection. If, however, large doses of vitamin A are not available the condition results in blindness. This is blinding malnutrition. Death follows soon after this stage. According to a statistic I read at the time, nearly three quarters of untreated xerophthalmia sufferers die within weeks of the onset of blindness. Xerophthalmia is, in fact, not an isolated condition but simply one sign of a larger syndrome of illness that results from vitamin A deficiency. In a report of some work carried out in Bangladesh, the following observation was made - "No mother of a child with active corneal lesions due to vitamin A deficiency had been to school beyond primary level".
The image we wanted to develop was one which community health workers could use to encourage slum-dwellers to increase their intake of vitamin A by eating more dark green leafy vegetables. These vegetables - spinach, methi, curry leaves and others - are very cheap and readily available to even the poorest people at Dharavi. The problem was that vegetables were generally considered to be low-status foods and, because they were undervalued, were not usually included in meals.
In Byculla
On this trip I stayed in a small hotel whose name I can't remember. It was in Byculla, an area described in Wikipedia as 'an upper-middle class enclave with a large Muslim population'. The hotel was not far from a zoo where I photographed a sign telling visitors not to throw stones at the snakes.
It was an area of great industriousness, full of textile mills and go-downs, and a busy vegetable market. I used to get the bus to Dharavi in the mornings. The difficult bit was figuring out the number of the approaching bus as its number was written in Hindi/Mahrati script. All unfamiliar squiggles, although I had learnt a bit of Hindi by then, including the alphabet, so was usually just about able to get on the right bus. I still have dreams about these wiggly bus numbers and the anxiety that they could induce.
There were always lots of people plying their trades along the street from the hotel. Barbers squatted face to face with their customers whose cheeks were liberally caparisoned with creamy shaving soap. Earwax removers also squatted on the pavement, picking the wax out of their customers' ears with long needles tipped with cotton wool. They were extremely dextrous, their fingers moving quickly to effect the cleaning process.
Further along, fortune tellers with strange books and trays full of little animal bones, bits of fur, stones and shells. Then others whose job was to scrape the corns off the feet of Byculla's throng. They had small boxes and bottles of unidentified stuff, while their pitch was decorated with pictures of feet disfigured by corns. One of the corn scrapers used to beckon to me to avail myself of his services. His sign read 'Cron Scraped'. Juice sellers, too, sitting behind bright red and yellow glasses of liquid with lumps of fruit in them. The juice sellers constantly fiddled with their wares, filling up glasses and then, soon after, pouring the contents back into a large saucepan.
Street dwellers also sat on the pavement, cutting up potatoes, marrows, radishes, tomatoes, cooking their meals among the pavement debris on little fires made with slats of broken boxes from the market, the ends of the sticks flaming under tiny saucepans. At one point a tree grows from the roadside edge of the pavement, its trunk leaning over so far that most pedestrians had to duck underneath it to get past. I often mused on the thought that nobody seemed to have thought of cutting it down.
