Spatial planning for mitigating human health risks to water stress: a case of Lucknow

Abstract

In a condition of water stress, there is difficulty in meeting the water demand for everyday activities which disturbs the other functions of human systems and poses risks to human health. Town planning was developed as a discipline to prevent water-borne diseases in the post-industrial era. However, over the years, this purpose shifted to the backfoot until the coronavirus pandemic rapidly spread across the cities. There are only a few studies that relate spatial planning, human health, and water stress, but the nexus is evident and essential to explore further. Many densely populated cities of the world are located in India and they also carry a huge water-borne disease burden, globally. The health department and city planning departments in Indian cities, seldom operate cohesively which makes the cities even more vulnerable. This study aims to assess water stress and recommend suitable strategies for mitigating its human health implications. The city of Lucknow, the capital of the state of Uttar Pradesh (U.P.), India, has been selected for a detailed study of this relationship. The national health profile from 2008-18, highlighted that more than 50% of total death cases due to typhoid and approximately 20% of total death cases of acute diarrheal diseases occurred in the U.P. state. The rapid urbanization in Lucknow, heavy discharge of sewage into the Gomti river passing through and increasing dependency on groundwater makes it the most critical case of multi-pronged water stress situations. To identify the critical areas in the city, four municipal wards were selected using a ‘comparison matrix’ of parameters like dependency on groundwater, existing land use and landcover, demographic profile, proximity to healthcare infrastructure, and municipal water supply. These wards were used to study the unique and similar attributes that affect the causal relationship between human health and water stress. The vast literature reviewed for developing this study establishes that this inter- relationship is influenced by multi-dimensional factors including pollutant loading in surface water bodies, a decline in freshwater, poor wastewater treatment, and inaccessibility to safe water. Most of the water security indices and assessments are undertaken at a regional or national level, hence many researchers suggest following a more detailed ‘context-specific’ approach at the local scale to enable better identification

of vulnerable areas and sectors. Therefore, a conceptual framework specifically designed for assessing the human health risks to water stress (induced by non-climatic factors) for the case study city of Lucknow has been used in this study. This framework is an ‘indicator-based approach’ for risk assessment. It was prepared by determining suitable indicators and variables of measurement, followed by normalization and formulation of a composite index reflecting the risks level to human health and water stress. The identified indicators are categorized broadly into seven dimensions, namely, Environment, Governance, Water Infrastructure, Water Resources, Human Health, Hygiene, and Socio-economic Profile; measured across three spatial scales at City level, Inter-ward level, and Intra-ward level. In addition to secondary data, a primary household survey was also conducted in residential areas of each ward. The sampling technique adopted for determining the sample size for the household survey was ‘clustered random sampling’. The city-level risk assessment highlighted that because of surface water pollution, unchecked groundwater extraction by individuals and lack of groundwater recharge causes a water stress condition in the whole city. The inter-ward level assessment highlighted the lack of open spaces, lack of coverage of the sewage network, and uneven distribution of healthcare. Further findings from the intra-ward level were spatially correlated by preparing multi-variate maps and it was found that water-borne disease outbreak was higher in the unplanned neighborhoods. The areas having a poor street network, improper solid waste disposal, and inaccessibility to healthcare were more exposed to water stress and water-borne/related diseases. Also, the residents living in the city-center experienced more water shortage and higher cases of Dysentery. Therefore, best practices from cities across the globe and within the country have been referred while proposing mitigating strategies for city-wide risks. While the risk indicators at ward level were found directly related to the quality of built-environment and basic infrastructure supply & management within the neighborhoods. Thus, strategies at the local level include spatially demarcating areas for green spaces, community-level groundwater recharge, healthcare facilities, etc. and other unit-level interventions that would reduce human health risks due to water stress.