The system of door-to-door collection has to be brought in. Citizens can take some initiatives and organise garbage collection in their own localities. They may also contribute an amount for the upkeep of their locality. I do not understand why do you have to wait for the municipal corporation to take responsibility of the garbage you create?
Solid waste management rules were framed in 2000 and by 2003, all the criteria, including a sanitary landfill site, were to be met. We didn’t have even one sanitary landfill in India then. The existing dumpsites are very close to residential areas and pose a huge health hazard to the residents.
The existing urban landfills, which are of no use, have to be closed; the land is wasted. Advanced landfill remediation technology can convert this land into a new township or an industrial area. In this remediation process, the soil is neutralised by removing the methane and the pH balance is maintained. The garbage is then excavated up to three metres and all materials that have not decomposed are removed. There are technologies, but the willingness of the government to adapt them is needed.
Tishani: What bothers me is the way by which the waste is managed. For me, one of the most difficult sights is the rag-pickers or the men going down the sewers. I have not seen that anywhere else in the world. In India, there are more than a million rag-pickers. Millions of children, instead of going to school, use their nimble hands to segregate garbage. What 
urban planners and the government need to focus on is to eliminate or at least minimise this direct human contact with waste entirely and to stop relying on this endless supply of cheap labour to do their dirty work.
“The sooner we recalibrate our systems so that we segregate garbage and waste in our own homes and the more mechanised we make our cleaning systems, the sooner we can hope to move towards a more dignified community.” Tishani Doshi is a Chennai based writer and dancer. In 2006, her book of poems ‘Countries of the Body’ won the Forward prize for best first collection.
Naina: We throw the mixed waste out but the rag-pickers find some value to it.
We did a study at a rag-pickers colony. They earn approximately Rs3000 a month even on a rainy day and if I multiply this with 10,000 rag-pickers just in Chennai, in 12 months they earn Rs36 crores. This is the value of waste which they have handled. Whom did it cost – the corporation? No. Did they get any sponsorship from the corporates? Did anyone look at the health of the workers or get insurance for them? No.
It’s a myth that we need support of all these corporations. May be a little support and finally, a little push to start up a project.
We had this very unique project at a mofussil bus stand in Vellore. It was handed over to a Federation made up of four Self Help Groups (SHG). The Federation employed 118 people, including 47 physically challenged, 21 widows, 12 battered women, four orphans and 34 unemployed. They designed a self sustaining model without external means and also generated high income, month after month. User friendly toilets and cycle/scooter stands were constructed and income was generated from them. They charged Re1 for the cycles and Rs2 for the scooters. They worked 24 hours round the clock. They got Rs3 for every bus that was parked at the bus stand. The bus stand was kept litter-free and the waste collected was taken to a shed for further segregation and sale.
Green waste from the kitchens of two hotels was collected and segregated and fed to the cows. Forty eight cows were integrated in the waste management. The cow dung and urine were collected very meticulously. The cow dung was mixed with equal amount of water and put into the bio gas system. Bio fertilizers like Panch Kavya, Amritpani, Vermiwash, vermicompost, Gunnaapjalapam and biopesticides were also made and sold.
All the wastewater from the urinals, toilets and other sources was collected in a pond and cleaned with the help of 1000 ducks. The income at the start of the project was Rs55,000. Slowly, it increased upto Rs450,000 per month. In 39 months, the income through SWM (inorganic material alone) was Rs1.04 lakhs and the total income generated by the federation was Rs1,37,10,458.
This was truly a novel way of managing a bus stand, empowering women and creating employment. However, when there was a change in the organisational structure of the Vellor Municipality, all these people were thrown out from the bus stand! Still, this experiment is being successfully replicated at many places.
Vidya: The important thing is that we need to continue with our efforts. I took photographs of certain areas in boat club road – corners dumped with garbage, cows eating sewage… I blew up these pictures and sent them to the Corporation. Within a day, the areas were cleaned.
Sanitation
Dr Priya: I work in a hospital for children which has the potential to be one of the dirtiest places in the world. Our hospital has 243 beds for new babies and children up to 18 years of age. 
The hospital caters to all sections of the society; a certain number of patients are treated at subsidised rates and some pay for deluxe treatment. We see cross-sections of the society.
“After my return from abroad, I was told the air in India caused different infections, but it was not true. The evidence showed that the infection came from cross-contamination.”
Dr Priya Ramachandran is a Consultant Paediatric Surgeon with Kanchi Kamakoti Childs Trust Hospital in Chennai.
The problem is that the standard of hygiene followed by mothers is what is being followed by them at their homes. I have mothers who let their children roam around without diapers. The child urinates anywhere and the mother picks up the baby and leaves the place. The next child runs right across it. Literally, on every floor, whether OPD or reception area, you need a cleaning crew not just with mop and towel, but with twin buckets system. You need one person walking around all the time. Because their standard of personal hygiene is so low, the mothers are very nonchalant about the fact that they are dirtying the hospital where the possibilities of spreading of infection are very high. They are not only jeopardising their kid’s lives, but even that of other kids.
We have put in place a waste segregation system by which different medical wastes go into different colour coded bins. The nurses have to constantly keep the mothers aware of it because on every floor, we have general ward and deluxe rooms. And in the general ward, mothers dump waste as they please, they don’t follow the segregation system. We have to tell the patient, “If you do this, we will have to throw you out of the ward.” We have to resort to threats.
The major issue is the level of care we have to give to the ICUs. Again, another major problem is the transmission of infection from one child to another. This happens more commonly in new-born babies because they are more susceptible. The 1:1 (one child:one nurse) ratio is impossible to achieve in neo-natal units. There are 3-4 babies per nurse. So there is hardly any time for the nurse to wash her hands in between taking care of these babies. The result is enormous rate of neo-natal infections because the nurses are the carrier of infections. Now, we have kept bottles of sanitizers by the side of every patient in every unit. It is an alcohol based solution and is given to the mothers when they come in. If the nurse touches the babies without using the solution, the babies’ lives are at risk. So the mothers have to ensure that whoever touches the baby, should have cleaned their hands. When you tell this to the mothers, they are uptight about it. They do it themselves and ensure others like the doctor and junior doctors do the same. We came to know that the senior most doctors were the ones flouting the rules and the junior most were the one diligently following them. The best way to avoid the transmission is by sanitizing the hands in between examining patients.
