Functional case studies of administration by the DM

As in any district, the functions of a DM are many and varied. The Bhopal DM, Nishant Warwade, has also been involved and has discharged responsibilities across a wide range of issues. The DM himself identified the following four cases based on priority as part of the case analysis of DM Bhopal with Nishant Warwade as the protagonist.

  • • Law and order maintenance including protection of public property.
  • • Converting Bhopal into a Smart City by facilitating and regular monitoring of major infrastructure work such as constructions of Bhopal- Hoshangabad Railway Flyover, Raja Bhoj hanging bridge, Savarkar Flyover, Public Bike Sharing Project, Bhopal Plus App, and the website “smartcitybhopal.org.”
  • • Basic child health initiative (named as Samarpan), which subsequently expanded to other programs such as Organ Donation, Run Bhopal Run, and Breast Milk Bank.

Among the many significant issues and interventions carried out in the district by the DM during 2014-2017, this study sampled four key areas of intervention:

Kisan Andolan (farmers’ strike, law and order issue)

Communal frenzy and riot control (law and order issue)

Bhopal-Hoshangabad railway flyover (development project)

Samarpan (treating early childhood disabilities, development project)

56 Case study of an urban district, Bhopal Kisan Andolan

Madhya Pradesh (MP) experienced steady high growth in agriculture in recent years. Between 2000-2001 and 2014-2015, agricultural GDP grew at an annual average rate of9.4%, second to Gujarat at 9.5% (see Figure 3.1). This is far higher than the all-India average of about 3.3% during the period. This high growth of agriculture in MP has been largely attributed to increased investment in irrigation facilities and water availability to farmers. The irrigated area increased from 0.7 million hectares to over 3.5 million hectares during the above period.

With good monsoon during 2016-2017, there was a bumper harvest across India and in Madhya Pradesh in particular. Ironically, the biggest source of surprise has been that Madhya Pradesh was the hotspot of farmers’ protests, a state that has posted record agricultural growth over the past several years. What could be the possible reasons for such a paradox? Is it an outcome of political rivalry or actual unidentified problems faced in agriculture and farming communities?

Despite the boost in farm earnings and increased GDP of the state, the average total earnings of agricultural households in MP continued to lag the national average (see Figure 3.2). While the cost of agricultural inputs such as market seeds, fertilizers, pesticides, and capital has been increasing, the farm gate prices for farmers have not been increasing at the same rate. The yield was higher with modern technology and seeds, the magnitude of inputs per unit of land in the

Growth Rate of Agricultural GDP across Indian States. Note

Figure 3.1 Growth Rate of Agricultural GDP across Indian States. Note: Figures indicate % CAGR of state agriculture GDP between 2000-01 and 2014- 15 for Gujrat, Himachal Pradesh and Kerala, the growth rate is calculated between 2000-01 and 2013-14. Source: Adapted by Authors using Data from the Centre for Monitoring Indian Economy, States of India, 2016.

Average Monthly Income of Agricultural Households across Indian States

Figure 3.2 Average Monthly Income of Agricultural Households across Indian States.

Note: Figures indicate average monthly income per agricultural household during the period 2012-13. Source: Adapted by Authors using Data from the National Sample Survey Organization, Government of India, 2018.

form of water, fertilizers, and pesticides have also been increasing. Despite the various efforts of the government, there seem to have been growing concerns among farmers. Suicide among farmers has been a recurring phenomenon in the state of Madhya Pradesh. These externalities created a law and order situation for the Bhopal district, as Bhopal has been the state capital of the state.

Further, the unequal distribution of farm incomes was an issue in the state. As per figures computed by the central government, rural inequality (as measured by the Gini coefficient2) rose faster in MP than in the rest of the country between 2002 and 2012. This could mean that small and marginal farmers, who often tend to work as agricultural laborers, have not seen a significant rise in their incomes over this period, a situation comparable to smallholder and tenant farmers in different parts of India. While MP’s farm performance is impressive, the distribution of gains seems to have been unequal and inadequate for the small and marginal farmers.3

The myriad of issues relating to agriculture and smallholder and tenant farmers in India including the issues aforementioned ostensibly point toward plausible causes behind the simmering massive farmer unrest in Madhya Pradesh that started on June 1, 2017, in the rural areas of Mandsaur district (325 km2 from Bhopal) and then spread over to the capital city of Bhopal. The immediate reasons for the unrest perhaps were the pandemonium created by the government’s decision to demonetize high-value currency notes in November 2016, coupled with neighboring states (Uttar Pradesh and Maharashtra) waiving their farmers’ loans. In the above context, MP farmers had the following demands:

  • • Higher crop prices to cover their input costs and to extend minimum support price for their farm produce even in case of crop failure.
  • • A farmer package to tide over the drought-caused losses.
  • • Besides farm produces, the farmers were also demanding that they should be given INR 50 per liter of milk as their cost of production of milk amounted to INR 37 per liter.
  • • Since cash is the primary mode of transaction in the agriculture sector and this was now made difficult by demonetization, the farmers demanded that half their dues at mandis (large wholesale market) should be paid in cash and the remaining via electronic transfer to their bank accounts.

Protests in Mandsaur turned violent as six farmers were killed and eight seriously injured by CRPF when they fired shots to control the protestors. Public property were destroyed and set on fire. Subsequently, curfew was imposed in the area and prohibitory orders were issued in other parts of the district. Chief Minister Shivraj Singh Chouhan tried to assuage frayed nerves, insisting that his government was taking all the necessary steps to address the issues of the agitating farmers including the establishment of a price stabilization fund of INR 10 billion to procure farm produce at minimum support price (MSP).4 These policy announcements had little effect and the protests shifted to Bhopal.

Based on police intelligence on the likely spread of farmer protest to Bhopal, the DM Bhopal had begun his preparation to handle the likely law and order situation in Bhopal. He was sensitive to appreciate the avoidable incidence in Mandsaur district where CRPF had to open fire at the farmers that unfortunately killed six farmers and was conscious not to allow such circumstances to prevail in Bhopal. Apparently, politically motivated protests had broken out in different parts of the city and unemployed youths from neighboring rural areas were coming in truckloads to join these protests.

As a regular exercise followed by the DM and standard protocol with Bhopal Police, a fine collaboration with Bhopal Police was carried out. The DM planned to employ only the local police forces and keep the Rapid Action Force (RAF) in reserve. As the head of district administration, he instructed the police personnel carefully and underlined the fact that they were to use options such as water cannons and tear gas to disperse the protesting farmers and were to open fire only as a last resort. As far as possible they had to hold their lines and prevent fresh wave of protestors approaching the capital city from different directions. Later, dispersing this wave of protestors proved to be a brilliant idea. Large unified protests are usually harder to contain than smaller spread out ones. Also, once the initial anger among protestors had settled, they became more open to dialogue.

Usually a DM does not spend much time in the control room. However, before the anticipated spread of farmers’ protest to Bhopal, he decided to stay in the control room with the Deputy Inspector General (DIG) of Police for nearly eight hours at a stretch. This was to signal the leaders of protest that the district administration was ready to take immediate action if required. The rapport between the DM and the Head of Police in the district also kept the police force focused and motivated. He knew each police officer in the control room by name and was able to elicit their quick support for all actions.

During this long period of watch in the control room, the DM took up to play a game of chess with the DIG in the control room. The media highlighted this act of the DM as an irresponsible act. When interviewed, the DM clarified that this was a conscious decision to lighten the stress among the police force and to help them deal with law and order in a calculated and calm manner. His long presence in the control room was to gesture the leaders of farmer protest that the district administration and police were one and ready to act if a protest broke out.

Even as the DM was engrossed in containing protestors, the CMO called him to inform that the CM was going to sit on an indefinite fast in solidarity with the farmers and till peace was restored in the state. Overnight, the DM had to make arrangements at the Dussehra ground in the heart of the city of Bhopal. He had to plan the layout of the tent in the ground in terms where the CM and his team of ministers and party workers would sit. Entry, exit, and office space for the CM and senior bureaucrats, rest rooms, the area for farmers to sit, distance between the stage and the crowd of farmers and general public, the location of the media persons, the location of police force, etc. were worked out. Accordingly, various utilities such as electricity, water supply, fire engine, and ambulance service were coordinated for. More importantly, the security or police bandobast (arrangements) was meticulously planned. The media management was also carefully planned, and the briefing to the media was articulated well by the DM wherever his intervention required. For all these the DM had to coordinate with the various line departments and clearly give instructions for the support services required from each line department, to assure that the site of fast is ready overnight.

A fully functioning temporary office of the CM had to be set up on the campsite with telephone, fax, Wi-Fi, printing, etc. All logistics arrangement for this was also to be overseen by the DM. He had to personally ensure that these facilities are operational, safe, and secure. He was often accompanied by the Deputy Inspector General (DIG) of the Police Department for on-the-spot checking and verifications. The personal rapport of the DM with the Police Department officials and the heads of various line departments of the district made the logistics and operations look very simple and effortless.

The CM eventually called off his fast after a day when no new fresh outbreak of violence occurred. The four days of ordeal for the district administration, especially for the DM, during this period of mass-scale protests by farmers across MP and around the capital city and the CM deciding to go on a fast leading to political turmoil and media blitz on farmers’ issues was a classic case of law and order situation that the district encountered. The great rapport of the DM with the police force, line departments of the district, and the senior bureaucracy in the state and his multitasking abilities helped him to coordinate well and maintain law and order in the district and state capital. The Kisan Andolan, which had raged through the city from June 1 to 7, rapidly frizzled out due to active efforts on the part of the DM and the police force with no human casualty and minimum damage to public property.

As researchers, we shadowed him during this period and found the DM to be quite conscious of his duties and responsibilities as a public official. The night before the day the CM was to go on fast, he gave us some time during dinner between two rounds of field inspection between 8.00 pm to 1.00 am. While he offered us with a good gourmet, he had a light dinner with a glass of fresh lime.

Communal frenzy and riot control

Communal riots have become a distinct feature of communalism in India. Whenever conflicting groups from two different religions, which are self- conscious communities, clash, it results in a communal riot. An event is identified as a communal riot if (a) there is violence and (b) two or more communally identified groups confront each other or members of the other group at some point during the violence. The reason for such a clash could be superficial and trivial, though underlying them are deeper considerations of political representation, control of and access to resources and power.

- B. Rajeshwari, Communal Riots in India: A Chronology (1947-2003f

India is a nation born in violence. An Outlook India report6 notes that 58 major communal riots have occurred in 47 places in India since 1967. Ten riots in South India, 12 riots in East, 16 riots in West, and 20 riots in North India. Since 1964, Ahmedabad has seen five major riots and Hyderabad four. The 1970s saw seven riots; the 1980s 14; the 1990s saw the most riots in the past five decades: 23; the 2000s have seen 13. Total toll: 12,828 (South 597, West 3,426, East 3,581, and North 5,224). According to the Ministry' of Home Affairs, 644 incidents of communal violence were reported in 2014, 751 cases were reported in 2015 and 703 incidents were reported in 2016. The number of injured in communal violence increased from 1,921 persons in 2014 to 2,321 persons in 2016. The death toll fell slightly from 95 in 2014 to 86 at the end of 2016. State-wise figures indicate that the Madhya Pradesh state has violence on the higher side.

In Bhopal city, the Hamidia Hospital adjacent to Gandhi Medical College was the epicenter of communal clashes in May-June of 2017. It is the Old City which has a greater concentration of Muslim population. The overview of the location of the hospital and the city of Bhopal is shown in the Master Plan (see Figure 3.3), and the hindrance to the plan, the point of dispute, is shown in Figure 3.4.

Master Plan of Hamidia Hospital and Gandhi Medical College Area. Source

Figure 3.3 Master Plan of Hamidia Hospital and Gandhi Medical College Area. Source: Bhopal District Collectorate.

Point of Contest and Hindrance to the Master Plan. Source

Figure 3.4 Point of Contest and Hindrance to the Master Plan. Source: Bhopal District Collectorate.

The issue of contention was whether Hawa Mahal, an old structure in the planned hospital and medical college area (shown as hindrance in Figure 3.5), was a mosque as claimed by the Muslim community and its leaders.

The existing hospital has been the largest hospital in the state and is being expanded to be a 2,000-bedded hospital. A medical college is also associated with this hospital. The planned hospital has several buildings with 13 floors, each including general hospital, multispecialty facility, nursing college, medical college, and student hostel. The legends in the previous figures show the various departments and sections of the planned hospital.

The communal violence in Bhopal occurred due to a dispute for a small old structure in the planned area of the hospital (see Figure 3.5). In addition to this old structure, there is also another small mosque inside the hospital area. There are also several temples build in recent years inside the hospital premises. Figures 3.6 and 3.7 show several temples of the Flindus and one mosque and an old structure (Flawa Mahal) of the Muslims within the hospital premises.

The Muslim group claimed that Hawa Mahal, the heritage structure, was a minaret from an ancient mosque over which the hospital had been built. Hawa Mahal, however, has existed more as a gate (see Figure 3.8). It also has an

Location of Hawa Mahal as a Hindrance in the Hospital Complex. Source

Figure 3.5 Location of Hawa Mahal as a Hindrance in the Hospital Complex. Source: Bhopal District Collectorate.

Temples of Hindus within Premises of Hamidia Hospital. Sources

Figure 3.6 Temples of Hindus within Premises of Hamidia Hospital. Sources: Photos taken by Authors.

Mosque and Structure of Muslims in Premises of Hamidia Hospital. Sources

Figure 3.7 Mosque and Structure of Muslims in Premises of Hamidia Hospital. Sources: Photos taken by Authors.

Minaret Claimed by Muslim Group as Part of a Mosque. Source

Figure 3.8 Minaret Claimed by Muslim Group as Part of a Mosque. Source: Photographed by Authors.

inscription to commemorate the soldiers who died in the First World War (see Figure 3.9). In recent decades, as this structure was adjacent to Hamidia Hospital, the two sides of the apparent gate were closed with bricks and the structure was being used as the medicine store of the hospital. Several private medicine stores also operated around this hospital.

Under the expansion plan of this largest state hospital, this structure that was being used as a medicine store of the hospital had to be demolished. The medicine store in-charge, Dr. Asif Khan, objected to the proposal and asked for a separate store facility for medicine before the structure could be demolished. This was reasonable and a new facility for storing medicine was built in another site and required infrastructure such as racks were provided.

Interestingly, about three more mosques had been claimed there within the hospital premise. Similarly, the Hindus had also taken to worship under a banyan tree. Seeing the resistance from the Muslim group, the Hindu group also objected to the removal of the temple under the tree which they worshipped. However, when the Hindu group was offered an alternate place to build a small temple, they agreed to shift.

Once the Public Works Department was about to demolish the structure of Hawa Mahal, Mufti Abdul Razak, the vice president of Jamaiet Ullema Hind, stuck a poster on the wall of this structure that this structure was a mosque and that the Muslims will reclaim it as their place of worship. Lead by the son of Mufti Abdul Razak, a group of nearly 20,000 Muslims gathered near the structure to express their solidarity to this view. The hospital area also happens to be densely populated by the people of the Muslim community.

The Inscription on the Heritage Structure. Source

Figure 3.9 The Inscription on the Heritage Structure. Source: Photographed by Authors.

It was a period of Ramazan, and a large number of Muslims gathered to pray here in the next four days. Seeing the expression of solidarity among the Muslims to protect their place of worship, a group of about 30 people from the Hindu community began a march from the Durga Devi Mandir located near the Peer Gate toward Imami Gate about 200 m where Hawa Mahal was located. The situation was defused on that day, but the issue unfortunately hovered around.

On May 30, 2017, tension gripped the Old City area of Bhopal after rumors spread on social media that a heritage structure inside the Hamidia Hospital campus had been desecrated. A large mob gathered at the spot. In the ensuing melee, mobs torched several vehicles and damaged a DIAL 100 police vehicle in Peer Gate area even though a huge contingent of police was deployed to meet any eventuality. It was three hours before any semblance of control could be reestablished in the area.

The two factions of Hindus and Muslim with opposing claims quickly sprang up. Panic quickly spread to other parts of the Old City - Budhwara Char Batti, Moti Masjid, Fatehgarh, Agrasen Chowk, Royal Market, Sofia College, and Imambada. The house of Bhopal Mayor, Alok Sharma, who resides in this area, was also surrounded by the angry mob. The situation seemed to be going out of control. The District Magistrate, however, ordered that they not declare any curfew in the area as this might send alarming signals across the state.

Earlier, the DM had received a briefing from the local intelligence about a potential flare-up in the area given the political climate. The regular peace meetings of the various religious groups of the city under the chairmanship of the DM were also a source for the DM and the police to sense the ensuing trouble in the area. The district has a standard protocol for regular peace meetings consisting of leaders from different religious groups and important members of the civil society'. The police also conduct regular Beat or Mohalla meetings as part of community policing. Under this provision, City Peace Committee (Nagar Raksha Samiti) consisting of 200-300 volunteers per Thana or police station is part of community policing. A roster of meeting is scheduled for every street or Mohalla. The Superintendent of Police (SP) conducts meeting with the Thana coordinators of the district.

Despite these standard protocols, the situation on May 30, 2017, however, blew out and caused serious communal riots. To control the two factions, the immediate tactic of the police was to fire tear gas shells and lathi charge people who were disrupting peace. As many as 400-500 tear gas shells and as many as 200 rounds of bullets were fired in air to bring order during the night of this riot.

Although, the DM decided not to issue curfew order in the area, the police and the district administration worked very hard and meticulously to bring back the situation to normal. One of the key strategies was to communicate with about 10-15 key people of both groups who have high credibility or who have the potential to influence people. Senior police officers, well known in the locality, were asked to speak to these local leaders. Both the DM and ADM were in constant touch with influential people of the community. The local volunteers of the Mohalla under community policing were taken into confidence to provide information of the lanes and by-lanes of the area and requisite police force were deployed so that mob movement could be controlled.

Once the mob was dissipated by early morning, the local volunteers of community policing and police together cleared the streets of the bricks, cans, shells, etc. before sunrise of the next morning. As people woke up in the morning, there was a sense of normalcy in the area. The strategy and tactics to deal with the communal riot worked, and the riot was nipped at the bud.

Following the night of high tension, the district administration refused to give permission to either group to offer prayers. Calling for peace, District Collector Nishant Wanvade said, “ There can be no greater place of worship than a hospital. We are confident that law and order will be maintained. ” Social media outflow was controlled by blocking the internet in the area. This way, messages that could fuel communal feelings were stopped from circulating. Although curfew was not imposed, there was heavy Rapid Action Force as standby, as well as continued deployment. The city was tense for a few days, with the police and DM being on high alert. But “on the feet thinking” by the DM and his excellent coordination with the police force and municipal corporation prevented the mayhem from blowing up further. Indeed, it is a case of great coordination and teamwork among the district administration, police force, Executive Magistrate, doctors, PWD, and volunteers. A senior police officer said, “The cordial and friendly nonofficial behavior and rapport of the DM with senior officials of Police and line departments contributed greatly for the success of this operation.”

To settle the matter on a long-term basis, the DM called for a team from the Madhya Pradesh Archaeology Department, which was headed by an expert, Dr. Ahmad Ali. He visited the hospital campus and studied the heritage structure. A detailed examination of the structure was done and concluded that it’s not a mosque, but an entrance gate to the Fatehgarh Fort that led to the old walled city of Bhopal. A marble plaque at the structure justifies the conclusion, as the plaque dating back to 1919 mentions 994 people from Bhopal taking part in the First World War, out of which 34 died. The gate through which these people crossed on their way to the First World War was then turned into a commemorative gate in 1919. Ali told The New Indian Express, We visited the site twice on 31 June2017 and concluded that it’s a heritage gate which could be 100 years old.

Maintaining communal harmony. The Bhopal district administration has had a dedicated Shanti Samiti (i.e., a committee for peace) headed by the DM himself to oversee the peaceful celebration of all religious festivals in Bhopal. Thus, the DM is not only able to elicit support from all communities to carry out efficient administration and crowd control, but by facilitating dialogue among communities, he is able to foster a sense of brotherhood and thus maintain communal harmony in the district. Members of the Shanti Samiti include influential persons of different religious communities along with key personnel from the administration (including members of police force). The rationale is that future riots can be controlled and stemmed right at the start if there is cooperation among religious community influences and the administration.

It is very heartening to note that there was no disturbance around Hawa Mahal during the Ramazan months ofMay-June, 2018-2020. The people seem to have accepted the decision of the administration, and the construction of the hospital was in full swing in early July 2018 when the researchers last visited. A request from the Public Works Department has been sent to the DM to safely demolish the structure (Hawa Mahal) so that the construction can be completed as planned. Accordingly, the subsequent DM, Dr. Sudani Kliade, issued an Office Order dated January 8, 2018, to the Police Department to provide security at the time of demolition. To facilitate the process, the DM also called for a Shanti Samiti (peace committee) meeting of local representatives from different religious groups and civil society organizations to discuss the demolition of Hawa Mahal in order to be able to complete the construction of Hamidia Hospital. The matter was amicably discussed among the various stakeholders of the city.

68 Case study of an urban district, Bhopal Bhopal-Hash a nga bad railway flyover

The population of Bhopal is approximately 1.8 million. Out of which around 28% use private vehicles for commuting and the remaining rely on public transport. Bhopal public transport system comprises of buses, mini-buses, tempos, autos, and private vehicles and is operated by unorganized sector leading to poor quality of public transport facilities. During the past two decades, the number of vehicles on the city roads has increased at a phenomenal pace. In 2017, more than 6 lakh vehicles are registered in Bhopal with 100 vehicles being added every day on the city roads. This increased congestion on the city roads has led to an increase in the accident rate and a gradual deterioration in the overall quality of driving in the city. Urban transportation development was being neglected for a long time and the increasing number of vehicles on roads led to massive traffic congestion in the city. Preliminary analysis identified the key reasons for traffic congestion in Bhopal:

  • • Existing pattern of mixed traffic: both motorized and nonmotorized plying together
  • • Inadequate infrastructure in terms of road lanes and public transport
  • • Lack of integration between land use and transport system
  • • Concentration of activities in core areas of the city
  • • Lack of effective utilization of existing road system
  • • High growth rate of vehicles
  • • Lack of traffic control and regulation
  • • Land acquisition failures
  • • People’s resistance to change

The Bhopal City Link Limited (BCLL), a subsidiary of the Bhopal Municipal Corporation, identified areas with worst traffic congestion and proposed plans to decongest these places. The Habibganj railway crossing saw some of the highest vehicular traffic in Bhopal. Table 3.5 details the result of observing vehicular traffic on a weekday through the Habibganj railway crossing, going to and from Hoshangabad road as well as to and from BSS College. Adding to the high traffic was the low time interval for the drop gates to function at the railway crossing. Habibganj railway station lies on the high traffic Nagpur-Dclhi route, namely, Jhansi-Bhopal-Itarsi line. Every day, about 140 trains halt at the Habibganj station, not counting the hundreds of trains that ply on the Jhansi-Bhopal-Itarsi route without halting at Habibganj given its relatively minor status. This translates to the drop gates at crossings being employed with very high frequency. A traffic bottleneck had thus formed at Habibganj crossing where the drop gates are employed. This railway crossing number 248 was indeed one of the special category crossings under the West Central Railways.

The proposed solution to overcome the congestion at this railway crossing was to build an overbridge. Both the railway authorities and BCLL were keen on the project. The proposed overbridge was planned under the Government of India

Table 3.5 Vehicular Traffic Per Day at Habibganj Railway Crossing in 2016

Time

Total Number of Vehicles (Motorized+Nonmotorized)

06:00-07:00

1,628

07:00-08:00

2,021

08:00-09:00

2,202

09:00-10:00

2,803

10:00-11:00

3,157

11:00-12:00

3,110

12:00-13:00

2,880

13:00-14:00

3,227

14:00-15:00

4,056

15:00-16:00

3,650

16:00-17:00

3,914

17:00-18:00

4,293

18:00-19:00

4,502

19:00-20:00

4,327

20:00-21:00

3,749

21:00-22:00

3,354

22:00-23:00

2,822

23:00-24:00

2,575

Source: Compiled by the authors.

Note: Motorized vehicles include private passenger vehicles (two-wheeler, three-wheeler, car, and mini-bus); goods vehicles (tempo, light commercial vehicle, two axle, three axle, and multi axle); agricultural vehicles (tractor and trailers); and public buses.

Nonmotorized vehicles include cycles, cycle-rickshaw, handcart, and animal-drawn cart.

JNNURM scheme, 2005-2012. The first survey of the area was undertaken in 2008 and the original design for the railway overbridge was drawn in 2008 but was redesigned and approved by the central government authorities only in 2013. Between 2008 and 2013, three District Collectors had changed in the district of Bhopal, and each had played their respective roles. Nishant YVanvade joined as the Collector of Bhopal district in 2013, and during his tenure, the project was completed.

Before Collector Nishant Warwade took charge of the Bhopal district, this project was in the pipeline for implementation for over five years (2008-2013). The major roadblock to the project was the acquisition of a suitable 4 acres of land. As per the design, the overbridge would have passed through the roofs of houses and schools built in the slum adjacent to the Habibganj railway crossing. Though the land encroachment was illegal, it was necessary for the administration to relocate the population of approximately 1,000 families before the land could be acquired for developing the project.

Since the land belonged to the Indian Railways, getting permission by the state government was the first step that the Collector undertook. It required him to coordinate with the state bureaucracy and the officials of the Indian Railways to get this process completed. Subsequently, the Collector had to carefully plan and communicate with the local community to relocate the families and small shops to another location in the city. All these sticky administrative processes took about three years since the Collector took charge of the district. The deadline of the project was extended six times in between 2013 and 2016. The budget for the bridge construction changed from an initial amount of INR 270 million to INR 820 million due to delays and modifications to the original design. However, once construction started, the Collector made sure that it was completed in record eight months’ time. Five different teams worked day and night and completed the construction of the bridge.

The BCLL authorities (particularly Shri Chandramauli Shukla and Shri O.P. Bharadwaj), in a series of interviews, outlined the steps taken to tackle the traffic problem as well as the role played by the DM in facilitating the work.

The first step taken was the constitution of a committee to oversee the relocation. The DM appointed a Tahasildar on a full-time basis to resolve the land issues of this project. Three to four sites at nearby locations for resettlement were identified. Using a lottery system, plots were identified and were allotted in the new locality. There was also clear documentation of families that were shifted out so that the newly built homes could be allotted to these displaced families and not for profit. Police force was employed in this endeavor because of continued resistance from some families. BCLL bus routes were also started to these new sites so that the settlers could commute to their usual areas of work. Simultaneously, the DM handled the paperwork with the railways and ensured that the land was transferred to the railways in least possible time so that the construction work could start.

The DM and the Municipal Commissioner of Bhopal often visited the site together to oversee the project work. The DM exhibited good rapport with the Municipal Commissioner of Bhopal Municipal Corporation (BMC) as well as the police that made the execution easy and smooth. The state government also extended full support to execute this overbridge project. As the project was directly under the Municipal Commissioner, BMC, he made ever)' effort during the construction period of the overbridge.

The INR 820 million Habibganj railway overbridge has been named the Veer Savarkar Setu. The 1.8 km, six lanes overbridge is the longest flyover in Bhopal to date. The overbridge forks out in three directions: one toward Arera Colony, the second toward Bhopal Fracture Hospital, and the third toward AIIMS hospital. The flyover reduced traffic on Chctak bridge as well as the railway crossing brought relief to die localities of Singarcholi, Chola, Bharat Talkies, Bogda Pul, and Subhash Nagar.

BCLL authorities have noted that the sharp turns of the overbridge could be improved in the light of the fact that vehicles often overspeed along the smooth flyover, resulting in accidents. Although there was some delay in getting new designs approved by concerned government authorities, BCLL hoped to complete the process soon.

Samarpan

Samarpan is an innovative project for early identification, screening, treatment, and rehabilitation of children with any form of disability of a developmental delay in the age groups of 0-5 years. Table 3.6 shows the number of children with defects at birth in the state of Madhya Pradesh. The idea of Samarpan evolved in early 2010 and was formally initiated on August 1, 2010, with the establishment of Sick New Born Care Unit (SNCU) in Hoshangabad. This experiment was replicated in Bhopal district as the DM, Nishant Warwade, moved from Hoshangabad district to Bhopal district. It gradually snowballed and became a national scheme for sick newborn children. This is one of the interesting development initiatives that was introduced in a district and soon became a national program.

Background to Samarpam Nishant Warwade, the DM, had a keen interest in understanding the psychology' of child development. Psychology was his main subject for his Union Public Service Commission (UPSC) examination. Studying this subject had fascinated him to do something for children. He was also moved by the SPARSH Abhiyan (Special Project for Assistance, Rehabilitation, and Strengthening of Handicapped) in which facilities7 were provided to children with disability.

However, until around 2010, as per the Social Justice Law,8 the disability certificate and the facilities are provided to a child only after he or she crosses six years of age. Some of these children needed surgery at an early age, but without a government-issued disability certificate, many could not get necessary treatments. There was no special government facility for children below the age of six with some disability.

The great passion and commitment of the DM toward the issues of child development led to the conceptualization of this project. His wife, Dr. Amita Chand, an MBBS, MD (Medicine), and a postgraduate in public health had a great role in grounding the project. As a qualified and experienced medical doctor, she provided the technical details and management architecture to ground

Table 3.6 Total Number of Children with Defects at Birth in Madhya Pradesh

Tear

Congenital

Heart

Diseases

Cleft Lip and Palate

Club Foot

Congenital

Deafness/

Cochlear

Implant

Congenita, Cataract

l Neural Tube Defect

2014-2015

69,223

35,551

19,377

23,191

10,808

18,288

2015-2016

90,515

27,618

72,019

25,869

17,970

82,414

2016-2017

107,775

24,935

30,352

27,078

16,991

10,282

2017-2018

101,347

19,931

24,635

20,537

10,691

6,695

Source: Compiled by the authors.

the project. With an eye for detail and operational expertise, she greatly contributed to the work of the district administration in grounding the concept in its early years.

Nishant and his wife, Amita, with the help of representatives from national institutes working with the same aim for the effective management of children’s health, conducted national seminars on issues highlighting early identification and intervention. Premier institutes such as the National Institute of Mental Health and Neurosciences (NIMHANS, Bangalore), National Institute for the Mentally Handicapped (NIMH, Secunderabad), All India Institute of Speech and Hearing (AIISH, Mysore), and other such institutions participated in the seminar. Dr. Arun Singh, Commissioner of Disability, and many doctors from different places were invited to attend the seminar. Based on the learning from the seminar, a basic format was developed to establish a Samarpan Screen Test.

Dr. Arun Kumar Singh had been the former head of Institute of Postgraduate Medical Education and Research (IPGMER), Kolkata, and so he was best suited to provide the DM guidance on designing a program, providing technical support, and later training specialists for the Samarpan facility at IPGMER. Based on the deliberations and discussion, the objectives were laid down for the project Samarpan.

Objectives of Samarpan

  • • To identify the early signs of development delayed under-5 age children (U-5) by conducting screening.
  • • To establish and develop surveillance of U-5 children registered in ICDS as well as “at risk” children discharged from the newborn sick care unit.
  • • To facilitate developmental growth with standard tools for identification of developmental tool or developmental disorder so that they receive more comprehensive evaluation in 0-5 years.
  • • To arrange for a specific evaluation of a referred children (0-5 years) for specific developmental disorder that may lead to definitive diagnosis.
  • • To provide early intervention services for 0-5 years U-5 children to modify the overall outcome.
  • • To establish linkages with tertian' institutions for treatment and rehabilitation and provide complete specialized multidisciplinary intervention to remove or reduce developmental obstacles.
  • • To facilitate acceptance in the family about the onset of development delay in their infant so that appropriate intenention can be taken at the right time.
  • • To increase the awareness on disability and delay in development in society, in particular, and to make people aware of early signs of delay to harness neuroplasticity.
  • • Through convergence, provide evaluation and intervention services under one roof and provide a complete specialized multidisciplinary examination of the child for visual, speech and hearing development, social development, mental development, and normal development growth under a single roof.

To begin with, a massive awareness and training program was undertaken. The key stakeholder government departments, namely, the Department for Women and Child Development (WCD), the District Health Department, the District Disability Rehabilitation Centre (DDRC), the Department for Social Justice and Empowerment, and the Revenue Department were brought together to converge right from the start and were provided specialized training at IPGMER. Even the child psychologist and special educator, physiotherapist, nurses and auxiliary nurses and audiologist, speech and language pathologist were trained at IPGMER. At the block level, the Mahila Baal Vikas and Anganwadi workers were also trained continuously to test children aged 0-6 for signs of development delays. A massive campaign was undertaken in the district to increase the awareness of people on this issue.

The Samarpan process

A detailed process for screening, identification, and treatment of children was developed under the Samarpan program. The stages included an initial survey of children, identification of development delays by local workers, and diagnosis of potential cases by the specialists and treatment. The associated administration, logistics, transportation, and care are all part of Samarpan. Figure 3.10 details the steps of Samarpan in a flowchart.

Challenges encountered'. There was a distinct lack of proper health-care policy in India about case of children below five years of age. Therefore, it took a long time to study and to implement a strategy in the case of Samarpan. Some challenges that continue to plague the program are:

  • • Insufficient funds and proper technical support (especially in rural and semi- urban areas)
  • • Lack of adequate awareness and sensitivity about the issues of child disability among health practitioners and educators
  • • Continuous treatment, monitoring, and follow-up
  • • Lack of convergence of all stakeholders
  • • Infrastructure limitations
  • • Resistance from parents to accept their child’s disability as well as societal mockery and its nonacceptance in its early stages

Despite the many challenges, one of the major reasons for the success of Samarpan has been the implementation process of this program: the way it was conceptualized, the implementation plan drawn up, resources converged, and the meticulous way it was implemented by the Samarpan team. Some of the highlights of the implementation process are described below.

Stages of Samarpan Process

Figure 3.10 Stages of Samarpan Process.

Implementation highlights

  • • Situational analysis of early intervention services in the current scenario and conceptualization of the initiative Samarpan.
  • • National workshop at Hoshangabad to discuss on concept and rollout plan, activities, and requirements for Samarpan attended by participants from all reputed national institutions.
  • • Mapping of resources and identification of nodal officers and personnel from Women and Child Development, District Disability Rehabilitation Centre and Social Justice, and Health Departments. More than 50 meetings conducted under the leadership of DM for developing action plan, HR mobilization and planning training, strengthening infrastructure, and procuring equipment.
  • • Tailor-made capacity building for the concerned officials of various departments, particularly of grassroot-level functionaries and reaching out and screening every U-5 child in the area using Samarpan Screening Test.
  • • Establishing a database and software for monitoring and tracking of the identified children.
  • • Early intervention center was thus established for evaluation and intervention services in a holistic way by an interdisciplinary approach of a multidisciplinary team under a single roof, along with referral linkages for specific domains.

Even after DM Nishant Warwade moved out of Hoshangabad district, he continued his involvement with the program and introduced it in Bhopal, his new district as well. Ms. Archana Awasthy, the implementation officer, mentioned how Nishant Warwade personally stepped in when Samarpan Hoshangabad was under threat to be moved out of its premises. He spoke to the DM and reiterated his commitment to the program and conveyed his vision of taking the program to an all-India level. Nishant Warwade also had an eye in picking out just the right team to support him in his endeavors.

Dr. Amita Chand had been connected to the Samarpan program since its inception. Dr. Amita, along with Dr. Arun and Dr. Vinay Dubey, was closely involved in creating the training and treatment center of the Sick Newborn Care Units (SNCU) in Hoshangabad (before Nishant’s transfer to Bhopal). He has had regular meetings with his team to stay abreast with the goings-on. To strengthen the program, a state-level resource center was set up in Bhopal when Nishant Warwade moved on to Bhopal, the state capital of Madhya Pradesh as Deputy Secretary, Public Health Engineering Department. Later he moved on to be the DM of Bhopal district.

Samarpan Resource Center (SRC): SRC is the apex technical institute of the state, the first of its kind in all of India, for promotion of early intervention services in the field of detecting and treating disability, diseases, defects, and deficiencies through education, training, research, evaluation, and translational research, networking with both national and international institutions, experts, consultancy, and specialized health-care services, through convergence.9 This initiative was primarily supported by the United Nations Office for Project Services (UNOPS) - Norway India Partnership Initiative (NIPI).

Impact of the Samarpan program: Samarpan has shown the power of convergence and how it can be effectively used to achieve success with limited resources. The model has been so successful that plans were drawn up to scale it to the national level. In 2013, the Rastriya Bal Swasthya Karyakram (RBSK, National Child Health Program) was initiated by the Government of India on similar lines. Community awareness toward disability and issue related to early intervention has also increased.

The success of the initiative was so evident that the initiative was nominated by the state of Madhya Pradesh for consideration by the Ministry of Personnel for 2013-2014 Prime Minister’s Award for Excellence in Public Administration. Here are a few highlights of the outputs of the initiative as reported in the above nomination.

  • • After initiation in 2010 and six rounds of Samarpan Screening Test on about 0.6 million plus U-5 children in the districts of Bhopal and Hoshangabad till August 2014, 14,448 U-5 children were comprehensively examined at Samarpan, out of which, 6,412 U-5 children were identified as true positive.
  • • Samarpan at district headquarters provided multidisciplinary evaluation and treatment by experts of different fields under a single roof in a single, dedicated building, and the following services are being provided at Samarpan centers: medical, occupational therapy, physical therapy, psychological, audiology, speech-language pathology, vision, health, nutrition, social work, and special instruction.
  • • In addition to the abovementioned services, hearing aid distribution, callipers, portable powered ankle-foot orthosis (PPAFO), congenital talipes equinovarus (CTEV) surgery, shoe modification, splint, congenital heart disease (CHD) surgery, gaiters, and cleft lip and palate surgery are also being provided/facilitated at Samarpan. Tertian' linkages for domain-specific services have also been established for comprehensive intervention.
  • • Thus, universal screening has not only led to early detection of early diseases, delays, and disability, resulting in timely intervention, but has also led to a reduction in morbidity and lifelong disability. Samarpan is, therefore, a paradigm shift in comprehensive child care, as dividends of early intervention not only enhance the improvement of survival outcome but also result in reduction of malnutritional prevalence, enhancing community development and educational attainment and overall improvement of quality of life.
  • • Secretary, Union Government, and Department of Health and Family Welfare visited the center at Hoshangabad. After checking, the District Collector was invited by the Secretary to give a presentation to Secretaries and Mission Directors of National Rural Health Mission (NRHM) of entire country in Vigyan Bhawan, New Delhi. A presentation by him was made to all the Secretaries and Mission Directors of all union territories and states of the country and efforts to replicate it across the country were thus started.
  • • In March 2013, the Ministry of Family Welfare and Health, Government of India, launched Rastriya Bal Suraksha Karyakram (RBSK), a child health screening and early intervention program to provide comprehensive care to improve overall quality of life of children through early detection of defects, diseases, deficiencies, developmental delays, and disabilities, which intended to cover more than 30 identified health conditions for early detection, free treatment, and management through dedicated teams all across the country. District early intervention centers, based on Samarpan Hoshangabad, were planned to be set up as first referral point for further investigation for treatment and management. RBSK focuses on effective health intervention, which is intended to reduce both direct cost and out-of-pocket expenditure while also reducing the extent of disability and improving the quality of life and enabling all persons to achieve their full potential. As per available estimates, 6% children are born with birth defects and 10% are affected with developmental delays leading to disabilities, and nutritional deficiencies affect about 4% to 70% of children. RBSK benefits more than 27 crore children and school-going students in the country. Additionally, provision of comprehensive child health care will also provide country-wide epidemiological data on various diseases of children for future planning of area-specific sendees.
  • • Samarpan Hoshangabad has been recognized as a nodal referral center for central India by the Ministry of Health and Family Welfare, Government of India. As many as seven different states and institutions had visited the center for understanding the Samarpan model for replication.
  • • Samarpan initiative has thus facilitated direct policy intervention at national level where there was a huge policy gap.
  • • Samarpan initiative has increased awareness on disability, delays, and disease and early identification and intervention in government functionaries and also in society. The massive increase in capacity of government human resource available at all three tiers - district, block, and grassroot (5,000+) - through tailor-made capacity building program is an evident benefit.
  • • Better utilization of time and government resources resulting in their optimum use: the often-neglected resource of time that is often lost without proper interdepartmental, inter-sectoral, and interinstitutional convergence framework.

Samarpan program and the experiment in Hoshangabad district were so successful that it drew the attention of many officials of the state government as well as from the central government. Many senior officials of the Ministry of Health and Family Welfare, Government of India, and experts on child health visited Hoshangabad and Samarpan centers. A list of officials who visited the Samarpan facilities is provided in Table 3.7.

Table 3.7 List of Senior Officers Who Visited Samarpan, Hoshangabad

SI. No

Name

Designation

1

Ms. Sujata Rao, IAS

Secretary, Ministry of Health and Family Welfare, Gol

2

Mr. S R Mohanty

Principal Secretary (PS) to Minister of Health, GoMP

3

Dr. Manohar Agnani

Commissioner of Health, GoMP

4

Mr. P К Pradhan, IAS

Secretary, Ministry of Health and Family Welfare, Gol

5

Ms. Anuradha Gupta, IAS

Additional Secretary, Ministry of Health and Family Welfare, Gol

6

Dr. Arun Kumar Singh

National Advisor RBSK

7

Dr. S. Sikdar

Deputy Commissioner Family Planning, Ministry of Health and Family Welfare, Gol

8

Dr. Ajay Khera

Deputy Commissioner Child Health, Ministry of Health and Family Welfare, Gol

9

Dr. Sila Deb

Deputy Commissioner Child Health, Ministry of Health and Family Welfare, Gol

10

Dr. Pranay Das

Consultant

11

Dr. Manpreet Khurmi

Consultant

12

Dr. Anubhav Shrivastav

Consultant

13

Dr. Amar Jyoti

Former Head of the Department, National Institute of Mental Health and Neuro- Sciences (NIMHANS), Bengaluru

This in turn has enabled the development of a new policy at the national level by the Ministry of Health and Family Welfare, Government of India. Dr. Arun Kumar Singh was associated in this initiative since the initiation of the workshop in Hoshangabad in August 2010. He has moved on to be the national advisor on the subject to the Ministry of Health and Family Welfare, Government of India. Dr. Singh’s letter indicated the significance of Hoshangabad initiative to address the existing gaps in children’s health and disability through the development of the national policy, RBSK. His letter emphasized that health practitioners are now able to detect the early sign of developmental delay and give proper guidance for recover)'.

With the impact of the national policy, RBSK has indeed gone a long way in early detection and treatment of disabilities among children across the state of Madhya Pradesh and across the country. Tables 3.8 and 3.9 show the progress in the state of Madhya Pradesh and across the country. All data for this case are from Bhopal District Collectorate.

The enormous success and traction of the initiative led to several evaluation studies, case studies, and articles on Samarpan as a successful case for teaching and training by several national and international agencies.

  • • A study had been commissioned by the Centre for Innovation in Public Service (CIPS) and Administrative Staff College of India (ASCI), Hyderabad, after the selection of Samarpan as a replicable model in Collector’s conference held in January 2013 by the Department of Administrative Reforms and Public Grievances. The study verified the processes and outcome of Samarpan.
  • • A study on Samarpan has been commissioned by the Planning Commission, with support of UNDP for publication in compendium of Good Practices in Social Service Deliver)'.

Table 3.8 State-Level Figures on RBSK, Child Health Screening and Early Intervention Services

Year

Target Screen Children (in million)

Screened (in million)

Found

Positive

Cases(in

million)

Total No. of Children Treated (in million)

No. of

Children’s

Surgery

2014-2015

16.2

12.2

1.2

0.2

3,314

2015-2016

15.0

13.8

1.6

0.9

13,597

2016-2017

12.5

11.6

1.5

1.1

23,019

2017-2018

8.0

9.3

1.1

0.8

35,394

2018-2019

8.0

2.1

0.2

0.1

7,825

Total

59.7

49

5.6

3.1

83,149

Source: Compiled by the authors.

Table 3.9 Progress under RBSK, Child Health Screening at National Level and Service Access (in million)

Items

2014-2015

2015-2016

2016-2017

2017-2018 (till Dec 2017)

Total Number of Children Screened

105.4

187

298

143

0-6 years

37.1

83.2

120

67.8

6-18 years

68.2

103

178

74.5

Referred to

5.2

8.8

9.9

6.7

Tertiary

Centers

(5% of the total children screened)

(4.6% of the total children screened)

(3.4% of the total children screened)

(5% of the total children screened)

Availed

2.2

4.6

5.9

4.3

Services in

Tertian'

Centers

(42.8% of total referred)

(52.39% of total referred)

(61% of total referred)

(65% of total referrred)

Source: Compiled by the authors.

  • • Samarpan has been developed as a case study in the field of Public Administration and Governance by Department of Administrative Reforms and Public Grievances, Gol. The case has been successfully rolled out.
  • • The DM and his team were awarded the Chief Minister’s Award for Excellence in Public Administration in 2014 at the state day function in Bhopal.
 
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