Managing Wellness Through Managing Waste
By: Hannah Nash
Planetary health examines the interdependence of human civilization and Earth’s natural systems. There are many concrete pathways linking the health of people to the health of the planet. My time working in Dharamshala, India, illustrated to me the inherent connection between waste management and human wellbeing. I went to India after finishing my undergraduate studies to explore two different potential career paths: medicine and environmental protection. I would find that these two areas are intrinsically intertwined, and both need to be addressed for human health to thrive.
I initially went to Dharamshala for an internship at Delek Hospital, a small hospital focused on treating the local Tibetan population. I shadowed physicians, worked on some public health projects, and got a snapshot of how disease profiles are both similar and different to those I had seen in American hospitals. The number of patients presenting with diarrheal illness and respiratory disease was particularly striking. When my time at Delek was over, I went on to work with a waste management NGO called Waste Warriors. At Waste Warriors, I saw how many of the diseases I had witnessed at the hospital were related to the lack of adequate waste management infrastructure.
The government’s role in the current waste management system in upper Dharamsala is minimal. There is one truck that occasionally collects trash from several overflowing dumpsters, but it does not collect garbage from businesses or people’s homes. This leaves people few options other than burning their trash or dumping it in nearby streets and streams. Waste warriors has been working to change this by providing a door-to-door trash collection and recycling service for local businesses and households, which also creates job opportunities for local men and women. In addition, Waste Warriors organizes cleanups around the city and in heavily trafficked trekking destinations several times a week. Its educational campaigns also reach many local schools, where staff and volunteers teach classes on proper waste disposal practices.
The connection between my experience at the hospital and my time at Waste Warriors became apparent when I visited the Dharamshala dump on a rainy day. The trash compactor that the Indian government had purchased for the dump had been laying broken and useless in a small shed for over a decade. As it rained, I watched the water pool up and flow through the masses of trash and into the adjacent river, which feeds many of the villages around Dharmsala. I couldn’t help but think of the patients I had seen just weeks before suffering from diarrheal disease and water-borne illnesses.
Staring at the dump, it was hard to deny the connection between our health and the health of our environment. Zonal hospital, a larger government hospital in Dharamsala, reported 50,910 cases of waterborne illness in 2017. The dumpsite is not the only place to blame. In the summer of 2018, a Masters student from TERI School of Advanced Studies in New Delhi, conducted research on behalf of Waste Warriors and sampled the tap water from different areas around upper Dharamsala, above the dump. She found E. coli and other pollutants in every tap water source she tested.
A few days after my trip to the dump, I was visiting a nearby village when I saw several smoking heaps of burning plastic outside local homes. With little to no waste management infrastructure available, homes and businesses have few other options, but burning trash has significant public health impacts. It produces large amounts of dioxins, carcinogens, particle pollution, and other harmful materials that can lead to increased respiratory distress, cancer rates, and other health problems. I was once again left thinking about patients I had seen at the hospital with COPD, asthma, and other respiratory illnesses.
Through public awareness campaigns and by offering a door-to-door trash collection service, Waste Warriors has dramatically reduced the rate of trash burning in the areas where it operates, namely in Bhagsunag ward in upper Dharamsala, in Dehradun city (the capital of Uttarakhand state), and in the rural villages within the forested landscapes of Corbett Tiger Reserve. There are still many areas in India and in the developing world with little or no waste management infrastructure. According to the United Nations Environmental Program, low-income countries often have waste collection rates beneath 50%.
Waste management is an example of a planetary health issue with very concrete impacts on human health. Poor waste management is a missed opportunity for creating new business and employment prospects, reducing greenhouse gas emissions, and creating new energy sources. Handling waste properly can drastically reduce the disease burden of a population by taking the surrounding environment into account. It is an example of the intrinsic link between our health and the health of the planet we inhabit.
Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the position of the Planetary Health Alliance or its members.
