In the 67 years that Dr Vikas Desai has spent in Surat, she has seen the city transform in subtle and significant ways - in its economy, infrastructure, population and governance systems. Surat’s most notable transformation, however, is from a town that gained international notoriety when it contracted the plague in 1994 to one of the only municipalities to have vector-borne disease surveillance through out the year.
These changes have served as a learning ground for Desai in her work as a health professional. “I can translate my childhood memories into public health challenges, ” she recounts. Daughter to parents who were freedom fighters during the British Occupation of India Dr Desai was raised with deep conviction that she should work to serve her country. Her home city of Surat has been the focus of her labours ever since.
Set on the coast in the North East of India, Surat is a town of just over 3.4 million inhabitants. Today the city is industrious accounting for 40% of the nation’s total fabric production and for 90% of the world’s rough diamond cutting and processing. The rough diamonds are a fitting representation of the city’s upward trajectory; cut and polished to take it from an unsanitary town with high incidence of contagious disease outbreaks, to a beacon of health policy excellence.
Boats on the riverbank with Surat city rising up in the background: Credit: TARU.
When the plague hit Surat following substantial flooding in the city, Dr Desai was a public health teacher in a medical college. A job she held for 37 years before becoming a state administer in the city health department.
“The ‘94 plague was a shock. We thought, ‘this cannot happen in our city’… There were arguments between private health practitioners and government agencies (on the city’s course of action to combat the plague) and this led to confusion and distrust among locals, and many people left the city.”
In 2006, when the floods hit again, Dr Desai says she was in a position of authority and used her knowledge and experience to make sure the situation of ‘94 was not repeated. “We decided that the government would first collaborate with other key stakeholders and then offer guidance to the people of the city.”
But even as governance systems and disease monitoring have improved in Surat in the last 2 decades, Dr Desai believes Surat remains vulnerable. “Days with very high heat-index values are increasing every year. Based on local observations, rainfall patterns are also changing and Surat is faced with sudden and heavy showers,” she says.
Flooding in Surat, 2006. Credit: TARU
Dr Desai’s involvement with public health and climate change began with the ACCCRN project and a need to connect the recorded and anecdotal experiences on temperatures increases, erratic precipitation in the city with changing patterns of vector borne diseases. The project fitted well with her previous work documenting the changing profile of infections in city.
The lessons learned in the living laboratory of Surat’s streets of how public health and climate change interact were ones that Dr Desai is determined not to lose. She was convinced that there was a need for an organization contributing to knowledge on climate change and urban health, not just for Surat but also the state of Gujarat and the country. This led her to start the Urban Health and Climate Resilience Centre (UHCRC) was conceived.
Launched with seed funding from the Rockefeller Foundation supported ACCCRN programme, the UHCRC is not in its second year. It has gone from strength to strength and has extended its initiatives on climate change and public health with to other municipal corporations in Gujarat state.
“The important thing now is to keep the momentum going, to keep learning and to sustain the research and knowledge sharing” said Dr Desai. Her efforts today are directed towards creating systems to sustain the work that she has initiated. She has taken considerable pride in helping to turn her city form a pariah to a best-practice case study, and she is keen to share these experiences as widely as possible.
The writing that changed me: India of my dream: Mahatma Gandhi
I read Gandhi’s “India of my dream” in my early retirement. His writings have encouraging inspiration about societal resilience. His philosophy has no short cuts or easy paths to success; it instead advocates a holistic approach.
Gandhi’s messages are important for working in urban centres, his writing advocate that the community holds many answers and that we resilience can only be achieved by working holistically, not focusing on just one part of life.
Finally Ghandi also advocates patience. He says that the road to resilience is a difficult one and we must sustain our efforts with purity, patience and perseverance"