Waterborne diseases in India usually spike during floods or the monsoon season, when sewage systems overflow and contaminate drinking water sources. However, the recent water contamination crisis unfolding in premier cities like Indore—celebrated year after year as India’s cleanest city and projected as a model Smart City of Madhya Pradesh—followed by Gujarat’s Gandhinagar, constituency of Home Minister Amit Shah, and parts of upscale Bengaluru, has shattered that assumption. It has starkly demonstrated that civic failure can be just as deadly even in the absence of extreme weather events.
Similar disturbing reports have also emerged from Greater Noida’s Sector Delta 1 in Uttar Pradesh, where dozens of residents, including children, complained of vomiting, diarrhoea, and fever after sewage reportedly mixed with the drinking water supply. When some of India’s most celebrated urban centres struggle to ensure something as basic as safe drinking water, it raises an uncomfortable question: what must be happening in cities with far less scrutiny and accountability? Clean water, after all, is not a reward for rankings or awards; it is a fundamental right.
Urban planners point out that at the heart of these recurring tragedies lies a long-ignored failure—India’s sewage infrastructure. Ageing, poorly mapped pipelines, routinely disturbed during drainage repairs and cable-laying work, have turned into ticking time bombs beneath densely populated neighbourhoods. Without systematic audits, timely repairs, and strict regulation of excavation activities, outbreaks like those in Indore’s Bhagirathpura, Gandhinagar, and Bengaluru are bound to recur.
The public health consequences are severe. According to the Ministry of Health and Family Welfare, nearly 70 per cent of disease outbreaks in India are waterborne, driven by illnesses such as cholera, typhoid, hepatitis A, and diarrhoea. Polluted water not only devastates health but also undermines livelihoods, erodes trust in public institutions, and imposes crushing financial burdens on already vulnerable families.
The gravity of the crisis has been acknowledged at the national level. The NITI Aayog’s Composite Water Management Index (2018) estimates that nearly two lakh people die every year due to inadequate access to safe water and warns that around 600 million Indians—about 40 per cent of the projected population—could face severe water stress by 2030. Dr. Siddharth Srivastava, Professor and Director, Department of Gastroenterology, GB Pant Hospital, Delhi, said contaminated water most commonly causes acute gastrointestinal illness, leading to diarrhoea, vomiting, abdominal pain, and dehydration. Diseases such as cholera, typhoid, dysentery, and bacterial gastroenteritis spread rapidly through unsafe water and can turn fatal if treatment is delayed, especially among children and the elderly. Repeated diarrhoeal episodes also cause severe dehydration and electrolyte imbalance, leaving children particularly vulnerable to malnutrition, stunted growth, and long-term weakening of immunity.
Dr. Sunil Kumar, psychologist and founder of Mind Zone, said that beyond physical illness, contaminated water generates fear, anxiety, and a profound loss of trust in civic systems. “Water contamination triggers a betrayal of the basics. When the most fundamental source of life becomes a threat, it disrupts our core sense of safety, leading to hypervigilance—where every glass of water is viewed with suspicion,” he said.
Over time, he added, this chronic stress erodes community resilience. “The psychological toll is not merely a temporary fear of illness but a long-term fracture in the social contract between citizens and the systems meant to protect them, often manifesting as collective helplessness and deep-rooted civic trauma.”
India’s struggle for clean water remains a work in progress, particularly in urban slums and low-income settlements, where leaking sewage lines, clogged drains, and unsafe storage turn everyday water use into a health hazard, said a city urban planner on condition of anonymity.
The World Health Organization (WHO) has repeatedly cautioned that unsafe drinking water can trigger deadly diseases such as cholera, typhoid, dysentery, and severe gastroenteritis—particularly among children, the elderly, and those with weakened immunity. Indore’s outbreak is a textbook example of how quickly infrastructure failure can escalate into a public health emergency.
In Indore’s Bhagirathpura locality, home to nearly 15,000 residents, warning signs appeared weeks before the tragedy unfolded. Residents repeatedly complained of foul-smelling, bitter-tasting, and discoloured tap water, but supply continued uninterrupted from a main drinking water pipeline running beneath a public toilet. Due to a leakage in the main line, sewage water reportedly mixed with drinking water. Several water distribution lines were also found damaged, allowing contaminated water to reach households. Similar patterns were reported in Gandhinagar and Bengaluru, where civic response came only after illness had already spread. The Indore contaminated water incident is now under the scanner of the National Human Rights Commission (NHRC), which has termed it a violation of human rights.
Community health expert Amulya Nidhi of Jan Swasthya Abhiyan India warned that such incidents often go beyond routine diarrhoeal outbreaks. “This is no longer just a gastrointestinal issue. We are seeing systemic effects—neurological, immunological and psychological—which indicate far more severe contamination,” he said.
A 2019 CAG report revealed that Bhopal and Indore alone recorded over 5.45 lakh cases of waterborne diseases, despite a USD 200 million Asian Development Bank loan for water management in Madhya Pradesh that mandated regular water audits and quality testing. “These were not optional conditions,” Nidhi said. “If only part of the water supply is monitored, the rest comes from borewells, tankers and unsafe sources, with no quality tracking at all.”
A city planner, speaking on condition of anonymity, said urban drainage in India continues to suffer from weak enforcement, fragmented responsibility, and political apathy. “Cities rely on short-term fixes instead of long-term planning, allowing sewage to seep into stormwater drains and drinking water pipelines with alarming ease.”
Stressing that resolving India’s sewage crisis can no longer be delayed, he said it requires modern sewer networks, strict enforcement against illegal connections, separate systems for stormwater and wastewater, and sustained investment in treatment facilities. Until sewage infrastructure is repaired, audited, and safeguarded, no city—however clean its streets may appear—can claim to be truly safe, proving yet again that everything that glitters is not gold.
