A Brief History of Madras
Strictly speaking, the history of Madras began with the history of the British in India. In 1639, twenty five years before the British reached Bombay and 50 years before they arrived in Calcutta, the Rajah of Chandragiri gave Francis Day a lease to open a trading post for the British East India Company on the site of Madras, then known as Madraspatnam. The following year, work began on Fort St. George, that was finished in 1653. From this strong hold, Britain held Madras until India achieved Independence with the exception of a two year period beginning in 1746, when Dupleix captured it for France.

Madras, also known as Chennai, the gracious capital city of Tamil Nadu is the fourth largest metropolis in India. Located on a 17 km stretch of the Coromandel coast, the city is trisected by the rivers Cooum and Adyar and the Buckingham Canal. Chennai is a city that is growing, expanding and changing every year.

Popularly regarded as the 'Gateway to the South', Chennai represents a culture that is distinctly different from that of northern India. Music, dance and all other art forms of the South are cherished and nurtured in this city which, though industrialised, continues to be traditional and conventional in many ways.

Chennai is a city where the traditional and the modern mix in everyday life everywhere. From traditional vegetarian fare to fast foods, from nine-yard sarees to the latest in fashion, from ancient temple architecture to modern highrise - with Indo-Saracenic and Victorian as stops along the way - from classical music and dance to discos throbbing to heady beats, Chennai has them all and many more vivid contrasts that are a constant surprise. And perhaps the most striking of them all is that there is a modern metropolis with beaches, parks and even sanctuaries in the heart of the City. Chennai offers a wealth of Nature and a rich historic past to visitors in the ambience of a city with every modern facility.

Pollution in Madras city
IT appears to be a strange paradox, a precarious balance of the extremes.  On the one side, Chennai has the distinction of ushering in the era of corporate healthcare in the country.  On the other side, the metro continues to be besieged by a multitude of diseases.

The city may have state-of-the-art medical technology but it is also host to insanitary conditions, pollution and deteriorating air and water quality.

Air pollution & its health impacts
The ambient air quality of Chennai has deteriorated with an increase in the number of vehicles and industrial pollution.  A recent study by the State Pollution Control Board (PCB) found that the levels of suspended particulate matter (SPM) ranged from 274 to a mind-boggling 1,470 micrograms/ cubic metre (micro g/m3) at several areas, which was much higher than the WHO prescribed limit of 200 pg/M3.  The level of carbon - monoxide ranged from 12 to 70 parts per million (ppm) as against the permitted 35 ppm.  The study also showed that emissions from nearly 50 per cent of the vehicles in the city exceeded the permitted levels and the pollution load in the atmosphere increased by 3.5 per cent annually.

A joint exercise in 1994 by the Automobile Association of South India (AASI), the Anna University and the PCB, showed that 73 per cent of the 1,746 vehicles tested randomly, exceeded the emission standards.  From less than 200,000 vehicles in 1981-82, the vehicle population in Chennai has risen to 889,000, with 250 vehicles being added everyday.  Nearly 75 per cent of the vehicles are twowheelers, a majority of them being two-stroke.  Dr. Krishna said the SPM level was high in most of the areas surveyed by the CPR Foundation, ranging from 163.15 to 1,835 pg/M3.  The situation on working days was worse than that on holidays.

Due to air pollution,  tuberculosis continues to be a major problem though there has not been a steep rise in the incidence in the last five years.  Dr. K. Jagannath, of the Institute of Thoracic Medicine, said a study conducted four years ago found 25 per cent of children living in slums to be suffering from primary complex (the early stages of TB). 

Dr. C. N. Deivanayagam, Superintendent of the TB sanatorium in Tambaram (a suburb), said the outpatient (OP) attendance at the hospital had doubled in the last five years and the bed occupancy rate had increased from 76.16 to 178.6 per cent.  The number of outpatients had more than doubled from 143,135 in 1995 to 300,376 in 1995.

The number of asthma cases has also increased substantially, according to Dr. Deivanayagam.  Most of the cases were reported from north Madras which is dotted by several polluting industries.  Non-seasonal asthma is also prevalent, with complaints of sneezing and sinusitis becoming common.  There is a slight increase in the fatalities due to acute asthma, according to Dr. Jagannath.  He also finds a perceptible increase in the incidence of respiratory diseases.

 Water pollution & its health impacts
The quality of water is no better.  A survey by the Department of Water and Sewerage in December 1996, showed that 16 per cent of the representative samples collected from different parts of the city were bacteriological poor and hence unfit for drinking.  Water at many points, mostly handpumps and taps, was whitish and turbid. The iron content was in excess of the agreeable limit of 1 gm/litre. 

Surveys conducted by the CPR Foundation over three consecutive years from 1992-93, showed groundwater to be of poor quality in many areas.  In 1995-96, only two out of the 20 samples collected from different parts of the city were potable, in terms of chemical and bacteriological quality.  The study also noted a high probability of groundwater getting contaminated due to seepage of sewage water from the waterways.

Contaminated waterways like the Adyar and the Cooum supply the city with hoardes of Armigeres mosquitoes, besides polluting groundwater resources.  For those living on the banks of these rivers, diseases like typhoid and cholera strike with impunity. 

The stagnation of water facilitates the breeding of the Anopheles mosquito which spreads malaria.  The city is notorious for water stagnation, particularly during the monsoon.  It also has innumerable open wells and uncovered water tanks.  Waterlogging is common at construction sites but civic officials plead their inability to check it.  The stormwater drains in the city are faulty and clogged at many places.  "They offer a damp, dark place for the vector to breed," says Dr. Nandita Krishna, Director, C. P. Ramaswamy Aiyar Foundation.
Leptospirosis, caused by an organism called leptospirum, also thrives in unhygienic conditions.  The disease, which simulates jaundice and in many cases leads to renal failure, is spread by rats, bandicoots and cattle through urine and faecal matter. 

The stagnation of water and mixing of sewage with drinking water, a common enough problem in the city, also spread the disease.  When water stagnation is acute, mere contact with such contaminated water is enough for the organism to enter the host.  During the monsoon, the incidence rises rapidly, according to Dr. Muthusethupathy, Head of the Department of Nephrology, Madras Medical College.

According to official figures, diseases like malaria, filaria, acute diarrhoeal diseases (ADD), cholera, typhoid, hepatitis and tuberculosis have shown fluctuating trends over the last five years.  The incidence of most of these diseases peaked in 1993 which witnessed torrential rain and floods.  While malaria registered an all-time high with 76,749 cases, ADD affected 1 1,263 persons, cholera affected 4,666 persons and TB 503.  However, the incidence of typhoid and hepatitis were relatively less.  "Most often, despite conducive conditions, all the diseases may not manifest with the same intensity," says Dr. Vijayaraghavan.

Malaria
Malaria is just one of the visible impacts of the increasing mosquito menace in the city, which has 11 highly polluted waterways and 600 km of stormwater drains.  Though civic authorities claim to be doing their best to contain the menace, recently even deciding to use biocides on a large scale, fliaria, another disease spread by the vector, is also on the rise.  Data with the DPH, the Department of Biotechnology, Anna University and the Tuberculosis Research Centre (TRC), show that several parts of the city have become endemic to the disease.  While the endemicity at some places is about 2 per cent, at some others even mosquitoes are highly infected.

Look at the facts: Chennai accounts for nearly 50 per cent of the total number of malaria cases and a mind-boggling 70 per cent of urban malaria in the State.  Drug resistance is on the rise, so also the incidence of cerebral malaria caused by the deadly Plasmodium Falciparum. While elsewhere in the State, there was a 62 per cent decrease till September last year in the incidence of Falciparum malaria (compared to the corresponding period the previous year), Chennai reported an increase of about 60 per cent.

Endemic to filaria
Many areas of the metro have become endemic to filaria.  Leptospirosis, a disease which only veterinary doctors were familiar with till a few years ago, has started claiming human lives too.  Though there has not been any major outbreak, dengue is not a stranger to the city so also Japanese encephalitis, better known as brain fever.  Though official statistics report only 33 "suspected cases" of dengue in the last five years, sources in the Directorate of Public Health (DPH) and the private sector say that the number could be much higher.

Regular visitors
Statistics show that in 1995 there was only one case of brain fever and none in 1996, But Enquirer point to the fact that the disease is quite common in localities having pig rearing farms.  Chicken pox makes a stormy appearance every year, usually from February to May and diarrhea is a regular visitor.  All these diseases, according to Dr. Vijayaraghavan, Director of Public Heath, are preventable but for poor environmental conditions,

Impacts of poor solid waste management
Garbage piles, which are the safe havens for rats and bandicoots, also help spread the disease.  In the case of chicken pox, a polluted atmosphere and congested living conditions are the facilitating factors.
According to Dr. Krishna, the city, once reputed for its parks, lakes and good living conditions, is weighed down by mounting sanitary and environ-mental problems.  Many of the lakes have become dumping grounds, affecting the quality of groundwater.  Several localities, known for better living conditions and an upmarket image, are fast becoming endemic to malaria.