When water kills: The cracks in the urban supply story

Leaking pipes, poor sewage systems, intermittent supply and polluted water sources make drinking water a hazard for millions in India, especially the poor

After battling for survival for over a month, Anita Kushwah, 65, passed away last Sunday. First admitted to an Indore hospital on January 28 with severe vomiting and diarrhoea, Anita was initially discharged only to be readmitted in three days as her condition worsened. Reports said she later suffered a cardiac arrest, her kidneys failed, and even after being placed on a ventilator, she could not be saved.

Anita’s enemy was not a natural disaster or illness, but what flowed from the very taps that were meant to provide clean drinking water. With her death, the official toll in the Indore water contamination tragedy rose to 32. Ironically, it occurred in a city that has been consistently ranked the cleanest in India since the launch of Swachh Survekshan in 2016.

While residents estimated that around 3,000 people in the affected Bhagirathpura area suffered symptoms, with 450 requiring hospitalisation, the state government submitted in the Indore bench of Madhya Pradesh High Court that only 16 deaths could possibly be linked to the outbreak, a claim that the bench also questioned.

Lab tests confirmed the presence of E coli, Salmonella and Vibrio cholerae in the water supply. The source? A public toilet was built directly above a 30-year-old water pipeline, without a proper septic tank, allowing sewage to seep through leaking joints. Reports indicated that the residents of the densely populated neighbourhood had complained of foul-smelling, bitter-tasting, discoloured water since mid-December 2025, yet the supply continued.

The incident drew much-needed attention due to its severity and Indore’s ‘cleanest city’ tag, but it took a dismissive ‘ghanta’ remark by state cabinet Minister and six-time BJP legislator Kailash Vijayvargiya to catapult into national focus.

Indore’s tragedy is not an isolated incident. According to a report by Down to Earth published by the Centre for Science and Environment, from January 2025 to January 7, 2026, at least 34 people died and 5,500 people fell ill across 26 cities, including 16 state capitals, spanning 22 states and Union territories after consuming sewage-contaminated piped drinking water.

In Gujarat’s capital, Gandhinagar, contaminated drinking water led to a typhoid outbreak, with over 150 people, mostly children, falling ill, in early January. The National Human Rights Commission took suo motu cognisance of the outbreak and sought a report from the state authorities.

Officials determined that leakages in water and sewage pipelines at over two dozen locations may have caused the bacterial outbreak. According to officials, one contributing factor was the ongoing revamp of water and sewage lines, which were laid nearly three decades ago.

In Bengaluru’s Lingarajapuram, a tragedy was narrowly averted after residents complained about foul-smelling water, and the Bangalore Water Supply and Sewerage Board (BWSSB) promptly stopped the supply. A day later, using robotic technology, the agency identified the exact spot of contamination and replaced the affected pipeline.

The officials said that the pipeline was older than four decades and was giving way to corrosion.

In less than a month, similar reports emerged from the V S Garden area in Bengaluru’s Rayapuram, where residents said that they had been receiving sewage-contaminated water for nearly a week. BWSSB officials who inspected the pipelines reported that an illegal connection, which had cut into the pipeline without permission, had caused the contamination.

Beyond sewage contamination, drinking water in cities is sometimes marred by dangerous chemicals. Delhi relies heavily on the Yamuna River for about 40% of its water supply. However, the river is heavily polluted with industrial waste and high ammonia levels. This has repeatedly forced water treatment plants to shut down or operate at reduced capacity, with key facilities like Wazirabad and Chandrawal curtailing output by 25-50%, causing shortages that affect millions of residents. In January 2026, elevated ammonia levels rendered the water too toxic to treat, resulting in black, foul-smelling water in some areas and disruptions that lasted several days.

A 2025 report by the Central Ground Water Board (CGWB) found that in Delhi, 13-15% of groundwater samples contained uranium above safe limits (30 ppb), along with elevated levels of salinity, nitrates, fluoride and other heavy metals. A Comptroller and Auditor General of India (CAG) audit released in January also pointed out that nearly 55% of tested groundwater samples in Delhi were unsafe for consumption.

While such cases are often dismissed as civic issues, they affect the everyday lives of large populations. An estimate suggests that in developing countries, inadequate drinking water and sanitation facilities account for around 80% of all illnesses.

Access to water and sanitation is recognised by the United Nations as a human right – fundamental to everyone’s health, dignity and prosperity.

In the above-mentioned and several other reported and unreported cases, a similar pattern emerges — old leaking pipes, sewage contamination, poor planning and ignored complaints — pointing to systematic failures in how Indian cities often fail to deliver clean water, a basic amenity, to their citizens.

The journey of water

For almost all cities, the journey of water starts at treatment centres, where water is pumped from multiple sources, including rivers and lakes. At these centres, the water is mandated to be treated as per BIS 10500: 2012 drinking water quality standards.

Taking the example of water pumping in Bengaluru, M N Thippeswamy, retired chief engineer of BWSSB, explained, “At the treatment plant, we provide disinfection and keep residual chlorine at one milligram per litre.”

"That water is pumped to the city in three stages and goes to different reservoirs within the city," added Thippeswamy, who has over 35 years of experience in the field.

From these ground-level reservoirs, water flows through a hierarchical network. "We have transmission mains from headworks to city reservoirs. We have trunk mains connecting to each reservoir. We have feeder mains emerging from all ground-level reservoirs," the engineer explains. "Feeder mains are connected to distribution mains. Ultimately, from the distribution point, we are connecting to each household."

The contamination cracks

While the initial steps are largely safe, contamination most often occurs in the final step, when clean drinking water is being transported to households through feeder mains. Water pipelines running in close proximity to sewage-carrying pipelines significantly increase the risk of contamination.

"The most critical point of pollution occurs when feeder mains pass through multiple areas, crisscrossing storm water drains and sewage lines," Thippeswamy says. "When these lines crisscross, the joints are vulnerable."

Historically, when Indian cities were developed, artificial drains were designed to carry the stormwater from rooftops, streets and roads to natural drains or water bodies to prevent flooding of local areas. However, today, in most cities, these stormwater drains are filled with filth, which often comes into contact with drinking water supply lines, leading to contamination.

However, multiple experts have highlighted that one of the greatest drawbacks of our water supply system remains intermittent supply. In most cities, water is often supplied twice or thrice a day, usually during specified timings.

“When no water is being supplied, there is low pressure in the pipeline. It allows outer contaminants to enter the pipeline during this time. Surrounding groundwater, if mixed with the raw sewage, can enter the drinking water system through cracks and loose joints. This is called back siphonage or intrusion,” Subrata Chakraborty, Director, Water Program at the Delhi-based Centre for Science and Environment, told DH.

“So even if from the water treatment plant, quality water is released, by the time it reaches the household, there is a possibility that the water is contaminated,” he added.

Structural challenges

The 2024 Manual on Water Supply and Treatment Systems, published by the Central Public Health and Environmental Engineering Organisation (CPHEEO), specifies that water mains should maintain a minimum horizontal separation of three metres from sewage lines. When water and sewage lines must cross, the water main's bottom should be at least 0.5 metres above the top of the sewer.

"If you maintain the distance, the chance of contamination is low," says Subrata. "But to maintain the distance, you need to identify the drinking water line and then go below that to install sewer lines. This is a challenge."

The challenge stems from the order in which the infrastructure is developed. "Almost all urban local bodies have some drinking water supply system," Subrata explains. "But not all areas of these cities are covered under sewer line systems. So, drinking water lines are already there. Now, when you need to lay down sewer lines, engineers first need to identify the drinking water line and go below it."

Implementing this requires tools, training and documentation, resources that most cities lack. “When excavation begins, you can see multiple pipes going here and there, and it is very difficult to identify which is the drinking water line,” Subrata says.

Another challenge stems from the institutional fragmentation of departments. While the drinking water supply is managed by one agency, sewage lines fall under another. Although data, including maps, are shareable, effective coordination often remains elusive. This confusion has given rise to the familiar Indian joke, “They laid the road but forgot to put pipes below, so they are digging it again.”

Vishwanath Srikantaiah, popularly known as the Rain Man of Bengaluru, highlighted another problem about the ageing underground infrastructure. “The typical lifespan of pipes is around 30-40 years. However, there is no publicly available database storing information about these pipelines. It is usually only when some incidents happen that they are changed or repaired.”

Asset replacement requires funds that cities often claim they lack. "Some amount is earmarked for asset replacement. They start with the oldest pipelines, gradually replacing them," Thippeswamy says. "But finances are always limited.”

Addressing water contamination also requires tackling an issue that most cities prefer to ignore: the lack of proper sewage infrastructure. While several cities lack basic facilities for sewage management, even in those that have some sewage infrastructure, coverage remains incomplete.

"For Delhi, around 50% of areas are non-sewered. For Greater Hyderabad, one-third of the city is still non-sewered," Subrata notes. Where sewer lines don't exist, the quality of septic tanks becomes critical — but here too, the system has failed. Although standards for the septic tank design exist, they are generally flouted, as in the case of Indore. With a lack of construction oversight, the septic tanks leak sewage into groundwater or water pipelines, contaminating the very sources from which cities draw drinking water.

The unequal tragedy

The geography of contamination outbreaks often follows a pattern. Bhagirathpura, where Anita Kushwah died, is a densely populated, lower-income neighbourhood. Most affected areas across Indian cities share these characteristics.

Physical constraints in these areas create the conditions for contamination. “The poor neighbourhoods in our cities are often the most unplanned ones, with narrow roads and community toilets, which is why often such contaminations emerge from such areas,” Vishwanath said.

The problem was echoed by Thippeswamy, "In most of the slum areas or remote areas, roads are very narrow, ten or twelve feet, even eight feet. Both the water supply and sewer lines run through these narrow roads. That is where a lot of pollution takes place. These are critical areas where we have to verify water quality very frequently."

The picture is even more stark among the poor, who are usually dependent on the government-supplied drinking water, while wealthier households turn to UV and RO systems or bottled water.

Big-ticket projects

On paper, programmes like the Atal Mission for Rejuvenation and Urban Transformation (AMRUT) were meant to address precisely these failures. Launched in 2015 and now in its second phase (AMRUT 2.0), the mission focuses on achieving universal water supply, expanding sewerage coverage and reducing non-revenue water (or unaccounted water which is water lost in leaks, theft, transmission or other errors) in urban India. Cities were encouraged to replace old pipelines, expand sewer networks and move towards 24x7 water supply to prevent contamination caused by intermittent pressure.

Yet a decade on, the outcomes remain uneven. While AMRUT-funded projects have added treatment capacity and kilometres of pipelines, experts point out that the mission has prioritised coverage and infrastructure creation over long-term operation, maintenance and monitoring.

Intermittent supply, which AMRUT seeks to eliminate, still remains the norm in most cities. “Unless cities move decisively towards continuous, pressurised water supply, back siphonage will remain a recurring risk,” Subrata noted.

Odisha is one of the few states that have explicitly attempted to break away from intermittent water supply. Launched in 2020, Odisha’s 24×7 drinking water programme, under the ‘Drink from Tap’ initiative, aims to provide continuous, potable water directly from household taps, starting with Bhubaneswar and gradually expanding to other urban areas. By ensuring round-the-clock pressurised supply, the state seeks to prevent back siphonage.

“When there is continuous pressure in the pipes, it is difficult for contaminants to enter the water supply. It also requires fewer resources with no need for sump tanks, motors or other storage facilities,” said Vishwanath, advocating for governments to push for 24/7 water supply.

Echoing similar arguments, Thippeswamy said that the move will also ensure reduced consumption as it would eliminate the need for people to store water for long hours. “Although we already have enough resources, if we can save around the unaccounted water, which is around 30%, we can supply 24/7 water.”

He also advocated that the BWSSB should adopt a Water Safety Plan, a comprehensive measure based on constant risk assessment and management, as advised by the World Health Organization (WHO).

The WHO emphasises that safe drinking water requires a preventive approach, not just reactive testing after contamination occurs. This is the foundation of Water Safety Plans, a systematic framework now adopted by countries worldwide to safeguard water quality from "catchment to consumer."

To ensure every Indian citizen’s basic right to clean drinking water, cities and governments need to prioritise maintenance over milestones, continuous supply over stop-gap fixes, quality over quantity and the safety of the most vulnerable neighbourhoods over headline-friendly rankings.

(With inputs from Ajith Athrady in New Delhi, E T B Sivapriyan in Chennai, Satish Jha in Ahmedabad and S N V Sudhir in Hyderabad)