Indore’s Waterborne Epidemic Followed Years of Documented Complaints and CAG Warnings

In 2016, the Ministry of Housing and Urban Affairs instituted the Swachh Survekshan Awards under the Swachh Bharat Mission. The awards acknowledge and benchmark cities, towns, and States on the basis of their performance in waste management, hygiene, and sanitation. In the inaugural year, Mysuru was crowned India’s cleanest city, while Indore placed 25th. The following year—and every year since—Indore has retained the title of India’s cleanest city for a staggering eight consecutive years. In 2021, Indore was conferred the distinction of India’s first “Water Plus” city, recognising its excellence in wastewater management and its success in eliminating the discharge of untreated waste into water bodies. However, the developments of the past few weeks have imperilled these titles and cast serious doubt on the credibility of the awards’ standards.

Between December 24, 2025, and January 10, in Indore, nearly 20 individuals died after drinking contaminated water. According to Amulya Nidhi, the national convenor of Jan Swasthya Abhiyan, close to 3,000 residents were hospitalised across the city, with nearly 200 still in intensive care units. A majority of those affected hail from the urban slum of Bhagirathpura. Complaints over substandard water quality predate the present crisis. In 2025, the municipal corporation recorded 266 complaints about the water quality, of which 23 formal submissions came from Zone 4, the administrative division that includes Bhagirathpura.

The health administration in Indore has designated the waterborne disease outbreak in Bhagirathpura as an epidemic, and has mobilised specialised teams from both the Central and State governments to curb the spread of the disease and ascertain the root cause of contamination. A public toilet without the mandatory septic tank, built on top of an ageing pipeline near a police outpost, was initially pinpointed as the source of the contamination of the city’s drinking-water network. The structure has since been razed, and authorities are still probing whether the contamination spread through local borewell connections.

Speaking to Frontline, Dr Danish Ansari, a medical officer at the Community Health Centre in Pithampura, Indore, observed that the death toll could have been lower had the victims been identified and profiled sooner. “Because it was predominantly a low-income neighbourhood, many daily wage earners were reluctant to forgo work or incur medical expenses. They assumed the illness would subside within a day. This mindset contributed significantly to delayed treatment for many,” he remarked. “Currently, many patients are recovering in hospitals across the city, while several have passed beyond the point of recovery. Among them are children and elderly individuals with compromised immune systems, rendering them more susceptible to comorbidities.”

Mismanagement of funds

The deaths underscore the systemic frailties and long-standing deficiencies in the State’s healthcare and water-supply apparatus. The Comptroller and Auditor General of India (CAG), in Report No. 3/2019 on the water-supply systems of Indore and Bhopal, documented that between 2013 and 2018, 5.45 lakh cases of waterborne diseases were recorded in the two cities. This was attributed to the government’s failure to supply safe drinking water to 3.62 lakh families in Bhopal and 5.33 lakh families in Indore—amounting to a combined 8.95 lakh households.

The report further flagged that no water audit was undertaken by the municipal corporations of either city. Consequently, a comprehensive assessment of the water-supply systems could not be determined. The Indore Municipal Corporation (IMC) allocates approximately 25–30 per cent of its budget to water supply and sanitation. This expenditure has expanded from Rs.1,680 crore to Rs.2,450 crore over the past five years. In addition, investments of several thousand crores have been channelled through the Asian Development Bank, the AMRUT (Atal Mission for Rejuvenation and Urban Transformation) scheme, and the Smart City Project to upgrade the water supply infrastructure and ensure round-the-clock provision. Yet, despite this massive outlay, the city’s water-supply infrastructure continues to be in a deplorable state.

The Jan Swasthya Abhiyan (JAS), Madhya Pradesh, has addressed a letter to Union Minister of Jal Shakti C.R. Patil, the Minister of the Public Health Engineering Department, and the Chief Secretary of Madhya Pradesh, listing 13 demands about the contaminated drinking-water supply in Indore. Amulya Nidhi, the national convenor of the JAS, interrogated the utilisation of public funds. “Where has the money gone? It’s almost one third of the whole budget. This suggests not merely expenditure in the name of water, but a deeper pattern of mismanagement. In several stretches, drainage lines and drinking-water pipelines have been laid perilously close—on opposite sides of the same drainage chamber—only to converge barely a kilometre later,” he said.

Nidhi further pointed out that over the past six months, more than 300–400 complaints had been lodged about foul-smelling and visibly contaminated water in the area, but these warnings, he alleged, were repeatedly disregarded by the authorities. “By ignoring these complaints, the administration has now allowed groundwater contamination to take hold,” he said.

‘Criminal negligence’

For the past 25 years, Madhya Pradesh has been predominantly governed by the BJP and, in recent months, the State has seen a spate of healthcare crises occurring almost every month. These have ranged from the deaths of two infants following rat bites in a neonatal intensive care unit, to the loss of more than 20 children after ingesting spurious cough syrup, to the incident in Satna, where children were administered HIV-positive blood.

Calling the latest episode “criminal negligence”, Nidhi alleged the existence of large-scale corruption. “There is corruption—very clearly. Funds are sanctioned, but where has the money gone?” he asked. He pointed out that under the Asian Development Bank’s loan conditions, a water audit is mandatory, yet no such audit was ever conducted, a lapse the CAG report itself documents.

“The CAG report clearly established that nearly 8.95 lakh people were exposed to contaminated water supplied to residents of Indore and Bhopal. Correspondingly, health department data records 5.45 lakh cases of waterborne diseases in these two cities over a five-year period,” he noted. Despite the CAG flagging extensive water wastage and the absence of audits as early as 2020, authorities have failed to initiate corrective action over the past five years.

Sanjay Yadav shows a picture of his mother, Urmila Yadav, who died after drinking the contaminated water supplied by the Indore Municipal Corporation in Bhagirathpura, Indore.
| Photo Credit:
A.M. Faruqui

T. R. Sreekrishnan, Professor in the Department of Biochemical Engineering and Biotechnology at the Indian Institute of Technology Delhi, with recognised expertise in wastewater engineering and management, attributed the tragedy to the absence of a preventive maintenance regime. “There is a reason—and that reason is money. Preventive work is routinely deferred: what ought to be done tomorrow is postponed to the day after, or even later, because it requires expenditure and funds are diverted towards what are perceived as more ‘important’ priorities. That sense of importance is constructed, not objective. When a catastrophe of this nature unfolds, no one will hesitate to overhaul the entire water-distribution pipeline of Indore. But had the same question been posed a day or two earlier, the response would have been predictable: there is nothing to fix, there is no money. This, precisely, is how the tragedy materialised,” he told Frontline.

Sreekrishnan added that incidents of this nature must be averted at the maintenance stage, rather than through design modifications or post-facto responses. “The critical question is what happens to the water as it travels through the pipeline and eventually reaches households. Ideally, the pipe should be intact, free of breaches, and of adequate quality. But in reality, that is seldom possible. In many places, pipelines were laid decades ago, only for buildings to be subsequently constructed above them. In several cases, the pipelines themselves can no longer be traced, let alone inspected for leaks or breaches,” he explained.

Lack of implementation

More recently, in Uttar Pradesh’s Greater Noida, over 15 residents fell ill with symptoms mirroring those reported in Indore. In response, the authorities constituted a “special committee” to inspect and address issues related to the drinking-water supply. Many experts advocate the enactment of a comprehensive Water Safety law, modelled on existing food-safety legislation.

However, Sreekrishnan argued that legislation alone would do little to remedy the crisis. “Our laws are among the best in the world. We are not bad at making laws; we are extremely poor at implementation. You may enact any law you like, but unless ground realities shift, it serves little purpose. I am not attributing this failure to any particular political party. There are structural reasons why policies flounder on the ground. My own research focuses on wastewater treatment and environmental systems, and through sustained collaboration with scientists and professors abroad, it becomes evident that our constraints are unique. The scale at which we must deliver services is enormous, and priorities in “peaceful” or non-crisis periods are consistently relegated. In ordinary times, water safety simply does not command attention—and that, fundamentally, is the problem.”

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