Sustainable human resource management for implementation of health policies and programme with reference to mass gathering

 

Bhamray Dushyant Motiram^1*, Mehata Pallavi ¹ , Darekar Avinash Bhaskar ²

¹Faculty of Management, Pacific University Udaipur- 313003 Rajasthan.

²KVNSPS IoPER, Canada Corner, Nashik, Maharashtra.

 

ABSTRACT:

An endeavour of this study is to adopt strategies that were effective, efficient and reliably high performing and the public expected governments to be more selective. For choosing priorities for identifying problems, and objectives, and for rational assessment of alternatives for intervention could be a tool for decision-makers, acted an explicit framework to justify their choices. For guiding decision-making, the complexity of the health field was another argument that pleaded in favour of the development of a policy framework.  Various sectors may require working in conjunction as health problems were multifaceted. Both on the health of individuals and on other economic and social sectors all the actions undertaken in the health sector may have significant and long-lasting effects. Therefore, some wrong decisions in the field may have particularly disastrous effects. In the health sector, it was important that, the decision-making process should be anchored in solid analytical skills, based on the proven management techniques, best knowledge and guided by a clear vision and the means needed to get there. In this paper a crucial part of the health policy development process is the development of the workforce thus appears to be putting workforce problems on the political agenda. By developing explicit HRM policies is a way to clarify objectives and priorities in this area and to promote a more comprehensive and systematic approach to HRM. The expectations and needs of populations in the long term, the prospect opens by developing more responsive health care systems.

 

 

 

INTRODUCTION:

Recently, more attention has been paid to the development of health policies and programmes. But the presumed benefits of these policies, many authors and researchers shared the opinion that major drawbacks of health policies are their failure to make room for issues of Human Resources Management (HRM) and HRH Human Resource for Health.

 

 

Characteristics of HR activities in the health sector

In Human Resource Management the two planning approaches are not mutually exclusive, but can even be complementary. The rational approaches encourage recognition of the role of information, of modern analytical techniques and of decision-making tools for developing sound policies. the development and implementation of policies take place as the second approach brings an appraisal of the economic, political, cultural and social context. In the process of developing and implementing HRH policies there are also some specifics to the health context that need to be taken into account.

 

 

Kumbh Mela

'Kumbh Mela' is the largest peaceful congregation of pilgrims on the earth nad this festival, held in Allahabad, Haridwar, Ujjain and Nasik, which represents a synergetic set of rituals related to worship in India. It is a festive event and social ritual closely linked to the perception of its own history and memory of the community. The element is compatible with the existing human rights instruments since people from the walks of life, without any discrimination they participate in the festival with equal fervor. As a religious festival or spiritual mass gathering the tolerance and inclusiveness that Kumbh Mela demonstrates are especially valuable for contemporary world.

 

Public health perspectives from Kumbh Mela:

The Kumbh Mela is a three months long religious conglomeration held every three years in one of four different cities in the north of India, by rotation. The most famous being held in Allahabad called Prayag. This is considered to be the biggest human gathering on earth and the last one held in Allahabad in 2013 had 120 million visitors and latest held in 2019. With a history stretching centuries before Hajj, Kumbh Mela receives little attention in academic discourse. In relation to the incidents of MG tragedies occurring across the globe, and even in India for events on a much smaller scale, the Kumbh Mela stands out for its better track record on safety and management. This relative absence of large-scale human tragedy during the Kumbh Mela, coupled with the limited international media coverage of this predominantly regional, albeit massive, event, could be the reason for the lack of research studies on the subject. Nevertheless, the sheer magnitude of the event poses a significant logistical and public health problem, and exploring its management and execution could provide crucial lessons and highlight the challenges faced in the management of MGs from a public health perspective.

 

MG events pose a unique set of public health challenges, including stampedes, crush injures, burns due to fires, exposure to extreme weather, infectious diseases, water-, sanitation-, and hygiene-related illness, and epidemic outbreaks. During MGs, special attention is also needed in relation to disease surveillance, infection control, and water and sanitation. This requires setting up and implementing systems from scratch, or usually the up-scaling of existing systems in place. Growing numbers and ever-larger crowds gathering at MG events lead to ever-increasing health risks, making it imperative to have robust mechanisms for prevention and pre-empting public health risks. MGs may also have considerable implications in relation to other acute public health incidents such as pandemics and disasters, which also require planning, preparedness, and management, and an increase in the capacities of the health systems. However, resource materials and studies on how to prepare for and manage health risks during MGs have not been developed fully and most of the existing guidelines on MG events focus mainly on crowd control and the prevention of stampedes, with little attention to public health. This makes it imperative to take a critical look at the public health risks, such as infectious diseases, that could severely disrupt the management of MGs.

 

Public health lessons for mass gathering events The Kumbh Mela has moved from compulsory inoculations to addressing a wide range of health needs of the pilgrims, with enhanced medical services and safe water and sanitation services. While there is more that can be done, the overall health risks associated with Kumbh Mela have improved considerably. The process of evolution towards better outcomes, challenges faced, lessons learnt, and strategies used in a low-resource setting need to be better documented, studied, and evaluated. This can lead to pragmatic solutions, which can be integrated into planning and policy, as well as contributing to the evidence on minimizing the health risks associated with MGs.

 

METHODOLOGY:

In this primary data is collected through the following ways:

i) Questionnaire: Detailed and comprehensive questionnaire was prepared for all categories of citizens mentioned earlier.

 

ii) Discussion and Interviews: A detailed discussion with the persons directly and indirectly related to SKM was conducted. These persons are in the various capacities as Administrators/manager, doctor-owners, executives, farmers, businessmen, students etc. In the interviews, open end questions were asked to gather information. The interviews conducted were unstructured.

 

OBJECTIVES OF THE STUDY:

The main objectives of the study are:

1.     To identify the HRM practices in the in the implementation of health policies/program.

2.     To study of mass gathering events and advocate for improved policies and programmes in the context of health during mass gatherings resource management functions and activities.

3.     To collect data about the human resource management practices in the implementation of health policies to better understand the public health challenges during mass gathering events.

4.     To highlight the need for comprehensive planning, rapid detection and effective management during MG events such as Kumbh Mela.

5.     To suggest HRM policy and practices for enhancing the quality of health care in MGs

RESULT AND DISCUSSION:

The empirical data collected from a collective consist of 1300 respondents who experienced the Kumbmela 2015 through different comprehensive schedules is being presented in a tabular form, analysed and interpreted

 

The presentation of statistical interpretation has been adequately supported by graphs whenever necessary.

 

Table 1. Identification of hazards

 

 

The identification of hazards was reported by the respondents during the event and the administrative authorities were successful to consider and illuminated it. According to the data total 100 % (1300) respondents agreed that planning was the foremost step of mass gathering management.  Here it was revealed that planning was the first fundamental principal implemented by the authorities to make an event successful. 

 

It was the beginning of the implantation of “Explorative Research on Sustainable Human Resource Management for Implementation of Health Policies/ Programme Vis a Vis Its Impact on Public Opinion”.

 

On accord of all, 98.46 % respondents reported that the uncontrolled crowd was the biggest hazard to manage by the government authorities followed by terrorism and bomb blast 75.75%, Public health hazards 68.46%, flood 61.53%, earthquake 58.15 % and fire 43.07%. Health hazards associated with food poising and accidents caused by stamped main concerned while disease of eye infection and skin was also the matter of worry among the people. The swine flu was also noticed critical issue during the entire event of mass gathering in the city.

 

 

These hazards were planned well by the authorities and HR practices play an important role to plan the event successfully.

 

Out of the 2000 targeted citizens only 1300 supplied the questioners filled appropriately to consider the data for final statistical calculations and hence, were taken up for detailed study under. The data presented in the subsequent tables, therefore pertains to these 1300 sampled respondents.

Table 5.1.2. Factors for Assessment of risks

Particulars	No. of Respondents	Percent (%)
Risk identified and based on- Type of event, Duration Location Day and Time, Season of event Expected no of visitors Age and mood of crowd Weather and local hazards Public health and sanitation	770 808 910 955 767 1040 890 780 645	59.23 62.15 70.00 73.46 59.00 80.00 68.46 60.00 49.61

The broad classification of the risks identified based on particulars mentioned in public health and sanitation was least reported by respondents and only of 49.61 %. The reason for the same was that the Kumbh Mela though it was considered the biggest mass gathering in the world the health and sanitation would be managed because it has the long back history in Indian mythology to complete it with success and minimum mortalities. Also, it was noted that there was great spiritual belief behind it though the respondents were form the category of learned class. The season of event that in the era of reported event there was danger of swine flu and both communicable diseases people were worried but up to certain extents of 59 % only. While the type of event means the day of holy bath (Shahisnan) and weather andlocal hazards were reported up to 59.23and 60% respectively. Duration of the event means during the entire period of kumbmela and mainly at the time of parwani (shahisnan) the risk was expected at high and reported by 62.15 % of the respondents. Age and mood of crowd could be the risk factor and reported by 68.42 % while day and time of the events also respondents replied with 70 and 73.46 % respectively. As kumbmela considered to be biggest mass crowd event on the earth and country like India with 1250 million of population expected to visit in the city in only 1 % would be more than one crore in entire Kumbmela and hundred thousand of people during the very special days of the event.  The reason for the crowd may be due to ease of availability of mode of transport and city connected with all major railway stations and close to airports in the vicinity. Also, attraction about places like Nashik and Trimbakeshwar which have very special importance in Hindu mythology and culture. Even pilgrims and researchers from the developed countries could expect to visit during the event. It has also attracted the scientist and students not only to study the management and administrative point of view but also to know the culture and traditions of Indian people. Hence 80% of respondents were reported that the handling of crowd would be the biggest risk factor.

 

Figure 2. Identification of Risk

 

Table 2. Information, Awareness and Sensitization

Particulars	No. of Respondents	Percent (%)
Public awareness and sensitization	1126	86.61
Adequate Information, education and communication	1096	84.30

 

The impetus was given on public awareness and sensitization. Adequate measures were taken to ensure proper dissemination of Do’s and Not Do’s among the public. It was included information, education and communication materials. Leaflets on the same were widely distributed with all the information on emergency numbers, maps showing public amenities, emergency services, locations including clear information on safe exits and route maps displayed on important junctions. Hence regarding public awareness 86.61 % and about information, education and communication 84.30 % respondents reported that the administrative authorities were prepared well and were successful to execute the same.

 

Figure 2. Information, Awareness and Sensitization

 

 

 

Table 3.  Electronic display board and PA system

 

 

The electronic display boards were placed along with PA system/speakers to prevent rumours and to provide proper information on real time basis to the public. Signboards were used as media to spread awareness on announcement on emergency situations with 81.53 % respondents and lost and found 96.53%, information on public amenities 88%, maps and displaying important places 77.07% emergency numbers highest with 97.46% and may I help you counters 73.84 respondents found appropriate and appreciated the same. It was also included with blown up maps of the area displaying important places as police stations, hospitals, open spaces etc. were displayed on billboards. Emergency numbers (police, firefighter service, medical service, FDA, ambulance, NDRF, etc.) were displayed at all the locations. Adequate numbers of “May I help you” counters were set up at all strategic locations included entry and Exit routes, Airports, Railway stations, Bus stands, auto stands, event areas with well connectivity with centralized Lost and Found booths in the event area. The researcher’s attempted to determine the catchment area of these pilgrims revealed that majority of the devotees were from Kasmhir to Kanyakumari including NRIs.

 

Figure 3.  Electronic display board and PA system

 

 

Table 4. Effective crowd management

 

A mass of individuals /people in the continuous and staggered movement have the characteristics as individuals attempted to move faster than normal 76.92%, interactions between individuals/masses lead to formation of groups within crowd 98.23%, exists became arched and clogged 73.84%, escape was slowed by fallen individuals serving as obstacles 19.69%, Individuals displayed a tendency towards mass or copied behaviour 94.84% and alternative or less used exits/shortcuts were overlooked 27.53% respondents were reported positively.

 

 

Table 5.  Efforts for the crowd management

Particulars	No. of Respondents	Percent (%)
Trained security or volunteers Clear exit and entry points Flow of attendees/devotees Avoidance of overcrowding Fire safety protocols Emergency exits points Plan for fire evacuation	1090 1100 1007 1200 1056 560 610	83.84 84.61 77.46 92.30 81.23 43.07 46.92

 

Figure: 4. Crowd Management

 

The crowd management was handled by using measures that included- traffic control, controlled access to restricted areas, lost or misplaced persons reports and assistance/help for emergency services.

 

The respondents were ported that there were only 43.07 % emergency exit points identified and entire city was barricaded so no access found to local people during the ‘Shahisnan’ or ‘Parwani’. Firefighting services were already to handle any emergency services but only 46.92% reported for plan for fire evacuation. Flow of attendees / devotees were directed in proper direction and reported that 77.46 %, fire safety protocols with 81.23%, and trained security personnel or volunteer were deputed at all important places in adequate manner. Due to clear exit and entry points 84.61 % reported that there was proper control on crowd. Hence crowd moulding based on space of movement, clear direction, available time and flow of crowd was done effectively.

 

Figure:  5. Efforts for the crowd management

 

Table 6.  Strategies for efficient crowd management

 

As shown in table the following strategies were also adopted for efficient crowd management, making traffic /crowd flow in one /unidirectional flow in any way to avoid blockages almost all means 94.90%, segregation of crowd based on vulnerable groups, VIPs, Media etc. 78.76%. While emergency services like fire fighters, security, police and NDRF, first aiders, bomb squads, life guards were stained near the venue to avoid any eventuality with 87.57%. it was also observed that the restricted vehicular movement with in nearby region event areas with 96.76% with strict control on very limited and essential vehicles only. The proactive management of use of coaches and buses adopted to reduce private/individual vehicles and usage, to avoid poetical problems with large /multiaxial vehicles and their access difficulties with parking requirements and potential road blockages and traffic jams were reported by 100% respondents in their replies.

 

 

Figure 6. Strategies for efficient crowd management

 

Table 7. Proper traffic management

 

A proper display for direction and important information was reducing chaotic situations in such events was found with 68.46%, Vehicle movement was closely monitored and regulated in the area of event by using CCTV in 92.38%. Restriction on vehicles in crowed area, their diversion to some other non-crowed routes and permission to ply with only small/ non-polluting vehicles were allowed with 96.38% to avoid all types of consequences in all manners. For regulating traffic flowing points were kept in mind for VIP passes and OSD/emergency vehicles, media and vanity vans with 96.15% and other remaining 4% respondents were not reported any kind of reply as they may confused with their replay because entire city was banned to visit at all important places without valid entry passes. It was also mentioned that 94% clear and visible signs and directions at important places/sites with 78.84% wide entry and clear exit routes were available.

 

Figure 7.  Proper traffic management

 

Table 8. Medical aid, Hospital and healthcare management

 

The planned, prioritized and evaluated medical/ healthcare needs for the mass gathering were considered. It included planning for the number and location of onsite first aid posts and medical/health care facilities with 96.53%. Human recourse management is the heart of our research and it was also observed that the administrative authorities of all departments applied it so effectively with great outcomes of 100% results. It was managed so well including ambulances, paramedics, emergency physicians, nurses, first aid volunteers, safety/ security officers and pharmacists.  95.46% reported that there was effective planning by FDA for provision of medicines in all event days and dates at all location and at all times. There was complete coordination with other health authorities in availability of beds, wheel chairs and stretchers to handle all emergencies. Proper education and training of healthcare personnel/volunteers/students were provided with 92.94%, while coordination with local hospitals and nearby districts for additional medical assistance and emergency care was reported with 97.38%. It was also noted that 85% of the respondents reported that there was existence of defining chain of command and communication strategies.

 

Figure 8.  Medical aid, Hospital and healthcare management

Table 9. Strategies for first aid posts and supporting /auxiliary services

 

First aid posts were established at strategic locations within the vent area and 92.00% respondents reported that it was properly managed with the help of doctors, paramedics, trained volunteers, district administration Red Cross, NGOs and community pharmacist. Hospitals of neighbouring districts and towns were alerted for assistance during the mass casualty found 97.15% with the administration kept the ambulance database handy 92.30%. Certain number of hospitals in government and private establishments allocated in advance with some CCIU/ICU/isolated wards to address emergency situation with 96.53%. It was also reported that a network of hospitals doctors and healthcare centres were developed who would work in the period of event 94.61%. It was the FDA authorities who implemented the sustainable human resource management practices for implementation of health policies/program me and its impact on public opinion was remarkable with 97.96% in proper stock of medicine was maintained with some dedicated chemists and druggist shops with confirmation by manufactures and wholesalers. Blood banks were confirmed with sufficient no of blood bags of all blood groups along with list of possible donors were ready and found with 94.41%.

Figure 9. Strategies for first aid posts and supporting /auxiliary services

 

Table 10. Firefighting services

 

The firefighting was set –up on temporary basis at strategic locations based on the flow of crowd and the density of shops/ stalls and establishments with 73.84%. Firefighting equipment mounted on vehicles were installed at all important locations to increase accessibility of areas where difficulty to reach easily found reported with 86.82%. Dedicated and specialized team was ready to respond to any emergency with 81.38%, prepositioning of the staff and officers was being done for the entire period 73.07%. For fighting with fire officers were installed fire extinguishers at the places where the congregation was within an enclosure/temporary structures/religious places and halls with 78.69%.  All 100% respondents reported that all explosive and combustible materials were banned in event areas but 50% reported that fireworks/crackers were allowed only in open spaces and away from gathering/densely populated areas. Only 40.46% found with fire retardant solutions/materials were used to construct all temporary structures and 50.15% reported that use of incense sticks/oil lamps at densely crowd areas was strictly prohibited.

 

Figure 10. Firefighting services

 

Table 11. Illumination/lighting and electricity

 

Figure 11. Firefighting services

The respondents reported that temporary hazards such as damaged approach roads, bridges, pedestrian ways, subways, foot paths and ring roads etc. were indented and developed for smooth mobility with 96.53%. These temporary hazards were removed by repairing of bridges, dressing of roads, development of ring roads, proper tilling of pedestrian ways, repairing and maintenance of other structures such as walls and paver blocks etc. were found 94%. Temporary accommodation and shelter in Sadhugram(place were sadhus i.e. an ascetic holy men) was constructed to ease out traffic on few identified paths with 84.61 % respondents. Since public activity in such event were continued even at late evening hours, the roads were properly illuminated and the areas were lightened with adequate street lights which helped in curbing anti- social activities and all 1300(100%) respondents were found positive in these regards.

 

 

 

Table 12. Adequate Water Supply

 

 

Figure 12. Adequate Water Supply

 

 

The safe drinking water was one of the basic requirements and adequate measures were taken care of to ensure its constant supply during the period and around 96.53 found satisfactory with these provisions made by administration. Ware supply though regular underground pipelines, temporary pipelines and tankers were made available to the public/crowd visited in the vent with 97.15%. Priority was given for the quality of drinking water and water tanks were adequately cleaned and chlorinated 92.38%. Around 97.61% respondents reported that provision of temporary outlets/taps for drinking water and bathing was provisioned separately to meet surge in demands. 

 

Table 13. Sanitation and solid waste management

 

 

Figure 13. Sanitation and solid waste management

 

 

Respondents reported about safety and security, Law and Order as mentioned the garbage containers in adequate number were placed at all locations and all those containers were emptied frequently, at least twice a day to maintain a clean and safe environment with 84.46%.  74.48% reported that the number of containers were placed depend on the size of the expected crowd for the event, the population density, crowd movement and the amount of waste generated per day. While 65.84% were agreed that dustbins were placed at strategic positions likes near the venue, near vending shops, market places etc help to maintain the cleanliness in the area.

 

The municipal corporation was ensured that there was availability of adequate sweepers and waste disposal units which covered the entire area and sweeping was done every day before and after the crowd movement good number of 75.98 % and Daily on time picks up and disposal of solid waste was made effectively with 77.76%.

 

Waste disposal and landfill sites were identified well in advance and it was out of the vicinity of the city. To maintain the health and hygiene 70 % respondents found satisfactory with zero discharged toilets were constructed to prevent open air defecation and additionally, adequate numbers of mobile toilets were placed at strategic locations.

Total 80 % were in the site of consideration of flash flood or cloud burst and drainage system of the city or the event area was properly inspected to unclog it.

To handle and manage such big crowd it was essential that the mindset of crowd also played an important role along with the efforts taken by the administration despite of the regular fogging, sprinkling of bleaching powder and other pest control measures were taken to constrain communicable /non communicable diseases during and after the event 60.69% respondents were agreed over it.

 

Adequate number of the health/sanitary inspectors was deputed in major areas to supervise the sanitation and solid waste management related activities with 80.92%.

To handle all public activities smoothly regular and frequent cleaning of Ghats and areas around water bodies were carried properly with 67.68% and for filtering of pollutants and waste materials from water bodies were done regularly to prevent diseases and skin related ailments and diseases with 88.92%.

 

While 95.96 % respondents were reported that the Green initiative such as banned on plastic and polythene bags during event period and use of paper bags, clothed carry bags and zero garbage etc under the initiate of ‘ Haritkumbh’ was promoted.

Table 14. Capacity Building by stakeholders/volunteers

 

 

Figure 14.  Capacity Building by stakeholders/volunteers

 

 

The city/town where the event was held identified the volunteer groups such as NCC,NSS,Red Cross, Students from local colleges and schools with proper training were deputed to help the administration in the various activities. 92.15 % respondents revealed that these groups acted as excellent resources responding to any unforeseen events and they were the helping hands to police and other administrative authorities. Simultaneously the police official and security personnel were given basic refresher on disaster management and imparted training on communication, behavioural and soft skills as they were interfacing very closely with general public but only 43.76% people were known about these aspects.

 

 

Table 15. Special care facilities

 

Figure 15. Special care facilities

 

 

As mentioned, senior citizens, pregnant women and children from a very sensitive and vulnerable group of the society. Hence, they needed special care and attention, while the administration paid special efforts and appreciated by 74.30 of people. Total 88.07% admitted that rickshaw and battery-operated vehicles, ambulances; emergency vehicles etc. were made available to such groups on emergency basis. Temporary/ permanent changing rooms for women near Ghats were provided for privacy, security and to reduce anti-social activities and very high appreciation reported by the respondents that 95.76% replied positively.

Table 16 Safety and Security, Law and Order

 

 

Planning, organizing, close coordination and working relationships were maintained throughout all stages of the event by:

 

The District administration 96.61%; The Health and medical services including FDA department 98.23%.

 

Other Police and other emergency services 87.23%, Fire fighters 83.84%; and Other security services including Civil Défense, Home Guards, NCC, Scouts and Guides, registered self-help groups and self-volunteers etc with 84.76%.

 

Police patrolling needed to beef up during the event with mobile vans and temporary check posts positioned strategically to constrain anti-social activities such as chain snatching, eve-teasing, and looting, vandalism, and molesting etc. with75.76%.

 

 

CCTVs with cameras were installed at important junctions, markets, bus stands, railway stations, ghats, kunds, temples, hospitals, shahipaths and event areas to have better monitoring mechanism. The CCTVs system were having sufficiently large back up periods (72 hrs or more) and storage facilities with 100%.

 

Watch towers with adequate resources were constructed at important places and all strategic locations for constant monitoring of the event area.

 

Such type of mass gathering events are soft targets for terrorists and antisocial groups; hence administration was ready for any unprecedented situation with sufficient number of Home Guards, NDRF along with bomb squad and sniffer dog squad were stationed at strategic locations in the area. NDRF had a highly developed team of divers, motor boats and accessories. They had their presence in and around the Ghats, Kunds and Shahipaths.

 

Table 16. Safety and Security, Law and Order

Table 17.  Control Room/Incident Command Centre (ICC)

 

 

To monitor, manage and make all emergency decisions, a dedicated center was established to coordinate with all concerned authorities with 55.57%. 74.38 % respondents reported that an Incident Command Center was ready to act as an Emergency Operation Center during the event. It was housed with CCTVs display/monitoring units, the communication equipment such as satellite phones, mobile phones, fax, fixed/ land line , walky-talky, computers, laptops, internet connectivity, video calling/ conferencing/ facility, teleconferencing, drone cameras, power back-up, trained technical staffs and important decision makers (in all shifts and 27X7) with skill and experience. The Lost and Found Booth and the security department was coordinated by ICC controlled with the PA system and all 100 respondents were very positive by these efforts of the administration as there was not a single case reported during this biggest mega event on the earth.

 

Figure 17. Control Room/Incident Command Centre (ICC)

 

Table 18.  Electricity and power supply

 

 

The respondents reported that-

55.57% for electricity supply based on extent and duration of event for uninterrupted supply of the electricity the entire area was divided into zones.

52.07% for adequate umbers of substations (based on load) and transformers were installed in and around the event area.

 

24.92% to meet any sudden surge in demand at any point there were mobile transformers readily available.

74.38% to minimize the increasing the risk of electrocution there was no wiring very close to the water bodies.

 

66.69% for the electric guarding and concealing was properly done so as to cut-off electricity supply in event of breach in wiring and power cut off.

 

76.53% for the PVC insulated pipes were used at all Places where wires come in close vicinity of people.

35.07% to reduce any chance of electrical overloads and related failure use of MCB/ LCB and copper wiring was found perfect.

 

69.15% there was proper planning of electricity supply and network of High-tension wires and Low-Tension wires so as to avoid heavy crisscrossing at major/ crowded junctions and densely populated areas.

 

81.53% The entire street lights were repaired; reinstalled and additional temporary street lights were being installed for complete illumination and brightening.

 

86.155 for the power back-up with provision of adequate fixed and mobile generators were done to avoid any blackout.

 

Figure 18. Electricity and power supply

 

 

Table 19. Use of modern technologies

 

The administration started investing on technologies such as-

65.38 % Geospatial technology for mapping of the space for better planning and quicker response.

 

52.07% The cloud-based crowd system counted the number of people walking over a specialized sensor mat.

24.92%RFID (Radio Frequency Identification) checked movement of people or crowd. 76.15% Good Public Addressing system, Enhanced Information Technology to visually monitor the space such as surveillance camera/CCTV etc and other surveillance devices.

 

35.07% Cyber security team was on high alert monitoring popular social media sites so as to prevent rumours and incorrect information to public and society.

60.38 % Ban imposed on improper/ unauthorized announcement systems and closed check on unnecessary replication of the same information as inappropriate announcements add to rumours and create confusion during the event.

 

52.69 % Information regarding the place, weather, traffic, route, public amenities, security and emergency services etc. was made available to public on internet and through mobile apps.

 

Figure 19.  Use of modern technologies

Table 20.  Role of Media / Publicity

 

The administration had deployed personnel on time and place for disseminating the information on regular basis from the field and to the control room with 53%. Around 69.15 % reported that the media personnel were given strict instructions on type of information that needs to be disseminated and casting the same. 85.30 believed that the regular briefing of media by administration was made to help developing a better coordination between media personnel, administration and devotees.

Media services like print, voice or visual - was an organized means of reaching a large number of people, quickly, effectively and efficiently. The suggestive, informative and analytical role of the media was a key component of disaster management, educating people about the hazard, prevention and self-help during the disaster and traumatic situation.

 

Media played important role in the following areas:

69.59 % in early warning alert to the people/ pilgrims

85.38 %  in making appeal to the people/ devotees/ pilgrims.

52.07 % in preventing rumors and panic management in the city.

68.46%  in controlling law and order situation at any time.

26.61% in replacement of established communication network

Table 21 Involvement of local groups

 

Figure 20.  Involvement of local groups

Administrative authorities were identified clearly the roles and responsibilities of the local groups and issued clear instructions to them in discharging their part of duty in collaborative and accountable manner and reported in the 88.83% cases. While the administration ensured that there were no mushrooming of such local groups thus causing conflict, civil unrest, confusion and frauds with 60.69%.

 

Table 22. Post disaster incidents management

 

Figure 21. Post Disaster Incidents Management

 

 

The 799 (61.46%) respondents reported on the comprehensive Disaster Response Plan was ready with all the departments of the government agencies. While prepositioning of specialized teams such as that of NDRF, Civil Defence, Search and Rescue team, First Aid team, Logistics Management team etc. was a precautionary and preparedness measure with zero error in 69.23% cases.   

 

Table 23. Plan for reverse logistics/exits

 

The events of mass gathering were temporary in nature and hence, a clear exit plan and reverse logistics need were included in the planning process. In 100% respondent replied that it helped to bring the city or the locality back to state of normalcy.

 

Table 24. Documentation records

 

 

Figure 23.  Documentation records

 

A proper documentation of each and every aspect of event was done right from the beginning or planning phase and extended up to the event execution and exit with 91.53 % people. 76.07 reported that the proper and compete documentation was most helpful toolkit to learn from the past and implemented the good practices evolved during the last event, and the needed assessment for future events.

 

 

Table 25. Event outcomes and HR perspectives

 

Figure 24. Event outcomes and HR perspectives

 

It was the secret of success by government and local bodies to coordinate and execute the desired policies and programs effectively. Out of 1300 participants around 1290(99.23%) respondents were replied very positively for this parameter under the study. Public opinion about sustainable human resource management for implementation of health policies/ program was found satisfactory with 97.46% of the respondents.

 

DISCUSSION:

The last one took place in 2003 and after twelve years wait for a holy dip to attain true enlightenment got over when Simhastha Kumbh Mela in Nashik began from July 14, 2015. Devotees from all across the country and outside were ready for a ‘holy dip’ at the bank of river Godavari at Trimbakeshwar in Nashik, which was all set to host one of India’s biggest religious festivals Kumbh Mela, the Government of Maharashtra (GoM) was all geared up to welcome them.From sanctioning the budget of over Rs.2000 crore to setting up 22 departments to putting up 700 CCTV  to waste management- the GoM had done all possible arrangements at the venue, which was expected to receive about 10 million pilgrims and visitors over the period of three months. According to Nashik district collector, at least 8 to 10 million visitors were expected that year. The Kumbh Mela, in 2003, witnessed approximately 0.5 million people only for Nashik city, and at Trimbakeshwar, it was 2.5-3.0 million for each Shahi Snan, adding, in year 2015 the event had witnessed approximately (on higher side)0.9 to 01 million people, on each Shahi Snan. The Shahi Snan was ritual which involved taking a holy dip in the river. In the year 2015, the ritual took place at Nashik HQ and the Trimbakeshwar Shiva temple by the river Godavari.  Expected a huge turnout of visitors, the state government had been sanctioned Rs.2,37.8 million to the organising committee to arrange all possible amenities and facilities. The sanctioned Rs.237.8 million utilized for infrastructure such as development of ghats, roads, flyovers, railway stations, and airport. Around 5-10 per cent of the fund used for temporary facilities such as parking, Sadhu Gram, sanitary, emergency services and drinking water facilities. To avoid mishaps and to keep a vigilant eye on the event, 22 departments had been set up by the organising committee. No shelter provided to visitors and Sadhus got plots, where they fixed their own tents. The GoM not provided tent or hut and just allotted plots to them (Sadhus) and named the area as ‘Sadhu Gram’. People looked for comfortable stay opted for hotels, guest houses, cottages, or even the dharamshalas. However, there was difficulty in finding budget hotels or cheaper stay during the Shahi Snan. IT (Information Technology) team had been put in place to tab all activities during the event. Visitors received necessary information from the Kumbh Mela’s special website (www. kumbhmela.net) and from mobile applications.

 

IT team installed more than 700 CCTV cameras in Nashik and at Trimbakeshwar to monitor the festival and a special toll-free helpline, 18002339985, had been set up for any emergency and to disseminate important information. They set up more than 60 LED video screens to provide live updates on the mela, including darshan of Trimbakeshwar Shiva Temple, and Shahi Snan along with displaying important information such as route maps, do’s and don’ts and photos of ‘most wanted’ criminals and missing person on regular intervals. Special community radios had also been set up in 3,000 buses to provide necessary information regarding the event.

 

Simhastha Kumbh Mela 2015 also known as ‘Harit Kumbh’ or ‘Green Kumbh’. The organising committee had taken various steps to clean the environment, including cleaning of river Godavari, removing 20,000 metric tonnes of waste from there, and planting 1 lakh saplings in the district, as the concept of ‘Green Kumbh’ was launched by the GoM to make the event eco-friendly. Various cleaning programmes were held on May 21, 28 and June 5, 2015 respectively.

Environmental- friendly bags were distributed at each toll plaza of the city. By giving jute and cotton bags at each toll plaza and all those entering in the city received jute bags. The size of these bags was between 5-10 litters, and carried a message “Don’t use plastic in Kumbh, Over 20,000 paramilitary and security forces had been deployed for the event completely barricading the city and over 60 units of dispensaries and medical teams, 25 emergency units and over 35 mobile medical units were working at the festival venues. Around 200 ambulances were available for the SMK. More than 20-25 thousand toilets had been constructed other than the urinary.  Large dustbins were provided at each tea or food stalls. All the waste material was collected after every interval. A total of 8,000 workers in three different shifts were deployed in Nashik and at the Trimbakeshwar, Shiva Temple. To keep the river clean, three sewage treatment plants were constructed to avoid untreated sewage water not be released into the river. Since Nashik is the only place where Kumbh takes place during monsoon season, there was a chance of excess flow in the river. Therefore, the government controlled the flow current from the dam, which was located at 25 km away. In excess rainfall, people were not allowed to enter into the river. In such cases, emergency alarms installed at handy. Most of the visitors were expected to come via road. But the GoM had special provisions on the railway stations also. As a lesson from the previous Kumbh mela’s mishap, in year 2015 the organizing committee had decided that the platform of arrival trains and departure trains were remain the same. There were no last moment changes.  Total 3000 buses had been assigned from outer to inner parking to avoid traffic jam at or near the SMK venue. Everyone, the government and concerned authorities were remain on their toes to deal with any untoward incident till the event end on September 25, 2015.Hence there was no major casualty reported at any stage of the event which as the secret of success of this world’s biggest mass gathering.

 

CONCLUSION:

As one of the biggest congregations in the world, Kumbh Mela saw a massive 12 million people attended it. With a population so large, it was a herculean task for the district administration to manage the event safely and successfully. The task was well managed by the administration, there were some isolated incidents of injury, life loss or any other incidents not observed as is was serious issues reported in all previous events.

 

The Mela was acknowledged to be traditionally managed; however, at this time the state government introduced modern technologies to manage the crowd. There were CCTV cameras, modern firefighting instruments, well equipped search and rescue teams and use of digital technology was opted at high level including drone cameras and starting of age of AI (Artificial Intelligence) etc. The total efforts were planned one and hence most of the activities were executed seamlessly.

 

There was however some slack in the planning as the administration could not allow the local population in first Parwani (a holy day of royal bath) to participate and prevent them by barricading the city which was eliminated in next all Parwani days. Also, a more aggressive awareness generation campaign was carried out to educate people of the personal safety measures.

 

Despite the shortfalls, one must appreciate that the government has done splendid work in managing this event of mass gathering and it has been able to handle a crowd of 120 million at a space as small as 50 square KM. Hence, it has adopted some of the best practices that have captured attentions of many practitioners, governments, international research firms etc.

 

This study was undertaken as special case study of use of HRM in management of health in world’s biggest congregation or Mass Gathering (MG) to capture these best practices from Simhtha Kumbh Mela (SKM). It may be useful for the other stare government of India in managing Kumbh Mela or similar events of MGs in a peaceful way with utmost safety and security.

 

SKM poses a complex public health challenge. The difference in healthcare seeking attitude and religious beliefs combined with high crowd mobility made it particularly difficult to measure the disease burden accurately. However, the focus was should not be only on accurately measuring the disease burden but also on mitigating the potential risk factors. Disease diagnosis, treatment and prevention more targeted by doctors and public health authorities who were aware of the common health risks involved during the pilgrimage.

 

Further research is needed on Kumbh Mela to bring into focus the strengths and weaknesses of this large event for its further improvement.

 

Public health lessons for mass gathering events The Kumbh Mela has moved from compulsory inoculations to addressing a wide range of health needs of the pilgrims, with enhanced medical services and safe water and sanitation services. While there is more that can be done, the overall health risks associated with Kumbh Mela have improved considerably. The process of evolution towards better outcomes, challenges faced, lessons learnt, and strategies used in a low-resource setting need to be better documented, studied, and evaluated. This can lead to pragmatic solutions, which can be integrated into planning and policy, as well as contributing to the evidence on minimizing the health risks associated with MGs. Otherwise there is a danger of losing the valuable lessons learnt in this process, leading to institutional memory loss, necessitating the proverbial ‘reinventing the wheel’ each time. Researchers have repeatedly pointed out the need for a specialized interdisciplinary approach to understand the health challenges that MG events pose.

 

From the above study it was concluded that fore effective implementation of health-related issues, sustainable HRM is the need of time and converging it with digital enabled solutions such as AI (Artificial Intelligence) will in a long way help in optimizing and effectively, efficiently help in managing such Mass gatherings.

 

REFERENCES:

1.          Alan M.  and Zuckerman. Healthcare Strategic Planning.  Prentice hall of India private Limited, New Delhi, 2006.

2.          Bapu PG. Marketing of Healthcare Services. Abhijeet Publications, Delhi, 2006.

3.          Bernard Katz. How to turn customer service into customer sales. Jaico Publishing House, Mumbai.2009.

4.          Bohlander G and Snell S and Sherman A. Managing Human Resources”, United States: South-Western College Publishing. 2004.  

5.          Budhwar PS. Human Resource Management in India. London: Routledge.2004.

6.          Pittsburgh PA and DeCenzo DA and Robbins SP. Personnel / Human Resource Management, New Delhi: Prentice Hall of India Pvt. Ltd. 2008.

7.          Krishna Mohan G and Krishna Naik CN. Health Care Marketing. Discovery Publishing House, New Delhi. 2006.

8.          Salgaonkar PB. Marketing of Healthcare Services. Abhijeet Publications, Delhi. 2006.

9.          Gomez-Mejia and Cardy RL. Managing Human Resources, Upper Saddle River, NJ: Prentice Hall Heneman. 1985

10.        Hussain SA. The National Culture of India, New Delhi: National Book Trust.1994.

11.        Kishore J. National Health Programs of India - National policies and legislation Related to Health.  Century publications, New Delhi.2006.

12.        Kandula SR. Human Resource Management in Practice: with 300 Models, Techniques and Tools, New Delhi: Prentice Hall of India Pvt. Ltd.2005.

13.        Memoria. CB. Personnel Management, Bombay: Himalaya Publishing House,1982.

14.        Bach S. HR and new approaches to public sector management: Improving HRM capacity. Prepared for the Global Health Workforce Strategy Group. Geneva: World Health Organization; Available from: URL: http://www. who.int/health-services delivery/human/workforce/papers/HR.pdf. [Last accessed on 2015 May 07].

15.        Bennett S and Franco LM. Health worker motivation and health sector reform. PHR Primer for policy makers. URL: [http://www.phrplus.org/Pubs/pps3.pdf] Washington: PHR Project.

16.        Egger D and Adams O. Imbalances in human resources for health: Can policy formulation and planning make a difference? Human Resource Devel J. 3:1. URL: [http://www.moph.go.th/ops/hrdj/hrdj6/table_contents.htm]. 2015.

17.        Abraham, M. Globalization and the Call Canter Industry”, International Sociology. 2008; 23(2): 197-210.

18.        Adams OB and Hirschfeld M.  Human resources for health – challenges for the 21st century. World Health Stat. 2010;(1):28-32.

19.        Alexander RA and Barrick MR. Estimating the standard error of projected dollar gains in utility analysis”. Journal of applied psychology. 1987; (72):475-479.

20.        Amba Rao SC. US Human Management Resource Principles: Cross-country Comparisons and Two Case Applications in India”, The International Journal of Human Resource Management. 1994; 5(3):755-778.

21.        Balasubramanian AG. Evolution of Personnel Function in India: A Re-examination, Part II”, Management and Labour Studies. 1995; 20(1): 5-14.

22.        Bhal KT. Perceived Role of Human Resource Management in Indian Organizations: An Empirical Study 1”, Global Business Review. 2002; 3(1):139- 152.

23.        Bhatnagar J. Looking from the Organizational Learning Lens at Technology enabled HR in Indian Organizations”, International Journal on Human Resource Development and Management. 2007; 7(1): 53-66.

24.        Bhatnagar J. Predictors of Organizational Commitment in India: Strategic HR Roles, Organizational Learning Capability and Psychological Empowerment”, International Journal of Human Resource Management. 2007;18(10).

25.        Bhatnagar J and Sharma A. The Indian Perspective of Strategic HR Roles and Organizational Learning Capability, International Journal of Human Resource Management. 2005; 16(9):1711-1739.

26.        Biscoe G. Human resources: the political and policy context. Human Resource Devel J. 2000; 4:3.

27.        Bjorkman I and et.al. Human Resource Management in foreign-owned Subsidiaries: China Versus India”, The International Journal of Human Resource Management. 2008; 19(5): 964-978

28.        Budhwar PS and et.al. Human Resource Management Systems of Indian Call Centres: An Exploratory Study”, International Journal of Human Resource Management.2006;17(5): 881-897.

29.        Ghosh P and Geetika. Recruiting Strategies: Exploring the Dimensions in the Indian Software Industry”, Asian Journal of Management Cases. 2007; 4(1): 5-25.

30.        Srinivasa Rao A. Effectiveness of Performance Management Systems: An Empirical Study in Indian Companies”, International Journal of Human Resource Management.2007; 18(10).

31.        Sunil Kumar Maheshwari and Ramesh Bhat. Challenges in sustaining a hospital: Lessons for Managing Healthcare Institutions”; Working paper No. 2004-02-03, February 2004.

32.        Suzanne C. and et.al. The Relationship Between Self-Reported Emotional Health, demographics, and Perceived Satisfaction with Prenatal Care”; International Journal of Health Care Quality Assurance, Emerald Group Publishing Limited.2004; 17(1); 26-38.

33.        Thomas V and Pemeger.  A Research Agenda for Patient Safety”; International Journal for Quality in Health Care, Published by Oxford University Press. 2006;189(1): 1-3.

34.        Tony Tricker. Student Expectations - How do we measure up? School of Computing and Management Sciences Sheffield Hallam University, UK. 2003.

35.        Ugur Y and Natalia R. Assessing Performance of Multi-Hospital Organizations: A Measurement Approach”; International Journal of Health Care Quality Assurance, Emerald Group Publishing Limited. 2005; 18(3): 193-203.

35.     Varma A and et.al. The Role of Interpersonal Affect in Performance Appraisal: Evidence from Two Samples - the US and India”, International Journal of Human Resource Management. 2005;16(11): 2029-2044.

36.     Vasco EJ and Anto'nio F. Quality Evaluation in Health Care Services Based on Customer-Provider Relationships; International Journal of Health Care Quality Assurance; Emerald Group Publishing Limited, 2005;18(6) 404-412.

37.        Dube N. Human Resource Management In India Industries,.Dr. Rammanohar Lohia Avadh University, Faizabad.2008.

38.        Vettriselvan, R. Human resource management practices in small and medium enterprises in select districts of Tamil Nadu.2010.

39.        Sawant, PD. Study of human resource management   Maharashtra Vidyapeeth, Mumbai.2018.

 

 

 

 

 

Received on 25.09.2019            Modified on 30.10.2019

Accepted on 12.11.2019           ©A&V Publications All right reserved