In Mumbai, most all residents are delivered their daily supply of water for a few hours every day, on a water supply schedule. Subject to a more precarious supply than the city's upper-class residents, the city's settlers have to consistently demand that their water come on “time” and with “pressure.” Taking pressure seriously as both a social and natural force, in this article I focus on the ways in which settlers mobilize the pressures of politics, pumps, and pipes to get water. I show how these practices not only allow settlers to live in the city, but also produce what I call hydraulic citizenship—a form of belonging to the city made by effective political and technical connections to the city's infrastructure. Yet, not all settlers are able to get water from the city water department. The outcomes of settlers' efforts to access water depend on a complex matrix of socionatural relations that settlers make with city engineers and their hydraulic infrastructure. I show how these arrangements describe and produce the cultural politics of water in Mumbai. By focusing on the ways in which residents in a predominantly Muslim settlement draw water despite the state's neglect, I conclude by pointing to the indeterminacy of water, and the ways in which its seepage and leakage make different kinds of politics and publics possible in the city.

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In this article I explore the political and technical controversies of measuring water leakages in Mumbai to demonstrate how the dense historical accretions of technology, material, and social life that form hydraulic infrastructures in Mumbai trouble the audit cultures of neoliberal government. While scholars have recently drawn attention to the generativity of ignorance in the making of the state, in this article I argue that ignorance is not only a technology of politics, produced and managed by municipal water engineers and their subjects. Leakages, and the ignorances of leakages, are also enabled by the vital materiality of the city’s infrastructure. As engineers work hard to improvise resolutions to the leakages they can fix, and ignore the thousands of others they cannot, the processes of leakage always exceed the control of the city’s government. As such, the uncertain appearances of leakage in Mumbai not only provide the grounds for the work of the state. Leakages also constantly disrupt governmental projects in ways that make the water department vulnerable both to the claims of marginalized subjects and to new reform projects in the city.

Infrastructural practices, made by the manipulations of pumps, pipes and hydraulic expertise, play a critical role in managing urban populations. Drawing on two years of ethnographic research in Mumbai, in this article I show how Muslim settlers in a northern suburb, are being rendered abject residents of the city. Abjection isn't not a lack of social and political entitlements, but a denial of them. As Muslim settlers are being pushed down to claim less desirable water through the deliberate inaction of city engineers and technocrats, this article shows the iterative process through which abjection is made through tenuous and contentious infrastructural connections between the government and the governed.

In scholarly and popular texts, Mumbai is invoked as an iconic example of the problem of urban informal settlements in the twenty‐first century. While such representations oscillate between tropes of accommodation and marginalization, they often obfuscate the compromised and historical successes of settler politics in the city. In this paper, the authors use an international urbanization conference as a starting point for exploring Mumbai settlers’ housing practices. They examine the processes through which emergent forms of inclusion have been conceptually unhinged from longstanding struggles against inequality. By examining the complex interplay of housing politics, social mobilization, and municipal policy in Mumbai, the paper argues for more careful attention to new regimes of governing that accompany aspirations for “inclusion” in the cities of the urban age.

Study Objectives: Peripheral arterial tonometry (PAT)-based technology represents a validated portable monitoring modality for the diagnosis of OSA. We assessed the diagnostic accuracy of PAT-based technology in a large point-of-care cohort of patients studied with concurrent polysomnography (PSG). Methods: During study enrollment, all participants suspected to have OSA and tested by in-laboratory PSG underwent concurrent PAT device recordings. Results: Five hundred concomitant PSG and WatchPat tests were analyzed. Median (interquartile range) PSG AHI was 18 (8-37) events/h and PAT AHI 3% was 25 (12-46) events/h. Average bias was + 4 events/h. Diagnostic concordance was found in 42%, 41%, and 83% of mild, moderate, and severe OSA, respectively (accuracy = 53%). Among patients with PAT diagnoses of moderate or severe OSA, 5% did not have OSA and 19% had mild OSA; in those with mild OSA, PSG showed moderate or severe disease in 20% and no OSA in 30% of patients (accuracy = 69%). On average, using a 3% desaturation threshold, WatchPat overestimated disease prevalence and severity (mean + 4 events/h) and the 4% threshold underestimated disease prevalence and severity by −6 events/h. Conclusions: Although there was an overall tendency to overestimate the severity of OSA, a significant percentage of patients had clinically relevant misclassifications. As such, we recommend that patients without OSA or with mild disease assessed by PAT undergo repeat in-laboratory PSG. Optimized clinical pathways are urgently needed to minimize therapeutic decisions instituted in the presence of diagnostic uncertainty.

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