A recent New York Times article, “In a Landfill, Locals Cling to Way of Life” discusses the enormous problem of waste in India. Profiling a family that is forced to live off of what they find in garbage mounds and landfills, the author underscores the need for extensive waste management programs across the country.

KARUVADIKUPPAM, INDIA — A row of houses — yellow, weather-beaten cement boxes — runs up against a giant mound of garbage. The garbage, which extends over about five hectares, or 12 acres, is the main landfill for the city of Pondicherry.

About 100 families live in the houses. Once, they were itinerant. Some still hunt rabbits in the fields surrounding this village that in recent years has grown into a suburb.

They live in appalling conditions. Their children sit naked in piles of garbage, preyed upon by flies and mosquitoes. Pigs, black from mud and sewage, roam through the settlement. Much of the year, clouds of toxic smoke, carrying dioxins and other chemicals, billow from the landfill, enveloping their homes.

Few of the people here have steady work. Most earn a living by scavenging for metal or plastic. On a good day, they say, they make 100 or even 150 rupees, about $2 or $3.

I have been coming to this landfill for over a year now. Its existence was forced on my consciousness on a recent summer, when the smoke and stench began blowing into my house, several kilometers away. It had never been a problem before. But India is increasingly prosperous, its citizens are consuming more, and a relatively minor municipal waste site has over the years mushroomed into a huge, ghastly sludge of plastic bags, rotting vegetables, water bottles and discarded clothes.

It seems unimaginable that human beings could live amidst this environmental catastrophe. But propose to the gypsies here that they move away or that the landfill be moved, and they object vehemently.

Garbage is their livelihood, they say. Without the landfill, they would starve.

On this paradox of a people clinging to the very thing that is killing them rests much of the dilemma of environmentalism, especially in the developing world. The more time I spend at the landfill, the more I realize that cleaning up India’s air and water is going to be even more complicated than the staggeringly complicated task it first appears.

I visited the settlement, most recently, on a cloudy November afternoon. The monsoons were in full swing. Outside the yellow houses, two men were grinding a paste of coriander, ginger, curry leaf and charcoal. They said it was to treat skin infections.

The men described their lives. K. Vijaykant complained about the lack of jobs, and the need for a road. He said that residents of the settlement, especially children, suffer from chronic colds, fevers, body aches and headaches.

He talked about a recent outbreak of Chikungunya, a painful viral fever spread by mosquitoes.

Mr. Vijaykant and others complained bitterly about their living conditions. But when I told them that a group of citizens (myself included) had been talking to the government about moving the landfill to a less populated place, they protested.

Mr. Vijaykant said that residents of the settlement get much of their food from the landfill. They scavenge for onions and tomatoes and garlic. Sometimes they even find a chicken bone.

“Our livelihoods are more important than our health,” he said. His only assets in the world were two pigs. How would he feed them without the garbage?

In 1972, Indira Gandhi, then the prime minister, announced at an environmental summit meeting that “poverty is the biggest polluter.”

It is a refrain that has long dominated environmental thought in India (and, indeed, in much of the developing world). It suggests that economic development comes first, and that environmentalism is a luxury for the rich.

It is an understandable line of thought, and certainly compelling in places like Karuvadikuppam. The environmental costs of the landfill are obvious. But what happens to the residents’ livelihoods if the garbage (with its noxious smoke and its chemicals that experts warn are leaching into the water table) is taken away?

Of course the rich world struggles to balance economic growth with the environment, too. But the choice in places like India is often more stark: It can literally seem like a choice between ecological well-being and human lives.

This drama is played out across the nation. Burgeoning villages, desperate for agricultural land, bump up against wildlife sanctuaries. Large mines and other projects that could generate jobs and incomes also threaten terrible ecological consequences.

There are no easy answers to the quandaries posed by these conflicts. It is fashionable to say a nation does not have to choose between the environment and development. What does this mean in practice? What is needed is a form of environmentalism that is as sensitive to socioeconomic consequences as to ecological benefits.

In some Indian cities, civil society groups have tried to solve the nation’s garbage problem by integrating scavengers into waste management programs. This addresses the environmental issue of uncollected and unsegregated waste while providing jobs to the people who live off that waste (and, importantly, who are willing to work with waste).

A few weeks ago I visited one such program in Dharavi, Mumbai’s biggest slum. I saw how “ragpickers,” as they are often called in India, can be organized and trained in recycling techniques and become part of efforts to collect waste from institutions like schools.

It was an impressive program. But it felt like a drop in the bucket — and far removed from the realities of Karuvadikuppam, where the people struggle on their own, all but forgotten by society.

As I was leaving the settlement, a woman called after me. “Sir, sir,” she said. “Don’t take the garbage away. We get everything from it. We survive because of it.”

I asked her about her family’s health problems. She shook her head. “They can go to the hospital for that,” she said. “It’s not a major issue.”