Tag Archives: slums

Slum health is not urban health: why we must distinguish between the two

Slum health is not urban health: why we must distinguish between the two. Econo Times, January 8, 2017.

We live in an urban century. Already more than 50% of the global population lives in urban areas. The United Nations estimates that by 2030 five billion of the world’s population of eight billion will be urban. Most of the growth in urban areas is expected to occur in the developing countries of Africa and Asia, continuing a trend seen in the past decade.

Rapid urbanisation in developing countries has been characterised by an accompanying proliferation of slum areas. Cities such as Nairobi, Kenya; Mumbai, India and Rio de Janeiro, Brazil are home to some of the world’s largest slum areas. Sub-Saharan Africa has an especially high number of slum inhabitants: 62% of its urban population lives in slums.

Slums constitute a large part of today’s urban reality and will likely persist as a significant feature in our urban future for decades to come. By 2030, projections indicate that two billion of the global urban population will live in slums, mostly in Africa and Asia.

Despite increased global awareness about the presence and persistence of slums, the health of their inhabitants is a little-studied phenomenon. The health of the urban poor, people with low socio-economic status living in urban areas, is usually conflated with that of slum dwellers. However, health outcomes for these two groups of urban populations often differ given the spatial differences of the areas they live in.

Slums are characterised by densely packed settlements with inadequate provision of services and infrastructure. These include sanitation, water, electricity, waste management and security among others. These conditions expose residents of slum areas to the spread of disease and poor health outcomes that are fuelled by their intimately shared environments.

Neighbourhood effects

The mechanism through which densely packed environments affect slum residents’ health is termed neighbourhood effects.

The influence of neighbourhood effects may result in poor health outcomes for slum inhabitants in comparison to non-slum dwellers. Studies done by the African Population and Health Research Center (APHRC) have shown that child mortality is higher in slums than in non-slum areas and even in rural regions.

Residents of slums are also likely to experience higher rates of undernutrition compared to those from non-slum areas. This may lead to stunted growth and development among children. There tends to be a high transmission rate of infectious diseases in these overcrowded areas because waste collection, water and sanitation are lacking.

Read the complete article.

Slum health is not urban health: why we must distinguish between the two

Slum health is not urban health: why we must distinguish between the two. Catch News, December 19, 2016.

slum-lead-gettyimages-533782708

Arun Sharma/Hindustan Times/Getty Images

We live in an urban century. Already more than 50% of the global population lives in urban areas. The United Nations estimates that by 2030 five billion of the world’s population of eight billion will be urban. Most of the growth in urban areas is expected to occur in the developing countries of Africa and Asia, continuing a trend seen in the past decade.

Rapid urbanisation in developing countries has been characterised by an accompanying proliferation of slum areas. Cities such as Nairobi, Kenya; Mumbai, India and Rio de Janeiro, Brazil are home to some of the world’s largest slum areas. Sub-Saharan Africa has an especially high number of slum inhabitants: 62% of its urban population lives in slums.

Slums constitute a large part of today’s urban reality and will likely persist as a significant feature in our urban future for decades to come. By 2030, projections indicate that two billion of the global urban population will live in slums, mostly in Africa and Asia.

Despite increased global awareness about the presence and persistence of slums, the health of their inhabitants is a little-studied phenomenon. The health of the urban poor, people with low socio-economic status living in urban areas, is usually conflated with that of slum dwellers. However, health outcomes for these two groups of urban populations often differ given the spatial differences of the areas they live in.

Read the complete article.

Community Slum Sanitation in India A Practitioner’s Guide

Community Slum Sanitation in India: A Practitioner’s Guide, 2016. Water and Sanitation Program.

Based on the experience of slum sanitation initiatives implemented in a number of urban centers in India, over the last decades, this Guide draws out the critical drivers that appear to explain some facets of successful community slum sanitation initiatives.

Initiatives from the cities of Ahmedabad, Pune, Mumbai, Bhopal, Trichy, and Kalyani are used as the examples to learn from (based on convenience and easy availability of information).

A set of generic steps are identified and described thereafter for the preparatory, planning, implementation, and monitoring and evaluation stages of community sanitation initiatives.

WASHplus Weekly – World Habitat Day: Focus on Slums

Issue 164 | Oct 3, 2014 | World Habitat Day: Focus on Slums

The first Monday in each October is World Habitat Day. This year the theme is Voices from Slums. This issue of the weekly contains news of upcoming urban events, urban innovation awards, recent urban WASH studies, and other reports and resources on issues faced by the urban poor.

EVENTS

World Habitat Day: Voices from Slums, October 6, 2014Link
Each year World Habitat Day takes on a new theme chosen by the United Nations based on current issues relevant to the habitat agenda. The themes are selected to bring attention to UN-Habitat’s mandate to promote sustainable development policies that ensure adequate shelter for all. This year’s theme, Voices from Slums, is intended to give voice to slum dwellers for improving quality of living conditions in existing slums. This is the UN’s official website for the event. washplusweekly

International Conference on Urban Health, March 9-12, 2015, BangladeshLink
The International Society for Urban Health is an association of researchers, scholars, professionals, community members, and workers and activists from various disciplines, roles, and areas of the world whose work is directly related to the health effects of urban environments and urbanization. The International Conference on Urban Health provides an international forum for information exchange among urban health stakeholders. The theme for the 2015 conference is Urban Health for a Sustainable Future: The Post 2015 Agenda.

URBAN HEALTH STUDIES

USAID/WASHplus Urban Health UpdatesLink
Urban Health Updates contains more than 800 peer-review articles and “gray” literature reports on health issues faced by the urban poor.

Urban Health: It’s Time to Get Moving! Global Health Science & Practice, May 2014. V Barbiero. Link
Policy makers must commit to a long-term action plan that addresses the triple burden of health issues faced by growing urban populations. A comprehensive global urban health strategy is in order; one similar to the global approach to HIV/AIDS, polio eradication, and malaria. The strategy should build on the urban experience, both positive and negative, from all regions of the globe and provide a clear vision and programmatic guidance.

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Campaign uses “Slum Britain art” for fundraising

Slums encroach on Buckingham Palace - still from Practical Action video

Slums encroach on Buckingham Palace – still from Practical Action video

A UK charity has set images of iconic landmarks like Buckingham Palace in typical South Asian slums for its latest campaign to tackle urban poverty. Practical Action’s Safer Cities Christmas appeal aims to provide clean water, sanitation and safe housing to over 4,000 poor people in Nepal and Bangladesh. The appeal is backed by the government’s UK Aid Match initiative which matches public donations pound for pound. UK Aid Match will award up to £120 million (US$ 200 million) in grants over 3 years.

Source: Practical Action, 20 Dec 2013 ; The Independent, 22 Dec 2013

India, Delhi: how sexual violence against women is linked to water and sanitation

Girls under ten being have been raped while on their way to use a public toilet, say women living in Delhi’s slums. In one slum, boys hid in toilet cubicles at night waiting to rape those who entered. These are some of the incidents mentioned in a recent briefing note based on research supported by WaterAid and the DFID-funded SHARE (Sanitation and Hygiene Applied Research for Equity).

The link between a lack of access to water and sanitation facilities and sexual violence against women is not well known and to date has received insufficient attention. The briefing note highlights this link within the context of urban slums in Delhi, and suggests how this problem can be addressed.

Lennon, S. 2011. Fear and anger : perceptions of risks related to sexual violence against women linked to water and sanitation in Delhi, India. (SHARE briefing note). London, UK, SHARE, London School of Hygiene and Tropical Medicine. 15 p. Available at: www.shareresearch.org/Resource/Details/violenceagainstwomen_india

When are communal or public toilets an appropriate option?

When are communal or public toilets an appropriate option?We would all prefer to have our own household toilet rather than just access to a communal or public toilet but in some low-income urban communities, provision of individual household toilets is problematic. A recently published Topic Brief from WSUP (Water & Sanitation for the Urban Poor) argues that, despite numerous challenges, communal or public toilets can be the most appropriate medium-term solution in some specific situations: notably in high-density slums with a high proportion of tenants and/or frequent flooding and water-logging. In such situations, what can be done to ensure that communal or public toilets provide a high-quality service of genuine benefit to all members of the community including women and the very poor? This Topic Brief offers an overview of these questions for sanitation professionals and planners.

Financing communal toilets
The financial sustainability and ongoing maintenance of communal and public toilets is a particular concern. The WSUP Practice Note “Financing communal toilets: the Tchemulane Project in Maputo” takes a look at issues around the financing of communal toilets in Maputo (Mozambique), including citywide scale-up costs.
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These publications form part of a newly initiated series of Practice Notes and Topic Briefs, through which WSUP aims to share experience and stimulate debate about water and sanitation service provision for the urban poor.

To keep up to date with this growing publication series, go to http://www.wsup.com/sharing/index.htm or join our mailing list at http://www.wsup.com/news/index.htm.

India: land of many cell phones, fewer toilets

Rafiq Nagar, Mumbai. Every family has a cell phone, but no safe sanitation. Photo: Guy Walder, http://www.guywalder.com

In the wake of President Obama’s visit to India, AP journalist Ravi Nessman writes that “he will find a country of startlingly uneven development and perplexing disparities, where more people have cell phones than access to a toilet”.

Interestingly, Nessman ends his article by suggesting that the spread of cell phones could empower slum dwellers to demand better sanitation services.

The Mumbai slum of Rafiq Nagar has no clean water for its shacks made of ripped tarp and bamboo. No garbage pickup along the rocky, pocked earth that serves as a road. No power except from haphazard cables strung overhead illegally.

And not a single toilet or latrine for its 10,000 people.

Yet nearly every destitute family in the slum has a cell phone. Some have three.

[…]

It is a country buoyed by a vibrant business world of call centers and software developers, but hamstrung by a bloated, corrupt government that has failed to deliver the barest of services.

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Sierra Leone, Freetown: photographer documents extreme sanitation conditions in Kroo Bay slum

He then asked me: you want to know the truth? We’re all suffering here in Kroo Bay. He began talking about the water issues again and showing me his arms with open sores, “you see these, they move at night” – he was talking about the worms in his body.

Photographer Dominic Chavez spent a week documenting the life of communities in Kroo Bay, one of the worst slums in Freetown, Sierra Leone. He writes about his encounters in the summer 2010 issue of Global Health magazine, a publication of the Global Health Council.

[A]fter meeting a wonderful family who lived underneath a small bridge in Freetown. I was surprised by the amount of raw sewage and the lack of clean water. After visiting this family a couple more times they told me there were communities in Freetown much worse.

This was when I first heard of Kroo Bay, a difficult slum filled with good families and shanty structures overrun with garbage, extreme sanitation issues, and a long list of health conditions due to the lack of clean water. Some of the biggest issues they are facing are polio, ringworm, typhoid fever and malaria, not to forget a high incidence of child malnutrition.

Kroo Bay, Freetown. Photo: Dominic Chavez

In Kroo Bay, Chavez saw some of the worse conditions he had ever seen: homes without with dirt floors, no windows, no doors and roofs that provided no shelter from the heat and rain, and children “digging in heaps of trash and pools of blackened water”.

See the full story and pictures.

Kenya, Nairobi: lack of sanitation leaves women sick and “prisoners in their homes”

Women and girls in Nairobi’s slums live under the constant threat of sexual violence, leaving them often too scared to leave their houses to use communal toilet and bathroom facilities, Amnesty International said in a new report released on 7 July 2010.

Amnesty International calls on the Kenyan government to enforce landlords’ obligations to construct toilets and bathrooms in the slums and settlements and provide assistance to structure owners who are unable to meet the costs of constructing toilets and bathrooms.

Insecurity and Indignity: Women’s experiences in the slums of Nairobi, Kenya [1] details how the failure of the government to incorporate the slums in urban plans and budgets has resulted in poor access to services like sanitation, which hits women in slums and informal settlements especially hard.

“Women in Nairobi’s settlements become prisoners in their own homes at night and some times well before it is dark,” said Godfrey Odongo, Amnesty Internationals East Africa researcher. “They need more privacy than men when going to the toilet or taking a bath and the inaccessibility of facilities make women vulnerable to rape, leaving them trapped in their own homes.

“The fact that they are unable to access even the limited communal toilet facilities also puts them at risk of illness.”

The situation is compounded by the lack of police presence in the slums and when women fall victim to violence they are unlikely to see justice done. Kibera, Nairobi’s largest slum and home to up to a million people, has no police post.

“I always underestimated the threat of violence,” said 19-year-old Amina of Mathare slum. “I would go to the latrine any time provided it was not too late. This was until about two months ago when I almost became a victim of rape.”

Amina was set upon by a group of four men while she walked to the latrine at 7pm. They hit her, undressed her and were about to rape her when her cries were heard and a group of residents came to save her. Although she knew one of the men involved in the assault, Amina did not go to the police as she feared reprisal attacks.

Unable to leave their one-roomed houses after dark, many women in informal settlements resort to ‘flying toilets’ – using plastic bags thrown from the home to dispose of waste.

Women also told Amnesty International how the poor sanitary conditions they live in – which include widespread disposal of human excreta in the open because of lack of adequate access to toilets – directly contribute to cases of poor health and to high health care costs.

Other women describe the humiliation of bathing in front of their relatives and children.

Even by day, public bathroom facilities are few and far between and invariably involve walking long distances. According to official figures, only 24 per cent of residents in Nairobi’s informal settlements have access to toilet facilities at household level.

Despite some positive features, Kenya’s Millennium Development Goal (MDG) policies to meet the target on sanitation do not address the specific needs of women who face the threat of violence because they lack adequate sanitation.

They also do not address the lack of enforcement of regulations requiring owners and landlords to provide sanitation.

“There is a huge gap between what the government commits to do, and what is going on in the slums everyday” said Godfrey Odongo.

“Kenya’s national policies recognise the rights to sanitation and there are laws and standards in place. However, because of decades of failure to recognize slums and informal settlements, planning laws and regulations are not enforced in these areas.

“The lack of enforcement of these laws has ensured that landlords and structure owners in the slums can get away without providing any toilets or shower places for their tenants”

Lack of security of tenure also remains a long standing problem for tenants, despite a national land policy in place, removing any incentives that landlords or owners could have to ensure proper sanitation, and measures to increase security.

Amnesty says the government must also take immediate measures to improve security, lighting and policing and ensure that relevant government authorities coordinate their efforts to improve the water and sanitation situation in the settlements.

Amnesty representatives met with officials from the Ministry of Health, the City Council including the Town Clerk, and also some officials from the official regulator of water and sanitation services within Nairobi, the Athi Water Services Board.

In almost all of the meetings, it was agreed that there was little coordination between the relevant Ministries in the government to ensure that women in slums had access to water and sanitation.

Even though Amnesty recognised that the situation is complicated, representatives stressed that this is no reason to pass the buck from one Ministry to the next.

Some of the officials committed to asking the Office of the Prime Minister to bring together all of the relevant officials in an attempt to ensure that water and sanitation is provided for women in slums.

[1] Amnesty International (2010). Insecurity and indignity : women’s experiences in the slums of Nairobi, Kenya. London, UK, Amnesty International Publications. Download full report

The report is one of the outputs of Amnesty International’s Demand Dignity campaign

Source: Amnesty International, 07 Jul 2010 ; Amy Agnew, Livewire, 07 Jul 2010