Slums The New Faces of the Developing World Cities By; Navid Foroutan BDS (India), PGDip Pub Health (School of Population Health, University of Auckland, New Zealand) For suggestions or comments please write to: navid1980@gmail.com

In today’s world, slums and their existence is a reality which can not be ignored Hundreds of millions of people are living in very poor living environments without access to basic living requirements Today, massive urbanisation and slumification of urban centres is one of the biggest challenges of public health

Learning objectives At the end of this presentation you will have a brief knowledge of; 1- Urbanisation in the beginning of 21st century 2- Basic characteristics of an urban slum 3- Major health issues that the slum dwellers face 4- Global statistics and slum concentration in different world regions 5- Millennium Development Goals (MDG) in relation to slums and slum dwellers

Urban Population In the developed world, 952 million people or 77% of the population (of 1.23 billion) will live in urban areas by 2015 In the developing regions, 2.9 billion people or 48.7 % of the population (of 5.97 billion) will live in urban areas by 2015

Urban Population growth

Urban vs. Rural population

Population of some of the Mega-Cities in Less Developed Regions by 2015 (in millions); Mumbai 22.6 Mexico City 20.6 Dhaka 17.9 Illegal Housing in developing world; e.g. of more than 50% illegal; Addis Ababa 85% Jakarta 62% e.g. of 30-50% of illegal housing; Manila 40% Karachi 50%

Slum (Definition) A slum household is a household that lacks any one of the following five elements: Access to improved water ( access to sufficient amount of water for family use, at an affordable price, available to household members without being subject to extreme effort) Access to improved sanitation ( access to an excreta disposal system, either in the form of a private toilet or a public toilet shared with a reasonable number of people)

Slum Definition Cont. Security of tenure ( evidence of documentation to prove secure tenure status or de facto or perceived protection from evictions ) Durability of housing ( permanent and adequate structure in non-hazardous location) Sufficient living area ( not more than two people sharing the same room)

Global Statistics 970 million people live in slums in 2005 More than 70% of urban population in Africa live in slums 270 million urban residents in south and central Asia live in slums It is projected that if urban poverty rises at the same pace nearly 2 billion people would be in slums by 2030

Slum vs. Non-Slum population in different world regions

Percentage of slum dwellers in different world regions

Water and Sanitation Water and sanitation for urban poor; In 2000 about 1.1 billion people around the world lacked access to safe drinking water Another 2.4 billion to improved sanitation Access to safe drinking water: – Slums 37.2% – Overall urban 75.8% access to safe sanitation: – Slums 19.8% – Overall urban 64.0%

Health risks to slum dwellers Contaminated water (cholera , typhoid, etc) Inadequate disposal of human wastes Wastewater and garbage Insects, pests (e.g. rats) and parasites in homes Insufficient living spaces, poor ventilation and overcrowding Children at risk from traffic, unsafe or contaminated sites Indoor air pollution

Health risks to slum dwellers, cont House sites vulnerable to landslides or floods Nutritional deficiencies No or inadequate health care and advice No emergency services High rates of mental illness and suicide AIDS

Urban population living in Slums The dark regions show higher concentration of people live in slums in that region or country. Now compare this with the next slide.  

Infant mortality in the world This slide shows the infant mortality rate among the world countries, as you see darker colour is indicative of higher infant mortality. What have you observed from the comparison of the two slides?

Infant Mortality in Bangladesh

Millennium Development Goals MDG (target 11, goal 7): to improve the lives of at least 100 million slum dwellers by the year 2020 It is only 10 per cent of the present worldwide slum population, which, left unchecked, will multiply three fold to 3 billion by the year 2050

MDG, cont. How ? Any programme ? No , at the global level no agency is driving this process There is a strong need for a new “healthy slums programmes“ that can be launched jointly by organisations like : WHO, UN-HABITAT and UNICEF.

Health Promotion for Slum Dwellers Any programme of health promotion and improving quality of life of the slum dwellers should; Bring high quality health interventions to the slum neighbour hoods Be accompanied by participation of the slum community in designing and various other stages

Health Promotion for Slum Dwellers, cont. Requires a multi sectoral approach involving a range of departments at local and national levels Include strengthening of the capacity of slum dwellers , local governments and other stakeholders

References and further reading www.unhabitat.org www.un.org/millenniumgoals www.unwater.org Robert Neuwirth: Shadow Cities, New York, 2006, Routledge Mike Davis: Planet of Slums, London, New York 2006 World Mortality Report, 2005