The hidden crisis in urban slums as population swells

Children play in Kibera slums, Nairobi. The crisis of poor infrastructure, overcrowding is exacerbated further by a high disease and morbidity burden in slums. Photo/Anthony Omuya  Nation Media Group

By IRIN

In Summary

• As rural populations migrate to urban areas, looking for new economic and job opportunities, cities will continue to grow, and governments will need to increase efforts to ensure that urban infrastructure like housing is able to cope with the growth.
• The crisis of poor infrastructure, overcrowding, few resources and poor sanitation facilities is exacerbated further by a high disease and morbidity burden, with most families being unable to afford medical care.
• Around a billion people living in the world’s cities today reside in deprived areas like Mathare, with few or no basic amenities.

In Mathare, a sprawling slum in Kenya’s capital, Nairobi, children in tattered clothes play with raw waste flowing from a burst sewage pipe. In the alley, crowded with tin-and-wood shanties, a food kiosk filled with people feasting on smoked fish stands on the burst pipe. Close by, a woman fries chopped potatoes on an open fire.

Uninsulated electricity cables hang precariously in people’s single-storey houses. The residents know the dangers, but they have little choice. They are not part of the national power grid and might never have a legal connection. A water-vending kiosk stands beside two dirty, poorly constructed pit latrines.

“The crisis of poor infrastructure, overcrowding, few resources and poor sanitation facilities is exacerbated further by a high disease and morbidity burden, characterised by high levels of malnutrition among children and the aged and high rate of communicable diseases like typhoid, malaria, dysentery and tuberculosis, with most families being unable to afford medical care. Health facilities are also limited, unequipped and understaffed,” Bessie Nikhozi, assistant programme manager of urban livelihoods and social protection at Concern Worldwide, told IRIN.

Paul Odero, a 27-year-old father of two and a resident of Mathare, told IRIN, “Here we share everything because nobody can afford anything of his own. We share latrines, and these people selling food near the latrine have no space to put their kiosks. It must be near there because that is where you can find space.”

He added, “We have no place to dispose our garbage, and we just throw it anywhere. At times, you find children playing with used sanitary pads because the women and girls who use them have nowhere to take them to. The children get diarrhoea and many die.”

In 2012, in a span of just six months, at least three children died from electrocution while playing with illegally connected power lines. In the same year, an illegal electricity connection caused a fire that destroyed some 300 houses, leaving thousands without shelter.

Mary Muiruri, a community health worker, told IRIN that the open dumpsites and the fumes emanating from them have meant respiratory infections are rampant.

“The running noses among small children you see do not mean their mothers don’t care. They do, but the health risks associated with poor waste disposal means their children are constantly suffering from respiratory infections. It is that bad,” she said.

“It looks simple but many women in the slums cannot go to work because they are constantly looking after sick children. Such people can’t come out of poverty because how do they get income? The unhygienic conditions make them very sick often,” said Mr Muiruri.

In 2010, the global health charity, Medicines Sans Frontiers (MSF) reported that pneumonia and respiratory tract infections accounted for 40 per cent of all consultations in its heath facilities in Kibera, a Nairobi slum.

An estimated 53 per cent of those who scavenge at a dumpsite in Dandora, another slum, have respiratory tract infections, coughs and asthma, according to Concern Worldwide.

The few toilets available in Mathare are privatised, and residents pay a user fee of Sh5 ($0.06). Many cannot afford this daily fee.

“Extremely poor people living in urban slums like Mathare are forced, on a daily basis, to significantly compromise their long-term well-being to meet their short-term survival needs. This includes pulling their children from school, engagement in transactional sex, etc.,” Ann Marie Swai, the food, income and markets coordinator at Concern Worldwide, told IRIN.

Around a billion people living in the world’s cities today reside in deprived areas like Mathare, with few or no basic amenities. In Afghanistan, Chad, Ethiopia and Nepal, more than 90 per cent of urban populations live in such deprived areas, according to the UN-Habitat.

“It is a concern that people live in overcrowded areas without any adequate policing or electricity, which raises a lot of other issues— and particularly the protection of women and children. They only have minimum services, and the humanitarian challenges they face can be overwhelming,” Kyung-wha Kang, the deputy emergency relief coordinator for the UN Office for the Coordination of Humanitarian Affairs, told IRIN.