Residents of Kibra slums,
Nairobi, walk to the neighbouring upmarket estates in search for food
relief on March 30. With the closure of many informal businesses and the
curfew imposed to help reduce the spread of the coronavirus, the
residents say it is hard for them to make ends meet since they depend on
daily casual jobs. [Elvis Ogina, Standard] .
The power of cities comes from the number of interactions they enable,
between people, firms and markets – they are centres of social
interaction.
For all their virtues, however, cities have a major downside. They are
fertile ground for contagion, such as the rapid spread of Covid-19.
This is because cities are by definition places of density, with large
numbers of people living and interacting in close proximity.
Furthermore, many cities are deeply embedded in national, regional and
global networks.
This is embodied by infrastructural features such as airports, ports and
other transport terminals ferrying goods and people at a high
frequency.
As such, the potential for transmission rates of Covid-19 within them
may be far higher relative to national averages. This is aptly
illustrated by New York City, which already accounts for approximately
half of all known cases in the US.
Perhaps even more shocking, it accounted for five per cent of all
confirmed cases in the world – and it is just one city of about 8.6
million people.
Given the characteristics of many African cities, the situation, without appropriate mitigation measures, could be far worse.
For example, density levels in certain parts of African cities, most
notably in slums and other informal settlements, maybe even higher than
New York’s.
It is estimated that about two-thirds of Nairobi’s population live on
just six per cent of its land. In Kampala, 71 per cent of households
sleep in a single room.
Contagion in African cities
These congested settlements have few amenities. Only an estimated 56 per
cent of the urban population in sub-Saharan Africa have access to piped
water. And even those with access, they can spend 30 minutes or longer
sourcing it.
This begs the question of whether frequent hand-washing – one of two of
the main measures to prevent transmission – is even feasible.
The same goes for social distancing, the second recommended
preventative measure, both given density and also because it runs
contrary to many African societal norms, which are inherently deeply
communal.
At the same time, one of the drivers of rural-urban migration in Africa
is the relatively better access to services in the city. This includes
health services.
Data from the countries with already well-developed and funded health
systems show that they are experiencing immense strain with Covid-19
patients. In the US, it is predicted that at least 200,000 intensive
care unit (ICU) beds will be needed in the case of a moderate outbreak.
The whole of Uganda, on the other hand, has 55 ICU beds in 12
operational units. It is clear that with similar infection rates African
health systems would collapse.
Yet people are still more likely to be treated in urban areas. In
Uganda’s case, 80 per cent of these ICU beds are located in Kampala. To
reinforce social-distancing, many governments in Europe and the US are
enforcing strict temporary lockdown measures.
African governments, which still lag behind in terms of the known
infection rate, are quickly following suit – some with even harsher
measures.
Given that urban centres are major economic nodes they will naturally
bear a disproportionate economic burden of any lockdowns. This effect
will rapidly percolate through the whole economy.
Informal sector
Urban dwellers working in the informal sector will be the first and
potentially some of the hardest hit. About 85 per cent of workers do not
receive a reported wage.
Rather in many African cities, the majority earn their daily keep from
the informal service sector, particularly selling or providing manual
labour.
Here there is no option to work from home: both because of the lack of
necessary infrastructure such as power and more importantly because
their jobs are predicated on face-to-face interactions.
Even though they are working, their daily earnings are small. In
Kampala, for example, a survey of informal sector firms showed that 93
per cent of them are already operating below the poverty line.
Therefore lockdowns, for these populations, will mean not earning a wage
and affect their survival. This is exacerbated as urban populations are
largely beholden to food prices, given in general they are not able to
grow their own food.
Early indications already show that some countries like Ghana have seen a
rise in food prices by nearly 30 per cent already due to panic buying
and disruptions in food supply chains. This is particularly worrisome
for some countries already concerned about a food crisis this year, due
to the plague of locusts affecting supplies.
With the timelines of the overall Covid-19 crisis remaining unclear,
feeding one’s family, particularly in urban areas, with no income and
rising prices is already becoming an increasing struggle.
Lockdowns may support curbing transmissions, but by potentially pushing
millions of more people in Africa below the poverty line, it could have
other detrimental, and potentially worse, longer-lasting effects beyond
the health impact.
Therefore, reshaping African cities in the pandemic’s aftermath to
ensure they can be engines of economic growth in the future, will be
key.
A critical element of this and in particular to prepare for the next
pandemic is the need for cities to invest in productive infrastructure,
focused on improving health outcomes.
This includes water and sewage infrastructure as well as increasing the number of health facilities.
The density of cities that make them susceptible to disease, also make
them more efficient to provide infrastructure to a large number of
people.
In managing and shaping Africa’s urban future there should be a central
role for public health officials, working alongside planners, economists
and others. This can help reduce the potential of contagion whilst
maintaining the power of cities.
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