Health Concerns in Urban Slums

Abstract

Bangladesh, with a population of 167 million, has recently emerged from being classified as a low-income country to a low-middle-income country and has made some progress in poverty reduction. However, in Bangladesh, mortality among children younger than 5 years is 33 per 1000 live births, life expectancy at birth is 72 years, and the most common causes of premature death are neonatal disorders and stroke. 1 The annual per capita income is US $1316, with approximately 15% of the population living in extreme poverty. 1 Dhaka, the capital, has a population of more than 20 million and is one of the most densely populated cities in the world. Dhaka is also considered one of the most environmentally contaminated cities in the world, yet for some of the increasing population of rural poor, it is a highly attractive place to live. For those living in rural areas, available land is decreasing because of overpopulation and climate change, and for some, the ground water is contaminated with arsenic. Given the struggles in their lives, people come to Dhaka by the thousands each week. With limited education, skills, and financial resources, most of these migrants end up living in a slum. Is this a glimpse of things to come in resource-limited countries?

Can we ‘WaSH’ infectious diseases out of slums?

“…Water, sanitation, and hygiene (WaSH) interventions are diverse, potentially including improvements in water access (e.g., water quality, water quantity, and distance to water), sanitation access (e.g., access to improved latrines, latrine maintenance, and faecal sludge management), and hygiene practices (e.g., handwashing before eating and/or after defecation, water treatment, soap use, and water storage practices) (Prasad et al, 2016;Turley et al, 2013;Ross et al, 2019). Interventions often include multiple components while also providing hygiene education.…”

“…Many in the WaSH sector believe that lasting change will come only when we bulldoze slums and rebuild them from the ground up with formal sewage systems, piped chlorinated water, and low cost housing (Ross et al, 2019;Pickering et al, 2019). High-income countries currently treat approximately 70% of their wastewater, while low income countries only treat 8% (Luby et al, 2019).…”

“…Even if scientists were able to come up with a sustainable blueprint for slums, what low income country would be prepared to bring it to scale for the poorest segment of their society? ABOD shelters (https://www.abodshelters.com/) in the USA are presently providing low cost housing in nine countries in Africa (Figure 2) (Ross et al, 2019). In Kathmandu, the Asian Development Bank is providing funding to overhaul the centuries-old water supply system.…”

Health needs assessment of the residents of the informal settlements in South-Eastern Iran

“…The world has witnessed a rise in urbanization since 1990, and this has been more prominent in low- and middle-income countries. [ 1 2 ] The increase in informal settlements has become one of the challenges city authorities have been facing, especially during the last two decades. [ 1 ]…”

“…The number has been increasing and is estimated to reach two billion in 2030. [ 2 3 ] According to the World Bank report, 73% of Iran's population in 2015 was urban dwellers, and it is estimated that the number will increase to 83% by 2050. The number of informal settlements has been on the rise in Iran since 1961, and according to the 2015 census conducted by the Ministry of Health and Medical Education, 10,280,270 people were living in 700 informal settlements quarters.…”