Reducing risks in urban centres: think ‘local, local, local’

Undefined

Most urban centres in sub-Saharan Africa and many in Asia and Latin America are dangerous places to live and work. This can be seen in aggregate statistics for nations' urban populations that show (for instance) high infant, child and maternal mortality rates.

The dangers particularly affect low-income populations living in informal settlements. These areas often lack most risk-reducing infrastructure (such as safe, sufficient, accessible and affordable water; good-quality sanitation and electricity; all-weather roads; and street lighting) and risk-reducing services (including healthcare, waste collection, emergency services and policing).

But when basic provisions for these are in place, urban centres can be among the world's least dangerous places to live – shown by very high life expectancies.

Local government responsibility

The Sustainable Development Goals (SDGs) mention addressing these risks and 'leaving no one behind'.  But they don't acknowledge that the responsibility largely falls to local governments, and that most risk in urban areas cannot be reduced when local governments fail their responsibilities.

These failures, and their causes, including inadequate support from higher levels of government and international agencies, are the most important reasons so many urban centres are so dangerous.  

In high-income and some upper-middle income countries, urban governments have dramatically reduced most of the life- and health-threatening risks by providing infrastructure and services, but also by managing land-use. This is important for making serviced land for housing available and affordable, for protecting watersheds, and for avoiding settlements on dangerous sites.  
 
In most cases, this has required well-functioning city governments and strong civil society pressure, including demands from organisations representing the urban poor.

There is little comparable progress in low- and many middle-income countries. Indeed, many have gone backwards: the proportion of their urban population lacking sanitation and piped water at home is lower today than it was in 1990 (PDF).

Data and local action

Cities in high-income countries also have information on risk: through censuses, vital registration systems, surveys, hospital records and data on air pollution. Reporting on road accidents, for example, has often led to concerted action. Similarly, understanding the health impacts of small particles has led to more stringent air pollution controls.

Reducing risk depends on local knowledge to identify and understand risk, and then local capacity to respond. Where conventional responses are too expensive or beyond local government capacities, communities are important.  

There are many examples of household and community-level action on risks. For instance, communities have led on installing sewers and drains (PDF) in many informal settlements in Karachi and other urban centres in Pakistan, and Mumbai's informal settlements have hundreds of community-designed and managed toilets and washing facilities (PDF).  

But community organisations cannot build the city-wide systems – the water mains, trunk sewers and drains, waste disposal, public transport, and so on. What was important in both these examples was community organisations working with government agencies and within local resource constraints.

When there is no local risk data

Where formal information systems don't exist, or where good information cannot be obtained from them, then new locally-rooted data collection is needed.  

Applying the DesInventar methodology to cities shows up many local risks that usually go unrecorded. This draws on local sources, such as newspaper reports, and includes events where people died or lost property but where too few were affected for a disaster to be recorded.

But it also faces limitations – for instance there are no records on most premature deaths from infectious and parasitic diseases on which it can draw.  

What too often gets forgotten is local people's knowledge and capacities. These can be accessed through household surveys, site visits, discussions with community organisations (PDF), and focus groups and interviews with key individuals (including local government staff and community leaders).

This is the third of three blogs drawn from the editorial in the April 2017 issue of the international journal, Environment & Urbanization. This issue is on 'Understanding the full spectrum of risk in urban areas' and it was prepared in partnership with Urban Africa Risk Knowledge (Urban ARK). The first blog was on 'Urban risks: where are the top five biggest blinds spots?' and the second was on 'Addressing the needs of vulnerable groups in urban areas'. 

Police, emergency services and hospitals also hold records on some risks. Then there are the detailed surveys and maps undertaken in hundreds of cities by slum/shack dweller federations. These provide much of the data needed to inform risk reduction and engage local populations in setting priorities. 

Functioning local democracies are another route to local knowledge on risks as they make local governments respond to demands by those who lack risk-reducing infrastructure and services, and this serves as a substitute for spatial data on risk.

Research programmes can help too. Urban ARK is a three-year programme of research and capacity building led by 12 policy and academic organisations from across sub-Saharan Africa, with partnerships in the United Kingdom. It aims to identify the most serious risks and break cycles that make risks accumulate.

The work is concentrated in four core cities – each presenting different development and hazard contexts: Ibadan (Nigeria), Karonga (Malawi), Nairobi (Kenya), and Niamey (Niger). Additional research is under way in Freetown (Sierra Leone), Dar es Salaam (Tanzania), Mombasa (Kenya), Dakar (Senegal), and Addis Ababa (Ethiopia).

International support for local action

International agencies must recognise they need to support local action by local governments, local universities and local civil society organisations. There is much they can do.

These agencies can help local groups access data from government agencies at all levels. They can pressurise national statistical offices and census bureaus to serve and support local governments and other local groups by providing useful data.

International agencies can also learn to support 'co-production' between local governments and groups at risk. But perhaps most important of all, international agencies must develop a capacity to help fund and support a range of initiatives in each locality, including civil society initiatives.

In short, the focus needs to be unrelentingly 'local, local, local', as agencies assess the most serious everyday risks, as well as the small and large disaster risks facing each settlement, and act on these.

Standfirst: 

Urban centres can be among the world's most healthy places to live and work – but many are among the least. How healthy they are is powerfully influenced by local government competence, local information, and support for local action.

 

 

Posted in Uncategorized

Addressing the needs of vulnerable groups in urban areas

Undefined

'Vulnerable', along with 'sustainable' and 'resilient', are three powerful words that appear so often in United Nations' recommendations and declarations – and in the literature on environment and development.

But are these now so commonly used that they are losing their power? Is the term 'vulnerable groups' used just as a convenient (but misleading) shorthand for showing concern for a long list of groups considered more at risk, without a need to ask why they are vulnerable and what needs to change?

An individual or household is said to be vulnerable to a risk (such as malaria-spreading mosquitoes, contaminated water or a flood) if they are more susceptible to being harmed or killed by it, or less able to cope or adapt (to lessen the risk). 

For instance, the lives of infants and young children are generally more at risk from malaria and contaminated water than the lives of adults. Groups more at risk to loss of their livelihood, income or assets – for instance to a flood – are also vulnerable.  

Is most of the world's population vulnerable?

It is now obligatory within UN declarations, discussions and recommendations to make special mention of 'vulnerable groups' or groups in vulnerable situations, and then often to list them – as in the Sustainable Development Goals (SDGs)and the UN's 'New Urban Agenda' (PDF)

The SDGs include many mentions of vulnerable groups – as in the need for attention to "the poorest and most vulnerable" and "people in vulnerable situations". Mention is also made of vulnerable countries. Vulnerable groups are said to include children, youth, persons with disabilities, people living with HIV/AIDS, older persons, indigenous peoples, refugees and internally displaced persons and migrants. 

Within the New Urban Agenda, the word vulnerable appears 15 times and those who are said to be in vulnerable situations include women, children and youth, older persons and persons with disabilities, migrants, indigenous peoples and local communities (paragraph 34) and communities that are most vulnerable to disasters (29).  

But this means that almost all the world's population is vulnerable. The only people who are not vulnerable according to this list are working age men that are not old, or migrants or disabled or indigenous or community members, or those in communities most vulnerable to disasters.

Going beyond lists to removing the risks

Rarely do the UN texts go beyond these lists to ask why these groups are vulnerable and what is needed to reduce or remove their vulnerability.

It is not so much vulnerable groups that are at issue, but the vulnerability of particular groups of the population to specific risks. To term all women or youth or migrants as vulnerable groups is to misrepresent their knowledge and their capacities to act – to cope with risk, to adapt to lessen risk or to remove risk.  

This is the second of three blogs drawn from the editorial in the April 2017 issue of the international journal, Environment & Urbanization. This issue is on 'Understanding the full spectrum of risk in urban areas' and it was prepared in partnership with Urban Africa Risk Knowledge (Urban ARK). The first blog was on 'Urban risks: where are the top five biggest blinds spots?'

For infants and young children, much of their vulnerability to risk is to specific diseases. Provide them with a good quality healthcare that ensures they get all the needed vaccinations and rapid responses if ill or injured, and much of the vulnerability disappears. It disappears even more in good quality housing in neighbourhoods with safe play spaces. 

The vulnerability that many women face is so often related to the discrimination they face – within the household in tasks and food allocations, in labour markets, in access to land for housing and credit….

Water piped into each home that is safe, sufficient, regular and affordable, and good quality sanitation, together with an effective, easily-accessed healthcare system, enormously reduces the risks of premature death and ill health. There is no "vulnerable group" if the risk that they are vulnerable to is removed. 

In informal settlements that are vulnerable to serious flood risks every year, those living there are no longer vulnerable if investment in drainage and flood management remove the flood risk.  

But vulnerable groups that need support may also be mislabelled 'resilient'. Maria Kaika (in a paper in the April 2017 issue of Environment & Urbanization) notes how a focus on resilience can simply transfer responsibility from government to citizens. She gives the example of Tracie Washington, president of the Louisiana Justice Institute, who requested that policymakers and the media stop calling Hurricane Katrina and BP oil spill victims "resilient", pointing out that this can become an excuse by governments for not acting on removing the risks.

Local engagement to act on urban risk

So we need local knowledge on all the main risks, on who is most susceptible to each risk – and who lacks the capacity to cope and adapt.  And what is needed to reduce risk. So how do we get this? In ways that empower those most at risk?  

This is only possible if there is a local engagement with at risk groups. Interviews with flooded households in Niamey (Niger) in 2015 showed large differences in household capacity to cope and adapt.

city-wide risk assessment in Karonga (Malawi) showed the range of risks facing the population with a need to consider who is vulnerable to each risk – whether these risks are from infectious or parasitic diseases, chemical pollutants or physical hazards (such as accidental fires, drowning or road vehicle accidents).

In urban areas, local government has many important roles and responsibilities in reducing the presence of hazards and people's exposure to them. A key step is ensuring provision of risk-reducing infrastructure and services to all neighbourhoods (such as safe, sufficient, affordable water, and good-quality sanitation, electricity, healthcare and waste collection). 

Upgrading informal settlements should reduce or remove many life- and health-threatening risks – as infrastructure and services are provided and as risk of eviction is much reduced. But ill-designed upgrading can increase vulnerability if it does not serve the needs and priorities of the residents.

David Satterthwaite (david.satterthwaite@iied.org) is a senior fellow in IIED's Human Settlements research groupand visiting professor at the Development Planning Unit, University College London.

Standfirst: 

For the billion urban dwellers living in informal settlements, there are many risks. Those who are more susceptible to these risks, or less able to cope, are termed vulnerable. But they are not vulnerable if the risks are removed. We need to focus more on removing the risks and less on endless lists of 'vulnerable groups', argues David Satterthwaite.

Posted in Uncategorized

Addressing the needs of vulnerable groups in urban areas

Undefined

'Vulnerable', along with 'sustainable' and 'resilient', are three powerful words that appear so often in United Nations' recommendations and declarations – and in the literature on environment and development.

But are these now so commonly used that they are losing their power? Is the term 'vulnerable groups' used just as a convenient (but misleading) shorthand for showing concern for a long list of groups considered more at risk, without a need to ask why they are vulnerable and what needs to change?

An individual or household is said to be vulnerable to a risk (such as malaria-spreading mosquitoes, contaminated water or a flood) if they are more susceptible to being harmed or killed by it, or less able to cope or adapt (to lessen the risk). 

For instance, the lives of infants and young children are generally more at risk from malaria and contaminated water than the lives of adults. Groups more at risk to loss of their livelihood, income or assets – for instance to a flood – are also vulnerable.  

Is most of the world's population vulnerable?

It is now obligatory within UN declarations, discussions and recommendations to make special mention of 'vulnerable groups' or groups in vulnerable situations, and then often to list them – as in the Sustainable Development Goals (SDGs)and the UN's 'New Urban Agenda' (PDF)

The SDGs include many mentions of vulnerable groups – as in the need for attention to "the poorest and most vulnerable" and "people in vulnerable situations". Mention is also made of vulnerable countries. Vulnerable groups are said to include children, youth, persons with disabilities, people living with HIV/AIDS, older persons, indigenous peoples, refugees and internally displaced persons and migrants. 

Within the New Urban Agenda, the word vulnerable appears 15 times and those who are said to be in vulnerable situations include women, children and youth, older persons and persons with disabilities, migrants, indigenous peoples and local communities (paragraph 34) and communities that are most vulnerable to disasters (29).  

But this means that almost all the world's population is vulnerable. The only people who are not vulnerable according to this list are working age men that are not old, or migrants or disabled or indigenous or community members, or those in communities most vulnerable to disasters.

Going beyond lists to removing the risks

Rarely do the UN texts go beyond these lists to ask why these groups are vulnerable and what is needed to reduce or remove their vulnerability.

It is not so much vulnerable groups that are at issue, but the vulnerability of particular groups of the population to specific risks. To term all women or youth or migrants as vulnerable groups is to misrepresent their knowledge and their capacities to act – to cope with risk, to adapt to lessen risk or to remove risk.  

This is the second of three blogs drawn from the editorial in the April 2017 issue of the international journal, Environment & Urbanization. This issue is on 'Understanding the full spectrum of risk in urban areas' and it was prepared in partnership with Urban Africa Risk Knowledge (Urban ARK). The first blog was on 'Urban risks: where are the top five biggest blinds spots?'

For infants and young children, much of their vulnerability to risk is to specific diseases. Provide them with a good quality healthcare that ensures they get all the needed vaccinations and rapid responses if ill or injured, and much of the vulnerability disappears. It disappears even more in good quality housing in neighbourhoods with safe play spaces. 

The vulnerability that many women face is so often related to the discrimination they face – within the household in tasks and food allocations, in labour markets, in access to land for housing and credit….

Water piped into each home that is safe, sufficient, regular and affordable, and good quality sanitation, together with an effective, easily-accessed healthcare system, enormously reduces the risks of premature death and ill health. There is no "vulnerable group" if the risk that they are vulnerable to is removed. 

In informal settlements that are vulnerable to serious flood risks every year, those living there are no longer vulnerable if investment in drainage and flood management remove the flood risk.  

But vulnerable groups that need support may also be mislabelled 'resilient'. Maria Kaika (in a paper in the April 2017 issue of Environment & Urbanization) notes how a focus on resilience can simply transfer responsibility from government to citizens. She gives the example of Tracie Washington, president of the Louisiana Justice Institute, who requested that policymakers and the media stop calling Hurricane Katrina and BP oil spill victims "resilient", pointing out that this can become an excuse by governments for not acting on removing the risks.

Local engagement to act on urban risk

So we need local knowledge on all the main risks, on who is most susceptible to each risk – and who lacks the capacity to cope and adapt.  And what is needed to reduce risk. So how do we get this? In ways that empower those most at risk?  

This is only possible if there is a local engagement with at risk groups. Interviews with flooded households in Niamey (Niger) in 2015 showed large differences in household capacity to cope and adapt.

city-wide risk assessment in Karonga (Malawi) showed the range of risks facing the population with a need to consider who is vulnerable to each risk – whether these risks are from infectious or parasitic diseases, chemical pollutants or physical hazards (such as accidental fires, drowning or road vehicle accidents).

In urban areas, local government has many important roles and responsibilities in reducing the presence of hazards and people's exposure to them. A key step is ensuring provision of risk-reducing infrastructure and services to all neighbourhoods (such as safe, sufficient, affordable water, and good-quality sanitation, electricity, healthcare and waste collection). 

Upgrading informal settlements should reduce or remove many life- and health-threatening risks – as infrastructure and services are provided and as risk of eviction is much reduced. But ill-designed upgrading can increase vulnerability if it does not serve the needs and priorities of the residents.

David Satterthwaite (david.satterthwaite@iied.org) is a senior fellow in IIED's Human Settlements research groupand visiting professor at the Development Planning Unit, University College London.

Standfirst: 

For the billion urban dwellers living in informal settlements, there are many risks. Those who are more susceptible to these risks, or less able to cope, are termed vulnerable. But they are not vulnerable if the risks are removed. We need to focus more on removing the risks and less on endless lists of 'vulnerable groups', argues David Satterthwaite.

Posted in Uncategorized

Urban risks: where are the top five biggest blind spots?

Undefined
Informal Settlement, Dar es Salaam

Whose lives are most at risk in urban areas of the global South – for instance from preventable diseases and disasters? And what are the most serious risks they face? We need a fuller picture/better data/more evidence on urban risk to inform governments and aid agencies and to guide their investment in risk-reducing infrastructure and services (such as safe, sufficient, affordable water, and good-quality sanitation, electricity, healthcare and waste collection).

For much of the world's 2.5 billion urban dwellers living in Africa and Asia, and for many in Latin America, there is surprisingly little information on the most serious health risks they face. 

So responses from urban governments and from national governments and international agencies that are meant to help address these are operating blind; there is little or no local data on the most serious health risks and their causes.

Where are the blind spots? 

The huge scale of premature death, illness, serious injury and impoverishment in urban areas that remains hidden because these are not recorded

Within this, the lack of health data for the billion people living in informal settlements 

No local records on many serious health problems. Surveys with relevant health data exist in most nations, but these do not provide the information needed for action: at street, ward, district and urban centre level

Discussion of risks often fails to include the 'everyday' risks from infectious and parasitic diseases even though these are usually the main causes of premature death in informal settlements, and

Documentation on the impacts of disasters usually covers only large disasters but in aggregate, floods or other disasters too small to be classified as disasters are among the main causes of premature death, injury and poverty in informal settlements. 

The lack of health data on informal settlements makes it impossible to plan and implement much needed upgrading programmes and effective disaster risk reduction and climate change adaptation.

Little local health data

We get some sense of the scale of the health issues from household surveys (such as the demographic and health surveys), which show very high infant, child and maternal mortality rates "for urban areas" in many African and Asian nations.

But for practical action, this kind of information is needed for each urban centre, district or ward – on what the problems are, where they are and who is most impacted.

Civil servants, politicians and civil society groups working at neighbourhood, ward, district and city levels may have some sense of the most serious health problems, based on their experience and on the concerns raised by the population within their jurisdictions.

But responses are often ill-focused, without data to guide their policies and to present to higher-ups. 

Lack of data for informal settlements

The availability of data is worst in the informal settlements that now house around a billion urban dwellers – and in many cities, house more than half the total population.

In Nairobi, the African Population and Health Research Center (APHRC) has shown that aggregate figures for infant and under-five mortality rates for the city hide the much higher rates in informal settlements.

Recent papers in The Lancet are also highlighting the lack of relevant data. But few city governments (or national governments) collect data on health problems in informal settlements. 

Measuring risk

It is possible to consider 'everyday' risks, risks from small and large disasters, and climate change using the same metrics – their contribution to premature death, illness and injury, damage to or destruction of homes and assets.

Everything that has impoverished, harmed or killed an individual or individuals in a city can in theory be recorded. This evidence can guide policy and implementation, especially for the city or municipal governments that are responsible for providing most risk-reducing infrastructure (such as safe, sufficient, affordable water; good-quality sanitation and electricity; all-weather access roads; and street lighting) and risk-reducing services (including healthcare, household waste collection, emergency services, rule of law/policing, and road traffic management).

What needs highlighting?

Among all the hazards facing urban populations, all the vulnerable groups, all the risks and all the factors that cause or influence these, what needs highlighting?

The first is the huge scale of premature death, illness, injury and impoverishment that remains hidden because these are not recorded and are not even seen as outcomes of risk by many actors.

The second is how much more serious this is in most informal settlements. The third is how effective risk reduction depends on the quality and capacity of local governments, including their capacity to listen to and work with those most at risk.

Assessments of risk for urban areas usually leave out the largest risk; the risk of premature death or serious impairment by illness from infectious and parasitic diseases.

It is likely that in most informal settlements, certain infectious and parasitic diseases will figure among the largest risks of premature death or impairment from illness. It is also likely in many cities that particular infectious and parasitic diseases are the highest risk for entire city populations – but with considerable differences in the scale of the risk by district and by income group.

It is likely that infant, child and maternal deaths represent a very high proportion of all premature deaths, concentrated in settlements where provision for risk-reducing infrastructure and services is worst.

What needs to happen?

Recognise how little we know: we have to start by admitting how little we know about the hazards facing much of the world's urban population, and thus also how little we know about the most serious risks they face.

Data on large disasters for cities (including the number of deaths) are recorded, although here it is difficult to get data for each urban centre that is impacted.

But data on disasters seldom include attention to disasters too small to be classified as a disaster (typically 10 or more deaths/or 100 or more people affected and/or a declaration of a state of emergency/call for international assistance) – that when taken together are the cause of so much premature death, injury and impoverishment.

Get a more complete picture: getting a more complete picture for any urban centre of the full spectrum of risks, and who is most at risk and why (and where they live), is a key underpinning for more effective action. This should also highlight where risk reduction is needed and is possible.

For those residents well served by risk-reducing infrastructure and services, many of the most common causes of premature death disappear – including infant and child deaths from diarrhoea and acute respiratory infections, and deaths from extreme weather events.

A good healthcare system should also remove TB and HIV/Aids from leading causes of death. Good provision for pedestrians and cyclists, and public transport and good traffic management can dramatically cut deaths and injuries from road traffic accidents. 

Changing perceptions, changing priorities: why is it that higher levels of government and international agencies give so little attention to this?

Why is there so little funding for effective city-wide provision for water, sanitation, drainage and solid waste removal? Why are the data needed on risk and its causes not available for each urban centre and its districts, wards and neighbourhoods?

Why do we know so much about the global burden of disease, but so little about the burden of disease in each locality (which is where the data are actually needed to guide action)? 

Enhancing the information base: all urban centres need an information base on the main causes of premature death (perhaps especially for infants, children, youth and mothers), serious illness, injury and impoverishment that can be made available for each small area (or if possible each street) and that can be mapped to show where each risk is concentrated.

Census data should be able to provide some data on health determinants (such as quality of provision for water and sanitation) even if only available every 10 years. It should be seen as a public good, with census authorities providing local governments with data on conditions in their jurisdiction, down to each street.

Vital registration systems need to be set up or restored so they can provide data on deaths, causes, age and location. Data from these should be available not only to local governments but also to citizens and civil society groups, and of course with census or survey data also guaranteeing the anonymity of respondents.

Police, fire service and hospital records should contribute relevant data – although hospital records provide no data on the many who cannot access hospitals.

Then there are the detailed surveys and maps of informal settlements undertaken in hundreds of cities by slum/shack dweller federations. These provide much of the data needed to inform risk reduction and engage local populations in setting priorities and acting on them. 

Standfirst: 

 

 

Posted in Uncategorized

Urban risks: where are the top five biggest blind spots?

Undefined
Informal Settlement, Dar es Salaam

Whose lives are most at risk in urban areas of the global South – for instance from preventable diseases and disasters? And what are the most serious risks they face? We need a fuller picture/better data/more evidence on urban risk to inform governments and aid agencies and to guide their investment in risk-reducing infrastructure and services (such as safe, sufficient, affordable water, and good-quality sanitation, electricity, healthcare and waste collection).

For much of the world's 2.5 billion urban dwellers living in Africa and Asia, and for many in Latin America, there is surprisingly little information on the most serious health risks they face. 

So responses from urban governments and from national governments and international agencies that are meant to help address these are operating blind; there is little or no local data on the most serious health risks and their causes.

Where are the blind spots? 

The huge scale of premature death, illness, serious injury and impoverishment in urban areas that remains hidden because these are not recorded

Within this, the lack of health data for the billion people living in informal settlements 

No local records on many serious health problems. Surveys with relevant health data exist in most nations, but these do not provide the information needed for action: at street, ward, district and urban centre level

Discussion of risks often fails to include the 'everyday' risks from infectious and parasitic diseases even though these are usually the main causes of premature death in informal settlements, and

Documentation on the impacts of disasters usually covers only large disasters but in aggregate, floods or other disasters too small to be classified as disasters are among the main causes of premature death, injury and poverty in informal settlements. 

The lack of health data on informal settlements makes it impossible to plan and implement much needed upgrading programmes and effective disaster risk reduction and climate change adaptation.

Little local health data

We get some sense of the scale of the health issues from household surveys (such as the demographic and health surveys), which show very high infant, child and maternal mortality rates "for urban areas" in many African and Asian nations.

But for practical action, this kind of information is needed for each urban centre, district or ward – on what the problems are, where they are and who is most impacted.

Civil servants, politicians and civil society groups working at neighbourhood, ward, district and city levels may have some sense of the most serious health problems, based on their experience and on the concerns raised by the population within their jurisdictions.

But responses are often ill-focused, without data to guide their policies and to present to higher-ups. 

Lack of data for informal settlements

The availability of data is worst in the informal settlements that now house around a billion urban dwellers – and in many cities, house more than half the total population.

In Nairobi, the African Population and Health Research Center (APHRC) has shown that aggregate figures for infant and under-five mortality rates for the city hide the much higher rates in informal settlements.

Recent papers in The Lancet are also highlighting the lack of relevant data. But few city governments (or national governments) collect data on health problems in informal settlements. 

Measuring risk

It is possible to consider 'everyday' risks, risks from small and large disasters, and climate change using the same metrics – their contribution to premature death, illness and injury, damage to or destruction of homes and assets.

Everything that has impoverished, harmed or killed an individual or individuals in a city can in theory be recorded. This evidence can guide policy and implementation, especially for the city or municipal governments that are responsible for providing most risk-reducing infrastructure (such as safe, sufficient, affordable water; good-quality sanitation and electricity; all-weather access roads; and street lighting) and risk-reducing services (including healthcare, household waste collection, emergency services, rule of law/policing, and road traffic management).

What needs highlighting?

Among all the hazards facing urban populations, all the vulnerable groups, all the risks and all the factors that cause or influence these, what needs highlighting?

The first is the huge scale of premature death, illness, injury and impoverishment that remains hidden because these are not recorded and are not even seen as outcomes of risk by many actors.

The second is how much more serious this is in most informal settlements. The third is how effective risk reduction depends on the quality and capacity of local governments, including their capacity to listen to and work with those most at risk.

Assessments of risk for urban areas usually leave out the largest risk; the risk of premature death or serious impairment by illness from infectious and parasitic diseases.

It is likely that in most informal settlements, certain infectious and parasitic diseases will figure among the largest risks of premature death or impairment from illness. It is also likely in many cities that particular infectious and parasitic diseases are the highest risk for entire city populations – but with considerable differences in the scale of the risk by district and by income group.

It is likely that infant, child and maternal deaths represent a very high proportion of all premature deaths, concentrated in settlements where provision for risk-reducing infrastructure and services is worst.

What needs to happen?

Recognise how little we know: we have to start by admitting how little we know about the hazards facing much of the world's urban population, and thus also how little we know about the most serious risks they face.

Data on large disasters for cities (including the number of deaths) are recorded, although here it is difficult to get data for each urban centre that is impacted.

But data on disasters seldom include attention to disasters too small to be classified as a disaster (typically 10 or more deaths/or 100 or more people affected and/or a declaration of a state of emergency/call for international assistance) – that when taken together are the cause of so much premature death, injury and impoverishment.

Get a more complete picture: getting a more complete picture for any urban centre of the full spectrum of risks, and who is most at risk and why (and where they live), is a key underpinning for more effective action. This should also highlight where risk reduction is needed and is possible.

For those residents well served by risk-reducing infrastructure and services, many of the most common causes of premature death disappear – including infant and child deaths from diarrhoea and acute respiratory infections, and deaths from extreme weather events.

A good healthcare system should also remove TB and HIV/Aids from leading causes of death. Good provision for pedestrians and cyclists, and public transport and good traffic management can dramatically cut deaths and injuries from road traffic accidents. 

Changing perceptions, changing priorities: why is it that higher levels of government and international agencies give so little attention to this?

Why is there so little funding for effective city-wide provision for water, sanitation, drainage and solid waste removal? Why are the data needed on risk and its causes not available for each urban centre and its districts, wards and neighbourhoods?

Why do we know so much about the global burden of disease, but so little about the burden of disease in each locality (which is where the data are actually needed to guide action)? 

Enhancing the information base: all urban centres need an information base on the main causes of premature death (perhaps especially for infants, children, youth and mothers), serious illness, injury and impoverishment that can be made available for each small area (or if possible each street) and that can be mapped to show where each risk is concentrated.

Census data should be able to provide some data on health determinants (such as quality of provision for water and sanitation) even if only available every 10 years. It should be seen as a public good, with census authorities providing local governments with data on conditions in their jurisdiction, down to each street.

Vital registration systems need to be set up or restored so they can provide data on deaths, causes, age and location. Data from these should be available not only to local governments but also to citizens and civil society groups, and of course with census or survey data also guaranteeing the anonymity of respondents.

Police, fire service and hospital records should contribute relevant data – although hospital records provide no data on the many who cannot access hospitals.

Then there are the detailed surveys and maps of informal settlements undertaken in hundreds of cities by slum/shack dweller federations. These provide much of the data needed to inform risk reduction and engage local populations in setting priorities and acting on them. 

Standfirst: 

 

 

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Urbanization in sub-Saharan Africa: Trends and implications for development and urban risk

English

In 2015, sub-Saharan Africa’s urban population reached 396 million. This was distributed among thousands of urban centres that included two mega-cities (with more than 10 million inhabitants), as well as three cities with populations of 5 – 10 million and another 41 with populations of 1 – 5 million. But it is worth noting that there are also a very large number of urban centres with less than 20,000 inhabitants and more than 1,000 urban centres with populations of 20,000-50,000, and these smaller urban centres include a significant share of the urban population in most nations in the region.

The region’s urban population doubled between 2000 and 2015. Much of it lives in poor quality and overcrowded housing that lacks access to the infrastructure and services that urban centres need and that reduce ‘everyday’ risks – including safe, regular water supplies and good provision for sanitation, drainage, roads, traffic management and health care. These also have relevance for disaster risk and, increasingly, for the threats that arise from or are exacerbated by the direct and indirect impacts of climate change. 

The everyday, disaster and climate change risks to which urban populations are exposed have severe implications for the development of urban areas, as well as the health and welfare of their populations. In many cities, these are concentrated in particular districts or settlements with ‘development deficits’ in relation to risk-reducing infrastructure and services. This is also generally where urban governments lack the resources and capacities to address these deficits. In addition, there is often little in the way of local government accountability to citizens, posing a major obstacle to the great potential of urban areas to support improved health outcomes, better living conditions and stronger economies.

Urban Africa Risk Knowledge (Urban ARK) is a three-year research and capacity building programme (funded by DFID and ESRC) that is examining the processes that define and shape urban risk in sub-Saharan Africa. This is to allow a better understanding of the ways in which Africa’s urbanization can lead to improved life chances and better health, but also to avoid the accumulation of disaster risk. Addressing disaster risk is central to building resilience in sub-Saharan cities and towns. Drawing on available studies, some general points can be raised that have relevance to this: 

1. It is common for between a third and two-thirds of an urban centre’s population to live in housing of poor quality, with high levels of overcrowding in terms of indoor space per person and number of persons per room. 

2. A perhaps surprisingly large proportion of urban dwellers in sub-Saharan Africa still use dirty fuels for cooking and heating, resulting in high levels of indoor air pollution and severe health impacts. Over half the region’s urban population cooks on open fires or inefficient stoves using fuel wood, charcoal or dung. The two most common implications of poverty for energy use among urban populations in sub-Saharan Africa are, first, no access to electricity, and second, use of the cheapest and often most polluting fuels and energy-using equipment, including stoves.

3. Much of the urban population lacks safe, regular, convenient supplies of water and provision for sanitation – far more so than the official statistics suggest. In 2015, 66% of the region’s urban population did not have water piped on premises, up from 57% in 1990. Most nations in the region have missed the MDG targets for water (when assessed by who has water piped on premises) and for sanitation in urban areas. Generally, provision for water and sanitation is worse in smaller urban centres, although there are many large cities too where provision is comparably poor. Most of the region’s urban centres, large and small, lack sewers.

4. Much of the urban population lack regular (or even irregular) services to collect household waste. The environmental health implications of non-existent garbage collection services in urban areas are obvious – most households dispose of their wastes on any available empty site, into nearby ditches or lakes, or simply along streets. The problems associated with this include smells, disease vectors and pests attracted by rubbish, as well as drainage channels blocked with waste. 

5. There are very large health burdens relating primarily to infectious and parasitic diseases, indoor air pollution and accidents. This includes large health burdens arising from unsafe working conditions for low income urban dwellers, with exposure to diseases, chemical pollutants and physical hazards in the workplace being a significant contributor to premature death, injury and illness – all of which have obvious economic consequences. 

6. In many urban locations, there are also large and often growing health burdens from non-communicable diseases. For instance, cancer, diabetes and strokes are often creating ‘a double burden’ as low-income urban dwellers face the increasing incidence of both communicable and non-communicable diseases. Much more work is needed on understanding the health problems that impact on urban populations, especially low-income groups, and disaggregated by age, sex and occupation. This should include research on the relative roles of communicable and non-communicable diseases, as well as further investigations to identify which diseases are most significant. 

7. Physical hazards evident in the home and its surroundings are likely to be among the most common causes of serious injury and premature death in informal settlements and other housing types used by low-income urban dwellers – for example, burns, scalds and accidental fires, cuts and injuries from falls. The risks from accidental fires are particularly acute in areas with high levels of overcrowding, housing made of flammable materials, and the widespread use of open fires, candles, kerosene lamps and dangerous stoves. 

8. Road traffic accidents are among the most serious physical hazards in urban areas – although there are no data that separate rural from urban. The World Health Organization (WHO) reports that about 1.3 million people die each year as a result of road traffic crashes, with over 90% of these fatalities occuring in low- and middle-income countries – even though these have less than half of the world’s vehicles. Children and young people under the age of 25 years account for over 30% of those killed and injured. 

9. There are also many cities and smaller urban centres, or particular settlements within cities, where levels of outdoor air pollution considerably exceed WHO guidelines – for example, certain centres of heavy industry, mining or quarrying, or cities with high concentrations of motor vehicles with elevated levels of polluting emissions. But there is little or no data on the pollutants that can have the most serious health consequences for cities in sub-Saharan Africa. 

10. But there are also the urban centres where conditions are even worse than the generalizations noted above. Hundreds of millions of people live in urban areas where, at least in terms of public and environmental health, there is in effect no functioning government – no public provision for piped water, sewers (or other excreta disposal systems that meet health standards), drains and solid waste collection, no land-use management to encourage and support good quality housing, no pollution control. Furthermore, there is often little or no available education or health care for large sections of the urban population. There are in fact thousands of small urban centres across the region for which there is almost no documentation. 

11. In the absence of data available in each city or smaller urban centres to ascertain the most serious environmental health problems and who is most at risk, it is obviously difficult to set priorities – both for action and for research. When this is combined with research and action agendas strongly influenced by external funding and the preferences of external professionals, it can lead to inappropriate choices. 

12. It is important to consider the impact of disasters on urban populations in the region and who is most likely to be impacted. There is also a need to consider how climate change has already affected, or will affect in the near future, the scale and range of extreme weather events and other changes that impact on urban populations and economies. The consequences, which will be felt hardest by low-income groups and could have the effect of puhing many others into poverty as well, have been greatly under-estimated. In part, this is because most disasters go unrecorded in national and international disaster databases. Another factor is that the metrics used to assess disaster impacts do not include many of those most relevant to low-income groups – for instance, damage to housing, injury, disrupted livelihoods and loss of assets.

Thus, we are confronted with very significant gaps in data to allow comparison and discussion across Urban ARK’s focus cities, each of which presents different development and hazard contexts: Ibadan in Nigeria, Karonga in Malawi, Mombasa and Nairobi in Kenya, Niamey in Niger, and Dakar in Senegal. Moreover, the core generalisations noted above provide important entry points for the Urban ARK programme, emphasising the need for more detailed and nuanced understandings of urban risk in sub-Saharan Africa and the ways these risks are evolving in the context of persistent poverty, urban growth and climate change.

- Blog also on Urban Transformations Website: http://www.urbantransformations.ox.ac.uk/blog/2015/urbanization-in-sub-s...

Posted in Uncategorized

Urbanization in sub-Saharan Africa: Trends and implications for development and urban risk

English

In 2015, sub-Saharan Africa’s urban population reached 396 million. This was distributed among thousands of urban centres that included two mega-cities (with more than 10 million inhabitants), as well as three cities with populations of 5 – 10 million and another 41 with populations of 1 – 5 million. But it is worth noting that there are also a very large number of urban centres with less than 20,000 inhabitants and more than 1,000 urban centres with populations of 20,000-50,000, and these smaller urban centres include a significant share of the urban population in most nations in the region.

The region’s urban population doubled between 2000 and 2015. Much of it lives in poor quality and overcrowded housing that lacks access to the infrastructure and services that urban centres need and that reduce ‘everyday’ risks – including safe, regular water supplies and good provision for sanitation, drainage, roads, traffic management and health care. These also have relevance for disaster risk and, increasingly, for the threats that arise from or are exacerbated by the direct and indirect impacts of climate change. 

The everyday, disaster and climate change risks to which urban populations are exposed have severe implications for the development of urban areas, as well as the health and welfare of their populations. In many cities, these are concentrated in particular districts or settlements with ‘development deficits’ in relation to risk-reducing infrastructure and services. This is also generally where urban governments lack the resources and capacities to address these deficits. In addition, there is often little in the way of local government accountability to citizens, posing a major obstacle to the great potential of urban areas to support improved health outcomes, better living conditions and stronger economies.

Urban Africa Risk Knowledge (Urban ARK) is a three-year research and capacity building programme (funded by DFID and ESRC) that is examining the processes that define and shape urban risk in sub-Saharan Africa. This is to allow a better understanding of the ways in which Africa’s urbanization can lead to improved life chances and better health, but also to avoid the accumulation of disaster risk. Addressing disaster risk is central to building resilience in sub-Saharan cities and towns. Drawing on available studies, some general points can be raised that have relevance to this: 

1. It is common for between a third and two-thirds of an urban centre’s population to live in housing of poor quality, with high levels of overcrowding in terms of indoor space per person and number of persons per room. 

2. A perhaps surprisingly large proportion of urban dwellers in sub-Saharan Africa still use dirty fuels for cooking and heating, resulting in high levels of indoor air pollution and severe health impacts. Over half the region’s urban population cooks on open fires or inefficient stoves using fuel wood, charcoal or dung. The two most common implications of poverty for energy use among urban populations in sub-Saharan Africa are, first, no access to electricity, and second, use of the cheapest and often most polluting fuels and energy-using equipment, including stoves.

3. Much of the urban population lacks safe, regular, convenient supplies of water and provision for sanitation – far more so than the official statistics suggest. In 2015, 66% of the region’s urban population did not have water piped on premises, up from 57% in 1990. Most nations in the region have missed the MDG targets for water (when assessed by who has water piped on premises) and for sanitation in urban areas. Generally, provision for water and sanitation is worse in smaller urban centres, although there are many large cities too where provision is comparably poor. Most of the region’s urban centres, large and small, lack sewers.

4. Much of the urban population lack regular (or even irregular) services to collect household waste. The environmental health implications of non-existent garbage collection services in urban areas are obvious – most households dispose of their wastes on any available empty site, into nearby ditches or lakes, or simply along streets. The problems associated with this include smells, disease vectors and pests attracted by rubbish, as well as drainage channels blocked with waste. 

5. There are very large health burdens relating primarily to infectious and parasitic diseases, indoor air pollution and accidents. This includes large health burdens arising from unsafe working conditions for low income urban dwellers, with exposure to diseases, chemical pollutants and physical hazards in the workplace being a significant contributor to premature death, injury and illness – all of which have obvious economic consequences. 

6. In many urban locations, there are also large and often growing health burdens from non-communicable diseases. For instance, cancer, diabetes and strokes are often creating ‘a double burden’ as low-income urban dwellers face the increasing incidence of both communicable and non-communicable diseases. Much more work is needed on understanding the health problems that impact on urban populations, especially low-income groups, and disaggregated by age, sex and occupation. This should include research on the relative roles of communicable and non-communicable diseases, as well as further investigations to identify which diseases are most significant. 

7. Physical hazards evident in the home and its surroundings are likely to be among the most common causes of serious injury and premature death in informal settlements and other housing types used by low-income urban dwellers – for example, burns, scalds and accidental fires, cuts and injuries from falls. The risks from accidental fires are particularly acute in areas with high levels of overcrowding, housing made of flammable materials, and the widespread use of open fires, candles, kerosene lamps and dangerous stoves. 

8. Road traffic accidents are among the most serious physical hazards in urban areas – although there are no data that separate rural from urban. The World Health Organization (WHO) reports that about 1.3 million people die each year as a result of road traffic crashes, with over 90% of these fatalities occuring in low- and middle-income countries – even though these have less than half of the world’s vehicles. Children and young people under the age of 25 years account for over 30% of those killed and injured. 

9. There are also many cities and smaller urban centres, or particular settlements within cities, where levels of outdoor air pollution considerably exceed WHO guidelines – for example, certain centres of heavy industry, mining or quarrying, or cities with high concentrations of motor vehicles with elevated levels of polluting emissions. But there is little or no data on the pollutants that can have the most serious health consequences for cities in sub-Saharan Africa. 

10. But there are also the urban centres where conditions are even worse than the generalizations noted above. Hundreds of millions of people live in urban areas where, at least in terms of public and environmental health, there is in effect no functioning government – no public provision for piped water, sewers (or other excreta disposal systems that meet health standards), drains and solid waste collection, no land-use management to encourage and support good quality housing, no pollution control. Furthermore, there is often little or no available education or health care for large sections of the urban population. There are in fact thousands of small urban centres across the region for which there is almost no documentation. 

11. In the absence of data available in each city or smaller urban centres to ascertain the most serious environmental health problems and who is most at risk, it is obviously difficult to set priorities – both for action and for research. When this is combined with research and action agendas strongly influenced by external funding and the preferences of external professionals, it can lead to inappropriate choices. 

12. It is important to consider the impact of disasters on urban populations in the region and who is most likely to be impacted. There is also a need to consider how climate change has already affected, or will affect in the near future, the scale and range of extreme weather events and other changes that impact on urban populations and economies. The consequences, which will be felt hardest by low-income groups and could have the effect of puhing many others into poverty as well, have been greatly under-estimated. In part, this is because most disasters go unrecorded in national and international disaster databases. Another factor is that the metrics used to assess disaster impacts do not include many of those most relevant to low-income groups – for instance, damage to housing, injury, disrupted livelihoods and loss of assets.

Thus, we are confronted with very significant gaps in data to allow comparison and discussion across Urban ARK’s focus cities, each of which presents different development and hazard contexts: Ibadan in Nigeria, Karonga in Malawi, Mombasa and Nairobi in Kenya, Niamey in Niger, and Dakar in Senegal. Moreover, the core generalisations noted above provide important entry points for the Urban ARK programme, emphasising the need for more detailed and nuanced understandings of urban risk in sub-Saharan Africa and the ways these risks are evolving in the context of persistent poverty, urban growth and climate change.

- Blog also on Urban Transformations Website: http://www.urbantransformations.ox.ac.uk/blog/2015/urbanization-in-sub-s...

Posted in Uncategorized