Urban water and sanitation problems

A child washing clothes in central Antanarivo, Madagascar

Credit: Brent Stirton

Unplanned slum and squatter settlements have numerous problems associated with water and sanitation provision and unsafe hygiene. Families often have no choice but to live in small, makeshift huts crowded together in vast, unplanned areas.

Without toilets, drainage systems or rubbish collection services refuse and human waste fill the areas. Without safe water on tap people are forced to collect what they can find. Water and sanitation-related diseases are rife - exacerbated by the overcrowded conditions and poor hygiene.

In many cities in developing countries you will see raw sewage flowing into rivers while only feet away children swim and adults wash themselves and their clothes.

Often the settlements are unofficial and so, without legal tenure, the people living in them are not entitled to connections to basic facilities like water and sanitation. These settlements are also vulnerable to demolition as governments reclaim the land for other uses.

Water

Water can be hard to find in these dense urban areas. And the choices are hard. Women and children either have to walk a long way to find safe water or use water from polluted sources such as factory outflows or unprotected wells. This leads to water-related diseases such as cholera, typhoid and dysentery; diseases which around the world kill a child every 15 seconds.

Another alternative is to buy jerry cans of water, often of dubious quality, from vendors at vastly inflated prices. The poorest people from Dar es Salaam, Tanzania, spend an average of 10% of their income on water from vendors.

Water sourced from water vendors can sometimes be heavily overpriced.

Credit: WaterAid / Daniel O'Leary

They pay far more per liter than the better off, who can secure piped connections or afford to invest in their own wells. In times of severe shortages, vendors increase their charges twenty fold, making it even less affordable.

Because water is so hard to find, or is so expensive to buy, families are only able to collect a small amount every day which affects their ability to wash themselves, their homes and their clothes regularly. They are also hindered from washing by the lack of privacy. This inability to wash regularly furthers the spread of disease.

Sanitation and hygiene

In dense, overcrowded urban conditions it is often difficult for people to find space to build latrines. Many have to defecate in the open or share whatever limited facilities are available which tend to offer no privacy, safety or hygiene.

In Addis Ababa, Ethiopia, like many cities, women report being prisoners of daylight as they are ashamed to go to the toilet in the open during the day. In Dhaka makeshift latrines hang over waterways, while in many slums without any other disposal facilities, human waste is simply thrown out in plastic bags.

Because of this human waste and refuse collect in stagnant pools spreading disease and contaminating water sources. The problem is made worse during the rainy season when rubbish and excrement are washed into cramped living areas.

In these conditions it is virtually impossible to remain healthy and clean. Diseases spread rapidly among the crowded conditions and the little money that slum dwellers earn often has to be spent on medicines to help the sick recover.

Solutions

Finding solutions in urban areas can be complex. Communities tend to be less cohesive than in rural areas and this can make development programs hard. As community involvement is central to the success of WaterAid's projects initial work often focuses on forming, or finding existing, community groups to take projects forward.

The higher population density in most urban areas means there is increased chance of groundwater pollution in hand-dug wells and pit latrines can fill too quickly and eventually pollute groundwater supplies.

While tubewells that reach deeper water sources can be a viable option, and septic tanks are sometimes used, different water and sanitation technologies are often needed instead.

Where appropriate, a preferable solution is to negotiate with the local government or water or sewerage providers to connect slum communities to the city's existing piped water supplies and sewerage systems.

Martin washes his hands after a visit to the slum’s child-friendly toilets, India.

Credit: WaterAid / Libby Clarke

WaterAid and its partners help community groups to build and manage communal tapstands along with toilet and washing facilities, which have separate places for men, women and children.

WaterAid's partners have found that children are often scared of the dark, enclosed spaces of latrine blocks and also get bumped from the queue by adults; so have built child friendly toilets instead painted with bright murals.

The communal water and sanitation facilities are owned and managed by the communities themselves; people are charged a small, affordable amount to use the latrines and to collect water and these funds pay for full time attendants to maintain the projects, pay the municipal water and sewerage bills, keep the facilities clean, buy soap and provide security. Children and those who are unable to pay are let in for free.

In some cases WaterAid's partners apply for land tenure on behalf of slum dwellers so that there is a legal site or negotiated access where water and sanitation connections can be made. Without this involvement communities are effectively barred from having these facilities.

Hygiene education

WaterAid and its partners carry out hygiene education in a variety of ways to ensure that the communities gain the maximum health benefits from their projects. In some areas hygiene workers are trained to carry out house-to-house visits, act plays or give talks at community meetings. Another option is to teach children who then pass the messages that they have learnt on to their friends and families.

Messages include the promotion of washing hands before eating and after going to the latrine (which can reduce diarrheal diseases by over 40%), wearing shoes to the latrine to help prevent the spread of hookworm, storing food and water hygienically and washing bodies, clothes and homes regularly.

WaterAid also funds some environmental sanitation projects such as rubbish disposal services and helps communities with footpath building to enable them to create a healthier, more hygienic living environment.

Advocating change

Water and sanitation problems are acute in densely populated, unplanned, urban slums.

Credit: WaterAid / Martin Argles

Connecting communities to cities' water and sanitation services can initially be problematic due to land tenure problems and facility managers believing that low income families from slum settlements will be unable to pay for water and sanitation services.

However, as these connections usually provide much cheaper water than that which slum dwellers buy from vendors, they are prepared to pay for these facilities themselves, sometimes with no or minimal subsidy.

In some areas where projects have been very successful communities have been able to repay all of the initial construction costs in addition to the running costs.

In others like Bamako, Mali the community has invested more than they have needed to into their water and sanitation schemes so that they can carry out other development work, while in India some communities have even lent money to their neighbors so that they can set up similar projects.

WaterAid is now able to use the success of these projects to persuade more water and sanitation providers that developments in low-income urban areas are viable. For example, following the communities' success in building sewerage that they funded themselves in Faisalabad, Pakistan, the local government agreed to pipe water to the community as well.

In Bangladesh the Dhaka Water Supply and Sanitation Authority has now reduced the security deposit that NGOs have to pay for a water connection in some squatter settlements following WaterAid and its partners' interventions.