COVID-19 and informal settlements – implications for water, sanitation and health in India and Indonesia

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Abstract

Informal settlements are home to over 1 billion people worldwide and are characterised by high population densities and poor environmental conditions. The authors identify the impact of COVID-19 on existing water and sanitation practices and potential pathways for the transmission of COVID-19 in informal settlements in India and Indonesia. In the short term, there is an urgent need for mobile and contactless hand washing, washing/bathing facilities and toilets. In the long term, COVID-19 provides an opportunity to invest in centralised water and sanitation networked solutions appropriate for high-density settings to integrate those settlements into cities and improve environmental conditions and health in these cities.

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Most cited references 11

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The history, geography, and sociology of slums and the health problems of people who live in slums

Alex Ezeh, Oyinlola Oyebode, David Satterthwaite … (2017)

Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study.

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Local response in health emergencies: key considerations for addressing the COVID-19 pandemic in informal urban settlements

Annie Wilkinson, Harris Ali, Juliet Bedford … (2020)

This paper highlights the major challenges and considerations for addressing COVID-19 in informal settlements. It discusses what is known about vulnerabilities and how to support local protective action. There is heightened concern about informal urban settlements because of the combination of population density and inadequate access to water and sanitation, which makes standard advice about social distancing and washing hands implausible. There are further challenges to do with the lack of reliable data and the social, political and economic contexts in each setting that will influence vulnerability and possibilities for action. The potential health impacts of COVID-19 are immense in informal settlements, but if control measures are poorly executed these could also have severe negative impacts. Public health interventions must be balanced with social and economic interventions, especially in relation to the informal economy upon which many poor urban residents depend. Local residents, leaders and community-based groups must be engaged and resourced to develop locally appropriate control strategies, in partnership with local governments and authorities. Historically, informal settlements and their residents have been stigmatized, blamed, and subjected to rules and regulations that are unaffordable or unfeasible to adhere to. Responses to COVID-19 should not repeat these mistakes. Priorities for enabling effective control measures include: collaborating with local residents who have unsurpassed knowledge of relevant spatial and social infrastructures, strengthening coordination with local governments, and investing in improved data for monitoring the response in informal settlements.

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Improving the health and welfare of people who live in slums.

Richard Lilford, Oyinlola Oyebode, David Satterthwaite … (2017)

In the first paper in this Series we assessed theoretical and empirical evidence and concluded that the health of people living in slums is a function not only of poverty but of intimately shared physical and social environments. In this paper we extend the theory of so-called neighbourhood effects. Slums offer high returns on investment because beneficial effects are shared across many people in densely populated neighbourhoods. Neighbourhood effects also help explain how and why the benefits of interventions vary between slum and non-slum spaces and between slums. We build on this spatial concept of slums to argue that, in all low-income and-middle-income countries, census tracts should henceforth be designated slum or non-slum both to inform local policy and as the basis for research surveys that build on censuses. We argue that slum health should be promoted as a topic of enquiry alongside poverty and health.

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Author and article information

Journal

Journal ID (nlm-ta): UCL Open Environ

Journal ID (publisher-id): UCLOE

Title: UCL Open Environment

Abbreviated Title: UCL Open Environ

Publisher: UCL Press (UK )

ISSN (Electronic): 2632-0886

Publication date (Electronic, pub): 07 September 2020

Publication date (Electronic, collection): 2020

Volume: 2

Electronic Location Identifier: e011

Affiliations

[1 ]University College London, Engineering for International Development Centre, Civil, Environmental and Geomatic Engineering, 2 Taviton Street, London WC1H 0BT, UK

[2 ]Aceso Global Health Consultants Ltd, London, UK

[3 ]University College London, Institute for Environmental Design and Engineering, London, UK

[4 ]Department of Epidemiology, Columbia University, New York, NY, USA

[5 ]Indonesia One Health University Network, Jakarta, Indonesia

[6 ]UCL Institute of Epidemiology & Healthcare, London, UK

[7 ]Population, Policy and Practice, University College London, Great Ormond Street Institute of Child Health, London, UK

Author notes

*Corresponding author: Email: priti.parikh@ 123456ucl.ac.uk

Author information

Priti Parikh https://orcid.org/0000-0002-1086-4190

Article

DOI: 10.14324/111.444/ucloe.000011

PMC ID: 10208312

SO-VID: 95591f93-8940-44f5-94c9-4d844ca21ba9

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This is an open access article distributed under the terms of the Creative Commons Attribution Licence (CC BY) 4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Date received : 02 June 2020

Date accepted : 17 August 2020

Page count

Figures: 1, References: 13, Pages: 5

Funding

This study received no specific funding. The CHIP Consortium is core funded by Aceso Global Health Consultants Ltd, London, UK.

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Reviewed by Samuel Godfrey Reviewed by Manu Mathur

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COVID-19 and informal settlements – implications for water, sanitation and health in India and Indonesia

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UCL: Covid-19 Research

Most cited references 11

The history, geography, and sociology of slums and the health problems of people who live in slums

Local response in health emergencies: key considerations for addressing the COVID-19 pandemic in informal urban settlements

Improving the health and welfare of people who live in slums.

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