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


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          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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          Global Access to Safe Water: Accounting for Water Quality and the Resulting Impact on MDG Progress

          Monitoring of progress towards the Millennium Development Goal (MDG) drinking water target relies on classification of water sources as “improved” or “unimproved” as an indicator for water safety. We adjust the current Joint Monitoring Programme (JMP) estimate by accounting for microbial water quality and sanitary risk using the only-nationally representative water quality data currently available, that from the WHO and UNICEF “Rapid Assessment of Drinking Water Quality”. A principal components analysis (PCA) of national environmental and development indicators was used to create models that predicted, for most countries, the proportions of piped and of other-improved water supplies that are faecally contaminated; and of these sources, the proportions that lack basic sanitary protection against contamination. We estimate that 1.8 billion people (28% of the global population) used unsafe water in 2010. The 2010 JMP estimate is that 783 million people (11%) use unimproved sources. Our estimates revise the 1990 baseline from 23% to 37%, and the target from 12% to 18%, resulting in a shortfall of 10% of the global population towards the MDG target in 2010. In contrast, using the indicator “use of an improved source” suggests that the MDG target for drinking-water has already been achieved. We estimate that an additional 1.2 billion (18%) use water from sources or systems with significant sanitary risks. While our estimate is imprecise, the magnitude of the estimate and the health and development implications suggest that greater attention is needed to better understand and manage drinking water safety.
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            The history, geography, and sociology of slums and the health problems of people who live in slums

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

              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.

                Author and article information

                UCL Open Environ
                UCL Open Environment
                UCL Open Environ
                UCL Press (UK )
                07 September 2020
                : 2
                [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@
                © 2020 The Authors.

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

                Page count
                Figures: 1, References: 13, Pages: 5
                This study received no specific funding. The CHIP Consortium is core funded by Aceso Global Health Consultants Ltd, London, UK.
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