MONROVIA, 19 November 2009 (IRIN) – Water and sanitation services in the Liberian capital, Monrovia, are getting worse as a growing urban population tries to squeeze more out of already skeletal services. On 19 November, World Toilet Day, NGOs are calling on the government to up its allocation, and on international donors to reprioritize funding to stamp out cholera and cut child mortality.

Just one-third of Monrovia’s 1.5 million residents have access to clean toilets, and 20 to 30 cholera cases are reported weekly; in 2008 there were 888 suspected cases, 98 percent of them in Monrovia’s overcrowded shantytowns such as West Point, Buzzi Quarter, Clara Town, and Sawmill.

Poor or non-existent clean water and sanitation facilities are linked to high malaria and diarrhoea rates, Liberia’s two leading child killers. 

In the Clara Town slum, 75,000 people share 11 public toilets and 22 public taps; West Point’s 70,000 residents must make do with just four public toilets, said Bessman Toe, head of the Montserrado County slum-dweller association, which represents over 40 slum communities in and around the capital.

Some households build their own toilets, but these tend to collapse during the seven-month rainy season, Oxfam emergency health engineer Jennifer Lamb told IRIN, so people defecate in the narrow alley-ways between their houses, on the beach, or into plastic bags, which they dump on nearby piles of rubbish or into the sea.

Read More – http://www.irinnews.org/Report.aspx?ReportId=87110

Newborn care practices among slum dwellers in Dhaka, Bangladesh: a quantitative and qualitative exploratory study.

Author: Allisyn Moran, Nuzhat Choudhury, et al.  Credits/Source: BMC Pregnancy and Childbirth 2009, 9:54

Urbanization is occurring at a rapid pace, especially in low-income countries. Dhaka, Bangladesh, is estimated to grow to 50 million by 2015, with 21 million living in urban slums.

Although health services are available, neonatal mortality is higher in slum areas than in urban non-slum areas. The Manoshi program works to improve maternal, newborn, and child health in urban slums in Bangladesh.

This paper describes newborn care practices in urban slums in Dhaka and provides program recommendations.

Method – A quantitative baseline survey was conducted in six urban slum areas to measure newborn care practices among recently delivered women (n=1,256). Thirty-six in-depth semi-structured interviews were conducted to explore newborn care practices among currently pregnant women (n=18) and women who had at least one delivery (n=18).

Results: In the baseline survey, the majority of women gave birth at home (84%).

Most women reported having knowledge about drying the baby (64%), wrapping the baby after birth (59%), and cord care (46%). In the in-depth interviews, almost all women reported using sterilized instruments to cut the cord.

Babies are typically bathed soon after birth to purify them from the birth process. There was extensive care given to the umbilical cord including massage and/or applying substances, as well as a variety of practices to keep the baby warm.

Exclusive breastfeeding was rare; most women reported first giving their babies sweet water, honey and/or other foods.

Conclusions: These reported newborn care practices are similar to those in rural areas of Bangladesh and to urban and rural areas in the South Asia region. There are several program implications:

• Educational messages to promote providing newborn care immediately after birth, using sterile thread, delaying bathing, and ensuring dry cord care and exclusive breastfeeding are needed.
• Programs in urban slum areas should also consider interventions to improve social support for women, especially first time mothers.

These interventions may improve newborn survival and help achieve MDG4.

November 16, 2009 Addis Ababa (U.S. Embassy): The United States Agency for International Development’s (USAID) Urban Gardens Program today launched a two-day conference called “Beyond Urban Gardens: Meeting the Growing Needs of Ethiopia’s Urban Population.” The conference highlights the challenges and the opportunities for urban gardening in combating HIV/AIDS and addressing food security, livelihoods, and health issues of urban populations in Ethiopia.

The USAID Urban Gardens Program for HIV-Affected Women and Children, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), began in Ethiopia five years ago. Since October 2008, the program has helped more than 15,000 women and children and 5,000 households to generate income, adhere to AIDS treatment protocols, improve their nutrition and health, and boost their attendance at school.

The program operates in six cities — Adama, Addis Ababa, Awassa, Bahir Dar, Dessie, and Gondor. In these urban areas, the USAID Urban Gardens Program creates school and community gardens using water saving methods such as trickle and drip technologies. Where possible, the program also has promoted the cultivation of fruit trees and the raising of poultry. While supporting the development of urban gardens in Ethiopia, the USAID Urban Gardens Program also assists program participants through referrals to health services offered by government and community-based organizations.

In opening the conference, USAID/Ethiopia Mission Director Thomas H. Staal said, “Interventions like urban gardens give people hope. They give women and children the opportunity to improve their health and raise income for their families’ needs.”

More and more, people worldwide are planting urban gardens as populations in cities continue to grow and health and livelihood needs increase. First Lady of the United States Michelle Obama raised the profile of urban gardening recently when she invited a group of children to the White House in March to help her plant a vegetable garden on the White House grounds, the first such garden at the White House in 60 years. The Ethiopian Urban Agriculture Office used the conference to release its draft urban agriculture strategy.

As part of the “Beyond Urban Gardens” conference, Ethiopian youth involved in USAID Urban Gardens Program will share their experiences and best practices via digital video conference with teenagers from a high school in Detroit, Michigan, who also engage in urban agriculture.

Source – Ethoblog

Bell DM, Weisfuse IB, Hernandez-Avila M, del Rio C, Bustamante X, Rodier G.

Pandemic influenza as 21st century urban public health crisis, IN: Emerg Infect Dis. 2009 Dec.

Full-text: http://www.cdc.gov/eid/content/15/12/pdfs/09-1232.pdf (pdf, 689KB)

The percentage of the world’s population living in urban areas will increase from 50% in 2008 to 70% (4.9 billion) in 2025. Crowded urban areas in developing and industrialized countries are uniquely vulnerable to public health crises and face daunting challenges in surveillance, response, and public communication. The revised International Health Regulations require all countries to have core surveillance and response capacity by 2012.

Innovative approaches are needed because traditional local-level strategies may not be easily scalable upward to meet the needs of huge, densely populated cities, especially in developing countries. The responses of Mexico City and New York City to the initial appearance of influenza A pandemic (H1N1) 2009 virus during spring 2009 illustrate some of the new challenges and creative response strategies that will increasingly be needed in cities worldwide.

SINGAPORE — Asia’s urban poor are worst-hit by spiking food prices, according to a report released Tuesday by a regional think tank which tipped rising volatility in commodity prices.

Impoverished families in the region’s teeming cities are more vulnerable than rural folk to swings in food costs, according to the Pacific Economic Cooperation Council (PECC).

“Food price increases’ greatest impact is on the urban poor who are more dependent on a money-based economy and spend a large share of the household budget on food,” said Walter Armbruster from the PECC taskforce which authored the report.

“The rural poor may have greater access to food through family relationships or the capacity to produce their own food.”

The report, released at the Asia-Pacific Economic Cooperation (APEC) forum in Singapore, said that food price volatility was set to worsen as trade in commodities became more interlinked with other markets.

“Real agricultural prices increased in the 2000s, as they became more closely linked to non-agricultural commodity and energy prices. Some of these price increases — such as fertilizer and transportation costs — changed the cost structure of agriculture,” he said.

Protectionist policies by major agricultural producers coupled with “the psychology of scarcity and propensity to hoard” were other factors behind volatility, Armbruster said.

“Policy intervention played a significant role in raising agricultural commodity prices, especially in the case of rice,” he said.

Describing swings in rice prices as “the single most important phenomena affecting the region’s food system in recent years,” Armbruster said that a major factor was slim trading volumes in the grain.

“An important lesson from this volatility was that the rice market intervention, if left unchecked, can be more destructive than economic events,” he said.

Commodities prices soared before the global downturn struck last year, causing serious concerns over food prices and food security.

The UN food agency said this week that although prices have fallen significantly since their peaks a couple of years ago, wheat and maize prices are rising and rice export prices are still way above pre-crisis levels.

Armbruster urged regional nations to adhere to the APEC Open Food System of liberalising trade and developing rural regions in agricultural economies in order to cushion the impact of food price volatility.

“We may be entering a higher volatility future in commodities prices, but there are some things that can offset that volatility,” he said.

Source – Nov. 11, 2009, AFP

It was around 15 years ago that Rajendra Joshi, Schwab Foundation for Social Entrepreneurship winner for this year, woke up to the power of social entrepreneurship.

Joshi’s NGO had been working on an Integrated Slum Development project in Ahmedabad since 1989, and that year, it tied up with the city municipal corporation to provide basic infrastructure — water, drainage, sewerage — to seven slums.

The slum-dwellers would pay Rs 2,000, a one-time fee, and in exchange the municipality would give a guarantee that it would not evict them.

In no time, 5,000 families had come on board.

“For me, that was an indication that the urban poor could be viewed as a market. What NGOs and the government sector needed to do was take the private sector approach. Innovations will come if there is money to be made,” says Joshi who is one of three winners of the Schwab Foundation.

It’s a lesson that Joshi has applied to Umeed-Udaan, the training programme in data-entry, hospitality, retail, spoken English, computers and other technical skills that Saath has been running in the slums of eight cities in Gujarat and Rajasthan.

In just four years, 15,403 youth, one-third of them female, have been placed, with eighty per cent of them in companies such as ICICI Bank, Vodaphone, and Reliance Fresh.

Joshi is now looking for an angel investor who will allow him to scale up Saath’s Urmila project. This is for the women from slums, who are trained to be ‘home managers’ and then be placed in households. Joshi says he hopes to take this to other metro cities.

Also in the works is a hand-held solar light for vegetable vendors, which will save them the Rs 10 they pay everyday to recharge their batteries.

Source – Nov. 12, 2009, Top News

In Lima, Peru, more than 1.3 million people have no access to drinking water. The citizens without it are in the poorest areas, where water trucked in can cost nine times as much as it does in richer areas. So, citizens have had to either make do without running water, or, with the help of a German NGO, make dew into drinking water.

The Telegraph reports on one slum in particular, Bellavista del Paraiso. With 200 residents in need of water, the mayor of the slum stated, “We are the very first to have fog-catchers in Lima’s poor neighborhoods…We have five panels that are eight metres by four metres (26 feet by 13 feet),” perched on the mountaintop above, he explained. “With them we are able to collect up to 60 litres per night in wintertime.”

The water is used for drinking and cooking, but also to irrigate small vegetable gardens. So the fog nets are bringing a much needed resource right to the kitchen steps of the citizens. While the nets cost around $800 each, and water purifying tabs are also required, the pay-off is far greater with citizens able to drink and raise food with the fog water.

German biologists Anne Lummerich and Kai Tiedemann created the system, and are behind Alimon, the German non-profit organization that has been working to bring drinking water to Peruvians since 2006. The “Green Desert” project is a two-stage affair, involving first human-made fog collectors, and then trees acting as natural fog collectors. According to the organization:

In the first stage fog collectors and water reservoirs are installed on the hilltop. Here we find the best conditions for a high water yield. Tree species which are adapted to aridity and are apt to comb fog are planted between the fog collectors and the water reservoirs. The fog water combed out by the fog collectors is conducted to the water tanks and is used fort the irrigation of the trees.

The second stage starts in the following winter season when the trees are no longer irrigated. Having reached a height of above 1 m they can irrigate themselves now. The taller ones have to do even more: They serve as natural fog-collectors. Channels or funnels are installed underneath them and a part of the water that falls down from their leaves and branches is conducted to the water tanks.

Source – Nov. 12, 2009, Treehugger

ATLANTA, Nov. 11 (UPI) — H1N1 flu in Mexico City and New York may have helped health experts understand the challenges posed by disease response in large cities, researchers say.

David M. Bell and colleagues at the Centers for Disease Control and Prevention in Atlanta said by 2025, almost three-quarters of the world’s population will live in cities.

“When millions of people are crowded together in huge cities, responses to disease outbreaks that have worked in rural areas or smaller towns may not work as well,” Bell said in a statement Wednesday.

“Several questions emerged. For example, how do you get many overlapping governmental agencies to cooperate? How do you get drugs and vaccines to people who travel, live in slums with no addresses, or are homeless? How do you separate ill family members from well ones in tiny one- or two-room apartments?”

U.S. health experts will need to answer these questions as the H1N1 pandemic continues, Bells said.

The findings are scheduled to be published to appear in the December edition of Emerging Infectious Diseases.

Source – UPI.com

PLoS Negl Trop Dis. 2009 Nov 10;3(11):e545.

Spatial evaluation and modeling of Dengue seroprevalence and vector density in Rio de Janeiro, Brazil.

Honório NA, Nogueira RM, Codeço CT, Carvalho MS, Cruz OG, Magalhães Mde A, de Araújo JM, de Araújo ES, Gomes MQ, Pinheiro LS, da Silva Pinel C, Lourenço-de-Oliveira R.

Laboratório de Transmissores de Hematozoários, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brasil. honorio@ioc.fiocruz.br

BACKGROUND: Rio de Janeiro, Brazil, experienced a severe dengue fever epidemic in 2008. This was the worst epidemic ever, characterized by a sharp increase in case-fatality rate, mainly among younger individuals. A combination of factors, such as climate, mosquito abundance, buildup of the susceptible population, or viral evolution, could explain the severity of this epidemic. The main objective of this study is to model the spatial patterns of dengue seroprevalence in three neighborhoods with different socioeconomic profiles in Rio de Janeiro. As blood sampling coincided with the peak of dengue transmission, we were also able to identify recent dengue infections and visually relate them to Aedes aegypti spatial distribution abundance. We analyzed individual and spatial factors associated with seroprevalence using Generalized Additive Model (GAM).

METHODOLOGY/PRINCIPAL FINDINGS: Three neighborhoods were investigated: a central urban neighborhood, and two isolated areas characterized as a slum and a suburban area. Weekly mosquito collections started in September 2006 and continued until March 2008. In each study area, 40 adult traps and 40 egg traps were installed in a random sample of premises, and two infestation indexes calculated: mean adult density and mean egg density. Sera from individuals living in the three neighborhoods were collected before the 2008 epidemic (July through November 2007) and during the epidemic (February through April 2008). Sera were tested for DENV-reactive IgM, IgG, Nested RT-PCR, and Real Time RT-PCR. From the before-after epidemics paired data, we described seroprevalence, recent dengue infections (asymptomatic or not), and seroconversion. Recent dengue infection varied from 1.3% to 14.1% among study areas. The highest IgM seropositivity occurred in the slum, where mosquito abundance was the lowest, but household conditions were the best for promoting contact between hosts and vectors. By fitting spatial GAM we found dengue seroprevalence hotspots located at the entrances of the two isolated communities, which are commercial activity areas with high human movement. No association between recent dengue infection and household’s high mosquito abundance was observed in this sample.

CONCLUSIONS/SIGNIFICANCE: This study contributes to better understanding the dynamics of dengue in Rio de Janeiro by assessing the relationship between dengue seroprevalence, recent dengue infection, and vector density. In conclusion, the variation in spatial seroprevalence patterns inside the neighborhoods, with significantly higher risk patches close to the areas with large human movement, suggests that humans may be responsible for virus inflow to small neighborhoods in Rio de Janeiro. Surveillance guidelines should be further discussed, considering these findings, particularly the spatial patterns for both human and mosquito populations.

Norwegian photojournalist Jonas Bendiksen spent six weeks living in the slums of Nairobi, then Caracas, Mumbai, and Jakarta.

His remarkable panoramic images take us inside slum families’ lives, revealing the profound human impulse to fashion not only shelter but a home.

Link: http://www.foreignpolicy.com/articles/2009/11/03/planet_slum?page=0,0