This blog is the third of the health in urban development blog series. View also:

Health in secondary urban centres: Insights from Karonga, Malawi
By Don Brown

Gaza: Cage Politics, Violence and Health
By Haim Yacobi

If you are interested in DPU’s new MSc in Health in Urban Development, more information can be found on our website.

In Dar es Salaam, Tanzania’s main economic and administrative centre, high population densities, the accumulation of informal lower-income residents, lack of access to clean water and poor sanitary conditions have been associated with a range of water and sanitation-related diseases. Cholera outbreaks are a frequent occurrence during the rainy season and some settlements in the city are among the worst affected in the country. In this context, I argue that urban water poverty needs to be tackled using a proactive rather than reactive approach at the local level to yield long-lasting health benefits.

Main access road in an informal settlement in Dar es Salaam after an episode of heavy rainfall (Photo © P. Hofmann, 2015)

Tackling urban water poverty and community health promotion

Internationally, the link between urban water poverty – i.e. inadequate access to water supply and sanitation facilities, and public health – is widely recognised whereby improvements in accessing water and sanitation are deemed crucial in tackling a diverse range of diseases and improving the lives of the poor.

Such thinking calls for integrated and consistent approaches, which, as emphasised by a UNICEF WASH specialist in Tanzania are evidently lacking in most policy-driven practices on the ground.

“Hygiene and sanitation awareness, behaviour change, communication and empowerment are maybe done in urban areas but erratically, not systematically. When the rains are coming and there is threat of cholera etc. then you will find people will announce:  ‘food vendors cover properly your food and make sure it is hot and whatever, please clean your surroundings, no solid waste should be seen and liquid waste, please drain it out completely’ etc. […] or there is a cholera outbreak in a certain locality in Dar es Salaam and it is feared that it might spread, so that happens but on a regular basis there is not a lot done” (quote from UNICEF WASH specialist).

During the recent cholera outbreak in 2015 government spending increased significantly to treat the affected population. While curative measures are vital, efforts to improve water supply and sanitation constitute essential steps towards future outbreaks. Similarly, some municipalities in Dar es Salaam have put continuous support into household fumigation programmes to impede the spread of malaria but fall short of investing in preventative measures to keep people healthy – i.e. reduce mosquito breeding sites through the provision of safe drinking water, improved sanitation and hygiene. Currently, the onus is predominantly on residents themselves to be pre-emptive in their everyday practices with regards to potential health implications but not everybody is equally aware or shares the same ability to act. In the absence of sufficient government action, those who can have invested in better access to water, improved sanitation facilities and even flood defences.

Drainage channel built by two neighbouring households to divert water from the Msimbazi river, which carries wastewater from nearby wastewater stabilisation ponds (Photo © P. Hofmann, 2015)

“In 2011 there was flooding and we lost our livestock and we had to start afresh. What actually happened is there has been increased silt in the Msimbazi river. At the same time, there is wastewater that comes from the ponds and where these meet, that impact pushes the water towards our land. […] we constructed this drainage channel jointly with my neighbour after the flooding to try and divert the water from coming in” (quote from a resident in an informal settlement in Dar es Salaam).

The need for a proactive, decentralised approach

Ward health officers are officially tasked with preventing water-related diseases and promoting environmental health in their jurisdiction through regular water quality tests at local water supply schemes and inspections of businesses and households with no equivalent paid staff at sub-ward level. However, with limited resources at ward level much of the action regarding water supply, sanitation and environmental health depends on voluntary efforts in the communities by residents themselves and facilitated through sub-ward committees, water committees and community representatives. Many health officers at the ward level understand the importance of sanitation, drainage and safely-managed water supply but struggle to influence the agenda at higher levels of government. The Decentralisation by Devolution Policy introduced in the 1990s transferred responsibilities to local government for service improvements but without fiscal decentralisation or devolution of decision-making power. Decentralisation should pave the way for bottom-up participatory planning processes but municipalities in Dar es Salaam focus on central government priorities while continuing to disregard lower levels of government and their efforts to address local challenges. Decentralised decision-making structures are therefore not a guarantee for more democratic processes.

The importance of engaging urban poor communities

To lower the burden of water and sanitation-related diseases, engagement of communities with the authorities (utility and municipal government) is crucial but often limited and slow. Until recently, one of Dar es Salaam’s municipalities prohibited low-income communities living near wastewater stabilisation ponds to use them for safe sewage disposal. A lengthy period of continuous interaction between the local community, the municipality and the utility, facilitated by a local NGO, eventually led to a pilot initiative that connects household toilets to the nearby ponds using simplified technology. This has reduced the number of pits being informally emptied during the rainy season and led to a safer and healthier environment for residents.

Inspection chambers of the simplified sewerage pilot in an informal settlement of Dar es Salaam (Photo © P. Hofmann, 2015)

The utility seems keen to replicate the scheme elsewhere in the city, which shows potential that policy-driven practices can be transformed, scaled up and institutionalised in ways that are more integrated and sensitive towards the needs of the urban poor if sufficient consideration is given to the scope for scaling up and sharing the benefits more equally within a settlement.

Pascale is a Lecturer at the Development Planning Unit, UCL, where she leads the MSc in Environment and Sustainable Development Programme. Her current research is particularly concerned with the dialectics of urban water poverty, examining different policy-driven and everyday practices and their impact on everyday trajectories of the urban water poor. She is interested in generating knowledge towards developing feasible pathways out of urban water poverty.

The global water crisis is happening right now. WaterAid states that “a lack of safe water, proper toilets and good hygiene affects women and girls most” making water poverty undoubtedly a gender issue. However, if we are going to properly understand and account for all experiences of water poverty, we need to change the way we think about gender, women, and water.

Gender and Development Approaches to Water Poverty

The gendered nature of water poverty was brought to the world’s attention by feminist critiques of gender inequality in development and access to natural resources. Through research, academia, and activism on gender inequality, the burden on women and girls of collecting water and carrying out domestic water tasks has become well-known, contributing to the continued promotion of ‘Gender and Development’ (GAD) approaches in international policy.

Borne out of critiques of ‘Women in Development’ (WID), which was the first attempt to integrate women into the international development agenda, GAD emerged in the late 1980s and has gained significant attention in academic research, development practice, and policy at all scales. It brought a new focus on the socially constructed differences between men and women to global development policy and discourse, and encouraged an analysis of gender roles and gender relations. In relation to water, GAD approaches therefore privileged investigation into how gender roles and relations influence uneven access to and control over water resources. Much of the work in the water sector is informed by this approach, meaning water programmes and initiatives, especially in the Global South, have increasingly had a gender focus.

However, there are many feminist authors who challenge the practical application of GAD approaches. Although GAD intended to move away from a focus just on women, in practice, ‘gender’ is still commonly synonymised with ‘women’ in policy and practice. As a result, gender approaches and gender mainstreaming in water programmes often slip back into single perspectives. Within gender mainstreaming, this focus on women also often results in the homogenisation of ‘women’ as a single category, suggesting that all who fall under that category experience water inequality in the same way.

I want to stress here that in writing this article I am no way trying to reduce or overlook the evident gender inequality and water struggles which many women and girls experience in their daily lives around the world. Rather, highlight the problems with the current way gender is commonly conceptualised in water projects; where generalised statements like ‘poor women are more impacted’ are common. Such statements perpetuate global narratives of a homogenous, vulnerable Global South woman suffering from water poverty, and render differing experiences of water inequality invisible. For example, images of water poverty are often of non-white women struggling to carry and collect water, as shown below.

However, it would be far too simplistic to say that these two women experience water inequality in the same way just because they are both women. What about other factors such as their age, where they live, their class? And how do all of these interconnect through different social relations? Nonetheless, inaccurate assumptions that all women suffer equally, and can therefore be empowered equally through targeted ‘gendered’ interventions, guide many water programmes.

The dominance of such simplified narratives is having negative consequences. Wider social relations can undermine programmes directed at women, and there are a number of examples of water interventions which actually resulted in further marginalisation due to a limited understanding of these other social factors and relations.

The Importance of Other Social Relations

The notion that gender constitutes something far more complex than simply ‘male’ or ‘female’ has gained significant ground in academic work. A feminist theory known as intersectionality has been at the forefront of such thinking, arguing that gender always intersects with other social identities and relations, including race, caste, class, age, ethnicity, sexuality, for example. Intersectionality suggests that it is all of these different identities and relations and how they come together in different ways which is important for determining how someone experiences (water) inequality and poverty. 

Allen and Hofmann explain this clearly in their recent book chapter on urban water and sanitation poverty in Lima and Dar es Salaam. They use intersectional analysis to show how women and men go through dynamic trajectories in and out of water poverty due to factors such as whether they are renters or landowners and relations with other people in the community. For example, they follow the life of one entrepreneurial woman who lives in her family house and sells drinking water in reused plastic bottles that she fills with water from the pushcart vendors. She is able to sell water because she is well known in the community, giving her extra income to secure access to water for herself. Whereas another woman, also with her own business, is constrained by her position as a renter. Her landlord keeps raising rents and, despite her business, she struggles to find the money to meet the basic water needs of her family.

Understanding water poverty in this way and further exploring how water inequality is differentially experienced is extremely important. It not only sheds light on how micro-politics shape differing levels of empowerment and disempowerment, but also links such dynamics to broader structural issues through multi-scalar investigation. This helps to explain at multiple levels why and how some women can escape water poverty water whilst others cannot. Too much of a practical focus on ‘women’ as a homogenised, fixed, singular category clearly hides other significant factors through which water poverty is embedded and comes to be produced and experienced.

Therefore, this could, and should, have meaningful implications for policy and water practices for better targeted interventions. Although intersectionality is a well-known theory, currently there is little literature and even less policy focus on intersectional water poverty, or even in relation to socio-ecological inequality in the Global South more widely. The hope is that with the gradual increase in academic publications which attend to complex ideas of gender and social difference in relation to water, there will be a shift towards those who experience multi-layered water inequalities right now. We have begun to change the way we think about gender, women, and water, but now we need to question how we approach and overcome water inequalities in practice.  

References

UNICEF/WHO (2015) https://www.wssinfo.org/fileadmin/user_upload/resources/JMP-Update-repor…

Photo credit for the image of two women carrying water: https://www.flickr.com/photos/adjourned/3069327644 

Rosa is an LIDC intern and a Master’s student of Environment and Sustainable Development at the Development Planning Unit, UCL. She is interested in water poverty and policy, gender, and development in urban contexts.

Rapid urban expansion and the emergence of new urban centres in the Global South is frequently accompanied by a lack of adequate infrastructure and services. This is resulting in declining levels of access to water supply and sanitation for a large number of urban dwellers, with the State increasingly unable to fulfill its role as a provider of basic services.

I will elaborate on this using the example of Dar es Salaam, a city that has been the focus of my research for a while.

Private vendors take on the responsibility for water delivery where formal infrastructure is absent. This usually means that those living in poorer areas end up paying more than those connected to the piped network.

In Tanzania’s largest city we see that formal service provision is limited to central and more affluent areas. The gap in service provision is particularly high in rapidly growing peri-urban areas such as Tungi and Kigamboni, whose inhabitants are among the worst served.

Both wards are areas that tend to absorb large proportions of the growing urban population, but with disproportionately high percentages of poor households. This is going to accelerate further once the construction of a new bridge that connects these two wards to the city’s main business district is complete.

Peri-urban areas may be incorporated into the city, but still lack services

At the same time, many informal areas previously labelled as ‘peri-urban’, like the Kombo and Karakata subwards close to the airport in the South, have become more consolidated and incorporated into the urban core. Yet they continue to suffer from non-existent or inadequate formal infrastructure and services.

As with the Kigamboni peninsula, the majority of those affected are lower-income people that experience varying degrees of water poverty, often with severe implications on their livelihoods; both in terms of the additional time spent to meet their needs and their income, if their economic activities rely on water.

Map of Dar es Salaam, with the area of Kigamboni highlighted in red. From Google Maps

Global efforts to meet water and sanitation needs

To address injustices in the current provision of infrastructure and services, there has been a renewed commitment globally towards universal access through the Sustainable Development Goals in order to activate people’s right to water supply and sanitation. Tanzania is one of the countries that have endorsed the right to water and sanitation.

In practice, however, efforts to tackle the shortfall have largely been seen as a problem of maldistribution. In other words, proposed solutions currently include expanding the water source, reforming the utility and improving the network – these plans assign major roles to utilities, the state and external support agencies.

Poverty, which is first and foremost conceived as people’s financial inability to pay, is regularly presented as the main reason for people lacking access to water supply and sanitation. This is in spite of evidence that Dar es Salaam’s lower-income households frequently pay more in relative and actual terms for a service that in reality is of a lower quality and lower frequency.

More than just a distributional struggle

But water injustices in cities are much more than just a distributional struggle. They are created by socially fabricated political-economic structures, which have led to clear power imbalances that misrecognise those without access. Power relations play a significant role in Dar es Salaam where water has become a commodified good. Even though water supply is in public hands the utility is heavily pushed to be financially autonomous and commercially viable.

In Dar es Salaam and many other cities in the Global South the lack of entitlement and recognition is associated with the informal status of the urban water poor and their disempowerment. While the utility acknowledges their responsibility to provide Dar es Salaam’s residents with water regardless of their tenure status the proportion of their action contributing towards improving supply in informal settlements has been negligible so far.

Co-produced water practices

The deficiency of utility networks and supply in poor urban settlements has given rise to the emergence of a range of alternative practices. Many of them emerge out of poor people’s needs and can range from individual coping mechanisms to collectively organised and negotiated initiatives. Some of these communal efforts represent different forms of co-produced service provision whereby organised groups of poor communities are collaborating with the state directly.

Goals of current DPU research

Earlier this year, I was part of a group of colleagues from DPU, in collaboration with a number of partner organisations, that embarked on the Wat Just research project – Translocal learning for water justice: Peri-urban pathways in India, Tanzania and Bolivia – to explore alternative practices to access services with a particular focus on co-produced water management in three cities; Cochabamba, Dar es Salaam and Kolkata.

In each city we found a variety of service co-production arrangements that range from latent state support to fully institutionalised co-production platforms. However, very little is known to date about their actual performance and their potential to operate at scale.

The aim of our future research is to examine their transformative potential to address not only the current service gap – i.e. meet the urban poor’s practical needs – but also to investigate how far they can tackle more strategic needs such as challenging and transforming existing power relations that threaten to keep the needs of the urban poor hidden.

Pascale Hofmann is a lecturer at the DPU and is currently studying for an EngD at the DPU and UCL’s department of Civil, Environmental and Geomatic Engineering (CEGE). She has been working with Professor Adriana Allen on a research project with seed-funding from the ISSC (International Social Science Council) Transformations to Sustainability Programme.

The project, on Translocal learning for water justice: Peri-urban pathways in India, Tanzania and Bolivia, has brought together academics and NGOs from Bolivia, India and Tanzania to discuss and share the challenges and opportunities of co-produced water and sanitation services in their cities. How can these platforms contribute towards water justice at the city scale? A series of Water Justice City Profiles have been produced, elaborating on the challenges in each urban region, as well as a series of videos that explain the concepts and contexts in which the research operates – several of which will be released in the coming weeks.

For the past two-weeks students of the MSc Urban Development Planning have been working in three sites across Dar es Salaam, Tanzania, as part of their field trip project supporting community-based initiatives for informal settlement upgrading.

Working with the Center for Community Initiatives (CCI), a local NGO, and members of the Tanzanian Federation of the Urban Poor, students have been trying to understand the realities of urban life in these three areas while developing ideas to guide more socio-environmentally just trajectories of urban development at the city-wide scale.

Incomplete houses on the Chamazi site
Image: Rafaella Lima

The three sites in which the groups are based—Karakata, Chamazi, and Mabwepande—have much in common: they are all growing peri-urban areas, they are all mostly “informal” or “unplanned”, most residents are low-income, and they face similar interlinking challenges such as infrastructure, access to basic services, sanitation, and solid waste disposal. But they also represent different patterns of land acquisition and development within the Tanzanian context.

Learning about the Gulper machine, a mechanism that the Federation has been using for the emptying of pit latrines in Karakata.

Karakata is the longest-established settlement of the three, and developed as residents from elsewhere in the city moved further out in search of more affordable land and rent prices. Considering Karakata’s close proximity to Julius Nyerere International Airport, as well as its diverse array of livelihood activities, the value of the land is currently rising at a rapid rate.

Residents face big issues such as sanitation and access to medical services, and the rapid erosion of the river in the area presents a grave environmental threat. Students assigned to this site have been working on ideas such as community-led environmental risk assessments and a more sustainable model for the Federation’s waste-disposal system.

Mapping the route between Chamazi housing site and the town centre.

In Chamazi, Federation members formed a housing cooperative to collectively purchase a plot of land to build homes for those who were evicted by the government from Kurasini Ward in 2008, due to the expansion of the port area.

However, since the project began in 2009, many houses have not been completed and a high percentage of families have yet to move to the site. One hypothesis for this has been that Chamazi’s distance from the city center (sometimes 3-4 hours with traffic) means much fewer livelihood and employment opportunities.

But the Chamazi site is not as isolated as it once was; in only the past few years the area around Chamazi town has grown rapidly, bringing new businesses, markets and services. UDP students have been exploring the seeming disconnect between the housing site and the town, along with the financing of the housing project to understand how it can remain affordable and viable.

A student-led focus group trying to understand the dominant challenges in Mabwepande.

Mabwepande is another peri-urban site for relocated people, however in this case the government allocated land for victims of flooding in the more central Suna zone.

At the moment the area feels rural and many residents use the non built-up space for agricultural purposes, but we have yet to see how increased development of the area and new pressures on land will affect them.

As the Federation has only just begun working in this site, Mabwepande had yet to be mapped in a way that was accessible to its residents. Along with conducting interviews and focus groups to begin to build a larger picture of the Mabwepande community, students created maps with the help of community members to be shared on the site.

Students present some of their findings and ideas to community members in Karakata.

These three sites are illuminating important citywide processes, such as the uncertain institutional relationships that govern the urban poor’s access to land (for example, there is no clear resettlement policy that might guide the relocation of people like in Chamazi and Mabwepande).

Students are understanding the notion of “scale” in practice, as they come to grips with the scale of informality and poverty across Dar es Salaam. This has been underpinned by the rainy season, in which intense flooding across the city has brought the hardships faced by Dar’s poorer residents into clear focus.

Observing a Federation and CCI-led focus group used in settlement profiling in Vingunguti settlement.

Finally, there is the challenge of gathering reliable data in a city that is growing so rapidly, in a context where certain forms of knowledge are not recognized. The field trip focuses on the way knowledge is built at the local level as students learn from the Federation model of settlement profiling, enumeration, and mapping.

In return, students offer input and experiences from their diverse home countries to try and support community-led processes of co-production of housing, land development, and knowledge.

Post written in collaboration with Josephine Wilka. Students of the MSc Development Administration and Planning

On the 30th October 2012 at 11am, there was a lot of commotion at the Cumberland Lodge: almost 180 DPU postgraduate students and staff were gathering in the back garden of this beautiful Windsor mansion to have their photo taken. It captured one of the many memorable moments of this year’s Windsor Workshop which was concerned with the subsequent topic: “Dar es Salaam – Negotiating a unified strategy for land use and affordable settlement upgrading”. Some of the students then headed towards the buses to return to London. For them it marked the end of two days full of intense group work, heated discussions, film-screenings from the ground, tricky negotiating and decision-making, certainly the most demanding tasks of the whole exercise. For the other half of the students the challenges of creating a solution to this Tanzanian reality with their stakeholder groups were still ahead. After all, this simulation project was attended by Tim Ndeze, who participates in the actual negotiations on site as a member of CCI (Centre for Community Initiatives)- a civil society organisation. He not only presented an invaluable in-depth local knowledge of the situation, but also, together with Ruth McLeod and Gynna F. Millan Franco, contributed to the excellent movie footage from Dar es Salaam, which had been collected in the weeks ahead. Their team effort allowed DPU students to immerse themselves into the perspective of one of the many actor groups they chose to represent, ranging from international financial institutions to slum dwellers, in order to envision the environment and to connect to the local people through the recordings. Despite the assignment itself being very serious in nature, there was also time to enjoy the historic surroundings, giving the foreign students the opportunity to get a glimpse of the British culture, and to socialise with other participants and coaches over a delicious meal or a drink at the cosy bar. For those that preferred to be more active, there was the chance to show off their table tennis skills, to hit the dance floor for some twists and spins and to explore the vast Windsor Park, ideal for a quick afternoon walk.

Following this period that resulted in defining the strategy, forming of alliances and the establishment of concrete points of action at the Cumberland Lodge, a final meeting of all “stakeholders” was being held at the Royal National Hotel in London, providing the last opportunity to maximise support for the respective actor group’s vision. The students representing slum dwellers, for example, did not let this chance pass by and took the liberty to stage some last minute demonstrations to remind everyone that the voices of the most marginalised should not be forgotten and that it is them who should be at the heart of the solution. With the objective being clear, interests and efforts had to be harmonised – a task which emerged as the most difficult struggle in achieving a comprehensive, far-reaching action plan by all parties involved.

Reflection upon the workshop and its effects shows how profoundly it had challenged many DPU students to engage with the multiple layers of causes and impacts in urban affairs. What’s more, the specific understanding of a region has been highly valued by various Windsor Workshop participants, whose opinion is resonated in the following statement by a DAP student who contemplated about her experience a few weeks after returning from the lodge: “I thought Windsor [Workshop] was fantastic! What I liked most about it is that I now know so much about Tanzania and its development-related problems, I knew very little before.” The benefits of attending far exceeded simply learning about Tanzania: everyone had the opportunity to assume a specific role as a member of one of the various actor groups, and by doing that each one could actively contribute to finding solutions to the many issues Dar es Salaam is facing right now. Moreover, all the activities, carefully planned by the DPU staff, were notably aimed at encouraging students to enhance their ability to work in teams, to think outside the box, to be creative, and to improve their presentation skills. Whether one was a  local government official dealing with  a lack of funds, staff and coordination or a member of a Chinese estate giant trying to develop the land for the people, yet securing commercial interests: working together was crucial to achieve common goals.

What especially made the whole project worthwhile was the fact that the proposals and solutions that have been developed, will be considered by the team of practitioners on the ground in Dar es Salaam, who have sent Tim Ndeze to London to attend to this task. In this sense, DPU students had the unique opportunity of making a real contribution  to the  positive change in some of the Tanzanian communities facing resettlement.

For more images visit the DPU flickr account

Pictures in this post by ©Remi Kaupp