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

Treat, contain, repeat: key links between water supply, sanitation and urban health
By Pascale Hofmann

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.

 

Over the last few years there have been several initiatives to develop practical and policy-relevant ways to measure environmental risks faced by low-income groups. This has been in response to a severe lack of information about disaster and health risks available for policy makers to draw on in most low- and middle-income nations. There is a need for both detailed settlement-level data, particularly for informal settlements, as well as for aggregated data needed to inform city-level or national interventions[i]. In this blog, I discuss innovative methodologies that are being developed in cities of the Global South to generate much needed data for action.

Innovative methodologies for understanding health and disaster risks at the urban scale

Innovative methods developed for understanding and measuring these risks range from profiling and mapping informal settlements with community-led or co-production approaches, to detailed analysis of hospital, police and newspaper records. Other methods seek to build consensus based on perceptions and experiences of risk with communities and local governments. DesInventar is a collection of national, regional and city-level databases, which use newspaper reports, as well as police, hospital and accident records to create a detailed portrait of both large or intensive disasters and small-scale extensive disaster events. Other methodologies such as Slum/Shack Dwellers International (SDI) settlement profiling and Action at the Frontline use community-generated information about resident’s experiences of health and disaster risks in order to enter into dialogue with municipal governments about their needs. ReMapRisk uses community-generated risk information and offers a spatial analysis with maps to interrogate and visualise the information, there are maps for Lima (Peru), Karonga (Malawi) and Freetown (Sierra Leone).  Other approaches, such CityRAP, The City Resilience Index and 10 Essentials for Making Cities Resilient focus on the municipal government’s perspectives of risks and capacities for addressing risk at the city-level, and often in dialogue with communities.

 

Health and disaster risks faced by the urban poor

These studies have found that women, men and children living in informal settlements are disproportionally exposed to small and large-scale disaster risks such as flooding, landslides and fires, as well as everyday risks, such as water borne illnesses and poor air quality. For example, the AXA-funded research I have been involved in in Dar es Salaam in Tanzania, used Action at the Frontline methodology, with household surveys, focus groups and action planning Mtambani settlement in Ilala municipality and Bonde la Mpunga settlement in Kinondoni municipality[ii]. The communities identified crime, poor solid management, lack of storm-water drainage infrastructure, lack of wastewater and toilet infrastructure, lack of basic health services and hospitals, flooding, high living costs and drug abuse as the main issues in their settlements. Many of these are directly related to health problems, such as malaria, diarrheal disease and personal safety. While big disasters, such a major floods, earthquakes, tsunami and windstorms do affect the health and welfare of millions across the globe every year, it is actually the smaller events and everyday risks that impact the greatest number of people’s health and well-being.

 

These different methods of understanding risks have been employed in close partnerships between researchers, community organisations, municipal authorities and other research users in many cities across Asia, Africa and Latin America. While there are many innovative initiatives for understanding and measuring risks, the data still remains extremely patchy and limited in scope. Furthermore, and its uptake into municipal government operations and planning is not guaranteed.

 

Principles for the uptake of risk information in urban planning and policy making

Through the Urban Africa Risk Knowledge programme[iii], researchers have identified some principles related to the uptake of local-level risk information into planning and policy making: 1) It is important not just to provide the type of information that are assumed to be useful, but to work closely with partners in identifying data that will be useful for policy and practice[iv]. 2) The community-driven process can be more conducive to driving change in practice and policy in local government than expert-driven data. The use of local knowledge that comes through communities collaborating with local level decision-makers can capture the qualitative experiences of risks and measure the burdens arising from these risks, while enabling communities to engage with local governments/state about their needs[v]. 3) Small steps at collecting local data that are ‘good-enough’ can be valuable in the beginning.[vi] 4) Project-based risk measurement initiatives are rarely enough to make a difference in government practices and policies. What is required is long-term and sustained engagement with information that is regularly updated. 5) Improving official data collection, such as census, vital registration systems and healthcare records will be necessary to systematically address disaster and health risks in informal settlements[vii].

 

Many cities in low- and middle- income countries, and especially in sub-Saharan Africa, do not have functioning local governments, they lack a metropolitan structure or their resources are too meagre to take on new initiatives. While some progress has been made in developing methodologies that help us to better understand the everyday and small-scale disaster risks that underpin women’s, men’s and children’s health in informal settlement, there is still much more to do to scale up these initiatives and to enable local governments to take actions to address risks.

 

References

[i] Satterthwaite, D and Sverdlik, A (2018). Assessing health risks in informal settlements in sub-Saharan African cities. Urban Africa Risk Knowledge Briefing, No. 10. June 2018. Available from: https://www.urbanark.org/assessing-health-risks-informal-settlements-sub-saharan-african-cities

[ii] Osuteye, E. at al. (2018). Communicating risk from the frontline: projecting community voices into disaster risk management policies across scales. Urban Africa Risk Knowledge Briefing, No. 19. October 2018. Available from:

[iii] See www.urbanark.org

[iv] Dodman, D., Leck, H. and F. Taylor (2017). Applying multiple methods to understand and address urban risk. Urban Africa Risk Knowledge Briefing, No. 7. July 2017. Available from: https://www.urbanark.org/applying-multiple-methods-understand-and-address-urban-risk

[v] Osuteye, E. at al. (2018). Communicating risk from the frontline: projecting community voices into disaster risk management policies across scales. Urban Africa Risk Knowledge Briefing, No. 19. October 2018. Available from: https://www.urbanark.org/communicating-risk-frontline-projecting-community-voices-disaster-risk-management-policies-across

[vi] Spaliviero, M. at al. (2019). Urban Resilience building in fast-growing African Cities. Urban Africa Risk Knowledge Briefing, No. 20, January 2019. Available from: https://www.urbanark.org/urban-resilience-building-fast-growing-african-cities

[vii][vii] Adelekan, I.O. and D. Satterthwaite (2019). Filling the data gaps on everyday and disaster risks in cities: The case of Ibadan. Urban Africa Risk Knowledge Briefing, No 22. January 2019. Available from: https://www.urbanark.org/filling-data-gaps-every-day-and-disaster-risks-cities-case-ibadan

Authors: Leong, Matilda; Vo, Son Nam; Kim, Hayeon; Korsi Simpson, Paul; Korsi Simpson, Peter and Allen, Adriana (Cockle Bay Group from the ESD MSc practice module)

In the early hours of Wednesday, 25 April 2018, the residents of Kola Tree in Cockle Bay were awakened to the shouts of fire. The blaze took place in the informal settlement located in the Western coast of Freetown and affected 97 people. Although there were no casualties reported, rampant loss of property, possessions and livelihoods were claimed by the incident.

When the team from Development Planning Unit (DPU) at University College London (UCL) and Sierra Leone Urban Research Centre (SLURC) arrived at the site, they were met with chaos. A crowd of residents were still dealing with the aftermath of the fire over the rubbles of their corrugated metal sheet homes. Despite all effort to mitigate damages, the flames had been eventually extinguished by burying them under the collapsing building structures.

It was soon established that the Cockle Bay community was left on its own to undertake responsive actions. There were minimal external interventions save for the fire brigade who attempted to extinguish the fire alongside the residents. The DPU/SLURC team quickly came to the support of the residents by conducting an enumeration process to determine who was affected and what was the impact of the fire.

This information was subsequently handed to the local leader of the Federation of the Urban and Rural Poor (FEDURP) and of the Community Based Disaster Risk Management Committee to facilitate the provision of relief for victims and temporary shelter for the night. While the source of the fire was yet to be determined, the rapid assessment conducted by partners on the ground speculated the possibility of an electrical fault. The Office of National Security (ONS) responded hours after the event and is reportedly conducting a more detailed assessment to identify the origin of the fire.

The absence of external support during small-scale disasters is not unusual for informal settlements. In most circumstances, external actors such as governmental institutions and non-governmental organisations have to conserve their limited resources. Consequently, they can only respond to severe incidents. For example, a prominent local NGO was only able to support 144 of the 2,048 victims during the 2015 fire in Susan’s Bay due to the lack of funding. Minor disasters such as that in Cockle Bay accordingly tend to be overlooked and underreported. Moreover, dismal planning characterised by limited road access and dispersed and insufficient water sources also hinder evacuation and relief efforts and exacerbate the everyday risks facing local communities. Moreover, although preliminary relief is given to the victims of disasters, this is often insufficient to ensure that those affected can recover from such events, let alone to escape risk accumulation and poverty cycles.

It is estimated that about 547 fires outbreaks affected those living in informal settlements in Freetown between 2011 to 2015 (Di Marino et al, 2018). Fires are only one of the multiple hazards facing poor and impoverished women and men in the city on a regular basis. Other hazards include floods, mudslides, landslides, waterborne diseases, and occupational hazards, amongst others. Each of these disasters, small and large-scale, disproportionately impact the urban poor – destroying their housing, disrupting their education and in some case, even terminating their sources of livelihood.

The fire outbreak in Cockle Bay brings to light the broader issue of prolonged systematic oversight of informal settlements and the invisibility of certain segments of the city population, such as tenants. As the fire was confined to a mere 8 compounds within a small area of about 100m², initial estimates speculated that about 20 people had being affected. However, the enumeration process conducted by the team in collaboration with local residents revealed that it was in fact a total of 97 people, a third of whom were children. About 80% of the victims were tenants. This yields an abrupt indication of how vulnerable groups such as tenants and the youth in households are often inadvertently not accounted for, leaving them virtually invisible by the community themselves in times of disasters.

Lacking the means to enter the housing and land markets elsewhere in the city, many women in men are forced to reside in informal settlements like Cockle Bay. Therefore, these areas have experienced consistent densification and land reclamation over the years, particularly since the Civil War. Aside from high housing densities, most informal settlements also face scarce provision of basic services. Communities are forced to utilise improvised infrastructures, causing overloading of electrical points. In the area affected by the blaze, all 34 families relied on two metered connections for electricity.

Some might posit that informal settlements are hazards in themselves and ought to be eradicated. However, these settlements house a sizeable proportion of Freetown’s population, with no alternative dwelling options. Moreover, their residents perform jobs that support the daily functioning of Freetown; quietly they run the city. Demolishing their living quarters as a ‘protective measure’ against risk simply displaces the issue – disrupting lives, livelihoods, family ties and social organisations – making poor women and men even more invisible. Events like the fire in Cockle Bay remind us of the need to stop blaming the victims and victimising the poor, the need to acknowledge that they live at risk not as an exception but as a common reality, the need to seek pathways for more inclusive urbanisation beyond risk.

 

Reference

Di Marino, Marco; Lacroix, Lea; Nastoulas, Illias; Simpson, Paul; Trintafillides, Georgina; Williams, Cai Anwyl ; and Yang, Deyu. (2018) Urban Risk Trap: Fire Dynamics in Freetown’s Informal Settlements. Policy Brief No. 2. SLURC/DPU Action-Learning Alliance.

 

 

Dr Andrea Rigon and Dr Alexandre Apsan Frediani  from the DPU coordinated and supported a delegation from Freetown (Sierra Leone) at the UN Habitat III conference. The delegation included Sam Gibson, Mayor of Freetown, Sulaiman Parker, the Environment and Social Officer of Freetown City Council and the two co-directors of the Sierra Leone Urban Research Centre (SLURC), Dr Joseph Macarthy and Braima Koroma. SLURC is a research centre created through a partnership between the Bartlett Development Planning Unit and Njala University with the aim of generating knowledge that could bring together city actors to achieve just urban development.

Sierra Leone is one of the countries with the lowest Human Development Index and is facing a process of urbanisation which has the potential to improve the well-being of its citizens. On Sunday, the delegation participated to the World Mayors Assembly. Mayors of the world strongly asked to be recognised as the central actors in the implementation of the New Urban Agenda and asked for more powers, particularly in terms of direct access to finance mechanisms.  There was also a mayor call for more women in local government leadership. The Mayor of Freetown had the opportunity to informally meet with UN Secretary General Ban Ki Moon and put the needs of cities in least developed countries on the political agenda. The delegation had the opportunity to meet with IIHS, an indian-based research institution which had similar purposes and learn form their history.

 

The Mayor of Freetown met with UN-Habitat to discuss the challenges of the city in terms of appropriate legal frameworks to implement city planning. These reflections were later presented at the special session on urban rules and regulations. The discussion also highlighted the need to clarify responsibilities between the city and central government and the need for the city to improve their own revenues. The delegation was also approached by the UN programme Capital Development Fund, which helps cities getting access to capital markets and bridging relationships with donors, in order to discuss municipal finance

The following day the delegation met with the Secretary for Territory and Housing of the Quito Municipality and their civil society partners to learn from the experience of Quito. A number of areas were identified in which Quito has very interesting and successful policies that could benefit Freetown. These are the effective system of property tax, betterment tax and land value capture which are used to invest in the city infrastructure. Moreover, the land regularisation process for Quito informal settlements can be a useful model for Freetown. The delegation was also introduced to the cooperative housing model which enabled low income groups to access high quality housing and regenerate important ecological areas next to the creeks. We discussed the potential for south-south city-to-city cooperation and the Quito Municipality was open to organising a trip to Sierra Leone. In the afternoon, we had a meeting at the Ministry of Urban Development and Housing where we furthered the discussion around south-south cooperation and the possibility of a delegation from Ecuador including both municipal and central government staff in order to share with Sierra Leone  on division of labour and cooperation between these levels of government could work for the city.

On Wednesday, the delegation met with Cities Alliance to discuss the possibility to expand their programme to Sierra Leone and focus on upgrading through an alliances of government, civil society and research institutions. Later, we met with the Government of Kenya to discuss slum upgrading approaches and learn from their experience with the Minimum Intervention Approach based on community building, land titling and infrastructure. They invited us to the session of the Participatory Slum Upgrading Programme (PSUP), a UN programme in multiple countries. The Mayor asked for Sierra Leone to join the programme and the European Commission which fund it welcomed Sierra Leone as long as central and local government are jointly willing to implement slum-upgrading policies.

 

On Thursday, SLURC was launched internationally through a press conference to explain how it operates as an urban learning alliance introducing a new mode of urban knowledge production through partnerships with central and local government, universities, civil society organizations, and local communities. The following people explained the importance of an organization such as SLURC: Mr. Sam Gibson, Mayor of Freetown, Mr. Francis Reffell, YMCA Sierra Leone, Dr. Joseph Macarthy, SLURC co-director of SLURC, Prof. Julio Davila, Director of Bartlett Development Planning Unit, University College London, Dr. Irene Vance, Comic Relief.

 

Following this international launch, a networking invited brought together six urban alliances between universities and city actors, from four continents to share their insights and recommendations for SLURC and how urban learning alliances can play a key role in the implementation of the New Urban Agenda.

Friday morning was dedicated to visit two communities and projects dealing with housing. In the morning, the delegation visited Los Pinos a community in the outskirts of Quito, while the afternoon was dedicated to getting to know the  housing project of the cooperative Solidaridad.