Building Pandemic Resilient Cities in India
TerraGreen|July 2020
It is well established that globally most pandemics have severely affected crowded urban settlements which are often the hub of significant economic activities, but yet they suffer from poor housing and basic Water, Sanitation, Hygiene (WASH) infrastructure. In this article, Mary Abraham and Nathaniel B Dkhar highlight that while washing hands and maintaining adequate hygiene has been advocated as the need of the hour, COVID-19 exerts the need to reassess the adequacy of the WASH infrastructure in slums and low-economic settlements. They rightly emphasize on the need for WASH infrastructure improvement to face pandemics in urban areas.
Mary Abraham and Nathaniel B Dkhar

India is one of the fastest urbanizing nations with around 459 million people living in the urban areas. As per the Census of India, about 28.53 per cent of the population in 2001 resided in urban areas which grew to 31.16 per cent by 2011 and estimated at around 34.3 per cent in 2018. 1 By the year 2050, around 52.8 per cent of Indians are estimated to live in urban areas. 2 Despite considerable progress in the urban Water, Sanitation and Hygiene (WASH) sector, the inequity of WASH infrastructure persists as a serious challenge especially in the context of the COVID-19 outbreak. Almost all the states in India are affected with coronavirus with urban areas being on high risk. Several measures are being taken by the Central and State Governments for containment of the pandemic, including a phased-out lockdown and strengthening of health infrastructure.

The World Health Organization (WHO) recommends hand hygiene or washing of hands with soap to prevent the spread of COVID-19 virus transmitted through respiratory droplets or direct contact. Good WASH and waste management practices in communities, workplaces, markets and institutions including health care facilities serve as barriers in the spread of the virus.

Although there has not been any clear connection of the virus spreading through drinking water, the safe management of drinking water and sanitation services is necessary for maintaining good health. The prevalence of gastrointestinal symptoms of the infected COVID-19 patients, 3 further demands access to adequate sanitation facilities. The faecal-oral transmission of the SARS-CoV-2 virus is yet to be clearly established. However, several studies point out the presence of SARS-CoV-2 virus in faeces and there is concern that untreated sewage waste could be a potential source of infection. 4 An examination of WASH infrastructure in urban areas especially urban slums is imperative to mitigate large-scale outbreaks of infectious disease.

While the consequences of the pandemic is still being understood and yet to be fully assessed, urban areas have already witnessed severe socio-economic consequences. In view of the fact that there is no vaccine yet, and recent reports from WHO indicating the possibility of COVID-19 being an endemic is unsettling. This is especially precarious for urban areas in developing countries where people face higher vulnerability for several reasons. The current scenario raises concern especially for 24 per cent of India’s urban population living in slums under dense habitations often lacking adequate WASH facilities. It is thus pertinent to assess the urban WASH sector in view of the current pandemic.

Urban Poor and WASH

Around 26–37 (33–47 per cent) million households 5 are reported to live in slums and informal housing facilities, often lacking adequate basic amenities challenging the maintenance of required hygiene during this pandemic. NSS, 2019 suggests only around 40 per cent of urban population have access to piped drinking water in their dwelling units, 16 per cent draw it from their yards, 7 per cent used public taps and 12.2 per cent use bottled water. Almost 50 per cent of the households treat water for drinking. A study by WaterAid in 2018 6 suggests that 74 per cent slums use tap water generally accessed through community stand posts. Several studies also indicate the inequalities in terms of quantity and quality of water supplied to urban slums. Another report suggests that slums receive less than one-third of the urban water supply which are mostly from informal sources such as local bore-wells, etc., and suffer with issues in terms of both quantity and quality as compared to other urban households. 7 Around 66 per cent of slum households have individual toilets and 15 per cent have access to public toilets, though several of them lack water for use and are poorly maintained.

Hand washing is also a concern due to poor water availability and lack of necessary infrastructure. NSS, 2019 suggests 44 per cent of the total urban population do not wash hands with soap before meals and around 12 per cent do not wash hands with soap after defecation, studies indicate the population washing hands with soap are much lower among slum and poorer communities. Most of these slums also have poor living conditions, with more than half the slums being affected by waterlogging and almost a quarter located near drains and waste dumping yards. 8 With projections indicating rise in urbanization, the urban slums are expected to further grow at a much larger pace. The pandemic exposes the risks posed to the urban poor living in slums due to their workplace exposure, inability to maintain social distancing and isolation while living in crammed habitations and poor basic facilities including WASH infrastructure.

Impact of COVID-19 on Urban Poor in India

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