GLOBAL: Tomorrow's Crises Today: The Humanitarian Impact of Urbanisation - Overview

Somewhere, some time this year, a baby will be born on the 25th floor of a city hospital or the dirt floor of a dark slum shack; a first-year college graduate will rent a cramped apartment in lower Manhattan or a family of five will finally concede their plot of farm land to an encroaching desert - or sea - and turn towards Jakarta or La Paz or Lagos in search of a new livelihood and a new home. The arrival of this family or graduate or baby will tip the world’s demographic scale and, for the first time in history, more than half the human population will live in cities.

At present, 3.3 billion people live in urban centres across the globe. By 2030 this number is predicted to reach five billion, with 95 percent of this growth in developing countries. Over the next three decades, Asia’s urban population will double from 1.36 billion to 2.64 billion, Africa’s city dwellers will more than double from 294 million to 742 million, while Latin America and the Caribbean will see a slower rise from about 400 million to 600 million, according to the UN Population Fund (UNFPA).

While megacities appear more frequently in headlines and on development agendas, overall growth in urban centres of 10 million or more inhabitants is expected to level out. Instead, over the next 10 years, cities of less than 500,000 will account for half of all urban growth.

Two sides of the urban coin

All this growth is not necessarily a bad thing. As David Satterthwaite of the International Institute for Environment and Development (IIED) points out, the speed at which a city grows - if it is responding to economic opportunities - is a benefit, not a problem. “A very large part of the economic value in any country is being generated in the urban areas,” Satterthwaite says. “Even in [developing] nations, where 60 to 70 percent of the population is in rural areas, you still have more than half the economy - and often more than that - generated in urban areas.”

The problem is not growth, but unplanned growth. In 2001, 924 million people, or about 31 percent of the world’s urban population, were living in informal settlements or slums, 90 percent of which were located in the developing world. By 2030, the number of worldwide slum dwellers is projected to reach two billion. In the Bangladeshi capital of Dhaka, 3.4 million of the city’s 13 million residents live in 5,000 slum and squatter settlements. Sixty percent of Nairobi’s city dwellers are packed into more than 130 informal settlements occupying only 5 percent of the city’s total land area, while the squatter settlements of Mumbai are growing 11 times faster than the city itself, with 300 people arriving from the countryside each day.

What this translates to is abject poverty, disease, and appalling conditions. Take Dhaka: every time the river level rises, it floods the illegal clusters of tiny stilted huts built on the flood plain with smelly water full of factory effluence. In Delhi, the water problem is one of scarcity as slum dwellers fight each other to gain access to the one working standpipe in their area and often go without for days at a time. Malnutrition is often highest in slums, as unemployment means people are too poor to purchase produce that could be grown on the land.

Defining a ‘slum’ and the ‘urban poor’ invariably focuses on what people lack - access to education, social services, employment, safe and affordable water, sanitation and housing, and residential status. In many cases, they live in sub-standard housing, in public spaces, or in squatter settlements near major urban areas.

It is generally assumed that urban poverty levels are lower than rural poverty levels, but the absolute number of poor and undernourished in urban areas is increasing. “In general, the locus of poverty is moving to cities … a process now recognised as the ‘urbanisation of poverty’,” the UN Human Settlements Program (UN-Habitat) noted in 2003.

If the locus of poverty is moving to cities, development aid has been reluctant to move with it. CARE USA chief Helene Gayle makes a blunt assessment of urban development capacity: “The NGO community is dependent on outside donor funding [and] its priorities often depend on where donors have put their focus,” with the result that “neither the NGO community nor the donor community has co-evolved in the direction of facing urban poverty as rapidly as urban poverty has occurred”.

‘More threatening than the village’

Throughout the 20th century, city growth was largely fuelled by rural to urban migration. Today, however, cities are mostly growing from within - more people are born than are dying in urban centres. This process of urbanisation - what demographers call ‘natural increase’ - is partly an indicator of medical advances across the developing world and of better access to healthcare in urban areas specifically.

But the fact that mortality rates are generally lower in cities masks a health crisis in slums. Worse, those most affected by this urban healthcare divide are children. A 2006 analysis in the International Journal for Equity in Health found that in 15 sub-Saharan African countries the difference in child malnutrition within cities was greater than the urban-rural divide.

As the UN’s 2006/2007 State of the World’s Cities report notes: in Ethiopia, child malnutrition in slums and rural areas is 47 percent and 49 percent respectively, compared with 27 percent in non-slum urban areas; in Niger, child malnutrition in slums and rural areas is 50 and 52 percent, against 35 percent in non-slum urban areas; and in the slums of Khartoum, the prevalence of diarrhoea among children is 40 percent, compared with 29 percent in rural areas. “Living in an overcrowded and unsanitary slum,” the report concludes, “is more life-threatening than living in a poor rural village.”

Access to water

Access to water and sanitation in urban areas, like access to healthcare, is generally better than in rural areas. But again, comparing aggregate urban and rural numbers hides the fact that - for example - in the Mbare neighbourhood of Harare, Zimbabwe, 1,300 people share one communal toilet with six squatting holes.

As urban populations increase, the number of people without access to improved water sources is also rising, doubling from 108 million in 1990 to 215 million by 2010. In dense city environments - and in even more dense slum environments - communicable diseases can quickly become epidemics, making the consequence of unsafe water and poor sanitation much more severe than in rural areas. And more people are affected due to city concentrations.

In addition to the outwardly identifiable impacts of poor access to water, sanitation, and health services (pneumonia, malaria, diarrhoea, tuberculosis, HIV/AIDS), a dearth of services also perpetuates poverty. The urban poor spend a higher percentage of their income on treating illness, and are more vulnerable to lost wages and have less job security when they are forced to miss work - all of which erodes their coping capacity, and can keep potentially mobile families trapped within a cycle of poverty.

Unnatural disasters

In the last quarter-century alone, 98 percent of the people injured or affected by natural disasters were living in 112 countries classified as low income or low-middle income, according to the World Watch Institute’s 2007 State of the World Report.

And while tsunamis and earthquakes continue to grab the headlines, flooding and landslides affect a much larger number of the urban poor. While the 2004 Boxing Day tsunami accounted for about 90 percent of that year’s natural disaster death toll, the 2.4 million people affected was a relatively small number compared with the 110 million people hit by flooding in Bangladesh, India and China the same year, according to the International Federation of the Red Cross (IFRC) 2005 World Disasters report.

With little available land in urban areas, the poor, by necessity, live on floodplains, unstable cliff sides and in the shadow of industrial facilities. In the developing world an earthquake or a hurricane is not a disaster, but a catalyst for disaster - exposing poor infrastructure, substandard housing, haphazard city planning, and often nonexistent response measures - all of which constitute the true disaster for the urban poor.

Urban warfare

Poverty has long been considered a key driver of violent crime. In recent years, however, this relationship has been challenged as too simplistic. A 2004 article on urban violence and insecurity in the journal Environment and Urbanization identifies inequality as a primary driver, noting that “interpretations based on statistical modelling have demonstrated that with regard to national-level data on murder rates, inequality is more influential than poverty, with income inequalities being generally more marked in urban than in rural areas”.

A World Bank study on violence in Latin American urban areas showed that homicide rates ranged from 6.4 per year per 100,000 in Buenos Aires to 248 in Medellin, Colombia. Rio de Janeiro, São Paulo, Mexico City, Lima and Caracas account for more than half their countries’ national homicides.

More difficult than measuring crime within urban areas has been differentiating between underlying structural causes (like unequal power relations), and trigger risk factors (such as alcohol and drug abuse), which can often precipitate gender-based violence.

The danger in mapping and measuring urban violence is that perceptions of violence are then reinforced; because statistically-speaking, urban centres (and especially slums) are subject to more crime, violence can become institutionalised, and more dangerously, a stereotype of slum dwellers as criminals is perpetuated.

From shanty to State House

In 1990, the UN Development Programme (UNDP) released its first Human Development Report. The fifth chapter dealt exclusively with the humanitarian effect of urbanisation in the developing world. Addressing the role of local and national governments in service provision for the urban poor, the report’s authors recommended that governments “shift from directly providing services to enabling others to provide them - be they formal and informal producers, community-based and non-governmental organisations or the urban residents themselves”.

By 2007, this outsourcing paradigm had come full circle. As author Rasna Warah noted in her assessment of the Kenyan government’s role in urban development, “The answer to Nairobi’s slum problem lies in stronger and more integrated intervention by government ministries and agencies.”

The promotion of healthcare, education, access to water and sanitation, together with the prevention of violence and the response to natural disasters, depends on active and accountable local and national governments. Indeed, underneath almost all aspects of urban development and poverty reduction are issues of governance.

At the most basic level, good governance involves recognising slum and squatter residents’ legal right to exist, and formalising this right through land tenure, ownership, city zoning regulations, etc. The realisation that government was missing from urban planning coincided with the realisation that the urban poor had been, at best, passive recipients and at worst, completely absent from the planning and implementing of slum upgrading projects; and that the urban poor were in the best position to advocate for their rights vis à vis local governments, and design and implement slum-upgrading schemes.

At present, urban development actors are struggling to define their roles, and to establish a more cohesive, active approach to urbanisation. CARE chief Gayle sees her NGO as a link between governments and communities: “We are not saying that we are marching on the halls of power within countries necessarily, but instead really looking at how we help at the grassroots level to give people a sense of their own ability to engage and make their government accountable to them.”

Cities of half-light

The UNFPA 2007 World Population Report states: “Cities concentrate poverty, but they also represent the best hope of escaping it … The challenge is learning how to exploit [a city’s] concentrated population.”

Over the next months IRIN will produce in-depth articles and interviews examining how this challenge is being met. The interviews will include conversations with leaders in the urban development field - from the heads of international NGOs to academics - and slum-dwellers themselves. The in-depth articles will explore issues of urban healthcare, resource scarcity, violence, disasters and the role of governance.

Is the rural model of top-down donor funding workable in urban areas? Is Millennium Development Goal 11 to improve the lives of 100 million slum-dwellers attainable? Does the fact that more than half the world’s population will now be living in cities represent a turning-point around which development practitioners and governments can begin to narrow the already wide gap between urbanites, or is it just a number?

For the urban poor the stakes are high. As the IIED’s Satterthwaite warns, “What we have now is a perfect example of what the future scenario is if we continue failing to change governments’ and international organisations’ response to urbanisation. Half of urban populations have infant and child mortality rates 20 times what they should be, with at least half of the urban populations housed in squatter settlements. We would obviously begin to see strong resistance movements creating civil unrest and possibly civil war.”