By Rajiv Shah
There have been numerous arguments in favour of improving and upgrading the infrastructure of slum settlements, many of which are interrelated. It has been shown by studies that improving living conditions can bring gains to the quality of life, health, and productivity of slum residents. As a recent study by Benjamin Stanwix, a South African scholar, for Mahila Housing Sewa Trust, Ahmedabad, states, “ It can help to break the cycle of poverty, ease the burden on women, and can also be a public good with positive spill-over effects on the wider economy and society. These arguments have been discussed in more detail below.” The study, titled “Urban Slums in Gujarat and Rajasthan: Study of Basic Infrastructure in Seven Cities” (2009) notes, life in the absence of adequate access to basic services such as water and ablutions can be precarious. It is detrimental to health, safety and the dignity of communities. It quotes a UN Habitat study which shows that lack of safe drinking water and poor sanitation can lead to a range of diseases, while factors such as overcrowding and pollution can also contribute to health problems.
Indeed, there is enough reason to believe that illnesses force households to pay extra medical expenditure which can push them deeper into poverty and indebtedness. This reduces the number of working days for ordinary wage earners and self-employed persons. Illness often leads to asset depletion and debt in order to fund private healthcare, and thus is one of the most powerful forces pushing households into poverty. Good sanitation and sewage facilities ensure a safer and healthier lifestyle, which in turn lead to a healthy workforce with higher productive capacity. Less money would be spent on illnesses, and in the long-term, these health gains would benefit not just the individuals concerned, but the wider economy and society.
Life in slums is particularly difficult for women as the burden of household work in the absence of infrastructure usually falls on them, for example fetching and carrying water. They also have to struggle to maintain household hygiene in the context of poor drainage and sanitation. It is women who are most vulnerable to harassment or assault when using open areas in the absence of toilet facilities, or due to insufficient street lighting at night. Thus, women may derive the greatest benefit from improvements in infrastructure. Improvements in water supply, access to toilets, and drainage reduce this burden on women, and increase their time for other activities. Access to water, for example, is a vital part of every day life.
The Census of India 2011 figures show that there is enough reason for Gujarat to be concerned about poor conditions in which the state’s slum dwellers live. Census data suggest, about 48.01 per cent of the slum houses are in “good” condition, while other houses may be either “livable” or in a “dilapidated” state. This is one of the worst in India. While all-India the comparative figure is 58.41 per cent, Gujarat is worse off most competing states – Maharashtra has 57.86 per cent of slum houses under the category, Karnataka 57.36 per cent, Kerala with 62.93 per cent, Tamil Nadu with 69.18 per cent, Madhya Pradesh with 57.85 per cent, Andhra Pradesh with 75.03 per cent, Rajasthan with 56.56 per cent, West Bengal with 50.51 per cent, and Uttar Pradesh with 49.51 per cent. The figures suggest that only Bihar (41.89 per cent), Orissa (38.09 per cent), and Punjab (42.67 per cent) fair worse than Gujarat as far as urban slum housing is concerned.
Things are not very different for the amenities available in the slum, if the Census data are any indication. In Gujarat, 64.41 per cent houses have latrines within the premises, as against the all-India figure of 66.01 per cent. Kerala, as expected, is the best, with 93.21 per cent houses having attached toilets, followed by Tamil Nadu’s 82.35 per cent. In Gujarat’s slums, 58.72 per cent of the houses have attached bathrooms, as against the all-India average of 66.57 per cent. As a matter of comparison, Andhra Pradesh’s 81.68 per cent and Maharashtra’s 75.12 per cent houses were found to be having attached bathrooms. Further, in 36.74 houses of Gujarat slums, there were no separate kitchens, as against the all-India average of 28.79 per cent. For comparison, Maharashtra’s 29.19 per cent houses and Andhra Pradesh’s 21.93 per cent of the houses did not have separate kitchens.
Spot surveys suggest that poor living conditions in slums in Gujarat have had a heavy toll on the health of the slum dwellers. A study published in the journal “Indian Pediatrics”, April 2013, by Archana S Nimbalkar, Vivek K Shukla, Ajay G Pathak and Someshekhar M Nimbarlkar, titled “Newborn Care Practices and Health Seeking Behavior in Urban slums and villages of Anand, Gujarat” says, “The socioeconomic and education status of the slum dwellers versus rural participants were significantly lower (P<0.001). Antenatal care (79.9 vs 94.4%,P<0.001), hospital delivery (82.5 vs 93.8%, P=0.002), neonatal follow-up (27.9 vs 78.8%, P<0.001), health seeking (56.5 vs 91.3%, P<0.001), essential newborn care and exclusive breastfeeding (6.5vs 85.6%, P<0.001) were also lower in urban slums, as compared to villages. Care seeking was low in urban slums, Hindus and illiterate mothers. Health care and socioeconomic status of neonates in slums of smaller cities is poorer than in surrounding villages.”
The authors further say that the “study has revealed wide socioeconomic gap between slums and villages. The gap exists even for a small town with a population smaller than the national average for a city. There is lack properly functional and structured healthcare delivery system in urban slums vis-Ã -vis urban and rural areas.” They add, “Proximity of the slums to two multispecialty hospitals and smaller private hospitals did not improve utilization of services. Urban slum dwellers are ignorant about their health needs and also lack attitude for seeking healthcare. There is lack of basic sanitation (72 per cent), and water supply facility (44.8 per cent) in most slum residents. Healthcare acceptability of government infrastructure was low in both areas. Neonatal follow-up and care of infants requiring medical attention was provided by unqualified personnel or not taken in 72 per cent of slum areas.”
The National Sample Survey (NSS) report report, “Some Characteristics of Urban Slums”, brought out in 2010, basing on the survey conducted from July 2008 to June 2009, found that the condition of slums in Gujarat is not only dismal but is perhaps worst compared to nine other states surveyed — Andhra Pradesh, Delhi, Karnataka, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal. Identifying slums as notified and non-notified, the NSS reports “wide variation across states” in pucca houses in urban slums. Identifying just 14 per cent and 29 per cent pucca houses in notified non-notified slums respectively in Gujarat, the report says, “In some states like Uttar Pradesh, Andhra Pradesh, Delhi, West Bengal and Maharashtra, 72 per cent or more slums had the majority of their houses built with pucca materials.” As for Gujarat, along with Orissa and Madhya Pradesh, its “majority of the houses are of type semi-pucca or katcha.”
As for urban slum facilities, just 19 per cent notified slums had pucca roads in Gujarat, which is worst than all other nine states surveyed. While the NSS notices a “marked improvement in the quality of the main road within the slum is seen since 2002”, it finds that “Orissa and Gujarat had the lowest proportions of notified slums with pucca main road within the slum.” Things were found to be no better with other facilities. As many as 59 per cent of notified and 53 per cent of non-notified slums suffered from water logging during monsoons, which is higher than all states except for Orissa. As for sanitation, the NSS report found that Gujarat’s 39 per cent notified slums and 48 per cent of non-notified slums did have latrines, as against the national average of 10 and 20 per cent respectively. This almost corroborates what the Census data suggest.
Benjamin Stanwix’s study further throws light on Gujarat slums. Her survey suggested that “in the slums of Ahmedabad about 3,200 person-hours were spent each morning in just collecting water”, mainly by women. She adds, “This time could be productively spent elsewhere if households had access to their own reliable water source. Her survey suggests that “58 per cent of households spent more than 30 minutes per trip to fill water, and 27 per cent of the families had to travel more than one kilometre to obtain water. In addition, for those who used public taps installed by the municipality, water supply was available on average for only 2.5 hours per day.” As against this, “99 per cent of households who had their own water facility spent little time collecting water, while a large number who did not have their own tap spent substantial time on collecting water.”
The survey found that 14 per cent of the families of the slums defecated in the open, adding, “Of those who did not have their own toilet facility, 2,700 households stated that they urgently required a toilet in their house, and of these families 80 per cent showed willingness to pay to acquire a toilet.” Further, it was found that 17 per cent households did not have any storm water drainage, and only 10 per cent had no gutter for sewerage. “Of those that did have some kind of drainage, 20 per cent reported problems of water clogging. One-third of all households had to pay for repairs on their houses in the rainy season because of lack of drainage system or due to dysfunction of drains. The regression analysis done later in the report examines the impact of drainage on health”, the report stated.
Sanwix concluded, “Overall, the data showed that about one-third of the families who lived in slums were poor. Many lived in inadequate houses and had insufficient access to basic infrastructure such as water, toilet and drainage facilities. When asked to rate which resources were most urgently needed, the first three were water, toilet and drainage, respectively. Regarding savings, only few households said that they saved, and those who saved were almost exclusively households with higher incomes. Nearly two-thirds of households took e loans, and the majority of them took loan from informal sources. The regression analysis suggests that the basic amenities have relationship with the health of the households, and therefore, also with the monthly amount spent on healthcare.”
Despite such conditions in urban slums, studies show that awareness among the slum dwellers about how to get out of such situation by taking advantage of government schemes was limited. A 2009 study, “Housing for the Urban Poor: A Study of Ten Towns under the Integrated Housing and Slum Development Programme (ISHDP) in Gujarat” — Anand, Boriyavi, Gondal, Halol, Himmatnagar, Jetpur, Khambhat, Prantij, Unjha and Upleta – says, “Despite the goal of implementing the IHSDP (which is Central government scheme having a participatory effort with a humane approach towards the urban poor) there are hardly any mechanisms created to ensure participation and sensitivity to the needs of the poor. Even in two of the five slums that are identified for in-situ upgrade, people showed lack of awareness of the scheme. The lack of awareness is very worrisome and shows that the nagarpalikas urgently need to review the methods used to communicate details of the scheme to the slums, and underlines the need to employ proper consultation mechanisms. Not only is there very poor awareness about the scheme, it is also doubtful whether many who seem to have applied will be able to afford it in the absence of appropriate financing arrangements that take into account the paying capacity and livelihood pattern of the poor.”
The study, carried out by Unnati, an Ahmedabad-based NGO, says that the IHSDP is a major initiative that subsumes most of the previous major schemes for slum improvement as well as those for housing the poor and the marginalised. Of the 10 towns included in this study, implementation of the IHSDP had begun in 2009, when the study was carried out, in eight, and in the remaining two the work was yet to begin. All the ten towns taken together had received almost 32 per cent of the planned outlay. “On the whole, when all units as planned are considered, 70 percent slum dwellers in the 10 towns cannot be accommodated in the scheme. Further, as the scheme is open to any urban poor, including the slums, the number of units planned is grossly inadequate compared to the scale of the problems it seeks to address. The local authorities do not appear to view it as an opportunity to move towards providing better living conditions in slums, but more as an opportunity to beautify the town”, the study underlines.
The study says, “In such a situation there is a possibility that many of the slums will be evicted from their current location and pushed to the periphery. In spite of the good intentions, the manner of implementation seems to lose focus on providing the poor access to affordable housing, and shies away from working out mechanisms that will enable the poor to fully realize the opportunity available to them through IHSDP. In the absence of creating supporting financing arrangements that take into account the peculiarities of the livelihood systems of the poor, there is the risk of this scheme subtly transforming into a slum clearance project. In the absence of genuine sensitivity to the plight of the poor, there is the danger that the officials in urban local bodies (ULBs) could become more concerned about ‘beautification’ of the town than ensuring affordable housing to the poor.”
The study found that less than 25 per cent of the households had electricity. “In many cases, the electric connection was illegal and amounted to stealing from the supply line. In nine slums not a single household has electricity. The discussions with the slum dwellers revealed a huge lack of trust and communication between the people and local authorities. The dismal lack of awareness about IHSDP and government schemes for the poor must be seen in this background. Hardly any local officials visited the slums, and on most occasions when they did so, it had been in connection with some survey, with the slum dwellers completely in the dark about the purpose of the survey. Only in very rare cases there were instances of visits by officials to discuss with people or conduct meetings to discuss the problems”, it said.
There have been numerous arguments in favour of improving and upgrading the infrastructure of slum settlements, many of which are interrelated. It has been shown by studies that improving living conditions can bring gains to the quality of life, health, and productivity of slum residents. As a recent study by Benjamin Stanwix, a South African scholar, for Mahila Housing Sewa Trust, Ahmedabad, states, “ It can help to break the cycle of poverty, ease the burden on women, and can also be a public good with positive spill-over effects on the wider economy and society. These arguments have been discussed in more detail below.” The study, titled “Urban Slums in Gujarat and Rajasthan: Study of Basic Infrastructure in Seven Cities” (2009) notes, life in the absence of adequate access to basic services such as water and ablutions can be precarious. It is detrimental to health, safety and the dignity of communities. It quotes a UN Habitat study which shows that lack of safe drinking water and poor sanitation can lead to a range of diseases, while factors such as overcrowding and pollution can also contribute to health problems.
Indeed, there is enough reason to believe that illnesses force households to pay extra medical expenditure which can push them deeper into poverty and indebtedness. This reduces the number of working days for ordinary wage earners and self-employed persons. Illness often leads to asset depletion and debt in order to fund private healthcare, and thus is one of the most powerful forces pushing households into poverty. Good sanitation and sewage facilities ensure a safer and healthier lifestyle, which in turn lead to a healthy workforce with higher productive capacity. Less money would be spent on illnesses, and in the long-term, these health gains would benefit not just the individuals concerned, but the wider economy and society.
Life in slums is particularly difficult for women as the burden of household work in the absence of infrastructure usually falls on them, for example fetching and carrying water. They also have to struggle to maintain household hygiene in the context of poor drainage and sanitation. It is women who are most vulnerable to harassment or assault when using open areas in the absence of toilet facilities, or due to insufficient street lighting at night. Thus, women may derive the greatest benefit from improvements in infrastructure. Improvements in water supply, access to toilets, and drainage reduce this burden on women, and increase their time for other activities. Access to water, for example, is a vital part of every day life.
The Census of India 2011 figures show that there is enough reason for Gujarat to be concerned about poor conditions in which the state’s slum dwellers live. Census data suggest, about 48.01 per cent of the slum houses are in “good” condition, while other houses may be either “livable” or in a “dilapidated” state. This is one of the worst in India. While all-India the comparative figure is 58.41 per cent, Gujarat is worse off most competing states – Maharashtra has 57.86 per cent of slum houses under the category, Karnataka 57.36 per cent, Kerala with 62.93 per cent, Tamil Nadu with 69.18 per cent, Madhya Pradesh with 57.85 per cent, Andhra Pradesh with 75.03 per cent, Rajasthan with 56.56 per cent, West Bengal with 50.51 per cent, and Uttar Pradesh with 49.51 per cent. The figures suggest that only Bihar (41.89 per cent), Orissa (38.09 per cent), and Punjab (42.67 per cent) fair worse than Gujarat as far as urban slum housing is concerned.
Things are not very different for the amenities available in the slum, if the Census data are any indication. In Gujarat, 64.41 per cent houses have latrines within the premises, as against the all-India figure of 66.01 per cent. Kerala, as expected, is the best, with 93.21 per cent houses having attached toilets, followed by Tamil Nadu’s 82.35 per cent. In Gujarat’s slums, 58.72 per cent of the houses have attached bathrooms, as against the all-India average of 66.57 per cent. As a matter of comparison, Andhra Pradesh’s 81.68 per cent and Maharashtra’s 75.12 per cent houses were found to be having attached bathrooms. Further, in 36.74 houses of Gujarat slums, there were no separate kitchens, as against the all-India average of 28.79 per cent. For comparison, Maharashtra’s 29.19 per cent houses and Andhra Pradesh’s 21.93 per cent of the houses did not have separate kitchens.
Spot surveys suggest that poor living conditions in slums in Gujarat have had a heavy toll on the health of the slum dwellers. A study published in the journal “Indian Pediatrics”, April 2013, by Archana S Nimbalkar, Vivek K Shukla, Ajay G Pathak and Someshekhar M Nimbarlkar, titled “Newborn Care Practices and Health Seeking Behavior in Urban slums and villages of Anand, Gujarat” says, “The socioeconomic and education status of the slum dwellers versus rural participants were significantly lower (P<0.001). Antenatal care (79.9 vs 94.4%,P<0.001), hospital delivery (82.5 vs 93.8%, P=0.002), neonatal follow-up (27.9 vs 78.8%, P<0.001), health seeking (56.5 vs 91.3%, P<0.001), essential newborn care and exclusive breastfeeding (6.5vs 85.6%, P<0.001) were also lower in urban slums, as compared to villages. Care seeking was low in urban slums, Hindus and illiterate mothers. Health care and socioeconomic status of neonates in slums of smaller cities is poorer than in surrounding villages.”
The authors further say that the “study has revealed wide socioeconomic gap between slums and villages. The gap exists even for a small town with a population smaller than the national average for a city. There is lack properly functional and structured healthcare delivery system in urban slums vis-Ã -vis urban and rural areas.” They add, “Proximity of the slums to two multispecialty hospitals and smaller private hospitals did not improve utilization of services. Urban slum dwellers are ignorant about their health needs and also lack attitude for seeking healthcare. There is lack of basic sanitation (72 per cent), and water supply facility (44.8 per cent) in most slum residents. Healthcare acceptability of government infrastructure was low in both areas. Neonatal follow-up and care of infants requiring medical attention was provided by unqualified personnel or not taken in 72 per cent of slum areas.”
The National Sample Survey (NSS) report report, “Some Characteristics of Urban Slums”, brought out in 2010, basing on the survey conducted from July 2008 to June 2009, found that the condition of slums in Gujarat is not only dismal but is perhaps worst compared to nine other states surveyed — Andhra Pradesh, Delhi, Karnataka, Madhya Pradesh, Maharashtra, Orissa, Tamil Nadu, Uttar Pradesh and West Bengal. Identifying slums as notified and non-notified, the NSS reports “wide variation across states” in pucca houses in urban slums. Identifying just 14 per cent and 29 per cent pucca houses in notified non-notified slums respectively in Gujarat, the report says, “In some states like Uttar Pradesh, Andhra Pradesh, Delhi, West Bengal and Maharashtra, 72 per cent or more slums had the majority of their houses built with pucca materials.” As for Gujarat, along with Orissa and Madhya Pradesh, its “majority of the houses are of type semi-pucca or katcha.”
As for urban slum facilities, just 19 per cent notified slums had pucca roads in Gujarat, which is worst than all other nine states surveyed. While the NSS notices a “marked improvement in the quality of the main road within the slum is seen since 2002”, it finds that “Orissa and Gujarat had the lowest proportions of notified slums with pucca main road within the slum.” Things were found to be no better with other facilities. As many as 59 per cent of notified and 53 per cent of non-notified slums suffered from water logging during monsoons, which is higher than all states except for Orissa. As for sanitation, the NSS report found that Gujarat’s 39 per cent notified slums and 48 per cent of non-notified slums did have latrines, as against the national average of 10 and 20 per cent respectively. This almost corroborates what the Census data suggest.
Benjamin Stanwix’s study further throws light on Gujarat slums. Her survey suggested that “in the slums of Ahmedabad about 3,200 person-hours were spent each morning in just collecting water”, mainly by women. She adds, “This time could be productively spent elsewhere if households had access to their own reliable water source. Her survey suggests that “58 per cent of households spent more than 30 minutes per trip to fill water, and 27 per cent of the families had to travel more than one kilometre to obtain water. In addition, for those who used public taps installed by the municipality, water supply was available on average for only 2.5 hours per day.” As against this, “99 per cent of households who had their own water facility spent little time collecting water, while a large number who did not have their own tap spent substantial time on collecting water.”
The survey found that 14 per cent of the families of the slums defecated in the open, adding, “Of those who did not have their own toilet facility, 2,700 households stated that they urgently required a toilet in their house, and of these families 80 per cent showed willingness to pay to acquire a toilet.” Further, it was found that 17 per cent households did not have any storm water drainage, and only 10 per cent had no gutter for sewerage. “Of those that did have some kind of drainage, 20 per cent reported problems of water clogging. One-third of all households had to pay for repairs on their houses in the rainy season because of lack of drainage system or due to dysfunction of drains. The regression analysis done later in the report examines the impact of drainage on health”, the report stated.
Sanwix concluded, “Overall, the data showed that about one-third of the families who lived in slums were poor. Many lived in inadequate houses and had insufficient access to basic infrastructure such as water, toilet and drainage facilities. When asked to rate which resources were most urgently needed, the first three were water, toilet and drainage, respectively. Regarding savings, only few households said that they saved, and those who saved were almost exclusively households with higher incomes. Nearly two-thirds of households took e loans, and the majority of them took loan from informal sources. The regression analysis suggests that the basic amenities have relationship with the health of the households, and therefore, also with the monthly amount spent on healthcare.”
Despite such conditions in urban slums, studies show that awareness among the slum dwellers about how to get out of such situation by taking advantage of government schemes was limited. A 2009 study, “Housing for the Urban Poor: A Study of Ten Towns under the Integrated Housing and Slum Development Programme (ISHDP) in Gujarat” — Anand, Boriyavi, Gondal, Halol, Himmatnagar, Jetpur, Khambhat, Prantij, Unjha and Upleta – says, “Despite the goal of implementing the IHSDP (which is Central government scheme having a participatory effort with a humane approach towards the urban poor) there are hardly any mechanisms created to ensure participation and sensitivity to the needs of the poor. Even in two of the five slums that are identified for in-situ upgrade, people showed lack of awareness of the scheme. The lack of awareness is very worrisome and shows that the nagarpalikas urgently need to review the methods used to communicate details of the scheme to the slums, and underlines the need to employ proper consultation mechanisms. Not only is there very poor awareness about the scheme, it is also doubtful whether many who seem to have applied will be able to afford it in the absence of appropriate financing arrangements that take into account the paying capacity and livelihood pattern of the poor.”
The study, carried out by Unnati, an Ahmedabad-based NGO, says that the IHSDP is a major initiative that subsumes most of the previous major schemes for slum improvement as well as those for housing the poor and the marginalised. Of the 10 towns included in this study, implementation of the IHSDP had begun in 2009, when the study was carried out, in eight, and in the remaining two the work was yet to begin. All the ten towns taken together had received almost 32 per cent of the planned outlay. “On the whole, when all units as planned are considered, 70 percent slum dwellers in the 10 towns cannot be accommodated in the scheme. Further, as the scheme is open to any urban poor, including the slums, the number of units planned is grossly inadequate compared to the scale of the problems it seeks to address. The local authorities do not appear to view it as an opportunity to move towards providing better living conditions in slums, but more as an opportunity to beautify the town”, the study underlines.
The study says, “In such a situation there is a possibility that many of the slums will be evicted from their current location and pushed to the periphery. In spite of the good intentions, the manner of implementation seems to lose focus on providing the poor access to affordable housing, and shies away from working out mechanisms that will enable the poor to fully realize the opportunity available to them through IHSDP. In the absence of creating supporting financing arrangements that take into account the peculiarities of the livelihood systems of the poor, there is the risk of this scheme subtly transforming into a slum clearance project. In the absence of genuine sensitivity to the plight of the poor, there is the danger that the officials in urban local bodies (ULBs) could become more concerned about ‘beautification’ of the town than ensuring affordable housing to the poor.”
The study found that less than 25 per cent of the households had electricity. “In many cases, the electric connection was illegal and amounted to stealing from the supply line. In nine slums not a single household has electricity. The discussions with the slum dwellers revealed a huge lack of trust and communication between the people and local authorities. The dismal lack of awareness about IHSDP and government schemes for the poor must be seen in this background. Hardly any local officials visited the slums, and on most occasions when they did so, it had been in connection with some survey, with the slum dwellers completely in the dark about the purpose of the survey. Only in very rare cases there were instances of visits by officials to discuss with people or conduct meetings to discuss the problems”, it said.
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