Introduction Introduction Chapter 5 Chapter 5
Chapter 1 Chapter 1 Chapter 6 Chapter 6
Chapter 2 Chapter 2 Notes for Indicators Notes
Chapter 3 Chapter 3 Notes for boxes Notes for boxes
Chapter 4 Chapter 4 Indicators Indicators
CHAPTER 2 Printer Friendly printer friendly version
Chapter 1 People In Cities: Hope
Countering Desolation

The Unseen Dramas of the Urban Poor

Slums: Unparalleled Concentration of Poverty

The Persistent Disparities

Women's Empowerment and Well-being: The Pillars of Sustainable Cities

Social Contradictions in Growing Cities: Dialogue and Discord

The Changing Demographics of Growing Cities

Improving Urban Governance and Involving the Poor: The Right Thing to Do

The Persistent Disparities

Nowhere are the disadvantages of the urban poor compared with other city dwellers more marked than in the health area.(12)Poor women are at a particular disadvantage. Although cash income is much more important in cities than in villages, income poverty is only one aspect of urban poverty. Others are poor-quality and overcrowded shelter, lack of public services and infrastructure such as piped water, sanitation facilities, garbage collection, drainage and roads, as well as insecure land tenure (see Box 5). These disadvantages increase the health and work burdens of the urban poor and also increase their risks from environmental hazards and crime.



Feryal El Sayed has called a tiny square room crammed with a bed and two seats, and a tinier cubicle containing a kitchen and a bathroom, “home” for the past 15 years. The makeshift roof is falling apart, and Ms. El Sayed, 62, had to install plastic sheeting under the ceiling to catch the debris. However, she is still better off than some of her neighbours in Ezbet El Haggana’s District 3, who have no roofs over their heads and who, on rainy nights, are forced to sleep under their beds.

Ezbet El Haggana, a sprawling slum in the north-east of Cairo, is one of the largest urban Ashwaiiyat, or “informal areas”, encircling this city. With more than a million inhabitants, it is among the few places where the poorest of Egypt’s poor can afford some sort of housing—a place where high-voltage cables hum constantly over their heads, sewage water seeps under their feet and the fumes of burning garbage fill their lungs.

“In addition to all sorts of diseases, we always have fires in these houses because of the high-voltage cables,” says Hazem Hassan, of the Al-Shehab Institution for Comprehensive Development, a grass-roots organization that has been assisting the residents of Ezbet El Haggana since 2001. Al-Shehab will soon construct new roofs for 50 of the most threatened dwellings in the district, including Ms. El Sayed’s.

Cairo’s population has exploded during the last three decades, doubling from 6.4 million people in 1975 to 11.1 million in 2005. The latest statistics of the Egyptian Ministry of Housing, Utilities and Urban Communities show that there are 1,221 “informal areas” similar to Ezbet El Haggana. They house 12-15 million of the country’s 77 million people. Sixty-seven of these are in Greater Cairo.

The Ministry has been diverting the flow of people from Egypt’s big cities through development projects and low-cost housing in “new cities”. Those in the Cairo area alone have absorbed 1.2 million people who would otherwise have ended up living in Ashwaiiyat. However, despite Government incentives, many still cannot afford to move there. People like Ms. El Sayed are sticking to Ezbet El Haggana. Despite her predicament, she remains optimistic, perhaps because she realizes that she is more fortunate than many of her neighbours—and that a new roof is on its way.

Poor people live in unhealthy environments.(13)Health risks arise from poor sanitation, lack of clean water, overcrowded and poorly ventilated living and working environments and from air and industrial pollution. Inadequate diet reduces slum-dwellers’ resistance to disease, especially because they live in the constant presence of pathogenic micro-organisms.(14)

The United Nations Development Programme’s Human Development Report for 2006 provides an excellent overview and analysis of the relations between power, poverty and water.(15)It highlights the fact that the stark realities of slum life defy statistical analysis. Frequently, many people live in compounds made up of several houses where one toilet serves all adults and children. Toilets may be reserved for adults, and children forced to go elsewhere in the compound or in the streets where they play.(16)Sharing three toilets and one shower with 250 households in a community is not at all unusual in cities of sub-Saharan Africa. Conditions like these increase stress on all inhabitants, especially women who are also subject to greater risks of gender-based violence.(17)In Latin America, only 33.6 per cent of the urban poor have access to flush toilets, compared to 63.7 per cent of their non-poor urban counterparts.(18)

Water is a scarce and expensive resource for the urban poor, often obtained in small quantities from street vendors. Bought this way, unit costs can be much higher than for people who have running water in their homes. If there is a piped supply, obtaining it may involve long journeys to the neighbourhood water post, long waits, tiring trips back home with full jerry-cans, careful storage to minimize wastage and reusing the same water several times, increasing the risk of contamination.(19)

Water chores take up a substantial part of women’s and girls’ time. A partial time-use study covering 10 sites in East Africa found that the waiting time for water increased from 28 minutes a day in 1967 to 92 minutes in 1997.(20)The physical and time burdens come not so much from long distances from the source of supply, as in villages, but from the large numbers who have to use the same source (see Box 6).



"Some say half a million people live there. Others put the figure at more than a million. No one really knows . . . Kiberans live in tin shacks or mud “houses” with no toilets, no beds and little water to speak of. Electricity is almost non-existent. Most of the pit latrines are full and locked up, so people use the aptly named “flying toilets” where they excrete into plastic bags and throw them in piles on the street. Children play on the heaps.

"Middle-aged Sabina sits by a standpipe to charge people for filling 20-litre containers with supposedly clean water. But the pipes, many of which leak, run through open sewerage ditches. When the pressure drops, as it does most days, the pipes suck in excrement. “I charge 3 shillings (4 cents) for a jerry can,” she explains. “But when there is less water, I put the price up to 5.5 shillings.” Sabina sits there 11 hours a day but doesn’t get paid. Standpipes are controlled by shadowy figures, rumoured to be government officials who make good money out of them."

The association between poverty, environment and housing in urban areas is critical because it indicates a key area for intervention. Policies directed to improving shelter in urban areas can have huge impacts on poverty reduction and on environmental well-being. Advances in health and mortality indicators depend very much on urban water and sewage treatment.