April 7, 2010 · Leave a Comment
Urban living can be bad for your health — at least in Uganda. To mark World Health Day tomorrow, whose theme this year is urbanisation and health, the Daily Monitor will run a two-part series, beginning with this story, on the many dire health consequences of the country's failure to plan its cities, by Evelyn Lirri
On the porch of a tiny mud-and-wattle hut in a slum section of Ggaba, a Kampala suburb, Ms Sarah Namutebi, 29, sits clasping her nine-month-old baby. She looks deeply worried.
Ms Namutebi's baby, looking frail and dehydrated, has been down with diarrhea for the past three weeks. The baby's eyes are sunken and the mother is desperately struggling to save its life.
It is easy to see why the child is sick. In front of the one-roomed house runs a drainage ditch carrying a mass of sewage, rotting garbage and plastic materials. The unsightly hodgepodge emits a horrid stench that suffocates the neighbourhood.
This is the reality of life for an estimated 3.3 million of the 5.5 million Ugandans who live in urban areas today.
Effective urban planning and enforcement would improve living conditions and sharply reduce disease. But the population is growing far faster than authorities can plan, hobbled by lack of funding, incompetence and corruption, can keep up.
The result: rapidly-growing mass slums where poor sanitation, dust, lack of proper ventilation, overcrowding and uncollected garbage all pollute and choke the living environment, making urban centres a death trap for dwellers (read a special report on rot of our towns in tomorrow's Daily Monitor).
The problem promises to get worse before it improves. "Uganda is fast urbanising and if you don't address urbanisation problems like health, water and infrastructure you will have a catastrophe," warns Mr Urban Tibamanya, the state minister for Urban Development.
The consequences are already here to see. In Kampala alone, some 40 per cent of the city's 1.8 million residents live in informal settlements like Katanga, Wabigalo-Namuwongo, Makerere-Kivulu, Ggaba, Kifumbira and Kisenyi.
Records show most communicable and hygiene-related infections break out in these areas, which often are unplanned and lack adequate housing and access to clean water and sanitation.
Intestinal worms, diarrhea and asthma topped the list of the most prevalent diseases in Kampala city between 2006 and 2009. Kampala City Council's health division says these diseases jointly contribute to more than 80 per cent of the disease burden in the city.
In 2009, 43,434 intestinal infections were registered in Kampala district from common parasitic worms like ascaris, tapeworms and pinworms found in unfiltered water. Acute diarrhea cases totaled 27,694 cases, while persistent diarrhea cases reached 9,717.
In Ggaba mission slum, diarrhea is so common that few there consider it a disease anymore. Rather, it is seen as a normal part of life.
Cholera, another deadly disease usually associated with poor hygiene, had been dropping, from 1,104 cases in the 2006/7 financial year, to just 40 the year after, but the number of cases increased to 74 in 2009. Dr. John Lule, the KCC chief health inspector, said increased public education and awareness on hygiene and sanitation have contributed to this decline over the years.
Respiratory illnesses also are on the rise. According to the State of the World Cities report 2010/2011 published by the United Nations Human Settlements Programme (UN-Habitat), acute respiratory infection cases in Uganda are high in slum and rural areas- with slums and rural areas. Twenty-three per cent of their residents suffer acute respiratory infections, compared to only 14 per cent of residents in urban non-slum areas.
Many of the hygiene-related illnesses arise from poor sanitation. Although latrine coverage in Kampala district stands at 85 per cent, health experts say the access is not even geographically because many slum dwellers cannot afford the Shs100 they are charged to use them. As a result, many end up using polythene bags — commonly referred to in slum parlance as "flying toilets" – to dispose of their waste.
The indiscriminate disposal of human waste, officials say, is the reason underlying perennial cholera outbreak in the city.
Organised developments
Most of these diseases can be prevented by making the environment healthier through proper planning, health experts say.
Source: Evelyn Lirri, Monitor / allAfrica.com, 6 April 2010
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