sowm_2015__int__africa_full_report_low_res

Unequal Life Chances
for the Urban Poor
In the developing world, one-third of urban
residents live in slums – over 860 million people
(and counting). If this percentage remains
the same, the number of slum dwellers in the
developing world could reach the 1 billion mark
by 2020. While urbanization in and of itself is
not inherently problematic, the pace and sheer
scale of urbanization has, in many places, far
exceeded local government’s ability to provide
essential services, including water, sanitation
and health care.
For mothers and children, the phenomena
of urbanization and the growth of city slums
present unique challenges. Recent trends show
an increasing number of female migrants to
cities are doing so on their own – less often
with husbands or other family members – and
an increasing number of women are now the
principal wage earners for themselves and their
families. 33 Young women may move to cities
seeking economic opportunities or fleeing
discrimination and early marriage. They often
have limited employment skills, and struggle
to earn sufficient income to support themselves
and their children.
Slum life for women is characterized by insecurity
on many levels. In slums across the world
there is a striking lack of basic infrastructure.
Most people live close together in shacks they
do not own, often sleeping several to a room,
on blankets or on a mud floor. In informal or
squatter settlements, many live in constant fear
of eviction or housing demolition, and even
those in recognized slums have little power
over landlords who fail to maintain housing
structures. Slum homes in the developing world
often do not have toilets or running water, so
women and children are forced to go outside to
attend to their basic needs. This exposes them
to the risk of attack, rape and robbery, especially
at night.
Health is a major concern for mothers and
children in slums. There is a higher risk of
contagion for any infectious disease in crowded
settings without proper sanitation. Water-borne
disease and inadequate diets lead to malnutrition
among mothers and higher than average
deaths rates for children. 34 And while health
Monrovia, Liberia
Too Many People, Too Few Toilets
Poor sanitation and related diseases are a major burden on the
health of slum residents in Liberia’s capital, Monrovia. Hygiene is
especially bad in the city’s overcrowded West Point shantytown,
which is home to more than 40,000 people and has only five public
toilets. “Open defecation is very common,” says Josephine Wachekwa,
a Save the Children health specialist. 35
Monrovia is the wettest capital city in the world. 36 Rainfall during
the wet season can exceed 20 inches (500 mm) per month. 37 When
it rains, the water flows through the streets, mixing with feces and
contaminating the wells most people rely on for drinking water. 38
When it floods, which it often does between May and November,
things get even worse.
“Some of the biggest issues for children, and adults too, are
malaria and diarrhea,” says Mattie Gartor, a registered nurse and
midwife who has worked at the Star of the Sea Clinic in West Point
for 10 years.
Sandra, 28, has come to the clinic with her 3-year-old daughter
Mary. Sandra is also taking care of three nephews who lost their
mother to Ebola. “I worry about the children getting sick,” she says.
“I don’t allow the boys to just go out. They need to stay around
our neighborhood so they don’t go anywhere that is too dirty
or unclean.”
Mattie worries that the rainy season is coming. “This always
causes more women and children to get sick,” she says. “There’s
just too much water in people’s homes and in the street. People will
develop coughs and colds, or malaria and cholera. Cholera is one of
my biggest concerns.” 39
STATE OF THE WORLD’S MOTHERS 2015 17