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CHAPTER 5 110 Conclusion Modern city life takes a heavy toll on health, partly through the unsanitary and often dangerous conditions in which millions of people are forced to live, partly through the lifestyle choices that it encourages and partly from the strains and stresses that it imposes. Lack of policy and poor planning by municipal and central government play a significant role in these outcomes. While it is true that the number of slum dwellers continues to rise, some of the most significant strides in health improvements are being taken in countries where good urban governance is actively encouraged and supported and where lifting people out of slum conditions is a public policy goal. China and India have made progress in recent years in reducing their slum populations, showing what economic growth and political will can do. Some specific examples of how this can be done, particularly through community-based initiatives, are cited in Chapter 3 of this report, including the Thai government’s support to community-driven upgrading whereby scale is achieved through the very large number of local initiatives that it supports. At a local level, NGOs such as Asha show what can be achieved by working with slum dwellers to improve living conditions and fight disease. In the 49 New Delhi slums in which Asha is active, child mortality is now 36 for 1,000 live births, which is less than half the rate of India as a whole. When it comes to non-communicable disease, there are signs that political leaders are waking up to the threat. Whether it be Bogotá’s ciclovia (specially constructed routes for cyclists in the Colombian capital) or Singapore’s green labelling of dishes on school menus to help students identify healthy foods, examples are multiplying of countries and cities taking initiatives to tackle the problems of inadequate diet and lack of exercise. Community networks are being forged to overcome the challenges of social breakdown and violence in poor and underprivileged city zones of both developing and developed countries. Underpinning all such initiatives is the growing awareness that tackling city health problems is not just a question of doctors and nurses. Nor is it solely a matter of alleviating poverty, although that is a crucial and necessary condition. It requires that cities be well planned, well managed and also well governed. Only then will they pose less of a threat to the health of those who live in them. Chapter 5 was written by Richard Waddington, freelance writer and former Reuters bureau chief. Boxes 5.1 and 5.2 were contributed by Denis McClean, Editor, World Disasters Report. Box 5.3 was contributed by Gérard Lautrédou, Road Safety Adviser, IFRC.
Sources and further information Burris, S. et al. ‘Emerging Strategies for Healthy Urban Governance’ in Journal of Urban Health, Vol. 84 (Suppl. 1), pp. 154–163, 2007. Available online: www.ncbi. nlm.nih.gov / pmc / articles / PMC1891653/. Chartered Society of Physiotherapy. ‘Lower life expectancy in cities’, BBC News, London, 20 June 2006. Available online: http://news.bbc.co.uk/2/hi / uk_news/5097778. stm. Durán, V.H. ‘Stopping the rising tide of chronic diseases – Everyone’s Epidemic’ in PAHO, Perspectives in health E-magazine, March 2008. Available online: www.paho. org / english / dd / pin / ePersp001_article01.htm. Food and Agriculture Organization of the United Nations (FAO). FAO launches antihunger petition. Rome: FAO Media Centre, 2010. Available online: www.fao.org / n ews / story / en / item/42158/icode /. Humanitarian Futures Programme (HFP). Urban Catastrophes: The Wat / San Dimension. London: HFP, King’s College, 2010. Available online: www.humanitarianfutures. org / main / content / usaid-future-crisis-drivers. International Monetary Fund (IMF). Food and fuel prices: Recent developments, macroeconomic impact and policy responses. Washington DC: IMF, 2008. Available online: www.imf.org / external / np / pp / eng/2008/063008.pdf. Leon, D.A. ‘Cities, urbanization and health’ in London School of Hygiene & Tropical Medicine, International Journal of Epidemiology, Vol. 37, No. 1, pp. 4–8, 2008. Available online: http://ije.oxfordjournals.org / cgi / content / short/37/1/4. Martinez, R. and Fernandez, A. ‘Child malnutrition in Latin America and the Caribbean’ in Economic Commission for Latin America and the Caribbean and UNICEF, Challenges: Newsletter on progress towards the Millennium Development Goals from a child rights perspective. No. 2, April, 2006. Available online: www. unicef.org / lac / Desafios_2_ing(9).pdf. Mercado, S. et al, ‘Urban Poverty: An Urgent Public Health Issue’ in Journal of Urban Health, Vol. 84 (Suppl. 1), pp. 7–15, 2007. Available online: www.ncbi.nlm.nih. gov / pmc / articles / PMC1891652/. Orzechowski, F. Soaring Food Prices: A Global Crisis. Speech given to 10th International Food Aid Conference, April 2008. Available online: http://crs.org / newsroom / testimony / entry.cfm?id=1455. Pan American Health Organization (PAHO). Haiti: Health in the Americas 2007 – Volume II. Available online: www.paho.org / hia / archivosvol2/paisesing / Haiti%20 English.pdf. World Disasters Report 2010 – Focus on urban risk 111
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The International Federation of Red
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World Disasters Report 2010 Focus o
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Contents International Federation o
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Chapter 6 Urbanization and climate
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Annex 2 Making cities resilient: A
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annually despite commendable effort
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Avoiding the urbanization of disast
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in low-income nations even though a
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The last few decades have also brou
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But only a very small proportion of
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einforce the view that disaster ris
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institutions. Poor people have a lo
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Box 1.2 Can Haiti build back better
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was ‘illegal’, makes reconstruc
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that the needs and priorities of th
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Ravallion, M., Chen, S. and Sangrau
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Urban disaster trends It is well kn
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about 65 per cent of the world’s
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With the exception of the South Asi
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fires and traffic accidents. Buildi
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large cities in low- and middle-inc
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Figure 2.5 Port cities with highest
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expansion is driving risk in many A
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know the phone number) and the fire
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However, the incentive for owners t
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The focus on assets, especially hig
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Munich Re Group. Topics Annual Revi
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Starting over: Community rights and
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on this. However, it is complicated
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all those in the evacuation centre)
Page 63 and 64: those affected, help them get organ
Page 65 and 66: disaster events. Governments often
Page 67 and 68: In urban areas, rebuilding homes an
Page 69 and 70: ownership or other formalized/legal
Page 71 and 72: However, the scope of the upgrading
Page 73 and 74: Sources and further information Ade
Page 75 and 76: Syukrizal, A., Hafidz, W. and Saute
Page 77 and 78: Urban violence As more people crowd
Page 79 and 80: Drug production and trafficking Sou
Page 81 and 82: Economic development In economic te
Page 83 and 84: Surrounding what happens in homes a
Page 85 and 86: Table 4.1 Measuring inequality Coun
Page 87 and 88: Crisis of legitimacy Many states wi
Page 89 and 90: and in a sense of hopelessness for
Page 91 and 92: At the same time, many of the world
Page 93 and 94: can help, but - as the Organisation
Page 95 and 96: Fukuyama, F. ‘A Quiet Revolution:
Page 97 and 98: Tedesco, L. Latin American States -
Page 99 and 100: Urban risk to health The rapid rise
Page 101 and 102: are malnourished, compared with 16
Page 103 and 104: show that prices of imported rice a
Page 105 and 106: pneumonia, diarrhoea, malaria, meas
Page 107 and 108: SARS caused near global panic for a
Page 109 and 110: Urban life affects the way people w
Page 111 and 112: The Red Cross has 90 first-aid stat
Page 113: private life. Equally significant a
Page 117 and 118: World Economic Forum. Global Risks
Page 119 and 120: Urbanization and climate change ris
Page 121 and 122: more frequent hot days and nights,
Page 123 and 124: impacts of changing precipitation p
Page 125 and 126: feedback have all been used to help
Page 127 and 128: Addressing the causes of climate ch
Page 129 and 130: The Green Party Minister for the En
Page 131 and 132: The inquiry dealt only with technic
Page 133 and 134: Ensuring climate and disaster prepa
Page 135 and 136: negotiations. However, there are no
Page 137 and 138: to peak if the planet is to have a
Page 139 and 140: Sources and further information Ade
Page 141 and 142: Mata, J. L. and Nobre, C. Backgroun
Page 143 and 144: Urban governance and disaster risk
Page 145 and 146: the city government has developed a
Page 147 and 148: For many cities, including those me
Page 149 and 150: many such cities is participatory b
Page 151 and 152: due to El Niño. Many other factors
Page 153 and 154: all provinces by the end of 2009. T
Page 155 and 156: in informal settlements than in the
Page 157 and 158: Conclusion As we pointed out at the
Page 159 and 160: Fay, M., Ghesquiere, F. and Solo, T
Page 161 and 162: Satterthwaite, D. et al. ‘Adaptin
Page 163 and 164: World Disasters Report 2010 - Disas
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(eight windstorms, one flood, one w
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�� Miscellaneous accidents: Col
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Information systems have improved v
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Table 2 Total number of people repo
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Table 4 Total amount of disaster es
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Table 6 Total number of people repo
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Table 8 Total amount of disaster es
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During the decade: Asia accounted f
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During the decade: Medium human dev
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During the decade: Medium human dev
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During the decade: Americas account
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Total number of people reported kil
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World Disasters Report 2010 - Disas
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Making cities resilient: A ten-poin
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The UNDP Country Office interventio
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which was the 1961 flood that invol
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with semi-rural mountainous areas,
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a Federal Relief Commission and an
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Benin 96, 119, 136, 182 Bogotá 86,
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disasters 7-8, 11-16, 18, 20-22, 26
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high-income nations 12-13, 16-17, 1
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landslide(s) 21-22, 45, 56-57, 117,
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Oceania 12, 166-169, 174-176, 178,
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slum(s) 7, 11, 15, 22-23, 28, 31, 3
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urbanization 7-8, 11-12, 16-19, 27-
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The Fundamental Principles of the I
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