Slums are becoming a focal point of the Covid-19 outbreak

Punit Paranjpe/AFP via Getty Images

For the 1.2 billion people around the world who live in densely populated slums, crowded conditions and scarce public services threaten to make the Covid-19 pandemic especially devastating.

An April study from Brookings India shows that these communities are already becoming a focal point of the pandemic. Researchers analyzed the “containment zones” that the Indian government set up in areas with Covid outbreaks, and overlaid that data with maps of slum communities. Their findings demonstrate that Covid-19 outbreaks in Mumbai, one of the world’s largest cities, are based in or near slum communities.

“The fact of the matter is that slums are being disproportionately impacted,” says Shaonlee Patranabis, research assistant at Brookings India and one of the authors of the study. “No containment zone’s epicenter was further than 800 metres from the nearest slum.”

Many residents of these neighbourhoods already face interlocking health crises. Slums are often located in areas of intense air pollution, a problem that can be exacerbated by indoor cooking with biomass fuels in windowless homes. Lung diseases such as tuberculosis are already prevalent, and in some areas – especially in South Africa – higher rates of HIV/AIDS could compound the severity of Covid-19. Limited access to fresh water and toilets is a grave problem in the best of times, and it’s only more dire amidst a pandemic.

“Social distancing is impossible in these conditions,” Patranabis says. “In a lot of slums, the water supply is one tap for 200 households. They have to queue up for the water that they need.”

Mumbai is the financial capital of India, but 42% of the population lives in communities with little access to basic services like fresh water, toilets, or health care. Residents are mostly employed in the informal economy, and depend on their daily wages for food, making the economic shutdown hellishly difficult to navigate.

As the pandemic blazed across the globe, policymakers in Mumbai decided to establish containment zones as a means to stymie the spread of the disease. Residents within a zone’s boundaries are placed in quarantine and under police surveillance. They are then tested for Covid-19, and those who prove to be positive are subject to contact tracing. On 31 March, there were 141 containment zones in the greater Mumbai area, increasing to 243 by 5 April and 490 by 14 April.

“We are a resource strapped country only able to do lockdowns and trace contacts,” said Patranabis. “There are cases where a single house is a containment zone, and where an entire lane is a containment zone.”

There have been successes with the containment zone model. Another outbreak in the Kasaragod district of Kerala – a coastal state with a long history of progressive governance and public health investment – was rapidly and successfully brought under control.

But in slums, the approach will be challenging to implement.

In many cases, residents have no legal property rights. Dwellings are usually densely populated and built from an eclectic array of materials. Patranabis describes units in Mumbai’s Dharavi, Asia’s largest slum, where five people live in four-foot-by-eight-foot dwellings, sleeping in shifts to manage the space constraints.

Conditions in these sections of Mumbai are mirrored in similar communities elsewhere, from the favelas of Brazil to the shanty towns of South Africa. Outbreaks have already been documented in Pakistan’s Orangi Town and Brazil’s Rocinha.

“Many of these communities don’t have real clean water sources, but one of the most important safety measures is to wash your hands frequently,” said Lee Riley, a professor of infectious diseases and vaccinology at the University of California Berkeley School of Public Health. 

“This virus can shed in stool, [so with limited access to toilets] it could spread in these communities not just through respiratory routes but fecal contamination of water and food.”

An April 24 paper published in the Journal of Urban Health, which Riley contributed to, argues that an array of government interventions are required, from eviction moratorium to direct income support and food distribution.

Some governments have begun pursuing these policies. Brazil and India have issued income support for their poorest residents. Some jurisdictions in India have banned evictions during the pandemic. The Municipal Corporation of Greater Mumbai is installing additional fresh water pumps in its slum neighbourhoods, Patranabis reports.

But residents and observers of these neighbourhoods fear that Covid will devastate the slum communities that house many of the world's poorest people. The history of government interventions in such areas is mixed, at best.

“Informal settlements are essentially abandoned by urban elites, which means they rarely receive the care and attention they need,” writes Robert Muggah, research director of the Brazilian think tank the Igarapé Institute. “Governments must be sensitive to the fact that there may be low levels of trust in informal settlements, as well as alternate systems of power and influence – including criminal groups.”

And although Covid spread across the globe on airplanes and cruise ships, borne by the wealthiest residents of the world, experts like UC Berkeley’s Riley say it is likely to harrow the world’s poorest for far longer.

“All respiratory pathogens are very successful in crowded, densely populated environments,” Riley says. “The trajectory of a lot of these diseases is that they end up in the slum communities of the world and then they linger.” 

Jake Blumgart is a staff writer for CityMetric.


What's actually in the UK government’s bailout package for Transport for London?

Wood Green Underground station, north London. Image: Getty.

On 14 May, hours before London’s transport authority ran out of money, the British government agreed to a financial rescue package. Many details of that bailout – its size, the fact it was roughly two-thirds cash and one-third loan, many conditions attached – have been known about for weeks. 

But the information was filtered through spokespeople, because the exact terms of the deal had not been published. This was clearly a source of frustration for London’s mayor Sadiq Khan, who stood to take the political heat for some of the ensuing cuts (to free travel for the old or young, say), but had no way of backing up his contention that the British government made him do it.

That changed Tuesday when Transport for London published this month's board papers, which include a copy of the letter in which transport secretary Grant Shapps sets out the exact terms of the bailout deal. You can read the whole thing here, if you’re so minded, but here are the three big things revealed in the new disclosure.

Firstly, there’s some flexibility in the size of the deal. The bailout was reported to be worth £1.6 billion, significantly less than the £1.9 billion that TfL wanted. In his letter, Shapps spells it out: “To the extent that the actual funding shortfall is greater or lesser than £1.6bn then the amount of Extraordinary Grant and TfL borrowing will increase pro rata, up to a maximum of £1.9bn in aggregate or reduce pro rata accordingly”. 

To put that in English, London’s transport network will not be grinding to a halt because the government didn’t believe TfL about how much money it would need. Up to a point, the money will be available without further negotiations.

The second big takeaway from these board papers is that negotiations will be going on anyway. This bail out is meant to keep TfL rolling until 17 October; but because the agency gets around three-quarters of its revenues from fares, and because the pandemic means fares are likely to be depressed for the foreseeable future, it’s not clear what is meant to happen after that. Social distancing, the board papers note, means that the network will only be able to handle 13 to 20% of normal passenger numbers, even when every service is running.

Shapps’ letter doesn’t answer this question, but it does at least give a sense of when an answer may be forthcoming. It promises “an immediate and broad ranging government-led review of TfL’s future financial position and future financial structure”, which will publish detailed recommendations by the end of August. That will take in fares, operating efficiencies, capital expenditure, “the current fiscal devolution arrangements” – basically, everything. 

The third thing we leaned from that letter is that, to the first approximation, every change to London’s transport policy that is now being rushed through was an explicit condition of this deal. Segregated cycle lanes, pavement extensions and road closures? All in there. So are the suspension of free travel for people under 18, or free peak-hours travel for those over 60. So are increases in the level of the congestion charge.

Many of these changes may be unpopular, but we now know they are not being embraced by London’s mayor entirely on their own merit: They’re being pushed by the Department of Transport as a condition of receiving the bailout. No wonder Khan was miffed that the latter hadn’t been published.

Jonn Elledge was founding editor of CityMetric. He is on Twitter as @jonnelledge and on Facebook as JonnElledgeWrites.