Further Evidence from Informal Settlements

At last slum health, featured in previous blogs, is starting to receive the attention it deserves. A recent report on the Mathare settlement in Nairobi, Kenya [1] correlates how far a person lives from a public toilet and risk of disease. The further a person lives from the facility, the more likely they are to be chronically unwell, especially with diarrhoeal diseases and childhood stunting. As readers know, poor nutrition and sanitation create a vicious circle. Also, the risk of violence against women rises with distance from a public facility. Clean water and sanitation remain huge challenges for slum dwellers. Improved sanitation would also produce an educational and economic dividend. Meanwhile toilet design has improved, for example, with the invention of the composting toilet, so cost-effective, logistically feasible improvements are possible and likely to be highly cost-effective. The CLAHRC WM Director liked this paper because it integrated disease surveillance, geospatial mapping, and the personal accounts of slum dwellers, to create a rich account of pathways to poor health.

— Richard Lilford, CLAHRC WM Director


  1. Corburn J & Hildebrand C. Slum sanitation and the social determinants of women’s health in Nairobi, Kenya. J Env Public Health. 2015. [ePub]

One thought on “Further Evidence from Informal Settlements”

  1. Richard, very interesting and reminded me of a walking trip (Exodus travel) to Jebal Saro (spelling?), part of the Sahara Desert, a few years ago. There were no toilets for the whole trip, not even compost ones. So a group of about 10 had to make do with anywhere they could find – people’s (market type) gardens, orchards, old buildings. No privacy. Disgusting and a disservice to locals and Exodus should know better. Coupled with this was use by some in the group of the cisterns and wells of scarce drinking water to wash their clothes; some angry reactions by locals. Again Exodus should know better.
    Back here, I do wonder about water usage in our modern toilets – 3 – 6 litres potable water to sluice 0.5L of urine? So the Nairobi work could have lessons for us in ‘developed’ countries where water availability is likely to worsen?

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