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Slums in Cape Town and Mumbai have far more in common than I thought – and that was even before I had heard about complexity!

By on November 27, 2014

PhD Candidate, Department of Family Medicine & CTC-QES Scholar at Institute of Health and Social Policy, McGill University. Shinjini is also from the EV2014 batch.

Emerging Voices for Global Health (EV4GH) is an initiative organized by a consortium of five Northern and Southern based universities with a keen interest in global health and health systems research, and in training the next generation of health systems researchers. This year’s EV4GH venture (2014) – the fourth already – was hosted by the University of Western Cape (UWC) and set up in sync with the Third Global Health Symposium on Health Systems Research,‘Science and Practice of people-centred health systems, in Cape Town, South Africa. Once again young bright minds from different countries and continents gathered to build capacities in health research and scientific communication and to participate in the symposium. The program introduces young health professionals to a network of more senior professionals and researchers as well as to their peers from around the world. It encourages them to improve their writing & presentation skills, and to raise their voice in scientific and other debates. Obviously nobody complained about the venue this year, in lovely Cape Town. But enough EV publicity, let’s get to the topic of my article.

As part of the EV face-to-face program, we had an opportunity to learn about the South African health system and local environmental health issues of Khayelitsha, an informal (and notorious) township in Western Cape, South Africa. Dr. Lena Stofie gave a brief but thought provoking presentation on the numerous challenges in these informal settlements, which was followed by a short visit to Khayelitsha. Our tour guide on the bus, a settlement ‘experience expert’, “entertained” us with lively stories about his past in a local gang and on what life really feels like in a tough place like Khayelitsha, for example for kids trying to go to school.  Very insightful. Many of us learnt a great deal, in a way dry statistics and figures can never do (our tour guide was less successful in converting us, though).

While sitting through Dr. Sofie’s presentation and listening to our rather entertaining tour guide, I wondered how similar the landscape felt to another informal settlement, thousands of miles away and in the very different culture and society of India, my home country – more in particular in Dharavi, Mumbai. I spent two years in Mumbai studying for my master’s course and did one of my internships in Dharavi, trying to understand the public health challenges there. Mumbai is well known for the luxurious lifestyle of the many Bollywood stars living there and for the newly constructed (and super-posh) Ambani home, ‘Antilia’. Yet, it is also home to some of the worst slums on the continent, as anybody can testify coming from the airport.

 

Dharavi

Both Cape Town and Mumbai are aspiring world class cities filled with beautiful skyscrapers and good amenities but they also share the burden of rapid and often problematic urbanisation. Despite a very different history and course of evolution, current challenges look quite similar in these poor areas, whether you call them settlements, townships or slums. In South Africa, these settlements represent a legacy of apartheid planning – till today, this path dependency causes enormous difficulty, including in terms of urban planning. Dharavi on the other hand was once a fishermen’s village, which gradually turned into a hub for poor people from different states to migrate to. Today, it stands as a marker of gross inequity in our society.

While listening to Dr. Sofie’s and other presentations on South Africa, I realized that South Africa and India share quite some other characteristics, both historic and 21st century ones. Both countries were once under colonial rule for a substantial time, and they are known as the land of Mandela and Gandhi, respectively, who devoted their lives to end discrimination and strive for social justice. The two countries have now emerged as growing world economies and are proud BRICS nations. As an Emerging Voice, it was nice to get to know another one of these “Emerging Countries” a bit better, even if my visit to Cape Town was only brief.

Moving on to the wicked problem of slums, and drawing from examples and experiences from working in Dharavi in Mumbai, let’s look through a range of complex issues that a slum dweller faces in a daily life. I will focus on Dharavi in the remainder of this piece, as I know this slum far better than Khayelitsha. As mentioned, though, I got a sense they have a lot in common.

 

A day in Dharavi

Dharavi is a small city within a city with its own socio-economic structure. A day in Dharavi starts with queuing for common toilets with your small water pot or small children sitting beside the open drain of houses. Long queues at common water taps, and filling up the blue coloured plastic storage drum. Cooking food in one small room which has no windows making one cough and choke. Waste thrown in drains or dumped in common open grounds for disposal. These (often choked or overflowing) drains are common sites to spot a rodent, food waste or faeces and they serve as a breeding place for mosquitoes, too.

Dharavi

Employment is mostly informal in a slum like Dharavi, as people do small-scale work from home which varies from making leather and textile goods, pottery, recycling of plastic and metal scrap to hand embroidery; some are working in small factories. Job insecurity is huge. Another constant worry for residents is their health status, with cases of Tuberculosis, recurrent diarrhea, skin ailments, unintentional injuries and fever all very common. Although city municipalities have tried to resolve the multiple problems in the slum and also to redevelop Dharavi, they have largely failed. They couldn’t sustain efforts towards a more conclusive solution and as a result, slum dwellers have now become very reluctant to leave their homes and resettle to a new location.

A multi-ethnic, multi-religious and multi-state population lives in these settlements – with squatters from all corners of India and social and economic backgrounds but sharing a common dream of a better, more “human” life. They act as societal mirrors reflecting our unexplainable tolerance for huge structural differences and inequities. For some reason, these horrendous disparities do not cause large-scale indignity and social disruption in our societies.

Dharavi2

 

Looking at slums through a complexity lens

The application of a complexity lens to these slums is more than just a theoretical exercise; it is very much necessary as such a lens forces us to ask hard and often uncomfortable questions about the real (obviously, complex and transdisciplinary) world. It allows us to think more holistically and seems crucial in identifying and conceptualizing both the problem and pinpointing possible solutions. The challenge of urban slums represents an interconnected web of problems, which can’t be reduced to smaller parts or even sectoral responses and requires more knowledge of formal and informal networks and linkages between various actors. Instead of the linear and top-down approaches tried (without much success) by municipal and other governments, room should be made for solutions that take into account nonlinearity, multiple causes, emergent properties and iterative adaption, tipping points, real world messiness and the like. As you might expect, that is as difficult as it sounds.

The problem of slums in a metropolitan city like Mumbai also has different (interconnected) layers – global, national, state and local ones – and a complex multilevel hybrid governance framework. Global, national and municipal policies will have to be put in place to try to solve the problem, all the while acknowledging that there is a lot of uncertainty in complex societal nested and/or co-evolving systems. Hope you’re still with me.

For instance, at the global level, neoliberal globalization has led to a booming trade, deregulated capital markets, imbalanced growth and very inequitable societies. In India, the consequences are felt in the rural areas. Many poor farmers have migrated to these slums, as they couldn’t survive anymore on their farms (sometimes literally, sadly). The Lancet/University of Oslo  Commission on global governance for health is one of the many high-level reports calling for global political solutions and new governance mechanisms to address the huge (market and other) failures of our current global economic system. At the local level, accountability of social and public policy is more often than not lacking, due to the chosen path of non-inclusive development. Taking into account all this, urban planners face a huge challenge to make their cities more resilient and a better place to live for all its citizens.

A complexity lens tries to look for solutions in urban slums using a multi-pronged approach. At a local level, it calls for buy-in, support and interventions from various social departments, which are often not very much into each other’s work, to put it mildly. The struggle to have proper shelter, employment, potable water, adequate disposal of waste and sanitation measures, and provision of health services cannot be seen as standalone determinants. They are basic needs but very much interdependent in the impact they can make: working on one component of water, sanitation and hygiene (WASH) without connecting it to the others leads to failure. Necessities have a profound effect on one another and to look at them with a linear and reductionist approach, without acknowledging the relationship between them, and possible feedback loops, is something we can’t afford anymore in this century. Or perhaps we never could.

Dharavi 4

Resettling of slum residents by urban planners has been largely inadequate due to a number of reasons: planners focused only on formal networks, and other factors like paucity of finances, lack of land, corruption and mismanagement by real estate agents and infrastructure companies all played a role in ‘resettlement going wrong badly’. The complexity approach stresses identifying also the informal networks which often have a far more profound impact – for instance through involving informal local leaders and capitalizing on them as conveners to mobilise and assist in organizing resettlement (or finding another solution).

In Dharavi, the delay and often lukewarm efforts in providing of housing and employment by formal social welfare departments have reached a tipping point long ago – unfortunately in the wrong direction. People have waited long enough for formal government work schemes to materialize and have finally settled for alternate mechanisms to provide for themselves. They have also taken loans and assistance from informal money lenders and local leaders to set up their own small-scale and often unauthorized, illegal work units and housing through their own initiative. Informal mechanisms and self-organization thus replaced more formal and top-down attempts to resettle populations. Depending on your perspective (local communities or urban planners), you can consider these as positive or negative feedback loops, or virtuous and vicious cycles. Anyhow, it is clear that urban planners’ initiatives have proved to be futile in the past for a number of reasons which can  (at least partially) be explained by complexity thinking. By now, slum inhabitants have strong doubts about “progressive” schemes for redevelopment and have lots of unanswered questions on the resettlement schemes, relocation areas, future of small and medium sized industries in the slum and employment guarantees.

So it seems obvious that the framing of the problems, planning and solutions for these slums require more intuitive, iterative and adaptive thinking, where people and communities are seen as part of the solution, from a sustainable development perspective. Good management of slum problems calls for being aware of uncertainties, doing pilot projects to induce learning by doing. It calls for inclusion of local leaders and organizations, allowing for meaningful bottom-up involvement.  Having said that, that doesn’t mean that urban planners have to meet with the local gang leaders to agree on the ‘way forward’!

 

Reframing the challenge of urbanisation

In line with this, there is an urgent requirement to reframe the global challenge of urbanisation. Unidirectional, top-down planning implemented by siloed departments won’t cut it, not in India, not anywhere. Creating healthy sustainable and equitable mega-cities, one of the key challenges in this century, will require complexity thinking, both in appropriately assessing the many dimensions, interdependencies and nonlinearity of a huge global societal challenge like this, and possible solutions. Not involving communities is a non-starter. Integration and collaboration of social departments, in an often multilevel governance constellation, including also civil society and private sector stakeholders, will be needed as well, but the city “stewards” will need to be prepared to adapt as they proceed, learning by doing. Imported solutions could inspire, sometimes, but it is likely that they will have to be adjusted to local contexts, partnerships and intricacies, or sometimes be ignored altogether.

All this is not very controversial, at least in the broader development community, as this is exactly what the new set of Sustainable Development Goals, currently under negotiation, aim to do –  at least in principle. They have been developed through a more consultative process (than the more top-down MDG process) and try to look at economic, social and environmental development in a more integrated and holistic manner. They also articulate flexible, tailored targets developed through participatory processes for regional, national and sub-national levels and leaving behind one-size-fits-all solutions. How this more holistic framework will work out in practice, is of course an entirely different question.

But as a young Emerging Voice, I prefer to look at the future from the bright side. So rather than looking at old failures and unsuccessful models of development, I see hope and opportunity for EVs to act upon. Together, we can act as drivers for change by engaging with development goals at our national, regional and local level. The brave ones among us could even take on the global powers that be. Through participation and engagement with real-world problems with our zeal, motivation and research skills and premised on building equity, trust, empowerment and promoting sustainability in local contexts, we can help rebuild solutions.

Even better, who knows, perhaps someday some EVs will become Mandela’s and Gandhi’s in their own setting, with a heart for social justice and a mind for scientific rigour? Then, perhaps, our world will look slightly less complex and more human…

 

 

 

 

Kristof Decoster (ITM & EV facilitator) provided some inputs for this article.

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