As the world becomes more urbanised, poor city dwellers are becoming increasingly vulnerable to natural disasters. Aid agencies should respond to these changes, say experts.

 

“As climate change and global migration to cities continues to change the landscape of the developing world, we can expect to see more and more disasters centered on urban areas,” says Jeffrey Wright, team leader for the US World Vision Humanitarian and Emergency Affairs in a press release this week.

 

Wright is currently working in Haiti, where an earthquake measuring 7.0 on the Richter Scale hit on 12 January. The epicentre was 17 km south-west of the capital Port-au-Prince. Current estimates suggest that as many as 200,000 people died in the disaster, and around 1.5 million are now in need of food, shelter, and health care.

 

Haiti is the poorest country in the Western hemisphere, and 80% of its people live below the poverty line. With the country’s limited infrastructure damaged in the quake, aid agencies have struggled to get relief efforts off the ground. The UN says crisis response has been hampered by logistical problems of an unprecedented scale.

 

Experts say the earthquake should serve as a wake-up call for the humanitarian community. Similar disasters will happen more often as more of the world’s population than ever before live in city slums with limited provisions to protect themselves from ill-health.

 

One billion of the world’s urban population live in shanty towns with little access to clean water, toilets, and health care, according to the World Health Organization (WHO). In Port-au-Prince, just a third of those living in the city’s slums had access to safe drinking water before the earthquake hit. Without these everyday provisions, relief workers have little chance of providing essential aid to people in the immediate aftermath of the emergency. Coupled with the high population density in city slums, this means a natural disaster hitting poor areas will bring higher rates of injury, illness and death.

 

“This is exactly what Haiti has shown us,” says Frederick Burkle, from the Harvard University Humanitarian Initiative in Massachusetts, USA. There are many more such disasters to come, he adds.

 

As more people flock to set up homes in cities, such humanitarian crises will only worsen over the next few decades, explains Burkle. The world’s so-called megacities, home to more than 10 million people, are growing by 25 million people every year, he adds. Slums crop up on the only land available, which is usually prone to natural disasters such as flooding or earthquakes.

 

Prior to the earthquake, the aid group Médecins Sans Frontières (MSF) ran two hospitals in Haiti. Beverley Colin, Health Policy and Practice Advisor for MSF-UK, says staff have to keep on top of treating patients admitted before the disaster as well as new arrivals.

 

Through their work in other countries, MSF have seen that changes to people’s living environment associated with urbanisation can affect which diseases become endemic in city dwellers. The arrival of a natural disaster can exacerbate these existing health problems and also bring new ones, she explains.

 

Burkle tells EHTF News that there are scant humanitarian provisions in poor urban areas, and this is where the need is greatest. “This is already a humanitarian crisis and it has been brewing for years.”

 

“We can’t keep giving aid ad-hoc,” says Burkle. The humanitarian community has shied away from improving public health in urban areas through the provision of safe water and sanitation.

 

But Burkle concedes that overhauling the aid system is a “massive” task. Making it a priority to improve public health for those living in poor urban dwellings and prevent disasters will not be easy. He calls for a single central organisation to take charge of disaster relief, saying the United Nations Office for the Coordination of Humanitarian Affairs would be a good candidate for the role.

 

This body should be granted similar powers to those the WHO holds when new infectious diseases emerge, says Burkle. Under the International Health Regulations, the WHO legally requires countries to report certain outbreaks of disease and public health events so they can coordinate and manage the response.