Promoting Safer Cities: Water, Sanitation and Hygiene, Mega City Dhaka

Case Study of Dhaka, a mega city

The city has become a vibrant place for improvements in living standards in developing countries. Dhaka is one of the ancient cities, even older than Kolkata but its population and territorial boundaries were not big till 1971.  Before that it was a colonial town which served only some administration services. Bangladesh Bureau of Statistics and Centre for Urban Studies reports show that in 1901 the total urban population in Bangladesh was only 0.70 million but by the year 2011 it was 39.22 million. It is estimated that in the year 2031 it will be 60.45 million. Around 30% of people now live in urban areas where Dhaka, alone has nearly 38% of the current urban population – this was 28% in 1974. Dhaka has reached at the status of megacity and it is also the fastest growing megacity in the world along with Lagos, Nigeria according to UN World Urbanization Prospects 2003.

street foodAs well as an increasing trend in the formal economy the city has achieved high growth of informal business and small traders on road sides and streets.  Millions of people depend on the street for their livelihood. One of the major trades is the restaurant and food business, which are the cheapest way to get instant foods and beverages for city dwellers and pedestrians. The dominant categories on sale are instant fried food, processed food and juices and chopped fruits sold uncovered!

Bangladesh has made a significant achievement in some health indicators e.g. the reduction of under five children mortality came down (1000 live birth) to 53 in the year 2011 (BDGS and UNICEF MICS 2000). It is close to achieving 100% access to safe drinking water and  sanitary latrines for all. It is now at 98.2% for drinking water and 80.4% for sanitary latrines (SVRS 2011 and MICS 2009). Therefore investment in health system has also successfully reduced communicable diseases significantly. International Centre for Diarrhoeal Diseases Research in Bangladesh (ICDDR,B) has been conducting a Demographic and Health Survey in the Matlab and findings show that a massive change in the mortality profile from acute, infectious, and parasitic diseases to non-communicable, degenerative, and chronic diseases during the last 20 years. It also showed that over the period 1986–2006, age-standardized mortality rate (for both sexes) due to diarrhoea and dysentery reduced by 86%.

Need for behavourial change

Perceived safe water

Perceived safe water

City dwellers understanding of germs and cleanliness and behavioural change related to sanitation and hygiene have also improved dramatically over the decades. In my childhood in the 1980s people depended on supplied water but it was uncommon to boil this before drinking. Sometimes when there was an epidemic of diarrhoea people used to boil or mix water purification tablets in their drinking water. Now it is common even among the street vendors to buy bottled water for drinking which is perceived as safe.  Selling water is now very a good business as people sense of germs and hygiene has been improved. A major water business now supplies water ina big plastic transparent container. People are also willing to pay for this at a cost of one taka per glass (100 taka = 86p).

To change people’s behaviour always takes long term effort. Therefore in health promotion or technology transfer in a community needs long term behaviour change communication.   However people’s behaviour on drinking water practices has improved.  Concern for hygiene and safe food preparation, processing and consumption practices remains at a poor level.  A recent study conducted by ICDDR,B in the Dhaka mega city entitled, ‘Behavioural Intervention of Street Food Vendors for Strengthening Street Food Safety in Dhaka City, Bangladesh’ shows that, more than 50% of food items and beverages sold on Dhaka streets were contaminated with various groups of bacteria called coliforms, while more than a third of street foods is unhygienic because of faecal pathogens such as e. coli. It is also reported that ‘the hands of 88% of vendors are stained with germs and about two thirds of vendors carry bacteria on their hands while preparing foods’.

Improving food hygiene 

I have found that some patterns are changing. Some vendors sell pancakes from a covered van and keep all the food in covered packages. The iron cooking pan is also covered when cakes are cooked. A rare case can be even be found where vendors use gloves for preparing and handling food. An ICDDR,B study has recommended that the situation could be improved to reduce the contamination rate if appropriate interventions are taken.  It has also been revealed that there is a lack of adequate public toilets for the large numbers of pedestrians and street vendors who spend a long hours on the street! Some NGOs have mobile toilets in the city but this  is like a drop of water in the sea where there are millions of people from dawn to night. Poor people spend more in comparison to their earnings on health and medication but due to inappropriate behavior, ignorance of preventive practices, delays in seeking health care from untrained health professionals all have negative consequences on household incomes.  Urban poverty is multifaceted challenge compared to rural poverty as poor people has to pay for everything but have very low social protection support.

Practical Action Bangladesh works to provide technological solutions to poverty. Its urban service programs in Bangladesh has been funded by Bill and Melinda Gates Foundation where it aims to improve pro poor urban governance by empowering the urban poor and marginalized to take part in the community development planning process. The experiences of working with some municipalities in Bangladesh on urban services particularly sanitation and urban hygiene can be scaled up in a mega-city like Dhaka where many people live in slums and depend on the streets for their livelihood but lack of access to safe food and water.

One response to “Promoting Safer Cities: Water, Sanitation and Hygiene, Mega City Dhaka”

  1. Kame Says:

    Wish we had those in the states, maybe they do, but I have never seen one. We do have the rick-shaws where pelpoe pull you on the little thing that looks like a bicycle .recently saw many of these in Washington D.C. Always thought it looked a little odd for pelpoe to actually be pulling others around on a bicycle while they sit in the back. Don’t know how one person could do so much exercise in one day, by pulling pelpoe around such a hilly city as D.C. (northern part is uphill).Believe the rick-shaw originated from Asia, but unsure. Sure you know what I am referring to, with your travels.

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