>> My name is Julio Davila.
I'm a Senior Lecture of the Development Planning Unit in UCL.
One case study that we looked at in some detail for the Lancet commission was the case of
Mumbai, a city of 11 million people in India, which has enormous numbers of informal settlements,
they call them slums in India, where about 1/2 the population live in enormous densities
- because only about 8% of the land is covered by these.
Because they're informal, because there's no planning and they don't conform to any
plan, then people just build a bit of house, a shack or improvised house or maybe even
more, before the municipality is able to install any services like sewage or water supply or
electricity or even roads.
So people live very close to each other and it's perfect conditions for epidemics to spread.
Because these services are lacking, then sanitation is a huge problem.
People have to defecate in the open.
So it is a severe health, apart from a social and human, individual problem.
Retrofitting or installing bathrooms and the whole sanitation infrastructure in a place
like that is a huge challenge.
And we chose Mumbai partly because it has a very large program called the Slum Sanitation
Program, to try and do that.
So the program seeks, between now and 2025, to provide one toilet for every 20 inhabitants
in these slums.
The aim of that is to involve the community as much as possible so that they manage the
toilets because the technological solutions to sanitation are that they exist.
It's not rocket science.
The main problem is people actually using the toilets.
And if you -- if they're located where people cannot access them, if they're not cleaned
or not accessible because they're too high, or if you charge people money that they cannot
afford, then people will not use them.
So what they have done is turn these blocks of toilets into places that the community
themselves manage, that bring in people because of other reasons, not simply because they
have toilets in them.
In some cases they have showers.
In other cases they have TV sets.
Or even in some cases they have English language courses are taught so that people come and
learn English after having a shower.
So you know it's about turning them into useable parts of the community that are maintained
and cleaned.
That's a crucial element of the whole process.
In the case of a settlement called Old Fadama in Accra, the capital of Ghana, what we've
observed, and is mentioned briefly in the article, is a very different set up where
you have a dense settlement, much, much smaller than your typical Mumbai informal settlements,
of only a few thousand families living very, very close together but where private investors
living in the informal settlements themselves, have created sanitation infrastructures, essentially
bathrooms, toilet blocks and these are not water borne toilet blocks.
These are toilet blocks using very basic bucket latrine technology and shower spaces which
are open, essentially.
They don't have showers.
They're essentially areas for bathing and they provide the water, which is bought from
the municipality or the municipal water company.
In this case, in the case of Accra, that has been partially privatised.
But they not only make money out of sanitation, providing people with water and places to
bathe and basically it's like defecating in the morning and so on, but they also make
money in the process.
And by doing so they fulfil a crucial sanitary function and help prevent the spread of disease,
compared to when people defecate in the open.