The latest UNICEF report presents a hard-hitting view of the condition of poor children in urban areas.
COMPARISONS between and studies of living conditions in rural and urban India are aplenty, though disaggregated data on the specific deprivations confronting populations in urban centres are not all that easy to find. This results in disproportionate allocation of resources to urban settlements. One of the consequences of the lack of disaggregated information and uneven advances, often because of a serious lapse and lack of interest on the part of policymakers, is that children in informal settlements and impoverished neighbourhoods in urban areas are excluded from essential services and social protection. This is one of the crucial revelations in the State of the World's Children 2012 report of the United Nations Children's Fund (UNICEF) titled Children in an Urban World. The findings of the report seem to suggest that there is a universality in the living and other conditions of the working poor. The focus of the report is somewhat skewed towards detailing the conditions of children of the urban poor in the developing world without identifying the systemic reasons for them.
It is important to understand why there has been a shift from rural to urban areas and why populations continue to move for survival and other needs. But the report does not provide a perspective on this. Population growth, it emphasises, becomes synonymous with slum formation and puts existing infrastructure and services under great strain. But it is also pertinent to ask why a mindset that associates population growth with a burgeoning slum population prevails. The degeneration of a habitat into a slum or a slum cluster does not happen owing to any fortuitous hand but is a reflection of the conscious and deliberate neglect by governments and the local administration. It is therefore not a surprise that slum populations often face the crisis of having to prove their identity. It is also significant that even without industrial expansion in urban areas, rural to urban migration continues unabated as living conditions deteriorate.
According to the U.N. Human Settlement Programme (U.N.-Habitat), quoted in the report, One city dweller in three lives in slum conditions, lacks security of tenure in overcrowded, unhygienic places characterised by unemployment, pollution, traffic, crime, a high cost of living, poor service coverage and competition over resources. The living and working conditions of the urban poor are far worse than described in the report. Official definitions of poverty, says the report, seldom take into account the cost of non-food needs. And the costs of living in urban areas increase owing to expenditures on non-food items, which include fuel, water, electricity, education and transport. In the village, there were no bills to pay. Now in the city, there is rent, electricity bill, water bill, gas bill and God knows what other bills, commented a domestic worker in New Delhi, perhaps articulating the feelings of a large segment of the population.
TISS surveyA survey of a slum population done by the Tata Institute of Social Sciences (TISS), Mumbai, mentioned in the report, revealed a high level of morbidity and mortality among children under the age of six. Almost 44 per cent of the children surveyed in the age cohort one to six were found to be stunted. However, the same cohort revealed a rather high degree of school attendance, mainly in unauthorised private elementary schools. Not surprisingly, the dropout rate before X Standard was also very high.
Around 40 per cent of the families bought water on a regular basis, spending around Rs.20 a day. This ironically happens to be the amount that the Arjun Sengupta Committee report (National Commission Enterprises in the Unorganised Sector Report, 2005) approximated as the upper ceiling of daily income of nearly 77 per cent of the population in the country. Ever since, the issue of numerically ascertaining the poor in the country has become a matter of debate. The preliminary findings of the TISS survey presented by the director, S. Parasuraman, showed how half a million people lived on unauthorised land, which was garbage-dumping ground, and how they faced the constant threat of demolitions and disruption of their lives.
Understandably, most of the growth in urban areas is taking place in low-income countries and in smaller towns and not in megacities, says the report. Over one-third of the children in urban areas, says the report, go unregistered at birth and about half the children in the urban areas of sub-Saharan Africa and South Asia are unregistered. This invisibility because of a lack of a birth certificate makes children vulnerable to all kinds of exploitation, including forced child marriage, hazardous work or even getting recruited by armed groups, says the report. It also agrees that registration alone is no guarantee of access to services or protection from abuse.
The report talks about the very basic deprivations that affect children in urban settlements despite the existence of several international covenants, conventions and treaties that have been signed, endorsed and ratified by countries to protect children. The Convention on the Rights of the Child, for instance, which encompasses the full range of civil, political, economic, social and cultural rights of children, is almost two decades old.
Deprivations are not merely a developing world phenomenon. In socio-economically disadvantaged urban areas in Nigeria, the under-five mortality rate is high; in Bangladesh the mortality rate for the same age cohort is 79 per cent higher than the overall urban rate; and in the crowded informal settlements of Nairobi, Kenya, pneumonia and diarrhoea are the major causes of death. However, in certain large cities of the United States, too, income and ethnicity are found to significantly affect infant survival.
The report repeatedly underscores that living in an urban settlement does not automatically translate into better living and working conditions. Low immunisation coverage, for example, is prevalent not only in parts of western Uttar Pradesh but also in Nairobi. Likewise, contrary to the general impression, access to and use of maternity and obstetric emergency services are poor in urban settings. Health services for the urban poor are of poor quality, and this forces them to approach the many unqualified health practitioners who thrive in the private sector.
Breastfeeding rates, too, are lower in urban than in rural areas. There is evidence to show that urban mothers are more likely to wean their children early even if they did begin breastfeeding. Low rates of breastfeeding, says the report, may be attributed in part to a lack of knowledge and to the fact that poor urban women have to spend more time working outside their homes, thus leaving them little or no time to breastfeed. It is in this context that state-supported child-care services such as crches for working mothers are urgently needed. It is quite probable that information about the latest cosmetic or soft drink is more readily available than information on breastfeeding or the wherewithal and support systems to increase breastfeeding rates and thereby ensure infant survival.
The only reason that the rural-urban gap in nutrition has narrowed is that the situation has worsened in urban areas, says the report. It also mentions in passing the problems of the rich, for instance, obesity among their children, which needs mention as it shows that while one set of children eats too much of the wrong thing, another set does not even get the opportunity for a decent and balanced meal three times a day.
The lack of clean and safe drinking water remains one of the main reasons for the heightened morbidity and mortality among the young. A congested settlement without a proper sewage, sanitation and garbage disposal system causes greater havoc to health than any other factor. Getting safe drinking water and running water for other uses is a struggle in the majority of urban slums. Open drains and exposed sewage are features that most urban slum residents learn to live with.
Quoting a study, the report says that it is common for the urban poor to pay up to 50 times more for a litre of water than their richer neighbours, who have access to water mains. The impact of poor hygiene and the lack of water and sanitation facilities is severe and it exposes girls to the danger of sexual harassment and abuse, especially once they start menstruating, says the report. The lack of these basic amenities has its impact in other areas as well, including attendance in schools. The threat of being displaced affects children's education adversely, too. Quoting the findings of a survey done in Delhi, the report says that in 2004-05, the primary school attendance rate was 54.5 per cent for children living in slums while it was 90 per cent for the city as a whole.
Crime also plays a role in the lives of children. The report says that in marginal urban settings, gangs can offer children financial rewards and a sense of identity. Children from poorer backgrounds end up becoming part of gangs because they see that as a way to escape the vortex of poverty. In urban areas, where the state fails to provide such essentials as safe water, electricity or gas, health care, housing, education and legal protection, gangs sometimes step in to fill this vacuum, says the report.
There is a supply-side deficit, the report acknowledges, but it does not say who is to fill this gap, state or non-state agencies. The barriers to inclusion can be dealt with by increasing the supply of services, and service coverage can be improved by abolishing user fees, setting up community partnerships and using mass communication and other strategies, says the report. The report recommends conditional cash transfers to poor families in urban settings as an experiment that has worked in certain Latin American countries and in Africa.
What the report does not emphasise enough is the need for governments to step in boldly and invest in a big way in the working poor in urban areas. It does not recommend making entitlements such as food, health and education universal. In a section that details the paucity of intra-urban data, it says while it is important to capture urban slum data, it should be emphasised that not all poor households are found in slums and that not all slum residents are poor. To underscore its point, it quotes a 2005 study of 85 demographic and health surveys that found that one out of 10 of a poor household's neighbours was relatively affluent, as measured by consumer durables and housing quality. It is this kind of scenario that obfuscates what it means to live in a situation of rising food prices and inflation. A typical slum household in Delhi or any other metro could have a television or even a second-hand washing machine, donated by a rich employer, but this does not mean that a typical family of five is eating three balanced meals a day or earning enough to meet other expenditures in areas such as health care.
The poor have been mapped enough; if policymakers do not already know where and how the poor live, they probably do not deserve to be making policy at all. Children in an Urban World is hard-hitting. Its underlying message is that there are no halfway measures in dealing with the problems faced by poor urban children. It stops short of fixing responsibility for the problem on anyone, but that does not undermine the fundamental disparities and critical deprivations faced by the urban poor and their children.