Ebola has had significant, negative effects in the rapidly expanding, unregulated areas of peri-urban and urban West Africa. The residents of these areas maintain vital connections with rural populations while intermingling with and living in close proximity to urban and elite populations. These interconnections fuel the spread of Ebola. The degradation of natural resources, temporary housing, inadequate water supplies, hazardous conditions and dense concentrations of people in peri-urban areas exacerbate the potential for zoonotic disease spread. Yet the peri-urban remains largely unacknowledged and under- addressed in development.
In considering the intersections between Ebola, peri-urban settlements and urbanisation, we must recognise that: basic hygiene and isolation of the sick are frequently impossible; disease control through quarantine often ignores poor people’s patterns of movement and immediate material needs; quarantine can reinforce the political exclusion of peri-urban residents; and there exists the potential for future zoonotic disease emergence in peri-urban contexts.
Recent efforts to reinvigorate the connections between urban planning and health have usefully brought the field back to one of its original roles. Current research, however, has focused on industrialized cities, overlooking some of the important urbanization processes in poor countries. This paper describes an emerging ‘health transition’ and the importance of socio-ecological approaches to understanding new health challenges in the developing world and uses the empirical case of Vietnam to examine the development dilemma of new industrial health concerns associated with economic development.
The paper summarizes original qualitative data suggesting that one of the main benefits and rationales of the system is the improvement in public health that it has promoted. Using a related original sample survey (n=200) from 2005, the paper then tests a set of hypotheses about the relationship between illness, connections to the new system, and the role of pollution of natural water sources in illness.
Using the principles of reputational case selection sampling procedure and thematic search of electronic databases and websites, we implemented a regional synthesis of evidence on the health vulnerabilities of migrant and mobile populations in urban areas of East and Southern Africa. The review identified key health challenges relating to various diseases, including the increasing challenge of non-communicable diseases, such diabetes among migrants by 2030.
While figures are difficult to obtain, our review suggested high levels of urban migrants, including refugees, internally displaced persons (IDPs) and asylum seekers in urban areas of the region, which for undocumented migrants poses particular logistics challenges in terms of administering targeted interventions, more so in contexts where poor socio-economic situations of countries do not provide them with opportunities to become self-reliant and less dependent on humanitarian assistance. This calls for policies, program interventions and research investments targeting vulnerable migrant and mobile groups in the region.
Refugees are increasingly migrating to urban areas, but little research has been conducted to compare health and wellbeing outcomes of urban refugees with those based in camps. This analytic cross-sectional study investigated differences in health-related quality of life (QoL) for urban and camp-based refugees in sub-Saharan Africa, and assessed the influences of both the environment and the perceived environment on refugees’ health-related QoL using the WorldHealth Organization’s Quality of Life scale (WHOQOL-BREF.) Data for urban refugees were drawn from an administrative database used by an international agency that serves refugee populations in South Africa.
Data for camp-based refugees were collected via surveys conducted at two refugee camps in sub-Saharan Africa. Refugees in urban environments reported significantly higher satisfaction with overall health, physical health and environmental wellbeing than refugees placed in camps. In multivariate analyses, urban environments were associated with better physical health for refugees,
This working paper reports on a study to identify the pace of Ebola-related social learning in urban and peri-urban areas around Monrovia, Liberia during August 2014, at the onset of the emergency phase of the epidemic. The research demonstrates how under conditions of accelerating health crises, social learning is rapid even in a context of heightened instability, suspicion, and misinformation.
Misleading information in the form of local rumours and unhelpful government and international healthcare messages complicate this process and can produce anxiety. However, contrary to widespread assumptions of ‘ignorance’, and amidst the circulation of conspiracy theories, communities were able to uptake essential information regarding Ebola transmission and management rapidly and efficiently.
This working paper reports on a study to identify epidemic control priorities among 15 communities in Monrovia and Montserrado County, Liberia. Data were collected in September 2014 on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networking/hotlines/calling response teams and referrals, management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education.
The study also reviewed issues of fear and stigma towards Ebola victims and survivors, and support for those who have been affected by Ebola. The findings provide several models that can inform international and governmental support for community-based management of the current Ebola outbreak.
This Technical Brief is intended to be a starting point for improving coordinated needs assessments in urban areas, without which the humanitarian community will not be able to ensure the quality and accountability of urban response itself. It provides guidance on carrying out joint rapid assessments of humanitarian needs in urban environments within the first weeks of a disaster.
Organisations can use this Brief to ensure that joint assessments are carried out appropriately in urban areas, and to update their assessment practice. The Brief does not cover more comprehensive or in-depth sectoral assessments that may take place in the longer-term, although the issues discussed are the same and many of the principles are still applicable. It does not provide sector-specific guidance, and does not focus on the needs of specific groups (such as women or the elderly),but it does list references and resources that provide this detail.