A lack of safe water supply in urban settlements around Asia and the Pacific complicates efforts to use improved hygiene to fight COVID-19
Handwashing with soap and proper hygiene are the first lines of defense to prevent the spread of COVID-19. Inadequate supply of safe water in urban informal settlements limits the practice of handwashing and increases the risk to virus exposure during water collection at communal sources. The lack of safe sanitation facilities also elevates the risk of disease transmission through fecal contamination, especially for households forced to use communal public toilets.
The physical conditions of dense household environments hinders the practice of social distancing and self-quarantine at home, in many cases it is impossible to follow the self-isolation protocols recommended by health experts. With insecure tenure, settlement residents become highly vulnerable to forced evictions due to rental default. Particularly for those working in the informal labor sector, livelihoods may be lost during long periods of lockdown. Preparing poor communities to respond and adapt to the threat of the pandemic entails utmost priority and collective effort of government agencies and development partners.
These are some of the challenges faced by Papua New Guinea, where the poverty rate is 38% and none of the Millennium Development Goal targets have been met. Access to basic water is 41% and sanitation services 13%, which is among the lowest in the Pacific. Waterborne diseases and acute respiratory infection are still the leading causes of morbidity among children under 5 years of age. The government has acknowledged the important role that water, sanitation and hygiene will play in the nation’s development. Papua New Guinea’s rich and unique cultural heritage (more than 800 languages are spoken) will continue to shape approaches to development.
Informal settlements have always been an integral part of Papua New Guinea’s urban landscape. The capital city of Port Moresby alone is home to at least half million people, of whom more than 50% reside in settlement areas. Informal urban communities are characterized by large overcrowded houses, typically comprising of 8-10 family members, some reaching as many as 30 people in extended families. Informal settlements fall outside the government’s official city planning and development jurisdiction. Unplanned growth in the city has taken a toll on formal utilities’ ability to provide adequate levels of water supply, sanitation, wastewater and solid waste management services.
Many of the informal settlements in urban and peri-urban towns are on customary land held by traditional landowners without formal registered title. The lack of land tenure is a major obstacle for settlers to upgrade their houses and living conditions, and is likewise a clear disincentive for water utilities to extend services. Recent household surveys supported by ADB in three settlement areas confirmed that residents collect water from multiple sources, mainly from public tap stands, rainwater and open dug wells. The quality of collected drinking water is often poor and water treatment is not commonly practiced. A study on sanitation in Port Moresby estimated that only 6.8% of urban informal settlers have access to safely managed sanitation service.
On a positive note, the coronavirus pandemic creates an opportunity for the government to implement policy and institutional reforms to address the situation. Getting back to basics, the first question is whether people are practicing good hand hygiene (including hand washing at critical times), and if not, what are the barriers that prevent them from doing so. Barriers may be behavioral (for example, individuals may lack an understanding of the risks, and therefore have no fear of what happens if they don’t wash their hands). Such barriers may be addressed through awareness creation, education and even “nudges” (e.g. cheerful footsteps in demarcated pathways led Bangladeshi school children from school latrines to handwashing stations brightly decorated with handprints).
Barriers may also be related to infrastructure (e.g. no handwashing facilities with soap and water available). Low access to safe water supplies in Papua New Guinea emphasize the need to focus support towards utilities, to strengthen their capacity to make safe water supplies available 24/7, especially during outbreaks of disease, and especially to those most at risk and to vulnerable communities. Safely managed sanitation and wastewater services are also critical to prevent the spread of diseases. The government and ADB continue to explore potential opportunities to support the provision of basic urban services.
The government will need to ensure proactive coordination between agencies providing basic essential services. In health care settings, special attention should be given to water, sanitation, hygiene and waste management. Safe management of health care waste needs to be integrated with the city’s waste management system, including support on awareness-building and training of relevant staff on health emergency protocols and standards.
The impacts of COVID-19 should drive our generation to accelerate universal and equitable access to safe water and sanitation services that will improve the quality of life for the most vulnerable communities.