With a population of 160 million, Bangladesh is gradually moving towards middle-income status with many people’s fortunes rising because of trade and industrial activity in cities like Dhaka and Chittagong. However, the growth of such urban centres has come at a cost, with urban sprawl and rapid rural-to-urban migration putting a strain on infrastructure and services. “We are gradually doing a lot of things to improve the conditions in the slums but because the number of people keeps rising every day, it is hard for us to keep up,” Slum Development Officer of Dhaka South City Corporation, A K M Lutfur Rahman, said. The annual population growth rate recorded in the 2014 Census of Slum Areas and Floating Population was 2.70%. This has created a housing issue where most of the urban poor have ended up living in slums that are not equipped with basic facilities such as safe drinking water, sanitation and healthcare. “The absence of a coordinating mechanism between the Ministry of Health and Family Welfare and the Ministry of Local Government is increasing the problem,” said Prof Nazrul Islam, a leading slum specialist. The 2014 census recorded a rise in the number of slums in Bangladesh from just 2,991 in 1997 to 13,935 slums in 2014. These were home to 2,232,114 people, or 6.33% of the urban population of the country. The census found that 52.5% of households in Bangladesh sourced their drinking water from tube wells, while 45.2% of households had tap water. In city corporation areas of Dhaka, 55.1% of slum dwellers got their drinking water from taps and 42.5% got their drinking water from tube wells. In stark contrast, 87.6% of slum dwellers in municipal areas got their drinking water from tube wells whereas only 10.3% of households had taps. About 5.7% of slum dwellers sourced their water from ponds or ditches. “It is very unfortunate that there are still a lot of people who are living without fresh drinking water,” Khairul Islam, country director of WaterAid Bangladesh, said.

House inside the Rayerbazar slum in Dhaka - Mahmud Hossain Opu/Dhaka Tribune

According to the Urban Health Survey 2013, 32.7% of slums under both the city corporation did not have any government facilities available, while 36.9% of the slums were bereft of community health workers. Additionally, the Demographic Health Survey 2014 found that the urban poor had little access to healthcare in the slums, where the prevalence of family planning and institutional delivery was 54% and 45.5% respectively. Of the many health indicators, Bangladesh has significantly reduced the child death rate through measures including a countrywide immunisation programme among children. Slum children also received the polio vaccine during a national programme introduced by the government. However, the percentage of slum children who received polio vaccine was about 94.9%, compared to universal coverage nationwide. Brig Gen Md Zakir Hassan, chief health officer of Dhaka North City Corporation, said ignorance is the reason why slum dwellers do not pay much heed to their health workers. “It often seems as though healthcare officials had to motivate parents to immunise their children or get a checkup when they had a cold,” he said. The prevalence of latrine facilities is treated as a substantive indicator of a healthy and hygienic environment. Data from the 2014 slum census showed that 42.2% of households used a pit for a latrine, followed by 26.2% using sanitary latrines. Tin latrines were used by 21.1%, hanging/kutcha by 8.6%, and open spaces by 1.8% on a national level. In city corporation areas, 42.5% of households used pit latrines, followed by 26% using sanitary (water sealed) latrines. Tin latrines were used by 23.6% of households, hanging/kutcha by 6.8%, and open spaces by 1.8% of households. In municipal areas, 41.8% of slum dwellers used pit latrines and 28.9% used sanitary latrines, while 14.8% used hanging/kutcha latrines, 10.4% tin latrines, and 4.2% open spaces. According to the 2014 slum census, the total number of household enumerated was 594,861, of which 431,756 were in the city corporation areas, 130,145 were in municipal areas and 32,960 were in other urban areas. The average household size is 3.75.