Makoko, Nigeria - It is no ordinary neighbourhood of Lagos - Nigeria's most populous city - with some calling it the "Venice of Africa". This 200-year-old water-world, however, is a vast slum with hovels built upon wooden stilts.

A paradox is also at play: While the Makoko community thrives on water, residents here lack access to safe drinking water. When it rains, conditions turn particularly nasty. On a recent Sunday, rain pushed sewage and waste through the slum, leaving behind a foul stench.

At the water's edge, a group of children manned what looked like a taxi stand. Only the taxis were spindle shaped wooden canoes that led passengers deeper into the heart of the shanty town.

"Come, come!" the boys yelled. They paddled hard, competing for their canoes to be closest to the pier. The boats - about three metres in length - are unstable but the only mode of transport available to most of Makoko's residents.

Back in the 18th century, Makoko used to be a small fishing village before it grew into the sprawling one-square-kilometre urban settlement. There are no official census records, but estimates suggest the population totals 150,000 souls.

They believe this water is clean, they will even wash fresh wounds in it. The government has a big role to play so that there is more awareness to improve the situation and the people know the water they are using is not okay. - Dr Theophilus Damijida, local physician

Many of Makoko's inhabitants are from neighbouring Benin and Togo - most have lived here for decades. An average of eight people live in each house, and sustain themselves on fishing or collecting wood from the lagoon.

The biggest challenge for Makoko's residents is finding drinking water. Benjamin Aide Moses and Gerald Frank Ogon are friends who were born and raised here.

"I grew up in Makoko. Day to day, water is a problem here," Moses told Al Jazeera.

Ogon nodded in agreement. "People have lived here for many years and there is no solution to the water problem. We have boreholes where they sell water to the people."

Local entrepreneurs such as Samuel Onoja dig out groundwater and sell it at different locations around the slum. He fills up a large tank from a borehole 200 metres into the lagoon and sells it near his home.

"I work for my boss. He buys the water for 2,000 naira [$13] and we sell it for 4,000 naira [$26]," Onoja explained, rushing to fill canisters for customers who had queued up in boats outside his hut.

It's routine in Makoko for one family member to queue up at local water kiosks to fetch their daily supply. On average, each family in Makoko spends about 5,000 naira ($31) each month on groundwater.

'Vast' health implications

Moses expressed concern about the safety of the water. "We use it for drinking, cooking and even bathing. But if you let the water stand overnight it turns red. I think that's because we don't have good technology to get clean water from the ground."

Theophilus Damijida is a general physician at the local health centre. "The health implications are vast. We encounter a lot of health problems as a result of no access to clean water," he said.

Patients coming here are diagnosed with diseases such as typhoid, malaria, diarrhoea and cholera. "It is all over as a result of no access to clean water."

It's not just unsafe drinking water that creates health complications, Dr Damijida added.

Makoko also lacks drainage and sanitation. Sewage from the slums flows straight into the surroundings, increasing the risk of infectious disease among inhabitants. Earlier this month there was an outbreak of cholera.

Lack of education among inhabitants further worsens the problem, said Damijida.

"They believe this water is clean, they will even wash fresh wounds in it. The government has a big role to play so that there is more awareness to improve the situation and the people know the water they are using is not okay."

Nigeria is one of Africa's leading economies, with its GDP second only to South Africa. The country has abundant natural resources such as gold, oil and natural gas and diamonds. Its economic growth, however, hasn't had the trickle-down effect.

Basic living standards such as safe drinking water and sanitation are abysmal, not only in Makoko but in other regions across Nigeria. According to the NGO WaterAid, 63 million people lack access to safe drinking water and 111 million have no sanitation.

The local administration and the health ministry have started an awareness campaign about waterborne diseases. We want to raise awareness and sensitise the population towards these issues. - Tunde Ojikutu , local administrator

Shockingly, 85,000 children die every year in the country from diarrhoea caused by unsafe drinking water and poor sanitation, its country report said.

Rapid urbanisation coupled with a growing population is also adding to the challenges. In the last 15 years, Lagos' population has doubled to more than 21 million residents. According to estimates, this number is likely to rise to 35 million by 2025, making it the world's most populous city.

Awareness campaign

Tunde Ojikutu is the local administrator of Yaba, the municipality under which Makoko falls.

"The local administration and the health ministry have started an awareness campaign about waterborne diseases," he told Al Jazeera. "We want to raise awareness and sensitise the population towards these issues. One of the next immediate steps will be the introduction of water purifiers."

Although Ojikutu's words were encouraging, the government's actions have not always matched up. In July 2012, city authorities left thousands of people homeless after an eviction in one neighbourhood of Makoko. Since the area was considered an illegal settlement, they were given a 72-hour notice before their houses were destroyed.

The government offered no rehabilitation or compensation. In an ever-growing city, where many desire waterfront property, there are suspicions the city wants the entire community gone.

But many who call Makoko their home and want to stay. A project that could be a starting point for change in attitude towards Makoko is a floating school. It was designed by Nigerian architect Kunlé Adejemi and supported by the Heinrich Böll foundation and the United Nations. Soon to be opened, the school will accommodate 100 students.

Developers see it is a pilot project that addresses the community's social and physical needs, and plan to develop Makoko into a sustainable floating community. It remains to be seen whether these efforts will come to fruition.

But a popular saying here exemplifies the hope people have for the future: "In Nigeria we don't have problems, in Nigeria we only have challenges."