Asia’s unnatural disasters

By Cathryn J. Prince

The stream of humanity fleeing the Asian countryside is growing daily. Millions dream of escape from rural poverty. All they find is an urban nightmare, unemployment, slums and pollution. The Red Cross and Red Crescent are responding. But is it sufficient? Is help coming fast enough?

Throughout history, cities have stood as temples of hope, seducing those who yearn for a better life to venture inside and try their hand at urban dwelling. Asia is no exception.

People are increasingly abandoning their homes on the farm, in the mountains, or by the rice paddies, for an urban life, unaware of how hard that existence may be. Already home to 3 billion people and host to the world’s most crowded cities, Asia is on an unstoppable course of urbanisation.

From Dhaka to Manila and Beijing to Hanoi the streets overflow with human misery. Unemployment, homelessness, poverty, crime, deteriorating infrastructure, pollution and congestion are the daily realities for millions. There is inadequate water and sanitation.

For Iain Logan, former head of the International Federation’s regional delegation in Kuala Lumpur, Malaysia, there is a dichotomy. ‘‘The world’s fastest growing economies are here; there is enormous growth and development. Consequently there is the idea in some quarters that the needs in Asia aren’t high,” he says. “But if you look behind the scenes you’ll see that’s not the case. One, it’s a very disaster-prone region. Two, the economy is an artificial catalyst.” It creates a population movement but people arrive in cities where the infrastructure isn’t up to speed, he says.

The problems will only increase. In 1970, Asia had eight urban areas of more than 5 million people. Twenty years later there were 31. The trend continues to accelerate. The UN predicts that within the next 10 years 50 per cent of the region’s population will live in or around major cities. Half of these people will be the urban poor.

With such high growth rates, experts agree that cities must become safer, cleaner and healthier. It’s when the discussion turns to problem solving that the consensus cracks. Some argue for government-led approaches while others argue for small, decentralised programmes. Yet if solutions aren’t found, more than 1.5 billion city residents will face serious life and health problems by the year 2025. Even now an estimated 200 million residents don’t have safe drinking water and 350 million don’t have basic sanitation, according to the UN.

This is the terrain on which the Red Cross and Red Crescent Movement must work. A grim landscape to be sure and more of the same awaits over the horizon. That’s why, as the next millennium approaches, National Societies across the region are asking how they can respond to the explosion of Asian cities. Urban roots approaches will likely be the norm, but many National Societies may also borrow ideas, as well as adopt and adapt current Federation rural programmes to the realities of ‘‘megacities’’.

“The logic isn’t for us to say that floods are no longer relevant and just focus on urban poor, but rather to build on those skills of disaster management and bring it into urban areas,’’ says Jerry Talbot, former Director of the Federation’s Asia/Pacific Department. ‘‘The first-aid curriculum doesn’t have to be just blood and bandages. It could include safe water and other solutions to problems of the urban setting. We need to find the right mix of what to do while waiting for the next earthquake.’’

Power to the people

The onus on National Societies is clear. They must plan ahead because disasters will only become more devastating as cities become more crowded, says Hiroshi Higashiura, the newly appointed Director of the Federation’s Asia/Pacific Department, formerly with the Japanese Red Cross. The major causes of disaster are threefold, he argues. More vulnerable people are now living in disaster-prone areas; there is rapid population growth, particularly among the poor; and the environment is being undermined by human activity. Clearly, in many recent disasters urban centres were the hardest hit.

Higashiura has seen urban disaster at close quarters. The 1995 earthquake in Kobe, Japan, killed 6,300 people and caused financial losses of $100 billion. It was one of the costliest disasters ever.

Shortly before the earthquake, the Japanese Red Cross tried to identify those individuals who would suffer most should disaster strike, and a survey indicated the elderly. The Society developed guidelines on how to cope with disasters for both the elderly and volunteers. Unfortunately the earthquake struck first and elements of this idea are now being re-examined. However, this is precisely the kind of small, community-based action that can ease the problems of city living, says Higashiura.

Whether initiated by government agencies or international non-governmental organisations, the programmes must involve local people. Outsiders can’t impose them. Says Floyd Barnaby, a Federation representative in Myanmar, “Programmes must be community-based. If it’s top down the people won’t feel they belong to them. They will neglect them.’’

Not just disasters

It isn’t the only consideration. Most of the time, says Barnaby, National Societies think of vulnerable people only in terms of disasters; from the cyclones that pound Bangladesh to the floods that inundate China. Yet vulnerable people are ever present, and ever suffering – the homeless, children, single women, and the elderly – even in countries where the standard of living is the envy of many.

Sometimes referred to as Asia’s Switzerland, Singapore might not spring to mind when talking of the needy. Yet, more than 20 years ago, the Singapore Red Cross found there were indeed those who could use a helping hand in the shining metropolis. In 1970 it launched a Home-Help Service for destitute elderly people. The programme may be small – there are only about 35 volunteers – but it could serve as an example for other National Societies.

Home-Help volunteers, aged 17 to 35, bring the elderly food, take them to medical check-ups, and provide them with some form of social interaction. ‘‘The Home-Help Service is designed to create social awareness amongst young people, to make them aware of the need to extend a helping hand to the less fortunate within the community,’’ says Suniwati Suni, director of the programme.

Bursting at the seams

Of course, the Home-Help programme is being run in a highly industrialised society which has the means to act. In reality, many struggling countries make up the Asian landscape.

Pakistan is the world’s ninth most populous country with 124.5 million people. By early 1994, about 32 per cent of them lived in cities, 13 per cent in just three – Karachi, Lahore and Faisalabad. Daily the percentage increases, as people continue to flow in from the countryside bent on escaping poverty and the rural lack of opportunity.

The coastal city of Karachi is bursting at the seams. More than 10 million people live there, with 500,000 more squeezing in every year. Four million live in illegally built squatter settlements. One of them, Orangi, has roughly a million people crammed into limited living space, often five people to a room.

In Karachi, 20 per cent of new-borns die before their first birthday. Public health is appalling, and will worsen with the extreme water shortages that are expected to hit this stressed city by 2010. Even now the majority of the population is without access to potable water. In much of Karachi sewage and water lines have been laid side by side and the water has been contaminated. Almost everybody boils water before consumption.

Spread around Asia, however, are many community-based pointers to urban solutions. The Pakistan Red Crescent may not yet have a clean-water programme in Karachi, but Hiroshi Higashiura says it could learn much from a rural Red Cross project in Nepal. With Japanese support, the Nepal Red Cross has been helping countryfolk get drinking water since 1983. Water is an equally grave issue there, since only one in four Nepalese has access to a potable supply.

Karachi, meanwhile, has shown the way in an unexpected quarter, the Orangi slums. A project started in the 1980s by a retired professor has inhabitants of this squatter settlement design, build and maintain their own sewers. It receives little government aid and often refuses foreign aid. It shows squatter strength. So far they have constructed more than 90,000 latrines connected to 5,000 underground lane sewers.

While Orangi illustrates how people can better cope with crowded and insanitary situations, many experts say population growth must be controlled if Asia’s urban nightmares are to be arrested. Pakistan, with one of the world’s fastest growing populations, again provides an example. Publicly officials report an annual 3.1 per cent growth rate, but privately they say it’s closer to 3.3 per cent.

Family planning, of course, is a sensitive subject because it is an Islamic country, although through the Pakistan Red Crescent work is being done. A population welfare programme helps parents plan families and space children.

Street children

Poor children are one of the most vulnerable groups in cities. And among poor children street children are perhaps the most threatened. They are abused, prostituted and maltreated. Many survive by foraging for food in dustbins, or earning pocket money as street hawkers. Most sleep rough in doorways, have little opportunity to keep themselves clean, and become victims of disease that runs rampant. The numbers are frightening.

The Philippine National Red Cross is helping 5,000 such street children in Manila. Seeing there was no safety net, the Society launched Captain Red Cross, a comic character who leads a crusade for a safer life. Captain Red Cross reaches the children through a vividly illustrated book in which he highlights key health issues, including the dangers of cholera, chronic diarrhoea and HIV/AIDS.

The programme, which has support from the Danish Red Cross, encourages street children to become Red Cross junior health workers. Seven professional nurses recruit and train children aged 9 to 15 to become peer educators in hygiene and first aid.

Erling Anderson, a Danish Federation representative recently in Manila, says the strength of the concept is that the Red Cross is working to educate street children, not just run a programme for them. “You can’t do that. Street children are very tough. They’ve had too hard a school of life and too many disappointments. They don’t trust easily. So no one is better placed to help the other kids than one of their own, someone who speaks their language.”

Such programmes provide important tools. Many urban poor lack the skills and economic opportunities to reduce their exposure to risks – be they man-made or natural.

Megaslum danger

In disaster-prone developing countries such as Bangladesh, Pakistan and Viet Nam, unchecked urban immigration is greatly increasing danger from acts of nature. Exceptionally high land prices, and lack of land in many cases, literally push the urban poor to the margins of society. In fact, according to the non-governmental organisation Inter-national Decade for Disaster Prevention, 30 to 60 per cent of Asia’s population live in densely populated squatter settlements on hazard-prone land, from flood plains to slopes often hit by landslides.

Take Dhaka, Bangla-desh. A swollen city, Dhaka has been dubbed a megaslum by some. Severe power, housing, and water shortages are facts of life. Even so, people keep coming in from the countryside, moving into the squatter camps that lace the city. And while they may escape the struggle of subsistence farming, they cannot flee the menace of floods and landslides.

Marking the millennium

Preparedness will be the cornerstone of sustainable urban foundations in the decades to come. And National Societies need to start planning now, says Michael Coyet, head of the Federation’s delegation in Viet Nam. That’s why the Red Cross of Viet Nam began its VNRC 2000 development programme.

Founded by Ho Chi Minh in 1946, the National Society is the country’s largest humanitarian organisation but it is only now, after decades of war, that it can consider the future, says Coyet. With 74 million people living in Viet Nam, 51 per cent of them impoverished, the challenge is awesome. Despite economic progress brought on by reform, it remains one of the world’s poorest countries.

Eighty per cent of the population, and 90 per cent of the poor, live in rural areas, but city dwellers too face serious problems, mainly pollution-related, such as bronchitis and pneumonia.

‘‘Here social work is a cultural thing,’’ says Coyet. “Every day people look for the hundreds of thousands of small things they can do on the lowest level to help others. What VNRC 2000 has done is to focus primarily on the larger cities. It is trying to strengthen the National Society’s provincial chapters, and its social welfare and community-based programmes. The National Society is realising the need for community-based approaches.’’

Through VNRC 2000, the Red Cross of Viet Nam aims to improve the quality of social services. Its social welfare department has developed a social work training manual for Red Cross staff and volunteers, and the training programme will be available in all 53 provinces by the year 2000.

At the same time, the Society will help the poor find housing, organise shelters for street children, build centres for the elderly, and work towards the social reintegration of the handicapped and people recovering from drug abuse and prostitution.

Already its campaign to ease the plight of elderly women known as the “Heroic Mothers” is making itself felt at a local level. More than two million Vietnamese women lost their husbands and sons during three decades of war. In a culture where children, particularly sons, are expected to look after ageing parents, many of these women have no social support. The Red Cross is stepping in to locate housing for them, and make sure they are provided with food and medical assistance.

The needs of the elderly, women and children, are obvious areas where the Red Cross and Red Crescent Movement can focus in the coming years, but it can also help people cope with the infrastructure of congested cities. In Beijing, a city of millions and perhaps as many bicycles, more and more people are buying cars, reports Xusheng Yang, a Federation desk officer in the Asia/Pacific Department. The roads cannot support the growth and accidents are frequent. So together with the police and transportation authorities, the Red Cross Society of China has started a traffic school where first aid is on the syllabus.

‘‘The idea is that if you have an accident, or see another accident, you can give immediate help,’’ Xusheng says. ‘‘The programme is slated to go national. But the Red Cross Society of China still needs to consider how to tackle the consequences of urbanisation if it is to reach the most vulnerable people.” He points to the hundreds of thousands who flow in and out of cities each day with no access to any kind of social welfare. Red Cross social programmes could alleviate their problems.

Too little, too late?

It is not always straightforward. In some countries official attitudes clearly impede those who would address the urban blight, authorities perceiving action to be interference. In Thailand, for instance, people working in slums are often viewed as revolutionaries, says François Grunewald of the ICRC.

It is one more disturbing fact for those within the Red Cross and Red Crescent Movement who, despite the hard work of some National Societies, feel the response so far is insufficient. Indeed, they say, unless more emphasis shifts Asiawards quickly, whatever is done will be too late.

Grunewald reflects the mood of many. “Very little is being done now by the Movement regarding urbanisation. There is no focus, no awareness,” he says. ‘‘It’s a dirty job, it’s a field job. You have to go places where the water isn’t clean and smells.’’

Others consider it will take time to change old attitudes. “The Red Cross doesn’t always look at it’s own front doorstep,’’ the Federation’s Logan says. ‘‘There has been a feeling in some of the more recent meetings, however, that these problems are here and we must help tackle them.’’

Yet even if consensus is at hand, in many Asian countries the Movement will have to tread cautiously. As with Pakistan’s population welfare project or the work with Manila’s street children, it cannot just impose programmes, emphasises Jerry Talbot. It is important not to lose the involvement of the people. The future must lie in home-grown programmes, programmes that spring from the streets and allow those who will benefit to participate.

‘‘People can show a great level of ingenuity. They are not passive,’’ says Barnaby in Myanmar. They need a helping hand. Today rather than tomorrow.

Cathryn J. Prince
Cathryn Prince is a freelance journalist based in Switzerland.