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
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
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
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.’’
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
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
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.
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
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.
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
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.
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
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
‘‘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
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.
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.
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