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Impoverished urban squatters face high risk of poor health

Impoverished squatters in Kathmandu survive with minimum income and can't afford a square of meals.
(Naresh Newar/IRIN)

The growing population of the Nepali capital, Kathmandu, has exacerbated the plight of the city’s estimated 50,000 squatters who are among the poorest people in Nepal, according to a study by local non-governmental organisation (NGO) Water Aid Nepal.

People living in squatter areas are the most vulnerable to preventable communicable and non-communicable diseases and have high rates of mortality, said the study, entitled ‘Health and Hygiene Issues of Vulnerable Groups in Low Income Urban Communities’.

Rapid rural-urban migration over the past decade has led to the overpopulation of most city areas, exerting heavy pressure on the city’s limited infrastructure and services. According to the Nepalese government, the population of the Kathmandu Valley tri-city area - including Lalitpur and Bhaktapur - has more than doubled between 1994 and 2004. Today, it stands at some 1.5 million people.

The major problems faced by the city’s poor are a limited supply of clean drinking water, and poor sanitation, health and hygiene, according to local NGO Lumanti.

In addition, urbanisation has contributed to making the already contaminated water of Bagmati River worse. The government has failed to manage a proper sewerage system in the city, according to Lumanti. Squatters are the most affected as they all live on land close to the river, the only available space for them.

It is a wretched life for 76-year-old Rohindra Bahadur Karki, a squatter in the Jagriti Nagar area, an impoverished neighbourhood in the city centre. Last year he lost both his 44-year-old son, Ram Krishna, and his daughter-in-law, 34-year-old Goma, simply because he was unable to afford medical treatment for them.

''Just take a look at how we live and you can judge why people, especially children and the elderly, get sick all the time''

Their health had been deteriorating over the years while living in the squatter area close to Kathmandu’s heavily contaminated River Bagmati.

“I took them to the government hospital but I didn’t have enough money to buy regular medication and they died,” Karki told IRIN.

“I don’t know how long I can survive. I don’t even have enough strength to work any more,” he said, and expressed concern about the welfare of his two grandchildren, who also often get sick due to poor hygiene in this largest squatter area of Kathmandu. Nearly 3,000 slum dwellers live there.

Four million squatters

In Nepal, there are about four million squatters, known locally as Sukumbasi, living in cities and towns, including 50,000 in Kathmandu, according to the Society for the Preservation of Shelters and Habitation in Nepal (SPOSH-Nepal), which advocates the rights of landless squatters.

According to SPOSH-Nepal, there are over 66 squatter settlements in Kathmandu and most are in unhygienic and unsanitary areas. The Sukumbasis migrated from their food-deficit villages decades ago after natural disasters, which made them homeless and landless, thus impoverishing them further. The squatters survive on less than US$1 a day, SPOSH-Nepal officials say.

“It is very common among the Sukumbasis to die of poor health due to poor sanitation and lack of clean water so we have stopped complaining,” said local squatter Padma Prasad, adding that people die in this squatter area every 10 to 15 days.

“Just take a look at how we live and you can judge why people, especially children and the elderly, get sick all the time,” said another squatter, Simi Lama.

Photo: Naresh Newar/IRIN
Unhygienic conditions in squatter settlements cause health concerns

No mains water

Lama said there is no mains water and people have to walk for nearly an hour to reach the nearest public tap where they then have to queue for as much as five hours to get a bucket of clean drinking water.

Now that the monsoon is imminent, local squatters fear sickness from water-borne diseases. Government hospitals are always crowded and squatters cannot afford to pay for treatment and medicines despite the subsidised health service.


“We decided to take matters into our own hands and not wait for the government’s help,” squatter Mankumari Ale told IRIN. She and her neighbours in Mandikatar decided to form a committee and collect money each month from whatever savings they had.

They were able to establish a cooperative and, with the support of Lumanti NGO, managed to collect enough funds to begin income generation activities, and members also started to clean their area, build toilets and install a drinking water tank.

“Over the last five years we have managed to save many lives, and now not many get sick,” said Ale, adding that other squatter settlements should try to form their own cooperatives and work together.

Women, babies at risk

Those squatters most affected by poor hygiene and poverty are women, and many still deliver babies at home in unsafe environments. Babies stand a high risk of infection due to unsanitary conditions, according to the Nepal Mahila Ekta Samaj, a squatter women’s group helping to promote the rights of female squatters.

“Urgent attention and the immediate introduction of health services are needed for the women. Failure to do this would put many lives of children and mothers at risk,” said Bina Bajracharya, a senior member of the group.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information:

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