Coronavirus: how Mumbai’s sprawling slums threaten to become a Covid-19 breeding ground

By Kunal Purohit

Published: 10:00 pm, 21 April, 2020

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  • With one toilet per 1,200 people, not enough clean drinking water and outbreaks of drug-resistant tuberculosis, the Govandi slums make health officials nervous

  • Yet fewer than 200 of the area’s 800,000 or so inhabitants have been tested for coronavirus – a shortfall which could be masking its true spread

The Janta Nagar area of Mumbai's Govandi slums. Photo: Kunal Purohit

In the Govandi slums of eastern Mumbai, 27-year-old Anjum Shaikh has heard enough about the coronavirus pandemic to know that she should wash her hands regularly to avoid infection.

Yet with no running water to the single-storey structure she calls home, she has few options but to pay a neighbour for access to his tap – for 7 minutes, at 4am, three times a week.

“If I don’t wake up in time, I will be left with no water. So, the days when it is my turn to fill water, I just don’t sleep,” she said.

Such sleepless nights aren’t Shaikh’s only concern, however. As well as the Covid-19 illness caused by the coronavirus, which has infected at least 99 slum dwellers so far, Govandi is also a hotspot of infection for another deadly disease: tuberculosis.

A doctor examines a tuberculosis patient in a government hospital in India, in this 2014 file photo. Photo: AP

In 2019 alone, some 2,000 active TB cases were recorded in the area, according to official government data. Many were infected with the extensively drug-resistant variant of the disease that is almost impossible to treat.

And locals believe mass under-reporting means that figure should actually be far higher, with one estimate putting the number of infected at one in every 10 people in some parts of the slum, which is home to about 800,000 people.

Though much attention amid the current coronavirus pandemic has been focused on Dharavi, Mumbai’s best-known slum, officials privately admit that they are more worried about Govandi – even though it currently has fewer confirmed cases of Covid-19.

One of many slum settlements in a city where more than 40 per cent of the population are thought to live in such conditions, what makes Govandi so apt to host disease outbreaks is its acute deprivation.

Officially, about 31,000 people live in each square kilometre of the neighbourhood – which had the lowest human development index of any area of the city, according to a 2009 United Nations Development Programme report – though population densities in the slums are many times higher.

Population densities in Mumbai’s slums can be far higher than official statistics indicate. Photo: AFP

A 2015 report by local not-for-profit organisation Apnalaya found more than half of the children in the slum to have stunted growth, with 44 per cent underweight. The average lifespan was just 39 years, compared to the national average of 67.9.

Homes here are often one-room tenements lacking toilets, sunlight and, often, ventilation. A survey of the area done last year found one toilet per 1,230 people, with 65 per cent facilities not even connected to a sewage system.

For decades, authorities refused to supply drinking water to those living in slums built without permission, and although a Bombay High Court decision in 2014 officially put an end to this practice, getting connected to the water mains is still an expensive and time-consuming process that not only requires navigating a maze of bureaucracy, but also paying expensive bribes.

More than half of the people who live in Govandi have no direct access to drinking water and buy it from others instead at huge mark-ups – an unhappy arrangement that has only become harder to maintain as work has dried up and people’s meagre savings have been exhausted in the wake of India’s now five-weeklong coronavirus lockdown.

Zainab Khatoon-Shaikh outside her house in Govandi's Janta Nagar slums. She gets water only once a week. Photo: Kunal Purohit

As a result, many slum dwellers are largely forgoing personal hygiene.

Zainab Khatoon-Shaikh, 29, scoffs at health advisories asking people to wash their hands with soap for 20 seconds to kill the coronavirus. She and her husband Kaleem, a carpenter, are only able to afford to buy water once a week and it has to last them for the full seven days.

“If I keep washing my hands, we won’t have enough water to drink and cook,” she said. “So, we decided that we will save water for our children to use by not bathing every day.”

Though such an approach may seem contrary to maintaining good health, in the slums, sustenance is survival and “survival is the first priority”, said Poornima Nair, health and disability programme director at Apnalaya, “everything else takes a back seat”.

An open drain filled with refuse is seen inside a slum area of Mumbai during the government-imposed nationwide coronavirus lockdown. Photo: AFP

For urban planner Vijayshree Pednekar, whose architectural practice The Urban Project helped survey Govandi’s sanitation facilities, the slums that sit in the shadow of the Deonar dumping ground – India’s oldest and largest landfill site – have become a “resettlement area … where people get dumped because they were found to be in the way of infrastructure projects in the city”.

Authorities privately admit that they are nervous about further outbreaks of coronavirus in the Govandi slums.

Since last week, confirmed cases in the area have officially dropped, coinciding with a decision by the Brihanmumbai Municipal Corporation – Mumbai’s governing civic body – to no longer test those who do not display obvious symptoms of Covid-19, despite the Indian Council for Medical Research’s estimate that up to 80 per cent of cases in the country could be asymptomatic.

In all, only about 190 people in Govandi have been tested so far, with an additional 200 close contacts of those who tested positive sent to quarantine. In addition, 27 parts of the slums have been declared containment zones and sealed off, according to government data.

Mohammed Umar Shaikh, 52, pictured near his home in the slums of Govandi. Photo: Kunal Purohit

“We have traced all the contacts and quarantined them. We are also having a fever clinic daily, where people with Covid-19 symptoms can come and get examined,” said Sudhanshu Dwivedi, assistant municipal commissioner of the M-East ward, which Govandi falls under.

But in an area where TB is commonplace, waiting for symptomatic patients to walk into clinics might not be the most effective strategy.

“Almost every other house either has or has had a TB patient,” said slum dweller Mohammed Umar Shaikh, pointing to the makeshift homes that surround his own. “No one will now admit to the [coronavirus] symptoms because they are scared they will be quarantined.”

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