`Up to our ears in ... ': political factors determining water and solid waste management issues in Karachi, Pakistan

Date: Thursday 1 November 10.45–12.15
Source: Forum 11
Authors: Gregory Pappas, Professor and Chairman, Department of Community Health Sciences, Aga Khan University, Pakistan

Abstract

Infectious diseases caused by inadequate clean water supply and solid waste management continue to be major problems in less developed countries. Indeed health problems caused by unsanitary conditions may be growing as mega-cities spiral out of control.

This paper presents two brief case studies of political determinants of health in Karachi, Pakistan. The first addresses the issue of water and solid waste management at the city policy level. Rapid population growth, competition for land, poor planning and corruption have exacerbated the spread of infectious diseases caused by poor sanitation in this mega-city of over 17 million people. The second case analyses one slum neighborhood's struggle for construction of a sewage line. This poor neighborhood was able to improve their sewage problems through community action in which a public health agency played a catalytic role. The two cases are linked and demonstrate both the obstacles and potential for positive change through community empowerment.