Urban public health is one of the most pressing yet neglected issues facing the developing world, according to public health experts. Neither the national nor local governments have enacted comprehensive plans for dealing with the country's rapidly urbanizing population. So far, most of the focus of both local authorities and the global health community has been on health programs in rural areas. Taking on urban health care problems is especially difficult because of the multitude of variables present in cities: immigration, insufficient housing, lack of space for infrastructure, political corruption, organized crime, pollution, and dysfunctional health systems.
"Urban poverty is not on the government's radar screen," said Dr Anita Patil-Deshmukh, executive director of PUKAR, a Mumbai-based urban health research and advocacy organization. From an official perspective slum dwellers, estimated to number more than 6 million in Mumbai alone, exist largely as an undifferentiated mass. They do not receive government services, lacking basics like water and sanitation. And yet they are a huge part of the productive power of the country, producing hundreds of millions of dollars a year in economic output.
Sam Loewenberg's stories examine the impact of having overburdened, poorly-functioning health systems in high-stress urban settings such as Mumbai and Nairobi.