KOROGOCHO, 27 September 2010 (IRIN) - Poor sanitation, lack of water and related disease outbreaks are making the lives of the residents of the sprawling Korogocho slums in Nairobi even harder.

"The lack of water and improper waste disposal are a big threat to our lives due to the risk of water-borne diseases," Nancy Wangari, a community health worker and village elder in Korogocho, told IRIN. "The threat of typhoid, cholera and other diseases from poor sanitation is real."

Though some pay-toilets have been set up, the cost remains prohibitive, forcing residents to dispose of excreta in plastic bags (so-called flying toilets), which litter the area. In the past few days, a broken sewer line running from the neighbouring Kariobangi Estate has been emptying its effluence into the slum, choking the already narrow pathways between rows of houses.

The scene in Korogocho is replicated elsewhere in Kenya where rapid urbanization has meant more informal structures with little or no water and sanitation services are springing up. According to the 2009 census, an estimated one in five Kenyans uses the bush as a toilet - access to piped water covers only 38.4 percent of the urban population and 13.4 percent of rural residents.

While the "water and sanitation challenges themselves are formidable... their impact on other social, political, and epidemiological systems is equally significant", notes a recent Humanitarian Futures Group (HFG) report, Urban Catastrophes: The Wat/San Dimension, which examines how water and sanitation stress drives other humanitarian crises in slums.

"As with any valuable good, the provision of clean water and sanitation facilities in slums is an attractive target for corruption, greed, collusion and exploitation," it states. "Solutions must therefore focus on understanding local social networks."

Profiting from misery

Korogocho resident Maurice Omondi said water vendors made a killing out of residents' misery. "I pay two shillings [0.025 US cents] per 20-litre jerry can but with the rampant water shortages it may cost between five and 10 shillings [0.0625-0.125 cents] for the same in the neighbouring estates," Omondi told IRIN.

Countless communities are exposed to their own and others' faeces 
Water vendor Peter Macharia* told IRIN he diverted the main water line running through the slum to his homestead.

"My business is now threatened as the National Water and Sewerage Company is demanding we instal meters on all supplies to our homes," Macharia said as he collected money from queuing women and children. The lack of land tenure may, however, make it difficult to ensure consistent water payments.

According to the HFG report, many urban environments have enough water in absolute terms to provide for residents' needs. The challenge is how to equitably manage and distribute it.

In Kenya, slum infrastructure has remained inadequate as it is not government policy to support development in what are considered illegal informal settlements. Residents tamper with electricity and water connections, often resulting in clashes as security personnel are deployed to stop the connections.

Health hazards

According to experts, slum conditions may make the settlements a breeding ground for tomorrow's pathogens. Already, health problems such as malnutrition, diarrhoea, cholera and typhoid fever are common, especially when water is mixed with industrial and sewage effluent.

"General cleanliness in the slums is not good at all. Even as we try our best to keep our individual compounds clean, some people litter our compounds with flying toilets," Korogocho resident Miriam Wangari said.

Progress towards halving the number of people without access to safe drinking water and sanitation by 2015 has been slow, say experts. "At present, there are 2.6 billion people living without safe sanitation, which means countless communities where people are exposed to their own and others' faeces. Excreta is then transmitted between people by flies or fingers and also finds its way into water sources, resulting in a public health crisis," states a Water Aid report, Ignored, The Biggest Child Killer.

In Africa, diarrhoea kills almost one in five children before their fifth birthday, it states.

Low-tech waste removal systems such as mobile toilets, bucket removal and dry composting toilets are among measures recommended in slums. In Korogocho, private individuals use handcarts with large drums to manually empty sludge from pit latrines at a fee. This is often done at night and the contents sometimes end up in the Nairobi River.

With Kenya's population projected to grow by up to one million people per year, existing water and sanitation facilities will be stretched further.

"The lack of resources and consequent inability to address the increasing demands on water and sanitation systems throughout the urban and peri-urban areas will not only threaten the viability of cities and towns as a whole, but could transform even relatively viable urban areas into slums," warned the HFG report.