|Fact sheet No 122: Cities and Emerging or Re-emerging Diseases in the XXIst Century - June 1996 (WHO, 1996, 3 p.)|
A large part of the worlds children live in overcrowded, poor-quality shelters, with several persons to each room and no piped water or adequate sanitation. Too often, people cannot turn to health services when their children are sick or injured. In such circumstances, one child in two may die before his or her fifth birthday.
Among households living in the poorest quality accommodations in Africa, Asia and Latin America, the proportion of infants who live and die of infectious and parasitic diseases is several hundred times higher than for households in Western Europe or North America. Most of these deaths are due to diseases that are easily prevented or cured. In the South, diarrhoeal diseases remain among the major causes of infant and child death in many urban areas, although good housing conditions and health care could prevent this. Children are more vulnerable to respiratory disease, and a child weakened by frequent illness and poor nutrition is more vulnerable still. Acute respiratory infections, mainly pneumonia, remain the largest cause of death in many urban areas and are aggravated by poor ventilation. Even so, such infections are easily cured if diagnosed quickly and treated properly. A child who contracts bronchitis or pneumonia in the South is 50 times more likely to die than a child in Europe or North America. Measles and tetanus also remain major causes of child death yet both are preventable by immunization.
Gender inequality may in extreme cases lead to prenatal selection in favour of boys, or female infanticide. Men and boys often receive preference within households, including higher expenditures on medicines and health care when sick or injured. Girls nutritional and health needs, including immunization, often receive a lower priority than boys. These discriminatory practices have serious implications on how girl infants and young children cope with disease and the impact of environmental hazards. For children of the street, or abandoned children, hazards to health are obviously much greater. They generally have poor quality accommodation (often sleeping in the open or in public places) and difficulties in getting access to latrines, health services and places to wash and obtain drinking water. They are also exposed to child abuse, not least when child prostitution - and its corollary of sexually transmitted diseases - is one of the ways of ensuring sufficient income for survival.
The health of children is closely linked to that of the women who care for them. Illiteracy among women deprives them of information that is central to their understanding of how their bodies function and how they can prevent diseases and protect themselves - and protect their children. To address the health needs of women, those responsible for health care and for other aspects of the urban environment must reach a better understanding of womens needs and priorities. Between Habitat I, the first UN Conference on Human Settlements in 1976, and Habitat II in 1996, a critical change in emphasis occurred, away from stating what national governments should do towards a support of national and provincial governments to the initiatives of those living and working in cities. One such example is the range of innovations developed in Guatemala City within illegal settlements, which included women being chosen by their surrounding households to be trained as health promoters and new models of community-based care. Improving womens health depends not only on improved health services, housing and basic services, but also on meeting needs such as increased access to resources, education and employment and to the promotion of human rights and fundamental freedoms.