Slums which are not given a recognition by the government are
termed as “non-notified slum” in India and Kaula Bandar in Mumbai is one of
them. These slums suffer from lack of legal rights and basic services such as
water, sanitation and security of tenure due to the ingrained barrier created
because of the non-notified status. In order to compare Kaula Bandar’s
statistics with other Mumbai slums, studies were done by India’s National
Family Health Survey-3 and it has been found out that Kaula Bandar lacks
several health and social outcomes including educational status, child health
and adult nutrition. An explanatory framework is therefore provided to justify
that being a non-notified slum, Kaula Bandar has to suffer poor health outcomes
due to absence of basic services. It is criminalization by the government of
activities necessary for fulfilling access to fundamental needs such as water,
toilets and shelter. Due to policy vacuum in such non-notified slums,
governance failure leads to poor health outcomes. So, India and other
developing countries need to establish and fulfil minimum humanitarian
standards in the non-notified slums.
In India, national
datasets have emphasized the problem of disparities in health and social
indicators between slum and non-slum population at a large scale but very few
studies have explored the inter-slum disparities to show the differences in
access to resources and health outcomes between slums of a given city. Variable
legal status is believed to be one of the factors in the eyes of the government
which leads to contribution to inter-slum health disparities.
There are no parameters for qualifying a slum as legal so
each state has different policies. But legal recognition by the government is
essential for receiving basic municipal services such as piped water, toilets
and electricity. There are two classes of slums: government recognized slums or
notified slums and government non-recognized slums or non-notified slums. As
per India’s 2008 National Sample Survey (NSS), approximately half of slums in
India and 45 percent of slums in Maharashtra are non-notified (Subbaraman et
In this paper, problem of inter-slum health disparities in
Mumbai are highlighted using the findings of Kaula Bandar and comparing data
between Kuala Bandar and other Mumbai slums captured by India’s National Family
Health Survey – 3 (NFHS-3). It has thus been shown that Kuala Bandar’s health
indicators are relatively worse than other Mumbai slums and there is a major
role of non-notified status in generating these poor health outcomes.
In the first section, brief introduction of Kuala Bandar and
a legal background of the slums in the city of Mumbai is presented followed by
the legal background of Kuala Bandar. Health and social outcome disparities are
then highlighted. In the fourth section, lack of government recognition and the
resulting health outcomes are reviewed individually followed by the conclusion.
& LEGAL BACKGROUND
is a non-notified slum with a population of 10,000-12,000 people and is located
on a wharf on Mumbai’s eastern waterfront (Subbaraman et al, 2012:644). More
than 50 years ago, it was established by Tamil migrants but now in the recent
years, more North Indians have been the migrants here.
Slum Areas Act of 1971 delineated rights to slum dwellers residing on
city-owned land in the state. The addendum also states that the city government
must extend basic amenities (such as water and sanitation) to slum residents
who have residency proof prior to 1 January 1995 whereas who arrived in Mumbai
after 1995 or who do not have residency proof are prohibited from legally
receiving basic facilities and security of tenure from the municipality.
Therefore, the 1995 rule has created inequality in access to resources such as
water and sanitation within slum communities.
has to face extra legal barriers in order to access resources since it is
located on the land which does not belong to the city government but to a
central government agency known as Mumbai port Trust (MbPT). Due to this, state
government cannot engage in the activities such as extension of water and
sanitation services to the slum without obtaining a document called No
Objection Certificate (NOC) from the respective government agency responsible
for the land of the concerned slum. But the government agencies do not provide
No Objection certificate due to the fear that extension of services by the
state government may support slum dwellers claims to land tenure. In simple
words, state government policies are not applicable on the land of Kuala Bandar
and the central government has not formulated any policy to fill the vacuum.
to these legal barriers, Kuala Bandar also has to go through some less tangible
obstructions to get access to the resources. The label of being a non-notified
slum has become the conceptual thought accordingly which government officials
view communities. Due to this, non-notified slums may prevent from extension of
resources and services to the slum even when the legal barriers do not
SOCIAL OUTCOME DISPARITIES
of living in Kuala Bandar are worse than other Mumbai slum. Kuala Bandar has a
higher proportion of migrants out of which Muslims form a major part. Large
number of houses are made built with poor quality materials, there is a very
low rate of ownership of assets such as refrigerator or television. There is a
huge gap in access to basic services such as the access to piped water is
present in almost all the NFHS slums but the household in Kuala Bandar
virtually have no access to water.
Kuala Bandar have limited access to non-shared toilets and high proportion of
adults defecate openly. High rate of people in the households there still use
biomass fuel for cooking which increases their health issues as the risk of
lung disease increases.
NFHS-3 report, there is a huge education gap for men as men who are illiterate
or uneducated are 3 times higher in Kuala Bandar whereas for women who are
illiterate or uneducated are 2 times higher than other NHFS slums.
child health indicator in Kuala Bandar is also worse than the other NHFS slums
as the infant mortality rate is even higher than 2 times and the rate of fully
immunized children are lower. High rate of children born are underweight and
very few number of children are born in a healthcare facility. The
institutional delivery that is the birth of a child in a healthcare facility is
important to note as this indicates the child health and maternal health and
signifies the mortality rate.
adult nutrition, about 32 percent of men in Kuala Bandar are underweight
compared to 25.6 percent in other NFHS slums whereas on the other hand, the
pattern observed is opposite in women as slightly less proportion of women are
underweight i.e., 20.3 percent compared to 23.1 percent and higher proportion
of women are overweight which is 37.1 percent compared to 25.1 percent in other
NFHS slums. Employment is believed to be one of the major reasons to explain
such trends. Kuala Bandar has a low rate of employment outside the homes
whereas in other slums women are employed as domestic workers which justifies
the higher percentage of overweight women in Kuala Bandar.
GOVERNMENT RECOGNITION AND THE RESULTING HEALTH OUTCOMES
section, the non-notified status of Kuala Bandar has been proved to be the
major factor for its relatively poor health and social indicators such as
access to water, access to sanitation and solid waste removal, access to
municipal schools, access to official documents, access to compensation
following disasters and forced eviction.
of access to water
the study done by NHFS-3 only 0.1 percent of households have access to
municipal water supply or taps compared to 99.7 other NHFS slums. This is due
to the non-notified status of the slum that prevents the residents from
accessing municipal water supply or taps and instead they have to purchase
water through private vendors living in the slum. They have to pay monthly fees
to these vendors for receiving and storing water in their homes but due to
inconsistent supply of water, majority of residents have access to water for
only three or more days. During system failure, which is due to raid of government
officials on vendors’ motors, residents obtain water by rolling 300 L drums up
to two km from a nearby community (Subbaraman et al, 2012:650).
A study done
during this system failure reveals that this informal water distribution fails
to fulfill even the most basic standards for health and social equity
indicators which includes water quality, quantity, cost, accessibility and
reliability and the sample collected from vendors’ motors were contaminated
with coliform bacteria.
organization (WHO) recommends minimum usage of 50 litres per capita per day
(LPCD) but in case of Kuala Bandar 48 percent (Subbaraman et al, 2012:651) of
the households did not even get 20 LPCD which indicates high health risk. Poor
quality and insufficient quantity of water results in poor health outcomes such
as diarrhea which leads to child mortality under the age of five and is a major
contributor to child malnutrition and in turn results in decreased educational
Kuala Bandar pay high water charges compared to other slums and spend 6-16
percent of their average monthly household income for the same according to the
NFHS-3 data. Hence, water insecurity in Kuala Bandar has an indirect impact on
health as it affects income, livelihood and education.
of access to sanitation
status of Kuala Bandar prevents its residents from government built public
toilets due to which 14 percent people practice open defecation and only 3
percent have access to non-shared toilet according to the data obtained by
study. Police arrest people who defecate by the sea and charge fine per person.
Open defecation Women have to usually cover long distances to access
pay-for-use toilets outside Kuala Bandar.
status of Kuala Bandar also prevents the development of sewer infrastructure due
to which excreta from the pay-for-use toilet blocks in Kuala Bandar empties
directly into the adjacent ocean. This has resulted in high fecal bacteria
count in the ocean water and 31 percent of residents have reported flooding in
their homes during monsoon season which expose them to the excreta. This leads
to increasing poor health outcomes such as increased diarrhoeal illness, child
death, malnutrition and poor cognitive function.
Insufficient solid waste collection
minimal solid waste collection in Kuala Bandar and this compromise is due to
lack of government recognition. Due to this, garbage is disposed of in the
surrounding ocean which has resulted in a giant mass of refuse extending
several meters into the ocean at low tide. Over last few years, JnNURM, a
central government initiative provides funding for social improvements.
many constraints in garbage collection service as municipal trucks do not
travel to the dumpsters located inside the slum and instead they collect
garbage from dumpsters located outside the slum. Most residents dump their
garbage in the ocean as the dumpsters are usually overloaded due to
unwillingness of garbage collectors and failure due to legal barriers to enter
has a major negative impact on the health of the residents due to growth and
spread of rats, flies and mosquitoes. Proximity to garbage dumps has resulted
in higher rates of helminth infections, child diarrhea, leptospirosis and
Hurdles in accessing electricity supply
company named BEST (Brihanmumbai Electricity Supply and Transport) used to
provide electricity meters to the residents of Kuala Bandar, as a result some
households established new electricity meters for which they used to pay. But
in recent years, BEST has refused to provide new electricity meters due to the
legal barriers in providing this service on central government land.
electricity wires, which cause electrocutions and overload fuse boxes have led
to severe health consequences. In addition to this, poor access to electricity
has an indirect impact on health, livelihood opportunities and educational
attainment as well.
Hurdles in accessing schools
the guidelines issued by the government of India in 1995, primary schools
should be located within one km for all children and there should be one
primary school per 3,000-4,000 people. But these standards have not been
fulfilled in Kuala Bandar and nearest primary school is more than two km away
whereas considering the guidelines, there should be five primary schools within
one km of Kuala Bandar.
There is a
huge difference between literacy and education between Kuala Bandar and other
NFHS slums due to difficulty in school access. Other resource limitations as
discussed earlier have indirect impacts on education such as water situation.
Nine per cent households reported that informal water distribution system
creates barrier for children to attend school as they miss school to roll back
drums from other communities to fetch water during system failure.
to education results in severe health consequences as studies from India has
revealed that mother’s education is one of the most important predictors of infant
and child mortality rate, immunization rates, nutritional status and
institutional delivery rates.
Trouble in accessing official documents
to notified slums, Kuala Bandar being non-notified slum have difficulty to
access official documents that facilitate civic rights and therefore have no
possibility of obtaining home ownership documents to establish security of
Kuala Bandar also have difficulty in obtaining ration card. PUKAR-HSPH-NYU
collaboration study analysis revealed that 33 percent of households did not
have a ration card and people such as tenants who are more vulnerable people
are even less likely to have a ration card. Application of ration card requires
residential proof which is not present with the residents of Kuala Bandar who
live in a situation of informality so it is almost impossible for the people
there to get a ration card.
ration card has an impact on the nutrition level of the people and as the
people are not able to get subsidized kerosene there is a higher usage of
unhealthy biomass fuel in Kuala Bandar. It is difficult for the residents to
obtain basic services and formal employment and also there is an impact on
health due to limited livelihood options and poverty getting deepened.
Inequity in compensation after disasters
Central government has no policy for providing
compensation to slum dwellers after disasters and once after a fire accident,
the only monetary assistance was given by local elected representatives from
the personal funds.
fire accident, 251 households were affected but only 164 were listed by
government and only 88 households got compensation. For 164 households
reported, loss of 8,729,500 rupees was estimated but only approximately
4,00,000 rupees were given as compensation with no additional support for
to Kuala Bandar, in Behrampada, a notified slum in Mumbai more than 1,100
shanties were burned down. Maharashtra government approved 650,00,000 rupees
per fire-affected household for rehabilitation which is 37 times greater than
households in Kuala Bandar (Subbaraman et al, 2012:657). So the consequences
are more severe in non-notified slums but the compensations are minimal.
slums are at an increasing risk of fires due to illegal electricity connections
and lack of legal water supply which makes fire handling difficult. Slum fires
may directly affect health due to loss of life, respiratory complications,
burns etc. Indirect impacts on health include negative affect on mental health
and deepening asset poverty.
eviction and loss of home
notified slums do not need to fear as they are protected from forced eviction
but it’s totally opposite for a non-notified slum as the residents there have
no legal protection against eviction or house demolition. Moreover, they have
no right rehabilitation whereas the government provides formal housing for
rehabilitation to residents of notified slums. Even forced eviction has impacts
on several health indicators such as mental health which may be difficult to
has numerous deficiencies compared to other Mumbai slums which is largely due
to the legal vacuum and its “non-notified” status. Even the basic human needs
required such as water, toilets and shelter are not provided to the residents
and there is criminalization of access to basic services and entitlements.
Residents of Kuala Bandar have suffered social and legal exclusion that
contained poor health outcomes as a major part embedded in it. These
difficulties and barriers were significantly due to the lack of government
recognition which further resulted in income and asset poverty. There’s a huge
inequality gap between Kuala Bandar and other slums in Mumbai as due the
non-notified status, residents of Kuala Bandar are not able to enjoy even the
minimal facilities and basic human needs that residents of other notified slum