Media statement

Visions & voices from people living in urban poverty – a community’s photographic portrayal of living conditions and health hazards

Professor Mathee, Director of the Medical Research Council’s Environment & Health Research Unit, today said that in 1900, only 10% of the world’s people lived in urban settlements. Now more than 50% of the global population lives in cities, and it is expected that by 2050 75% of the planet’s people will live in cities.

Amongst the highest urbanization rates are found in African countries. However, in contrast to the urbanization process that occurred in Europe and the USA around the industrial revolution in the late 1800s (which was associated with an overall increase in wealth), growth in the cities of African countries is occurring mainly in settings of poverty, such as degraded inner city areas and informal settlements.

While the concentration of people in cities ought to make it easier and cheaper to provide housing and services, delivery is not always certain. Around 60% of South Africa’s people already live in urban areas; nevertheless, city authorities in the country struggle to keep pace with the demand for housing, water, sanitation, safe fuels, education, health, shopping and recreation facilities and services for new arrivals in both large and smaller cities in the country.

For the past seven years, under the umbrella of the World Health Organization Collaborating Centre for Urban Health (WHOCCUH), four institutions (the Medical Research Council, the University of Johannesburg, the University of the Witwatersrand and the City of Johannesburg) have been responding to the global call for research to unmask the hidden health consequences of rapid or unplanned urbanization, especially for those living in urban poverty. In 1997 the WHOCCUH initiated a long-term urban health study (the Health, Environment and Development, or HEAD study) in five sentinel settings of relative poverty in Johannesburg – Bertrams, HIllbrow, Riverlea, Bramfishcerville and Hospital Hill. The findings generated over the past seven years have been invaluable in painting a picture of emerging environment and health challenges associated with urban poverty, said Professor Mathee, including:

• the identification of a virtual epidemic of hookah pipe smoking in certain neighbourhoods. Of particular concern is the mistaken, yet apparently widely held belief that hookah pipe smoking is safer than cigarettes or that it is protective of health;
• that food insecurity and hunger are major concerns in certain communities, with a decline especially in the consumption of fruit and vegetables;
• that rodent infestations are a major cause of concern in the majority of communities, with concomitant, widespread and regular use of pesticides. The affected communities face multiple health hazards, including rodent bites, an elevated risk of disease transmission, an elevated risk of pesticide poisoning and the long term health consequences of chronic exposure to pesticides;
• levels of inter-personal violence (gunshot wounds, stabbing, rape and severe assault) are more than three times higher than levels of unintentional injuries (such as traffic-related injuries, drowning, poisoning and injuries from falls) in the HEAD study communities;
• levels of common mental disorders (such as depression and anxiety) are high, mental health services are weak or absent in poor urban communities.

Mathee said that in the past year, with funding from the Wellcome Trust, researchers from the Medical Research Council and the University of Johannesburg have been able to supplement the quantitative data collected through the HEAD study, with communities’ own depictions of their daily lives and living conditions, collated through a photography project. Professor de Wet, from the University of Johannesburg’s Centre for Anthropological Research explained that “community members were provided with cameras and asked to photograph the best and worst aspects of their daily lives. The result has been an invaluable and rich portrayal of the challenges of daily community life in settings of poverty, in the assessment and words of people themselves,” she added.

Professor de Wet went on to say that the Visions and Voices Community Photography Exhibition will be launched as a side event to the 2012 Helen Joseph Memorial Lecture, which this year is to be delivered by Advocate Thuli Madonsela. The launch will take place at 17.00 on 21st August 2012, at the FADA Building on the Bunting Road Campus of the University of Johannesburg, and will be followed by Advocate Madonsela’s lecture at 18.00, which is titled “Following in the footsteps of Helen Joseph: the place of South African woman leaders in our democracy”.

A sample from the visions & voices community photography exhibition

Figure 1. Sick Lady, by Thapelo Mabaso

This photograph was taken in the informal settlement of Hospital Hill in Lenasia.

The photographer says “This photograph is a disgrace on us as a community and on the government. This lady is sick, poor, hungry and trying to make a living by recycling rubbish but we have isolated her and turned a blind eye. Also the government, although it claims to be helping people, has forgotten her. The most vulnerable should be identified and provided with assistance. This picture should set an example that we never want to see this again. Instead we should see a picture of a woman who is happy and eating food despite the fact that she is sick.”