AmeriCares – Creating Health and Hygiene Awareness in slum dwellers in Mumbai

Background:  The picture that conjures up in our minds, when we talk about slums, is that of a dirty, unhygienic cluster of impoverished shanties with long lines of people crowding around a solitary municipal water tap, bowling babies literally left on street corners to fend for themselves and endless cries emanating from various corners. Most of them are engaged in eking out their daily lives, always below the poverty line, by working as construction laborers, domestic helps, rag pickers and “chhotus” in neighborhood dhabas. Though their living conditions are utterly unhygienic, gloomy, dismal and dehumanized, many of them still dream of improving the quality of their lives

The majority of slum dwellers identify themselves with the city rather than with their native place and plan to settle permanently in the city. In spite of poor conditions in slums, second generation residents who are not nostalgic about their rural background – feel that life in slum is reasonably tolerable and city life is probably better than rural life. They greatly value improving their working situation through getting a better job, yet have low aspirations and have an optimistic view of their chances of improving their socio-economic status.

Urbanization has created a number of problems like shortage of housing, mushrooming growth of hutments, encroachment of public land and expansion of unauthorized residential colonies. The rapid growth of urbanization is creating a number of problems. Daily a lot of workers migrate to towns in quest of employment. With no proper place to live, they usually encroach public land and the sites earmarked for various developmental projects. This causes expansion of hutments and unauthorized colonies, thus building enormous pressure on civic services and creating major bottlenecks in the proper development of cities.

Problems in Slums:

People residing in slums face many problems like improper sanitation, unhygienic health & environmental conditions, social, economic, health, educational and cultural problems and many more. The basic problems inherent in slums are Health hazards. Lack of basic amenities like safe drinking water, proper housing, drainage and excreta disposal services, make slum population vulnerable to infections.

It is projected that more than half of the Indian population will live in urban areas by 2020 and nearly one third of this urban population will be slum dwellers. The ongoing process of rapid urbanization has deleterious repercussions on health and nutrition, especially for children. Malnutrition in young children has long-term negative effects on physical and cognitive development.

Poor sanitary conditions and poor quality of water lead to illnesses like diarrhoea and other water borne diseases, affecting the life expectancy of slum dwellers. According to a recent case study, water and sanitation diseases are responsible for 60 per cent of environmental health. Among water borne diseases, diarrhoea disproportionately affects children under the age of five. In turn, poor health among children adversely affects the attendance rate at schools.

In dense, overcrowded urban conditions it is often difficult for people to find space to build latrines. Many have to defecate in the open or share whatever limited facilities are available which tend to offer no privacy, safety or hygiene. Because of human waste and refuse collecting in stagnant pools spread disease and contaminate water sources. The problem is made worse during the rainy season when rubbish and excrement are washed into cramped living areas. In these conditions it is virtually impossible to remain healthy and clean. Diseases spread rapidly among the crowded conditions.

Breeding Ground for Diseases
Overcrowding in Slums

Poor Sanitation practices – breeding ground for mosquitoes

Hence there was a need to create awareness among this section of society and educate them on basic health issues.

The aim of health and hygiene education is to make people in slums aware of the importance of personal hygiene, clean drinking water, regular exercise & healthy and balanced diet. Simply organizing medical camps in urban slums is not enough behavioral change is also needed to ensure proper use and maintenance of the facilities and better hygienic behavior. In the fight against diseases, hygiene education, including hand washing, is the single-most cost-effective health intervention. Health, nutrition and hygiene education focuses on developing the knowledge, attitudes, values and life skills needed to make appropriate and positive health-related decisions. An active and participatory teaching approach is required in the promotion of life skills in the wider community.

The main objective of the exercise is to create awareness about the most prominent and serious health concerns that are aggravating in our population, such as diabetes, cardiovascular disease and high blood pressure, as part of our “Parivartan” mission.  Since a “Picture is worth a Thousand Words”, the educational materials, props and aids are mainly visual. Some textual material is translated in Hindi. The Visual Aids are exhibited in the Medical Mobile Vans during health camps and our Social Workers explain the message in vernacular languages. A record of all educational campaigns is maintained in a registerTo date, AmeriCares India Foundation has conducted awareness campaigns on health and personal hygiene benefiting a total of 2766 people. The medical camps are particularly oriented to the slum dwellers of Mumbai who are the most vulnerable to disease.

Woman filling water from a common tap.
Health & Hygiene Awareness Poster conceptualized by GSK Volunteer, Bhagesh
People listening with i
Our Social Worker talking to people on the need for good hygiene 
Using Visual aids to communicate the message

I am answering questions on basic cleanliness, personal hygiene & balanced diet.
Driving the message – “A Healthy Family is a Happy Family”.
I am answering questions on basic cleanliness, personal hygiene & balanced diet.
All smiles after an awareness session with children in a peri-urban Adivasi village. Hopefully, they will remember lessons on good hygiene and therefore good health.
Diabetes – Warning Signs and Risk Reduction


Health and hygiene awareness must be implemented among slum residents on an ongoing basis to achieve long lasting changes in behavior. This will ensure empowerment of people to improve their health.  


    1. Dan, thanks for your encouraging words. I am enthused more than ever, since only few weeks remain before the PULSE assignment comes to an end. I am looking forward to the visit in Muzzaffarpur, Bihar where there is a high incidence of Japanese Encephalitis. I shall keep you posted.

  1. Hi Ma’am,

    This is indeed a very positive step by Gsk volunteers for creating awareness among the low socio-economic class about the simplest and useful practices for maintaining hygiene and the importance of having balanced diet. However, the snag is not about being unaware of hygiene, but due to lack of facilities in those areas. This issue is the major hindrance in cultivating the good habits among them. Thanks for sharing your valuable experience with us.


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