Introduction
Urbanisation is a major demographic trend globally. Informal settlements, which account for much of global urban growth, are especially vulnerable to ill-health because of poor environmental and socio-economic conditions. The water cycle is a critical factor exacerbating the linked challenges of poor environmental quality and poor human health. The conventional hydraulic water engineering solution to these challenges has changed little in 150 years and comes at major financial, environmental, and social costs, and is an unlikely option for informal settlements as their rate of growth increases.
Methods
Supported by the Wellcome Trust’s ‘Our Planet Our Health’ programme, this five year randomised controlled trial will quantify the human health, environmental, economic and social benefits of an alternative, more holistic and modular water-sensitive approach to revitalization processes. With capital funding provided by the Asian Development Bank, the project will supply new infrastructure and housing to 24 informal settlements across Indonesia and Fiji as an alternative to conventional approaches. This approach involves providing the urban poor with more sustainable water supply, sanitation, flood protection, environmental stewardship and greater resilience in the face of climate change. This will be achieved through the provision of novel green technologies (such as wastewater wetlands and nature based stormwater biofiltration systems) and green urban design and architecture, from the scale of the house to that of the precinct.
Results/Conclusions
Findings
The project will assess environmental and human health conditions in revitalized and control communities in order to provide data on the efficacy of this alternative water-sensitive approach. This will involve testing soil and water environments for microbial diversity, drug-resistant gene markers and pathogens, and concurrent testing of faecal specimens from children under five years old living in the settlements using identical genomic and pathogen testing, as well as specific measures of intestinal inflammation.
Conclusion
This interdisciplinary project seeks to provide an evidence-based assessment of the efficacy of the water sensitive approach in revitalising informal settlements poorly served by water infrastructure in the Asia-Pacific. This project aims to deliver the first public health and environmental data on the outcomes of an alternative water management approach, and potentially the basis for new water infrastructure policies and investment strategies for informal settlements. We anticipate that the changed physical environment and improved water-servicing will also lead to enhanced psychological, social and economic outcomes, resulting in further benefits to human health and wellbeing.