The More the Merrier? Public Health in Third World Megacities.

by Rakesh Dara on February 19, 2014


By: Rakesh Dara

The overall growth of the human population in the past century has had a great impact on the population increase in metropolitan areas.  This “urban explosion” has caused a slew of problems.  A major concern is the standard of living in certain third world megacities, urban areas with a population of 10 million or more.  The subpar public health of these residents is caused by poor access to running water, air pollution, and basic sanitation.  More needs to be done, specifically education of the people, to obtain sustainable public health solutions in third world megacities.

Population growth has already made an impact on the standard of living available in underdeveloped megacities like Chennai, India and Shanghai, China.  “Such growth is already having a staggering impact on the ability of those municipalities to provide even the rudiments of a decent standard of living” (Nadakavukaren, 49).  This is ironic considering most people head for the city in hope for a comfortable lifestyle and instead are met with worse poverty than their rural counterparts.  Approximately one half of the world’s impoverished live in urban settlements.  “A large percentage of urban dwellers in developing countries are migrants who have brought their peasant culture with them” (Nadakavukaren, 50).  This rapid influx of uneducated migrants into metropolitan areas has dangerous public health implications.

Inadequate access to safe drinking water and sanitation facilities has affected the health of many poor individuals in urban settings.  This leads to issues such as diarrhea, malaria and cholera outbreaks.  For example, in the slum areas where space is limited and access to common sanitation is nonexistent, many families will share overflowing public latrines and will even resort to open ditches on the sides of roads.  This exposed fecal matter can then get trapped in the rainwater and lead into adjacent waterways causing an immediate public health threat.  Another public health threat is water related disasters such as floods and droughts.  In Chennai for example, India’s fourth largest city, “a prolonged drought during the early 1990’s resulted in the restriction of tap water provision to just two hours every two days” (Nadakavukaren, 50).  These problems have been identified by organizations like WHO and attempts at creating a sustainable lifestyle for these people has been approached.  For example, water supply and sanitation coverage was increased from 1990 to 2008.  “1052 million urban dwellers gained access to improved drinking water and 813 million to improved sanitation” (United Nations).  However during this same time period the urban population grew by 1089 million in that same time period!  It is important that education is given to these people so they understand the effect inclining growth rates have on their own health.  Sustainable public health relief in these areas is in vain if the birth rate continues to increase.

Air pollution is another big concern in impoverished megacities.  “The advent of the Industrial Revolution gave a tremendous impetus to the growth of cities, and the rate of increase has continued to accelerate ever since” (Nadakavukaren, 48).  Ironically enough, this revolution that attracted so many, is a cause for their gradual public health degradation.  Air quality has continued to worsen ever since the advent of the revolution by air pollution via fuel, oil, biomass, and coal combustion.  Transportation of the large amounts of people via buses and the shipment of goods via trucks has also grown exponentially, another cause of air pollution and poor public health.  It is imperative to note that this air quality is present in developed countries as well, however, it affects the impoverished more, simply because of the population density, commuting time, lifestyle, and exposure to the air.

It is easy to put a Band-Aid on these issues.  However really finding the root problem and changing the lifestyles of the impoverished city-dwellers is what is needed for a sustainable public health solution.  In my opinion, fixing the water and sanitation issues will require active government intervention.  The governments of these countries must educate their citizens and convince them to either move back to their rural areas and let the educated contribute to the social web, or strive for a more healthy lifestyle.  They must be educated about the effects of inclining birth rates and how their own children will have to deal with the public health issues in the future.  Air pollution is difficult to overcome because of the commerce, factory labor, and transportation necessary for a megacity.  However, working towards creating shelters with roofs would be a step in a positive sustainable direction by preventing respiratory diseases.  Creating a holistic public health model for third world megacities will not only benefit the people presently engulfed in this crisis, but will benefit their children and their children’s children.


Nadakavukaren, Anne. Our Global Environment: A Health Perspective. Prospect Heights, IL: Waveland, 2000. Print.

{ 7 comments… read them below or add one }

doudoun armani March 2, 2014 at 5:02 am

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Carmen Vienhage March 3, 2014 at 11:13 am

This article is very interesting and has a ton of great information. Very relevant to today’s world and a must read for many.


Basem Awad March 3, 2014 at 11:35 am

This was a great article. It gives good insight on the conditions outside of our country.


Jack Schmerold March 3, 2014 at 3:28 pm

Greatest article I’ve read in awhile. Amazing. Life changing.


Brad Lenke March 3, 2014 at 4:04 pm

Wow awesome article. It should be read by everyone.


Azman Rashid March 3, 2014 at 6:35 pm

Dara has done something rare: he has not only identified the situation in these third-world cities, but has proposed long-term solutions to benefit the next generation. Once again Rakesh (Rocky) has wowed audiences, I cannot wait for his next piece


Alvi Rahman March 3, 2014 at 6:54 pm

The writer Mr. Dara has performed an important service to the community by writing about this issue. I have learned a lot of about megacities in third-world countries and wow I am blown away by his amazing writing skills. He even embodies a solution for this issue! It has been a very long time I have seen such talented writing. Great read


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