India – Diseases prevention programme in slums

October 15, 2009 · 1 comment

  • More than 125 slums in Coimbatore brought under this programme
  • Use of public toilets by children being stressed

COIMBATORE: The Coimbatore Corporation has drawn up an elaborate programme for diseases prevention in the city’s slums. It has prepared a list of slums in the four zones and assigned health teams the task of educating the slum-dwellers on the various diseases that are caused by lack of hygiene.

The health wing of the Corporation is also concentrating on diseases such as malaria, dengue and chikungunya. That these vector-borne diseases can be prevented if breeding grounds for mosquitoes are eliminated is the message being given in all the slums.

More than 125 slums in the city have been brought under this programme. Even as the Corporation takes up a scheme under the Jawaharlal Nehru National Urban Renewal Mission to provide houses for the slum-dwellers, it wants to bring about hygiene in the present dwellings.

The objective is that by the time these slum-dwellers shift to the new tenements, hygienic practices should be in places.

A major focus in terms of personal hygiene is the prevention of open defecation. A specific programme is on to rid the slums of this problem. Health workers and officials are educating the people on the various health hazards from this practice. The use of public toilets by children is being stressed.

Assistant City Health Officer R. Sumathi says audio-video presentation on malaria, dengue and chikungunya is being made in the slums. Unsafe storage of water in open containers provides breeding ground for the mosquitoes that carry the malaria-causing parasite or the viruses that cause dengue and chikungunya.

This component of the disease prevention education programme points out that water scarcity compromises hygiene. While the scarcity affects cleanliness, it also leads to frantic storage – even in open containers. Ultimately, the objective is to create diseases-free slums in the city. With most of the slum-dwellers being conservancy workers, the Corporation wants to ensure that they are healthy first so that hygiene can be ensured across the city.

Source – The Hindu

UNICEF – Diarrhoea: Why children are still dying and what can be done

October 15, 2009 · 0 comments

NEW YORK, 14 October 2009 – Despite the existence of inexpensive and efficient means of treatment, diarrhoea kills more children than AIDS, malaria and measles combined, according to a report issued today by UNICEF and the World Health Organization (WHO).

View report: Diarrhoea – Why children are still dying and what can be done (PDF, 5.48MB))

The report, titled Diarrhoea: Why Children Are Still Dying and What Can Be Done, includes information on the causes of diarrhoea, data on access to means of prevention and treatment, and a seven-point plan to reduce diarrhoea deaths.

“It is a tragedy that diarrhoea, which is little more than an inconvenience in the developed world, kills an estimated 1.5 million children each year,” said UNICEF Executive Director, Ann M. Veneman. “Inexpensive and effective treatments for diarrhoea exist, but in developing countries only 39 per cent of children with diarrhoea receive the recommended treatment.”

Dr Margaret Chan, Director-General of WHO, said: “We know where children are dying of diarrhoea. We know what must be done to prevent those deaths. We must work with governments and partners to put this seven-point plan into action.”

Diarrhoea is a common symptom of gastrointestinal infection, which can have a variety of sources. However just a handful of organisms are responsible for most acute cases of diarrhoea and one, Rotavirus, is responsible for more than 40 per cent of all diarrhoea-related hospital admissions of children under five. A new vaccine for Rotavirus has been found to be safe and effective but is still largely unavailable in most developing countries.

Though most episodes of childhood diarrhoea are mild, acute cases can lead to significant fluid loss and dehydration. This dehydration can lead to death unless fluids are quickly replaced. Oral rehydration therapy is the cornerstone of fluid replacement and the new low-osmolarity formula of oral rehydration salts (ORS) is a simple, inexpensive and life-saving remedy that prevents dehydration in children suffering diarrhoea.

Some 88 percent of diarrhoeal deaths worldwide are attributable to unsafe water, inadequate sanitation and poor hygiene. As of 2006, an estimated 2.5 billion people around the world were not using adequate sanitation facilities, and about 1 in 4 people in developing countries practiced open defecation.

Access to clean water and good hygiene practices are extremely effective in preventing childhood diarrhoea. Hand washing with soap has been shown to reduce the incidence of diarrhoeal disease by over 40 per cent, making it one of the most cost-effective interventions for reducing child deaths caused by this neglected killer. Thursday October 15 is annual Global Handwashing Day when millions of children and adults in over 80 countries will take part in activities to highlight this key intervention.

The overall health and nutrition of children is also critical to their susceptibility to diarrhoea and the damage it can cause. Undernourished children are at higher risk of suffering more frequent, severe and prolonged episodes of diarrhoea, and repeated bouts of diarrhoea also place children at greater risk of worsening nutritional status.

The seven point plan to save the lives of children stricken by diarrhoea includes two treatment and five prevention elements.

The two treatment elements are:

1. fluid replacement to prevent dehydration; and
2. zinc treatments, which decrease the severity and duration of the attack.

The five prevention elements are:

1. immunization against rotavirus and measles;
2. early and exclusive breastfeeding and vitamin A supplementation;
3. handwashing with soap;
4. improved water supply quantity and quality; and
5. promoting community-wide sanitation.

Campaigns targeting childhood diarrhoea in the 1970s and 1980s achieved success by educating caregivers and scaling up oral rehydration therapy to prevent dehydration. The campaigns delivered promising results but following that success, focus shifted to other health problems. There is now an urgent need to shift attention and resources back to treating and preventing diarrhoea.

Urban Health Workshop – American Public Health Association Conference

October 15, 2009 · 1 comment

URBAN HEALTH IN DEVELOPING COUNTRIES: A MAJOR NEGLECTED AREA

Saturday, November 7 th, 2009, Philadelphia Convention Center Room 110B

Philadelphia, 8:30 am to 5:00 pm

Workshop Leader: Diana Silimperi

Urban health in developing countries is a major neglected area of public health. In the near future, more than half of the world’s population will live in urban areas with most of this population living in underserved neglected urban slums in developing countries. With the leadership of Diana Silimperi we aim to define the current status of urban health in developing countries, discuss what tools are currently used, and distinguish the particular needs of urban versus rural CBPHC. Using participant contributions we aim to grapple with the problem issues encountered in public health in this urban setting and what solutions are needed to address these problems.

Dr. Diana R. Silimperi is the Vice President of the Center for Health Services at Management Sciences for Health. She is a public health pediatrician and epidemiologist with 25 years of experience implementing primary health care in Africa, Asia, and Latin America for WHO, UNICEF and diverse bilateral donors. She was the Director of the Urban Volunteer Program in Bangladesh in the late 1980s, and spearheaded primary health care in the urban slums of Lagos. She is one of the founding members of the International Society for Urban Health (ISUH) and will be a keynote speaker at the Conference in Kenya this October.

Diana will be aided by a team of experienced international health facilitators. Activities will be facilitated to allow the maximum networking and discussion between participants. CBPHC is now an area with increasing prospects for young professionals. Those interested in international CBPHC are also invited to attend our business meeting on Tuesday 10th November at 5.00 pm at the Philadelphia Convention center. Young professionals are especially encouraged to attend.

To register contact: Sandy Hoar (e-mail: npaseh@gwumc.edu )

Registration including morning coffee $25 (students $20 payable at the door) To facilitate planning please register ASAP but certainly by October 24th and indicate if you will be joining us for dinner afterwards. For further information contact: Sandy Hoar or Paul Freeman (email: freeman.p.a@att.net) Chairman CBPHC-WG International Health Section.

Is Urban Waste the Solution to Tackling Climate Change?

October 15, 2009 · 1 comment

ScienceDaily (Oct. 3, 2009) — Converting the rubbish that fills the world’s landfills into biofuel may be the answer to both the growing energy crisis and to tackling carbon emissions, claim scientists in Singapore and Switzerland. New research published in Global Change Biology: Bioenergy, reveals how replacing gasoline with biofuel from processed waste could cut global carbon emissions by 80%.

Biofuels produced from crops have proven controversial because they require an increase in crop production which has its own severe environmental costs. However, second-generation biofuels, such as cellulosic ethanol derived from processed urban waste, may offer dramatic emissions savings without the environmental catch.

“Our results suggest that fuel from processed waste biomass, such as paper and cardboard, is a promising clean energy solution,” said study author Associate Professor Hugh Tan of the National University of Singapore. “If developed fully this biofuel could simultaneously meet part of the world’s energy needs, while also combating carbon emissions and fossil fuel dependency.”

The team used the United Nation’s Human Development Index to estimate the generation of waste in 173 countries. This data was then coupled to the Earthtrends database to estimate the amount of gasoline consumed in those same countries.

The team found that 82.93 billion litres of cellulosic ethanol could be produced from the world’s landfill waste and that by substituting gasoline with the resulting biofuel, global carbon emissions could be cut by figures ranging from 29.2% to 86.1% for every unit of energy produced.

“If this technology continues to improve and mature these numbers are certain to increase,” concluded co-author Dr. Lian Pin Koh from ETH Zürich. “This could make cellulosic ethanol an important component of our renewable energy future.”

Journal reference: Shi et al. The biofuel potential of municipal solid waste. GCB Bioenergy, 2009; DOI: 10.1111/j.1757-1707.2009.01024.x

Source – Science Daily

Ghana: Accra Urban Profile 2009

October 7, 2009 · 0 comments

United Nations Human Settlements Programme (UN-HABITAT). 2009. Ghana: Accra Urban Profile. (pdf, 2.6MB) Nairobi, HABITAT.

The urban profiling is a rapid and action-oriented urban assessment of needs and capacity-building gaps at national and local levels. It is currently being implemented in over 20 countries in Africa and the Arab states. The urban profiling uses a structured approach where priority interventions are agreed upon through consultative processes.The urban profiling methodology consists of three phases: (1) a rapid participatory urban profiling at national and local levels, focusing on governance, informal settlements, gender and HIV/AIDS, environment, and proposed interventions; (2) detailed priority proposals; and (3) project implementation. The urban profiling in Ghana encompasses profiles of Accra, Tamale, and Ho, each published as a separate report.

This report constitutes a general background, a synthesis of the four themes: governance, informal settlements, gender and HIV/AIDS, and environment – and priority project proposals.

Table of Contents
Executive summary 6
background 8
GOVERNANCE 13
slums 15
GENDER AND HIV/AIDS 17
ENVIRONMENT 20
PROJECT PROPOSALS Governance 23
Slums 25
Gender and hiv/aids 27
urban Environment

Save the Children – Two million Indian slum children die every year

October 5, 2009 · 1 comment

Two million slum children die every year as India booms

Save the Children says state-run health system is failing to give skilled care to poor. Child mortality rates have doubled in India’s slums. In Rajasthan, Surma lost her son Parmesh to easily preventable diarrhoea at only four years old. Source: Save the Children

Link to this video

India’s growing status as an economic superpower is masking a failure to stem a shocking rate of infant deaths among its poorest people.

Nearly two million children under five die every year in India – one every 15 seconds – the highest number anywhere in the world. More than half die in the month after birth and 400,000 in their first 24 hours.

A devastating report by Save the Children, due out on Monday, reveals that the poor are disproportionately affected and the charity accuses the country of failing to provide adequate healthcare for the impoverished majority of its one billion people. While the World Bank predicts that India’s economy will be the fastest-growing by next year and the country is an influential force within the G20, World Health Organisation figures show it ranks 171st out of 175 countries for public health spending.

Malnutrition, neonatal diseases, diarrhoea and pneumonia are the major causes of death. Poor rural states are particularly affected by a dearth of health resources. But even in the capital, Delhi, where an estimated 20% of people live in slums, the infant mortality rate is reported to have doubled in a year, though city authorities dispute this.

In the Bhagwanpura slum on the north-west fringes of the capital, numerous mothers have lost one or more infants in their first years of life through want of basic medical attention.

Akila Anees’s son, Mohammed Armann, who was almost three, died in her arms three weeks ago. A torrential downpour had flooded the slum, rainwater mixing with the raw sewage which fills the ink-black drains bisecting the narrow lanes. It rose to a depth of 2ft. Within days, Armann had fallen ill and died soon afterwards.

Save the Children says millions of mothers and their babies are simply not getting the skilled medical care they need, and the poor, in particular, have been left behind. “For many poor parents and their children, seeking medical help is a luxury and health services are often too far away,” said Shireen Miller, its head of policy and advocacy in India.

“The difference between rich and poor is huge. In a city like Delhi it is more stark because we have got state-of-the-art hospitals and women giving birth under flyovers. The health service has failed to deliver. They are supposed to reach the poorest, but they have not.”

India’s state healthcare system is supposed to be open to all, offering access to government-run hospitals. The reality is that, while government hospitals often offer high standards of care, they can be overcrowded, and if they are short of the required medicines patients are asked to pay for them themselves. In the meantime, private health care has surged and now accounts for the majority of India’s medical provision, giving access to world-class facilities for those who can pay or who can afford private insurance premiums.

According to the UK India Business Council, about 50 million middle-class Indians can afford private healthcare – a growing number but still a tiny fraction of the overall population – while the country still lags behind other developed countries, with only 0.7 hospital beds per 1,000 people compared with a global average of 4.

Many slum-dwellers are too far from hospitals to make use of their facilities, because they cannot afford to use private auto-rickshaws to reach them and there is no public transport. Instead they turn to quack doctors – a slightly cheaper option, but because they are unregulated and notoriously unreliable, one fraught with dangers.

According to the report, the national mortality rate for under-fives in the poorest fifth of the population is 92 in 1,000 compared with 33 for the highest fifth. The national average is 72.

A couple of hundred yards from Anees’s shack in Bhagwanpura, Gudiya, 22, sat holding her surviving daughter, Priya, two, amid scenes of abject squalor. Almost every square inch of the slum is covered in a layer of rubbish and human and animal waste. She has lost three children in four years.

Her most recent child, a boy, died two days after she gave birth at home, she said. “He cried, but it was feeble and he gradually turned cold. We wrapped him in blankets and took him to the hospital but I could feel he was getting weaker, and then I could see he was not breathing and there was no heartbeat and then the doctor said he was dead.” Three years ago her three-month-old son, Ahmit, died from pneumonia. A year earlier her five-month-old daughter, Kumkum, died after developing a fever.

Delhi’s health minister, Kiran Walia, has blamed migration into the city for its problems, but many poorer families simply feel that they are shut out by the system. Selma Shakil’s son, Muzzamil, died in July after she was turned away from a government hospital. He was a year old. She sat on the hard wooden bed in the tiny room in Bhagwanpura that is home to her two surviving children and her crippled husband and dabbed at her eyes with her headscarf.

“It was shattering for us. We were so happy when he was born, he was so happy and playful. I would give everything to get him back, but we can’t,” said Shakil, 27.

Muzzamil had been ill for months. Shakil had taken him to a government hospital three times; the first time they gave him medicine and sent her home, the second time he was admitted for a few days and then discharged, and the third time they turned her away. “They said they would not take him; they said, ‘You can’t keep coming here, the child will be fine’.”

The day he died the doctors told her he was sleepy because of the medicines he was taking. She went home, but then he started groaning. “His breath was shallow, and that was when I realised it was too late. I took him in my arms. He opened his eyes once and said ‘Ammi’ [mummy] and that was it. He died in my arms.” They buried him the same evening.

The Save the Children report says nearly nine million children die worldwide every year before the age of five. India has the highest number of deaths, with China fifth. Afghanistan has the dubious distinction of featuring in the top 10 of total child deaths and of child deaths per head of population, a list topped by Sierra Leone.

The charity accuses the world’s leaders of a scandalous failure to meet the Millennium Development Goals, agreed in 2000, to cut child mortality by two- thirds between 1990 and 2015 and calls for a sharp increase in health spending.

Source – http://www.guardian.co.uk/world/2009/oct/04/india-slums-children-death-rate

Nutrition in India

September 30, 2009 · 1 comment

Fred Arnold, Sulabha Parasuraman, P. Arokiasamy, and Monica Kothari. 2009. Nutrition in India. National Family Health Survey (NFHS-3), India, 2005-06. Mumbai: International Institute for Population Sciences; Calverton, Maryland, USA: ICF Macro.

Full-text: http://www.measuredhs.com/pubs/pdf/OD56/OD56.pdf

This report provides clear evidence of the poor state of nutrition among young children, women, and men in India and the lack of progress over time, based on measurements of height and weight, anaemia testing, testing for the iodization of household cooking salt, utilization of nutrition programmes, and information on child feeding practices and vitamin A supplementation. Young children in India suffer from some of the highest
levels of stunting, underweight, and wasting observed in any country in the world, and 7 out of every 10 young children are anaemic. The percentage of children under age five years who are underweight is almost 20 times as high in India as would be expected in a healthy, well-nourished population and is almost twice as high as the average percentage of underweight children in sub-Saharan African countries. Although poverty is an important factor in the poor nutrition situation, nutritional deficiencies are widespread even in households that are economically well off. Inadequate feeding practices for children make it difficult to achieve the needed improvements in children’s nutritional status, and nutrition programmes have been unable to make much headway in dealing with these serious nutritional problems.

Adults in India suffer from a dual burden of malnutrition (abnormal thinness and overweight or obesity). Almost half of Indian women age 15-49 (48 percent) and 43 percent of Indian men age 15-49 have one of these two nutritional problems. Although the percentage of women and men who are overweight or obese is not nearly as high as it is in many developed countries, this is an emerging problem in India that especially
affects women and men in urban areas, those with higher educational attainment, and those living in households in the highest wealth quintile.

India – Health and living conditions in eight cities

September 30, 2009 · 0 comments

Kamla Gupta, Fred Arnold, and H. Lhungdim. 2009. Health and Living Conditions in Eight Indian Cities. National Family Health Survey (NFHS-3), India, 2005-06. Mumbai: International Institute for Population Sciences; Calverton, Maryland, USA: ICF Macro.

Full-text: http://www.measuredhs.com/pubs/pdf/OD58/OD58.pdf (pdf, 3.46MB)

This report analyzes health and living conditions in eight large Indian cities (Chennai, Delhi, Hyderabad, Indore, Kolkata, Meerut, Mumbai, and Nagpur). The report is based on data from India’s 2005-06 National Family Health Survey (NFHS-3). A special feature of NFHS-3 is that the sample was designed to allow separate estimates of population, health, and nutrition indicators to be generated for each of these eight cities, as well as for the residents of slum and non-slum areas in these cities. In addition, a wealth index was constructed for households in urban India as a whole, using NFHS-3 data on household assets and housing characteristics.

For the purposes of this report, the urban poor population is defined as those persons belonging to the lowest quartile on this wealth index. The study examines the living environment, socioeconomic characteristics of households and the population, children’s living arrangements, children’s work, the health and nutrition of children and adults, fertility and family planning, utilization of maternal health services,
knowledge of HIV/AIDS, attitudes of adults toward schools providing family life education for children, and other important aspects of urban life for the eight cities by slum/non-slum residence and for the urban poor

The analysis shows that more than half of the population in Mumbai lives in slums, whereas the slum population varies widely in the other seven cities. Major differences in the estimation of the size of the slum population are found depending on how slum areas are defined (according to the 2001 Census designation or observation of the area by the NFHS-3 team supervisor at the time of the fieldwork). The poor population in these cities varies within a narrower range, from 7 percent in Mumbai to 20 percent in Nagpur. The analysis finds that a substantial proportion of the poor population does not live in slums and that a substantial
proportion of slum dwellers are not poor (that is, they do not fall into the bottom quartile on the NFHS-3 wealth index). In some cities, the poor are mostly concentrated in slum areas, whereas the reverse is true in other cities.

Although slum dwellers are generally worse off than non-slum dwellers, this pattern is not consistently true for all indicators in every city, and the differentials are quite small in some cases. However, there are large disparities in health and living conditions between the poor and the non-poor in these cities. Although there is an obvious need to improve living conditions and the health of slum dwellers, it is equally apparent that programs that focus solely on slum areas will not be able to address the urgent needs of the large poor population not living in slums.

India – Chronic growth faltering amongst a birth cohort of Indian children begins prior to weaning

September 29, 2009 · 0 comments

Chronic growth faltering amongst a birth cohort of Indian children begins prior to weaning and is highly prevalent at three years of age.

Poor growth of children in developing countries is a major public health problem associated with mortality, morbidity and developmental delay. We describe growth up to three years of age and investigate factors related to stunting (low height-for-age) at three years of age in a birth cohort from an urban slum.

Method – 452 children born between March 2002 and August 2003 were followed until their third birthday in three neighbouring slums in Vellore, South India. Field workers visited homes to collect details of morbidity twice a week. Height and weight were measured monthly from one month of age in a study-run clinic. For analysis, standardised z-scores were generated using the 2006 WHO child growth standards. Risk factors for stunting at three years of age were analysed in logistic regression models. A sensitivity analysis was conducted to examine the effect of missing values.

Results: At age three years, of 186 boys and 187 girls still under follow-up, 109 (66%, 95% Confidence interval 58-73%) boys and 93 (56%, 95% CI 49-64%) girls were stunted, 14 (8%, 95% CI 4-13%) boys and 12 (7%, 95% CI 3-11%) girls were wasted (low weight-for-height) and 72 (43%, 95% CI 36-51) boys and 66 (39%, 95% CI 31-47%) girls were underweight (low weight-for-age). In total 224/331 (68%) children at three years had at least one growth deficiency (were stunted and/or underweight and/or wasted); even as early as one month of age 186/377 (49%) children had at least one growth deficiency.

Factors associated with stunting at three years were birth weight less than 2.5 kg (OR 3.63, 95% CI 1.36-9.70) ‘beedi-making’(manual production of cigarettes for a daily wage) in the household (OR 1.74, 95% CI 1.05-2.86), maternal height less than 150cm (OR 2.02, 95% CI 1.12-3.62), being stunted, wasted or underweight at six months of age (OR 1.75, 95% CI 1.05-2.93) and having at least one older sibling (OR 2.00, 95% CI 1.14-3.51).

Conclusions: A high proportion of urban slum dwelling children had poor growth throughout the first three years of life. Interventions are needed urgently during pregnancy, early breastfeeding and weaning in this population.

Author: Andrea Rehman, Beryl Gladstone, Valsan Verghese, Jayaprakash Muliyil, Shabbar Jaffar, Gagandeep Kang – Source: Nutrition Journal 2009, 8:44

Swine-Flu Slaughter Leaves Cairo Without Pigs to Devour Trash

September 29, 2009 · 1 comment

Sept. 29 (Bloomberg) — Egypt’s pigs are getting their revenge.

Five months after anxiety about swine flu prompted Egyptian President Hosni Mubarak’s government to order the slaughter of all the country’s 300,000 hogs, the organic waste they once devoured is piling up on Cairo’s streets, contributing to a garbage crisis.

The government’s action destroyed the livelihood of about 70,000 families known as zabaleen, who were freelance trash collectors and urban pig farmers. It forced all pork processors and retail outlets to close and created a potential health hazard as neighborhoods reek of decaying garbage. Some residents, concerned that yesterday’s discarded kebab might become tomorrow’s cholera outbreak, are burning refuse in bonfires.

“No one took into consideration the economics, much less the environmental problems” the pig cull would create, said Magdi Fouad, 47, whose pork-processing and sales business, founded by his grandfather in 1945, was wiped out overnight.

To locate the impact on Mohandessin, an upscale area on the Nile River’s west bank, follow the flies. Gobs of moldering meat and vegetables lie wedged between parked cars, clustered against lamp posts and clumped under bushes. Dumpsters are rare; people customarily placed refuse in bags outside their front doors for pickup. Building superintendents try to keep them from tossing it into the street.

“You could always count on the zabaleen,” said Fayez Aissa, 51, who oversees an apartment block. “They came every day, took everything. Now rats and snakes are hiding in our garbage.”

Harvesting Rubbish

Zabaleen — trash collectors in Arabic — are rural migrants who have harvested Cairo’s rubbish since the end of the 19th century. Families in the central district of Embaba and in Manshiet Nasr, an outlying neighborhood, were dedicated to picking up trash and sorting organic matter from metal, glass and paper.

They disposed of as much as 80 percent of organic waste, feeding it to the hogs, which often lived in sties next to zabaleens’ homes along undrained dirt lanes. Families made money from recycling and from selling pigs to meat processors.

The Agricultural Ministry ordered the pigs eliminated in April, after the outbreak of H1N1 virus in Mexico and the U.S. Police clubbed the pigs to death and bulldozed them alive under desert sand. The United Nations Food and Agriculture Organization called the action a mistake, partly because no link was proven between pigs and transmission of flu.

Islamic Rules

Parliament had clamored for the cull. Zabaleen are Coptic Christian, 10 percent of Egypt’s overwhelmingly Muslim population. Pigs and pork are taboo under Islamic rules, and Copts complained the ministry’s order was based on religious bias. Some zabaleen rioted in protest.

No Egyptian came down with flu before the slaughter began. Since then, 891 cases have been reported, including two deaths, according to the World Health Organization.

In 2003, city districts hired foreign firms with trucks and compactors to collect garbage as part of Egypt’s privatization drive. The enormity of the job still left plenty for the zabaleen, who would climb stairs in apartment buildings without elevators, haul down trash bags and navigate alleys too narrow for trucks.

Tons of Trash

Cairo produces 14,000 tons of rubbish a day; the zabaleen handled half, said Laila Iskandar, 62, an expert in grassroots development and chairperson of CID Consulting, a Cairo-based marketing, management and communications firm.

Now that the pigs are gone, many families have stopped picking up the trash. Some are also abandoning the recycling business, because without hogs, the tedious work of sorting through paper, cans and bottles isn’t worthwhile, said Samir Saber, 48, a zabaleen who raised pigs and a member of the Garbage Collectors and Transporters Association in Embaba.

“Now there’s nothing,” said Saber, who spends his time in cafes. He said the government paid him between $10 and $50 for each pig he lost, depending on its size; meat processors would give him as much as $200.

Compounding the rubbish problems, International Environmental Services, contracted six years ago by Cairo’s Giza district to collect garbage, suspended operations last month in a financial dispute, said Ahmed Nabil, the company’s general manager. That left no one to haul away any waste in large parts of the capital, which has 17 million people.

‘Cash-Flow Problems’

IES, with offices in Cairo’s Dokki district, resumed work the week of Sept. 14, even with the “cash-flow problems,” Nabil said. Giza officials didn’t respond to requests for comment.

Agriculture Minister Amin Abaza defended the cull, saying the H1N1 virus might combine with the H5N1 bird-flu virus to produce a new strain.

“We had been planning to get rid of the pigs for three years,” he said in an interview. “The swine-flu fears gave us the opportunity.”

Eliminating the pigs may create other hazards, said Abd-el Rahman Shaheen, spokesman for the Health Ministry.

“If the garbage problems continue, the organic waste can be a source of infectious diseases,” he said.

The zabaleen are scrambling to pool their resources, said Gamil Aweida, an Evangelical preacher who works with the families. Some want to open a grocery store or buy a taxi — “anything they think will make money,” he said.

Source – http://www.bloomberg.com/apps/news?pid=email_en&sid=aMODvyHlOBAE#

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