Health, hygiene and appropriate sanitation: experiences and perceptions of the urban poor

“Don’t teach us what is sanitation and hygiene.” This quote from Maqbul, a middle-aged male resident in Modher Bosti, a slum in Dhaka city, summed up the frustration of many people living in urban poverty to ongoing sanitation and hygiene programmes. In the light of their experiences, such programmes provide “inappropriate sanitation”, or demand personal investments in situations of highly insecure tenure, and/or teach “hygiene practices” that relate neither to local beliefs nor to the ground realities of a complex urban poverty. A three-year ethnographic study in Chittagong, Dhaka, Nairobi and Hyderabad illustrated that excreta disposal systems, packaged and delivered as low-cost “safe sanitation”, do not match the sanitation needs of a very diverse group of urban men, women and…