Disasters cost an annual $520 billion and impoverish 24 million people. Focusing on urban centers small and intermediate in size, a senior fellow at IIED and visiting professor at the Development Planning Unit at the University College London, David Satterthwaite conducted a study published in the December 2017 issue of International Journal of Disaster Risk Reduction titled “The impact of urban development on risk in Sub-Saharan Africa’s cities with a focus on small and intermediate urban centres,” that examines risk and urban development in Sub-Saharan Africa.

According to the study, there is little literature on small urban centers in sub-Saharan Africa, with big cities taking the center of attention in urban studies. Sub-Saharan Africa’s urban population grew from just 19 million inhabitants in 1950 to 294 million in 2010, and is projected to grow to 621 million by 2030. Satterthwaite argues that the future will see rapid urbanization in small and intermediate urban centers in Sub-Saharan Africa, backing his argument with calculations of urbanization rates in big cities like Lagos and Greater Johannesburg – which are slowing – in comparison to smaller urban cities.

A woman cooks in sub-Saharan African city Karonga, Malawi.

A woman cooking in Karonga District, Malawi. CC: Swathi Sridharan (ICRISAT)

Satterthwaite finds that many small urban centers are characterized as administrative cities and towns, with significant percentages of their populations working directly or indirectly with the governmental bodies established there, such as in health care, hospitals, schools, postal services, the police, and courts. Among the many other economic underpinnings of small urban centres are mining enterprises, tourism, border posts, river or land ports – the latter being key nodes linking local settlements to larger markets.

Even though small and intermediate urban centers are also at risk of natural disasters, a case study on a Malawian intermediate urban center, Karonga, highlights how everyday risks may be causing more premature deaths than disasters. Everyday risks include traffic accidents, drought, drowning, animal attacks, cholera, and injury caused by politically-linked or gender-based violence. Records from Karonga District Hospital show 67 tuberculosis-related deaths and 32 respiratory disease-related deaths – mostly of infants and young children – in 2014.

Market in Lagos, sub-Saharan Africa.

Market in Lagos, Nigeria. CC BY 2.0

The study finds that large sections of Sub-Saharan Africa’s urban population face health problems due to the absence of risk-resilient infrastructure and services, including very high infant, child and maternal mortality rates. The causes include very poor quality and over-crowded living conditions and the lack of provision for safe, regular, affordable water, good quality sanitation and household waste collection, health care, schools, and emergency services.

Satterthwaite argues that the reason behind the lack of infrastructure is the financial challenges that small and intermediate cities face. Most cities in Sub-Saharan Africa have very limited financial resources, therefore depend on national government and international agencies. However, most national governments have been reluctant to fund urban initiatives or urban governments, sometimes for political reasons, because most members of Sub-Saharan African parliaments with rural constituencies or urban centers are governed by opposition parties. International financial sponsors, on the other hand, don’t prioritize tackling urban problems.

“We know that the absence of risk reducing infrastructure and services, poor quality, overcrowded housing and use of dirty fuels greatly increase risks of premature death, serious illness and often injury in urban areas,” Satterthwaite writes. “Although most of the documentation of this lack of urban infrastructure and services in Sub-Saharan Africa is for relatively large cities, there is no reason to think that this does not apply to smaller urban centres – smaller concentrations of urban populations, especially high density concentrations.”

He warns, however, that the absence of city-oriented data available on what the most serious environmental health problems are and who is most at risk socially and spatially, assumptions will often point to inaccurate priorities both for action and for research.