Unsafe Water Could make Latin America’s Shanty Towns an Epicenter of COVID-19

A grim consensus among public health experts seems to be taking shape around Latin America's impending COVID-19 crisis. While the region benefited from weeks of valuable forewarning in relation to the current hotspots in Europe and North America, the disease's rapid spread and the underlying realities of inequality in much of the region mean SARS-CoV-2 will soon be wreaking havoc across the Americas. As of May 10^th, Brazil had already confirmed well over 160,000 cases and 11,000 deaths, while neighboring Peru had identified nearly 69,000 cases and Mexico had counted just under 3,500 deaths.

Those numbers reflect a trend that has held true across much of the planet. While Mexico, Brazil, Peru, and Ecuador - the country that has witnessed the region's most horrific outbreak thus far - all have distinct political and social factors at play, each is home to a brand of urban poverty uniquely susceptible to this new and highly contagious disease. Developing countries worldwide are ill-prepared to stop the spread of SARS-CoV-2, but Latin America stands out with its combination of widespread informal urbanization and inequality of access to public services. Fully 22% of Brazil's population lives in slums and shanty towns, as do 11% of people in Mexico.

The tens of millions of people living in slums and shanty towns across Central and South America - be they the asentamientos of Guatemala, favelas of Brazil, or barrios of Venezuela - face similar challenges in terms of respecting the public health guidelines recommended as the best defense against the spread of COVID-19. Without clean running water, being able to wash one's hands for 20 seconds is a rare luxury. Similarly, when multiple families have to share the same cramped accommodations and more than half of the region's jobs are in the informal economy, social distancing and "working from home" are impossibilities.

Guayaquil foreshadows the disaster to come

Ecuador has already given its neighbors in South America a preview of the humanitarian catastrophe which could await these marginalized populations, with images of dead bodies and makeshift coffins shocking global audiences even as the primary epicenter of the pandemic remained on the other side of the Atlantic.

According to official statistics, the country has had just over 30,000 cases and 2,300 deaths, but those numbers reflect the limitations of testing in a developing country more than the actual death toll. As the New York Times found, the actual death toll in April was potentially fifteen times higher than that reported officially. Ecuadorian officials, to their credit, instituted mandatory confinement even more strict than in many European countries. Residents were barred from leaving their homes entirely after 2 PM and public transport was shut down entirely. The country's intensely divided politics and ongoing economic crisis, however, limited the government's capacity to support a housebound citizenry.

While the situation in Guayaquil has now improved, the city's stark economic inequalities between affluent and working-class communities showed how cramped and unsanitary housing conditions propel COVID-19 outbreaks. Years before the SARS-CoV-2 virus first surfaced, Guayaquil residents were already complaining about the highly polluted local water supply and the risks it presents for waterborne illnesses. Driving the contamination was the fact thousands of Guayaquil residents living in "informal settlements" were excluded from the privatized sewage network, meaning their untreated waste had nowhere to go but the Guayas river.

Clean water key to stopping COVID-19

The likelihood that COVID-19 can spread through human waste makes it all the more important that residents of informal communities in major Latin American cities like Guayaquil and Rio de Janeiro in Brazil have access to clean water for drinking as well as handwashing. The cramped conditions and economic deprivation of Rio favelas like the Rocinha make both stay-at-home orders and social distancing unfeasible. Unfortunately, for the impoverished residents of Rio's favelas, buying hand sanitizer can mean forgoing putting food on the table. Many do not have access to running water.

Then again, even those Rio residents connected to the municipal water system cannot necessarily trust the water that comes out of the tap. In January, Rio's water utility - Cedae - was forced to shut down a water treatment plant responsible for serving nine million people for 13 hours after finding dangerously high levels of detergent. The water crisis quickly turned bottled water into Rio's hottest commodity, with stores having to limit purchases and favela residents using what money they had to stock up alongside the rest of the city.

That history means the current emergency is just the latest reminder of the public health dangers posed by the lack of access to clean water in Latin America's largest cities. Much as in Guayaquil, expanding access among Rio's favelas to the municipal water and sanitation systems has been hampered by requirements that residents show proof they have paid property taxes. As favela resident Tiê Vasconcelos stated succinctly on Twitter in mid-March: "Having water in the favela to wash your hands is a luxury. You have no idea about our reality!"

Could the COVID-19 crisis now provide a lasting impetus for change, overcoming these bureaucratic obstacles to address one of the most obvious manifestations of inequality across the region? The pandemic has already upended political status quos across Europe and North America, transforming proposals like universal basic incomes from fringe ideas to state policy in a matter of weeks. For the poorest residents of Rio, Guayaquil, and many other cities in Latin America, simply having access to clean water and sanitation would be equally revolutionary.