The Baltimore Sun

Last week, the low-budget film Slumdog Millionaire received eight Academy Awards, including Best Film. Slumdog tells a story of success and love of a child from the slums of Mumbai, India. It warmed the hearts of the world. But in reality, most slum-dwellers continue to face desperate living and health conditions. The international health community knows that most slum stories do not have a happy ending.

Experts agree that the world is rapidly urbanizing: Three of five people are expected to live in urban areas within the next 25 years, and 95 percent of urban growth will be in the developing world - with most of that growth occurring in slums. About 1.2 billion people live in slums. Africa is now surpassing Asia as the fastest-urbanizing continent, where 72 percent of urbanites are slum-dwellers.

We at Jhpiego, an affiliate of the Johns Hopkins University specializing in the health care of women and their families, hope the film's success will call attention to the needs of slum-dwellers worldwide. We believe that we must pay greater attention to this growing issue, which the United Nations highlighted in a comprehensive report in 2003.

Jhpiego's urban slums expert in Baltimore, Stuart Merkel, has worked with a team of colleagues to manage several programs that address the health care needs of people in urban slums. In Africa, for example, Jhpiego has spearheaded strategies including peer education, support groups and community mapping to meet the health needs of the very poor.

Mr. Merkel says, "People from the slums in Haiti, to Mumbai, to Nairobi are living in squalor with limited or no access to health care, clean water or sanitation. ... [but] effecting change in these areas is possible."

Leslie Mancuso is the president and CEO of Jhpiego. More information about Jhpiego's work in urban slums is available at

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