Category Archives: Uncategorized

Favelas in Rio de Janeiro

Brazilian urban slums, known as favela, resulted from rapid urbanization in Rio de Brazil, and present many health and safety problems but the government failed to improve the situation because of housing crisis, unevenly divided resources in Rio, and inefficient programs.

Located on the outskirts of countries’ largest cities, like Rio de Janeiro, were originally formed by impoverished former slaves in the late 19th century, but proliferated by migration from 1940s to 1970s.

From 1950 to 2015, the percentage of Brazilian population living in urbanization jumped from 36.5% to 87.5% and it is estimated that by 2030, up to 90.5% of the population will live in cities. As Brazilian government try to expand metropolises, the rural poor found themselves relegated below the elite in the city center. The poor squeeze into urban areas for job opportunities, higher qualities of education, and health care but it turns out they may live in crowded and dangerous favelas. For example, approximately two million individuals, 22.03 percent of population, live in favelas of Rio De Janeiro.

Social Divides and Urbanization in Brazil

Favelas in Rio are dangerous and crude; they are built on steep slope where buildings can’t be built on. They are mainly made of cardboard, corrugated iron or scrap wood, which offer little protection from elements and can’t support homes safely. Majority of them lack in water, electricity or a safe means of sanitation so favelas are susceptible to disease outbreaks. They are always far from shops, schools or transportation routes as well.

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Rocinha is the largest favela in Rio de Janeiro. It is estimated that anywhere from 150 thousand to 300 thousand residents crowded in the 0.8 square miles of Rocinha. Houses in Rocinha are built nine, ten, or eleven stories tall to fit 21 neighborhoods.


Due to lack of infrastructure, especially sanitation, Rocinha is ranked 120 out of the 126 neighborhoods in Rio on the Human Development Index. People in Rocinha suffered from tuberculosis and other contagious diseases as other favelas. Another major problem with Rocinha is that the population of Rocinha is younger and less educated than other favelas. Violence is a major concern here. Due to Wrld Cup and Olympics in 2016, Rocinha’s young population connects more to the world around and looks for a better future with better education, less violence and less disease.


Cities lack enough spaces to accommodate migrant people and the situation is worsened by the Brazilian housing crisis. The housing shortage around 7 million units, most among those earning less than minimum wage.  In fact, Brazil has enough housing but the most housing estates exist vacant in urban centers for real-estate investment. Housing investments exist mainly in more wealthy urban areas where favela residents can’t afford. The resources that are supposed to be devoted to favelas remain stagnant in city centers.

The Brazilian government has run multiple programs to eliminate or reduce favela violence problem in Rio but they all failed. In 1930s and 40s, the government launched a favela removal program to redistribute all the favela residents but it failed to solve the root problem of Rio’s housing shortage. The favela’s population continued to grow steadily during 1960s, 60s, and 70s. The government constantly redistributed residents during these years but the result wasn’t satisfying. As a result, the government officials eventually decided that a complete elimination of favela was impossible. In 1998, the Pacifying Police Unit(UPP) program was launched, which stationed 9,500 officers in 37 favelas, serving nearly 780,000 people.

It sought to end violent confrontation between rival gangs by getting weapons out of the favelas and maintaining a permanent police presence. At first the program worked and the homicide rates went down largely.

But overtime police officers have gradually reduced the practice of community policing and become more repressive. Tension between the police and residents rose. By 2015, armed gangs had returned to once-pacified favelas and the UPPs were disappearing. Police also feel frustrated in favelas because they found themselves helpless and had to choose between daily shootouts and a coexistence between gangs and police.  Police again tend to use violence and gun shooting to force arrests. 

Due to Brazil’s economic crisis, police haven’t been paid in months so that also kidnap suspects, take bribes and negotiate to save lives of criminals. The violence and crossfire in favelas isn’t fundamentally resolved up until today.

Favelas in Brazil is still an urgent issue for Brazilian government to settle. Without proper measures to reduce the number and stop the violence inside, it will only get worse and hurt the benefits of citizens living in the inside circle.

Urbanization in Peru

Urbanization in Peru causes a big internal migration. People that live in rural areas migrate closer the urban areas both legally and illegally and start settling and building the houses around the urban areas without official papers. Once the houses are united together as a neighborhood, municipality starts to give them the official papers for their lands.


Urban population has been gradually increasing every year. In 2016, 78.92% of the total population live in urban area. Peru is mountainous and hilly, people build their houses everywhere they could near the cities. More than half a million of Peruvians, who live in a suburban area of Lima, is suffering and killed from mud sliding.


Internal migration makes Lima, the capital city of Peru, and other cities overpopulated, and forces people to live in poor conditions. Wastewater and sewage from houses contain a high level of nutrients, cause algae and weed growth when they mix in the water. Water sources around the areas lack oxygen and living things in the water can be killed. Drinking water sources are also polluted by algal blooming. Consuming the water can cause serious health problems in human, such as respiratory problems, stomach and liver illness, and rashes. Using of fertilizers contaminate drinking water, babies who consume water that is high in nitrates can become ill with a blue-baby syndrome, which can lead to death if not treated early enough.



The unemployment rate is at the highest point in the past decade, it has been increasing since 2012, and seems to continue increasing. The amount of jobs doesn’t cover all the population that has been moving to the city areas.


Peru’s capital city, Lima, has the worst air pollution of all Latin American cities. The burning of fossil fuel is one of many main causes of air pollution in Lima. The fume from the car exhausts contains dangerous gases including carbon monoxide that increase the chance of heart attack in people. It also negatively affects the respiratory system, causes wheezing, coughing, and breathing problems.

Air pollution also worsens the existing heart problems, asthma, and other lung complications. Animals also get an effect of air pollution like humans. burning fossil fuels can cause water pollution. Burning more fossil fuels turns rain to acid rain, acid rain damages trees and acidifies soils and water bodies. Fish and other living things in the water cannot survive in acidified water.


Lima, Peru has many of significant historic sites, but They have been torn down and build more of new residential buildings, schools, etc., to meet the population’s growing demands. Some of the historic sites that survive demolishing are surrounded by high-rise apartment buildings.

Urbanization is destroying the bond between the people and the huacas (historic sites). Instead, people see them as a treasure, people took bricks from an old temple wall that are painted with ancient reliefs to build new homes beginning in the 1980s. Even the government spends only enough to protect 1 percent of those sites.





The Hungarian Divide

Poverty in Hungary has become an increasingly large problem over the last several years, and there is a great rift in between rural life and urban life in Budapest, the capital of Hungary. Urbanization of Hungary has created an even larger divide between the rural areas and urban areas, as well as destroying the agricultural industry.

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There is a very high percentage of Hungarian citizens living in cities, and this has been rising over the last decade, with people migrating from rural areas to urban areas. This factor greatly contributes to the failing agriculture in Hungary, as the rural farmers are all migrating to cities because they are far too poor to maintain their land. As the urban population is rising, the rural population is in decline at a fairly high rate in the past decade.

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The population in rural areas has dropped almost 6% in the past decade, giving way to the gradual decline in agricultural production. This does not improve poverty rates in the country, as the poor farmers move to the city only to get stuck in the slums. The unemployment rate is a growing problem in Hungary as well, going hand in hand with the poverty rate, with many people requiring financial assistance. There are as many workplaces as there are workers in most rural areas outside of Budapest, with more people living off the benefits of assistance than people who actually hold jobs. The image below depicts how poor some of the rural farmers are; no electricity and no internet, keeping them walled of from the outside world. This man must use the water in his well in order to keep things cold, as he does not have a refrigerator.

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The rural citizens compared to the residents of Budapest have a completely different lifestyle and views, and Viktor Orban, the Prime Minister of Hungary, appeals to them much more than urban areas, truly showing the divide between the different lifestyles. Orban has a strong anti-immigrant policy that those in rural areas agree with, for many of them are older and lived through soviet union control and are terrified of culture change. The Urban populous tends to be younger and be pro-immigrant, however Orban won his third election by a small margin in the past month. This caused a massive protest in Budapest by young and old alike, for they were outraged Orban’s terrible immigrant policies would be enforced.

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This urban-rural divide does not seem to have any immediate fixes, and will take large efforts by the Hungarian government to bring change and unite the people, and fix the agricultural decline.

Mexico & Drugs

The Mexican Drug Cartel, created in 2006, has been generating many problems for Mexico as a country. This discussion focuses on the urbanization of drugs in Mexican States. The urbanization of drugs impacts Mexico in many ways, but tourism is at the top of the list. The dangers that arise in Mexico due to drugs greatly affects the tourism, and more-so, the revenue generated from tourism. Due to the dangers that exist in Mexico, the U.S. State Department has instituted a system that is devised of four levels of danger in foreign states to warn American travelers of the dangers in foreign countries. Level 1 means that there is not much to warn travelers about; there isn’t much conflict in a foreign country or state. Level 2 means that there is increased warning directed to travelers when traveling to a foreign country or state. Level 3 means that travelers should reconsider their decision to vacation in a foreign country or state. Finally, Level 4 highly advises travelers to steer clear of the foreign country or state, as it is very dangerous.

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There are 31 Mexican states; as a whole, the country is rated at a Level 2. Level 2 means that American tourists should have increased caution when traveling to Mexico. This discussion focuses on Playa Del Carmen, Mexico City, Jalisco, and Colima. All of these Mexican states range from Level 2 to Level 4 travel warnings.

Playa del Carmen is a very popular Mexican tourist sight, especially for college students around Spring Break. In February of 2018, a ferry exploded in Playa Del Carmen. The explosion ultimately prohibited U.S. Government employees or officials from travelling on ferries in Mexico; private transportation is required. The explosion injured 25 people, but did not kill anyone. While some fingers point to Mexican drug gangs as being responsible for the incident, terrorism has been ruled out. To date, no one has been convicted of the crime. Due to this incident, the U.S. State Department has categorized Playa Del Carmen as a Level 2 for danger.

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Mexico City is another popular destination in Mexico.  An article states that in Mexico City, alone, there are over 20,000 places to buy drugs from undercover or well-hidden drug gangs. Drugs are being sold everywhere in Mexico City, such as small grocery stores, football fields, and apartment buildings. Overall, the sales of drugs have increased from 200 places to 3,000 in the past five years. This overgrowth has increased in homicides. The state is rated as a Level 2 by the U.S. State Department.

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Jalisco, Mexico is rated by the U.S. State Department at Level 3. While U.S. citizens are highly advised to not go to Jalisco, U.S. government employees are under strict instruction if they are to stay in the Mexican state for work.  Jalisco is also home to the Jalisco Cartel, a Mexican Drug Cartel group that is infamous for horrible kidnappings and killings.  Most recently, the gang was involved in a mass shooting of 15 Jalisco police officers back in 2015. Months later, the gang acted again and shot down a military helicopter. The gang has access to many military grade weapons. Overall, Jalisco is considered a dangerous city, and not recommended for tourism.

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Colima, Mexico is known as the fourth smallest Mexican state. Recently, it has gotten the reputation for being controlled by drug cartels and crime. Drug cartels are fighting for the territory to easily important synthetic drugs in and out of Mexico.  Colima, Mexico has been rated by the U.S. State Department as a Level 4. The state cautions that no one travels there.  U.S. State Department officials must abide under strict rules if they are to travel to the state. Some of these rules include not attending adult entertainment clubs or participating in any kind of gambling. At Level 4, Colima is considered an extremely dangerous territory for tourism and travel.

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Mexico is often considered a popular vacationing country. Over the years, it has become increasingly dangerous, impacting its ability to generate income via tourism. The U.S. State Departments levels its individual states from Levels 1 to 4; 1 being safe, 4 being extremely dangerous. Playa Del Carmen, Mexico City, Jalisco, and Colima range from Levels 2 to 4 in safety. Although none are classified at Level 1, Playa Del Carmen and Mexico City are considered the safest, ranked at Level 2. While Jalisco and Colima are ranked at 3 and 4, respectively, travel there is scarce. Mexico’s drug urbanization is greatly impacting tourism and ultimately Mexico’s ability to produce an ample income.

Death, Taxes, and Urbanization

Ulaanbaatar Mongolia, the capital of one of the most nomadic Asian nations, has also become one of the world’s most densely populated cities today. It has struggled to cope with the inevitable urbanization that the rest of our planet is being faced with, and in response to the nearly seven month long winters, poor schooling, and lack of opportunity in the rural areas of Mongolia, many Mongolians have begun to relocate to Ulaanbaatar. This rapid movement has caused serious infrastructure issues in the capitol as well as serious pollution, and poverty issues throughout the city.


The overpopulation that came with urbanization has resulted in the development of what is known as “Ger” areas; small huts and yurts that are tightly surrounding the industrial and developed part of the city. Ger areas epitomize the struggle that Mongolia is dealing with. Ger households are roughly 45% below the poverty line and have very little access to resources relative to the rest of the city. Ger areas account for nearly 60% of Ulaanbaatar population, and Ulaanbaatar as a whole accounts for roughly 40% of the national population.



When it was designed, Ulaanbaatar was only designed to hold 500,000 people. Today it holds 40% of the nations 3.1 million. When the population density gets high there are bound to be problems that spark not only including overpopulation. Road and traffic issues have become a larger issue since the mass migration to the cities. Pollution is another issue that has emerged as one of the largest threats to the city as it surpassed Beijing in pollution levels in late 2016.


Coal plants are the main reason for pollution levels in Ulaanbaatar and it has resulted in Ulaanbaatar becoming one of the leading producers of black smog. In 2016, when they surpassed Beijing they exceeded the safety level for pollution by a factor of 80. The smog and dangerous pollution levels have resulted in a spike in respiratory issues throughout the cities, and in Ger area, where healthcare is almost nonexistent and the hygiene is minimal due to lack of resources, health problems are far more serious to the people especially living in such close quarters to others.

The efforts to combat the issues that have risen through drastic urbanization have included land laws, banning migration to certain areas, and forcing mayors and other political leaders to form policy, but the issue still remains. Urbanization has been on the rise for decades and is only becoming more popular. The only way Mongolia can deal with such rapid urbanization is to embrace the pull factors to the city and fight against the issues in which they have control over such as pollution, lack of resources, and the infrastructure.

Lagos: Drowning in Trash

Lagos, Nigeria: The center of western Africa’s economy and one of the worlds largest trash producers. Lagos was planned to be a small town, but two hundred years later, Lagos grew, almost one hundred times over. One of the biggest cities in the world, it sits sixth on the list of the largest cities in the world. Like most cities, it is saturated in slums and poor boroughs. Areas are so bad, most of the city is not connected with water or sanitation. The original streets were designed for a fraction of the people, leading to hours of traffic daily. Lagos is projected to be one of the largest cities in the world within a hundred years, amounting a population of a staggering one hundred million people. The situation is dire right now, and it is only going to get worse.

Skeptics will say that Lagos isn’t in danger, they will refer to the birth rate and refer to the fact that it is decreasing per one thousand people.


The birth rate is decreasing in Nigeria, however, it is still one of the HIGHEST birth rate in the world per one thousand people. This is an issue, and not only is the birth rate high, the life expectancy is increasing as well. Life expectancy is increasing drastically in Nigeria, a generally good thing, but the current average age is fifty three, tied for the third LOWEST in the world.


This is symbolic of a change in Nigeria, one centered on Lagos. More people are getting access to healthcare, people are realizing that with more medical care in Lagos, it is a top priority to relocate there. However health is also an issue there, with garbage borne illnesses spreading rapidly, such as Lassa.  This is just one example of a looming issue literally towering over the city, garbage.

This is a picture of the Olusosun dump, one of the largest dump sites in the world. Located in the center of town, Olusosun is a place where twenty million pounds of trash gets dumped a day. Olusosun is part of the city now, and is blended into its backbone. It is situated next to a hospital and a school, with the smell of hot trash wafting through the air to the apartments surrounding the dump, and even downtown.

Garbage is so prevalent in the city, that it has become its own business. People have constructed small villages on top of mountains of trash, in order to gather valuable recyclable materials to turn into cash.

This is symbolic of the general trend in Nigeria, the focus on recycling, and the general shrinkage of trash. However, Nigeria doesnt have enough energy to recycle the garbage into pellets. Nigeria suffers from a lack of energy, an issue that the minister of Nigeria, Fashola touches on: “Although the country has expended what may appear sizeable, the money so far spent was inadequate to address the current challenges.”. Nigeria is currently only running on half of its potential energy production, meaning that it lacks the ability to recycle at a reliable rate. This has resulted people flattening the trash into pellets and shipping them to China.

Lagos is an example of what the future is going to look like. If Lagos is expected to inflate enough to house one hundred million people, they are going to need to fix their rising trash issue. Trash, along with lack of power and sanitary conditions is plaguing the country, and even though it seems like a long road ahead, something needs to change or else Nigeria is going to be uninhabitable.

Guyana: No Unification, No Urbanization

Since Columbus’ alleged sighting of the coast of Guyana in 1492, the land has been controlled by the major European powers. The Dutch were the first to colonize Guyana in 1616. The British arrived in South America shortly after the Dutch created their first outpost in Guyana. Eventually, the British strengthened the control of the area and were formally gained control of the colony in 1814. Great Britain maintained control of Guyana until the South American country declared its independence  on May 26, 1966.

During the time of British control Guyana saw huge changes in its people. As the British realized that Guyana was comprised of good, fertile, farming land, the colonial powerhouse recognized the agricultural and economic potential of their new colony.  Britain quickly started transporting thousands of slaves from West Africa and Caribbean islands to Guyana, where the majority of the country was made up of  sugar plantations ready to be worked on. Eventually, the British were forced to ban slavery in 1807, but quickly found a way around it. Within the next 25 years, they brought around 30,000 indentured slaves from on of their other major colonies, India. The production of sugar and other natural goods continued as these workers stayed in the country. Instead of returning home after finishing their work in Guyana, almost all East Indian workers gave up their rights to return home in exchange for a piece of land in Guyana.

Since the presence of European powers of in Guyana, the country has turned into a melting pot of ethnicities today. Some Dutch, British, and Afro-Guyanese (descendants of slaves) remained in the “urban” capital of Georgetown, and the East Indians (descendants of indentured servants) and Amerindians (native Guyanese) reside in the rural interior of the country.

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Today, East Indians make up the majority of the population in Guyana (40%) and have mainly remained on the rural farming land given to their ancestors. Taking this into account, about three fifths of Guyana’s population still lives in rural areas.


 guyana urban population percent of total wb data


During the British control of Guyana, there was no real incentive or reason to urbanize the country as the main focus for the British was to maximize its economy through the abundance of sugar production in the rural areas of Guyana. Since the British left the country in 1966, there has yet to be much urban development in Guyana.

Considering that the country is extremely heterogeneous, maintaining and effective and productive of government has been extremely difficult. Each major political party has desires for its own people or ethnicity, and no one is considering the countries wants and needs as a whole. Today, there has been very little incentive to develop the country as agricultural is still the major source of income for the country. There have been plans in the past to develop the capital, Georgetown, but without the entire country’s full cooperation, Guyana will remain an underdeveloped country that relies on its natural resources.

The Loss of Rural Culture: Urbanization in Colombia

Beginning nearly fifty years ago, Colombia experienced urbanization as a response to political unrest. Around 1964, warfare broke out between the Colombian government, semi-militarized forces, and rebellious marxist guerrilla troops, the largest group being the Revolutionary Armed Forces of Colombia (FARC). The areas hit the hardest in response to this war were rural areas, where each group fought to control a specific land. Due to the rise of various insurgencies across Colombia, rural peoples sought security and opportunities for work.  Therefore, rural Colombians flocked to the cities where job growth and security appeared prevalent.

The move to cities provided rural Colombians not only economic growth, but also an improved quality of life. Colombians did not have to fear violence or instability, a drastic change from their rural lives, where frequent kidnappings and other violence related to the narcotics and drug trade devastated their societies. Cities provided people with better accessibility to technology, transportation, health-care, and education. The Brookings Institution claimed that in Bogotá, the capital of Colombia, more than 350,000 people have migrated into the city from rural areas due to displacement caused by violence and insecurity.

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As a country, Colombia has faced one of the highest urbanization rates in Latin America. In 2006, about 74 percent of people were living in Colombian cities. In 2016, 78 percent of people resided in cities. Over the course of a ten year period, Colombia experienced a four percent increase of peoples in urbanized areas.

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As more and more rural people flock to Colombian cities, the strain on the cities becomes more poignant, for the lack of resources available dwindle. Today, Colombian cities are so dense that basic needs are not met, making poverty a reality for many urban areas.  

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Due to the rapid increase of population within Colombian cities, the government had no chance to prepare.  In the cities, many residents were required to live in temporary settlements, having nearly one-third of the population living in poverty. Currently, the government struggles with developing a successful plan to bring basic necessities to these impoverished, dense cities, where the quality of life remains poor.

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In order to bring stability and security to these densely populated areas, the Colombian government must make it a priority to build infrastructure and bring basic necessities and services into the poorest of slums. The second requirement needed to progress Colombia’s slums would be to reconstruct and nurture the rural-urban relationship, which has been destroyed due to the belief that rural areas house violence, while urban areas provide economic growth, development, and success. If the relationship goes untreated, Colombia will have to deal with the loss of rural culture, for no Colombian will choose to reside there any longer.

Tuberculosis: The Challenge Facing Peru

Millions of Peruvians have moved from inland towns and villages to Lima, the country’s urban area, over the past several decades. Since 1980, Lima’s population has doubled, going from 4.8 to 10 million in 2015. This migration to urban areas has encouraged political stability in the country and the improvement of education and healthcare systems. Despite these positive changes brought about by urbanization, Peru still faces severe problems even in the realms of these newly improved systems, especially healthcare.

Figure 1: Between 2006 and 2016, the percentage of Peru’s total population living in urban areas has increased.
Figure 1: Between 2006 and 2016, the percentage of Peru’s total population living in urban areas has increased.

This urbanization has driven great economic growth. Peru has become one of the best-performing Latin American countries. Peru’s economic scenario is optimistic as inflation is low and investment rates are high. As a result of this situation, Peru’s middle class is flourishing and urban areas are expanding. However, rural areas continue to struggle. Although the poverty rate in Peru has dropped, it remains at more than 55% in rural areas.

Figure 2: Percentage of Peruvians below the poverty line
Figure 2: Percentage of Peruvians below the poverty line

The number of Peruvians making a middle-class income has increased greatly, though income inequality remains an issue in the country. Although urban and rural populations are about equal, only 15% of non-urban citizens are middle class.

Despite the economic achievements that Peru has made, the country still struggles to reconcile the disparity between rural and urban citizens. This is most prominent in regard to healthcare. Peru established a comprehensive health system in 2002 that succeeded in increasing enrollment in health insurance (from 41.7% in 2003 to 54.1% in 2008). However, this system was aimed primarily at women and children under 18 years old, and while it did reduce maternal and child mortality, it did not provide care to the adult population as a whole. A new healthcare policy was introduced in 2009, though there has been little progress in its implementation. Information on health insurance is not available in rural areas, particularly among the indigenous Amazonian people who live in those areas. The inadequacy of the country’s healthcare system is demonstrated by its struggle to face its severe tuberculosis (TB) problem.

Peru contains 3.1% of the population of the Americas but reports 13.6% of TB cases and 41% of cases of multi-drug resistant TB (MDR-TB) in Latin America. When compared to Latin American countries with similar or lower GDPs, its poor performance becomes significant, as those other countries have lower incidence rates of TB.

Figure 3: Gross National Income compared to TB incidence rate
Figure 3: Gross National Income compared to TB incidence rate

In Peru, tuberculosis affects 33,000 people and kills 4,000 every year. In the recent past, Peru has had the highest number of cases of drug-resistant tuberculosis in the Americas. Although the number of deaths due to tuberculosis has decreased in recent years, TB cases are on the rise in impoverished districts.

Figure 4: The number per 100,000 people in Peru with TB has decreased over the years.
Figure 4: The number per 100,000 people in Peru with TB has decreased over the years.

Oil exploration and logging in rural Amazon territories, which comprise 60.9% of national territory, have exposed the indigenous people there to new diseases, including TB, causing them to develop rapidly and aggressively. The geographic accessibility of health facilities in rural areas such as these is a major challenge to the treatment of TB throughout the country. Primary health clinics may be many hours away on foot from rural areas, making it difficult for patients who are undergoing treatment that are required to visit health clinics daily. There is also a major gap in access to accurate information on TB, as well as its management and treatment.

Tuberculosis is not limited to rural areas. The living conditions brought about by mass migration to urban areas have caused the disease to proliferate. Because of the great number of arrivals in cities, migrants have had to create informal settlements to live in. These slums are breeding grounds for tuberculosis due to overcrowded, poorly-ventilated, and often damp living spaces.

It must be noted that although Peru has the greatest number of TB cases in the Americas, it also has some of the world’s highest cure rates for the disease (87% for new cases and 66% for a multi-drug resistant strain).

The DOTS (Directly observed treatment, short-course) program was implemented in Peru in 1990. It is the tuberculosis control strategy implemented and recommended by the World Health Organization. Patients were eager to participate through the promise of food packages, employment training, and free transportation. The program has increased the case detection in the country and has decreased the number of deaths due to TB in Peru.

Figure 5: The morbidity and incidence rates of TB in Peru after the implementation of DOTS.
Figure 5: The morbidity and incidence rates of TB in Peru after the implementation of DOTS.
Figure 6: Enrollment of patients in Multi-Drug Resistant Tuberculosis (MDR-TB) treatment programs has been successful.
Figure 6: Enrollment of patients in Multi-Drug Resistant Tuberculosis (MDR-TB) treatment programs has been successful.

The implementation of DOTS has caused positive results, including the decrease in the number of TB cases and the maintenance of a high percentage of cured patients. However, the number of cases of multidrug-resistant TB (MDR-TB) has grown in recent years, and the emergence of extensively drug-resistant TB (XDR-TB) in Peru is a great threat to the country.

The newest development to the TB treatment approach in Peru is a training program for community volunteers that teaches them how to tend to TB patients at their homes. A Boston-based non-profit, Partners in Health, works with Peru’s health ministry to train people to ensure that patients take their medicine daily and to help these patients navigate the country’s public health service.

One in four Peruvian TB patients drops out of treatment because the medicine prescribed has such harrowing side effects, including changes of skin color and occasional bouts of psychosis. Patients need accompaniment and personal support in the treatment process, which is why the current treatment program in the country is successful.

Mexican Cities Seek Walls

Over the past half century, Mexico’s cities have undergone a stark transformation. Today, Mexico’s urban population is as at an all-time high, and growth is projected to continue.

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Housing settlements to accommodate these bloating populations have oozed out from already crowded city centers, creating sprawling, largely residential areas around city peripheries. Since 1910, the metropolitan area of Mexico City has risen dramatically, expanding into the hillier terrain at the city’s edges. While population remains most concentrated around the city’s core, expansion continues at its edges.

Mexico City, 1910

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In peripheral housing developments, staggering economic equality persists. About half of Mexico’s population is estimated to live in “colonias populaires,” informal settlements that typically spring up along urban peripheries. Many new residents are crammed into these areas, where living conditions and access to amenities often lag.


Slums outside of Mexico City

The economic promise of these cities has proven hollow for many. Despite rapid growth in size and population, many of Mexico’s cities have not experienced significant growth or development in the types of jobs they offer.

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“High value” jobs, like finance and technology, have not been added to city economies at the same pace as lower level jobs in the service industry, which now employs about 50% of Mexico City’s working population. Even within the service sector, the “value” of new jobs has declined. Over half of all jobs within the service sector have been deemed “low value.” In Mexico’s largest cities, growth in population has outpaced growth in opportunity. Despite lags in high-value employment, movement to cities continues, aided largely by lack of opportunity elsewhere.

Mexico’s richest regions lie in its North, where NAFTA has allowed the manufacturing sector to flourish. In the South, rural regions must rely more heavily on agricultural enterprises, which, thanks to technological advances, now require far fewer workers. For many residents of the south, cities flaunt the tantalizing possibility of economic opportunity.

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If development is a steady march forward, Mexico’s cities have been forced into an all-out sprint. And, like many amateur-athletes, their legs have begun to give out.

City growth has occurred with very little long-term planning, and has relied largely upon the spread of informal housing developments. Within Mexico’s expanding cities, government services, like infrastructure and housing complexes, are operating out of sync with each other. Crucial services like water access and sewage treatment are unreliable and inefficient. A lack of coordination and pre existing infrastructure has trapped city governments in a process of accommodating population influxes with superficial but immediately effective solutions, rather than long-term reworking. Mexico City imports about forty percent of its water from outside sources, and loses another forty percent to faults in its distribution system. Despite these efforts, nearly twenty percent of the city’s population cannot rely upon consistent access to tap water.

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On the outskirts of Mexico city, donkeys are used to transport water to residents disconnected from pipelines.

Hope for Mexico’s struggling cities may seems sparse, but a relatively recent decline in birth rates may alleviate some of the nation’s growing pains.

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This abrupt decline in fertility rates, corresponds, in part, with a shift in government policy. In the late 1970s, the Mexican government began an extensive promotional campaign for birth control. In a nation where abortions and other forms of contraceptives can be expensive and extremely difficult to obtain, sterilization has become an increasingly practical, albeit dramatic, option. Today, forty percent of women in Mexico are sterilized. While this decline may help cities struggling with the weight of their ballooning populations, it is far from a panacea.