By 2050 the world’s urban population is expected tonearly double, making urbanisation one of the 21st century’s most transformative trends. At the same time, natural disasters, armed conflicts and extreme violence are increasingly taking place in urban areas, causing long lasting and cumulative damage to fragile or often already dysfunctional public services (such as sanitation) and posing substantial sustainability challenges.

When crises in urban areas last years or even decades, the humanitarian needs become acute as entire systems and public services are weakened to the point of collapse. The resilience of society is stretched to the limit when the means of covering basic human needs is beyond their control. This is particularly the case for those living in urban rather than rural areas, as they are dependent on increasingly complex essential services, such as sanitation infrastructure, sewage networks or faecal sludge management services. Humanitarian approaches and responses must therefore be designed very differently from at present.

Particular attention should be given to the cumulative impact of chronic service degradation and the increasing risk to public health. To a large extent, the problems stem from the complexity of urban systems and their dependence on large-scale, interconnected infrastructure that relies on the availability of qualified staff and reliable energy and water supplies to ensure service delivery. In many of these contexts, the water supply system fails, electricity is cut off and the collapse of this infrastructure significantly affects the capacity to run a complex sanitation system. This is compounded by the fact that educational institutions often stop working and job opportunities in established sectors are lost. Coupled with the social, political and economic fragility of many states, as well as natural disasters, these dynamics force millions of people to flee their homes and seek safe havens elsewhere, usually in cities either within their own country or abroad, often overburdening the capacities of the host city’s infrastructure.

While traditional humanitarian approaches have been largely developed in rural contexts, addressing vulnerabilities and specific needs of urban populations under protracted crisis requires complex socio-technical approaches and long-term solutions that go beyond the current humanitarian-development divide and often beyond the capacity and skill-set of humanitarian actors. In terms of sanitation challenges, it also means that humanitarian organisations need to deal with more complex offsite sanitation systems and services, and sometimes the rehabilitation of sewer-based systems and largescale centralised treatment plants.

Understanding Essential Urban Services

Local and global economic and political forces are constantly changing the way people live and where they reside, blurring the once clear distinction between “rural” and “urban” areas. However, critical components   of essential services, such as wastewater treatment plants, are often located outside the city limits. Urban contexts can therefore be defined as the area within which people reside who are vulnerable to disruptions in essential services and the network of components supporting those services.

Urban services are the provision of commodities, actions or other items of value to an urban population. Essential urban services are those that are vital to ensure the subsistence of the population, including electricity, health, water, wastewater collection and treatment, and solid waste disposal. All urban services require three elements in order to function: people (e.g. service providers, private-sector contractors and entrepreneurs), hardware (e.g. infrastructure, equipment, heavy machinery) and consumables (e.g. fuel, chlorine,  medicines). Disruption to an essential service is understood to occur when the functions of any of the critical people, hardware or consumables are compromised. Short-term disruption to a service may not have a major impact on the survival of the civilian population, while its deterioration over the long term brings about the cumulative impact on services with the related risks to public health.

Direct, Indirect and Cumulative Impact

Direct impact refers to the (usually) immediate and physical impact such as damage to essential urban infrastructure, the death of technicians and repair crews, looting of hospital stores or service providers’ warehouses and/or removal of parts directly from service infrastructure.

Indirect impacts are understood to derive from direct impacts, affecting an associated component of a system, usually in the short to medium term. An example is the “brain drain” that occurs after massive social disruption, or shortages of spare parts due to a lack of finances to buy them. These impacts can accumulate over time, resulting, for example, in a lack of maintenance due to insufficient long-term staffing and thus a lack of long-term service provision, poor or no infrastructure maintenance and/or machinery being run with poorly calibrated or poorly fitting parts.

Cumulative impact refers to the long-term deterioration of essential services through incremental direct and/or indirect impact(s) on one or more of the critical components of essential service delivery (i.e. people, hardware and consumables). Field experience suggests that the cumulative impact is the most destructive and the most difficult to recover from. This is typically due to the large scale of the infrastructural rehabilitation work needed to restore any service or combination of services in urban areas. Cumulative impact is even more evident in situations of protracted conflict in urban areas.

More specifically, the concept of cumulative impact calls for a move from traditional assistance paradigms to one that takes into account the longer-term realities and needs in urban areas. It also explains how the quality of essential urban services can deteriorate to a point of no return through a “vicious cycle” of accumulated direct and indirect impacts, which pose serious risks to people’s health and well-being and lead to undue displacement.

A Better Approach to Assisting Affected People

When considering urban sanitation services under protracted crisis the distinctions between the stages of relief-rehabilitation-development response are rarely ever clear. For example, the asymmetries in quality or coverage of services between neighbourhoods mean that multiple types of programs, such as pit emptying or rehabilitation of a large wastewater treatment plant, may be required simultaneously in the same city.

Given the intricacy of the interconnectivity of urban services inside and outside urban areas, as well as between the services themselves, attempts to impose clarity through responses driven by artificial boundaries (e.g. attempts to shift from emergency relief to “development”) may be counterproductive. Responses are context dependent and the needs in urban areas can at times therefore necessitate a mixture of the stages classically referred to as “relief”, “rehabilitation” and “development” at any given time during a protracted crisis.

Additionally, the main shortcoming of funding models for humanitarian contexts has been well identified: short term funding cycles that do not match the needs of the people or of authorities attempting rehabilitation. More context-adapted and sustained funding mechanisms are required to enable a shift away from reactive repair of damage to infrastructure (direct impact) to the   proactive preventive maintenance and rehabilitation (indirect and cumulative impact) necessary to stabilise or even to restore essential urban services. It is especially the case for sanitation, which is often perceived as a low priority by different local and international stakeholders, in comparison with other essential services, such as water and electricity.

The complexity of urban contexts makes partnerships particularly important in restoring more resilient systems, yet also makes them trickier. The ability to engage with the numerous horizontal networks of informal governance overlaid onto vertical hierarchies is best acquired through experience. As an example, engaging with those private companies that regularly guarantee technical support to public service providers might represent the turning point in providing assistance during a protracted crisis. As there is no preferred model for such partnerships, the most relevant vulnerabilities and opportunities in the context will ultimately shape relations with authorities, beneficiaries, the private sector, and other non-State actors.

All the above-mentioned core issues are best addressed by pursuing a path of acknowledgment of the sheer scale and duration of the challenge, the multifaceted interconnectivity of essential services, cumulative and indirect impacts as well as direct impacts, the need to rethink the relief-rehabilitation-development spectrum; and funding that does not match the duration or scale of the needs. The key to success in addressing such a challenge lies in achieving a consensus that reinforces the paradigm shift in the way assistance is delivered to affected people in urban settings.