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CC-BY: Ben Gilbert/Wellcome Images

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CC-BY: Ben Gilbert/Wellcome Images

A city slum can be many things – a community, a poverty trap, a potential escape route for the next generation. Michael Regnier visits two in Delhi.

The smell of urine and human excrement betrays the entrance to the slum. There is a line of fresh turds alongside the main road. Most look healthy enough; a couple are what you might call loose.

Dilip Jha admits to feeling nervous. Ben Gilbert (Mosaic’s photographer) and I have asked him to show us around Delhi, including its slums to see where some of India’s poorest rural-to-urban migrants live, so Dilip, a senior research project manager at the South Asia Network for Chronic Disease, has brought us to Sector 7.

We turn left, down a side road, except that this street marks a social, political and moral boundary between two superposed cities. Ben and I walk about 50 metres before Dilip quietly but urgently suggests we go back to the main road.

At the junction, Ganchem sells freshly squeezed orange juice. Like everyone else in this slum, he is from Rajasthan and, like everyone else, he specialises in drumming at functions and weddings. It is only ever part-time work, so people have other jobs, often house-painting. They have done well to secure painting and drumming as their niche – other slums might specialise in rag-picking, bringing the city’s rubbish home on handcarts and sorting through it for plastic or paper scraps they can sell for a pittance. Migrants often find the only opportunities to make a living are doing the jobs too dirty, degrading or dangerous for anyone else.

Ganchem, however, has his stall. He has lived in the slum for 30 years, ever since deciding that Delhi would be a better bet than his home village, where opportunities for work had dried away to nothing. He still goes home four or five times a year to drum at weddings and festivals. No one wants to miss out on the big occasions, he tells Dilip.

Streets in Delhi's Sector 7 slum

Sector 7, Delhi.

CC-BY: Ben Gilbert/Wellcome Images

Behind and to the left of Ganchem’s stall is a narrow alleyway. Dilip asks permission and then we walk with growing confidence through the shady lanes – no more than the gaps between houses, poorly paved, murky fluid at the sides, the lanes navigate and define the heart of the slum. The dirt and the squalor are obvious but the people are proud of their homes that rise crookedly up two or three storeys of patchwork brick and concrete walls painted pink or blue or purple. Electricity cables run to meters on walls – their supply is legal, a fixed-rate deal negotiated with a subcontractor to the power company. Water containers stand piled in every doorway, nook and cranny, though, because there is only one pipe supplying intermittent running water to the whole slum. The supply is so infrequent there isn’t even a tap on the end of the pipe. There is no sanitation either: the adults pay to use nearby communal toilets; the children can’t afford it, so it is generally they who shit in the street, albeit as far from their homes and their neighbours as is practicable. By the time they are too embarrassed to defecate in the open, they will probably be earning some money of their own. The sound of drumming practice erupts from time to time, suggesting how most of the children will earn their first trip to a toilet.

Women sweep their front steps with brushes of sticks, front steps that may just be an uneven slab of cement but represent the threshold of their home, where visitors leave their sandals, the boundary of their space in this city. Clothes are washed on the step with soap and just enough water, then hung to dry on the criss-cross of washing lines that decorate the lanes above head-height like bunting. Every home has a cup nailed to the outside wall where they keep their toothbrushes. Eight, nine, ten brushes for each one- or two-roomed house.

Toothbrushes outside a house in Delhi's Sector 7 slum

People living in the slum make the most of limited space.

CC-BY: Ben Gilbert/Wellcome Images

A gaggle of boys and girls run through the lanes, laughing and shouting to their friends, enjoying the weekend break from exams – they all attend the government school nearby, which means they get a free lunch. Niraz, 14, says he wants a government job with a good salary when he grows up.

The lane comes to a dead end. There is no way out of the slum except back the same way – the residents worry about what would happen if there was a fire.

We retrace our steps back to Ganchem and his oranges. Dilip asks him about health and he replies that they are a healthy lot. His perception doesn’t seem to extend to his three sons, who all died in childhood, or the constant threat of serious infections.

Would he ever consider moving back to Rajasthan?

No, he says. Life here is “good enough”.

Slum doctor

There is a government hospital near Sector 7 that offers free primary care; for more specialised treatments, people have to travel further away, paying for transport. But the ID cards needed to access free services are issued to households, not individuals, so many migrants have to leave their card with their family at home in the village. It is not uncommon for migrants to need to spend 75 per cent of their income just on food, and another 40 per cent on fuel, soap, tea and medicine. The fact that this adds up to more than 100 per cent reflects the fundamental inequality they face. Many can and do choose to use private healthcare services – but there is another option.

Suresh Sarkar sits behind a table facing out into the lanes of the slum but also facing his TV. An elderly couple finish their consultation and leave him to the film he is watching at high volume. An array of medicines are lined up on the table and on shelves to his right. He is wearing a white shirt and a black leather jacket. He has a stethoscope tucked away for when he wants to impress.

He is not from Rajasthan, he does not live in the slum, and he is not qualified to practise medicine. All that aside, he offers his services as a doctor to the people here: they come with colds, coughs and pneumonia mostly, but also diarrhoea and skin infections. Stomach problems are common, and urinary tract infections among the women. Sarkar dispenses Western pills and traditional Ayurvedic medicines; he sells dietary supplements, which are popular, and protein extract, too.

A medicine dispensary in Delhi's Sector 7 slum

Suresh Sarkar sells medicines from his shop in the slum.

CC-BY: Ben Gilbert/Wellcome Images

There are crackdowns and court cases trying to stop or at least regulate people like Sarkar, but others are lobbying the lawmakers to give them a place in the system. He doesn’t see why unqualified people shouldn’t be able to do this kind of work, if it helps others. In the summer, he says, the hospitals fill up with diarrhoea cases: “They won’t see you.” Whereas he can give you saline without the need to camp in the queue outside the hospital, waiting for a real doctor. His shop is far from an ideal clinical environment to administer injections or saline drips, but he claims to save lives.

This is primary healthcare in the slum.

In-between places

We reach another of Delhi’s slums, Bhumihin Camp, in the afternoon. Dilip first came here when he was a research student – he had been given a long list of names of people with tuberculosis. His task was to track them down, if they were still alive, and interview each one about their experience. Working alone in the slum, he had felt threatened a few times, nothing physical but enough to make him wary.

There is no hint of trouble today, though, as we walk past stalls, people sewing, scrap metal workers, children playing, shops selling crisps and snacks. Ben wants a high vantage point for his photographs, so Dilip asks someone if we can go up to the top of the tallest building in the slum, a five-storey block.

We are ushered in. Within seconds of passing through the doorway, the daylight dwindles away to nothing. Up rough stone stairs in the dark, passing curtained-off rooms, the occasional blast of noisy entertainment from an unseen TV.

Bhumihin Camp, a slum in Delhi

Bhumihin Camp and nearby roadside advertising in Delhi.

CC-BY: Ben Gilbert/Wellcome Images

The sun is setting as we emerge onto the roof, and a muezzin is calling the faithful to prayer. The building is at the edge of the slum so we can look back over the rooftops stretching out below us. Houses piled on top of each other, higgledy-piggledy, not wasting a square foot. Aeroplanes drone softly overhead, and voices drift up from the street.

A woman sits on the roof, finding up here a rare moment of peace amid this most bustling of cities.

On our way to Bhumihin Camp, we had driven past the Gandhi Museum, which has a board outside with a quote in Hindi on it: “Inequality breeds violence”. Dilip says inequality has got worse in India. “In the early 90s, when the Indian economy opened up, people had the feeling they could get rich overnight. Before, people used to be content. It breeds violence because of envy.

“Very early on when I moved to Delhi,” he explains, “I copied the aggression of the city because I didn’t want to be identified as an outsider.” But this caused problems when he went back to his home state of Bihar. “Guys my age would start making fun of us, trying to start a fight. The only reason was that they were envious. People don’t like to see the differences becoming so much. So now I try to dress and behave like them.”

“Here, people judge you by the way you look and the car you drive and so on. So I try to maintain a certain look. I’m more at home in the village. You don’t have to worry about how you walk. But when you talk to people there, it’s not about science, you know? It’s their language that you speak.”

I ask Dilip what his natural state is. “Somewhere in between Delhi and Bihar,” he admits.

In the slums, the older generation, the ones who migrated like Ganchem, don’t belong there. Strong ties to their home villages protect them from being entirely defined by the slum, and perhaps make it easier to put up with an in-between life, a “good enough” life. But what of their children? What of those born in the slum, those who survive – do they belong there? If they feel that they do, then perhaps they, like their parents before them, will strive to leave the place they belong to, in search of somewhere better.

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