Case study: Dharavi

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6.4.1 Development of squatter settlements

6.4.3 problems and management, improvement schemes: top-down approaches.

  • Top-down schemes are expensive large-scale plans, usually by the government, aimed to improving squatter settlements
  • A $2 billion development project aims to rehouse slum dwellers in high-rise apartment blocks built next to the slum
  • This is controversial as it will break the sense of community to the settlement

Improvement schemes: Bottom-up approaches

  • Bottom-up schemes are cheaper and smaller plans usually by the community and NGOs to improve squatter settlements by helping the individual
  • Self-help schemes give people the tools and training to improve their homes

Land, housing and gentrification in Mumbai

Case Study on Dharavi

dharavi geography case study

Mumbai houses the largest  slums in Asia. Most notable is Dharavi, which lies in the center of Mumbai where more than one million squatters live in temporary housing on one square mile of government land, juxtaposed beside the modern and high-priced commercial developments. 

In this section, we look at the gentrification process in Mumbai through the slum redevelopment project in Dharavi.

This will be analyzed by looking at the process of the proposed Dhravai Redevelopment Plan (DRP), combined with examining failed policies regarding gentrification in Dharavi.

Archithoughts, (2009). Dharavi Mumbai . [image] Available at: https://archithoughts.wordpress.com/2009/10/06/room-with-views/ [Accessed 1 Apr. 2017].

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  • 1.5 Settlements and service provision
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Squatter settlement case study: Dharavi, Mumbai, India

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SFGate - Slums separate Bombay from its future / Struggle over plans for redevelopment slows city's progress [12 October 2006]

  • Where in the world is Dharavi?
  • Describe the location of Dharavi.
  • Briefly describe the history of Dharavi.
  • What is the current population of Dharavi?
  • Describe the industry and economic activities that can be found in Dharavi.
  • Using actual quotes and examples – describe what it is like to live in Dharavi.
  • Why do some people want to redevelop in Dharavi?
  • Describe the planned redevelopment of Dharavi.
  • What criticisms have there been of the planned redevelopment of Dharavi?
  • What alternative projects have been suggested to improve Dharavi besides its complete destruction?
  • Which proposed project – building a new town on the site or improving the current shanty town – do you think is the best and why?

A map of part of the urban settlement of Dhaka, Bangladesh

  • Give three pieces of map evidence which suggest that this area is part of a squatter settlement and not occupied by high-cost housing. [3 marks]
  • Suggest why many people living in rural areas in developing countries make the decision to migrate to urban settlements such as Dhaka. [5 marks]
  • Describe what has been done to improve the quality of life in squatter settlements in developing countries. You should refer to examples which you have studied to illustrate your answer. [7 marks]
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  • Case study: Urban growth in Dharavi: redevelopment for the future

dharavi geography case study

Geographical skills: Reading Ordnance Survey maps for urban areas

Urban growth in dharavi, redevelopment for the future.

GCSE candidates are expected to understa nd someof the opportunities and challenges for residents living in informal settlements. How can urban planning strategies, such as redevelopment, improve the lives of the urban poor? This article explores how Dharavi (Asia’s largest area of informal housing) might be affected by a new redevelopment plan.

  • Volume 35, 2023/ 2024
  • Development
  • Emerging megacity
  • Human Geography
  • Urbanisation

Kate Williamson

dharavi geography case study

Since 2007, more than half the world’s population has been living in cities and this is expected to rise to 60% by 2030. This trend has been accelerated by rapid rural to urban migration and high rates of natural increase. Roughly one quarter of the world’s population lives in informal housing, sometimes known as squatter settlements. Due to rapid rates of urban growth in low-income countries (LICs) or developing countries, the number of people living in informal settlements is projected to increase even further.

One city affected by rapid urban growth is Mumbai, located on the west coast of India and the capital of Maharashtra state. Mumbai has experienced population growth from less than 16 million in 2002 to just over 21 million today. Mumbai is now one of the most densely populated cities in the world.

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Learning from the Slums for the Development of Emerging Cities pp 159–171 Cite as

Dharavi: Where the Urban Design Episteme Is Falling Apart

  • Camillo Boano 4  
  • First Online: 30 July 2016

1280 Accesses

Part of the book series: GeoJournal Library ((GEJL,volume 119))

Dharavi is the iconic symbol of a “slum” understood as an inevitable spatial product of global predatory capitalism. Contemporary Mumbai and specifically Dharavi serve as an extreme example of urban design episteme falling apart and putting in place new urban imaginations and practices of resettlements and displacement. Such multiple forms of different urbanisms and heterogeneous forms of urban lives and occupations may be challenged by: fighting non-critical engagement with (re)interrogation of design practice, design thinking and design education, adopting a more nuanced and critical, transdisciplinary and multidisciplinary vision of architectural and urban design, as well as dealing with precariousness, scarcity and informality as constituent materials of everyday urban planetary condition.

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See for example: recent exhibitions such as Design with the Other 90 %: Cities exhibit at the UN and MoMA’s Small Scale, Big Change or Stefano Boeri, Sao Paulo Calling; or the Lotus International 143 (2010) and 145 (2011), Harvard Design Magazine, Architectural Design May 2011, Magazine dell’Architettura, n. 53, 2012 just to mention a few.

Design is a term here adopted very broadly, aiming to encompass both architecture and urban design, and any design actions and design practice going beyond the urban scale and the expert knowledge. Design is conceived as holistic practice loosely refereed to imagining, making, strategising, building and inhabiting urban spaces. (For more see Boano 2014 ).

The practice of informal upgrade is critical and has been the subject of different critical reflections, especially in relation to density, typologies and design processes. See Boano et al. 2011 .

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Boano, C. (2014). Architecture of engagement. Informal urbanism and design ethics. Atlantis Magazine, 24 (4), 24–28.

Boano, C., La Marca, M., & Hunter, W. (2011). The frontlines of contested urbanism: Mega-projects and mega-resistances in Dharavi. Journal of Developing Society, 27 (3-4), 295–326.

Boano, C., Hunter, W., & Netwon, C. (2013). Contested urbanism in Dharavi. Writings and projects on the resilient city . London: Development Planning Unit.

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Patel, S., & Arputham, J. (2007). An offer of partnership or a promise of conflict in Dharavi, Mumbai? Environment and Urbanization, 19 (1), 501–508.

Patel, S., Arputham, J., Burra, S., & Savchuk, K. (2009). Getting the information base for Dharavi’s redevelopment. Environment and Urbanization, 21 (1), 241–251.

Rao, V. (2006). Slum as theory: The south/Asian city and globalization. International Journal of Urban and Regional Research, 30 (1), 225–232.

Rao, V. (2012). Slum as theory: Mega-cities and urban models. In C. G. Crysler et al. (Eds.), The SAGE handbook of architectural theory (pp. 671–686). Cornwell: SAGE Publications.

Roy, A. (2005). Urban informality, toward an epistemology of planning. Journal of the American Planning Association, 71 (2), 147–158.

Roy, A. (2009). Strangely familiar: Planning and the world of insurgence and informality. Planning Theory, 8 (1), 7–11.

Wade, A. (2013). Informality and Injustice in the Resilient City: Interview with William Hunter . http://www.thepolisblog.org/2013/07/contested-urbanism-dharavi.html . Accessed 12 Aug 2013.

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Further Reading

Arputham, J. (2012). How community-based enumerations started and developed in India. Environment and Urbanization, 24 (1), 27–30.

Arputham, J., & Patel, S. (2010). Recent developments in plans for Dharavi and for the airport slums in Mumbai. Environment and Urbanization, 22 (2), 501–504.

Bapat, M., & Agarwal, I. (2003). Our needs, our priorities; women and men from the slums in Mumbai and Pune talk about their needs for water and sanitation. Environment and Urbanization, 15 (2), 71–86.

Buckley, R. M. (2011). Social inclusion in Mumbai: Economics matters too. Environment and Urbanization, 23 (1), 277–284.

Burra, S. (2005). Towards a pro-poor framework for slum upgrading in Mumbai, India. Environment and Urbanization, 17 (1), 67–88. doi: 10.1177/095624780501700106 .

Burra, S., Patel, S., & Kerr, T. (2003). Community-designed, built and managed toilet blocks in Indian cities. Environment and Urbanization, 15 (2), 11–32. doi: 10.1177/095624780301500202 .

Burrows, R., Ellison, N., & Woods, B. (2005). Neighbourhoods on the net: The nature and impact of internet-based neighbourhood information systems . T. P. Press (Ed.): Joseph Rowntree Foundation.

Chaplin, S. E. (2011). Indian cities, sanitation and the state: The politics of the failure to provide. Environment and Urbanization, 23 (1), 57–70. doi: 10.1177/0956247810396277 .

Das, A., & Parikh, J. (2004). Transport scenarios in two metropolitan cities in India: Delhi and Mumbai. Energy Conversion and Management, 45 (15–16), 2603–2625.

de Zoysa, I., Bhandari, N., Akhtari, N., & Bhan, M. K. (1998). Careseeking for illness in young infants in an urban slum in India. Social Science & Medicine, 47 (12), 2101–2111.

Desai, V. (1988). Dharavi, the largest slum in Asia: Development of low-income urban housing in India. Habitat International, 12 (2), 67–74.

Fernandes, L. (2004). The politics of forgetting: Class politics, state power and the restructuring of urban space in India. Urban Studies, 41 (12), 2415–2430. doi: 10.1080/00420980412331297609 .

General Bibliography – India, Mumbai

Meschkank, J. (2011). Investigations into slum tourism in Mumbai: Poverty tourism and the tensions between different constructions of reality. GeoJournal, 76 (1), 47–62. doi: 10.1007/s10708-010-9401-7 .

Mukhija, V. (2002). An analytical framework for urban upgrading: Property rights, property values and physical attributes. Habitat International, 26 (4), 553–570.

Nijman, J. (2008). Against the odds: Slum rehabilitation in neoliberal Mumbai. Cities, 25 (2), 73–85.

O’Hare, G., Abbott, D., & Barke, M. (1998). A review of slum housing policies in Mumbai. Cities, 15 (4), 269–283.

Pacione, M. (2006). Mumbai. Cities, 23 (3), 229–238.

Patel, S., & Arputham, J. (2007). An offer of partnership or a promise of conflict in Dharavi, Mumbai? Environment and Urbanization, 19 (2), 501–508. doi: 10.1177/0956247807082832 .

Patel, S., & Arputham, J. (2008). Plans for Dharavi: Negotiating a reconciliation between a state-driven market redevelopment and residents’ aspirations. Environment and Urbanization, 20 (1), 243–253. doi: 10.1177/0956247808089161 .

Patel, S., d’Cruz, C., & Burra, S. (2002). Beyond evictions in a global city: People-managed resettlement in Mumbai. Environment and Urbanization, 14 (1), 159–172. doi: 10.1177/095624780201400113 .

Patel, S., Arputham, J., Burra, S., & Savchuk, K. (2009). Getting the information base for Dharavi’s redevelopment. Environment and Urbanization, 21 (1), 241–251. doi: 10.1177/0956247809103023 .

Rathi, S. (2006). Alternative approaches for better municipal solid waste management in Mumbai, India. Waste Management, 26 (10), 1192–1200.

Roy, A. N., Jockin, A., & Javed, A. (2004). Community police stations in Mumbai’s slums. Environment and Urbanization, 16 (2), 135–138. doi: 10.1177/095624780401600205 .

Saglio, M.-C. (2001). Mumbaï: mutations spatiales d’une métropole en expansio n. Mappemonde , 62 (2001.2).

Shukla, A., Kumar, S., & OÖry, F. G. (1991). Occupational health and the environment in an urban slum in India. Social Science & Medicine, 33 (5), 597–603. doi: http://dx.doi.org/10.1016/0277-9536(91)90217-Z .

Sridhar, K. S. (2010). Impact of land use regulations: Evidence from India’s cities. Urban Studies, 47 (7), 1541–1569. doi: 10.1177/0042098009353813 .

Stephens, C. (1992). Training urban traditional birth attendants: Balancing international policy and local reality: Preliminary evidence from the slums of India on the attitudes and practice of clients and practitioners. Social Science & Medicine, 35 (6), 811–817.

Tiwari, P., Parikh, K., & Parikh, J. (1999). Effective housing demand in Mumbai (Bombay) metropolitan region. Urban Studies, 36 (10), 1783–1809. doi: 10.1080/0042098992827 .

Zérah, M. H. (2007). Conflict between green space preservation and housing needs: The case of the Sanjay Gandhi National Park in Mumbai. Cities, 24 (2), 122–132.

Zérah, M.-H. (2008). Splintering urbanism in Mumbai: Contrasting trends in a multilayered society. Geoforum, 39 (6), 1922–1932.

Specific Bibliography – Dharavi

Dupont, V. (2008). L’urbanisation en Inde: révision de quelques mythes et vrais défis. Rayonnement du CNRS , 47 .

Gerster, R., & Zimmermann, S. (2005). Up-scaling pro-poor ICT-policies and practices . Swiss Agency for Development and Cooperation.

Goethert, R. (2001). The use of IT in scaling up urban slum improvement efforts . Proceedings of the Institution of Civil Engineers, 145(4).

Keny, R. (2008). Urban Typhoon . Workshop Koliwada-Dharavi.

Risbud, N. (2003). Urban slums reports: The case of Mumbai, India . Understanding slums: Case studies for the global report on human settlements

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Boano, C. (2016). Dharavi: Where the Urban Design Episteme Is Falling Apart. In: Bolay, JC., Chenal, J., Pedrazzini, Y. (eds) Learning from the Slums for the Development of Emerging Cities. GeoJournal Library, vol 119. Springer, Cham. https://doi.org/10.1007/978-3-319-31794-6_15

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Reengineering an urban slum: a case study of Dharavi, India

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CASE STUDY: DHARAVI

  • Created by: Jamie Grainger
  • Created on: 16-04-17 11:14

Mumbai is India's financial captial. Until 1980's, Mumbai's economy was based upon textile production. Bollywood capital. There has been an increase in IT and financial services. 

It is a megacity, with a current population of over 12 million. In 1947, population was only 4 million. The population density is said to be about 22,000 people per km2. 

Causes of urban growth:

  • People are drawn by the prospect of employment of various skills.
  • The port known as "gateway to India" by the Europeans leading to industrilisation.
  • Banking and finance established during British rule brought wealth and development.

Problems with urban growth:

  • Respiratory health problems due to pollution.
  • Widespread poverty and unemployment.
  • Due to lack of education, many still have as many children as they would in the rural areas.
  • World cities

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Asia's largest urban slum-Dharavi: A global model for management of COVID-19

The Dharavi sector of Mumbai, India is constituted as one of the biggest slums of Asia and the world's most populated areas. The COVID-19 outburst is at its peak in May and curve gets flattened within next two months. This article focuses on factors responsible for transmission, prevention and in controlling the COVID-19 spread in Dharavi. The COVID-19 data was interpreted in terms of Case Recovery Rate (CRR) and Case Fatality Rate (CFR) for total and closed both. The CFR per closed reached 10.12% nearly to per total 9.82% in Dharavi on 31st July 2020. The CRR per total cases in Dharavi and Mumbai is 87.16 & 76.18% and per closed cases is 89.87 & 93.20% respectively in comparison to the CFR. The calculated CFR and CRR for both Dharavi and Mumbai suggest that the COVID-19 recovery rate is more than the fatality rate. The Dharavi people serve as an important role in controlling the pandemic by adopting 4-T model tracing, tracking, testing, and treating strategy. This article is beneficial for government policy makers and private agencies in controlling the COVID-19 pandemic in densely populated areas and also for nations with high fatality rate.

1. Introduction

The world's corona virus pandemic (COVID-19) is caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The COVID-19 declared as a Public Health Emergency of International Concern and global pandemic on 30th January 2020 and 11th March 2020 respectively by the World Health Organization (WHO) ( Sohrabi et al., 2020 ). 1 India's first case of COVID-19 was reported on 30th January 2020 which had originated from Wuhan, China. 2 Currently, India has a total number of 16,38,870 confirmed cases, the highest number in Asia and third in the world after the United States and Brazil as on 31st July 2020. 3 Although, India has the lowest case fatality rate i.e. 2.41% in the world and the recovery rate stands at 63.18% which continuously increasing day by day according to the Union Health Ministry of India as of 23rd July 2020. 4 Six cities of India Mumbai, Delhi, Ahmadabad, Chennai, Pune, and Kolkata reported for half of the cases in the country as of 31st July 2020. 5 Mumbai, the capital city of Maharashtra contributed to 66% of the total cases in the state and over 20% of all cases in India. 6 Mumbai is the biggest metropolitan city also known as the commercial capital of India, located on the western coast towards the Arabian Sea at coordinates 18.96° North and 72.82° East ( Ramasamy & Sundararajan, 2020 ). The Mumbai City and suburban areas, collectively known as the Greater Mumbai region occupy only 483 km 2 . Mumbai is recognized as the 4th most populous city of the world and having an estimated population of 20 million presently. 6 The migration of people from other Indian regions to Mumbai for Business and employment opportunities leads to a high population in the city. Due to this rapid expansion, a large percentage of residents live in the city's slums. The estimation of people living in slums is over 9 million which means a rate of 41.3% as of Greater Mumbai. 7 Dharavi is recognized as one of the densest slum areas of Asia and the world's one of the largest slum located in India's financial capital-Mumbai. Around 8.5 lakh people live in approx. 55,000 dwelling units in Dharavi with a population density of 3.4 lakh per km 2 and covers around 535 acres of land ( Ramasamy & Sundararajan, 2020 ). Dharavi comprises of nearly 15,000 single-room factories and 5000 businesses ( Alam & Matasuyuki, 2020 ). All over the world, Dharavi is recognized as one of the most densely populated urban agglomerations. Other than ever-increasing population density, the dearth of hygiene and awareness, miniature homes and low income has made living conditions in the Dharavi even worse. In these conditions, social distancing during the COVID-19 pandemic was very difficult. When the COVID-19 cases were reported in early April month in Dharavi, an overpopulated slum area in the heart of India's financial capital, controlling the spread of the disease is an immense challenge. Despite these conditions, the COVID-19 outbreak can be manageable and not reached at the community level. In this perspective, this research study is conducted to provide insights on understanding the spatial spread of the virus in Mumbai with a special focus on its slum area Dharavi which would be useful in planning and implementing control efforts to prevent COVID-19 spread. This research paper presents the COVID-19 data of Dharavi and evaluates the Case fatality rate and Case recovery rate of the Dharavi in comparison to Mumbai. The various strategies planned to prevent and control the COVID-19 spread in a world's densely populated area Dharavi slum are discussed here which can be implemented in other places to control the disease.

2.1. Study design

This research is based on an observational investigation of COVID-19 in the Dharavi sector in Mumbai, India as of the end of 31st July 2020. Fig. 1 shows the geographical location of Mumbai in India and a satellite image of the Dharavi sector. The Brihanmumbai Municipal Corporation (BMC) is Municipal Corporation of Greater Mumbai which is a local governing body. The BMC is monitoring and responsible for the implementation of the public health and economic activities in the wards. During the COVID-19 outbreak in this region, BMC is closely monitoring the situation and plans and executes the policies to control the spread of disease. The information about COVID-19 cases updated and informed to the ‘corona war room’ in the control unit through the BMC's Health Department team. The data for analysis of COVID-19 cases is extracted from the official portal of BMC. 8 The BMC publicized its data for public use on its website. The nationwide data for COVID-19 is extracted from the Ministry of Health and Family Welfare (MoHFW), India. 9 The United Nation Population Report is used to extract the population data. 10

Fig. 1

(a) Geographical map of India and Mumbai (b) satellite image of Dharavi (Mumbai).

2.2. Data analysis

The descriptive statistics of confirmed cases in Mumbai were compiled to study the epidemiological characteristics of COVID-19 spread. This analysis involves the calculation of Case Fatality Rate (CFR) and Case Recovery Rate (CRR) for confirmed cases of COVID-19 diagnosis in Mumbai till 31st July 2020 and calculated as per equations given below ( Ghani et al., 2005 ; Kim & Goel, 2020 ; Mahajan & Kaushal, 2020 ; Spychalski et al., 2020 ):

In India, a total of 1,693,274 COVID-19 confirmed cases along with 36,513 deaths have been reported in as of 31st July 2020, 08:00 GMT+ 5:30 according to the MoHFW. Maharashtra is in first place with 422,118 COVID-19 cases followed by Tamil Nadu, Andhra Pradesh, Delhi, and Karnataka the top five states with the number of cases more than one lakh. 9 The case fatality rate of Maharashtra is nearly 4.3% that is significantly higher than other Indian states with large numbers of cases however it is lower than the global average rate as of 31st July 2020.

Mumbai, the financial capital of India is the worst affected city with about 115,346 cases with 6395 deaths as of 31st July 2020. 8 Fig. 2 represents the timeline of the confirmed, recovered, and death counts of the COVID-19 pandemic in Mumbai from 21st March to 31st July 2020. This pattern indicates the incomparable disaster that is happening in the commercial capital of India. In India, only Delhi as a metropolitan city and capital of India is somewhat closer to Mumbai city with 136,716 confirmed cases and 3963 deaths. 9 Otherwise, no other cities are near to Mumbai city in terms of COVID-19 cases. Though Mumbai is affected severely in India, the numbers of confirmed cases are less as compared to other cities of global importance. Around 2% of the population is affected in New-York city with 387,272 cases while Mumbai stands with 0.32% cases for its population of 20,411,274 ( Desai, 2020 ). 11 The population density of Mumbai is more than double of New York City, which is currently the epicenter of the COVID-19 pandemic in the USA. 12 However, it is affected six times worse than Mumbai. Lombardy (Italy), Moscow (Russia), Sao Paulo (Brazil), Lima (Peru) etc. are greatly affected by COVID-19 and having confirmed cases in thousands with high number of causalities in comparison to Mumbai ( Ramasamy & Sundararajan, 2020 ). Mumbai's 60% populations live in Dharavi and they occupy only 6% of the total land area of the city. 13 However, the confirmed number of COVID-19 cases reported in Dharavi is only 2.2% in comparison to Mumbai. The total confirmed patients, recovered and deaths from the COVID-19 timeline of the Dharavi sector up to 31st July 2020 have been shown in Fig. 3 .

Fig. 2

COVID-19 timeline of Mumbai (India) from 21st March 2020 to 31st July 2020.

Fig. 3

COVID-19 timeline of Dharavi from 21st March 2020 to 31st July 2020.

The first COVID-19 case and causality from Dharavi were accounted for on 1st April 2020 after three weeks of the Mumbai's first case. In the April month, the COVID-19 cases in Dharavi shot up severely to 491 cases with a 12% growth rate and 18 days doubling period. The month of May, an average of 48 cases per day reported in Dharavi with highest record of 94 cases on May 3. Thereafter, the practical measures are taken by the BMC and other agencies to control the disease, and the growth rate declined to 4.3% at the end of May. In June, Dharavi appears to have changed the scenario and cases are increasing only by 18 per day. It has been also observed that the doubling time increased from 18 days in April to 43 days in May, 78 days in June spelling, and slowed down 430 days in July. Indeed, only 5 cases have been reported on 23 June 2020, the lowest since 5th April 2020 and BMC forced to shut down its two COVID Care Centers (CCC). 14 As per 31st July 2020, Dharavi has only 77 active cases and 2479 patients have recovered and discharged.

The CFR and CRR for Dharavi in comparison to Mumbai from April to July 2020 summarized in Fig. 4 , Fig. 5 respectively. The early stage of the outbreak in Dharavi started in the third week of April. As shown in Fig. 4 , the maximum peak value of CFR per closed for Dharavi is found at 37.50% whereas for Mumbai it is only 26.88% on 21st April 2020. The CFR per closed value dropped to 4.55% for Dharavi and 9.36% for Mumbai as of 1st July 2020. This difference suggests that the outbreak of the COVID-19 pandemic is a downturn stage in the June. This sharp decrease in COVID-19 cases in Dharavi recognized by the Union ministry of health and family welfare of India and it issued a release soliciting the Dharavi model on June 21. The CFR per closed (10.12%) reaches nearly to per total (9.82%) in Dharavi with only 77 active cases as per 31st July 2020. As shown in Fig. 4 , CRR per total cases in Dharavi and Mumbai is 87.16% & 76.18% and per closed cases is 89.87% and 93.20% respectively in comparison to the CFR. These findings suggest that the COVID-19 recovery rate is more than the fatality rate for both Dharavi & Mumbai. But, still Mumbai has 20,863 active cases to be recovered. In Dharavi, 87.16% of COVID-19 patients have been recovered so far with only 77 active cases.

Fig. 4

CFR comparison of COVID-19 cases in Dharavi and Mumbai from April –July 2020.

Fig. 5

CFR comparison of COVID-19 cases in Dharavi and Mumbai from April–July 2020.

4. Discussion

The WHO confirmed the pandemic outbreak of COVID-19 on March 11, 2020 and announced the guidelines to limit the transmission of the virus which focused on lockdown, social distancing, and use of facial masks for the general public. As COVID-19 infection is supposed to be highly susceptible to densely populated areas such as slums and informal settlements in cities, the situation become worst when these slums emerged as hotspots of COVID-19 virus. The developed nations like USA, China, UK, Brazil, Russia, Italy etc. with well-equipped health systems have struggled on war foot to tackle the situation. In comparison to these nations, the challenges in these slums are much more and required more innovative solutions to curb the spread of disease. Dharavi, a most populated an urban slum of Mumbai City emerged as such hotspot of the COVID-19 pandemic. The challenges in Dharavi were enormous to control the COVID-19 spread as shown in Fig. 6 .

Fig. 6

Challenges in Dharavi to control transmission of COVID-19 virus.

Dharavi is basically a complete city within Mumbai city, with a non-spacious endless stretch of lanes with open sewers and overcrowded huts. Approximately 850,000 people reside with an inordinate population density of 277,136 per km 2 in the Dharavi sector which has the only area of 2.5 km 2 . 13 On average, 10–12 people live in minuscule homes of 10 × 10 ft size situated in narrow lanes. The common toilets and water taps are used by thousands of people daily. 13 In addition, several legal and non–legal small-scale manufacturing units are located in Dharavi. About 15,000 single-room factories and 5000 registered companies having the capacity of international export with an annual turnover of 1 billion USD are operated inside Dharavi. Hence, the dearth of hygiene, miniature homes, illiteracy, and lack of awareness has intensified the living conditions in the Dharavi dwelling. These are severe confines the precautions such as ‘physical distancing’ and ‘home quarantine’ to prevent the spread of COVID-19. At the point, when the first COVID-19 case was identified in Dharavi, a packed trap of one-room shacks in the core of India's financial capital, epidemiologists raised concern about the rapid and out of control COVID-19 spread in Dharavi. Therefore, the Maharashtra government recognized Dharavi as one of the threatening zones of Mumbai city. Despite all the challenges, COVID -19 doubling rate of the virus decreases and infection gets controlled in Dharavi as depicted in Fig. 7 .

Fig. 7

Timeline of doubling rate of COVID-19 in Dharavi (Mumbai).

The transmission of the COVID-19 infection in Dharavi is successfully controlled through an innovative 4-Ts model as described in Fig. 8 . The government authorities decided to “chase the virus” in concern to high risk of transmission of the virus in a densely populated area. The authorities don't want the Dharavi to become Lombardy (Italy) or New York (USA) where COVID-19 spread at a very high rate and resulted in hundreds of causalities. So, the health officials decided not to wait for people to become COVID positive and then confirm through testing. They start the testing rather than wait for the patients to report. The 4-Ts model i.e. Tracing, Tracking, Testing, and treating model was adopted by authorities to control the spread of the disease. For the successful operation of this model, a multi-sectoral approach has been adopted. The bureaucrats, politicians, government health officials, private doctors, municipal corporation workers, communities, families and individuals all played a significant role in the control of pandemics.

Fig. 8

4-Ts Dharavi model.

The administration sealed the border and set up 24 check-posts at entry points of the slum with immediate effect. To implement containment measures in hotspots, several actions have been taken. All types of shops, small factories and markets were closed; public and private transportation was stopped; people movement was restricted strictly and drones are employed for reporting to police. A number of volunteers came forward for effective executing of these containment measures. The Corona war room was also established to kept eye on a very minute development in each aspect of tracing, tracking, testing, and treating the COVID patients in the slum area.

Approximately 700,000 people screened in the slum area through temperatures and oxygen levels measuring. 15 The fever clinic has been set up inside the slum area which becomes very helpful in tracing the virus and the symptomatic patients immediately shifted to quarantine centers. Kiran Dighavkar, the assistant commissioner of the G Northward of the BMC, with the consent of state officials, changed the traditional approach style of waiting for patients at the health care center. The civic bodies took the help of 350 local and private medical practitioners of the same vicinity and equipped them with PPE kits and essential medical tools to commence proactive screening door to door at Dharavi. 16 Due to the highly congested area, it was impossible to keep social distancing and lockdown. Local religious places, 15,000 mobile vans operated for the awareness of COVID-19 symptoms by announcements. Nine quarantine centers were arranged in nearby schools, sports complexes, marriage palaces, and community halls. For providing critical care, the BMC took over five private hospitals in the area. Approximately 7 lakh people were screened and suspected 14,000 were tested and 13,000 placed in quarantine centers. These were provided with a free community kitchen. In the April, 491 corona virus positive cases were reported which gradually increased to 1212 in May. Therefore, at the first stage, state authorities directed 2450 health workers for mass testing and containment to gradually slow down the spread of the virus. 16 Due to clinical management, hard-hitting testing initiated on potential cases, and positive detected were isolated, and quarantine at separate COVID centers. Suspected cases were placed under different COVID Care centers and marked as CCC 1, who were asymptomatic, CCC2 having slight symptoms, and severe cases held under Clinical Management. Contact tracing, generating huge quarantine services, and separating the susceptible population were major steps, which pave the way for controlling the cases in Dharavi.

More than 70% of people in Dharavi use Community toilets and it was the main apprehension in the enhancement of positive cases so to reduce this factor, community toilets were sanitized every hour by civic authorities. Many migrants in Dharavi who were daily wagers and in May, nearly 1.5 lakh returned to their homes and it also further decreases the burden of civic bodies. BMC and many NGO's also distributed more than 25,000 grocery kits, food packets for lunch and dinner to minimize the movement of people from their homes. Hence, the collective efforts of BMC, local clinical management, NGOs, and media could be able to curb the corona virus spread and slow down the cases in Dharavi.

The 4-Ts model i.e. Tracing, Tracking, Testing, and treating proactive patients, adopted by BMC was highly appreciated by WHO also. 17 This model appeared as a role model to combat the virus across the globe. The WHO acknowledged the Dharavi success as “Dharavi should be seen as an example across the world.” The WHO confirmed that the 4-Ts model has become a success stone and helpful in breaking the chain of virus transmission. Thus, this 4-Ts model becomes the template for the densely populated urban areas globally around the world to prevent the spread of COVID 19. This is also important to note that the Dharavi model is an ideal of setting where social distancing is impossible or difficult to follow. For instance, the other populated areas of world such as Makoko in Lagos (Nigeria), Mbare in Harare (Zimbabwe) and Kibera in Nairobi (Kenya) where seven people on average sharing a shed and it is not possible social distancing or lockdown in these slums ( Kuguyo et al., 2020 ). As most people living in these areas depends upon daily wages and had to step out to earn their livelihood and a strict lockdown is impossible without proper planning. To control the pandemic in these areas, the officials could look into the model and the policies adopted in Dharavi.

Despite of high population living in unhygienic conditions in Dharavi, the case fatality rate is found to be quite low. This can be possible only with 4T-s model of timely chasing, screening, isolating and regular monitoring of patients infected with virus. The decision of chasing the virus before spread also ruled out high fatality in the area like Dharavi with poor health resources. This could be eye opener for nations with high COVID-19 fatality rate like USA and Italy which are known for their best health services. Still, the transmission of virus is not under control in many parts of world. The second wave of transmission of virus is also seen in some European nations. Hence, the policymakers around the globe the developed as well as developing nations could replicate this model to curb COVID-19. In future, the Dharavi model plays a significant role as a case study in control such pandemics.

5. Conclusion

COVID-19 pandemic is still up-and-coming; many new approaches and policies are sprouting from best- employed practices around all over the world. Many countries like Iceland, South Korea, Taiwan, Spain, Papua New Guinea, New Zealand, Greece, Montenegro, Fiji, Vatican city, and Mauritius have effectively controlled the COVID-19 pandemic and set an example for other nations. The strategy followed by these nations may be applied to developed nations equipped with well-functioned health systems. However, these cannot be feasible for developing nations and resource-limited nations. For such nations, the approach followed in Dharavi (Mumbai), a highly-populated area of the world to control COVID-19 pandemic could be a boon. The 4-Ts (Tracing, Tracking, Testing, and treating) model approach adopted in Dharavi proven to control the COVID-19 virus spread through the breakdown of the chain of virus transmission. Mumbai still has emerged as a hotspot of the COVID-19 outbreak where Dharavi spelled the unprecedented doom. Despite being with zero possibility of social distancing, the Dharavi people set an example for the entire world for not only to curb the spread of the virus but also to control fatality rate. Thus, the “Dharavi Model” can be a role model for not only in controlling pandemic in informal settlements, slums etc. but also for developed nations where fatality rate is quite high. The success of the Dharavi model narrated the gritty groundwork, farsighted management, practical approach, efficient government-private sector, and most important people commitment. The other densely populated slums around the world could take a lesson from the Dharavi people. COVID-19 pandemics also provided opportunities for policymakers to create more comprehensive and flexible health policies in cities which in turn, strengthens public health improves the living standards of people, and improves the economy of the nation.

This research work didn't receive any funding.

CRediT authorship contribution statement

Conceptualization: J.K.; Data Analysis & Interpretation: P.M.; Supervision: J.K.

Roles/Writing: Original draft: P.M.; Writing - review & editing: P.M. & J.K.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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