Peter Joseph says he does his best to keep his family safe during the coronavirus pandemic. They all wear masks. They use hand sanitizer when they can find a supply – it's in short supply across the Pakistani capital Islamabad, where they live.
What Joseph, a 39-year-old painter, can't change is the risky situation at home: His family of how many lives in one room in a crowded house in a slum called the French Colony, wedged between upscale Islamabad suburbs. The front doors of the dozens of dwellings lie just feet apart. The only open space is a trash-strewn canal that runs through the slum, reeking of sewage.
"Even if somebody falls ill I would still have to keep them in the same room, because I have only one room," Joseph told NPR last week. Nearby, a gaggle of children crowded onto a sidewalk, playing marbles. Another child flew a kite.
For many Pakistanis like Joseph and residents of the French Colony slum, space is a luxury — and social distancing is nearly impossible both within their homes and on the narrow streets around them.
Even transportation has its risks: poorer Pakistanis cram into vehicles to get about, like on a recent day in Islamabad, when more than a dozen men crammed into the back of a pickup truck – and about five more sat on the roof of the vehicle. Wealthier motorists looked on in horror from their cars.
What's more, worshippers crowd in mosques in working-class areas – there is often no other space for communal prayers and many clerics have dismissed the danger of contagion. And as authorities shut down parks and other green spaces, poorer families have nowhere to go for fresh air — while well-off Pakistanis tend to have well-tended gardens.
Urban planning activists like Professor Nausheen H. Anwar, believes that city slum dwellers in Pakistan and across developing countries may emerge as one of the most vulnerable populations to the disease.
"I honestly believe that urban Pakistan is at the front line of the COVID-19 crisis," says Anwar, founder and director of the Karachi Urban Lab.
Think about countries badly affected by the pandemic, like Italy or Spain, "where there is almost universal access to clean water, sanitation," Anwar says. "What we've seen is that the virus has spread at an absolutely unimaginable pace. So what are we looking at when we think of urban Pakistan?"
She is referring to places like the Lyari slum in the southern Pakistani city of Karachi, a city where about two-thirds of its population of at least 16 million people live in slums – or informal urban settlements, according to Anwar's research.
Adding to their woes, many residents of those areas do not have running water. They purchase water from tankers. It is expensive, up to $100 a month, the equivalent of a monthly wage for many laborers. It is used sparingly, often just for cooking and regular handwashing is an unimagined luxury.
Anwar describes Pakistan's urban slums as black spots. They often lacked running water, sewage systems and reliable electrical power, she says, and officials don't keep data on these communities, making it very difficult to formulate good policies – including how to keep residents safe during a pandemic.
So even as the pandemic looms across Pakistan, the crowding continues. On March 26, a video uploaded on Twitter by human rights activist in the slum, Sameer Mandhro showed a Lyari street after provincial officials announced a shutdown just days earlier. Crowds crammed on a narrow street, brushing against each other, buying food. They have nowhere else to go, said resident Pir Bux, whom NPR contacted by phone – no room inside their homes, no open spaces elsewhere.
"Everybody is on the streets, kids, young people, the elderly. If the police ask them to leave – they just converge somewhere else," said Bux.
His neighbor is Mohammad Abid, a day laborer who shares a five-room apartment with 25 people: his brothers, their wives and children. Abid says if the coronavirus rips through here, it would be worse than Italy. He says: "There won't be enough people left to collect the bodies."