Water supply and sanitation services are important for a whole host of reasons – time saving, dignity, convenience, economic growth, – including of course, public health. Yet it remains difficult to evaluate the extent to which those services actually do change health outcomes. Public health is affected by many variables, which interact in complex ways.
While on its path to becoming the largest city in the Americas, Sao Paulo used its natural capital - water - to generate electricity, fuel industry, and satiate its ever-growing population. Natural infrastructure was traded for the concrete form and the city’s great rivers paid a high price for industrialization.
The result? Tremendous growth (averaging 5% per annum) that stimulated rapid and unplanned migration to the city and environmental pollution. Urban sprawl generated little to no infrastructure for managing water, sanitation and wastewater, or solid waste. Clearing the land for houses caused erosion and compacted soils, and the resulting increase in runoff has made an already wet city even more prone to floods.