 Hello everyone, my name is Sarah Tucker and welcome to the webinar. So I'd just like to take a quick moment to introduce our panellists to you today. So we have the amazing Alice Fedlick, who is a social development lecturer at the University of Manchester's Global Development Institute and previously worked as a researcher at IED. We're training in city planning and social policy. She's interested in health equity, shelter and informal livelihoods in African and Asian cities. We also have Kanipria Kothiwal, who is a research associate at the Urban Health Resource Centre in India. She is a sociologist interested in qualitative and mixed methods research, gender and multiple vulnerabilities of informal urban communities. We also have Artwell Kanduguri, is a programme officer at the Training and Research Sports Centre in Harare Zimbabwe, where he's worked since 2009. His research has explored health financing, participatory action research methods and access to primary health care in Zimbabwe. Joining Artwell is Wispor Malaya, and he is the Secretary-General of the Zimbabwe Chamber of Informal Economy Associations, and he has been part of Zikia since its inception in 2002. We are also joined by David Dodman, who is the director of IED's Human Settlements Group and has served as the co-ordinating lead author on cities, settlements and key infrastructure for the IPC's sixth assessment report. His expertise in urban governance for climate adaptation and community-based environmental management. We are joined by our discussants today, who is Christy Bram, who is a workers' health coordinator for the Women in Informal Employment, Globalising and Organisation. That's Wego. Christy has a PhD in public health and has expertise in informal labour, migration and access to health care for marginalised groups. Additionally, she is the founder and coordinator of the African Platform for Migration and Inclusion in Health. Joining Christy as part of our discussants are Shari Kovats, an associate professor at London School of Hygiene and Tropical Medicine, based in the Department of Public Health, Environment and Society. She has researched the effects of weather and climate change on human health over 20 years. And we'll also be joined by Ranga and Siddharth, who will join us in the Q&A section. Yes, just a big welcome to all of our panellists today. And I will be handed over to Alice now to take us through the first bit of the webinar. Brilliant. Yes. Thank you all so much for joining us. It's a pleasure to be with you. As mentioned, I used to be at IID and I'm now wearing my hat at the University of Manchester. I'm here just to welcome and introduce you to our project and then we'll pass very quickly over to our panellists to tell us more about lessons from India and Zimbabwe, followed by commentary, as you heard from Shari and Christy, with plenty of time for your questions. Just to give you a quick overview, as I'm sure many of you are aware, informal workers are the norm throughout much of the global south and globally, in fact, over 60% of livelihoods are informal, including over 75% of livelihoods in India and sub-Saharan Africa. Just to be clear on terminologies, I'm sure you're aware. Informal sector refers to production and employment in unregistered enterprises. Informal employment is can occur in both formal and informal firms. As we're here, informal workers could say work in a formal factory, and then the informal economy covers all firms, workers and activities operating outside the legal framework. And informal jobs are especially vital to vulnerable groups, including women, youth, migrants and others experiencing multiple marginalization forms of marginalization. And just as a brief overview as well of informal workers, occupational and environmental health risks, given the lack of access to health insurance, sick leave and other vital social protections, informal workers face many challenges that can also be linked to lower incomes and less training than formal workers and more limited access to protective equipment. Of course, there's an enormous variety in informal workplaces, which could be everything from public markets and streets to private homes, but in many instances they will lack services and infrastructure. And as this project has shown, there's an important overlap between informal workers and those living in informal settlements, many of whom live and work in their settlements or in slums that are home to over one billion people globally and where they may face several environmental and occupational health risks. So to take home-based workers as an example here, these workers will often face ergonomic risks, say from sitting on the floor, as we see here, exposure to toxic substances, respiratory illness, injuries and cuts and bruises, limited access to wash and clean energy, as well as other risks linked to low quality shelter. So this is one particular set of overlapping risks that we're particularly interested in this project. And at the same time, of course, climate change is affecting workers' health, is expected to lead to more frequent and extreme heat waves. In 2020, analysis from the Lancet indicated that almost 300 billion hours of potential work hours were lost due to extreme heat exposure. And this, of course, in the context of COVID, when many workers were unable to work anyway, but on top of that, there are an enormous amount of lost work hours due to heat. And at the same time, climate change will likely amplify other workers' health risks, such as due to flooding, water scarcity, air pollution or vector-borne diseases, all the while curtailing workers' access to critical infrastructure and shelter. And many of these studies that look at climate change and occupational health just don't consider the risk facing informal workers, including those long-standing risks at the home and workplace, which will inevitably interact with climate-related threats. So as we argue here, it will be vital to create multifaceted strategies that can strengthen informal livelihoods and well-being. So this leads into our project that we'll be sharing with you today. We conducted participatory action research in the cities of Indore, Mashfingo and Harare in Zimbabwe and in India, and we analysed informal workers' key health determinants and health outcomes while looking at the impacts of extreme weather and climate change and their impacts on informal workers' health and livelihoods. At the same time, we wanted to understand how workers are responding and how to produce holistic solutions that can foster health and enhance resilience to climate change. So in particular, our research was examining the first question here on key determinants of health and health outcomes for both informal workers and those living in informal settlements, to understand the interaction between these risks in relation to public health, occupational and environmental health, and then to bring in the climate change lens. And at the same time in the project, we did want to understand what approaches are already being used to mitigate risks and how to enhance benefits. So I will pass over now to our colleague Kanupriya in India who will take us through their findings from Indore. Thank you so much. The India presentation will be focusing on three sections, risks and challenges of informal workers, solutions that were implemented and their outcomes and recommendations for policy and programme. We conducted 90 qualitative in-person interviews with informal workers and 20 key informal interviews in Indore. One of the first set of findings is linked to heat stress, where workers reported that number of odd days have substantially increased in the last 10 to 15 years. Many informal workers in Indore live in smaller, single-room houses with poor ventilation. Housing materials such as corrugated metal sheets absorb and transmit heat into the living space where women also have to cook. This is a picture of a single house in one of the slums in Indore. Heavie downpour was another risk linked to climate change, which became cross. Residents reported observing a few days with intense rains resulting in water logging in narrow drains, which was also contributed by lack of storm water drains. In many low-lying houses, water enters and damages household items, documents, food drains and heightening food insecurity. Rainwater also links to crevices of homes resulting in dampness and walls and increasing risks of bronchitis. The livelihoods of informal workers were also affected by heat and heavy downpour, as workers faced challenges with respect to commute in heat, resulting in dehydration and exhaustion. Heat stress was also aggravated by poorly ventilated workspaces, especially factories with hot furnaces. As you can see in one of these pictures of a chips factory where discipline is burning, home-based workers in street vendors dealing with perishable items such as food-based risk of damage. Casual workers lose work in the time of heavy downpour and so do street vendors who face lower customer turnout. Food price inflation and food insecurity was another risk of climate change, which we understood. Most workers reported that cost of grains had increased over the past several years, as grains are cheaper in their native villages than in Indore. Only a few workers have ration cards or food subsidy cards enabling them to access subsidised grains. Those who do not have have to buy food from costly markets. Water scarcity and insecurity was manifested in the form of residents having to fetch water from external source such as municipal or private bore wells or municipal water tankers. In the summers, most of these municipal bore wells become dysfunctional. The burden of fetching water fall mostly on women and children impacting their daily activities. Some slum dwellers have fight water supply connections in their house, but these are mostly non-functional. Environmental health and deficient sanitation was manifested through inadequate sewage, where slum lanes usually lag sewage. Families often let their toilets flow out of the back of their house, increasing risk of infections. Poor maintenance and infrequent cleaning of toilets often become unusable till the sewage line is cleared and sludge is often left on the streets. You can see in one of this picture how a toilet is outflowing from a house. Owners occupies usually have toilets exclusive to their families. Some households have toilets connected to sanitary outflow, but others flow it out in the open. Among tenants, typically four to five families share a toilet. Several families get young children to get at a suitable place. They dispose a stool in a vacant plot or with household garbage, thereby resulting in increasing the risk of infections. Occupational health and safety concerns as reported by workers included workplace injuries, which was often linked to machines, to heavy or sharp objects, electrocution in factories and bricks from foreign agricultural fields. Musculoskeletal pain of women was experienced through pain in their arms and legs, going to do with the burden of livelihood and obstrictions. Backache would lead to reduced productivity and more common among women with several pregnancies, often indicating a medical condition called osteomalacia. We also were able to uncover some gender challenges of women and former workers, particular burdens facing by female primary owners such as widows, those deserted by husbands, alcoholic husbands who would not be able to contribute to family income, husbands incapacitated due to illness. Domestic challenges as faced by women and former workers would include domestic violence, the triple burdens of earning, caring and household chores, gender disparity in wages at skill upgrading at workplaces. COVID-19 also aggravated many of these risks. This included food insecurity, where wage loss was incurred by many workers and they had to borrow to buy food. Workers who did not have food subsidy cards were not able to access subsidised grains. Children's education was disrupted as they were unable to pay school fees when to loss livelihoods. Many children did not have smart phones to access online education. Non-COVID healthcare was also affected as children missed humanisation doses during lockdowns. Supplementary nutrition services for young children pregnant and lactating mother could not reach them. Maternity services were adversely impacted as most of the hospitals were dealing with COVID patients. These are some of the resilient practices which we learned from workers. I'm going to only focus on climate change here, which was manifested as workers could elevate plins to prevent water entering in houses. Workers were able to store food grains and grow vegetables to reduce food insecurity and underground water storage was being constructed by many workers so that they could use water for long-term use. Now, what are the solutions which we implemented? Often, informed by these resilient practices, we were able to draft some of these action booklets and disseminated in slums by co-opting field functionaries from health department, local political leaders, ward councillors, members from CSOs and academicians. These action booklets covered ways and sources to access water, information on low cost private and government hospitals and ways to navigate them, strategies adopted by more resilient communities to access municipal services and how these municipal services can be accessed through community requests, information on welfare schemes for informal workers related to health, subsidised food grains, labour benefits, where to apply and what are the documents that are required and what are the local strategies that they can adopt of accessing and storing food grains so that they can be protected from damage to ensure food security. So these are all the practices which we learned from the workers themselves. We conducted some community sessions to facilitate community requests for different slum upgrading requirements. This was to understand how they related to the idea of submitting collective requests and develop collective confidence to make requests for civic works. We identified a number of vulnerable settlements with different sum of grading requirements such as laying or cleaning of sewage pipes. Residents prepared community requests which were submitted to ward councillors office and district magistrates office. When no action would be taken for a few weeks, we would also submit written reminders. This is the picture of a UHRC team member facilitating a community request with all these women. This is the example of a collective request. And on the right, on the right, you can see some of the signatures of slum residents who had applied for this request. These requests were made for clearing clock sewage, laying new sewage line activation of individual water connections, paving lanes, street lighting, cleaning back lanes, garbage collection vehicle and household pipe water connections. These collective requests are then submitted to ward councillor. Now among all the outcomes, we will be sharing six outcomes with respect to the successes we could achieve during the project time frame. New sewage lines were laid and clock sewage was cleared into slums. Lanes were paved into slums. Back lane was cleaned in one slum. Garbage collection vehicle started arriving in one slum. Street light was installed in one slum. Household pipe water connections were activated in two slum lanes. With respect to enhancing access to individual entitlements, we shall be sharing two outcomes out of several. A total of 632 eashrom card applications, which are the labour cards were submitted on government's online portfolio for informal workers. Nearly all workers received their cards. This is the picture of a labour card of a beneficiary. Forty widows pension applications were processed and 10 women started receiving their pensions. We conducted some behaviour promotion sessions in the community where these sessions covered how to manage sanitary toilets coping with heat stress at work and workplace who heavy downpour and brain storage practises. Promoting collective strategies or collective savings to steadily improve housing was another solution which was implemented through a network of slum women's groups. These collective savings help them in improving their housing such as elevate plins towards a more climate resilient housing. So you can see in this picture where the plinth elevation is in progress. Some of the challenges that we came across in implementing solutions was linked to enhancing access to food subsidy entitlements. The inability to arrange basic documents such as universal IDs, details being wrongly entered earlier such as data of birth, spelling of name, not having updated addresses or not having updated basic documents of family methods. The elderly persons in particular face challenge onto their restricted mobility, social, any support system or difficulty in understanding requirements to apply for pension. Some of the other constraints included limited autonomy of informal workers such as adopting behaviours, coping with heat stress, high cost of constructing septic tanks, plinth elevation, strengthening walls and ceilings, authorities dealing with responses to upgrading requests such as paving of lanes which would often sometimes impact the motivation of the community. Some of the lessons which we could learn during the project timeframe, which also has significant policy implications, are linked to enhancing resilience to climate related risks at home and workplace, including supporting incremental housing construction that can foster climate resilience, facilitating household level practices to enhance resilience, including construction of underground water storage tanks and obtaining grains to strengthen food security, raising awareness with workers and poor development strategies to address workplace related stresses, building community capacities to foster improved living conditions by the way of gentle negotiation with municipal authorities and effectively improve access to urban services. Slum level community groups can be trained to negotiate collectively for municipal services. Promoting gender equality and women's empowerment is another very key lesson which we learnt. Slum women's groups can be trained to manage collectively savings and loans which can lead to greater autonomy of women and household decisions. Women's groups can also stimulate leadership and solidarity to empower additional women, especially the vulnerable women who do not have any support. Enhancing access to social benefit is crucial. This needs to be done through enhanced outreach that can improve workers access to food subsidies and labour benefits, providing clear information on how to apply and the documents that are required is necessary. Application procedures for social benefit should be consistent, clear and easy to understand and should not be changed time to time because it becomes very confusing to workers and the beneficiaries to access these services. Fostering collective empowerment and solidarity for community building capacity, where we need to engage informal workers through community groups and build their capacities. In India, we have several policies and programmes such as National Urban Health Mission, National Urban Livelihoods Mission and the Integrated Child Development Services, which already mandate community groups and partnership with local NGOs. So these organized communities are appropriate platforms for building capacity in addressing climate change risk mitigation, application procedures for welfare schemes, gender negotiation, urban services from civic authorities, health and nutrition care. And lastly, demand side efforts and priorities of informal workers and settlements need to be enhanced and need to be included in all policies and programmes. Thank you. Thank you very much. I'm kind of Priya and thank you for being able to communicate so much of what has been done over a long period of time in in section and effective way. As Alice mentioned at the start, we're going to go straight through the presentations and kind of if you can stop sharing your screen and that will enable Artwell and his colleagues to start sharing their screen. We're going to move straight on to the second presentation to hear about some of the similar issues in Harare and Mashvingo in Zimbabwe. And after that, we will have commentary and questions. So we now move over to the presentation from Artwell Ranga and Wispon Malaya on the issues in Zimbabwe. Over to you. Thank you very much, David. And greetings to everybody. My name is Artwell Khadungure from training and research support center task best year in Harare Zimbabwe. We are going to be sharing with you some insights. OK, just a moment. I think just need to ensure that my slides are moving. Yes, I'm going to be sharing with your insights from Zimbabwe on the project that we implemented that was trying to understand the interaction of the various risks, the occupational, public and environmental and climate change in informal sector workers and residents of informal settlements, a project which we implemented in two sites in Harare, the capital city and Mashvingo, another urban city in Zimbabwe. Our presentation is going to be structured into structured into three parts. Basically, I will share with you the highlights from the research. My colleague, Mr Malaya, will share with you the follow-up actions and will briefly present to you the key messages from our research. So, basically to highlight that our research used multi-methods, employing a review of secondary sources, a survey of informal sector workers and residents, as well as six focus group discussions and interviews with key informants with the findings feeding in to community validation meetings and as well as meetings with local authorities and a national stakeholder meeting. We basically used three entry points for this research. First, informal sector workers who are involved in urban agriculture. Secondly, workers who are involved in waste picking, plastic waste picking and recycling. And we considered also water access as a key and cross-cutting issue. We found out that the health status or the health conditions of people were living in informal settlements, mainly, is sent us around provision of infrastructure, as well as basic services, particularly for wash, as well as issues to do with provision of energy and housing. So we also know that these issues have been documented for quite some time now and they are driven by some structural issues which relate to the legal status of the people who live in informal settlements, for instance, which also links into or links to the issues around their involvement in urban planning, the siting of the places they are living in, issues to do with poverty, inequities in urban areas and so forth. So these structural drivers need to be also looked at and we continue to flag them because they continue to exert an enormous amount of pressure or influence on the health outcomes of people in informal settlements. And from the research, indeed the research confirmed that basic infrastructure on the positive side exists in some of these areas and there is some use of some safe alternatives, for instance, the ventilated pit latrines where flash toilets are not available. But if you now look at the negative side or the short force or the gaps that exist in these areas, you are looking at some of the services that are not functional, they are of poor quality because the infrastructure is old and none availability of services in some areas and use of unsafe alternatives. For instance, use of old shoes, use of tyres, is energy sources for cooking in the house of cooking, for instance, in informal residence areas. We also found out issues to do with cost barriers with regards to access to energy and also use of inferior materials in the construction of housing. And this is also influenced by these structural drivers that I've talked about. If you notice that there is little or no monitoring or enforcement of housing standards in informal settlements. And if you look at those pictures, which are showing a well that is very close to your house on the right, then on the left there, that housing structure, which seemingly looks like it's located in a water cost, so issues to do with flooding and so forth, you can think of the impacts that are likely to arise in such cases. And this picture is just illustrating some of the alternatives, both, the top one is functional, but the bottom one is not functional. In terms of the working conditions, basically we found out that on the positive side, there was some technical and financial support for West Pickers, for instance, but we found out huge gaps, which were arising from the lack of social and legal status of informal sector workers, which sort of increased their susceptibility to poor health and injury. These workers were working in the open, exposed to harsh weather conditions, with high exposure to risks and hazards arising from them working for long hours, and also travelling long distances. Some of them travelling about 15 kilometres on foot, trying to fend for themselves and for their families, picking plastics and so forth, and also for the West Pickers in particular, exposure to chemicals and heat and air pollution as additional risks that threatened their health, and yet there was minimum use of clothing, protective clothing, due to cost barriers. For the West Pickers, we also found out injuries which may mainly arising from physical hazards, arising from the sharp objects from where they were picking these plastics, bends because some of the dump sites would be on fire, fires between competitors, then also economic risks from lifting heavy loads and the chemical risks that I talked about. For the urban agriculture workers, mainly risks around economic factors because of the postures when they are working, and also sexual abuse of women, particularly when farmland was very far, then also the issue of our biological hazards like snakebites. These are just quotations to illustrate some of the challenges these workers are facing, the lack of knowledge and its intersection with chemical risks is heightening chemical risks, the use of no protective clothing and also the West related risks and the direct health impacts from that. These are just pictures that are illustrating some of the points. You can see the kind of work environments, the informal sector workers are working in, the dump sites are sometimes on fire and they sometimes get banned and sometimes they have to carry those heavy loads on their own. And if you look at the kind of the work environments as well, on the top right there, those plastics are being cleaned in a dam, you can see now the interaction of the work environments and also the environment of issues where some of the West from the plastic that is cleaned ends up in water and that also ends up polluting even water sources for drinking downstream. But on the right there some infrastructure provided, for example, for water and those sinks, but the lack of a roof sort of limits protection from other factors like heat and so forth. And the bottom right picture there, we also wanted to illustrate how some of these risks are not only affecting the people who are directly involved with informal work, but if you look at women, for instance, they actually bring some of their children to some of these work spaces and so those risks actually end up also affecting the children. So if you look at how these living conditions and working conditions were interacting with the climate and other environmental factors, we just summarised them here where we are looking at the extremes of heat, how that was contributing to reduce the work time and work efficiency for the workers and also if you look at households, the informal sector residents and so forth, and those involved in urban agriculture, how it was also affecting availability of water, challenges with diseases like headaches and so forth. Then the flooding, how it was limiting movement, making work spaces uncomfortable and how it was leading to contamination of water at household level and also leading to sewer blockages, flooding of fields and increasing risk of infections and the air pollution, how it was impacting directly the health through respiratory diseases, reduce productivity and some direct health impacts, for example, related to eyesight and so forth. For the urban agriculture workers, contamination of water, the acid rain, impacts particularly on children in terms of respiratory diseases and so forth, same as water pollution, as reducing water available for production and also water for crops and also impacting diets, food and water bond diseases. So you can see quite a lot of interactions happening there in both directions in terms of the occupational, the living conditions, the environmental conditions and climate change there likely to heighten some of these insecurities. Yet the communities and local authorities were responding in some way to some of these risks and challenges from the community and household side. We found out assets in terms of community networks, education, household resources, financial resources and some food funds. And in terms of approaches, use of diversification, for instance, integration of systems, trying to build relationships, for example, those who are in West Peking and recycling, becwads and forwards, building of relationships, beneficiation and addition of value and investments in high impact areas like health and education, which not only benefit derived, lead to the derivation of benefits in the needed term, but also in the long term. We found that as a key and very important area there and also some risk avoidance we have found. But largely, these approaches, we found them as sometimes not enough and sometimes not better coordinated and will come to that when we look at the implications of these findings. So these are some of the examples that we found out upcycling of plastic, for instance, in Marsringo reported during some of the assessments or the field visits that we undertook, and the top left picture, those pervers are sort of constructed using plastic with support from local agencies at the local level and top right picture showing sort of ports manufactured using recycled aluminium. And at the bottom there, responding to water stress in Marsringo, where old maes tops were being used to sort of act as water conservation material or moisture conservation material should the rains come. Reflecting on the findings broadly, we found out that water is a major determinant of health and survival for those who are working in the informal sector and those who are living in informal settlements. As it's improved or it leads to improvement in several households and wider determinants, you look at your wash and also water is being used in production activities. And water was is also a key ingredient in terms of coping with extremes of heat as a source of rehydration and reliance on open sources. We also found that with climate change, there's also going to be reliance on underground sources more and the issue of pollution and condemnation risks becomes very critical going forward. And we should also consider the equity issues as well. So police attention should also pay attention to these wash related issues. Energy, it was also found to be central in terms of its relationships with other areas of other determinants of health. For instance, pollution from indoor cooking fuels and also as an ingredient in terms of promoting our work spaces and workloads and also energy for water supply. So energy was central. So it was water in terms of responding to climate change and also as a determinant of health. My colleague Mr Malaya will quickly go through the sort of follow up actions that are taking place following our research. So it's over to you, Mr Malaya. Let me just mute my mic. So from all the work which we have been doing, I think one key thing is we have developed relationships with local authorities. We work with two local authorities, City of Arale and City of Masingo. But we have seen a very positive response from the City of Masingo who found the research work is very important for their development in the future interventions to make the city a better city for all. We have managed to then sign a memorandum of understanding with the City of Masingo, where we have also come up with a champions team, which is sitting regularly with the City of Masingo to discuss all the challenges to do with climate change and come up with agreed and structured intervention measures. I can confirm we've also done the same with City of Arale, where we have champions teams. So we have about 40 members who are in two teams of champions. And with that same approach of the champions team, we have gone as far as doing some training on risky monitoring. And to this day, we have trained close to about more than 300 community members from both Masingo and Arale on risky monitoring and effects of climate change. And we have developed some data materials which they are using their communities to keep tracking the challenges of the changes happening and presenting them for us to keep assisting each other as well as the local authority. Go to the next slide. So, and from those actions which are happening, we are also developing what we are calling a mapping exercise or an example which we want to do with the City of Masingo. If you see the pictures there, I will talk to the picture in the middle where you see that garbage, it is garbage of agricultural products. So we are trying to have a relationship where we put up something like a biogas digester in partnership with the city fathers in Masingo so that we can put all that garbage into good use instead of it being a waste, as you are seeing on that picture. And we also have agreed that we have actions beyond giving the research work which we have done where the champions team are going to continuously meeting with the local authorities and other key stakeholders to keep promoting the changes that can improve the City of Masingo. I can also talk in terms of the risk monitoring and improving the information flows where evidence is always going to be provided to the local authorities which they are going to also use for their community planning. We have also engaged in a lot of literate awareness raising in the community where the champions team are also expanding the training to the community members so that they can do the door-to-door information sharing on the importance of mitigating the effects of climate change. So this picture is just showing how the city of Masingo is also now responding in trying to create a better environment for the city, informal workers and traders in the city. I end it over to you to just finish on the last slide. Thank you so much, Mr Malaia. The last slide basically captures our key messages from the work in Zimbabwe. The first one being that climate change will disproportionately affect vulnerable informal workers and residents of informal settlements. And it will also interact with several underlying risks, including at home and at the workplace. Secondly, informal workers and residents and authorities are responding in some way to climate and occupational risks, but these current measures are short-term largely and are not realistic and local and national plans therefore need to promote integrated equitable and forward-looking approaches. And the last set of our key message relates to how the addressing of the risks and the creation of multiple benefits to support health and climate resilience require co-ordinated action at various levels. And this should involve development of inclusive national and local level policies that will listically consider the full spectrum of the health risks guided by collaboratively set principles of equity, protection of rights, promotion of duty bearers and as well as their capacities. And also the use of evidence on workers and residents local lived experiences to inform our city and national level policy and engagement. And lastly, we should begin to think about how to strengthen the assets that promote public. Of course, these assets are key in promoting public, environmental and occupational health responses and also enhancing informal workers' resilience to climate change. Just acknowledging all the teams that are involved or that are involved in this research in both in Zimbabwe and elsewhere. Thank you so much. Great. Thank you very much to Artwell, Karanguri, and to Wizbon Malaya for again, covering a substantial amount of work in a very brief period of time. And I think from both of these presentations, we've had a very rich sense of both what the issues are facing informal workers, but also how these can be responded to and what the implications are at the different scales and for different types of policy actors. For the next section of the webinar, we're going to have a combination of commentary and discussion. We are going to invite our first commentator, Dr Emshari Kovats, who as was mentioned before is at the London School of Hygiene and Tropical Medicine, and I'll ask Emshari to make some comments and then we'll open the floor for comments or discussion. And then we'll have the words from our second commentator as well. But please do put any questions or comments in the Q&A box, which you can find by clicking at the bottom of your screen. Emshari, over to you. Thank you so much. Really interesting presentations. That's an amazing amount of work. And there's so much in there, such a richness. But I'm only going to, I'm going to limp myself to three comments, because I know we're slightly tight for time. And, you know, I'm coming from this from the climate change and health perspective and sort of the impacts on health and how to support evidence for adaptation, essentially. And I guess the key point is that this is addressing a huge evidence gap. I mean, if you look across the literature, there's very little sort of primary research on environmental health issues in these communities and informal settlements and in workers in the informal sector, there's very little epidemiology, because there's very little data, because there's this lack of evidence that, again, is one of the reasons why there's not the only reason, but it is a reason why there's perhaps less focus and less action, particularly around the kind of adaptation responses. So clearly, this is a really important gap that's being addressed. And I urge you to get this evidence up into these sort of adaptation places and in the national kind of adaptation strategies and when countries are looking at their risk assessments, and this is an ongoing process, so most countries are now looking at which of their populations are most at risk from climate change and what interventions can be done. So all this information can be carried through into their national and local types of adaptation planning, particularly where you focus around interventions and these interventions are low cost and they also have co benefits, which is really what the decision makers want to hear. Well, the second point is these two climate risks that you're mostly focusing on, heavy rainfall and heat, these are increasing as participants have already noticed, they are increasing now and they will accelerate in the future, particularly extreme rainfall and they do interact as well. So it's the interaction between these climate risks as several speakers noted and the kind of social vulnerabilities as well, which is really nicely explained and showing how the pathways by which high temperatures and too much water or not enough water increases health risks is really important and the interaction between the climate risks. So we know that water is a key strategy for dealing with heat stress as well. And then the third point is what's really important and really nice about this project is the co-design and this is not often done and I think it's really important that you pull out the lessons about how some of the challenges in co-design so working with the communities to help you frame the research and then identify the interventions and then implement the interventions and those lessons learned could be translated back to the funders to support further types of research in this area. So that knowledge of how you did it, what lessons you've learned, what could other groups do, how could they could do it better is really important and that's not lost. And I guess and my final comment is also the kind of vulnerability because it's not just the interaction between climate risks. It's also the fact that the people are on the verge of poverty. Climate events can push people into poverty because of this lack of social protection and both case studies show the importance of universal health coverage as an adaptation to climate change. So I think that's quite a strong message that you could could go with. OK, I'll stop there. Thank you. Thank you very much. I'm sorry for bringing across some of the over the points that arise from both the broader set of work and some of the implications and for that. I'm multitasking and trying to look at the Q&A box as well and I don't see any questions in that box right now. So what I will propose doing if nothing comes in in the next few seconds would be to move on to on to Christy Brayham's observations in case that does prompt any and further questioning as well. And I see nothing coming in. So let's do that and let's go to Christy, who's the women workers health coordinator for WeGo. Christy, over to you. Hi, everyone. Thank you, David. Thank you to our colleagues in India and Zimbabra. Thank you to Dr Covets as well. My name is Christy Brayham. So I am the workers health coordinator at WeGo and WeGo stands for Women in Informal Employment, Globalising and Organising. So I just want to give a few reflections from our side and I'm very much coming from the perspective of labour rights intersecting with essentially health for all and health as a human rights. So just a very quick background to WeGo as I'm not sure people are actually familiar with us, but we are a global network of researchers, development practitioners and workers in the informal economy. We are present all across the world, particularly in the global south. We're very much rooted in the politics of the global south. And we have members of our network across 40 countries. And while we do look at informal, informal employment in general, we do focus on all key worker groups. So that's waste pickers or the claimers, street vendors, market vendors, domestic workers and home base workers. And this is just a infographic showing how extensive the formal economy is and how presence it is across different continents. So as you can see on that previous slide, South Asia and South Saharan Africa in particular have a very, very, very high concentration of informal labour. So just zooming in on the intersection between climate informality and occupational risks. So workers in informal employment are really rather exposed to a range of risks in the workplace. And of course, this also applies to to those living in informal settlements. And while they're exposed, they remain largely unprotected. And this is largely because there's just simply not covered by mainstream occupational health and safety laws and frameworks. And the reason for that is because informal employment is outside of the so-called formal employment relationship. There's for the most part, there isn't necessarily an employer. Many informal labourers are self-employed, but not all. And of course, because lots of occupational health and safety frameworks apply to formal workplaces. And many of these informal jobs are in urban spaces that are not fully regulated. They just really fall outside of that. And as a result, workers are often forced to be self-reliant in managing occupational health and safety risks. So they shoulder the burden, the financial and social burden of a lack of protection, while also simultaneously dealing with often quite profound income insecurity. Now, workers informal employment are agents of environmental sustainability. So I've attached here our GHG emissions calculator. So one of my colleagues at Weego has masterminded this calculator, which works out in the CO2 emissions that are saved, are mitigated as a result of informal labour. So I've got some examples here. So some of the waste pickers are members in Dakar and Senegal, who are working on the Mabur's dump site, have been preventing the emission of 258 tonnes of CO2 per year. And also our members in India, who are working in a waste picking co-operative, have been mitigating the emission of 167,000 tonnes of CO2 and more than 107,000 tonnes of CO2. So workers really are so important in the fight against climate change, yet they are especially vulnerable. And I think that's really come out very strongly in the research done by our colleagues in India and Zimbabwe. I know our colleagues have spoken a lot about the various different risks they've identified. I just wanted to zoom in on one that we've been honing in on a little at Weego. So we recently did a global study of the impacts of COVID-19 on workers in informal economy across 12 cities across the world. It was a longitudinal mixed method study. And we surveyed and interviewed thousands of workers across a variety of sectors. And we're all familiar with the idea that access to water has been a problem for a very long time down our far proceeds of the pandemic. But we've actually noticed that across the course of the pandemic, access to water has further declined. And I've got some stats there, waste pickers in particular, street vendors. And I've highlighted two cities in India, which are part of our study where around 85% of all street and market vendors that we engage with did not have any access to water at all. And of course, so this is more anecdotal rather than being part of the study, but our colleagues and comrades and sisters in our partner organisations have really talked a lot about the gendered impacts of this. So domestic work is especially feminised. It's dominated by women and a lot of our colleagues in the International Domestic Workers Federation have talked about how resources are becoming increasingly more scarce. So women workers are having to work harder to search for water, having to walk further. And on those journeys, they're accumulating even more risk. So those journeys are becoming longer and more treacherous. So there's more exposure to harassment and violence, et cetera, et cetera. So there really is a strong gender angle here. And I know that's come out as well in the work in Indian Zimbabwe. And just to build on the reflections from our colleagues in Indian Zimbabwe, where they've talked a lot about the community-based actions and responses, I wanted to hone in a little bit on some of the broader level social protection-related responses that I definitely think would be critical for this. So workers are often excluders from employment-linked social insurance, but also because many workers are in effect not poor enough to qualify for social assistance initiatives. They are often excluded from those initiatives too. So this is why we call workers in informal employment the missing middle. And so we really need a system-wide set of social protections which can be extended to them. And this is really about the state. So the government and also those who possess capital really taking responsibility for the risks imposed by climate change and how those risks impact on health. I know this was identified previously as well, but these social protections could also include supplements to income in the event of acute climate crises if there's a flood or if there's an extreme heat event. But everyone must have full accessibility to these. And of course, as Dr Covats correctly highlighted, we need universal health coverage models that are truly universal. So this is really speaking to the idea of healthcare being affordable so that workers are not forced to make out-of-pocket payments which force them into poverty. We need healthcare to be available to all. So this is really speaking to the idea that there are especially vulnerable groups of workers who often face further exclusion. For example, undocumented migrant workers. Healthcare needs to be appropriate, it needs to meet the needs of workers, especially given that they work a set of hours, they work a certain distance from their homes often. And of course, healthcare needs to be of good quality. So I really think that these are the longer term initiatives that will help to set us on the path to address these climate-related health risks. A few references there, but I wanted to thank everybody for listening. And thanks again to our colleagues in India and Zimbabwe. Thanks to IUD and thanks to NIHR. Great, thank you very much, Christy, and thanks, Shari, as well. I mean, those two sets of comments I think were really useful and added a lot to the understanding and to the discussion. I have a couple of questions which have been coming in, which I will bring up, which the panellists can also see in the chat. The first thing that I think would be, is a good question to hear from both teams, is around the role of community health workers and other professionals, whether these were professionals that were engaged within the course of the research, and what the role that these community health workers and other health professionals might have. And that came as a question that came from Shari, I would actually like to add to it a little bit as well, which is just if there is any broader reflection on the relative role of the health sector and other sectors in terms of addressing the issues faced by workers that are posed by climate change. So that's the first question that it would be good to hear from both groups around health workers and other professionals. A second question is around specifically I think the challenges facing waste pickers and the potential for waste segregation at source as being something which is often suggested as being a better way of managing waste. I'm sure that both teams will also have experiences and thoughts on why it remains significant to work with waste pickers and any reflections about the potential and the limits for trying to achieve waste segregation at source as opposed to waste picking and waste recycling. So if you'd like to address those things as a collection of comments and I'll pass first to the team from the Urban Health Resource Centre, I don't know who would like to pick up on that but over to you. Yeah, with respect to Shari's question of involving health professionals or professionals from health sector in identifying these priorities of workers or in UHRC we did include field functionaries from health department in identifying vulnerable settlements or weaker families where we can strengthen our solutions particularly linked to information on accessing government health care services and what are the ways through which they can be navigated. Some of the challenges that we came across during COVID-19 pandemic as they were on COVID duty and were not available but in our experience we have found that co-opting field functionaries from the health department is an opportunity which can be materialized because they are very much familiar with the settlements, they roam in those settlements and they can also be co-opted with respect to addressing other climate change and multidimensional risks that we identified in our study. And with respect to waste segregation, a question on waste segregation is, I mean because we did not include waste pickers in our samples so our understanding of waste pickers is still quite limited so it will not be very prudent on my part to comment on it. I think the Zimbabwe team will be far more competent in addressing this question. I just comment on the community health workers and professionals in India. The health department has what are called auxiliary nurse midwives who are trained by the government or quasi-government agencies. They also have the accredited social health activists. So these are two workers directly of the health department. Then the women and child development department has the what are called Anganwadi workers and Anganwadi helpers. So we involve all of them, they are regularly involved in our program including what Kanu mentioned and one aspect of climate change that they address is the Anganwadi workers actually provide supplementary nutrition which is in the form of some type of food. The material changes from time to time but it is some food for children, for lactating mothers and pregnant mothers. I also will not comment even though I have observed the waste segregator for some time and we will hopefully do some work in the next few years but not right now. Thank you very much. Would somebody from ZCTU task force actually like to comment on those issues as well around health workers and around waste segregation? Yes, David, thank you and thank you very much for the questions. I think they are quite pertinent regarding the health workers, community health workers question. It's something that came out also in the Zimbabwean work where we were sort of looking at the organization of health services and primary healthcare in areas and the informal workers in particular were saying sometimes the conditions that they face, the diseases that they face from working under unsafe conditions and so forth, exposure to chemicals, they sort of take time to sort of appear and when they visit the health services it will be too late. So the issue of having community health workers being integrated as part of an ebony health system that is responsive enough to the needs of the informal workers is key. And if you look also at how the informal workers work from early in the morning to evening, they really have enough time to be visiting the health services and so forth. So in the follow up discussions the issue of health services that are responsive to their needs to be integrated in their work spaces and so forth is being followed up within the local authorities as key actors who provide health services in urban areas. So that's a key point as well. In Zimbabwe in particular community health is more pronounced in rural areas and part of the focus of this work is also to strengthen community health in urban areas, as part of a universal health coverage dialogue. In terms of waste segregation, yes, that's a key component, not only in terms of reducing some of the risks that these workers or the pickers face where they have to go to the dump sites being exposed to the physical hazards and chemical risk and so forth, but also as a framework of moving to greener cities where local authorities can sort of enter into partnerships with the private sector for instance and have that kind of collaboration on particular areas around waste segregation with roles for the private sector, for the community and also enterprise development around the waste management ecosystem. So yes, that's a priority and it's being considered as part of the follow up actions as well, particularly in mushroom. Thank you. Great. Thanks very much. Christy, given Wigo's experience with waste pickers, do you want to comment on that issue at all as well, or if not we can move in but I'll move on, but I'll give you a chance if you think there's Wigo experience to contribute there. Well, at Wigo we do have an entire waste team and I wish they were here to ask your question because I'm not a waste specialist. However, if anyone would like to be in contact with one of our waste specialists, I can facilitate that. That's great. Thank you. I know there's a lot of rich resources on the Wigo website about looking at both segregation at source and waste picking and why waste picking remains significant in many waste management chains and how it can be done in ways which are more inclusive and safer for the people who are involved. Rangor, I see you have a hand. Please do speak up and then I think we might have time for one more round of questions. So this would be your last chance to put something in the Q&A box. Rangor. Thank you very much David, just to add on to what Atwell has said in responding to the question on community health workers. Just to add that indeed, the work that we did in Mershingo, mostly the informal economy workers and residents confirmed the existence of public facilities, particularly clinics in all areas, and they preferred to go to government clinics which were working together with community health workers at that level because of their accessibility, their affordability and availability of health workers at that level. But we also, in further looking for more information, we also established that atwell, these were really strong assets in responding to community health challenges. The clinics needed to be better resourced to improve their availability and of course affordability of medicines including health personnel and services for both the chronic conditions as well as other health challenges which they were facing. And that's where we also found out that issues of mental health came out quite strongly in our discussions with the communities, especially in the informal economy in terms of, if the workers or residents had to visit clinics, they would find clinics being stuffed by nurses who had their own challenges with regards to poor salaries or any other challenges which they were facing. So much so that it became difficult even for the nurses themselves to attend to the informal economy workers and we then established that there was a need for perhaps a broader approach to all the challenges. Which Sari talked about when she raised the issue of universal health coverage which I think is really a fundamental issue in addressing the issues such that the informal economy workers and residents have a package of all health services which will address such issues like mental health. Then with regards to some government departments, they also organized some health clubs at community levels which would also work together with communities where they would be taught to respond to some of the health challenges to environmental challenges and so forth. In these health clubs we're working also together with some community health workers who are also staffed to support the work that these health clubs will do in order to provide capacities to residents and workers of the informal economy. I thought I should just add this part. Thank you. Thank you very much. We're seeing a bit more action in the Q&A and I can see that there's one question there that's relating food and health to which an answer is being typed so I would point people to that. What I'd like to do is just in the final round and if we have a very brief time so if our colleagues could keep their comments to a couple of minutes I'd like to raise two more issues that have come up through the chat. The first is around the position of the government and whether governments are supportive or restrictive of some of these vulnerable groups of informal workers maybe what governments have been doing if there are cases where governments have been supporting what they are or where there are limits to the ways in which governments have engaged with informal workers including street vendors and waste pickers. If there's a second thing which I think has come up which is very relevant and there may not be an answer to it here is around the question of the loss of earnings from climate related impacts whether this has been quantified whether it could be quantified because I think as we move to some of the new areas around thinking about climate finance and climate responses the quantification of things like loss of income is going to be really valuable. So I'd like to ask the two teams just to comment as briefly as possible on those two issues around the role of the state and around loss of earnings. I see Wispon Malaya has a hand up so maybe Wispon you can comment from the Zimbabwe example and then someone from the UHRC team can comment over to you. Thank you very much. I can confirm from the Zimbabwe review I think from the way we did the research the certification for us to do the research was authorised by the government through different research systems and that on its own show that the government is responsive to understand what is happening on the ground so that they can also make it from the decision. I can further confirm that as we went to Masingo we saw a very strong response from the seat of Masingo in terms of wanting to work with us and in action they do they also have a central government system where they report to. So from that end we feel there is a policy from the government to make sure we can intervene in the area. However, in Arari we have observed that there were some challenges in terms of identifying how best we can have the relationship with the seat of authority and the government due to different political tensions. So we are looking forward that space will also become friendly like what we have seen in Masingo. Thank you. Thank you very much. Would somebody from colleagues in Indore wish to comment on these things? Yes, David. With respect to the role of the government the government wants to look good by saying that they are doing a lot for informal workers. So that is what they usually limit their role to but at the level of individual officers where we negotiate for access to services and entitlements or social benefits we have come across many supportive government functionaries and officers who would provide the correct information. So for example, they sometimes say that you need to be a resident of Indore for 25 years before you can apply. And then when we meet some officer they say that this is not how the scheme actually works. So there are both types of people. Some of them are supportive and some of them are dismissive because they don't want to increase their work. But the policy recommendation is that the demand side component needs to be built inside the policy itself. And the policy maker or the policy implementer needs to understand that just by the supply side dimension in a policy no policy can be successfully implemented or can reach the intended beneficiary. So the policy itself should have budget allocated for the demand side. One of the examples is the National Urban Health Mission which I had the good fortune of drafting with the team. So there is an element and there is budget for the demand side. Thank you. I'm conscious of time although I know we haven't answered everyone's questions so apologies for that. I think you might just have to ask some of these questions to be taken offline and we're certainly happy to remain in touch with all of you. Just in the interest of time I'm going to just try to summarise some of the rich discussion and findings while they're recognising that much of the complexities are not possible to capture in just a few slides and the few minutes we have remaining. But I think we want to underscore that policy makers should recognise climate change as a key threat affecting workers, informal workers health and livelihoods. So just to underscore one of the headline findings from our surveys in Harare and Moshfingo, heat extremes are already leading to reduced work times for over 55% of informal waste pickers and unavailability of water for 75% of the urban agriculture workers whom we surveyed. This was over 400 people just indicating the widespread challenges that are already occurring, affecting health and livelihoods. And even as informal workers are particularly vulnerable to climate-related risks, we've seen that their work is vital for environmental sustainability and food security with contributions from informal waste pickers, urban agriculture workers and food vendors among many other sectors. We've seen the importance of including informal workers' voices, priorities and well-being in urban climate plans and there are already some significant co-produced solutions emerging as we've heard in both India and Zimbabwe thanks to such mechanisms as workers' champions teams and community mobilisations for improved services at the settlement level in Indore. And just to close with a few recommendations, decision makers will need to recognise informal workers major economic contributions and the complex health risks that they face, including but not limited to climate change. We've tried to capture some of these pre-existing and interacting risks and recognise that these will all vary by local context and by worker group, but we hope that we've gone some way towards capturing some of these interrelated challenges. And in response, informal workers will need further support to enhance health, support adaptive behaviours and diversify livelihoods where relevant, including particular attention to the vulnerabilities facing such groups as women, youth and people with disabilities. We've seen the need for enhanced clean energy sources, support for incremental housing construction and repeatedly underscored the need for universal healthcare and social protection amongst other services and infrastructure. And finally, we would argue that local decision makers and health officials will need to work closely with informal workers to co-create inclusive multi-prong strategies, which can create several benefits for livelihoods, health and resilience. We've tried to bring these different threads together and we hope to continue these conversations with all of you. And finally, we do want to recognise the contributions from our own side of the slide. It's frozen. Apologies. I was wanting to acknowledge this project being supported by the National Institutes for Health Research, but my slides are not allowing me to. So we recognise and appreciate the support from the NIHR and I'm afraid I'm not able to share them with the final slides. I'm going to have to stop. But we will also share some of our publications in the chat, including some recent digital case studies where we've featured workers' voices and tried to bring together some of their stories in a more engaging way. We will also be preparing some policy briefs and some journal articles, so stay tuned for those. And yes, and the many publications that we do have are being shared right now in the chat. So thank you all for your time and we're really grateful for the great discussion and appreciate all our panellists very much. We'll look forward to staying in touch. Thank you.