Ali, Nura; (2025) The Hydro-Social Production of Health in Lagos. How socio-material relations in water production, distribution and consumption shape the health of Makoko residents. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

How water flows through a city tells a story about the priorities of power - a story that manifests in the everyday infrastructures and health of urban citizens. This piece of research traces such hydro-social relations and their production of urban health in the metropolis of Lagos, where existing vocabularies of citiness cease to explain the realities of a majority of urban dwellers. An important contribution to the growing efforts to democratise theories about what the urban is, this doctoral research folds conceptualisations of the hydro-social cycle into prevalent understandings of social and political determinants of health and finds that epistemic determinants of health are central to the understanding of the urban water-health nexus. It does so from the standpoint of Makoko, a contested low-income residential neighbourhood of Lagos where water and health entanglements produce a unique form of what I term hydropolitan urbanisation, predetermining the ways in which residents are in the city. Lagos’ urban water insecurity manifests along socio-spatial health gradients while private, local water systems emerged as a counter narrative to public service absenteeism, thereby both mitigating and producing water-borne diseases in low-income neighbourhoods along Lagos lagoon. Applying a Grounded Theory Method rooted in pragmatist epistemology and understanding the research question as a problem space rather than a fixed container, I trace how the different stakeholders involved in Makoko’s water supply system shape access to water, which implications this holds for socio- spatial health inequalities, and how these health inequalities are mitigated by local, non-state actors through decolonial, yet formalised health practices. Analysing the dialectic relationship of water infrastructure and socio-spatial marginalisation, this piece of research hopes to contribute to a multi-layered understanding of health through empirically-based theorization that is able to speak to policy making to close the urban health gap through improving water infrastructures.

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