The cold reality is that in many countries families who want to construct, purchase, or improve their housing situation, are inhibited because they cannot borrow funds. Loans that are available are channeled to middle- and higher-income families. In these countries most families, especially the poor, improve their housing only as their savings will permit as they are unable to leverage their incomes through loans. The effect of this situation, combined with extremely low income levels, are families in cities and in the countryside who live in extremely difficult conditions characterized by poor quality dwellings and an absence of water and sewerage services that much of the world takes for granted.