Making Healthy City Planning Work

Here is a recent article on some of the work we are doing in Richmond, CA, promoting Healthy City Planning. Importantly, the article emphasizes that it takes leadership and action on multiple levels to make healthy city planning work -  not just in the planning or health departments.  The City Council and Mayor have made this part of their agenda, as has the City Manager and multiple city agencies. Contra Costa County Health Services, the public health department for the city of Richmond, is also playing a leading role.  While the article rightly notes that moving toward a healthier and more equitable Richmond is not about health care alone, improving access to and affordability of clinical services is important.  To support this, the County-run health clinics, including school-based services, as well as Kaiser - the largest health care provider in Richmond - are taking an active role in linking prevention programs with essential basic care.  Perhaps most important, community-based organizations are leading the way - - organizing residents, proposing and participating in projects and holding the government and industry (such as Chevron) accountable.  One sign of growing community accountability toward health, is the resubmission on May 23, 2011, by Chevron for a Conditional Use Permit to upgrade its Richmond refinery and a commitment to address the environmental issues the company ignored and Communities for a Better Environment and others successfully sued the company to address. 
Making healthy and equitable city planning work demands action and leadership on multiple fronts, and Richmond is increasingly moving in the right direction.  

Community-led water service: Kosovo village, Mathare slum, Nairobi

Our UC-Berkeley-University of Nairobi and Muungano Support Trust (MUST) collaboration in 2009 resulted in many positive outcomes for the residents of the Mathare Valley informal settlement.  In one village, called Kosovo, we helped plan and design for piped, 24-7, water access for each household. The Nairobi Water and Sewer Company eventually installed new water pipes and community members, through Muungano, are managing and maintaining the service by supporting residents to obtain meters and assist them in paying water bills.  While a comprehensive evaluation of this intervention is ongoing, here is an article by SDI describing some aspects of this community-level utility management .  Importantly, we are SCALING UP lessons from this project in our current Mathare Valley Zonal Plan, which aims to offer a comprehensive and integrated plan for improving infrastructure, economic livelihoods, housing, land rights and essential services, such as health care for all villages and over 150,000 residents of the Mathare Valley.

$300 slum house? Worthy but Worthless

The Economist published an article last month on the competition to build a $300 house intended to improve the lives of slum dwellers.  The article came from a blog post in the Harvard Business Review by Vijay Govindarajan, of Dartmouth College’s Tuck School of Business, and Christian Sarkar, a marketing consultant, who set out to explore the possibility of Govindarajan's idea of  'reverse innovation' - or an idea that starts in the Global South and makes its way to more wealthy nations (many of us know this already happens through stolen intellectual property, but that is a topic for another post).
What is the problem you ask?  Well, for starters, the response, Hands off Our Houses, in today's NY Times captures why this is fundamentally a bad idea for the urban poor - it doesn't include those intended to live in these houses in the design process.  This is a also a BAD idea because it fails to grapple with the complex relationships in informal settlements between housing, land rights, economic opportunities, gender rights, health and safety and a host of other issues.  With worthy intentions, this idea is likely to redirect resources toward a worthless outcome - a rational and nice looking house that will not improve the lives of slum dwellers.   
A fundamental error here is that design alone is NOT the solution - despite what green builders, architects, entrepreneurs and others continue to say.  The solution is an urban planning process where:
(a) slum dwellers drive the process;
(b) designs are not one-size-fits-all - but flexible to accommodate different uses, can expand and improve the existing social and cultural fabric of a community;
(c) donor & private sector resources support improvements to basic infrastructure (i.e., water, sanitation, roads, electricity, etc), schools, health care facilities AND housing, and;
(d) the process offers jobs, new skills, and builds community power.

Well, this isn't easy either, but it is being done.  Slum/Shack Dwellers International (SDI) has been doing just this in tens of countries around the world.  As I've mentioned in previous posts, our team at UC Berkeley has been working with one SDI-affiliated network, Muungano WA Wanavijiji, since 2008 to support community-led planning in the Mathare Valley informal settlement in Nairobi, Kenya.  Our process aims to act as an alternative to other planning and housing improvement schemes in Kenya, particularly the Government of Kenya's slum upgrading project in Kibera - -  where the government built housing for the urban poor, but local people prefer to rent out the housing rather than live in it! 

We must avoid the boutique design and technological quick-fixes promoted by business schools and the global elite in the donor and entrepreneurial community and invest in complex, messy, people-centered, locally-driven processes.  

Jason Corburn Keynote at International Conference of Urban Health

Jason Corburn at the ICUH 2010 from The New York Academy of Medicine on Vimeo.

Berkeley's Nairobi Slum Upgrading Project & UN-HABITAT

Professor Jason Corburn is delighted to report that he and partners from his collaborative slum upgrading project in Nairobi, focused on the Mathare Valley informal settlement, were invited to present at the 23rd Session of the Governing Council of UN-HABITAT, in April 2011.  Our partner organizations include the University of Nairobi, Slum/Shack Dwellers International, Muungano Support Trust (MUST) and Pamoja Trust.  Jason Corburn's project at UC Berkeley was also invited to join The Habitat Partner University Initiative, which aims to promote the cooperation between UN-HABITAT and institutions of higher education, to facilitate exchange and cooperation between and among universities in developing and developed countries, to link UN-HABITAT’s approach on sustainable urbanization with university curricula and to bridge the gap between theory and practice by strengthening knowledge management, training for practitioners, providing policy advise and by preparing students for the needs of cities.

Cities & Environmental Health Regulations

Moving toward more healthy cities will require better enforcement of exiting environmental laws and new environmental health regulations tailored to protect a city's most vulnerable populations.  A recent decision by the US Supreme Court refusing to hear New York City's case for why they want to regulate fuel emissions from taxis sets a dangerous precedent that may limit local governments' ability to set health-protective rules.  The Court refused to hear the City's case for why local jurisdictions should be able to regulate automobile emissions by stating, in-part, that the setting of ambient air pollution and vehicle emissions standards is the responsibility of the Environmental Protection Agency under the  Clean Air Act (CAA).  Yet, since the 1970 Clean Air Act, local governments, particularly California, have been allowed to set their own, more strict air pollution regulations because of their "compelling and extraordinary" circumstances related to unhealthy air.  The Obama Administration recently reiterated their support for California's more-strict air pollution rules in an executive order.  California has also been allowed to move forward, ahead of the EPA and Congress, with climate change related regulation.  In short, the Supreme Court's refusal to hear New York City's case for clean vehicle taxis is a major step backwards for allowing local governments to innovate and set health-protective regulations and comes, not surprisingly, as republicans unfairly attack the EPA.  To help show the importance of the CAA, EPA and local air regulations, the EPA released a new study  highlighting that the benefits far exceed the costs of clean air regulations (see example in table below).  Now is not the time to scale back or limit government regulations that can improve urban health and benefit the economy.

Toward the Equitable & Heathy City - Santa Ana, California

I recently gave a talk at UC Irvine on my book, Toward the Healthy City, and we had close to 200 people turn out, including many community members from the City of Santa Ana.  Santa Ana is one of the sites for the Building Healthy Communities (BHC) initiative sponsored by The California Endowment.  I also participate in a half-day workshop organized by Professor Michael Montoya, students and community organizations working in both the Santa Ana and Long Beach BHC sites.  The folks organizing for health equity in Santa Ana are doing amazing work, particularly America Bracho of Latino Health Access.  America is one of the most dynamic and inspirational community organizers and public health leaders in the United States.  We talked about the importance of and difficulty to sustain long-term community-university partnerships and the critical role of local knowledge for addressing health inequities, something I wrote about in my first book Street Science.  In particular, Latino Health Access has trained community leaders through their Promotores model, and these folks (mostly women) are some of the most important experts on what it will take to build a more equitable and healthy community.   I learned a lot from America and enjoyed our conversations about how to truly work for a more healthy and socially just city that address the specific needs of Latinos, people of color and everyone. I truly look forward to working closer with her team to help build a more equitable and healthy Santa Ana.   

Kenyan Informal Settlements Improvement Programme (KISIP)

The Kenyan government recently launched the Kenyan Informal Settlement Improvement Programme (KISIP) with the soupport of the World Bank and the Swedish International Development Agency (SIDA).  Our partnership in Kenya that includes the Muungano Support Trust (MUST), Slum Dwellers International (SDI) and the University of Nairobi, Department of Urban and Regional Planning, and my team at UC Berkeley, have been actively involved in trying to shape this program to ensure civil society groups are at the table and shaping project investments.  Our work in the Mathare Valley informal settlement in Nairobi aims to act as a model for how urban upgrading can meaningfully involve community residents, NGOs, the academic community and local service providers including government agencies.  We are also working to ensure that KISIP and other Kenyan Government supported initiatives aimed at improving the well-being of slum dwellers, such as the Kenyan Slum Upgrade Program (KENSUP) supported by UN-HABITAT, learn from the expertise of residents, the enumeration and planning work that has already happened and continues in communities like Mathare, including the plan our team helped draft for the Kosovo community in Mathare.  I am also leading a studio class during this semester that will run simultaneously at Berkeley and the University of Nairobi, involve all our community partners, and will draft an upgrading plan for the entire Mathare Valley in Nairobi.  More on that soon.