Saturday, October 17, 2009

Festival of Lights

For over one billion people around the world, most of who are in India, today will mark a new beginning. A celebratory beginning symbolized by among other things – a festival of lights. This celebration known to many Hindus and even some Buddhists as Diwali involves lights, fireworks and sweets and is the most popular South Asian festival. The Times of India has called it the ‘reaffirmation of hope’.

In India, all across the country, houses and shops have already been decorated with oil lamps called diyas. In the developed world as is in many parts of India, electric lights are an attractive alternative for decoration during the festival. Sadly, electricity and access to it, remain a luxury for millions of the country’s poor. Despite improvements to the infrastructure, over 400 million people in India still lack access to electricity – namely rural households but most often, the urban poor living in India’s slums.

Electrification can hardly be seen as a mere ingredient of infrastructural development among the poor. In fact, it should be viewed as integral part of systemic strategy for improving health systems. For India’s rural poor, electrification means providing pumps to supply the villages with clean water – a necessary risk-aversion from numerous communicable disease challenges. For the country’s urban slum dwellers, it means the provision of refrigeration for vaccines at clinics. Studies have evidenced the direct correlation between electrification and health among the poor households. In Gambia and Nepal, improved access to electricity was shown to have a direct correlation with substantially reducing Acute Respiratory Illnesses (ARI) in children. In Guatemala, electrification among poor communities resulted in higher birth weights, and in South Africa, a substantial reduction in burns from paraffin poisoning was recorded.

For India’s poor, which (depending on who supplies the data) is stated to be 25, 50 or 75 percent of the population, tomorrow may not be an entirely new beginning. Electrification, if and when it does arrive will not only represent vital improvements to the country’s standard of living. For millions it will most certainly be a reaffirmation of hope that the despite their living and housing conditions, they can begin to close the gap on widening health disparities across the sub-continent.

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Sunday, April 05, 2009

Building Green must first mean: Building Health

As I alluded to in my last entry, we are in the midst of a global momentum of humanitarianism – not focusing on an epidemic or a post-disaster reconstruction effort but what Sachs has described as The Climate Change Revolution. There is, without a shadow of doubt, the need and urgency to build green. Yet beyond the tax reliefs and altruistic motives, how do we incentivize ordinary homeowners, renters and household occupants - particularly the poor, to build, rent and live green? We must first necessarily build health.

The USGBC and EPA ask rhetorically, why build green? Among the responses, we are told that it ‘improves air, thermal and acoustic environments, enhances occupant comfort and health and contributes to overall quality of life.’ Meanwhile, the Healthy House Institute defines a green home as, among other things, ‘one which is healthier for the people living inside.’ In both cases, it would seem that at first glance, health is considered a by-product of building green rather than an incentive for taking such action.

However, what incentivizes the poor to conserve water or consume less energy in an attempt to save the planet, when it already requires every ounce of their energy to strategize how to save themselves and their families from overt risks to health? These are some of the irreconcilable issues that the poor must face every day.

Those who earn less than $10 a day represent 80 % of all our entire world population. For those living in poor housing conditions - informal settlements or otherwise, housing represents safety, a living place for the family and protection from adverse weather. Rarely is housing used as an operational term to suggest a way of improving health. If we can first change the paradigm in which we define and understand the concept of housing, we may be able to fully embrace the potential for housing to be considered a tool/process rather than a fixed entity.

Where the poor can be encouraged to build and improve housing as a means to improving their health, re-defining our concept of housing may be a key strategy in encouraging them to do the above in an environmentally sound way. But let’s not kid ourselves by thinking that this would be a new strategy for the poor. The world’s poor have been building green long before the developed world made it trendy. They have been recycling old car tires for use as furniture, using paint cans as flowerpots and utility cables as clothes lines.

Therefore, what is now needed is not a new solution but rather the deployment of a strategic focus to empower the poor to rent housing with features like adequate ventilation, which reduces humidity and potentially TB. Whether the target groups are those that earn less than $1 per day or $10 per day, incentivizing them to build, rent and live green must first mean: building health.

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Friday, March 06, 2009

How to start building health globally

In Building Health Globally (BHG), we must begin by prioritising the interconnections between housing and health. Within international development, a great many issue come and go – holding headlines, stirring sensations and driving donor-dollars. The past twenty years hasve seen an emphasis placed on post-disaster reconstruction, famines, conflict, epidemics and recently climate change. The challenges to development are not confined to improved roads, education, health or carbon emissions alone. They are widespread, much more than mentioned and so too are the strategies for success – these are in fact multi-sectoral. My advocacy for pairing human settlements and health stands on my firm belief and observation that the two are mutually informing agents of development.

From Maslow to MDGs, adequate housing and health are necessities for reversing cycles of poverty and installing the seeds of improved livelihoods for persons in many countries. When AIDS has run its course, ie. A vaccine has been developed and new infections, are minimal , we will still be under threat much as we have always been, from new and emerging diseases that threaten to be even more devastating than those of the 20th century. BHG for the 21st century is designing and building effective and sustainable quarantine strategies in response to an influenza pandemic, building well–ventilated homes to limit TB risks, covering interior dirt floors to prevent diarrhoea, and making home repairs to prevent Chagas. Increasingly, BHG will also require building for the millions affected by Neglected Tropical Diseases such as Bilharzias, even though it is not yet our problem. The increased threat from poor health is among the greatest threat to our urbanized world.

As the urban population sets to double over the next 20 years, one can only imagine the outcome. Building Green, must necessarily first mean building health. We cannot think of sustainable and integrated approaches to our brave new urban world without a focused strategy of how to simultaneously improve urban living conditions and health.

Monday, December 22, 2008

By the Rivers of Kingston

This entry was written over a year ago but it is just as relevant today as it was when first drafted.

It shouldn’t be difficult to accept that the more we build, the less our environment will be able to tolerate us. I was in Jamaica back in March 2007 and experienced what easily would be described as a typical rain day in the life of most Jamaicans. It was my drive through Kingston one afternoon that alerted me up to what little has been done in my hometown regarding the city’s ever expanding building-boom. The rain hadn’t seemed to be falling for 15 minutes when I turned unto Trafalgar Road opposite the pulse fashion house. Trafalgar Road can only be described as the Orchard Road of Singapore, the Madison have of New York or the Kensington High Street of London. You get the drift. Yet driving through what must have been about 10 inches of water seemed a bit surreal. We were bumper to bumper what few cars had been able to creep slowly along and by the time I turned off a minor road and unto oxford road. (50 meters from the magnificent Jamaica Pegasus hotel) my engine seemed to be on its last leg as it tried with all its might to overcome the 13 inches of water which turned the boulevard into a raging river. This was not to be…rather this needed not be the case. What Kingston was suffering was not only the effects of blocked drains through poor maintenance but in adequate foresight on the part of planners to specify adequate drainage for storm water that has resulted from the city’s building growth.

Concisely, the more we build the more we need to drain. Surface runoff is caused by the creation of pavement, driveways, tiled floors, sidewalks, etc. all of which act as substitutes for the previous lawns, soil, earth, ground which absorbed much of the water that would accompany a rainfall of this type. Where lack of sufficient drainage exists, water simply flows in the direction of its lowest point, which can then take hours to find a means of escape. With building over the past ten years taking on the scale which it has in Kingston, the city ought to have simultaneously invested in expansion and clearing of drains to accommodate increased runoffs. While the problem as I described affected only my ability to drive around comfortably, many imagine while others more personally recall the damage caused by a neglect of this problem: for homes as well as possible loss of life. Runoff from highways and major roads enter into low-lying housing areas; usually the only option afforded to those who lack the means to afford suitable locations. Many homes have been damaged through floods and residents have drowned by being washed away by the currents of these waters. Kingston needs less rivers and better solutions to protect those most vulnerable.

Tuesday, December 02, 2008


It’s the time of year again when we witness much of the world’s attention (or so I hope) turned towards HIV/AIDS and the many challenges it has brought to millions around the world. Though ARCHIVE is often mistakenly described as an AIDS organization, the members have agreed to place the pandemic at the forefront of our work. As organizations and governments continue to meet the challenges brought on by the disease, my hope for the year ahead is that we increasingly include if not prioritize attention to the root causes of the pandemic: poverty.

We have known for sometime that HIV/AIDS is much more than a public health issue. Therefore we run the risk, even over dinner conversations, of negating discussions about poverty which is exponentially more endemic than HIV/AIDS.

World AIDS Day 2008 is marked by steady and encouraging reports over the past year that many countries have finally began to experience a tapering and in many cases, a slowing of prevalence rates. Other cases highlight recent admissions that previous estimates for HIV cases in India had been exaggerated and actual figures suggest a prevalence rate in the country of 2.7 million. While these declines point to a host of reasons, it is certainly not time to be complacent. What remains true: i) one in every three persons globally is exposed to TB resulting 2 million deaths each year and; ii) 8 out of every 10 persons exist on less than US10 a day: both attendants of HIV/AIDS.

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