The UIA World Congress of Architects 2023 is an invitation for architects from around the world to meet in Copenhagen July 2 – 6 to explore and communicate how architecture influences all 17 UN Sustainable Development Goals (SDGs). For more than two years, the Science Track and its international Scientific Committee have been analyzing the various ways in which architecture responds to the SDGs. The work has resulted in the formulation of six science panels: design for Climate Adaptation, design for Rethinking Resources, design for Resilient Communities, design for Health, design for Inclusivity, and design for Partnerships for Change. An international call for papers was sent out in 2022 and 296 of more than 750 submissions from 77 countries have been invited to present at the UIA World Congress of Architects 2023 in Copenhagen. ArchDaily is collaborating with the UIA to share articles pertaining to the six themes to prepare for the opening of the Congress.
In this fourth feature, we met with co-chairs of design for Health architect Arif Hasan, former Visiting Professor NED University Karachi and member of UNs Advisory Group on Forced Evictions, and architect Christian Benimana, Senior Principal and Co-Executive Director at MASS Design Group
Read on to discover the conversation.
The perspective with which you regard the connection between health and architecture is set within a more holistic and multidimensional understanding than what is commonly articulated for the field. Can you elaborate a little on some of your key perspectives, and also how they are reflected in your work with the panel?
Arif Hasan: The built environment has a direct relationship with health conditions. Natural light, ventilation, density, and the provision of basic infrastructure are key requirements for improved health conditions. In the South Asian region, to which I belong, the majority of the population lives in informal urban and rural settlements. The urban settlements are high-density and can be up to 3,000 persons per hectare at night and up to 5,000 in the daytime. Most of these settlements have no security of tenure and, as such, can be subject to evictions, creating intense mental stress and an impossibility of upward mobility. The lack of potable water and sewage disposal are responsible for a large number of water-related diseases, especially in children. The absence of a drainage system results in the flooding of these settlements, causing immense damage to the existing housing stock. Health and management services to deal with disease and mental stress are almost non-existent in these informal settlements.
Christian Benimana: The design of places, products, and systems, makes visible the invisibility of contagions, and of relationships, that affect our individual, community, and planetary health. Architecture and health are inseparable, from the direct design of hospitals and places for healing to the strategic design of infrastructures and city planning, architecture affects the physical and mental health of individuals and communities.
In the aftermath of the COVID-19 pandemic, it became clear that we should start questioning the nature of the spaces we occupy as this pandemic has highlighted the vulnerabilities of the systems we rely on in our daily lives. From the design of healthcare facilities, places for healing and the strategic design of infrastructures, and the planning of cities that we live in, architecture affects the physical and mental health of individuals and communities.
For instance, one of the biggest threats that are faced by communities is the availability of land.
Land represents a key asset in the lives of the communities as it provides key resources such as food, energy, shelter, and fodder, among others. Land is a health issue and its availability, location, and quality directly affect the life of the population. As stated by the UN-HABITAT (2008), access to land is a fundamental basis for human shelter, food production, and other economic activity. By 2050, 68% of the world's population will be living in urban areas with 90% of this rise occurring in Asian and African cities (United Nations, 2018). What does this mean? As cities are expanding, the population number is increasing, and access to land is becoming more expensive. This inaccessibility of land pushes the urban poor to build on unstable lands that are prone to climatic change catastrophes, or they choose to live in unplanned settlements that are faced with many problems. These populations are vulnerable because they don’t have access to land tenure and this threatens their health.
The Design for Health panel tries to understand the role of architecture and how health can be conceived as a design issue, how land rights impact healthy living, and how legislation, planning, and building impact inequality.
The aspect of architectural education has been concurrent throughout your reflections and discussions while developing the scientific panel for Design for Health. For example, you have discussed how to better connect students with the urgencies of societal needs and also contemplated the possibility of an architectural oath. What motivates this focus? What changes do you hope to see in education, and subsequently in architectural research and practice?
AH: In the panel, these issues were discussed at length and formed a part of the panel conclusions. Architectural education, for the most part in South Asia and Southeast Asia, is conventional and similar to that which is delivered in the Global North. Its focus is mainly on design aesthetics, new and imported materials, and a lack of climatic sensitivity. This delivers an architecture that does not respond to the climate, is expensive to build and maintain, and alienates the poor from the built environment. An understanding of what is required can only be cultivated by a long period of interaction between communities (not necessarily health-related, but more on the nature of communities, their culture, their settlements, and inter-community relations). This can help one grasp the pros and cons of the administrative structure which governs them, their social problems and how they deal with them, their economic and job-related pressures, and how they view the infrastructure problems that they have to deal with on a day-to-day basis.
Projects built around understanding these issues from the point of view of the communities and their organizations can lead to a more functional and appropriate architecture. In Karachi, I initiated a project in 1979 known as the Comprehensive Environmental Design Project, which tried to understand administration, social conditions, and economic pressures from the point of view of communities. It has been adopted by all the architectural schools in the city and most of the architects working on social and community issues are its product. This is the power of academic institutions if properly utilized.
The project has led to a better understanding of the constraints architects face in dealing with upgrading programs and the constraints in removing the constraints. And the conflict between their perceptions and that of architecture-related academia. The oath for architects emerged out of a better understanding of this conflict and of official planning. We also tried to understand the impact of the Hippocratic oath on the medical profession and found that it was considerable. It was on this basis that we proposed an oath for architects, which I have been true to. It is my belief that if 20 lead architects had followed this oath, we would be living in a much better social and built environment. The oath gives an ethical framework for the teaching and practice of architecture in an environment where equity and justice are missing.
CB: By 2050 Africa’s population is projected to double, from 1.2 billion to 2.5 billion. This growth will be accompanied by rapid urbanization, as cities grow to accommodate over 55 percent of the population. The infrastructure required to support the healthy and prosperous growth of this population is immense, and yet there is an extreme shortage of trained professionals on the continent, especially in the field of Architecture. Architectural education has to transform and adapt itself in order to ensure a role with greater relevance in a global search for sustainable solutions to address these changes.
The current curriculum should be redesigned to accommodate a better understanding of rapid population growth, climate change, environmental degradation, inequalities and informal/illegal development, and other challenges that the world is faced with. Students should be educated and trained to understand these challenges but also to cooperate with other professionals in seeking better and sustainable solutions. I believe this is achievable. For the next generation of creative leaders, we have to shorten and streamline their education journey for their talent to materialize the ambitions of an alternative model of development into reality.
In addition, combining academic research and design elements to address these challenges faced by the communities through architecture is a subject of immense significance. It is important to look at how academic research can play a positive part in healing the community.
In this context, it is not necessary that people designing for let’s say the African continent must come from Africa, but it’s important that work on the continent be developed within an African context. So far, there has been a focus on importing solutions that have been developed elsewhere.
The health-related challenges people and communities face - and the resources available to tackle these challenges – vary considerably across geographies and societies. What have your considerations been on knowledge exchange across these differences in conditions?
AH: In the Global South, there are two important requirements. One is the placement of health-related facilities (especially referral ones, which are in or close to low-income settlements). For this, a process of land acquisition through a just and transparent process would be required — giving easy access to curative health options. And, two, a public health program that develops low-cost sewage, water supply, and drainage systems that can be upgraded over time. The Orangi Pilot Project in Karachi, which has reached out to about 200,000 households who have invested their own money into building toilets and lane sewers, is an example, while the state has built the outfalls and trunk sewers at its own cost.
There has been a lot of knowledge exchange between Global North academic projects and Southern NGOs, which has resulted in a number of international financial institutions investing in development. However, the results of these research and extension programs have been far too expensive for purposes of large-scale application because they're based on existing Northern engineering standards, the hiring of expensive consultants, and an organizational culture that conflicts with local conditions. This can be overcome by challenging Northern engineering standards and a desire to achieve "excellence" whereas an incremental process would be more economically and socially acceptable, and result in a better process of learning.
In many Southern countries, we also deal with a strong anti-poor bias in planning, and the existing processes of academic research and its link with donors enhance this bias. However, a long period of association and evolution of a program that takes these considerations into account can lead to a more meaningful exchange — both for the aid-giving agencies and for the local communities.
CB: The recent health crisis has demonstrated to us the fragility of the current health systems that we rely on. In societies where there is inequity and major social differences, there is usually a very strong anti-poor bias in planning. As a result, few healthcare institutions are built in the poorest settlements, which then have to travel long distances to access healthcare. Also, insufficient funds are provided for the maintenance and management of these healthcare units, considerably lowering their efficiency and outreach.
The majority of the global population lives in poor, unserviced, or semi-serviced settlements -- which, as a result, have poor quality and quantity of water, and absence of sewage disposal and draining causing epidemics and resulting in high child mortality and morbidity rates.
The Design for Health panel seeks to question not only what fell short or what went wrong in the response, or how to build resilience in the current setting, but also serves as a time to dig deeper and question whether the foundations of the practice aren’t fundamentally flawed so much so, that seeking efficiency of existing solutions is insufficient to achieve the desired outcomes. One of the most important things in determining the efficiency, the location of health facilities, their design parameters, and their scale is the involvement of the communities in the neighborhood. These issues cannot be left simply to planners and bureaucrats, but also in the management of these facilities, there should be community participation.
One of MASS Design Group’s first projects was the 150-bed Butaro District Hospital. The beauty and success of this project took time and collaboration to come together. We were encouraged to think differently—to design from a patient’s perspective—ensuring each one had a window and a view of a beautiful landscape. We also sourced local materials, such as a volcanic rock from the nearby Virunga mountain chain, and worked with local craftspeople to deliver a site-appropriate and sustainable design, reducing the project’s embodied carbon and ensuring that 85 percent of the building costs were invested in the local economy. By the time the project was finished, it was something the entire community could celebrate. The hospital made people healthy; it was good for the environment and brought dignity to the community.
In which ways do you find that engaging with the 17 UN SDGs can contribute to architectural research and practices? How can we grow and support a continued understanding of and commitment to architecture’s active role in driving the sustainable transformation of our societies?
AH: As ideas and subjects of discussion and debate, the SDGs play an important role in an understanding of the interrelationship of the various subjects that the SDGs cover. This helps both the student, the teacher, and the bureaucrat in the planning-related theoretical and practical work. However, to make this happen, an intelligent debate is required — which is not always possible, and for which an understanding of the present physical and socioeconomic environment is imperative. So research on how things function today in relation to the various goals is a necessity. Unfortunately, not enough research on this subject takes place, and it is not related to the interrelationship of the various elements that constitute the SDGs. Such research and its relationship with the SDGs can create a more meaningful academic environment, leading to better practice.
CB: The 17 UN SGDs create clear, measurable goals which we can measure the impact and effectiveness of our work against. It’s not enough just to make beautiful structures; buildings must also benefit the communities for which they are built. Each project should have a transcendent idea that instills systemic change to make the world a better place and works towards those sustainable development objectives. Architecture is not just about design, but also about a building process that creates long-term impact. For instance, in the developing world, cities are being built up through technologically innovative and modern engineering projects, with little to no regard for potential consequences to the social structure of these communities or the health of the planet. We are slowly awakening to the realization that most of these projects are made possible by varying degrees of labor exploitation and toxic materials. This type of building process is responsible for about 40 percent of all global greenhouse gas emissions, exacerbating the plight of climate change. There is, however, an understanding that the conventional model of development is not suitable, and a movement to create solutions that enhance communities through design. We are beginning to understand that architecture and design have the power and the agency to address the most complex problems. Architects and designers have the ability—and even the responsibility—to help develop a model of effective and sustainable development for our communities.
What are you hoping the Congress delegates will take with them from the UIA World Congress 2023 CPH and what legacy from the event would you hope to see?
AH: What I hope for the delegates to take back is that what is paramount in architecture is the human being and the community they create, and the comfort that architecture can produce for them in every sense of the word (climate, work, family relations, etc.). My hope is that the delegates of the Congress take back with them the close relationship between architecture, dignity, justice, and equity. These can lead to the creation of a better world in which poverty does not figure as a major cause of deteriorating health conditions like it is today.
The legacy of the Congress will last only if there is a post-Congress agenda that keeps the issues raised in this Congress both at the level of theory and practice.
CB: At MASS, we have leaned on the Ikinyarwanda term umuganda. For us, it means going beyond our day-to-day interactions, to collectively develop, enhance, and make better the community. This sense of community informs an architecture that goes beyond a physical product, as an act of building the society and building up the community. I hope that delegates will leave with that conviction. It’s a relentless pursuit of progress, modeling a future where we can understand and leverage where our materials come from, what our building processes are, and the impacts they create.
Stay tuned to the collaboration with UIA World Congress of Architecture 2023 and to our coverage of Copenhagen, the UNESCO World Capital of Architecture for 2023.
