Create healthy cities, decolonize urban planning

Mojgan Sami
'I think Manila is making the same mistakes the US did 100 years ago when it planned for cars and profits (for a few) instead of people'


Last August, I was invited to Manila to speak at the Global Forum on Research and Innovation for Health (Forum 2015) and the New Leaders for Health Pre-Forum. This year’s Forum 2015, which is a global conference organized roughly every 3 years by the Council for Health Research and Development, revolved around the theme “Putting People at the Center of Research and Innovation for Health” and examined “Health in Mega-cities” as one of its subthemes.  

As an urban planner from the United States (US) who is passionate about putting people’s health at the center of all policies, plans, and designs, I was excited to be in Manila to observe the city’s development since my last visit to the Philippines nearly 10 years ago.

I was certain that Manila’s leaders and residents had worked hard to implement the lessons learned from poorly-designed cities in the developed world that had too much automobile traffic congestion, poor air quality, decaying road infrastructure, civil unrest, elite capture, rising inequity, lack of affordable housing, and high disease and death rates (particularly from the rising burden of chronic non-communicable diseases such as hypertension, diabetes, and cancer).  

I was surprised to experience the opposite.  

I think Manila is making the same mistakes the US did 100 years ago when it planned for cars and profits (for a few) instead of people. My friends wanted to show me the best of Manila’s planned communities and took me to Bonifacio Global City (BGC) in Taguig, which is branded as the new face of Metro Manila.

I looked around at the street accommodations for automobiles without designated bike paths and rapid bus lanes or room for urban transportation infrastructure such as the metro.  If this is the new face of Metro Manila, I worry about the future health and environmental quality of the city’s residents and ecology.  

The lesson learned from American cities is that planning for cars means more automobile traffic, rise of obesity and respiratory diseases, destruction of the environment and a dependence on the (mostly foreign) fossil fuel industry.

Don’t worry, I’m not a pessimist. I don’t believe that this is the inevitable pathway of Manila’s future development. There is a global movement to reimagine our cities by putting health and sustainability at the heart of policies that guide the built environment. By reinserting people and planetary health at the center of policies and planning, we can change the tide of development away from a tsunami of disease and environmental degradation towards a healthy and sustainable city for all.

‘Cities without doctors’

First, we have to systematically invite our urban planners, city officials, engineers, architects and real-estate developers to conferences that provide spaces to think about health as more than “healthcare” (i.e., hospitals, doctors, vaccines). We have to create “healthy urban planners” that understand how the built environment impacts the health of people and the planet. In fact, planners are true health specialists because health is ultimately shaped by the way they design homes, subdivisions, neighborhoods, cities, transportation networks, shopping districts, hospitals, schools – basically, cities at large!  

A truly healthy Manila would be one where no one gets sick or injured as a result of the built environment. In the 21st century, “cities without doctors” would mean urban environments where health is shaped by health-promoting infrastructure that encourages people to walk, bike safely, and breathe clean air.

For example in the US, we talk about the need to build cities that encourage active lifestyles to combat the ‘obesogenic’ environments that discourage physical activity and make it easy to drive. This has led to an obesity epidemic (and consequently a rise in Type II diabetes, cardiovascular disease and hypertension).

Decolonizing cities to heal historical wounds

Second, we have to decolonize the way we plan and manage our cities. The practice of urban planning has not changed since colonial powers invaded foreign lands and created structures and  regulations which separated the colonial settlers from local populations (e.g., zoning laws).  These zoning laws perpetuated inequality and injustice among local populations, which continue to plague cities throughout the world.  

Colonial planning systems also provided a way to commoditize natural resources (e.g., the science of forestry) and forever changed the governance of human-land relationships away from collective stewardship towards one of adversarial (and often violent) land-ownership. Decolonizing the way we plan and manage our cities must include the exploration of alternative conceptualizations of planning and governance.  

This complex process of ‘decolonization’ won’t be easy, but it must be done, not just to design healthy, sustainable, and equitable cities for the future, but also to address deep historical wounds of injustice and inequity that are most manifested in cities. For instance, the new urban planning must include everyone in the community, particularly the indigenous communities who have been marginalized and absent from planning and decision-making spaces.

How do we decolonize urban planning? This is where we need to create interdisciplinary spaces that allow participants do some deep soul searching.  In my participatory action research with communities around the world, we use three questions to guide these spaces. The first question is how did we get here?   

How did Manila get here? Who makes decisions on road placement, connectivity and flow in Metro Manila? Who benefits (and who is negatively impacted) from decentralization of planning decisions? How did a developer receive a permit to build a condominium complex that now towers Dr Jose Rizal’s monument in Luneta? We need to understand these historic pathways.

Urban visions guided by ‘decolonized’ values

The next question is, where do we want to be in 5, 10, 20, 50 years from now? To answer this question, there is a need for creative spaces for inclusive yet frank conversations that will cement the moral and ethical values that will guide our urban visions in the future. Part of this process is to look for examples of cities around the world that have adopted ‘decolonized’ values to develop and transform their urban environments.

For example, in the 1990s, two consecutive mayors in the city of Bogota, Colombia in South America decided that they would not use donor funding for transportation infrastructure to build for the rich car-owning minority.  Instead, they democratized transportation infrastructure to include multi-modal transportation uses which allowed dedicated public bus lanes, bike paths and walking paths.

Because this system was proven less expensive than the auto-centric designs of highways and freeways common in the US, the government was able to mobilize funds for providing Bogota’s residents with access to safe drinking water and sanitation.

The final yet equally important question to ask is, “How do we get from where we are at today to where we want to be?” This process includes both short- and long-term thinking skills.

We need to examine our systems of urban governance, which does not only pertain to the city ‘government’, but to the relationships that underpin individuals, communities, and institutions in cities.

In this phase, we need to consider which stakeholders need to be brought into these conversations, how resources can be mobilized, what policies must be put in place to institutionalize the urban vision that we want, and what regulatory frameworks are needed to incentivize good practice and run after erring actors.

‘Pinoy’ is global

Decolonizing our urban mindset is key to building the healthy cities we want in the 21st century. This is one way of reconceptualizing our problems which will lead us to reconceptualize our solutions. Once we have begun asking the difficult, often-ignored and sometimes painful questions, only then can we illuminate issues of equity and justice that in turn are reflected in the distribution of health and disease in urban societies.

Decolonizing and reconceptualizing will help us ensure that we are not repeating the mistakes of the past – for instance, in the way we subsidize our economic growth with rising burdens of disease and environmental degradation.  When we reconceptualize our situation, we will also realize that we can’t do this alone. We need to organize a movement that works for the common good – of the people and the planet.

It is high time for a new moral framework that will guide the development of our cities in the future, and I am strongly optimistic that Manila can lead the way especially in the developing world.

I hope that Manila’s vision of the new urban health will draw from the innate positive values of the Filipino which I will cherish forever – hospitality, compassion, dedication, persistence, social cohesion, collective identity, and loving attitude that I’ve seen in each and every one of my old and new friends in the Philippines.

By setting an example through innovative practice, Manila could then spread these values to other cities and cities-to-be in the world. This global cultural diffusion would be easy, because ‘Pinoy’ is global. –

Dr Mojgan Sami is an interdisciplinary practitioner, scholar and lecturer at the University of California, Irvine working at the intersection of urban planning, public health, and sustainability.  

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