Photojournalist of the month: Tomislav Georgiev

Currently based in Skopje, Georgiev is a photographer who covers the least popular – and populist – subjects and contexts. It is perhaps for this reason that he is so little-known having ducked beneath even the radar of increasingly celebrated photojournalists and war correspondents. He is, however, a member of the Balkan Photographers Collective and numbers commissions from UNICEF MK, the branch based in Macedonia, as well as nationals including Le Monde and The Sunday Times. 

His most powerful work focuses on Kosovo A Power Station, a lignite power station with five units at Obilić. It is the second largest power station in Kosovo and is described as the worst single-point source of pollution in Europe and it is expected to be closed by 2017. Indeed, the A block alone emits around 2.5 tonnes of dust per hour, which exceeds EU regulation standards by some 74 times. The following are drawn from Georgiev’s series called Toxic Legacy and with their associated captions, expose a terrible insight into the lives of the people living within its shadow.

Approximately 5,000 people die each year from cancer in Kosovo. The proportion of those from family units in the Obilić area is far higher than elsewhere and surpasses worst expectations for an otherwise non-urban area. The following billboard is from the local Pristina hospital reading ‘For Good Health’:

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The power plant behind a man with his cow in the village of Dardishte. The local terrain is heavily polluted making vegetable production and grazing low yield and problematic.

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Children play near the power plant:

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Following the closure of Cesmin Lug camp near the Trepca mine in North Mitrovica, Kosovo. The camp was built close to the Trepca lead mine and smelting works. The factory was closed by order of UN administration in 2000 but the slag heaps were never cleared. As a result, the residual lead blackens the teeth of local children, affects their memory and leads to stunted growth. Their activity patterns jump from bursts of nervous hyperactivity to comatose states. Doris Nitzan of WHO said, at the time, “This is the worst ever lead poisoning that we know of in Europe”. The inhabitants from Cesmin Lug moved to the Osterode camp.

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The home of Rodna Zifkovksa with her grandchildren in Osterode camp in North Mitrovica. To limit risk of poisoning, the existent topsoil was replaced with concrete, which was later classified by WHO as “safer” than before. 600 people now live here.

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Hyra Shanini’s house is only 50 metres from the 40 year old power plant. Her only son, Kahmiron, died in December 2010 when he was thirteen years old following  brain tumour, considered directly related to environmental factors. He was initially operated on in Tirina, but Shanini was not able to afford his second operation. Here she is holding her late son’s shoes.

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While Georgiev continues to quietly document the lives of his fellow nationals, awareness of the lasting health impacts and consequences of living within the shadow of polluting giants must be raised and addressed, for the safeguarding of future generations in Kosovo.

Image credits (all): T. Georgiev.

Book of the Month: Self Portraits

Lauded by Susan Sontag as ‘a valiant writer whose work honors literature’, Frederic Tuten is a recently revisited favourite of mine in the form of his ‘Self-Portraits: Fictions’, which was given to me earlier this month. He is best known for ‘Tintin in the New World’ which is characteristic of an oeuvre studded with Borgesian, Conradian and Proustian influences and edged with mystical realism. Published in 2010, ‘Self-Portraits’ brings these same influences together in a series of interrelated stories that offer as much enjoyment as narratorial ingenuity. Cross references and allusions are frequent but lightly spun across trajectories that wind out of control and back again.

Not dissimilar to the premise of this website’s ‘Writing Health‘ section, Tuten’s self-portraits contour lives and experiences through words in an attempt to hold them up to a readerly, or spectator’s gaze. Although not directly claiming to pertain to health, global citizens and readers will relish the thread through tales in which  a young boy barters with pirates for his grandmother’s soul; Death appears as a genial waiter in a bar across from the Metropolitan museum; a lonely man lectures circus bears on the history of art; miniature glaciers tumble from a refrigerator in an East Village apartment, heralding a voyage to Antarctica on a frozen schooner anchored in Tompkins Square Park with two lovers reappearing time and again in new guises, through new voices and in new places.

Reading as escapism is true of all of Tuten, but especially of this work. Writing at the close of the Prologue, he muses ‘Stories. Like air, like food, like hope. I read them, I told them, and later, I wrote them, stories about men and women seeking the faraway in revolutions, in art, and in the dreamy search for love’. I can offer no better invitation into another world.

 

Image Credit: Tournesols, A. Bow-Bertrand

Relief/Development: bridging the divide

When one reads a news article titled ‘policy change crucial for international development’ or ‘governments must get behind the relief effort in XYZ nation, in XYZ context’, one rarely pauses to consider the link, interchangeability or otherwise of ‘relief’ and ‘development’ as terms and actualities. Perhaps it is the history as an English Literature student, but ingrained in me is the habit of dissecting every term to the sum of its parts and to consider how it interacts variously given its context, narratorial voice, intended audience and so on. But this scrutiny over terminology is necessary from any critical reader, particularly one concerned with global health, and the international agenda for it determines accountability, motivation and outcome.

So, what’s in a name? The two definitions most readily associated with ‘relief’ include a feeling or encouragement of emotions of reassurance following periods of anxiety or high stress as well as financial or practically oriented assistance given to those parties or persons in critical need or difficulty. Meanwhile, ‘development’ is most generally associated with a specifiable state of growth, optimistically linked with progress or change through space, time and people. The crossovers between the two are apparent and, indeed, rather than considering each term and concept in silo, it is best to see them as a continuum. In temporal terms, relief humanitarian assistance usually segues into development, but this chronology is not always linear with the two happening in tandem in many circumstances of humanitarian crisis,  fragile states and insecure environments.

But this broad brush approach to theory does not always trickle down into good practice, which returns us to the reason behind discussing these terms and states in the first place. Humanitarian, relief and international development organisations usually pitch themselves as just that – umbrella groups that want to address the acute and the chronic like the most forward-thinking, prophylactic minded doctor. However, the two states have diverse objectives and priorities as usually a different government department is involved in allocating relief aid funding to that involved with international development. This is evidenced in the United Kingdom’s Department for International Development (DFID) which regularly has to clarify the position of it’s central funding mechanism, UKAid Direct, which awards grants to small and medium sized UK and International Civil Society Organisations to reduce poverty overseas.  It was formerly known as the Global Poverty Action Fund (GPAF) but this titular revision also likely has something to do with managing interpretation and associated expectations.

The divide is also widened in related funded  gaps frequently carved through donor motivations and constraints that are, at times, sadly at cross purposes to those in most need. The group of diseases that fall under ‘Neglected Tropical Diseases‘, such as Kala Azar and leprosy are, in part, so categorised because they are less de mode, or emotive than some of the often great, white man killers such as AIDs which dominated funding and coverage in the late twentieth-century across the United States. So too, the missions around ‘relief’ and ‘development’ demand and employ different skills with income generation a priority of current development such as the food security approach. Furthermore, different priority is given to sustainability. Vaccination programmes, a cornerstone of many development initiatives, are frequently hard to implement in anything but a scatterfire manner in acute crisis zones such as mutating refugee camps through which peoples often pass unidentified.

To bridge these gaps, it seems that best practice is to both speak about and act on development in relief and relief in development. There is a clear opportunity here for researchers and workers in disaster preparedness (i.e. the measures taken to prepare for and reduce the effects of disasters) to increasingly bring these two closer together, so that when relief is needed, it is readily available and part of a comprehensive, on-going development effort.

 

Image Credit: Jonction, Geneva. A.Bow-Bertrand

Photojournalist of the month: Jiro Ose

Hailing from Osaka, Japan, Jiro Ose has worked as a freelance photojournalist since 2005, and has covered the historical election in Congo, the Sudanese refugee crisis and the departure of deposed president Jean-Bertrand Aristide in Haiti amongst other events and states. His coverage of the Democratic Republic of Congo election won him the Award of Excellence in the Magazine General News Story category of the Pictures of the Year International competition . The selection below are drawn from Ose’s ‘SOS from Iraq’ which he describes as follows:

I was sent to cover the 2003 Invasion of Iraq by Newsday, one of New York’s dailies. I entered Northern Iraq (Kurdistan) through Iran, like many other journalists who were rushed in to cover the war. When the City of Kirkuk fell, I entered with Kurdish Peshmaga fighters and thousands thronged the streets and greeted us as though we were liberators of the city. Saddam was finally gone. The air was filled with euphoria. People danced and chanted on the street. A bronze statue of Saddam was brought down and beaten with their sandals.

I hardly saw any fighting except American bombers dropping bombs on Kirkuk in the distance. Infamous Republican Guards peeled off their uniforms and melted into the population. It was dangerous, still. It was still a war. I walked the field where another journalist was killed by stepping on a landmine. I drove past the intersection where, only half an hour later, another journalist was killed when a suicide bomber drove through in a car laden with explosives. What was to come there after is beyond comparison: the total collapse of Iraqi society, fighting between religious and ethnic lines. Yet, the only time I saw the dark sign of what was to come was the second night in Kirkuk.

I heard a lot of commotion outside the hotel. Parked in front was a taxi. On its bonnet lay a boy’s lifeless body. Half of his head was blown clean off. A group of men who had surrounded the taxi were shouting; these were Turkmen, one of the many minority groups in Iraq. They said they were under attack by Kurds, and that the boy was shot by a Kurdish sniper. They knew that a group of international journalists were staying at the hotel. The protest lasted about an hour and when the men left the lifeless body on the ground remained. Several hours later, someone could no longer tolerate its sight, so covered it with a flag of Turkmen.

Yet, I still did not really seen the real cost of the war, if you call it a war, until I visited Red Crescent Hospital in Amman, Jordan 5 years later.

Walking through the 2nd floor of Red Crescent hospital in Amman, Jordan, you bear witness to the devastation the war and ensuing violence have brought upon the civilian population on a daily basis in Iraq. Because of the curfew, lack of safety and medical supplies, hospitals inside Iraq cannot perform long and complicated surgery. They are the lucky ones (referring to a selected few who are brought to the hospital to the program by Medecins Sans Frontiers , MSF, France),” said Dr. Nasser, an Iraqi plastic surgeon who preferred that only his first name to be used. Because of the escalating violence, MSF France pulled their international staff from Iraq three years ago. Now they assist Iraqi hospitals across the border by providing drugs and medical supplies. They also set up a surgical program in cooperation with the Jordanian Red Crescent Hospital in Amman where they perform reconstructive surgery for patients who have been handicapped by injuries or incomplete procedures free of charge, including transportation from Iraq and back after the recovery. 

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Brexit and Non-place

What’s the current situation?

It is a week since almost half (48% to 52%) of the United Kingdom (UK) reeled at the news that the majority had voted to leave the European Union (EU) – its constitution, ideals and politico-economic partnership. Since then the respective leave and remain campaigns have been posthumously dissected, their leaders and leadership questioned and the integrity and informedness of the voting public duly challenged.

As the title of this blog suggests, MattersduMonde is about matters that affect the world, often starting from the local, and health-based infrastructure with previous posts exploring the National Health Service and foreign aid programmes via the Department for International Development (DFID). However, if nothing else, these critical days since the largest suffrage determined political decision taken during my voting history, I have been struck by countrywide engagement with what it means to be the United Kingdom, more commonly – and loosely – used interchangeably with notions of ‘Britain’ and ‘British’.

Notwithstanding the disappointing level of abstaining voters particularly of the 18-24 age range, and the widely varying degrees of information or mis-information (given the complex, often contradictory and repeatedly deceitful policies of both campaigns) held by each voting citizen, every one of those 30 million plus voters has an opinion, before, during and most importantly following the outcome of last week’s referendum.

Bit of a mess?

Bit of a mess? Somerset House ‘Utopia’ exhibition, detailed below.

 

Where does this ‘leave’ us?

While there is real value in reading, sharing and re-writing the present experiences and reactions of the UK’s constituents, it is imperative to note that while a local issue for many, the implications of this vote have global consequences, from Donald Trump’s looming presence in Scotland last Friday morning and that state’s predicted distancing from the result, to Northern Ireland’s renewed clamour for independence. Fundamentally, the economic, social and literal health of the populace of the UK we are ever a part of is ironically dependent on the peoples and places beyond this island’s increasingly literal borders.

Many leave voters cast their weight behind a campaign that promised an impossible finite end to free movement to the UK associated with membership of the EU. Many of these same voters claim it is acceptable for immigration in the form of skilled workers – doctors, lawyers, pharmacists. All of which crystallises into a persistent and little explored anxiety that this referendum was seen less as a heterogeneous, multi-faceted decision of unity in all its forms, and more of a reverse process founded on the widely silent, but influential idea of what the UK or ‘Britain’ really is.

The much-cited statistics that show a demographic skewing of the older population across England, Northern Ireland, Scotland and Wales towards a leave vote and vice versa at the other end of the age scale should be increasingly seen not based on electoral or life experience, but in terms of how this shaped one’s understanding of what it is to be British. What is palpably clear as orchestrator of the leave campaign, Boris Johnson, has shown in his sudden shadowy disappearance from the now 5-way race Conservative leadership line-up, is that the people of Britain and their understandings of it are so wildly different, that to try and unify them for a future Britain that is based on modern change, innovation and progression, is an insurmountable ask.

Utopian vacancies at Somerset House exhibition, 2016.

Utopian vacancies at Somerset House exhibition, 2016.

Indeed, our respective understandings of Britain and our role as citizens of this nation are most formally pinned to the ‘Life in the UK’ citizenship test first introduced in 2013 under the imperative ‘prove your knowledge of English or citizenship and settling’. Such lexicon of proof and knowledge are constructs bandied about during this referendum as though quantifiable. But of course, it goes without saying that such a test is so anachronistic when so many current citizens would not pass. It is intellectually comic that one of the questions in the aforementioned test is as follows:

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Reproduced from the condensed version of the YouGov citizenship test for the Independent.

Aside from ideological correctness of such answers, many of the other constituent questions are so divorced from educational-derived curricular knowledge as well as national identity that this test’s value – and marker for ‘Britishness’ – is undermined.

 

Where has this come from?

Rather than suggest what our future will look like, as I don’t think that there is a clear nor comprehensive vision, or reality, this discussion turns instead to look back through history and literature to the model of utopian thinking and impossible dreaming that has coloured and discoloured every sovereign state and every independence narrative. Utopian thinking, the American dream, scriptural, Edenic Paradise are all permutations of a similar model characteristic of humanity – the striving for something that is perfect in the eyes of the perceiver.

Of course, perception rarely correlates with feasibility which in turn causes the very personal and emotive fall-out experienced by so many of us in the UK and beyond this past week. Furthermore, ‘utopia’ is etymologically rich, deriving from Greek stems to form the hybrid of ‘non-place’. From Thomas More’s possibility dreams (Utopia 1516) to Francis Bacon’s political ideology (New Atlantis 1627) and Margaret Cavendish’s wonderland of the imagination, the seventeenth century reader and audience alike were accustomed to the idea of ‘a world elsewhere’. In itself an epoch of upheaval across currencies of religion, philosophy and politics, these learnings and writings are increasingly critical to the immediate now.

In addition to the main Somerset House exhibition and series of talks, there are collaborative pieces running in conjunction with the neighbouring Courtauld Institute and King's College London

In addition to the main Somerset House exhibition and series of talks, there are collaborative pieces running in conjunction with the neighbouring Courtauld Institute and King’s College London.

The debt Thomas More owes to humanism for the origins of Utopia is an area in which much debate has been devoted, in part due to the malleable connotations and contextual meaning of pigeonholed definitions. The Renaissance saw a resurrection of the classics and humanists heralded furthering the arts of reason and the dignity of man within the Christian doctrinal frameworks. Famously described as a ‘revival of good letters’, humanism was perhaps less ideological than often attested.

Whilst the humanist influences of Plato and Erasmus are powerfully vocal in Utopia, so too is a contradictory turn from them, most notably in discussions which theorise beyond the boundaries of Christian monogamy both on personal and national levels. The principal elements of utopian writing so understood, are a chance landing or shipwreck on the coast of what turns out to be an ideal commonwealth followed by a return to – specifically – Europe, and a commentary on what has been remarked.

 

What are the dangers of utopian thinking?

So too, as argued by Margaret Cavendish (1623-73) who engaged with and practised a form of experimental science through her literature, imaginative freedom is considered a prerequisite for intellectual maturity, social change and intellectual development. Indeed, commonly held truths (or unexamined perceptions or ‘proof’ of what Britain is) are utopian experiences that must be deconstructed for they are ultimately unavailable for representation and appropriation.

In Cavendish’s The Description of the New World, Called the Blazing-World (1666), Cavendish, herself the actual and literary figure of the ‘Duchess’ of Newcastle finds herself on a satirical trajectory as scribe to a beautiful maiden – the Empress – who writes her way into another world with different stars in the sky and creatures on its shorelines. When the Empress desires to share this found world, the guiding-force of the Duchess encourages her to construct her own, redirecting utopian expectation away from material production to shared creative activity.

The ‘Britain’ idealized in the subconscious of all voters is a utopia of sorts – not a venture until is examined in the open – but still an irreconcilable state. The other; the ‘European’ in this case, like the Orient and prolific discourses in the field of global health of the ‘west and the rest’ quickly become the subject of the languages of dream and Utopia, ‘the object of a powerful fantasy’ (Hall, 1992).

 Readers and citizens must surely be left wondering about the value of the ‘otherness’ of Utopia and its paradoxical comparability with sixteenth-century England. Unlike Plato’s Republic, Utopia is not a maquette for an ideal commonwealth; it seems more dramatically to be one of More’s theatrical metaphors ‘in which disparate and seemingly discontinuous aspects of […] existence come together, touch, and resonate’ (Greenblatt, p. 27).

Preach.

Preach.


And the possibilities of such dreaming?

The contradictory design and rhetorical paradoxes of these cited utopian writings are self-interrogative, challenging, and reflects the wealth and the weakness of words to influence worlds. The final line of More’s Utopia hovers in the subjunctive, so what happens next is for us to decide. Certainly, the utopia of one human may be the dystopia of another, so to the very last, the polemical nature of the literature and author remain. More specifically, when angling this pitch through a perspective of health and globality, the idea of a global society should not be construed as a utopian world free of conflict. Rather, as in most national societies, one would expect a global society to be characterised by ongoing political conflict and competing views. As Frenk (2010) notes, ‘what the notion of a global society does imply is that underpinning such conflicts would be a widely shared understanding of health interdependence and an acceptance of some responsibility for the health of others as members of the same society—in other words, a shared commitment to realisation of health as a human right based on a recognition of our common humanity’.

Is this pathetic fallacy? Dark and gloomy Somerset House quad the weekend post-Brexit vote

Is this pathetic fallacy? Dark and gloomy Somerset House quad the weekend post-Brexit vote. Might just be the monochrome filter.

It so happens that it is the 500th anniversary of More’s Utopia celebrated in a challenging and ever-relevant events programme at London’s Somerset House. Yet, as the programme preface articulates: the text and commemorative events are, once again, ‘not a blueprint for the future, instead he [More] places importance on the process of dreaming in the now. His work continues to inspire communities and provide a framework for true innovation in our time.’ In a world that has just witnessed the return of ESA astrologer Tim Peake from the International Space Station, surely the brand of extra-terrestrial exploration and utopian dreaming as read through Francis Goodwin’s The Man in the Moone (1638) indicates the worth in looking at the bigger picture and reassessing the simple but time-old answers we would give to an alien asking ‘what is Britain’?

With constant personal reflection translated into political representativeness, I think there might be hope for a Britain that is united in understanding the nation is ‘great’ for being in flux, flawed but imperatively free. A renewed brand of utopian ideology, distanced from it as a reality, will be instrumental in shaping this future.

As simple as an OS map.

‘Paths to Utopia’: as simple as an OS map…

 

Bibliography

Bruce, S. (ed.), (1999) Three Early Modern Utopias: Utopia, New Atlantis and the Isle of Pines (Oxford: Oxford University Press)

Comp, A. and F. K. Pizor (eds.) (1971), The Man in the Moone: An Anthology of Antique Science Fiction and Fantasy, (London: Sidgwick and Jackson)Frank E. and Fritzie P. Manuel (1979), Utopian Thought in the Western World (New York: Belknap Press).

Frenk, J. et al (2010), Global Health is Public Health in The Lancet. Vol. 375; pp. 535-6.

Greenblatt, S. (1980), Renaissance Self-Fashioning: From More to Shakespeare (London: The University of Chicago Press)

Hall, S. (1992), The West and the Rest: Discourse and Power. Available from: <https://analepsis.files.wordpress.com/2013/08/hall-west-the-rest.pdf&gt; [Accessed 28 June 2016]

Lilley, K. (ed.) (1994), The Blazing World and Other Writings, ed. Kate Lilley (Harmondsworth: Penguin)

Logan, G. M. (1983), The Meaning of More’s Utopia (New Jersey: Princeton University Press)

Nelson, E., Greek Nonsense in More’s Utopia. The Historical Journal, 44 (2001), pp. 889-917.

Skinner, Q. (2002), Visions of Politics. Volume III: Hobbes and Civil Science (Cambridge: Cambridge University Press)

Image Credits (all): A. Bow-Bertrand. The featured image reads ‘Utopia’ transliterated into Thomas More’s alphabet.

Recent Restoratives

I rarely publish personal creative writing, not least because I have a strong suspicion that if it were classed as poetry it would really fall under stream of consciousness or rumination. Anyway, since finding myself largely immobile following a broken clavicle after a misplaced enthusiasm for a trial session of tag rugby (I know), words have been typically helpful in filling the vacuum from press work, painting and living as normal. ‘Road 1.0’, ‘Jonction’, ‘Pachinko’ and a final jottings that really wants to be called ‘cheese soufflé’ follow, written recently and in the past 12 months.

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Policy in Practice: Cambridge

Abstract: 2016 is a critical year for sustainable development warranting this urban health proposal for Cambridge. With exponential population growth forecasts and some of the highest levels of homelessness, air pollution and house price rises across UK cities, interventions must be multi-sectoral. Evidence-based recommendations are to: 1) develop affordable housing prioritising settlement for the destitute identity group, and 2) reduce air pollution through improved safety and attractiveness of pedestrian areas. Review and target periods of 12- and 36-months will support and shape this vision for a modern, healthy city by 2030.

 

It was a dreary morning when the wheels / Rolled over a wide plain o’erhung with clouds, / And nothing cheered our way till first we saw / The long-roofed chapel of King’s College [Cambridge, William Wordsworth]

Wordsworth’s verbal mapping and visual transit into Cambridge is not so unlike our own. To know Cambridge is to come to it afresh, travelling into the urban nexus with the potential to offer recommendations that benefit from perspective: both academic and geographic. The city’s low lying above sea level and development height restrictions means that, as for Wordsworth, it remains visible to the unaided human eye across the surrounding lowlands. Unlike Wordsworth’s 18th-century movement across ‘wide plain’ into an urban nexus marked by King’s College Chapel, current comers register the place as a city – one which was conferred this status in 1951 in recognition of its history and continued behaviours as a productive space. Whether via East Anglian rail tracks on a 46-minute train journey from London’s King’s Cross station, or along the M11 or A14 roads, or rising through the system of locks and weirs as a bargerman, the city evidences the challenge of any modern urban hub: how to support the health of its users while ensuring sustainability for future peoples. By considering interactions within the urban system, forward-looking policy can be employed to change and benefit the health of Cambridge, noteworthy for its status as a magnet to people variously acting as ‘commuters’ of business, trade, travel and intellect. Cambridge’s citizens are a product of their city – and vice versa.

Through this overview of existent urban health policies and projects, the Cambridge polis has demonstrated its willingness to consider and customize initiatives from across the world to most effectively meet local needs. This wide-reaching outlook relates the local to global health, along a people-community-planet pathway (as employed by the Cambridge Sustainable Food Charter, 2014). This report offers renewed vision for Cambridge between 2016-2030 and negotiates recommendations in terms of amenability, costing, risk and feasibility. Cambridge has been lauded a pioneering city in terms of academia and more recently business, with the adoption of the ‘Silicon Fen’ appellation (referring to the regional aggregation of biotechnology based businesses) and one which is developing. In the Centre for Cities (2016) list, Cambridge was ranked sixth of the ten fastest-growing cities by population in the UK with an annual growth rate of 1.4%. Within this demographic swell, the Cambridge City Council’s Improving Health Plan (2008 p5) reported that ‘the number of people aged 65+ in Cambridgeshire is expected to rise by 60%’ by 2021. As a result of this context, this report focuses on the urban challenges of sustainable settlement and air pollution, recommended for their immediate relevance and demonstrable capacity to influence urban-related health outcomes for the major share of this population.

To date, sustainable settlement and affordable housing initiatives have frequently been included in urban health reports pertaining to the Cambridge city region in recognition of its considerable tourist capital and population growth. There is, however, room to improve. Such reviews have considered this demographic swell conceptually as a case of more people equating to a need for more houses, rather than recognizing the mobility and heterogeneity of population sub-groups. Indeed, Yvonne Rydin (2012 p1) highlights that average levels of health witnessed in Cambridge: ‘hide the effect of socioeconomic inequality within urban areas’. Urban poverty exists and persists in Cambridge. Last year, the main regional news outlet Cambridge News (2015) reported a 41% increase in homelessness associated with a range of factors: job losses, welfare reform and benefit sanctions. At present, there are some group-specific support services such as the University-based Streetbite society and Jimmy’s homeless shelter working on a short-term care model. For many of these individuals, their homelessness is a symptom of being out-priced from a depleting stock of affordable housing. Indeed, according to the Centre for Cities (2016) report, Cambridge came out top in terms of the highest rises in house price with a staggering 12.5% annual growth across 2014-2015 [Figure 1]. So too, it was ranked alongside Oxford and London as the least affordable cities in relation to the British average. Existent plans to increase the housing stock and to push through welfare reforms while demonstrative of sound regulatory structures and nurturing governance, overlook the need for new housing stock to be targeted to specific audiences within the overall population swell.

Screen Shot 2016-06-15 at 21.06.23A similarly broad stroke, if simplistic, approach is witnessed in existent management and reduction of air pollution measures in the city. Mark Slade (ITV NEWS, 2016) remarked that: ‘air pollution is a problem for people’s health, we know that it is a problem for the environment’. Meanwhile, local think-tank Cambridge Past, Present & Future (2016) report that carbon dioxide emissions in Cambridge regularly breech UK and EU legal limits, contributing considerably to elevated air pollution and ‘must be tackled as a chronic public health issue’ directly associated with morbidity. Once again, this report advocates starting with the urban citizen and their unique, decentralized patterns of movement within – and use of – the city centre. I would invite you to imagine that you are rushing along King’s Parade to attend a choral service at King’s College Chapel on a Sunday morning [Figures 2, 3]. You are faced with a transit conundrum: cycle and plough through pedestrians who step onto the Parade for that all important Instagram snapshot; walk and risk being late for the service, or jump into a Hackney carriage for a horn-blaring drive. Scale-up this scenario to a weekly occurrence and this seemingly flippant narrative becomes one in which all three options have quantifiable urban, physical and psychological health impacts pertaining to air pollution. As an existent conundrum, the City Council has implemented traffic-centric actions such as guided bus routes and removal of Park & Ride charges so promoting public transport use and reconsidering personal vehicle use via the regional CamShare scheme. As a corollary, there has been effective promotion of walking habits. Certainly, the objective to reduce air pollution has the associated effect of protecting the local environment. As has commonly been attested, a healthy city is one which is pedestrian friendly. According to Clayton Lane of the Institute for Transportation and Development Policy, ‘the pedestrian is the indicator species for a sustainable transport system – and, it turns out, for a healthy one’ (DeWeerdt, 2015). Indeed, many thoroughfares in Cambridge’s centre are pedestrianized but what does this mean in practice? Too frequently this equates to narrow or poorly demarcated pedestrian areas such as the sidewalks of King’s Parade [Figures 1,2] that are regularly transgressed by pedestrians. So too, these zones are not always functional in terms of personal aesthetic or evaluations of security. In summary, current measures to reduce air pollution in Cambridge are a piecemeal effort that requires greater nuancing. As Executive Councillor for Planning and Climate Change Tim Ward identifies, ‘although the City Council has undertaken a significant amount of action in the past five years … climate change [and air pollution] still presents very significant risks’ (Cambridge City Council, 2012).

Many existent initiatives in the county and at a global health level reach their published expiry date in 2030, namely the Cambridge 2030 Vision project, and more latterly the Sustainable Development Goals. For ease of monitoring and comparison, this end-date has been chosen to achieve the proposed targets as below delineated to improve the health of persons living in Cambridge. The individual human user and consumer of the urban space must be the main beneficiary for the proposed set of initiatives, reaping complementary benefits, with many of the lower scale actions immediately delivering quantifiable changes and improvements in health. Furthermore, by appropriating the model of Cambridge University’s 2010-2020 Carbon Management Plan, there will be 12- and 36-month targets for policy development and management drafted in the Gantt Chart following:

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This report recommends a 2030 target of affordable housing for all, a reassessment of council and social housing selling practices and prioritisation of settlement for the destitute population. This housing must be socially sustainable factoring in the projected rise in city house prices to ensure that residents are not out-priced, possibly for the second time. This will reduce the numbers of street-dwelling destitute so improving urban sanitation but will also augment the image of the city with attractiveness key to its magnetism for commerce and creativity. This intervention will require the appropriation of disused buildings, promotion of room-to-lets within personal properties for short-term provision and a reconsideration of brownfield sites ‘that might have development potential’ (Cambridge Past, Present & Future, 2014) within the urban green belt. This process will reap energy efficiency co-benefits by adopting the most advanced energy efficient repurposing build methods. Meanwhile, air pollution will be reduced through a comprehensive review and overhaul of pedestrian areas and walkways in the city to promote carbon efficient modes of movement and a transition from vehicle use. Indeed, the archaic limits of the city are marked by the green belt so improvements made in the present must be sustainable on-going in a city uniquely preserved from patterns of urban sprawl due to its compact nature and inherent walkability. The majority of pedestrian areas in the city are also cycle routes. The two can productively co-exist, but there must be clear zoning [Figure 5], introduction of pedestrian lanes in the wards furthest from the market epicenter and improvement of existent pavements. For instance, the walkways straddling Sidgwick Avenue [Figure 4] are inhospitable and represent a trip hazard as tree roots have surfaced. In this particular instance, an add-on benefit of resurfacing would be to consider the attractiveness of both walking routes and their value to users in terms of commodity and safety. Van Cauwenberg et al. (2012) support this imperative to make pedestrian lanes ‘pretty’ and recommend that tree planting becomes central – rather than ancillary – to road planning, possibly encouraging users to walk further. Many routes would benefit from a green lane, implemented through citywide planting of trees and maintenance of the existent stock. In addition to the beneficial carbon offsets of increased canopy coverage in the city and associated disruption of the urban heat island effect (Corburn, 2009), walking promotes health. Indeed, Cambridge City Council’s brochures promoting 1-3 mile walking tours and pedestrianized commuter routes would satisfy the UK government’s weekly physical activity recommendations of walking two 1-mile journeys daily (Walking for Health, 2013). The associated global health benefits of adequate physical activity acts prophylactically warding against non-communicable diseases and improving mental health and combating stress, (Klaperski et al., 2013) in turn reducing the local health system load.

These recommendations function across comprehensive plans projecting towards 2030, but are also characterized by meaningful, microcosmic behaviours and actions. Indeed, Cambridge will always be a city in flux; the nerveline of the River Cam symbolizes transition, arrival and departure; but the landed area will remain largely constant given planning restrictions and limited scope for urban sprawl. By adopting these initiatives that prioritise sustainable and cost-effective repurposing, by 2030, Cambridge will have secured its position as a self-supporting urban centre able to share its models of urban heath, affordable settlements, social progress and carbon efficiency to other cities.

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Appendix

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Image Credits:

Footer panorama: The River Cam. KBJX6, 2015.

Header panorama: From King’s College Chapel. A. Bow-Bertrand.

MdM Reads of the Month

Every month MdM recommends an anthology or monograph for readerly perusal. Inevitably, these suggestions spark discussion both on and off-screen, including a recent request for a showcase of the other global health blogs (and vlogs) that  I return to again and again.

The below is a wild but wonderful selection of my most tried and tested reads as well as some more recent discoveries, to which I am always delighted to add. Please comment below if there are others we should know about.

 

This Week in Global Health (TWIGH)

Dr. Martin has achieved cult status amongst student global healthers for his brand of accessible, bitesize updates on careers, policy and research each week. While this is all published on his blog , his YouTube channel is really worth following. Offering a platform for entry-level professionals across NGOs and PPPs, his vlogs also feature charmingly dodgy web-cam use from his token resident global health elder, Terry Schmidt. Would recommend plugging in your sound and skipping the visuals or just heading straight to the podcast playlist.

 

Prospect Journal

Categorised by part of the world, this online journal showcases the writings of University of California (SD) students of international affairs. With a considered scientific angle, the editor’s blog explores contemporary issues making national news. Many of the blog titles err towards clickbait, but looking beyond the excessive use of the rhetorical question the content invariably represents a skilful distillation of complex issues such as climate change into academic yet accessible reads.

 

Polygeia

Admittedly, I spent a lot of my spare time at university as Press Officer and Blog Editor for this think tank, but the content is noteworthy for its breadth and tangible policy implications. Spanning topics and commissions as diverse as Action Against Hunger to leprosy missions with Lepra, the blogs track the progress of policy work for external organisations generally over 12-month periods, drawing on the most current comment and research in their respective focal sectors.

 

National Public Radio (NPR): Goats and Soda

Less traditional blog, more broadcaster with accompanying transcripts, NPR’s ‘Goats and Soda’ publishes stories from a changing world with a prioritisation of health and development concerns. As a starting point, I would recommend reading their blog that details how the name ‘Goats and Soda’ came about. There is a lightness of touch in all of their work as well as great visuals and some outstanding interview pieces. Not always topical, but a constant source of inspiration.

 

Global Health NOW

Perhaps slightly biased given that I was fortunate enough to be commended for my suggestion of an untold global health story in their recent competition, for which the I wrote an article on the overlooked killer, Kala Azar (available here), but with due credit: Global Health NOW is an initiative from the John Hopkins Bloomberg School of Public Health. One of the most prolific of all these recommendations, GHN staff scour the daily news, reports and published research for the most interesting reads, compiling these into their e-newsletter which is disseminated along with social media coverage. A favourite for spotting new writing and noteworthy topics.

 

LinkedIn groups: Global Public Health

LinkedIn’s largest public health group, GPH is for those working professionally or studying areas of international public health importance, with a focus on health issues impacting low- and middle-income countries. One of the benefits of joining such a group is that discussion is often more lively and instantaneous than on blogging sites. Forums associated with these groups facilitate a blog conversation that extends beyond the confines of the written piece.

 

The Lancet Global Health Blog

The Lancet Global Health journal is a comprehensive periodic read, but the tangential blog platform is worth dipping into. Guest and regular writers cover a host of topics from access to medicines, blood donations, urbanisation and collectively take a macro look at challenges within the field and consider possible answers to these.

 

GH on the Guardian 

Sadly this series finished last year, but thankfully the blogs have yet to be archived. Sarah Boseley is a magical writer, making the unfathomable feintly outlined and the tragic compelling rather than hopeless. Described as ‘The Guardian’s health editor on the politics, policies, philanthropy and progress being made in the fields of global health and aid‘, you can look back through titles that consider the policies and politics of Pharma, the hidden costs of healthcare in conflict zones and commentaries that consistently explore issues from every angle.

 

Comment below with your own must-reads.

 

Image Credit: A. Bow-Bertrand