Feature 
 

The Housing Perspective

Housing should provide a safe and healthy environment for inhabitants. Many technical, social, planning and policy factors relating to housing may affect the physical and mental health and social wellbeing of people.

By Azhar Ali | May 2020


A common view till the early 2000s while entering Ankara, the capital of Turkey, from the airport was existence of shanty towns on both sides of the road, the route taken by all dignitaries coming to the city. It was a well-documented legend that the Turkish government used to bring in all dignitaries from the airport to the state guest house at night. It is said that once a French leader saw lights in the shanty houses and asked his counterpart about them. The answer was, we made these huts for accommodating animals. He was impressed with the Turkish sense of humanity.

Alas, this was not the real case. People from central Turkey started moving to the capital right after its re-birth in 1923, though Ankara is one of the oldest settlements in Turkey. With time, by the 1980s and 90s, shanty towns sprung up on all peripheries of the city. There have been doctoral studies on how life for the poor villagers improved after they moved to the city from rural areas. Unfortunately, on close inspection, the truth bites. These towns did not have running water, almost no electricity, no gas and there were no houses with heating systems against the famous “Ankara Ayaz’, meaning Ankara’s cold wind. People lived in apathy till the early 2000s when the government decided to convert all shanty towns in the country to properly designed and maintained mass housing projects. Ankara got its share and now, while moving on the same road, one can see beautiful mass housing schemes populated by all those who lived in shanty towns earlier.

Conditions of such shanty towns and the need for proper housing has been well-documented during the last two centuries in wake of the industrial revolution that brought more people to the cities. England started taking notable policy decisions in this regard from 1844 onwards while the USA made a headstart in 1890. Public health and housing moved hand in hand and improved life for millions. Since then, provision of ‘healthy housing’ has been made certain and accepted as a basic human right by the UN.

Housing has two types of effects on people from the public health perspective. One is direct and is related to the quality of housing. The other is associated with ecological and environmental conditions. The effects have also been classified in physical, social and cultural terms. Damp houses have been blamed rightly for a number of diseases, including tuberculosis and common headaches and body pains. Similarly, inadequate heating, regardless of its duration, is important. There are increased fatalities in winter as compared to summer. The indoor temperature is more important than the outside temperature. The house should have a proper drinking water supply, sewerage and solid waste disposal systems. The house should have enough lighting and ventilation. All these factors affect people’s health directly.

Neighbourhood, affordability and access to basic facilities are major factors that affect health indirectly. Affordability is of key importance as, when a house is purchased by a family with heavy mortgage, their mental health does not improve by owning the house. The neighbourhood is also important as it has been observed that in crime-hit areas, newcomers may not only feel uncomfortable but even tempted to join the gangs. Housing schemes should also provide access to basic facilities, of which primary healthcare units are most important.


Coming back to the Turkish model, the government in December 2019 announced building of a hundred thousand houses in 2020 for middle to low-income people. It received a million applications. The model has been very successful to date as it has one simple axis to build on. The government, through the Mass Housing Authority (TOKI), has provided a sovereign guarantee to the builders about their payments for properly designed and approved mass housing schemes. It also encourages builders to build at least 25% more houses in a scheme. They must be of good quality so that they can be sold in the open market. Each scheme must have quality houses, open spaces, proper water and sewerage systems, road network, schools, primary and secondary health facilities, places for worship, shopping centres and connectivity to the nearest city centre. The scheme of requirements aligns well with all the parameters defined for the public health sector.

In the case of Pakistan too, it is time to concentrate on quality rather than quantity. Millions of working hours are lost every year due to ill or fatigued personnel. Living in badly constructed houses has put people’s mental health at stake. Pakistan needs to include central heating as well as cooling systems in new houses. There are many examples in the world where thousands of houses have central heating systems. Being a country with most of the population living in the warm region, but with climate changes, Pakistan cannot avoid central heating for long.

A detailed analysis during the winters would certainly indicate that the mental and physical health of people becomes very poor during the winter months. All this adds to what is known as the Allostatic load, i.e. the wear and tear accumulated by an organ. Climate change is expected to worsen winters and summers, so the quality of houses would be a key factor for a healthy population in the near future. Similarly, for mass housing schemes, the government should plan and adequately implement all the parameters required for improved public health. There is an increased need for authorities to follow in drawing up coherent policies for housing and public health. This is becoming all the more imperative for a country like Pakistan which is an outstanding victim of climate change.

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