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This article first appeared in Architectural Review Asia Pacific issue 127: The Residential Issue.
All illustrations courtesy of Healthabitat.
Flicking through the pages of this magazine and many others, one could imagine that Australia is awash with beautifully designed, finely crafted houses in fantastic locations. So it’s something of a shock to realise that a substantial number of Australians live in houses with no hot water, where the plumber may never have bothered to connect the waste pipes, or where fittings and fixtures rust away in a few months.
Healthabitat operates at this gritty end of residential work, aiming to improve the health of disadvantaged people through better housing and living conditions. This includes the very basic but fundamental activity of ensuring that sinks and toilets are in fact connected and that electrical fittings are installed in a way that prevents the electrocution of inhabitants. It sounds simple but it isn’t, and it’s incumbent on all of us to understand why this work is necessary, what it says about Australia and how we might help.
The Healthabitat team has been working to address this inequity for almost 30 years, building capacity and knowledge in disadvantaged, predominantly Indigenous communities. The principal vehicle for change is the Housing for Health program, based on ‘Nine Healthy Living Practices’ and Fred Hollows’ code of ‘no survey without service’.
The work informing Housing for Health began in 1985, in the Anangu Pitjantjatjara Lands in northwest South Australia. It was initiated by Yami Lester, then-director of the Nganampa Health Council, who realised that health outcomes have a direct relationship to the conditions in which people live, and that health and housing needed to be approached together. Lester brought together architect Paul Pholeros, thoracic surgeon Paul Torzillo and public and environmental health officer Stephan Rainow to address this.
Over time, Pholeros, Torzillo and Rainow, now the directors of Healthabitat, have demonstrated that substantial improvements in health can be achieved through relatively minor investments in the fixing of existing housing stock.
Housing for Health is not a quick fix of the ‘fly-in fly-out’ variety, nor is it a survey that sits on a shelf unactioned. Projects are set up in collaboration with local Indigenous communities (over 75 per cent of project staff are local Indigenous people), and standardised, repeatable tests are used assess the safety and health function of houses as part of a combined survey/fix process. ‘Fix’ work is begun immediately as part of the survey, with priority given to life-threatening dangers: electrocution, gas explosion and asphyxiation, injury from fire and structural collapse.
Over the following six to 12 months, essential trades work with members of the original survey/fix team to improve the function of the house and surrounding living environment. A second survey/fix then checks that all work has been completed satisfactorily and a detailed report is provided to the community. To date 184 Housing for Health projects have improved 7450 houses across Australia and the program is being piloted internationally.
Making things safer and more liveable for 7450 households and training 1500 people to undertake basic maintenance within their own communities is a significant achievement. But the rigorous collection of data that goes along with the Housing for Health survey/fix program is equally as important. Statistical analysis of this data disproves a number of entrenched myths about housing in Indigenous communities and identifies important issues for future work and policy. As such, the statistics are fundamental to understanding the situation these communities find themselves in.
Once again, we all need to grasp the consequences of these findings, and what it means for the public and political discourse around Indigenous housing. For example, the statistics prove over and over that the poor state of much Indigenous housing is not a result of neglect or abuse by the inhabitants. As Pholeros points out, if any of us were put into houses of this quality in this environment, we would all experience similar health and social problems. This has significant implications for government policy and for the way politicians, policymakers, journalists and the wider public discuss Indigenous housing and health.
The data gathered also provides a significant evidence base for future housing. This knowledge, collected from literally thousands of houses around Australia, informs the content and direction of the National Indigenous Housing Guide, which has now been published in three editions and has been endorsed by all Australian governments.
Each edition represents a significant development over the last and provides a very strong evidence base. However, after decades of effective programs, funding has been pulled and the fourth edition, which was due in 2009, has still not been published.
Even more alarming is Healthabitat’s contention that the largest ever investment in Indigenous housing – the $5.5 billion National Partnership Agreement on Remote Indigenous Housing currently underway – is proceeding in a manner that disregards this evidence base and the lessons learned.
On its website, Healthabitat writes: ‘The current Australian government policy obsession with number of houses built (or upgraded) and the state government implementation of the national program that seems disinterested in housing history, house function or health will lead finally to a large number of non-functioning houses. This approach is strikingly similar to the 1980s where the final act of the tragedy was the blaming of Indigenous tenants for the housing failures.’
In fact, the failure to publish the updated Guide may not be unrelated: ‘It can be used to measure the housing being designed and upgraded under the National Partnership Agreement on Remote Indigenous Housing. The Healthabitat testing of new and upgraded houses in four states of Australia over the last year, after big money has been spent on the houses, shows that the houses repeatedly fail many of the Guide’s assessment criteria.’
Healthabitat is not deterred, though, and work continues in other ways: lobbying government; identifying taps and hardware that won’t fail in harsh environments; investigating the possibility of an updated, online version of the Guide. They are also taking the approach developed in Australia to other locations and communities. This includes a program in Nepal, a pilot program in New York and offers to commence work in East Timor and Bangladesh. In August this year, the Healthabitat team was also in Venice as part of the Australian exhibition for the Venice Architecture Biennale, conducting survey/fixes of housing there and, in the process, telling the world’s architectural community about the issues faced.
The Healthabitat website outlines a range of ways that we all might help. We’re not all in a position to undertake on-the-ground work ourselves, but we can all be involved in the public debate. We all have a responsibility to comprehend the statistics and what they mean, and to demand more of our governments.
So, even as we admire the architectural delights of the finely crafted house, we must find space to think about and support other kinds of architectural activity, including the work of organisations such as Healthabitat.
We can all contribute to changing the public and political discourse around Indigenous housing.
Drainage is often the forgotten workhorse of the building and design function. Yet drainage maintains a simple albeit vital purpose.