West Philadelphia
Boston's Dudley Street neighborhood, poor, black and Hispanic, took its future
in its own hands a decade ago, formed a local board, got a Ford Foundation loan
for engineers and architects, convinced the city to give it imminent domain
powers, and set out to rebuild itself: rehabilitated housing, a business
district, parks and playgrounds.
Healthy Boston, the oldest of the big-city projects in the U.S., has been in
operation for less than three years. Yet in that time it has brought together a
coalition of 21 neighborhood groups and begun to address such issues as
substance abuse, street gangs, violence, public safety, economic development,
job training, and support for parents and families. The effort has already
blossomed into street festivals, health fairs, job fairs, candidates forums,
art contests for young people, economic town meetings, voter registration
drives, and public forums about community issues.
The basic goal of the master plan of this thousand-year-old city reads:
"Health, well-being, and better conditions of life for the citizens must go
hand in hand with development of industry and trade, considering nature and the
environment."
Horsens' Healthy City projects, run out of a storefront on the town's
main square, include:
- "Big Bag Day:" 400 schoolchildren stuffing plastic bags into 23,000 household
mailboxes, each with a letter from a child asking them to use the bag to
dispose of household toxics, plus a route map of the city's new toxic disposal
service
- the "emergency team for people in sorrow and crisis," a free, drop-in open
therapy group
- "Healthy lunch at school:" each class takes a turn planning, buying, making
and selling a healthy lunch to the rest of the school
- "Torsted West:" planning and building an entire new neighborhood according to
ecological principles
- "Priorsløkke:" turning around a neighborhood with a lot of problems
through local democracy and common projects
- "A clean inlet:" bringing together various interests around Horsen's little
piece of the Baltic to try to protect and improve its ecology
- The Healthy City Shop: a storefront across from City Hall that puts Healthy
City on display, with room upstairs for the Foundation's offices.
- The Health and Environment Group: a consulting company founded by the Healthy
City Foundation to bring in funds by selling its expertise to other cities
across Europe.
Horsens has few minorities. One is a small, tightly-knit group of
immigrant Turks, few of whom speak any Danish. To protect their culture and
religion, the men only allowed the women to go where they went, which for the
most part was not anywhere they would contact Danes. A Healthy Cities group
concerned with children's health in that part of town realized that this was
one group of children they could not reach. Rather than invent some
bureaucratic answer to this isolation, they searched for something they might
have in common with the Turkish women. They threw a few parties, got up a few
Bingo games, and got to know about 15 families. Then they hit on sewing. That
was innocuous enough -- the men would allow their women to go alone to a sewing
class and sewing circle with Danish women. When the Turkish women showed up,
they brought 50 kids with them. So daycare was arranged for the next session.
After the sewing became routine, the Healthy Cities group introduced another
idea: the women could learn Danish. By this stage, the men would even let the
women do that. Bit by bit, the walls crumbled, and the Danes gained the
confidence of the Turks.
In West Baltimore's Sandtown-Winchester Neighborhood, retired developer and
city planner James Rouse has teamed with local residents to upgrade housing and
healthcare, improve local schools, begin new community policing effrots, and
bring in enterprises that could provide jobs. Seven paid community advocates
roam the neighborhood, seeking oout pregnant women and mothers of young
children for pre-natal care, early child health care, and help in parenting.
After a year, the effort is already showing up in rows of brightly-painted
rehabbed houses, computers in the schools, drug rehab programs and food banks.
Sandtown used to have the one the highest infant mortality rates in the nation;
since the program started, only one child has died at birth. Rouse believes
that "Sandtown will demonstrate absolutely that it is less costly to change
things than to let them stay the same."
In the midst of the drug wars of the `80s and `90s, Rodrigo Guerrero won
election as mayor of this beleaguered city. As a doctor and a graduate of
Harvard's School Of Public Health, Guerrero focused on making a healthy Cali.
He started with the basics: providing building materials for poor people in the
favelas. Now providing building materials for the favelas is the largest
business in town. Food was next: he founded a huge CostCo-style market to sell
food inexpensively. In the midst of great poverty, a confused economy, a drug
war and a terrorist war, Cali has emerged as an example of using local
resources and smart, passionate leadership to change people's lives for the
better.
Since 1991, Atlanta has been re-growing itself in an impressive effort started
by former President Jimmy Carter. "Project Atlanta" teams up a major corporate
sponsor with local residents in each of 20 poverty "clusters" around the city,
using local money, federal funds and corporate donations and involvement to
fight teen pregnancy, homelessness and drug abuse, build economic activity, and
rehabilitate housing.
The big problem in Smith #1 is keeping the kids alive through the years of
malnutrition, diarrhea, respiratory infections and dengue fever. The 208
families of in this ramshackle favela have a lot in common with many of the
people of other marginal areas around Tegucigalpa, the capital. The average
family has six members, no family planning, and a marginal existence. Almost a
quarter of the children are malnourished, and more than a third of the homes
have no functioning latrine.
Yet the desperately poor people of Smith #1 have shown a remarkable energy in
working to pull themselves out of their desperate situation. Through community
effort, they have succeeded in:
- getting every family access to fresh, safe water
- vaccinating 85 percent of the children under five
- organizing a waste train that travels through the community collecting and
disposing of solid wastes
- building a wall to divert the runoff that used to flood much of the community
in wet weather, contaminating water and contributing to the spread of
disease.
- convincing the authorities to give them a school for the children, getting
the Honduras Fund for Social Investment (FHIS) to finance it, then building it
themselves
- securing FHIS funds to set out a system of garbage barrels
- improving the community's streets
- building a bridge over a small ravine that used to impede access
- starting a miniature bank to help the women of the community finance small
entrepreneurial projects
- attracting the efforts of Project Hope, which has helped train local health
volunteers who provide information and regualrly visit families in their homes,
teaching them health and nutrition, helping them spot children at risk, and
guiding them to what intervention is available.
Their hopes for the future include:
- installing a sewage system (they have gotten the design done, and are waiting
to hear whether FHIS will fund it)
- pushing the vaccination rate to 90 percent.
- seeing that 70 percent of the mothers in the community have basic knowledge
of health matters.
The birthplace of the Healthy Cities movement, Toronto as a city has set itself
an ambitious goal: to be the healthiest city in North America. The "Healthy
Toronto 2000" initiative, organized at the city government level, includes such
efforts as:
- a self-help project for homeless people, including a "Street
Enterprise Centre" and "StreetCity."
- healthy neighborhoods, involved in
everything from urban food production to the "Take Back Toronto" street safety
initiative
- a "Clean Air" project involving both public education and
action, such as parking conservation, a report on cars, and a by-law against
idling parked vehicles.
- a "State of the City" research effort and annual
report, including a "Citizens Guide" and study groups
- Healthy City Week
- the Toronto Young People's Advisory Board
Toronto is a living laboratory, a working example of what happens when you
mount a serious, conscious effort to nurture the health of a major city. The
example is both positive and negative, encompassing both the great number of
creative projects that the people of Toronto have mounted, and political
mistakes and infighting that have hampered efforts and drained energies.
This city of 300,000 rose out of the desert sands on the outskirts of Lima.
Under the leadership of Maria Elena Moyano, homeless squatters built a city,
planted hundreds of thousands of trees, organized businesses, taught widespread
literacy to adults, and fought for representation in the regional and national
government. Moyano was something of a young Gandhi, who had dropped out of
school herself at age 16 to teach literacy to adults. In 1992, guerrillas of
the Maoist Shining Path faction assassinated her. All of Belem Salvador came to
her funeral in a massive outpouring of grief.
Up the wandering Roanoke River from Albemarle Sound in the flatlands of
northeastern North Carolina, the hamlet of Tillery presents dismal statistics:
high infant mortality, 97 percent African Americans with a median income of
$8500, 40 percent of the families headed by single women, 39 percent of the
children living in poverty. Most people in Tillery make their living at
minimum-wage second- and third-shift factory work, there are no doctors or
public health facilities within 20 miles and no public transportation, doctors
in the area are white and refuse to physically touch black people, the only
local school has closed and the industries that the state has lured to the area
-- mass hog farming, poultry-processing, a paper mill, a hazardous waste
incinerator and a hazardous metals recycling plant -- pour nitrates, dioxins
and other toxic chemicals into the air, water and soil.
Yet in the past decade, the "Concerned Citizens of Tillery" have built
themselves a clinic and found doctors from East Carolina University to staff it
a few times a month, convinced a doctor to set up practice in the area,
organized transportation for those who don't have it, successfully lobbied the
state to end the foul environmental practices of the local factories, taught
each other classes in literacy, basic health care, healthy eating, and
exercise, and organized programs for the young people.
All their projects are staffed by volunteers, and worked cooperatively. But the
process of organizing around health and environmental concerns has pushed many
of the poor, rural black citizens of Tillery into doing things many of them had
never done before, such as write letters to the editor, carry petitions, attend
and speak at County Commission meetings, and even organize conferences -- one
92-year-old black woman addressed a hearing of the State Department of
Environmental Management. The effect of taking leadership has been
revolutionary. Suddenly Tillery finds itself helping other communities
throughout the area organize around health, the environment, and housing. It is
a prime example of how much a community with almost no resources can do for
itself.
England's third-largest city, Leeds has been reborn from the ashes and rust of
the country's industrial North through "anti-politics." Leaders in nearby
Liverpool, Bradfield, and Sheffield continue to see issues as opportunities for
left-right bashing, and continue to sustain unemployment of 20 percent or
higher among the shuttered factories and mills. In Leeds local politicians have
taken a different tack over the last decade: the Labor majority, the
Conservative opposition, and the Liberal Democrats work together on
transforming the city's economy with redevelopment and housing ideas. The
Conservatives then sell the ideas to business, and extract the necessary
permits and concessions to the Conservative government in London. And the
Laborites sell the ideas to the unions and the Labor voters. As a result, Leeds
has blossomed into what the papers call "pinstripe city," supporting an influx
of bankers, lawyers, and managers from the 27 banks, 230 accounting firms, and
120 insurance companies that have established offices. The downtown shopping
district have been reborn. Opera, dance, and theater companies have bloomed.
Wine bars and brasseries decorate the banks of the River Aire. Unemployment in
Leeds is now 8.5. percent, far below the 11 percent European Union average.
Says Leeds city councilor Andrew Carter: "What government is all about -- and
what both parties have ignored on a national level -- is to have an eye for
what the people actually want."
A mining and smelting community on James Bay in Quebec, far to the north of
Montreal, Rouyn-Noranda might seem like an odd place to declare a "healthy
community." Though the clouds of sulfur dioxide from the Noranda Mines smelter
that earned the town the reputation of "the most polluted city in Canada" have
been substantially reduced, still the problems of lead contamination, other
toxic elements, and acid rain, added to a climate that counts only 100 days per
year frost-free, would seem overwhelming. But in fact Rouyn-Noranda Ville En
Santé started in 1987 as one of the world's first "Healthy Cities"
projects. A robust local committee, operating at first without the blessing of
the municipal authorities, gradually gained the confidence of the town and
began an impressive series of projects. They started with projects with what
they call "sparkle," such as a winter festival, and a botanical garden at a
local lake. From these they moved to more substantial projects, such as
recycling, and the creation of a network of healthy towns and villages in
Quebec, and then to such heavy-duty projects as convincing Noranda Mines to do
their part cleaning up the lead contaminating the neighborhoods near the
smelter and reducing the pollution at the source. Their projects are all the
more impressive in that they had no one to copy, and no encouragement or
funding from outside.
Since last October, Dee Uhila, a 45-year-old Samoan woman, has opened her home
every school afternoon to about 20 kids who otherwise would be "latchkey" kids
-- or wandering the streets. Her program: hot food, hugs, and homework. No
theory, no bureaucracy, just major mothering distributed for free. Now the
project is spreading to other homes in the area, Stanford students are dropping
by to tutor, young gang members hang out and learn (respecting Uhila's dictum:
"If you're a gang member, it is not going to go in this house. This is not a
gang house). One foundation has given $20,000, and parents are dropping in to
lend a hand.
To fight malnutrition among Memphis' poor, the Memphis Regional Medical Center
conducts shopping classes in the projects, showing people how to make their
food money cover the month, and how to shop and cook healthy food that will
keep their families fed.
This Hispanic town that dates to 1694 has begun to revitalize itself using the
town's "untapped resource:" women and children. In one year, they have made
major changes for so small a place. They have developed a women's task force,
and organized a fitness center with a women's aerobic class and a karate class
for the kids. They have found the first woman principal for the local school,
and involved the kids in upgrading the curriculum to make the schools more
competitive. Kids tutor other kids -- including the Head Start kids, so that
they can read by the time they hit first grade. empowered youth. Teens learn
leadership skills, and teach them to younger children. Parents, teachers, and
students take part in a child abuse prevention program called "Cuidandonos los
ninos." Parents can take a free, culturally sensitive, ten-week parenting
course based on Systematic Training for Effective Parenting (STEP). Young
people with problems can call the 24-hour "I care" hotline just to talk. "We
need to do this," says Luisa Holman of Mora. "We will lose our children if we
don't help them."
At the City Jail and in the streets of the City, Cathy Sneed helps prisoners
and parolees regain their self-respect and their connection to family and
community through a powerful and direct method -- gardening.
In the "Kids Place" program, Seattle has set out to make its central
city a place that is easier for kids, following the observation of Robert
Aldrich, a pediatrician at the University of Washington Medical School: "If you
have a city that's not a place where children like to live, it eventually
becomes a place where adults will not like to live." It started with a simple
word-association survey of what 60,000 of the city's school children thought of
different places in Seattle: what places came to mind when you said, for
instance, "helpful," "wet," "dangerous," or "fun," what were their favorite
places, where did they most like to go with their parents, and what would they
do if they were mayor of Seattle. It resulted in a whole series of projects and
changes aimed at meeting the needs of kids -- including some that were cheap
and easy. The aquarium modified its benches, so that kids could stand on them
to see over the wall and watch the sea otters. This made the aquarium a much
more popular place. The bus system redesigned some routes so that kids could
get to Science Park more easily -- and this increased the use of the bus
system. The project also took on larger concerns, such as childcare and
homeless youth.
Elsewhere, organizers working from John McKnight's principles comb the streets
of Seattle's poorest areas, searching out and bringing together the gifts and
capacities of the citizens. The homeless, drug addicts, and sex workers of the
waterfront gather in the Street Outreach Services Storefront one block from the
city's famous Pike Street Market to help each other with job skills, find
health care, meet in men's groups and women's groups, and organize housing.
Once a center of the meat-packing industry, the economy of this town of 21,000
on the Mississippi collapsed when Swift closed its plant in 1969, followed by
Armour in 1979. Young white people with families streamed elsewhere to find
jobs, leaving behind their older relatives to deal with the poorer, ethnically
diverse families that moved into the old houses. Stillborn attempts at
redevelopment devastated the downtown, destroying more than 100 old
buildings.
But since its centennial in 1987, South St. Paul has regrouped under the
Healthier Community agenda, using Town Meetings, block parties, Community
Partnerships, and the River Environmental Action Project to pull the community
together around a series of goals that range from re-developing the riverfront
to dealing with the lead-based paint in all those old houses and fostering a
sense of neighborhood amid the new ethnic mix.
In this mostly-African-American community, Pentecostal and Baptist churches,
political block captains, the local Chamber of Commerce and the local hospital
have organized Partnership 2000, a broad-guage effort to improve the quality of
life in the area. One program among many teaches kids conflict resolution and
mediation skills.