How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney
-
0:12 - 0:16The idea of eliminating poverty
is a great goal. -
0:17 - 0:20I don't think anyone
in this room would disagree. -
0:21 - 0:26What worries me, just a little,
is when politicians with money -
0:27 - 0:30and charismatic rock stars -
-
0:30 - 0:31(Laughter)
-
0:31 - 0:33use the words,
-
0:33 - 0:36" ... it all just sounds so, so simple."
-
0:37 - 0:40Now, I've got no bucket of money today
-
0:40 - 0:43and I've got no policy to release,
-
0:43 - 0:45and I certainly haven't got a guitar.
-
0:45 - 0:47I'll leave that to others.
-
0:48 - 0:49But I do have an idea,
-
0:49 - 0:52and that idea is called
Housing for Health. -
0:53 - 0:56Housing for Health works with poor people.
-
0:57 - 1:00It works in the places where they live,
-
1:00 - 1:03and the work is done
to improve their health. -
1:05 - 1:08The work is much more about work,
than words. -
1:10 - 1:12Over the last 28 years,
-
1:12 - 1:16this tough, grinding, dirty work
-
1:16 - 1:20has been done - around Australia,
and more recently overseas - -
1:21 - 1:24it's been done by literally
thousands of people, -
1:25 - 1:27and their work has proven
-
1:27 - 1:32that focused design can improve
even the poorest living environments. -
1:32 - 1:34It can improve health
-
1:35 - 1:39and it can play a part in reducing,
if not eliminating, poverty. -
1:39 - 1:41I'm going to start
where the story began - -
1:41 - 1:441985, in Central Australia.
-
1:45 - 1:48A man called Yami Lester,
an Aboriginal man, -
1:48 - 1:49was running a health service.
-
1:51 - 1:52He saw,
-
1:53 - 1:56walking in the doors
of the clinics he controlled, every day -
1:56 - 1:59eighty percent of what walked
in the door, in terms of illness, -
1:59 - 2:01was infectious disease -
-
2:01 - 2:04third world, developing world
infectious disease, -
2:04 - 2:07caused by a poor living environment.
-
2:07 - 2:10Yami assembled a team in Alice Springs.
-
2:11 - 2:13He got a medical doctor.
-
2:13 - 2:16He got an environmental health guy.
-
2:16 - 2:20And he hand-selected a team
of local Aboriginal people -
2:20 - 2:22to work on this project.
-
2:22 - 2:24He also put into the room
-
2:24 - 2:27a very green,
inexperienced architect. -
2:28 - 2:33More familiar with trying to make
some wealth in Sydney, -
2:33 - 2:36than improve health in Central Australia,
-
2:36 - 2:39and I won't name the person,
because it would be too embarrassing. -
2:40 - 2:43I won't get a vote
on who was the weakest link in the team. -
2:44 - 2:45Yami told us at that first meeting,
-
2:45 - 2:48"There's no money," -
always a good start - -
2:48 - 2:51" ... no money, you have six months,
-
2:51 - 2:54and I want you to start on a project -"
which, in his language, -
2:54 - 2:57he called "Uwankara Palyanku Kanyintjaku,"
-
2:57 - 3:01which, translated,
is "a strategy for well being" -
3:01 - 3:05or more simply translated,
"a plan to stop people getting sick" - -
3:05 - 3:07a profound brief.
-
3:09 - 3:11That was our task.
-
3:12 - 3:16First step, the medical doctor went away
for about six months. -
3:17 - 3:21And he worked on what were to become
these nine health goals - -
3:21 - 3:23what were we aiming at?
-
3:25 - 3:27After six months of work,
he came to my office -
3:27 - 3:31and presented me with
those nine words on a piece of paper. -
3:31 - 3:36[The 9 Healthy Living Practices: Washing,
clothes, wastewater, nutrition, crowding, -
3:36 - 3:37animals, dust, temperature, injury]
-
3:37 - 3:41I was very unimpressed.
Big ideas need big words, -
3:41 - 3:42and preferably a lot of them.
-
3:42 - 3:44This didn't fit the bill.
-
3:44 - 3:47What I didn't see and what you can't see
-
3:48 - 3:52was that he'd assembled thousands of pages
-
3:52 - 3:56of local, national
and international health research -
3:57 - 4:01that filled out the picture
as to why these were the health targets. -
4:01 - 4:06The pictures that came a bit later
had a very simple reason. -
4:06 - 4:09The Aboriginal people who were our bosses
and the senior people -
4:10 - 4:12were most commonly illiterate,
-
4:12 - 4:15so the story had to be told in pictures
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4:15 - 4:16of what these goals were.
-
4:16 - 4:19We worked with the community,
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4:19 - 4:21not telling them what was going to happen
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4:21 - 4:23in a language they didn't understand.
-
4:23 - 4:26So we had the goals
and each one of these goals - -
4:26 - 4:28and I won't go through them all -
-
4:28 - 4:32puts at the center the person
and their health issue, -
4:32 - 4:34and it then connects them
-
4:34 - 4:39to the bits of the physical
environment that are actually needed -
4:39 - 4:40to keep their health good.
-
4:40 - 4:43And the highest priority,
you see on the screen, -
4:43 - 4:47is washing people once a day,
particularly children. -
4:48 - 4:49And I hope most of you are thinking,
-
4:49 - 4:51"What? That sounds simple."
-
4:51 - 4:54Now, I'm going to ask you all
a very personal question. -
4:54 - 4:58I want a show of hands,
of who in this great house -
4:58 - 5:00this morning before you came,
-
5:00 - 5:03who could have had a wash using a shower?
-
5:05 - 5:08I'm not going to ask if you had a shower,
because I'm too polite. -
5:08 - 5:09That's it.
-
5:09 - 5:10(Laughter)
-
5:12 - 5:14We'll call this
the dirty side of the room. -
5:15 - 5:17All right, I think it's fair to say
-
5:17 - 5:20most people here could have had
a shower this morning. -
5:21 - 5:23I'm going to ask you to do some more work.
-
5:23 - 5:25I want you all to select one of the houses
-
5:25 - 5:27of the 25 houses you see on the screen.
-
5:27 - 5:31I want you to select one of them
and note the position of that house -
5:31 - 5:32and keep that in your head.
-
5:32 - 5:34Have you all got a house?
-
5:34 - 5:36I'm going to ask you to live there
for a few months, -
5:36 - 5:38so make sure you've got it right.
-
5:38 - 5:41It's in the northwest of
Western Australia, very pleasant place. -
5:41 - 5:44Let's see if your shower
in that house is working. -
5:44 - 5:46I hear some "Aw!" and I hear some "Ah!"
-
5:46 - 5:49If you get a green tick,
your shower's working. -
5:49 - 5:50You and your kids are fine.
-
5:50 - 5:52If you get a red cross,
-
5:52 - 5:54well, I've looked carefully
around the room -
5:54 - 5:57and it's not going to make
much difference to this crew. -
5:57 - 5:59Why? Because you're all too old.
-
5:59 - 6:02I know that's going to come as a shock
to some of you, but you are. -
6:02 - 6:04And before you get offended and leave,
-
6:04 - 6:06I've got to say that being too old,
-
6:06 - 6:10in this case, means that pretty much
everyone in the room, I think, -
6:10 - 6:11is over five years of age.
-
6:11 - 6:14We're really concerned
with kids naught to five. -
6:14 - 6:15And why?
-
6:15 - 6:19Washing is the antidote
to the sort of bugs, -
6:20 - 6:23the common infectious diseases
of the eyes, the ears, -
6:23 - 6:25the chest and the skin
-
6:26 - 6:29that, if they occur in the first
five years of life, -
6:29 - 6:32permanently damage those organs.
-
6:33 - 6:35They leave a lifelong remnant.
-
6:37 - 6:39That means that by the age of five,
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6:39 - 6:42you can't see as well
for the rest of your life. -
6:42 - 6:44You can't hear as well
for the rest of your life. -
6:44 - 6:45You can't breathe as well.
-
6:45 - 6:49You've lost a third of your lung capacity
by the age of five. -
6:49 - 6:50And even skin infection,
-
6:50 - 6:54which we originally thought
wasn't that big a problem, -
6:54 - 6:56mild skin infections
naught to five give you -
6:56 - 6:59a greatly increased
chance of renal failure, -
6:59 - 7:01needing dialysis at age 40.
-
7:01 - 7:04This is a big deal, so the ticks
and crosses on the screen -
7:04 - 7:06are actually critical for young kids.
-
7:06 - 7:10Those ticks and crosses
represent the 7,800 houses -
7:10 - 7:12we've looked at nationally
around Australia, -
7:12 - 7:13the same proportion.
-
7:13 - 7:15What you see on the screen -
-
7:15 - 7:1735 percent of those not-so-famous houses
-
7:17 - 7:20lived in by 50,000 indigenous people -
-
7:20 - 7:2335 percent had a working shower.
-
7:23 - 7:25If you're shocked by that, then
-
7:25 - 7:31ten percent of those same 7,800 houses
had safe electrical systems. -
7:32 - 7:37And 58 percent of those houses
had a working toilet. -
7:37 - 7:40These are by a simple, standard test.
-
7:40 - 7:42In the case of the shower:
-
7:42 - 7:45does it have hot and cold water,
two taps that work, -
7:45 - 7:49a shower rose to get water
onto your head or onto your body, -
7:49 - 7:51and a drain that takes the water away?
-
7:51 - 7:54Not well-designed,
not beautiful, not elegant - -
7:54 - 7:55just that they function.
-
7:55 - 7:58And the same tests
for the electrical system -
7:58 - 7:59and the toilets.
-
7:59 - 8:02Housing for Health projects
aren't about measuring failure - -
8:02 - 8:04they're actually about improving houses.
-
8:04 - 8:08We start on day one of every project.
-
8:08 - 8:11We've learned - we don't make promises,
we don't do reports. -
8:11 - 8:12We start work on the first day.
-
8:12 - 8:17We arrive in the morning with tools,
tons of equipment, trades, -
8:17 - 8:21and we train up a local team
on the first day to start work. -
8:21 - 8:22By the evening of the first day,
-
8:23 - 8:27a few houses in that community are better
than when we started in the morning. -
8:27 - 8:29That work continues for six to 12 months,
-
8:29 - 8:31until all the houses are improved
-
8:31 - 8:35and we've spent our budget
of 7,500 dollars total per house. -
8:35 - 8:36That's our average budget.
-
8:37 - 8:41At the end of six months to a year,
we test every house again. -
8:41 - 8:43It's very easy to spend money.
-
8:43 - 8:45It's very difficult to improve
-
8:45 - 8:48the function of all those
parts of the house. -
8:48 - 8:51And for a whole house,
the nine healthy living practices, -
8:51 - 8:54we test, check and fix
250 items in every house. -
8:55 - 8:59And these are the results we can get
with our 7,500 dollars. -
8:59 - 9:01We can get showers
up to 86 percent working, -
9:02 - 9:05we can get electrical systems
up to 77 percent working -
9:05 - 9:08and we can get 90 percent
of toilets working -
9:08 - 9:10in those 7,500 houses.
-
9:10 - 9:11(Applause)
-
9:11 - 9:13Thank you.
-
9:13 - 9:18(Applause)
-
9:18 - 9:22I think there's an obvious question,
that I hope you're thinking about. -
9:23 - 9:25Why do we have to do this work?
-
9:25 - 9:28Why are the houses
in such poor condition? -
9:28 - 9:31And it's a valid and important question.
-
9:33 - 9:37We note why we fix things,
and of those houses -
9:37 - 9:3970 percent of the work we do
-
9:40 - 9:42is due to lack of routine maintenance,
-
9:42 - 9:45a sort of things that happen
in all our houses, things wear out. -
9:45 - 9:48Should have been done by state
or local government, -
9:48 - 9:50simply not done,
the house doesn't work. -
9:50 - 9:5321 percent of the things we fix
are due to faulty construction -
9:53 - 9:56literally things that were built
upside down and back to front, -
9:56 - 9:58they don't work, we have to fix them.
-
9:58 - 10:01And if you've lived in Australia
in the last 30 years, -
10:01 - 10:04the final cause,
you will have heard always, -
10:04 - 10:07that indigenous people trash houses,
-
10:07 - 10:10that's one of the almost
rock solid pieces of evidence -
10:10 - 10:12which I've never seen evidence for,
-
10:12 - 10:15that's always [unclear] that's the problem
with indigenous housing. -
10:15 - 10:19Well, 9 percent of what we spend
is damage, misuse or abuse of any sort. -
10:19 - 10:22We argue strongly that the people
living in the house -
10:22 - 10:24are simply not the problem.
-
10:25 - 10:27And we go a lot further than that,
-
10:27 - 10:30the people living in the house
are actually a major part of the solution. -
10:32 - 10:35Seventy-five percent
of our national team in Australia - -
10:35 - 10:37over 75 at the minute -
-
10:37 - 10:42are actually local, indigenous people
from the communities we work in. -
10:42 - 10:43They do all aspects of the work.
-
10:43 - 10:49(Applause)
-
10:51 - 10:54In 2010, for example, there were 831,
-
10:55 - 10:57people who look sort of like those people,
-
10:59 - 11:01all over Australia,
and the Torres Strait Islands, -
11:01 - 11:06all states, working to improve the houses
where they and their families live, -
11:06 - 11:08and that's an important thing.
-
11:08 - 11:11Our work's always had a focus on health.
-
11:11 - 11:12That's the key.
-
11:12 - 11:15And I've made a very bad pun,
-
11:15 - 11:18because the eye in this picture -
and it is a bad pun - -
11:18 - 11:21will not be able to focus,
because it has a bug called trachoma. -
11:21 - 11:25The developing world bug,
is annoying and then causes blindness. -
11:25 - 11:27It's a developing-world illness,
-
11:27 - 11:29and yet, the picture you see behind
-
11:29 - 11:33is in an Aboriginal community
in the late 1990s, -
11:33 - 11:37where 95 percent of school-aged
kids had active trachoma -
11:37 - 11:39in their eyes, doing damage.
-
11:40 - 11:41OK, what do we do?
-
11:41 - 11:44Well, first thing we do,
we get showers working. -
11:44 - 11:46Why? Because that flushes the bug out.
-
11:46 - 11:49We put washing facilities
in the school as well, -
11:49 - 11:51so kids can wash their faces
many times during the day. -
11:51 - 11:53We wash the bug out.
-
11:53 - 11:57Second, the eye doctors tell us
that dust scours the eye -
11:57 - 11:58and lets the bug in quick.
-
11:58 - 11:59So what do we do?
-
11:59 - 12:02We call up the doctor of dust,
and there is such a person. -
12:02 - 12:04He was loaned to us by a mining company.
-
12:04 - 12:07He controls dust on mining company sites.
-
12:07 - 12:09And he came out and, within a day,
-
12:09 - 12:11it worked out that most dust
in this community -
12:11 - 12:14was within a meter of the ground,
the wind-driven dust - -
12:14 - 12:17so he suggested making mounds
to catch the dust -
12:17 - 12:21before it went into the house area
and affected the eyes of kids. -
12:21 - 12:24So we used dirt to stop dust.
-
12:24 - 12:26Yeah, who would have though
of that one? -
12:26 - 12:29We did it. He provided us dust monitors.
-
12:29 - 12:32And the dust monitors checked
had we actually made success. -
12:32 - 12:34And we had.
-
12:34 - 12:36We tested and we reduced the dust.
-
12:36 - 12:38Then we wanted to get rid
of the bug generally. -
12:38 - 12:39So how do we do that?
-
12:39 - 12:44Well, we call up the doctor of flies -
and, yes, there is a doctor of flies. -
12:44 - 12:45As our Aboriginal mate said,
-
12:46 - 12:48"You white fellows ought to get out more."
-
12:48 - 12:50(Laughter)
-
12:50 - 12:53And the doctor of flies
very quickly determined -
12:53 - 12:56that there was one fly
that carried the bug. -
12:56 - 12:59He could give school kids
in this community -
12:59 - 13:01the beautiful fly trap you see
above in the slide. -
13:01 - 13:04They could trap the flies,
send them to him in Perth. -
13:04 - 13:06When the bug was in the gut,
-
13:06 - 13:09he'd send back by return post
some dung beetles. -
13:09 - 13:11The dung beetles ate the camel dung,
-
13:11 - 13:12the flies died through lack of food,
-
13:13 - 13:14and trachoma dropped.
-
13:14 - 13:19And over the year, trachoma dropped
radically in this place, and stayed low. -
13:19 - 13:22We changed the environment,
not just treated the eyes. -
13:22 - 13:24And finally, you get a good eye.
-
13:24 - 13:26And we've talked about eyes,
-
13:26 - 13:28a number of the talks today
have involved eyes -
13:28 - 13:30in one way or another.
-
13:30 - 13:32All these small health gains
-
13:32 - 13:36and small pieces of the puzzle
make a big difference. -
13:36 - 13:38In New South Wales,
the state we're in now - -
13:38 - 13:40The New South Wales Department of Health,
-
13:40 - 13:41that radical organization,
-
13:41 - 13:44did an independent trial over three years
-
13:44 - 13:47to look at 10 years of the work
we've been doing -
13:47 - 13:49in these sorts of projects
in New South Wales. -
13:49 - 13:55And they found a 40 percent reduction
in hospital admissions -
13:55 - 13:59for the illnesses that you could attribute
to the poor environment - -
13:59 - 14:01a 40 percent reduction.
-
14:01 - 14:07(Applause)
-
14:12 - 14:14Just to show that the principles
we've used in Australia -
14:14 - 14:16can be used in other places,
-
14:16 - 14:18I'm just going to go
to one other place, and that's Nepal. -
14:19 - 14:20And what a beautiful place to go.
-
14:20 - 14:24We were asked by a small
village of 600 people -
14:24 - 14:27to go in and make toilets
where none existed. -
14:27 - 14:28Health was poor.
-
14:29 - 14:31We went in with no grand plan,
-
14:31 - 14:33no grand promises of a great program,
-
14:33 - 14:36just the offer to build
two toilets for two families. -
14:36 - 14:39It was during the design
of the first toilet -
14:39 - 14:40that I went for lunch,
-
14:40 - 14:43invited by the family
into their main room of the house. -
14:44 - 14:46It was choking with smoke.
-
14:46 - 14:49People were cooking
on their only fuel source, green timber. -
14:49 - 14:51The smoke coming off
that timber is choking, -
14:51 - 14:54and in an enclosed house,
you simply can't breathe. -
14:54 - 14:58Later we found the leading cause
of illness and death -
14:58 - 15:01in this particular region
is through respiratory failure. -
15:01 - 15:04So all of a sudden, we had two problems.
-
15:04 - 15:06We were there originally
to look at toilets -
15:06 - 15:08and get human waste
off the ground, that's fine. -
15:08 - 15:10But all of a sudden now
there was a second problem: -
15:10 - 15:12How do we actually get the smoke down?
-
15:12 - 15:16So two problems, and design should
be about more than one thing. -
15:16 - 15:20Solution: Take human waste,
take animal waste, -
15:20 - 15:23put it into a chamber,
out of that, extract biogas, -
15:23 - 15:25methane gas.
-
15:25 - 15:28The gas gives three to four
hours cooking a day - -
15:28 - 15:32clean, smokeless and free for the family.
-
15:32 - 15:37(Applause)
-
15:40 - 15:43I put it to you:
is this eliminating poverty? -
15:43 - 15:47And the answer from the Nepali team
who's working at the minute would say, -
15:47 - 15:48don't be ridiculous -
-
15:48 - 15:50we have three million
more toilets to build -
15:50 - 15:53before we can even make
a stab at that claim. -
15:53 - 15:55And I don't pretend anything else.
-
15:56 - 15:58But as we all sit here today,
-
16:00 - 16:02there are now over 100 toilets built
-
16:02 - 16:04in this village and a couple nearby.
-
16:04 - 16:08Well over 1,000 people use those toilets.
-
16:08 - 16:11and the key point of all this work,
they all have names. -
16:13 - 16:16Yami Lama, he's a young boy.
-
16:17 - 16:21He's got significantly less gut infection
because he's now got toilets, -
16:21 - 16:24and there isn't human waste on the ground.
-
16:25 - 16:28Kanji Maya, she's a mother,
and a proud one. -
16:28 - 16:33She's probably right now
cooking lunch for her family -
16:33 - 16:35on biogas, smokeless fuel.
-
16:35 - 16:36Her lungs have got better,
-
16:36 - 16:38and they'll get better as time increases,
-
16:38 - 16:40because she's not cooking
in the same smoke. -
16:40 - 16:43Surya takes the waste
out of the biogas chamber -
16:43 - 16:46when it's shed the gas,
he puts it on his crops. -
16:46 - 16:48He's trebled his crop income,
-
16:49 - 16:52more food for the family
and more money for the family. -
16:52 - 16:56And finally Bishnu,
the leader of the team, -
16:57 - 17:00has now understood that not only
have we built toilets, -
17:00 - 17:02we've also built a team,
-
17:02 - 17:04and that team is now
working in two villages -
17:04 - 17:07where they're training up
the next two villages -
17:07 - 17:08to keep the work expanding.
-
17:08 - 17:10And that, to me, is the key.
-
17:10 - 17:15(Applause)
-
17:20 - 17:23I'm going to end with one slide,
and that is, simply to say, -
17:23 - 17:25people are not the problem.
-
17:27 - 17:28We've never found that.
-
17:28 - 17:31The problem: poor living environment,
-
17:31 - 17:34poor housing and the bugs
that do people harm. -
17:35 - 17:40None of those are limited by geography,
by skin color or by religion. -
17:40 - 17:42None of them.
-
17:43 - 17:45The common link between all
the work we've had to do -
17:45 - 17:47is one thing, and that's poverty.
-
17:49 - 17:52Nelson Mandela said, in the mid-2000s,
not too far from here, -
17:52 - 17:58he said that like slavery and apartheid,
"Poverty is not natural. -
17:58 - 18:02It is man-made and can be
overcome and eradicated -
18:02 - 18:04by the actions of human beings."
-
18:06 - 18:07I want to end by saying
-
18:07 - 18:13it's been the actions of thousands
of ordinary human beings -
18:13 - 18:16doing - I think - extraordinary work,
-
18:17 - 18:19that have actually improved health,
-
18:19 - 18:23and, maybe only in a small way,
reduced poverty. -
18:23 - 18:24Thank you very much for your time.
-
18:24 - 18:31(Applause)
- Title:
- How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney
- Description:
-
In 1985, architect Paul Pholeros was challenged by the director of an Aboriginal-controlled health service to "stop people getting sick" in a small indigenous community in south Australia. The key insights: think beyond medicine and fix the local environment. In this sparky, interactive talk, Pholeros describes projects undertaken by Healthabitat, the organization he now runs to help reduce poverty--through practical design fixes - in Australia and beyond.
This talk was given at a local TEDx event, produced independently of the TED Conferences. - Video Language:
- English
- Team:
- closed TED
- Project:
- TEDxTalks
- Duration:
- 18:36
Ivana Korom approved English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
Ivana Korom accepted English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
Ivana Korom edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
Ivana Korom edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
Ivana Korom edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
TED Translators admin edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
TED Translators admin edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney | ||
TED Translators admin edited English subtitles for How to reduce poverty? Fix homes | Paul Pholeros | TEDxSydney |