Home is where the health is

By Fran Molloy

Architect Paul Pholeros is immensely proud of the 2011 World Habitat Award given to the non-profit organisation he co-founded, Healthabitat. He’s even more proud of the NSW Health report that shows Healthabitat’s work has reduced Indigenous hospital admissions by 40 per cent.

Image of simple toilets being built

Healthabitat works to lift standards of health in poor communities by improving housing. It is led by managing director Pholeros (BSc (Arch) ’74 BArch ’77), who recalls his years at the University in the 1970s as being pivotal in his approach to his work. “It was a time when the teaching of architecture changed radically, and the University of Sydney led the charge in that,” he recalls. “In our first year, we had courses on ecology, anthropology, sociology – all completely new concepts to budding architects.”

Healthabitat was last year also awarded the Australian Institute of Architects Leadership in Sustainability Prize, and this year was selected for the Venice International Architecture Biennale.

Now it is extending its “Housing for Health” expertise overseas.

Simple projects with dramatic effects

In a recent project, simple toilets and biogas systems were installed in three villages in Nepal, improving the lives of many poor families. Biogas is a renewable fuel produced from waste treatment, providing enough fuel for around three hours of cooking a day for a village family.

The latest project uses Healthabitat’s “survey and fix” methodology to address problems in public housing in New York. This involves assessing the safety and health functions of a house and carrying out basic repairs from day one. Rather than simply receiving a report listing their home’s faults, residents see an immediate improvement, which builds trust and allows for more complex and time-consuming work to then be carried out.

Pholeros and his colleagues have perfected this methodology over the past 27 years, since they were first engaged by Indigenous activist Yami Lester, then head of the Pitjantjatjara Land Council’s health service in central Australia. Despite Lester’s improvements to local health services, Indigenous people were quickly getting sick again. He was looking for solutions.

Housing in remote communities was in crisis. Many washing facilities didn’t work, electrical connections were frequently dangerous, drains were often disconnected or blocked, and uninsulated houses offered little respite from the relentless outback sun.

Making the connection

Lester realised poor housing was linked to illness. In 1985 he commissioned three people to help him resolve the issue: Pholeros, who was on a short-term contract supervising additions to the health clinic; Paul Torzillo (MBBS ’76), a doctor with the Nganampa Health Council; and anthropologist Stephan Rainow, who worked as the Health Council’s environmental health officer.

Lester told them, “Stop people getting sick.” “It was a simple, one-line brief that was to completely change my future,” Pholeros says. Six months later, the team had developed the nine healthy living practices that were to direct all their projects from that point on.

“I couldn’t believe it at first,” Pholeros admits. “These principles all looked so simple that they were almost dumb, but they were very basic things that maintain health, such as washing kids once a day and washing clothes and bedding.”

Years later, the Healthabitat team were able to cite statistics discrediting the commonly held belief that Indigenous residents were responsible for all damage to their homes. Rather, they found that poor design, overcrowding and bad building practices were the main cause of housing failure, with just nine per cent of damage attributable to residents.

Healthabitat has now repaired more than 7500 homes, but since Federal funding for its programs came to an end last year, Pholeros sees greater potential for change offshore.

“In Australia, our work has been enthusiastically accepted by Indigenous people, but we’ve spent a lot of time and energy battling bureaucracies and government departments every step of the way,” he explains. “People overseas are actively seeking our expertise, so it makes more sense to put our energies into delivering services that improve people’s lives rather than lobbying and debating our work here.”