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31 August 2020 | Story André Damons | Photo Supplied
Prof Ivan Turok
Prof Ivan Turok

The number of people infected by the coronavirus is linked to the density of urban living. South Africa’s townships and informal settlements are bearing the brunt of the disease, on top of all their existing problems of unemployment, poverty, hunger, and crime. This is a disturbing situation and demands greater attention across society.

This is according to Prof Ivan Turok from the Human Sciences Research Council (HSRC), the Department of Economics and Finance, and the Centre for Development Support at the University of the Free State (UFS), who has recently been awarded a Research Chair in City-Region Economies at the UFS by the South African Research Chairs Initiative (SARChI).

Prof Turok was part of a webinar discussion on ‘Urban Living Post-COVID-19’ with Dr Geci Karuri-Sebina – who manages the research programme at South African Cities Network and who has two decades’ experience working and publishing in the fields of urban development, innovation, and foresight – and Mr Thireshen Govender, architect and founder of UrbanWorks. They analysed how COVID-19 challenges urban living, social distancing, and the de-densification of cities as South Africa heads towards 70% of its population living in urban areas.

According to Prof Turok, urban density has been blamed for the spread of the virus. “The fear of people crowding together has caused negative reactions from government, from business, and from households. This is unlikely to be a short-lived, temporary phenomenon. It will be with us for some time to come.”

“The virus poses an ongoing risk to society, with the prospect of second and third waves taking hold. A lockdown could be re-imposed and further efforts could be made to enforce distancing and de-densification of cities, particularly our densest settlements,” said Prof Turok.

 

De-risking urban density

There was a simple but compelling idea at the heart of his presentation, which should also be “at the heart of a more effective and inclusive response to the pandemic”. At the moment, the government’s response to the crisis facing our poorest communities is uninspiring. “We need a more positive vision for the future than wearing masks and washing our hands.”

“We need to be bolder and more imaginative about de-risking urban density. In other words, making crowded neighbourhoods safer and more secure for people to live in. Density poses multiple risks to residents. How do we reduce these risks in ways that generate wider benefits, rather than business as usual – forcing people to change their behaviour and follow protocols?”

With reference to New York, which was severely affected by the virus, Prof Turok showed that it was not density per se that was the problem, but rather the type of density. The densest part of the city (Manhattan) was far less affected by the virus than poorer outlying communities. “This gives us a clue that more floor space in taller buildings helps to prevent crowding and makes density more liveable,” said Prof Turok.

The reality in South Africa is also different when you drill down and distinguish between different kinds of places. Big cities have been affected worse than towns and rural areas – in terms of the incidence of infections and the number of deaths. Within cities, there have been far more problems in the townships and informal settlements than in the suburbs. In Cape Town, for example, the southern and northern suburbs and the central city have been barely affected by the virus. However, infections have been very high on the Cape Flats, including Khayelitsha, Langa, Gugulethu, Philippi, and Mitchells Plain.

“Population densities in some of these areas are more than 100 times higher than in the affluent suburbs. The differences are very striking.”

“Incomes on the Cape Flats are also much lower than elsewhere in the city. So, there is a correspondence between density and the disease, unlike New York,” says Prof Turok.

All the discussions about the pandemic so far has focused on the negative aspects of urban density for the risk of transmission. This ignores all the benefits of dense urban living. Intense human interaction fosters learning and creativity, which raises productivity and innovation. Concentrated populations generate economies of scale in the provision of infrastructure and institutions such as universities. Cities give firms greater choice of workers and vice versa.

 

Pure population density and economic density

Prof Turok continued by saying that physical distancing can be socially and economically damaging. “Attempts to force people apart through de-densification undermine all kinds of personal networks, weaken the social fabric of communities, and erode the economic advantages of proximity that are so important for cities.”

“We need to understand that people crowding together in dense informal settlements is a symptom of something more fundamental, namely poverty. The pressure on land reflects the fact that low-income households can’t afford the space standards of middle- and upper-income groups. Forcing people apart (or to stay home) to reduce the risk of transmission just treats the symptoms of the problem. It cannot be a lasting solution. It doesn’t build resilience to confront the multiple challenges facing poor communities,” said Prof Turok.

A key part of a lasting solution can be summed up as building economic density. This involves increasing investment in two- or three-storey buildings to give people more living space and to free up land at ground-floor level to accommodate essential infrastructure and more public space for markets and social interaction. A better living and working environment would strengthen community resilience to public-health problems and promote all-round development. The idea of economic density offers a practical vision that can inspire hope in a better future, rather than the status quo of wearing masks in crowded places.

“We need to de-risk urban density through tangible investment, rather than forced distancing or dispersal. This will help to bring about far-reaching improvements to people’s lives in cities. At the moment, the lack of economic density in impoverished communities is a much bigger problem than excessive population densities.”

News Archive

A position statement by the School of Medicine, UFS, regarding the crisis in health care in the Free State
2009-05-27

The executive management of the School of Medicine (SOM) at the University of the Free State (UFS) and its senior members wish to express their grave concern at the way the financial crisis in the Free State has negatively impacted on the provision of health care to the population. The unavailability of goods and services at every level of care has become so severely compromised that the staff of the SOM can no longer remain silent on this issue. By remaining silent it may be construed that we are either indifferent to, or even accepting the situation. Neither is true. The SOM can in no way condone, sanction or accept the current situation of health care in the Free State.

Other concerns expressed by the SOM include:

  • Medical services have been severely compromised due to the disintegrating primary health care system in the FS. This has resulted in patients who were in need of more advanced levels of medical care not being referred appropriately or timeously to level two hospitals and from there for tertiary care. Inpatient as well as outpatient numbers are steadily declining and the tendency now is to fill fewer beds with critically ill or terminally ill patients. It is also becoming increasingly difficult to find suitable patients for training and examination purposes.
     
  • It becomes more difficult to attract and retain experienced and suitably qualified medical specialists interested in an academic career, due to the inability to provide prospective career opportunities. This is particularly the case in the surgical disciplines.
     
  • It is also becoming more difficult to attract and appoint highly qualified registrars (future specialists) since the reputation of this SOM has been compromised by the negative publicity created by the financial difficulties of the FSDoH. Registrars form the backbone of the clinical work force in all teaching hospitals. If vacant posts cannot be filled in time service provision, as well as undergraduate teaching are severely jeopardised.
     
  • As a direct consequence of the rationing of health care, fewer surgical procedures are being performed. The point may soon be reached where registrars in the surgical disciplines may not get sufficient hands-on experience to allow them to qualify within the required time frame.
     
  • Non-payment of accounts to service providers and suppliers including the National Health Laboratory Services (NHLS), maintenance contracts and industry will severely compromises health care and future loyalty, goodwill and provision of critical services.
     
  • The dwindling number of qualified and experienced nurses in the public (and private) health care sector is an ongoing unresolved issue. Despite the fact that primary health care is mainly nurse-driven, nursing colleges were closed during the previous decade. These colleges must now be re-commissioned at high cost adding to the financial burden.
     
  • The morale of health care workers at all levels of health care has reached an all-time low
     
  • It is becoming increasingly difficult to conduct meaningful research in all disciplines due to staff shortages and lack of funding.

See attachment for the full statement on by the School of Medicine, regarding the crisis in health care in the Free State.

Media Release
Issued by: Mangaliso Radebe
Assistant Director: Media Liaison
Tel: 051 401 2828
Cell: 078 460 3320
E-mail: radebemt.stg@ufs.ac.za
26 May 2009
 

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