Building technologies, local resources and empowerment:: A low cost housing project in East London, South Africa

The poverty and housing problems of the black, coloured and Indian communities of South Africa did not disappear with the end of the apartheid era. Besides a housing backlog of 1,5 million and a demand for 220 000 new houses every year, South Africans are suffering from underdevelopment at economic and social levels. This situation is not disconnected with the recrudescence of violence that is happening now in South Africa. Besides the persistence of the tensions between the different groups inherited from the former regime, the poor seem to be weary of waiting for a fairest redistribution of the wealth that is too slow to happen. Housing is only a part of the problems faced by developing countries. It should not be treated independently from the whole. The choice of a material, a technology is everything but innocent. It reflects political choices, values and cultures. In front of tremendous housing of developing countries, cost criteria often weight much in the balance. For that reason and in situation of emergency, project stakeholders often borrow models and technologies from overseas which are not suited to their new context. Beside not being adapted to the local climate and culture, these models often prevent the housing project to bring positive socio-economical impacts on the community. This paper is about a low cost housing project in East London, South Africa. Through the introduction of the compressed earth block technology, the project succeeded to reintroduce the use of a traditional material, and to bring it into urban areas. In maximising the use of local (material and human) resources, the project aimed to use housing to be a lever for local development and to bring positive socio-economical impacts on the community and the less possible negative impacts on the local and global environment. By modernising the use of a material that could be found almost anywhere in the world and that shelters more than a third of the humanity, the project succeeded to valorise earth as a noble local material, helping the communities to reduce their dependency on external materials, components and technology. The paper attempts to contribute to the development of local solutions to the universal housing problem rather than universal solutions to local housing problems. It also tries to present housing as a lever on which other local needs such as health, education and economy could find support to develop. It aims to propose economical solutions and building details that maximise the use of local (human and material) resources, that are simple enough to facilitate a technology transfer but not simplistic since it also wants to serve educational purposes. For these reasons, it tries to favour solutions that are respectful and correspond to the local know-how, and the cultural values of the communities that will benefit from such projects

Housing, Development and Cultural Resistance: the amaXhosa of East London, South Africa

Research on human settlements over the last four decades has changed the views of scholars in the field who now accept housing less as a problem to solve than as an important aspect of overall sustainable development. This led stakeholders to concentrate most of their energy on the economic and, more recently, environmental dimensions of development to evaluate its costs and impacts. The cultural dimension was, however, neglected despite having been identified as being not dissociable from the others in the Agenda 21 at the Earth Summit held in Rio de Janeiro in 1992 (UNICED, 92). At the social housing level, under pretext of the pressure created by the state of emergency left by the tremendous needs, the projects tend to propose standard solutions seldom related to the context and that ignore the cultural values of the group or people affected by these projects. This approach often aimed for quantitative results and mainly considers the economic and environmental impacts, and thus engenders its own failure in the near future. This paper is about the life in the informal townships (squatter settlements) of East London in South Africa, where almost one third of the 560,000 inhabitants of the city reside. Specifically, it looks at the locations occupied by the Xhosa people, who make up 80% of the non-European population living in East London. This port city on the Indian Ocean is wedged between the Ciskei and the Transkei, former homelands where most of the Xhosa people find their roots and where they still migrate back and forth. Through a recall of parts of their history, the description of objects, spaces, dwellings and building techniques of the amaXhosa (Xhosa people), this paper aims to identify and unveil some signs of persistence and/or resistance of the peasant culture of this group in the urban context. Rather than seeing them at odds with their new setting (Mayer, 63), the goal of this paper is to seek ways to reinforce, and to build on them as important elements of the cultural core of the Xhosa People. These elements are essential for the permanence and continuity of the group, and should be taken into consideration by any project involving the built environment, especially a housing project, that aims to be supportive of the concerned group, and of the blossoming of its culture and identity

Straw, sticks, mud and resistance : development and evolution of the South African Xhosa dwelling and settlement

This research is about the life and material conditions of existence of Xhosa people living in three informal settlements of East London (now part of Buffalo City) in South Africa. Most observers see such unplanned settlements as a radical shift away from the groups' traditional rural homestead, some describing them as "neo-vernacular" since---like the vernacular dwelling---these are built from the materials coming from the surrounding environment. The research went beyond this perception and rather proposed that despite changes in the building forms, materials and techniques, the informal Xhosa urban settlements are still---consciously or not---governed by Xhosa traditional rules.To demonstrate this hypothesis, the study attempted to understand the culture of the group through the review of the literature dealing with the Xhosa life and customs in the group's traditional rural setting. Then, it established the evolutionary process of the Xhosa architecture, which was also (re)integrated not only in the history of South African architecture but also in the whole architecture history's continuum. Next, followed the description of the elements that have been found in the three informal settlements as well as in the dwellings and plots that have been selected for the case study. Finally, from the comparison between the elements found in the three squatter settlements selected and the traditional Xhosa setting it is concluded that the traditional Xhosa culture has survived in the three informal settlements of East London. Its persistence has been confirmed in the rituals and everyday activities, the objects, spaces and buildings created, as well as in the way they are constructed, used or lived in

Housing sector profile studies : Tunisia, Senegal, Uganda and Malawi; final technical report

The table of contents for this item can be shared with the requester. The requester may then choose one chapter, up to 10% of the item, as per the Fair Dealing provision of the Canadian Copyright ActThe urban Housing Profile Studies act as both a diagnosis and an analytical tool to help governments identify gaps and bottlenecks in the housing sector that impede the housing market from working properly, particularly in terms of the urban poor. They provide evidence required to support necessary institutional, regulatory and policy reforms, both at local and national levels, where urban population densities are rapidly intensifying. This final technical report illustrates processes and activities as well as the results achieved in the four demonstration countries, with reviews of project research, outputs, and outcomes, and including lessons learned and recommendations

Assessing local building cultures for resilience & development: A practical guide for community-based assessment

International audienceThe development of a set of tools to enhance appreciation of local practices developed by communities regarding settlements and risks is an initiative that aims to promote context-based strategies for responding efficiently and adequately to habitat improvement and vulnerability reduction needs. This guide offers a methodological and operational support for decision-making and practices towards approaches and actions deeply rooted in local contexts. It is a practical tool that provides detailed explanation on planning, preparing and undertaking field assessments of local practices related to habitat and risks. It refers to a participatory approach suitable for, and adapted to, various geographical, cultural and risk-prone areas. By supporting habitat assessment in all its different aspects, it also fosters links between programmes, providing clues and keys to define and implement coherent projects including income generating activities, livelihood, health and other related sectors. The necessary investment to be taken into account in project planning to achieve the basic step described in this booklet will result in huge savings, as logistical issues will be drastically reduced during the project implementation. It is a worthwhile investment that will lead to decisions ensuring more benefits to the affected communities, including a long-term enhancement of their resilience capacityCet ouvrage s'adresse aux responsables de projets et aux preneurs de décisions. L'auteur explique tout d'abord la démarche de projet respectueuse des cultures constructives. L'auteur présente ensuite une méthode d'évaluation des cultures constructives locales et expose l'importance de celle-ci dans un proje

Regional Practice Variation and Outcomes in the Standard Versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) Trial: A Post Hoc Secondary Analysis.

ObjectivesAmong patients with severe acute kidney injury (AKI) admitted to the ICU in high-income countries, regional practice variations for fluid balance (FB) management, timing, and choice of renal replacement therapy (RRT) modality may be significant.DesignSecondary post hoc analysis of the STandard vs. Accelerated initiation of Renal Replacement Therapy in Acute Kidney Injury (STARRT-AKI) trial (ClinicalTrials.gov number NCT02568722).SettingOne hundred-fifty-three ICUs in 13 countries.PatientsAltogether 2693 critically ill patients with AKI, of whom 994 were North American, 1143 European, and 556 from Australia and New Zealand (ANZ).InterventionsNone.Measurements and main resultsTotal mean FB to a maximum of 14 days was +7199 mL in North America, +5641 mL in Europe, and +2211 mL in ANZ (p p p p p p p p = 0.007).ConclusionsAmong STARRT-AKI trial centers, significant regional practice variation exists regarding FB, timing of initiation of RRT, and initial use of continuous RRT. After adjustment, such practice variation was associated with lower ICU and hospital stay and 90-day mortality among ANZ patients compared with other regions

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death