Priya Ritu, Singh Ranvir, Das Sayan
Centre of Social Medicine and Community Health, Jawaharlal Nehru University, New Delhi, India.
Health Swaraaj Samvaad Group, South Asian Dialogues on Ecological Democracy, New Delhi, India.
Front Public Health. 2019 Sep 2;7:239. doi: 10.3389/fpubh.2019.00239. eCollection 2019.
In the past 200 years, urban spaces have been imagined as neatly laid out, well-planned, sanitised and civilised places of dense human habitation with regulated economic activity, where political power, financial capital, the frontiers of knowledge and technology thrive. This has been the urban planners dream, even while it does not reflect the full reality, whether of cities in the LMICs or the HICs. In the face of such homogenising visions arising from Euro-American models, formal urban systems fail to provide adequately for residents' needs, who then carve out their own resources and processes for meeting them, largely within the domain of urban "informality." While large part of literature presents urban informality as reflected in the slum, others have shown how it is found in relation to all classes (1). The concept of informality has largely been applied to the core dimensions of economic life of the city. Applied to people's "ways of life," intermingling of the formal and informal becomes distinctly evident in everyday practices in locations such as the peri-urban, and in activities such as health care. This paper opens up the sphere of health care for urban planning that has, in recent decades, left it largely untouched. It uses data from a rapid assessment of health seeking behaviour of three socioeconomic groups-the middle class, slum-dwellers, and homeless- in Delhi, the capital city of India. The findings, relevant beyond the specific location, reveal that people of all sections resort to myriad informal arrangements for their health care, challenging the dominant connotation of the formal-informal denoting a legitimate-illegitimate dichotomy. This provides potential directions to bridge the formal-informal divide, to re-configure urban planning towards more sustainable futures with plural visions of land use and urban greening for healthier urban conditions and for health care provisioning. The analysis posits that, besides the economic and political relations shaping the formal and informal, the politics of knowledge must be factored in if the informal has to be adequately understood for building sustainable futures.
在过去的200年里,城市空间被设想为布局整齐、规划良好、卫生且文明的人口密集居住区,有着规范的经济活动,政治权力、金融资本、知识和技术前沿在此蓬勃发展。这一直是城市规划者的梦想,尽管它并未反映出全部现实,无论是低收入和中等收入国家城市还是高收入国家城市的现实。面对源自欧美模式的这种同质化愿景,正式的城市系统无法充分满足居民需求,居民于是在很大程度上在城市“非正规”领域内自行开辟资源和途径来满足这些需求。虽然大部分文献将城市非正规性呈现为贫民窟所反映的那样,但也有其他研究表明它存在于与所有阶层相关的情况中(1)。非正规性的概念主要应用于城市经济生活的核心层面。应用于人们的“生活方式”时,正规与非正规的交织在诸如城郊地区的日常实践以及医疗保健等活动中变得尤为明显。本文开启了城市规划中医疗保健领域的研究,近几十年来该领域在很大程度上一直未被触及。它使用了对印度首都德里三个社会经济群体——中产阶级、贫民窟居民和无家可归者——的就医行为进行快速评估的数据。这些发现超越了特定地点的范畴,揭示出各阶层的人们都为其医疗保健采取了无数非正规安排,这挑战了正规与非正规表示合法与非法二分法的主流内涵。这为弥合正规与非正规的鸿沟提供了潜在方向,以重新配置城市规划,朝着拥有土地利用和城市绿化多元愿景的更可持续未来发展,以实现更健康的城市状况和医疗保健供应。分析认为,除了塑造正规和非正规的经济和政治关系外,如果要为建设可持续未来充分理解非正规性,还必须考虑知识政治因素。