Authors: Dr. Xavier Casas. Deputy Major for Public Health. President of the Ciutat Vella District. Barcelona City Council.
Dr. Rafael Manzanera. Executive Director of the Public Health Department. Barcelona City Council.
Dr. Salvador Monca. Head of the Division of Programmes. Department of Public Health. Barcelona City Council
Dr. Lucía Artazcoz. Healthy Cities Project Coordinator. Department of Public Health. Barcelona City Council.
Barcelona is a city of about 1,6 milion inhabitants, with almost 100.000 living in the old district calied Ciutat Vella. After years of deterioration, the district became the most deprived one in Barcelona. The health indicators have been more negative for this district for years, with higher mortaiity rates, higher prevalence of tuberculosis and of AIDS and so on (table l).
| District | CMR | PYLL | LE
|
| Sarriá-Sant Gervasi | 84,3* | 74,8- | 79,38
|
| Les Corts | 90,0* | 71,9* | 79,18
|
| Eixample | 94,5* | 88,9* | 78,12
|
| Grácia | 95,5 | 97,3 | 77,52
|
| Horta-Guinardó | 96,8 | 86,7* | 77,96
|
| Sant Andreu | 101,5 | 89,6* | 77,52
|
| Nou Barris | 104,5* | 107,1 | 76,77
|
| Sant Martí | 105,3* | 98,9 | 76,74
|
| Sants-Montju'ic | 105,9* | 1 1 7,2* | 75,91
|
| Ciutat Vella | 128,8* | 199,1* | 71,44
|
| Total | 100 | 100 | 77,2
|
Table 1. Comparative mortality rate (CMR), potencial years of life lost (PYLL), and life expectation of the ten districts of Barcelona. Barcelona, 19921. * Statistically significant
With this evidence, showed thanks to a comprehensive health information system at the local level working in Barcelona for years (mortality statistics at the local level are available since the beginning of the century), the city council decided a global strategy to recover the district, with actions ranging from urban design, to social and medical programmes, with the participation of different sectors and of the community. This is one of the most ambitious programmes of a city that defined its health policy with these points:
The objectives defined in this freid by the city council were:
And the ways to achieve these objectives proposed by the city council?
Barcelona Health Report 1993. Department of Public Health, Barcelona City Council, 1992 2 Barcelona Health Report, 1991. Departrnent of Public Health, Barcelona City Council, 1992.
1. Ciutat Vella: Background
After some years of rehabilitation programmes and of special programmes carried out in Ciutat Vella, the Old Quarter of Barcelona, we are able of defining the measures to be taken in order to stop the rocess of deterioration of this district situated in the downtown.The causes of deterioration range from the inadequate urban planning to the lack of a normativa and financial framework to keep and improve the current buildings with actions of restoration and renewing of those with a more important social component, i.e. the buildings used as dweiling.
In this context, the term rehabilitation is a broad concept that takes into account both the immediate improvement of the quality of dweilings and the promotion of primary facilities and actions to improve the open spaces. The rehabilitation programme aims at restoring but preserving the intrinsic values of this zone by paying especial attention to its cultural and historic values. The limited public resources oblige to a rationalization process so that they are addressed to those areas where the need of improvement of the urban quaiity is clearer and where a detailed analysis of the situation guarantees the efficiency of the economic and human investment.
2. The downtown in Barcelona
Ciutat Vella is made up of four different quarters with their own identity, Barceloneta, Casc Antic, Gótic, Raval and Rivera. The "Third Wall" rounded it since the XIV century. The Ciutadella Garden in the XIX and the creation of the Barceloneta in the coast (XVIII) constitutes the final shape of the district. With such a long history it is a district absolutely identified with the political, urban, cultural and social life of Barcelona.
The planned growth of the rest of Barcelona (Cerdá's Project of the Ensanche) out of the 3rd Wali, had a negative effect in the district that experimented a chaotic growth. For years, there has been an important deterioration of the buildings, its population has got older, there has been also a process of social deterioration, a replacement of the tradicional trading by other inadequate commercial activities, that gave as a result a deterioration of the Barcelona downtown.
The reform of Ciutat Vella, followed different steps of urban change:
* First step: The walied city. In this phase, Ciutat Vella is the whole city. Durant this phase it is important the creation of the Barceloneta (1753-1759), Sant Miquel del Port Church (1755) and the Cuartel de Infantería (1764).
* Second step. Urban reforms in the downtown. The creation of la Merce's Church (176575), la Llotja (1769), Palacio Moja (1771) and la Virreina. Another important event is the application of the "Order of Carlos lii" about cemeteries, that resulted in the Sant Just Square and Sant Miquel Square, and through a long and difficult process, in the improvement of the streets with the elimination of the smail streets and the changes and enlargement of the rest of the streets (1802).
* Third step. Opening of new streets and squares, Ferran and Princesa streets (1824), Sant Jaume Square (1823-31), the elimination of convents (1835), el Liceu de Garriga Roca (1 844) and finally the Plaga Reíal (1 854).
* Fourth Step. Urban proposals in order to adapt the old city to the rest of the new city: the Concurso de la Ciutadella (1868), el Plan Baixeras 81880), the opening of Via Laietana (1 908-1 l), the Darder Plan (1 91 8) and finally the proposals of Plan Maciá and GATPAC (1930-36).
* Fifth Step. The municipal action that starts with the proposais for planning that include the PERI's of Raval, the Eastern Sector and the Barceloneta (1 981-85), aiways emphasizing the restoration of dwellings in order to keep the residencial function of Ciutat Vella. In this process it shouid be emphasized its two main characteristics:
a. The Deciaration of Area of lntegrated Rehabilitation, as the basic mechanism of management of the contradictory aspects of the revitalization poiicy, requiring a balanced action between the contradiction of interests and the consensos between agents and institutions.
b. The Program of investments is managed through a mixed enterprise (PROCIVESA), responsable for the effective mechanism of expropriation and the execution of the infrastructure of the quarters, requiring a comprehensive option of balance between the complexity of the operations and, at the same time, the need of operativity.
The Municipal lntervention
In 1979, Barcelona has its first democratic City Council after 40 years of dictatorship. That means a change of the urban policy of the past years. it should be recognized that Ciutat Vella has a lot problems difficult to solve, but there are a lot of factors that positively affects its possible transformation such as centraiity (Barcelona and Catalonia), activity (administrativelpolitical, commercial, cultural, touristic, and hotel), size and diversity, a stable population and the quaiity of life (silence, caimness, communication).
These factors encourage to coordinase efforts in three directions that allows the economic, social, and urban revitalization. Since the beginning of the 80s, but mainiy since 1987, a plan calied "Comprehensive Plan of Transformation of Ciutat Vella" is launched which objectives are:
a. To improve the living conditions.
b. To fight against the deterioration of dweilings
c. To decrease the density of population
d. To increase the facilities of social use
e. To promote the community participation
f. To attract new population, especially young people.
g. To reinstal people affected by the expropriations in the same district.
To achieve these objective the interventions have been:
* Municipal descentralization giving to the districts the abiiity to decide and to act.
* Creation of structures of polítical and community participation.
* Creation of the mixed society of Promotion Ciutat Vella (Sociedad Mixta Promoció Ciutat Vella S.A.) in order to accelerate the process of municipal intervention.
* Safety and hygienization of public spaces.
* Promotion of social weifare through different programmes
* Creation of facilities and socializa its use
* lmprovement of infrastructures, services and car parks
* Urban change with the execution of PERI'S. The Plans of lnner Reform have the objective of determining the deficits of each quarter in the city and to improve the standards and facilities.
* Restoration of dweilings
Promoció Ciutat Vella S.A. is the organism of participation between the City Council and the private sector to promote the revitalization of the District through the corresponsibiiity. The City Council delegates the management of the process in this organism in order to increase the effectiveness and the efficiency. it is the financial instrument that allows the city to accelerate an investment that, otherwise, would take about 15 years.
The Plans of Action of PROCIVESA for the restoration of the historic downtown consist of:
* Creating new open public spaces in the district to mitigate the deterioration of the district
* Generating new buildings, promoted either by the public sector or by the private sector.
* Carrying out the rehabilitation of the old buildings where people affected by the urban reform will be reinstaled.
* Promoting the private rehabilitation of the buildings and dweilings of Ciutat Vella.
* Carrying out the public constructions that improve the communications of pedestrians or vehicies, the sanitation and the lighting and modernizing the supply networks of the different companies of services.
* Promoting the reactivation of the economic activity of Ciutat Vella through the adequation and modernization of the current activities, the creation of new activities both for its population and its visitors taking into account its centrality and its historic value.
* Stressing and promoting the values of the District to be visited.
* In summary, acting as the motor of the comprehensive rehabilitation process of Ciutat Vella
The people's accessability to open spaces and to any facility including housing, cultural, health and educational services was idenfitified as one of the key issues, so that new spaces and buildings have been designed avoiding architechtonic barriers to allow handicapped people to normally use them.
4. Description of the Project
The special characteristics of the District, pienty of narrow streets and smali squares, permits a new urban design through the especial plan of inner reform and taking into account both aspects of urban environment (type of ground, trees, restoration of historic buildings and fagades ... ) and functional aspects (traffic restriction, increasing pedestrians streets, paths for cyclists and so on).
The process of renewing requires the demolition of some buildings according to the Special Plans of lnner Reform, and the construction, currently working, of dweilings to reinstale the same people today living in the deteriorated dweilings that, either are about the ruin, or they do not have the minimum facilities, and that permits the increase of green spaces.
The rehabilitation carried out during these six years has resulted in new public spaces with some streets without pavements and oniy for pedestrians. The mobility in the District was limited in the vertical direction, thus making that the rehabilitation could be compromised if the problem is not solved. The generation of green spaces strategically located, has ímproved the vertical mobility and reduced the population density as weil as permitted to build dweilings replacing others where the current population has been reinstaled.
The whole operation consists of rehabilitating the social and urban context, by applying actions of regulation and urban discipline with actions addressed to mix the uses of the zone, and actions that rehabilitase some pieces of special architectonic value.
This process taking place in Ciutat Vella couid be a good example and a pilot experience that follows the orientation of the Green Book of Urban environment of EEC. The concentration of so many different uses, the mixture of people with so different socioeconomic status and information, the renewing of the urban and architectonic context make this experience interesting enough to taik about a process of a comprehensive urban renewal.
5. Other integrated actions in Ciutat Vella
At the same time of this process of urban redesign with its consequences on the quaiity of life of people living in Barcelona, other social programmes have been developed in the district. In 1988 the centers of assistance for marginal people were definitely ciosed and its assistance integrated in the normal health services in order to effectively eliminate inequalities in health services. The reform of primary care health centers, according to the Alma Ata criteria has been completed in Ciutat Vella (it is the oniy district in Barcelona were it has been finished) so that health services offer an assistance that goes beyond the biological component of health and takes into account also its social and psychological aspects.
Other programmes have been developed, some of them new experiences that have been exported" to other parts of Catalonia and outside:
* The programme of tuberculosis that, promoted by the city council, worked from 1988 to 1992, and responsiblity is now of the catalan government that, has spread this successfui experience to other cities of the region;
* the programme of Al DS prevention (1 987-90);
* the programme of health agents for drug abusers with the whole commitment of exdrug abusers acting as health agents for others currentiy addicts;
* the programme of prostitution also with the commitment of prostitutas as health agents and organizers of health workshops;
* programmes of mother and child health care;
* programme of syringes collection at the district carried out by the associations of neighbous;
* civic and sportive centers have been also created;
* programmes to reduce school absenteeism (higher in this district),
* programmes for older peopie, and
* the creation of coordinators of community associations
6. The investment of Funds of Cohesion in Ciutat Vella
Programme: Central Plan of Raval
According to the Regulation (CEE) 792193 of the Council of 30 March 1993, where the financial instrument of cohesion was instituted, as weil as to the Articie 130 R of the Treaty about the European Union (Maastricht, 7 February 1992), the projects to be funded by the Funds of Cohesions should contribute to the achievement of the Community Objectives of
Environment and therefore shouid be adequate to the Fifth Programme of Environmental Action.
The objectives of the 5th Programme of Environmental Actions are reflected in the priorities of the Progamme LIFE (1993), where the programmes of urban environment are considered prioritary, mainiy those addressed to reduce the traffic density, to increase open spaces, and to a mixed use of the urban space.
Given that the Funds of Cohesion aims at reducing social and economic inequalities (articie 130 D of the Treaty of Maastricht), by financing projects in the sector of infrastructures, of transportation and environmental programmes, in those cases with structural deficiencias and with limited economic resources, the present project is adequate to the objectives of the Funds of Cohesion.
Quality of life in the urban environment is affected by aspects of the urban mobility with its consequences (traffic jams, pollution, noise ... ). it is also affected by other aspects such as the lack of green spaces that could emerge if old constructions are demolished. it is also important to build new dweilings, to increase the diversity and the density of uses in the same space as a guarantee of stability and reduction of marginality, of increase of organization and of the complexity of social and economic relations.
The programme in the centre of the Raval, that it is inciuded in the project of revitalization of the downtown of Barcelona, could be applied in other historic centers of Spain. it emphasizes three aspects, say, it proposes a new balance in the mobility of people and energy, a renewal of the urban context without driving out people currently living there, and it may be considered as a pilot project of mixture and diversity of urban used in a reduced place.
The principies of reducing inequalities, the community participation and the collaboration between different sectors both public and private have been in the spirit of this project. So far, after six years, the public administrations have already invested 81 thousand milions pesetas (it is probably the most ambitious project of this kind in Europe) and nowadays it has received funds from the Funds of Cohesions, making it one of the examples to be studied when planning urban changes in other parts of Spain or of the rest of Europe.
Final remarks
Have all this changes improved the health and quality of life of Ciutat Vella's innhabitants, inciuding those with physical and mental defficiencies ?.
Unfortunately, we do not have so far health or quality of life data enough as to correctly answer this question, but we think that, at least, we can say that peopie, all Ciutat Vella people, have today more opportunities to face the chalienges of every day's life and health.
it looks quite reasonable to think that if today this district has more and befter parcs and open spaces, more and befter cultural instalations, more and better social and health services, that quality of housing is improving, and that social marginality has decreased, we can feel moderately optimistics.
lf we take a walk today by Ciutat Vella we will find a mix of people very different that those we found some years ago. We find the students who attend the courses in the new university centres and tourist who visit the very important new museums and cultural centres recently created in the middie of the most deprived area. We will find inhabitants of other districts going around and looking for new changes.
The more disavantaged population is the one who will benefit more from this changes. Handicapped people have today some things a liftie easier than years ago, despite we perfectly know that still lacks a long way to reach equity.
We are sure that what have been done so far is not enough, we are positive on that. But to start changing the shape of historical and deep tendencias is the needed first step that the City has taken.