‘Nothing effectual can be done for the elevation of the poor in England,’ wrote Charles Dickens, in the introduction of Oliver Twist, ‘until their dwelling places are made decent and wholesome.’ It was perhaps the first time that buildings were seen not as a neutral space – some may be grander than others, but overall these were just variations on the basics of having a shelter over your head – but instead acknowledged that urban design is an essential facet of social, physical, and mental health and well-being.
The new Wellcome Collection exhibition Living with Buildings: Health and Architecture begins quite literally in the Dickensian slum of Jacob’s Island, a place dismissed by elites at the time for being too outrageous to ever exist outside of fiction, that it didn’t accurately reflect the living conditions of the Victorian working class. The brutal truth was revealed in Charles Booth’s famous coloured ‘poverty maps’ of London, which showed the number of people living in substandard housing was far larger than he or his peers believed. The revelation triggered a wave of philanthropic efforts to replace these overcrowded neighbourhoods, creating urban spaces designed with health in mind, including ventilation and proper sanitation.
While visionary garden-based towns with wholesome names such as Bourneville (constructed near the Cadbury factory) and Wellcomeville (planned by Wellcome’s own founder Henry Wellcome, sadly never realised) had mixed fortunes, a far more mainstream replacement for the cleared slums emerged in the form of modernist structures such as social housing tower blocks (‘streets in the sky’, as they were marketed) and large housing estates, many designed and/or inspired by architectural giants such as Le Corbusier and Goldfinger. The juxtaposition between the positive, almost utopian, language and imagery used to promote these new post-war behemoths, and the stereotypes of poor, decaying sites of social deprivation that they quickly became, is jarring.
Most poignantly, a special section devoted to Grenfell Tower exposes the rapid rise and fall of the popularity of such buildings. Grenfell was completed in 1974, yet only three years later the local Kensington News & Post dubbed it ‘a big, ugly disappointment’ under the heading ‘From dreams to drabness’ (various news clippings are included in the exhibit). Residents complained about a lack of communal spaces, as well as feeling devoid of local infrastructure such as shops and other facilities. Such complaints were echoed across many similar buildings constructed around the same time, hence the speed with which they became undesirable spaces, leading ultimately to many being demolished (although few ended as tragically as Grenfell in June 2017, itself evidence of a lack of investment in creating safe living conditions).
Creating healthy buildings, it turns out, requires much more than the clearing of a few slums. Getting the replacements right is a major issue too. Perhaps including more of the psychology behind why these modernist designs failed to create positive social contentment would be been a fascinating accompaniment to the exhibition.
Equally as important as healthy housing are healthy hospitals. From the loose approach to sanitation and cleanliness on display in pre-NHS facilities – with such examples as St Pancras Smallpox Hospital, so overflowing with patients that many were kept outside in temporary tented housing – we meet a grand and picturesque scale model that toured the country in the 1930s, raising money for the King Edward’s Hospital Fund. Incorporating large windows and rooms, it sought to educate people on the importance of light and space in modern medicinal facilities.
Finland’s Alvar Aalto was one architect who saw buildings as a ‘medical instrument’, a tool just like anything to be found in a doctor’s briefcase. He designed special washbasins, windows and chairs specifically for the purpose of enhancing personal health within his sanatoriums (especially focusing on the treatment of tuberculosis patients). Numerous facilities in the post-war years sought to embrace the mindset of outside space, such as the Peckham Pioneer Centre, baking health-focused architecture – revolving around light, ventilation and openness – into its very foundation from the start.
As we ponder the present and future, building materials start to evolve, moving from cold and sterile pre-cast concrete blocks, to warm and friendly timber struts. A model of the Foster + Partners-designed Maggie’s Centre, a network of cancer support centres, shows how such an approach can create a calming environment for healing. Similarly, a special exhibit upstairs shows the new temporary yet robust ‘global clinics’ for Doctors of the World. These plywood structures can be quickly designed, ‘printed’ and constructed (almost like a model plane) with minimal skill requirements, enabling the organisation to respond more efficiently to global health crises as soon as they emerge.
In a way this brings us back to the beginning of the exhibition. While London’s slums do not exist as they did in the Victorian era, there are still hundreds of millions of people living in such conditions today. Understanding how developed nations such as Britain transitioned away from such unhealthy environments paints a rough path that other countries could follow, to ensure that healthy buildings populate as much of the planet as possible.
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