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1. Health services in the area

It is this neighbourhood's wealth of health services that makes it an obvious base for a development such as the HPP. The City's department of health provides primary healthcare and local clinics, and the provincial department of health offers higher-stage services and district-level facilities.

Esselen Street Clinic
The City of Johannesburg's Esselen Street Clinic handles tuberculosis, sexually transmitted infections, contraception and HIV counselling and testing. The clinic, a partnership between the City and Wits University's Reproductive Health Research Unit, sees up to 350 people daily and plans to increase this to up to 1 000 - which will require significantly more space.

Hillbrow Community Health Centre
This provincial health facility is based in the old Hillbrow Hospital complex, much of which had been decommissioned by 1998. The Hillbrow Community Health Centre (CHC) provides a range of services, including:

  • family planning, ante-natal and post-natal services, pregnancy termination;
  • home-based care;
  • medical and legal facilities to tackle child and sexual abuse, and domestic violence;
  • 24-hour casualty services; and
  • physiology and radiology
The centre is being upgraded to consolidate, within a single building at the southeast of the site, services such as:
  • maternity and obstetrics;
  • mother and child health;
  • 24-hour casualty services and minor theatre;
  • a polyclinic and outpatient services;
  • psychology; and
  • dental care.
This will free up buildings for disposal or alternative use. In addition, the provincial health department is considering re-opening the Hillbrow Hospital as a small 100-bed district facility.

The proximity of these City and provincial facilities provides a compelling opportunity for expanding the Centre of Excellence concept at Esselen Street. Under-used land and property has the potential for adaptation to accommodate a wider range of organisations that could improve healthcare provision and impart synergy. These include departments from Wits University, government social service and welfare providers, and a variety of health NGOs. The precinct already houses others in the health sector, such as the National Centre for Occupational Health, the SA Institute for Medical Research and the National Laboratory Service.

2. Hillbrow's developmental, economic, social and environmental issues

Johannesburg's inner city has the most acute and multi-faceted urban problems in the country. But it is also the crucible in which new approaches are tested and implemented.

The residential centre of the inner city is Hillbrow. At least 90 percent of its residents live in blocks of flats. Although the 2001 census put the neighbourhood's population at 49 600, officials believe that to be an underestimate due to overcrowding and migration.

Urban design framework
The urban design framework and related assessments have identified a range of development issues:

  • Historic buildings: a significant number occupy the site, which will restrict physical restructuring through demolition.
  • Ad-hoc development: much of the precinct comprises a dense agglomeration of buildings; there is minimal open space.
  • Declining quality of building stock: the older built fabric has started to decay faster than usual because of the ingress of storm water and the lack of maintenance of under-used and empty buildings. Vandalism is also a problem.
  • Rationalisation and demolition: the rationalisation of activities and the demolition of buildings will be needed to restructure the precinct, introduce parking and establish the envisaged public environment.
  • Urban management: physical restructuring and reorganisation will help the management of the precinct and enable development (which is dependent on financial and institutional arrangements) in incremental phases.
  • Parking: the introduction of parking is an important component, especially for accessibility to the precinct.
  • Access and transport: the precinct is well served by public transport and is accessible by foot from all sides.
  • Pedestrian movement: busy traffic routes hinder the safe movement of those on foot. Pedestrian crossings are a high priority for those who walk or rely on public transport.
Economic issues
Hillbrow is primarily a residential area: economic activity is confined to a small number of nodes. The direct economic-growth potential of the HHP is fairly limited, given its focus on public health. But indirect benefits may flow from the Centre of Excellence.

In addition, the expansion of health training will lead to an increase in the number of staff and trainees who visit or need to stay in the area. The demand for accommodation provides an important opportunity to restore buildings to productive economic use.

Social issues
Key social issues identified in the studies supporting the Hillbrow-Berea Regeneration Initiative include: street children; homeless people; sex workers; drug abuse; and sexual and domestic violence.

Hillbrow also hosts a high proportion of the 235 properties the City has identified as bad buildings. These under-maintained, "slummed" buildings are usually overcrowded residential blocks. Such properties, the tenants of which are exploited by unscrupulous landlords, become associated with atrocious living conditions and anti-social activities.

Environmental issues
Hillbrow is a high-density residential suburb without accessible, pleasant, safe and secure public open space. An important element of the spatial development plan will be to identify and open up suitable spaces for public use.

The HHP comprises an agglomeration of land with institutional use. But these buildings are clustered in such a way that they face inwards and are isolated from their surroundings. The latter has also prevented the development of thoroughfare linkages, effectively forming movement barriers.

In particular, the layout of the Hillbrow Hospital complex is unintelligible due to ad hoc building over the past 100 years.

The urban design framework report sets out the following broad development principles for the precinct:

  • making connections;
  • a grid of streets;
  • a public open space network;
  • a mixture of land use;
  • landmark elements;
  • catalytic projects; and
  • "putting it all together".

3. Implementing the urban design framework

The adjusted urban design framework is based on the urban design scoping study and comprises the following elements:
  • Crossroads and quadrants
    To reinforce the crossroads principle the HHP is structured into four quadrants. The north-south axis of the cross is Hospital Street and the east-west link De Korte Street, with an extension through the Hillbrow Hospital site to link to Klein.
  • The crux and functionality
    The crossroad is not a divisive element, but literally and figuratively forms the "crux" around which the identity, public image and functionality of the health precinct is formed. It is to act as a seam, providing vehicular and pedestrian access to each of the quadrants. This "crux" also establishes design principles that aim to improve the overall legibility and imageability of the area. It provides for the collective and cohesive unity of the HHP, while allowing each quadrant to have nuances of individual character depending on particular function, use and nature.
  • Public space
    The "crux" is reinforced by two public spaces. The first is the existing park within the grounds of the National Health Laboratory: it is proposed that this is opened to public use. The second is the proposed combination park and square at the intersections of Hospital and Smit streets. The proposed public space is to be multi-functional, providing for structured parking, a public park on the surface of the structured parking and retail activities.
  • Linkages
    The four quadrants are connected by a system of public environment linkages in the form of pedestrian pathways, parking courts and public areas (not unlike local access lanes) that allow for vehicular and pedestrian movement.

4. Stakeholders

This development has the potential to attract dozens of stakeholders. Those who are on board already are:

  • the City of Johannesburg health department;
  • the University of the Witwatersrand's Reproductive Health Research Unit;
  • the Johannesburg Development Agency; and
  • the Gauteng department of health.
Potential partners include:
  • Wits University's schools of public health, law, architecture and human and community development;
  • the City's social services in Region 8;
  • NGOs in the fields of social development and HIV/Aids;
  • health and medical institutions;
  • loveLife;
  • the Central Johannesburg Partnership;
  • the Johannesburg Property Company;
  • NGOs and private residential developers and managers;
  • current and future international development cooperation partners; and
  • current and future local corporate social-responsibility partners.