|Managing Natural Disasters and the Environment (World Bank, 1991, 232 p.)|
|About the contributors|
|Managing environmental degradation and natural disasters: an overview|
|Climate hazards, climatic change, and development planning|
|Which costs more: prevention or recovery?|
|Case study: Rio Flood Reconstruction and Prevention Project|
|Case study: La Paz Municipal Development Project|
|The International Decade for Natural Disaster Reduction|
|Minimizing the greenhouse effect|
|Development: from vulnerability to resilience|
|Case study: housing reconstruction in Mexico City|
|Living with floods: alternatives for riverine flood mitigation|
|Case study: creating job and income opportunities for refugees in Pakistan|
|Managing drought and locust invasions in Africa|
|Disasters and development in East Africa|
|The link between reconstruction and development|
|Disaster response: generic or agent-specific?|
|Integrated planning for natural and technological disasters|
|Economic incentives and disaster mitigation|
|Coastal zone management|
|Disaster insurance in New Zealand|
|Case study: reconstruction after North Chinas earthquake|
|Case study: Nepal Municipal Development and Earthquake Reconstruction Project|
|Training in the Asian-Pacific region|
|Remote sensing and technology transfer in developing countries|
|Case study: Minas Gerais Forestry Development Project|
|Case study: Da Xing An Ling Forest Fire Rehabilitation Project|
|Case study: Sudan Emergency Flood Reconstruction Program|
|UNDP coordination of disaster and development planning|
|The role of nongovernment organizations in Sri Lanka|
|Managing natural hazards|
|Case study: Taiz Flood Disaster Prevention and Municipal Development Project|
|Writing an action plan for disaster preparedness in Africa|
|List of colloquium discussants, moderators, and speakers|
|Key to acronyms, initials, and abbreviations|
Alcira Kreimer and Edward Echeverria
The earthquake that struck Mexico City in September 1985 took more than 5,000 lives and damaged the housing of about 180,000 families. RHP, the agency that was set up three weeks later to rebuild urban areas damaged by the earthquake, is a textbook example of successful reconstruction. By July 1987, only 14 months later, RHP had rebuilt 45,100 dwellings - an average of 3,220 dwellings a month. Today one of every seven families living in the citys historic center has a new or rehabilitated RHP dwelling. This was one of the largest reconstruction programs since the recovery from World War II. Almost all of the federal and city development and management agencies contributed to reconstruction. More important, the beneficiaries - the earthquake victims - helped daily to expedite decisions and construction. More than 1,200 private companies participated in the program and more than 175,000 jobs were created, but by May 1987 RHP had begun reducing its staff and most personnel had returned to their former agencies. As Manuel Aguilera Gomez, RHPs director general, wrote afterward: We all learned to conciliate the desirable with the feasible. We learned to listen with care and interest to the sentiments of those affected by reconstruction. Little by little - in stages - the attitudes of the program beneficiaries changed from hostility, uncertainty, incredulity, suspicion, and doubt to hope and confidence.
On September 19, 1985, at 7:19 a.m., Mexico City was struck by an earthquake that measured 8.1 on the Richter scale and lasted more than a minute and a half. The next day there were a number of lesser quakes, the strongest of which measured 7.8 degrees. The maximum horizontal acceleration was nearly 20 percent of gravity on a dominant two-second cycle. This ground movement resonant cycle coincided with the natural vibration period of the five- to 12-story buildings that predominate in the citys dense historic center - making the earthquake one of the most destructive in the hemispheres history. Poorly built tenements housing low-income families in overcrowded conditions suffered the worst damage. They had already deteriorated from lack of maintenance and repair. Tenement rents had been frozen since World War II so there had been no incentive for rehabilitation. The catastrophe took more than 5,000 lives, caused 16,000 injuries, and damaged or destroyed 12,700 buildings - 65 percent of them residential. The housing of about 180,000 families was damaged and 50,000 people had to be temporarily rehoused. Also affected were 340 office buildings in which 145,000 government workers were employed, plus 1,200 small industrial workshops, 1,700 hotel rooms, 1,200 schools, and 2,000 hospital beds. The loss exceeded US$4 billion as calculated by the Ministry of Finance and the Economic Commission for Latin America and the Caribbean (CEPAL).
The government of Mexico asked the World Bank for assistance for the reconstruction of hospitals, schools, and low-income housing and for research into revised building codes, zoning, and regulatory measures to reduce the citys vulnerability to earthquakes. There were four rehousing programs:
· Popular Housing Reconstruction (RHP) - 48,000 dwelling units, benefiting 260,000 people, reconstructed onsite on expropriated sites.
· Phase II - 12,000 dwellings on nonexpropriated sites.
· Casa Propia - 8,000 dwellings rehabilitated for resident owners.
· Housing Foundation (FOVI) - 12,000 units of relocated housing.
What follows is a description only of the first of these, RHP - a success story in emergency construction and a model for community involvement.
Popular Housing Reconstruction
On October 14,1985 (just three weeks after the disaster), RHP (Popular Housing Reconstruction) was set up by presidential decree as an autonomous agency with a life of two years (see box by Manuel Aguilera). RHP had a mandate to:
· Rebuild and reorganize urban areas damaged by the earthquake, following the principles of urban renewal and social development.
· Define a policy of social development that preserves and protects the physical and social patterns of urban life, guarantees ownership of the dwellings to the beneficiaries, and provides needed urban services.
· Combat land speculation.
· Rationalize the building finance and investment that would be channeled to the program.
The program was to unfold in five stages:
Stage 1. October 1985 - March 1986. Damage assessment, planning and design.
Stage 2. April - December 1986. Intense construction and social organizing.
Stage 3. January - March 1987. Allocation of dwellings, legalization and registration of deeds.
Stage 4. April - September 1987. Completion of program.
Stage 5. October 1987 - April 1988. Diagnostic history, records, and closure.
1. DAMAGE ASSESSMENT, PLANNING AND DESIGN
In the first months after the earthquake, RHP updated an initial survey to estimate the number of people affected, their socioeconomic characteristics, and the physical condition of their dwellings. On the basis of this census, the victims were awarded certificates validating their eligibility for housing assistance. Early proposals for reconstruction focused on vacant land in outlying areas, including a site adjacent to the airport. But World Bank financing was contingent on rebuilding onsite with minimal relocation, a policy based on negative experiences the Bank had had with large-scale relocation in other disaster areas. Most families had lived in their neighborhoods for a generation or more and wanted to remain there, so the government adopted a policy of reconstruction onsite. 1
This decision required expropriation of privately held land and the provision of temporary shelter by families in the immediate vicinity. This called for both political and administrative skill and enormous sensitivity in dealing intimately, day in, day out, with 60,000 families for more than a year and a half.
On October 11,1985, the Expropriation Decree was published in the Official Gazette. Some greeted it with appreciation for its social justice; others condemned it as populist and demagogic for its violation of property rights. Errors and omissions needed correcting and individual cases were protested in the courts, but the decree itself was successfully administered with a taking of 4,312 lots or 200 hectares (500 acres).
The Expropriation Decree announced that meeting the collective needs of the people whose homes were destroyed by the earthquake was in the public interest; that the city government was to occupy the property immediately, authorize its upgrading and renewal, and sell the new housing to the people who had been living there; and that the city government was to pay compensation to the former owners within 10 years, according to the capacity of the Treasury.
By January 1986, the RHP was reorganized to create two departments, Construction and Administration, at the same level as the Office of the Director General. The most important change was the decentralization of the Construction Department into five zonal offices in charge of supervising and controlling construction and of building temporary shelters. To reinforce the core staff, RHP borrowed senior planners and engineers from the Ministries of Communications and Transport, the Secretariat of Urban Development and Ecology (SEDUE), the Federal Electricity Commission, the Urban Transportation Commission, and many agencies of the Federal District (DF) of Mexico City. The zonal offices were further decentralized into 12 construction and operations modules that managed all construction activities.
In January 1986 social and technical teams started to match socioeconomic survey data to data on the physical condition of each dwelling. In the process they organized the earthquake victims into community groups to review the whole program, site plans, and prototype apartment designs. Based on the census, the government issued certificates of residency establishing earthquake victims eligibility for benefits. These were issued regardless of who legally owned the building. Many families had abandoned their dwellings immediately after the earthquake, however, so it was difficult to track them down to document their rights to new dwellings. Regular meetings were held to maintain the quake victims social organization, to review and revise program plans, and finally to approve plans and sign documents for the construction of each apartment. For many groups, planning and redesign took as long as eight to nine months, construction only four. Only after agreement was reached were beneficiaries legally formed into a condominium association that agreed to vacate the building so reconstruction could start. Temporary shelters of corrugated aluminum or zinc were generally located within a block of the building site. Wherever possible, they were built on public lands - parks, sport centers, roadway median strips, service roads, and sometimes actually in adjacent streets.
The social teams organized the condominium associations into renovation councils for each reconstruction or rehabilitation site. Although they had no legal status they provided forums for people to speak out. The councils were formally installed with elected representatives authorized to negotiate with the RHP about individual needs. They also had to decide on the legal status of their housing association - whether to be a condominium, a cooperative, or a nonprofit organization.
Many people who had no previous experience in community action found themselves as spokespersons for their association. They became outspoken not only to the press but also to the RHP and city officials. The Director General and Director of Social Affairs spent long hours negotiating and responding to their concerns. The beneficiaries participation made the process far more rewarding for the federal government, the city, the community, and the beneficiaries.
During planning and design, five types of groups worked with the earthquake victims: political parties, university groups, technical support groups, and private voluntary and religious organizations. More than half the sites received support from one or more organizations, starting with the census survey. University groups began by evaluating damages and later acted as technical support. The political parties also played an important role.
By February 1986 the new Personal Certificate of Rights was developed to replace the original Certificate of Residency, to eliminate fraud and clarify other questions of need. RHP experienced great difficulty handling so much data and residents were reluctant to be interviewed again. There were two main problems. First, people were uncertain and mistrustful because, months after the earthquake, reconstruction had not begun. Second, there was discord about the size of dwellings. Many felt that the size of the dwelling should be proportionate to the titleholders ability to pay. But this was impractical, given the number of beneficiaries and the time constraints. By the end of February the Social Development Office issued a Handbook of Social Procedures explaining how disaster victims could get the replacement housing conceded to be their right.
The technical staff of architects, planners, and engineers labored over criteria to distinguish which damages were caused by the earthquake and which by physical deterioration of the dwellings. The detailed building survey showed that the earthquake had damaged or destroyed 59 percent of the buildings beyond repair or rehabilitation. A third had deteriorated because of neglect and some of these would have to be rebuilt. Rehousing on the expropriated sites was initially set at 46,700 dwellings, of which 23,200 (half) were to be rebuilt, 14,900 (32 percent) rehabilitated, and 8,600 (18 percent) improved by minor repairs. Exposing the structural elements revealed that many buildings slated for rehabilitation had to be replaced. So the number of reconstructed dwellings increased to 35,900.
Reducing urban and natural risks in Mexico City
Manuel Aguilera Gomez
The director of Mexico Citys incredible housing reconstruction effort after the earthquake of 1985 describes what happens when artificially induced ecological changes heighten a citys natural vulnerability. He calls for a reorientation of urban development - a qualitative long-term change to close the gap between the citys urbanization pattern and degree of vulnerability. He stresses the need for community development over the continuing development of a metropolitan program vast beyond reason.
In this last decade of the twentieth century, Mexico City - located more than 2,000 meters high, on an enormous lakebed - has become one of the largest metropolises in the world. Risk and disaster have always been part of life in the nations capital. Home to more than 15 million Mexicans (about 19 percent of the countrys population) who live in the Federal District and 17 surrounding municipalities, the city is a disjointed assembly of mixed urban habitats.
These habitats - located in the Valley of Mexico, surrounded by volcanos and mountain chains - differ in their subsoil, altitude, and degree of modernization. Their major infrastructure and service systems are not integrated, and a complex network of regulations and overlapping administrative jurisdictions operate in isolation, with no sense of metropolitan unity. The metropolitan area now covers nearly 1,500 square kilometers.
Economic, political, and cultural factors have all played a part in Mexico Citys current problems. The period of fastest urban growth in the valley was from about 1955 to 1982, when expansion averaged 3 percent yearly. This period coincided with a general agricultural crisis in Mexico and the adoption of a development model based on a strong concentration of industry and services. At present, nearly 30 million industrial plants are located in the Federal District alone, which covers 55 percent of the metropolitan area. Although rural migration to the city has fallen off in the last five years, it remains high, with about 300,000 new arrivals each year. Improvements in the Federal Districts demographic policy have reduced the annual rate to 1.2 percent, but the same is not true of outlying areas in the State of Mexico, such as Chalco, in the Northeast of the metropolitan region, where the population is growing more than 5 percent a year.
The citys size, artificially induced ecological changes, and constant changes in the use and allocation of urban land have clearly heightened the citys vulnerability. When urbanization pushes the rate of expansion beyond a certain point, risk and vulnerability increase and become a constant factor that must be considered in the design and implementation of urban development policies. The city now lives with permanent risks of earthquake, landslides, floods, severe traffic congestion, and interruptions of the water and power supply to certain critical regions.
We live in an urban complex that began to deteriorate ecologically more than 400 years ago, when the Spanish conquistadors began the prolonged drainage of Lake Texcoco. This was completed only at the start of this century, but the consequences of this action are still at the root of many of our problems. In our time we have seen a city rapidly modernizing but as a result it is a victim of bold architecture that sometimes defies the swampy and geological nature of the basin of Mexico.
Its residents are aware of overexposure to contingencies of varied nature and magnitude. But not until the 1985 earthquakes did we become fully aware of our profound vulnerability as an urban community. The painful experience of the 1985 earthquakes illustrates the vulnerability we live with daily and the communitys ability to organize quickly in response to devastation from natural disasters.
The earthquake on September 9, 1985, reached 8.1 on the Rich-tor scale. In parts of the city with soft and humid subsoils, or because of amplification, the intensity topped 10. The effects of the seismic waves caused the death of more than 5,000 people and damaged buildings more than eight stories high located in the epicenter, the central-eastern part of the city. Similarly, the duration of the earthquake destroyed older neighborhoods, multifamily dwellings, and such strategic service networks as the water supply, drainage, and main roads and avenues - thus delaying rescue operations.
But as a witness and actor in this period in the history of our capital, as head of the Popular Housing Reconstruction program, I can state that the emergency and subsequent reconstruction were times of unforgettable solidarity and human effort. Few countries and cities have gotten back on their feet in so short a time. Reconstruction was overwhelmingly successful. For example, 48,000 dwellings in the hardest hit areas were raised from the rubble - in the poor but well-serviced center of the city - within 18 months. Virtually all of the citys infrastructure and service systems were restored in only three months.
The terrible lesson of the earthquakes has resulted in increased community awareness of not only the constant risks but also vulnerability caused by so-called over-urbanization. The first step in reducing the vulnerability of the Federal District was the redesign and implementation of an integrated civil protection system. The second was a reorientation of the urbanization process and the citys development model.
MODERNIZING THE FEDERAL DISTRICTS CIVIL PROTECTION SYSTEM
The first task was to identify the most vulnerable zones and regions, especially the nature and scope of risks in the central and northeastern part of the city which, because of its soil and structures, is most likely to be affected by geological phenomena. The belt of gullies, depressions, and ravines that crosses the city from west to southeast has the highest risk of cave-ins and land faults, as well as flooding because of intense annual rainfall and inadequate storm drainage. The basic purpose of the civil protection system in the Federal District is to guarantee an organized, speedy, and efficient government and community response to any emergency and to coordinate joint efforts to restore normalcy in services and the rhythm of daily life.
The project to modernize civil protection has five strategic guidelines:
· Fostering solidarity.
The spirit behind these strategies is solidarity and grassroots participation. All of our equipment and trained personnel are useless in a catastrophe if we cannot incorporate the solidarity, civic-mindedness, and the responsibility demonstrated by the millions of anonymous citizens who saved Mexico City in 1985. Specialized teams of volunteers must work with groups in the community, contributing their resources and personnel to promote more collective security. By the end of 1989, neighborhood organizing efforts in the Federal District had attracted 16,000 volunteers to the civil protection system. The second phase will tap the imagination and talent of these volunteers for tasks of such magnitude and importance that we must all join in.
REORIENTING URBAN DEVELOPMENT
Mexico City has reached a stage in its development that requires medium- and long-term qualitative changes to close the gap between the citys urbanization pattern and degree of vulnerability. We cannot say that Mexico City will stop growing or that its vast problems of pollution and vulnerability will cease to exist or continue to increase if we reduce urban growth. But the urbanization pattern must be reoriented to stabilize the pollution and vulnerability indices, so that we can gradually make overall improvement and restore environmental quality.
For many years, urban growth meant that most investments went to expand such major infrastructure systems as the water supply, storm drainage, and the subway. Improvements were virtually the exclusive preserve of the modern microregions of the city, to the detriment of the poorer, deteriorated areas. True, many of the major infrastructure systems must continue to provide a centralized service that serves the urban whole. But most government action - whether to reduce pollution, improve the urban space, or diminish the uncertainty of foreseeable risks - should be a local, decentralized response to the priority demands of specific, localized social entities.
In the future, most investments in Mexico City must be made in mixed urban habitats. If they are to be integrated in a just and fair manner, community development must be stressed over the continuing growth of vast metropolitan programs. Aggregate demand must yield to priority demand - which should be met primarily by use of local resources.
Through group representation, communities must participate directly in managing everything that bears on their daily lives. This is the true meaning of democracy and the only real way for social justice to prevail in one of the largest cities in the world.
The technical staff, together with architectural consulting firms, selected three prototype designs for reconstruction. RHP had to take a pragmatic approach to unit size, rebuilding for an average family of 4.6 persons. Each dwelling unit has a minimum net area of 40 square meters, a kitchen/living/dining room with hot water, two bedrooms, a complete bathroom with shower, and a small laundry patio or balcony. The structures are all earthquake-resistant.
The architects and planners were ingenious in providing a diversity of building shapes and heights with a striking use of color and texture. Most buildings are three stories high, with grade beams of 20 x 40 centimeters, load-bearing walls, and reinforced concrete slabs. The structural beams on each floor are tied to the columns to provide a rigid structural frame. The common walls serve as shear walls to provide added rigidity. Many of the sites had such poor (highly compressible, saturated) soil conditions that as much as 1.2 meters had to be excavated and replaced with compacted crushed stone.
2. INTENSE CONSTRUCTION AND SOCIAL ORGANIZING
The bureaucratic procedures for plan approvals, construction, modification, and completion of each building were streamlined between RHP, the Low-Income Housing Fund (FONHAPO), the office of the Federal District (DDF), and the National Bank of Works and Public Services (BANOBRAS). Plans and construction contracts for more than 3,000 sites had to be approved, so it was imperative to reduce approval time to days instead of months. Close daily supervision by zonal offices, community groups, and future condominium owners kept the construction on schedule. A technical team from FONHAPO helped RHP administer the loans. The average cost of the dwellings on the first group of sites was US$4,030, so repayment was based on a down payment of 10 percent and the rest, US$3,630, was amortized over 5.5 to 8.5 years, depending on the purchasers ability to pay. Monthly payments were set at 20 percent to 30 percent of one minimum wage indexed to inflation. The payments were adjusted once a year using a computerized formula. A special municipal trust was activated to receive the monthly payments and maintain the loan portfolios. As construction expanded to hundreds of sites, construction management teams had to streamline their daily accounting and budgeting systems, which quickly reached a peak expenditure of US$1 million a day. Auditors from the National Chamber of Deputies periodically reviewed the financial accounts. Their reports were published for public commentary - which was continually favorable.
Under the emergency act to expedite procedures, in July 1986 RHP called for tenders on delivery of 12,000 toilets and 32,000 wash basins, kitchen sinks, and water heaters. The government and World Bank procurement guidelines on local and international competitive bidding were fully respected but early approval of documents and down payments ensured on-time delivery. Savings of about US$1.5 million were achieved by the bulk purchase, despite the difficulty of storing such quantities of goods.
By mid-1986, RHP had been asked to rehabilitate or restore more than 100 buildings considered to be of historic value, providing residential living space, security, and adequate sanitation within the programs budget. Project designers from the National Institute of Anthropology of History helped identify buildings that were candidates for restoration and conversion to residential use. In many of these old mesones, densities before the earthquake were one family per room, so many families had to be relocated. The decision of whom to move was left to the group. Residents on the alternative site had accepted the move of those who were relocated. On acceptance, final sales prices and plans - including the date construction was to start, the date people were to move to temporary shelters, and the agreement to receive monthly rent during reconstruction - had to be ratified by all partners.
Help from social and community groups and universities was essential. Interdisciplinary groups of students of medicine, psychology, sociology, architecture, and engineering - coordinated by RHP social services - provided the much-needed social services in the temporary shelters, while RHP paid for utilities and provided security, fumigation, and maintenance and repairs to the sanitary installations. As a rule, the beneficiaries were willing to accept the rules of the reconstruction program.
Demand for temporary shelters increased and it was difficult to build more of them in the streets, so in May 1986 SEDUE acquired 28 hectares next to the airport on which to build 1,200 prefabricated dwellings. These were occupied initially by one family per room. When reconstruction was complete, they were modified back to one family per four rooms of about 48 square meters and sold to the beneficiaries. A total of 20,000 temporary dwellings were built. As a complementary measure, rent assistance was increased to significantly reduce the demand for temporary shelters.
By mid-December RHP technical and administrative teams were so immersed in construction management, with many sites operating around the clock, that they chose to work through their normal Christmas holiday to advance the program. In the first eight months of construction, RHPs construction management team maintained its output at the rate of more than 2,600 dwellings a month - a remarkable achievement. By the end of December 1986 (the end of Stage 2), 21,200 dwellings had been completed and 10,437 of them were already occupied. Dwellings were finished and assigned so quickly that it was necessary to speed up removal of the temporary camps - first those on the streets, then those on expropriated lots.
3. ALLOCATION OF DWELLINGS, REGISTRATION OF DEEDS
In January 1987, RHP began to restore the streets and parks that had been occupied by the temporary shelters. Sidewalks were repaired and the area was cleaned up, gardened, and repaved. On February 6th the International Union of Architects announced that RHP had won an international architectural award, the Sir Robert Matthew Gold Medal award. The reconstruction program was considered by the Architects Union the best piece of work on human settlements carried out internationally in the previous three years.
During this period, the Legal Department was verifying the massive data the notaries needed to legalize the transfer of deeds to the new owners and to register them in the Public Registry of Properties. This involved deeds for permanent housing on 2,870 lots constituted as condominiums, along with 46,720 individual deeds for each dwelling or commercial outlet. In addition, the 1,200 prefabricated dwellings near the airport were divided into 11 lots for deed registration. The Social Development Department undertook the problem of verifying the technical and social historical data on each lot. Each site development lot required a complete technical-social file. There were external problems as well. Many of the lots were unregistered and the Cadastral Office of Deeds had incomplete or no data. The Public Register of Properties was not equipped to handle this enormous load, so RHP had to send its personnel and computer data equipment to help check out the background information of the register in the Treasury, the Legal Department of the City Government, and the Tribunals. By the end of March 1987, they had distributed 1,807 deeds for individual dwellings and 188 condominium deeds. Construction was virtually complete, but on March 31 the President of the Republic authorized that closure activities continue until the end of September 1987, that the Low Income Housing Loan Trust Fund (FIDERE) would recover the loans, and that the City Government would take over all of RHPs rights and obligations on RHPs demise.
4. COMPLETION OF PROGRAM
By July 1987 the reconstruction of 45,100 dwellings was completed. It had taken 14 months, with an average 3,220 dwellings a month. During the peak period of February-April 1987, RHP was completing more than 120 dwellings a day. To process final payments to the more than 700 construction contractors, on the more than 10,000 contracts of supplies and services, RHP developed a computer program that indexed construction costs to inflation and completion schedules. Final estimates were reviewed by building control personnel who sent them to finance personnel for verification. Contractors who owed money to RHP completed payment by certified check. If payments were due the contractor, a final balance sheet was sent to the financial department for final payment. RHP would return bond security on the advanced payment, leaving the bond covering construction warranties.
By the end of September, the rent payment assistance program was closed. It had benefited 19,900 families with an average of 364,704 pesos (US$750) a family. Rent assistance, which lasted an average eight months per family, included payments for moving furniture and personal possessions twice. The loan portfolio for recovering the loans for 42,000 dwellings and commercial outlets and 2,745 lots (or 94 percent of the total) - together with the hardware and software used to administer the system - was handed over to the financial trust, FIDERE. By September 1987, the gross repayment (monthly payments, advance payments, and insurance) had reached about US$ 10 million.
Decentralizing Mexicos health care facilities
The earthquake of 1985 caused disproportionately heavy damage to Mexicos health care facilities because they were concentrated in the capital city center. The Ministry of Healths Centro Medico (3,000 beds) and the Central Hospitals of the Social Security Institute (IMSS, 2,600 beds) - which included important Mexico City hospitals - were virtually destroyed. Immediately after the quake, plans to rebuild these health care facilities followed the national strategy of decentralizing federal government functions to other states.
Health care reconstruction
The Government of Mexico (GOM) took an integrated approach to decentralization. Financing and investments were coordinated at the federal level, planning and programs at state and municipal levels. The World Bank had supported a policy of decentralization since 1985, helping the GOM in projects aimed at achieving spatial decentralization by developing alternative growth poles outside of Mexico City. The earthquake and reconstruction provided an opportunity to execute this policy.
IMSS, the second most important health care provider in Mexico, serves 40 percent of the population: workers covered by health insurance. In the last 20 years, IMSS has gained extensive experience in the design, construction, and operation of health care facilities throughout the country. IMSSs technical design office, which had a deconcentration plan, organized and managed the replacement of 2,000 beds destroyed by the earthquake. It proposed to provide about 1,200 beds in six second-level zonal hospitals to serve an estimated 1.2 million people on the periphery of Metropolitan Mexico City. Each hospital would provide ambulatory and hospital services, including gynecology, obstetrics, pediatrics, general surgery, internal medicine, orthopedics, trauma, ENT (ear, nose and throat), and ophthalmology. These zonal hospitals would take care of 95 percent of the cases locally, eliminating the need to travel to the Centro Medico - which henceforth would provide specialized third-level services, with only 300 beds. Before the earthquake, about 40 percent of IMSS hospital beds were in the city center, more than two hours from most of the 7 to 10 million IMSS beneficiaries living in the metropolitan area.
The remaining 800 beds were to be built in five regional hospitals distributed countrywide according to need. Some were new nursing units and health care facilities added to existing hospitals so that the five regions - Ciudad Obregon, Vera Cruz, Leon, Puebla, and Merida - could become fully autonomous in providing all types of health care. This would reduce further the need to transfer second- and third-level-care patients for treatment in Mexico City. These actions would improve the level of health services and make them more accessible, at lower unit costs. Costs would continue to be recovered through user and employer fees in accordance with established practices.
Cost and schedules
Four of the hospitals on the periphery of Metropolitan Mexico were built on schedule and operating in 1989. Problems in site acquisition delayed the other two. They had to be relocated, which meant revising site and building plans. Their completion was scheduled for September 1990. The five regional hospitals were completed, equipped, and operating in 1989.
Procuring medical equipment (especially the CAT scan) required a long lead time. Bids for more than US$44 million worth of equipment were finally opened in December 1987. Despite large price increases the project had to absorb, costs remained within the projected range of US$50,000 to $55,000 per bed for equipment and $50,000 per bed for construction.
5. DIAGNOSTIC HISTORY
With the help of personnel from the General Archives of the Nation, RHP began analyzing the documentation for the whole program. The structure and content of the General Archives were designed so data could be retrieved for research. A building was rehabilitated to store: (1) construction contracts, bidding documents, licenses, and papers for temporary housing; (2) social-legal documents and certificates of rights; (3) accounts, budgets, and data on sources of finance; and (4) information on communications with the media. Security measures were set up so that, by law, the documents would be available for seven years for audits, revisions, and research.
By May 1987, RHP had begun reducing its staff. Most personnel returned to their former agencies. Borrowed equipment and furniture were returned and prefabricated offices and warehouses dismantled. RHP donated much of its office equipment and many computers and vehicles to the city government, the Phase II housing program, and other housing organizations.
From suspicion to hope
RHP finished 45,100 dwellings and 3,600 commercial workshops. It was one of the largest reconstruction programs since the recovery from World War II. Today one of every seven families living in the historic center has a new or rehabilitated RHP dwelling. Clearly, Mexico City could renovate a major portion of the city when both the human and financial resources were mobilized. Almost all of the federal and city development and management agencies contributed to reconstruction. More important, the beneficiaries - the earthquake victims - helped daily to expedite decisions and construction.
A total of 1,240 private companies participated in the program - 738 building contractors, 64 professional firms of supervisors, 184 suppliers, and 258 firms preparing studies and projects. From October 1985 to December 1987, more than 175,000 jobs were created - including 1,200 for the RHP agency itself and many more in construction and services.
Toward the end of reconstruction, Manuel Aguilera Gomez, RHPs director general, wrote, The earthquake revealed the nakedness of part of the city center. The solution was not to hide the poor in the suburbs, but rather to provide them with appropriate housing. To achieve this aim we all learned to conciliate the desirable with the feasible. We learned to listen with care and interest to the sentiments of those affected by reconstruction. Little by little - in stages - the attitudes of the program beneficiaries changed from hostility, uncertainty, incredulity, suspicion, and doubt to hope and confidence.
1. Data revealed that 65 percent of the families had lived in the neighborhood for more than 20 years, 18 percent for 10-19 years, and 15 percent for nine years or less. More than 97 percent of them rented their dwelling and 70 percent of the dwellings occupied less than 40 square meters. Moreover, 80 percent of the heads of household - 87 percent of the men and 69 percent of the women - said they were working. These data were consistent with data on the main economic activities of the city center.