(Mis)adventures in the former Soviet Union with the WHO

Chronicling the struggle for urban health to be a priority, we discover possible reasons why initiatives failed to make progress in a ‘lost decade’ for international action.

David Satterthwaite's picture
Senior associate in IIED's Human Settlements research group
21 August 2023
The transition to a predominantly urban world
A series of insights and interviews designed to share the experiences of community leaders, professionals, researchers and government from the global South
City traffic and buildings in Stalinist architecture.

The Hilton Moscow Leningradskaya Hotel is one of seven famous ‘high rises’ approved by Joseph Stalin, and built in the Stalinist style between 1947 and 1953 (Photo: Jorge Láscar, via FlickrCC BY 2.0)

In 1984, Jorge Hardoy and I were invited by the World Health Organization (WHO) to help develop a new initiative on 'environmental health in rural and urban development in housing’ – known as the RUD programme.

This programme joined with the UN Environment Programme, and later UN-Habitat, in forming a technical panel. The role of this panel was to advise where limited resources could be directed to greatest effect to generate more interest, knowledge and action among professionals, governments and international agencies on environmental health problems – with a special focus on poorer groups in the global South.

The programme was on urban health but it had to have ‘rural’ in the title to get approval. As noted in part one of this blog, within the UN system there is an influential network that even now sees any urban programme as unfair bias against rural areas – even blaming this ‘urban bias’ for development failures.

The poor relations

But more generally ‘urban’ was not seen as a high priority within WHO, and as a result the new RUD programme’s technical meetings were held in St Petersburg and Moscow. By contrast, WHO’s priority programmes met at its Geneva headquarters – and some even got their own new, dedicated buildings.

Costs were in roubles which meant WHO could spend the Soviet Union’s contribution thus making use of a currency that was worthless outside the country.

But the RUD programme brought together a wonderful mix of specialists interested in urban health and WHO staff who shared our curiosity, including Robert Novick, Wilfred Kreisel, Greg Goldstein and their colleagues at the WHO division of environmental health.

Surreal moments...

We got to experience these two wonderful cities first hand. In Moscow, our hotel was in one of seven famous ‘high rises’ approved by Joseph Stalin, and built in the Stalinist style between1947 and 1953. We had to smuggle in a Xerox machine in because our hosts could not provide printing and photocopying facilities.

At immigration, one official took exception to a picture of former Communist party leader Leonid Brezhnev on the front cover of my ‘Economist’ magazine, so they cut it out.

In the hotel we were not allowed to visit each other’s rooms and a ‘purity patrol’ ensured each floor of the hotel was exclusively women or men, and monitored 24/7.

I recall sitting in the aforementioned Stalinist hotel listening to a live group whose repertoire included ‘White Rabbit’ – a song about experimenting with mind-altering drugs – by the archetypal, Californian hippy band Jefferson Airplane. Lyrics that would have been censored (even in the West) if their meaning hadn’t been so effectively hidden.

Another night a Filipino water engineer (Ely Ouano), a Brazilian public works professor (Luis Costa Leite) and I decided to eat out. With very few restaurant choices, we finally found one, but with our limited local language skills had no idea what was on the menu. Our salvation was a student from Afghanistan working in the kitchen, who translated for us and who spoke perfect English. He was working to earn some money while studying for a Masters programme, but was later able to join us for a boozy evening.

…and lost opportunities

Most discussions focused on how best to get more attention to urban health in informal settlements, especially through upgrading. Our Soviet hosts – mostly very distinguished physical scientists – could not grasp the importance of upgrading. Their views were very simple: “if they are illegal, you bulldoze them.”

Of course, formal meals involved toasts: “to comrade Lenin… (toast), “to comrade Brezhnev (toast)”. Then it came to the turn of a Tanzanian sociologist (Hildegarde Kiwasila) who proposed a toast to comrade Nyerere. But then she began to toast other African heroes (comrade Mandela, comrade Luthuli, comrade Biko…). Each name was toasted with another slug of vodka. I have no idea how I got back to my hotel room, but I do remember having the mother of all headaches the next morning.

But these meetings were important – strengthening and expanding the network of people and institutions committed to urban health. Their outcomes fed into various WHO initiatives as the next part of this blog will describe.