The Bill of Rights states that equal access to healthcare is the
constitutional right of all people living in South Africa (SA 1996).
However, with the current healthcare model being made up of a
divided public and private sector, gross inequalities in terms of access to
healthcare have become a familiar occurrence in the way our society
functions and as a result, the statement above is not a reality for many
communities. One such community is Plastic View in Moreleta Park,
Pretoria East, the research site for this dissertation.
In order to rectify this situation found across South Africa, a number
of proposals have been put forward from both a governmental (top
down) approach and a grass roots (bottom up) approach, in order to
re-engineer the current primary healthcare model. These proposals are
critically analysed in later text, and the conclusion that this dissertation
proposes, from a programmatic point of view, is how the bottom up
preventative approach to primary healthcare may be used to support
the larger top down curative primary healthcare model in order to move
closer towards a Health for All (Kautzky & Tollman 2009:26).
As health is defined as not only being free from disease or infirmity, but
rather a state of complete physical, mental and social well-being (WHO
2003), this dissertation investigates the role that the built environment
can play in spatially support the proposals being made from a top down
and bottom up approach by assisting the holistic healing process of
all the users of such facilities. In order to achieve this, the architectural
investigation focuses on facilitating a more preventative approach to
health care as opposed to a solely curative approach, and turns to the
historical beginnings of healthcare facilities for informants, rather than
the case studies present in our society currently. These informants include
the design of monastic cloisters and Florence Nightingale's pavilion
designs which were centred around the holistic well being of the user's
experience.
Vervolgens die Handves van Menseregte is toegang tot
basiese gesondheidsorg 'n konstitusionele reg wat elkeen in
Suid-Afrika toekom (SA 1997). Huidiglik bestaan Suid-Afrika se
gesondheidsdienste uit 'n verdeelde privaat- en publiekesektor.
Ongelyke toegang tot gesondheidssorg is aan die orde van
die dag. Baie gemeenskappe het nie toegang tot die basiese
gesondheidssorg wat hulle toekom volgens die reg nie. So 'n
gemeenskap is die fokusarea van hierdie verhandeling, Plastic
View, in Moreleta Park.
Daar word tans, en is ook al in die verlede, verskeie voorstelle
gemaak om die huidige model te herstruktureer. Die voorstelle
kan verdeel word in twee bre? benaderings ? die eerste
stel voor dat die staat alle gesondheidsdienste verskaf en
bestuur ('n sogenamende 'Top-Down- benadering) terwyl die
teenoorgestelde benadering voorstel dat die gemeenskap self
meer betrokke raak by die lewering van gesondheidssorg in hulle
onmiddelike omgewing. Albei benaderings word later in die
teks in krities geanaliseer, waarna tot die slotsom gekom word
dat die twee wyses mekaar kan ondersteun wanneer dit saam
geimplimenteer word. Die gemeenskap se betrokkenheid by die
lewering van basiese dienste sal die druk op staatsinstellings verlig.
Op hierdie wyse kan beter dienste aan almal gelewer word binne
die beperkte hulpbronne tot ons beskikking.
Dit is belangrik om in ag te neem dat gesondheid gedefinieer word
as algehele fisiese, geestelike en sosiale welstand, eerder as slegs
die afwesigheid van siekte (WHO 2003). Dus word daar in hierdie
verhandeling gekyk hoe die ruimtelike omgewing bydra tot die
proses van genesing by persone wat van gesondheidssentrums
gebruik maak. Historiese voorbeelde, soos die ontwerp van
kloosters en Florence Nightingale se pawiljoen-ontwerpe, dien as
inspirasie eerder as kontempor?re gevallestudies. Die fokus van die
ondersoek is die rol van argitektuur en die stedelike omgewing in
die skep van 'n gesonde omgewing wat bydra tot die holistiese
gesondheid van stedelike inwoners.
