HEALTH centers and hospitals should stand out as places that maintain clean environments, are accessible for people of all abilities and promote good health. The Philippines still has a long way to go to realize these aspirations, but even small steps forward are meaningful. One that deserves commendation is Department of Health (DoH) Memorandum 2024-0156 on “Establishment of Active Transport and Bicycle Support Infrastructure in Healthcare Facilities and DoH Offices.”
The memorandum states that the “DoH encourages the establishment of support infrastructure in all health care facilities and DoH offices to encourage active transport among health workers, medical professionals, employees, and patients or clients. The active transport support infrastructure may include the following:
“1. Parking Facility. This includes parking facilities for bicycles and light mobility transport vehicles or vehicles using electronic or non-motorized vehicles weighing not more than 100 kg. Racks and parking facilities may be provided at street level if possible, and at most one level or floor above or below the street. In addition, it is encouraged that the parking facilities are provided with security surveillance and proper lighting.
“2. End-of-Trip Facility. This includes provision for showers and/or changing rooms, bicycle repair stations and pumps, electric charging stations, and lockers, whichever is possible.”
When all parking in a health care institution is devoted to cars, it delivers the message that health care is prioritized for those privileged to have a private motor vehicle. This implicit message naturally motivates Filipinos to favor car use, leading to greater car dependency and more polluted and congested roads. If roads around health care facilities are congested with motor vehicles, it also means that the surrounding air is more polluted, and the area becomes less accessible.
To reduce air pollution and motor vehicle congestion around health care facilities, patients and health care staff need to have convenient and safe options for walking, cycling and using public transportation. Because bicycles and pedestrians have the least environmental impact, they should be actively promoted and prioritized. For staff and patients who live within 2-3 kilometers from the facility, walking or cycling should be an available and desirable choice.
Therefore, safe and attractive pathways leading to health care facilities are a must. Sidewalks should be wide enough and smooth enough for anyone using a stroller or crutches. Bike lanes should be well-marked, physically separated from motor vehicles, and without potholes and obstructions. Where possible, trees and greenery should be planted along the walking and biking paths to offer shade and a welcoming environment.
Safe and attractive pathways to health care facilities are urgently needed but are not sufficient. The health care facilities need to have safe and sufficient parking for bicycles, and giving bicycles the best-located parking areas makes total sense. Under the DoH memorandum, bicycle parking should be close to street level, accessible, visible and well-secured, rather than tucked away in the far, dark reaches of a building or basement where bicycles and their owners become easy targets for thieves and muggers. In addition, end-of-trip facilities (showers, lockers, repair stations, etc.) go a long way toward making a destination bicycle-friendly.
Already, many health care workers nationwide are using bicycles to get to and from work. When roads are clogged with motor vehicles, a bicycle offers shorter and more predictable travel times. During rush hour in Metro Manila, for example, traveling by bicycle can cut one’s travel time in half (compared with travel by car or public transport). And then there are the health gains from having regular physical exercise. They say that walking or cycling for 30 minutes or more daily is also key to good mental health. A powerful incentive is the savings in travel expenses (public transport fares or in the cost of running and maintaining a private motor vehicle). And with fewer motor vehicles that approach the health care facility, everyone benefits from having cleaner air.
However, the sad reality is that many clinics and hospitals do not provide safe and sufficient bicycle parking, even for their own employees who travel on bicycles. These health institutions reserve all their parking spaces for patients’ and doctors’ cars. This is clearly unjust and irregular practice, especially for publicly funded institutions. In the same way that roads should not be designed only to serve people in private cars, parking spaces should not be exclusively for four-wheeled motor vehicles. In fact, car parking that is transformed into bicycle parking or motorcycle parking can serve many more people than if the parking area is exclusively for cars. In the same parking space for one car, there is sufficient space to park around 10 bicycles.
For the reasons cited above, the DoH should not permit any health care institution to offer the excuse that it does not have any available parking for bicycles because cars already use up all their parking. One way to avoid this excuse is to require a minimum percent or ratio of the parking area to be devoted to bicycle parking. For example, a requirement could be that, for every four car parking spaces, the equivalent area of one car parking space should be devoted to bicycle parking. Another rule could be that, when 90 percent or more of the bicycle parking slots are occupied on a normal day, additional car parking spaces should automatically be converted into bicycle parking.
For the DoH bicycle parking memorandum to deliver tangible results, it will be important for department to have measurable targets and results, to monitor compliance, and to reward institutions that have done well in prioritizing pedestrians and persons on bicycles. (On this point, The Medical City-Ortigas deserves kudos for having in my book the best bicycle parking among the major hospitals.)
Robert Y. Siy is a development economist, city and regional planner, and public transport advocate. He is a co-convenor of the Move As One Coalition. He can be reached at [email protected] or followed on Twitter at @RobertRsiy.
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