But we didn’t account for the debilitating traffic jam that confronted us outside the gates of our village in southern Metro Manila. Desperate pleas to the traffic officers manning the intersection to proceed went ignored.

So a much-loved dog, whose life could have been saved, died in my arms while stuck in one of Manila’s interminable traffic jams.

Later that day, sitting outside the crematorium, awaiting my dog’s ashes, I told myself that I just couldn’t live in Manila anymore. The traffic, the pollution, the decayed infrastructure and the equally low level of national discourse had become just too much for me to take—just as I know it is for so many millions of Manileños.

I did leave, and in May 2017, I joined the staff of a United States-headquartered, global infrastructure company, AECOM.

Over the past year and a half, I’ve been fortunate to work with an amazing group of people imagining and designing the next generation of the world’s cities.

From our Southeast Asia regional headquarters in Singapore, I’ve extensively traveled across Asia. These trips have enabled me to undertake a deep dive into the issues confronting Asia’s megacities.

For many Filipinos, any trip abroad is sobering. From the moment they land at the visited country’s airport, they confront world-class infrastructure and technological connectivity and mobility.

Each visit is a reminder of how far the rest of the world is racing ahead, and how we will continue to be left behind.

Amazing models

What are Asia’s cities doing right?

Singapore and Hong Kong are amazing models to study.

When I worked for a former employer in the 2000s, I would marvel at how efficiently I could go from Hong Kong International Airport to our office at Exchange Square within 30 minutes.

Today, when I land at Singapore’s Changi Airport (currently ranked the world’s best), I go through the automated immigration in about 10 seconds.

Singapore and Hong Kong are examples of how the challenges of high density, connectivity and mobility are being successfully addressed.

Jakarta in Indonesia is a megacity long plagued by massive traffic. But when the government made the decision to address infrastructure issues, the game changed.

In February, the Harvard Graduate School of Design and AECOM launched a national conversation about the future of Manila and other Philippine cities.

The city’s first heavy-stock rail line is already on trial run, and the second line will open in just a few years. Soekarno-Hatta International Airport has been successfully expanded.

In Kuala Lumpur, Malaysia, investments have been made, from the expansive trains and sparkling stations of the Klang Valley Mass Rapid Transit, to the River of Life Project, a multi-year project to regenerate the city’s Klang and Gombok Rivers.

Not only has the project brought about the biological rebirth of the river, it has also reinvigorated Kuala Lumpur’s once blighted downtown.

The delivery partner for this project has been AECOM, and I encourage you to visit the project in downtown Kuala Kumpu.

There are many examples in our literal backyard that we could—and should—draw from to reimagine a new trajectory for the future growth of our cities.

The common denominators I see across all these great cities is the general sense of purpose and civic discipline that national and local political leaders, businesses and residents share.

Much of my career in Asia has been invested in Philippine urbanization. In the early 2000s, I was in the management of Metro Pacific, the original proponent for Bonifacio Global City (BGC).

A new way

I still clearly recall my beloved former boss, Manny Pangilinan (now better known to the nation as “MVP”), relating how, when he was “the original OFW” building First Pacific in Hong Kong, how much he wanted to deliver a new way of urban living to Manila.

That drive is what led his consortia then to invest billions of dollars in the acquisition of the original BGC site, and deploy massive infrastructure investments.

BGC was a project that required incredible discipline to get off the ground. In the years since they took over the project, Ayala Corporation and Ayala Land have taken it to glittering new heights.

It’s that kind of discipline that needs to be deployed today, but on a much larger scale and more complicated palette, if Manila is to be truly saved and improved for the future.

I propose a path for Metro Manila to move ahead.

First, decide that enough is enough! Filipinos need to decide that two-, three-, four-hour traffic jams, decrepit infrastructure, no public parks, blight and decay are completely unacceptable .

Today, when I drive across Metro Manila and see ambulances attempting to carve a path in bumper-to-bumper traffic, I pray for the passenger inside.

Second, we must agree that Metro Manila needs to become a city for all Filipinos. BGC, Rockwell, Alabang, Makati, Ortigas—Metro Manila will never progress if it continues to exist with fabulous pockets of extreme wealth and privilege, disconnected by tremendous swathes of urban blight and poverty.

In 1905, Daniel Burnham, the American designer and planner of Chicago, presented a plan for Manila that sought to create a grand and elegant capital city, with inner city trams, public parks and the attendant infrastructure to support an aspiring middle class. When creating that plan, he didn’t perceive Philippine society to be divided between the privileged and the “masses.”

Gentrification

Metro Manila can only be “saved” once we review the whole of the city. We must convince the leadership of the City of Manila, for example, that a more sustainable and value-creating future can only be created by urban regeneration, versus building isolated islands in Manila Bay.

The revitalization of the Pasig River, and gentrification of areas such as Baseco Compound or North Harbor, will in fact bring in higher earnings and leave a more lasting legacy.

Hong Kong’s infrastructure is iconic and world-leading.

Third, to do this, government, business and civil society need to come together. In our charged local political environment, this may seem unrealistic. But if we don’t want to lose any more competitiveness—or lives—it’s absolutely necessary.

A national task force focused on fixing Metro Manila, examining the critical challenges our cities face, should be convened and empowered. And this task force should be given the resources to implement transformative solutions.

Fourth, infrastructure projects need to be approved faster and incentivized to be delivered on time. Recently, I was thrilled to traverse the portion of the completed connector road beyond Buendia in Makati. After about 20 seconds when the road ended, I was dismayed to find myself crawling again on South Super Highway.

In most of fast-growing emerging Asia, governments have established “coordinating ministries” that ensure red tape gets cut and projects are completed. It’s a crime that the Philippines is paying fees today for projects we have failed to complete, and we need to fix this.

Fifth, all of this must be addressed via a real, comprehensive and long-term plan. Metro Manila is 16 independent cities and one municipality, each with its own unique governance. It can be saved only if we recognize that this system does not work anymore.

All of Metro Manila needs to be considered as one urban fabric. The strengths of one city can help improve the weaknesses of another.

Sixth, we must recognize that we need outside help. Across Asia, national and local governments are turning to global companies, think tanks, universities and other institutions and crafting uniquely local fixes. It is a not an adverse commentary on our nationalism to say that we need to bring in international ideas and expertise.

As it turns out, just like the Hotdog song, “I keep coming back to Manila.” It is our home, and it needs urgent and comprehensive surgery if we are to save her, and prepare her for future generations.

On Sept. 27, visit “Manila: Future Habitations,” a presentation by the Harvard University Graduate School of Design (the world’s premier school for architecture, urban planning and landscape design) and AECOM on proposed future solutions Manila could consider.

A public forum will be held from 2-4:30 p.m. at the Jesuit Mission House, corner Arzobispo and Anda Streets, Intramuros, Manila.

After the forum, an exhibit of proposed ideas by the students of the Harvard Graduate School of Design will be held from 4:30-6 p.m. at the adjacent San Ignacio Church Exhibition space.

Both events are open to the public. For registration, visit the Facebook page Manila Studio 2018, or e-mail RafaelAudric.Imperial@aecom.com.

This program is brought to Metro Manila in conjunction with the Intramuros Administration and the Department of Tourism. –CONTRIBUTED

The author led the external communications practice for AECOM across Asia. All the opinions, reflections and recommendations are his own and in no way reflect those of the Harvard Graduate School of Design or AECOM.

In a world where digital is king and disruptors are changing life as we knew it, the importance of retaining the intricacies of traditional crafts while embracing the modern cannot be overstated. It is for this reason that the Support Arts and Crafts International Centre of Thailand (Sacict) under the patronage of Her Majesty Queen Sirikit has adopted as one of the trends in its strategy for 2019 a “Retelling the Detailing” concept in the making of new craft products that are both eye-catching and creative.

To get its point across, the centre recently hosted the “Sacict Craft Trend 2019 Open House” at its Craft Gallery in Ayutthaya where it unveiled the mechanisms for creating and presenting the richness of original work and traditional knowledge while increasing the perceived value of handicrafts.

“The story has to be told in a way that’s more appropriate to modern values. We believe that making innovative crafts a part of people’s lives is crucial to passing down the value of Thai arts and crafts to the new generations while simultaneously contributing to the strengths of the community in a sustainable way,” says Sacict’s chief executive says Amparwon Pichalai.

Millennials, she adds, already make up the most influential consumer group in the tourism and service industry. Ever eager to experience a different kind of lifestyle, this segment of society will continue to research what they are buying while comparing prices and quality, and pay attention to the origins from which product is sourced.

The “Tropical Dreams” trend brings nature into the home.

The “Retelling the Detailing” concept communicates contemporary designs in line with modern lifestyles. It represents the richness of original works in ways never seen before and preserves and transfers traditional knowledge to a new generation while enabling manufacturers, designers, local artisans to take pride and raise the value of the products bestowed upon them by ancestors.

“Retelling the Detailing” thus responds to Sacict’s initiative campaign, “Today’s Life Crafts – smart craft, craft studio, and craft society”. The other three trends for 2019 are “Tropical Dream”, “Righteous Crafts”, and “Surreal Hospitality”.

The trend book explains that storytelling provides an opportunity to communicate a good value that will lead a consumer to choose a specific product. And so, retelling the story provides an avenue to highlight new details about the manufacturing process including the material selection, designs, and a series of events associated with a specific product. It can be a story about how a brand was born or the history of a community craft passed on from generation to generation and which continues to flourish in even more attractive physical forms.

Part of the exhibition showcase in the gallery, “Grid Collection: Vastly Patterned” features a network of decorative diamond shapes with floral ornaments designed by Pornphun Sutthipraph. The delicate network of intersecting lines is redesigned and gets a contemporary look in Thai Benjarong (five-colour design) tableware. “Headphones” designed by Kris Putpim and Boonyarat Benjarong, stand out from other listening devices thanks to hoods concealing the drivers that are adorned with a criss-cross pattern symbolic of the Thai Benjarong traditional design.

“Patchwork” by Parsuree Wirachwiboolkit transforms the everpresent plastic chair into a seat everyone will love. 

With silk a manifestation of the Thai culture, designer Kris Yesudjai proudly presents the new work from the Mudmee silk Weavers Group of Baan Hua Fai, in Khon Kaen province. “Patchwork” is about transforming the common plastic chair into exciting new form, colour, and texture by upholstering it in multi-colour patchwork. Designed by Parsuree Wirachwiboolkit, it gives an ordinary object an entirely new meaning.

Thanavat Klongvishar and Prapanpong Suksawanf’s award-winning chair named “Where are you from?” is a great example of “Retailing the Detailing”. The pair, who won the Innovative Craft Award, used materials common in craft making such as rattan, wood, ceramics to build furniture that inspires and connects.

The second trend, “Tropical Dreams” refers to an attitude that has become entrenched in the mindsets of the new generation, with the “green is the new gold” code increasingly being adopted for home and workplace decor. Alternative materials are being pressed into service to mimic a natural environment and rising to the challenge is the “Bamboo Low Stool” designed by Plural Designs and the Bamboo Works Group of Baan Sri Pan Krua, Chiang Mai, which uses bamboo strands tightly wound up in a coil. The natural fibre stool is created out of four coils, three for the legs, and one for the seat.

Urbanites are also showing a preference for wood, with wooden lamps turning the room into a relaxing place and a wooden leaf chair adding to the impression of being part of nature.

The third trend known as “Righteous Crafts” is an attempt to show that what matters most consumers nowadays is the origin of products – the source of the raw materials. It is something both manufacturers and new-generation consumers are taking into consideration. In this way, they are able to repay or reward the community for their role in the development and preservation of handicrafts. The Bamboo Basket by Plural Designs has been working with the Bamboo weaving group from Baan Kai Noi, Mae Tang district, Chiang Mai province on this trend too, coming up with a raw material that not only has no environmental impact but which also generates more income for the locals. Also part of this trend are smart and casual outfits made from crafted cotton hand-dyed with organic substances that are nature-friendly.

Millennials enjoy luxury but are also keen on possessing an “experience”. The fourth trend ‘Surreal Hospitality’ caters to this new generation of travellers.

“Hotels these days often make their accommodations more exciting to entice Millennials to visit and experience new places rather than going to popular tourist destinations,” says Damrong Leevairoj, editor in chief of Room Magazine, who also curates the gallery.

“They often use handicrafts to add atmosphere. Crafts are works of art; they take time, manpower, and substantial amounts of money to make and this has turned them into items of luxury. If a hotel owner can work jointly with the artists and craftsmen in the community in creating outstanding pieces, they are sure to benefit and have interesting stories to tell.”

Highlight pieces include “Su-kwan” a suspended luminaire by Takorn Tavornchotivong that draws on the traditional welcome ceremony, Bai-sri-su-kwan, which is adorned with folded banana leaf, and a pendant wrapped in countless shimmering pieces of sheet metal folded and affixed to the enclosing boundary.

“Passion of Craft on the Wall” by designer Kritsanalak Pakkhakuntawi, features a papyrus floor mat that embodies the skill and knowledge of the traditional handicrafts found in all regions.

 The increasing prevalence of non-communicable diseases and an ageing population means healthcare resources will continue to struggle to meet the growing demand.

In the next decade, more Asians will suffer from chronic diseases such as cancers, cardiovascular diseases and diabetes, which will put strain on healthcare systems across Asia Pacific. It is expected that by 2040 there will be 350 million diabetics living in Asia, an increase of 110 million in about 20 years. By 2025 about 80 per cent of the deaths in the developed countries in Asia will be due to non-communicable diseases, while in emerging markets dual-disease dynamics will still be observed.

In parallel, we will see the number of elderly in Asia continue to rise. It is expected that the expenditure for elderly care in the region will increase fivefold by 2030 compared to that of 2015 . This again will put additional strain on healthcare systems and economies across Asia. In Thailand for instance, the growing number of elderly will undoubtedly lead to higher expenditure in health care, affecting the size of Thai economy by as much as 4.4 per cent in the next decade.

And with the middle-class continuing to grow, by 2030, Asia could represent two thirds of the global middle class population, creating an even greater demand for quality healthcare .

Meeting this demand however, will prove to be a challenge. The next 10 years will see a shortfall of nearly 18 million healthcare professionals in Asia Pacific. This will be exacerbated by a lack of efficient management in public health, insufficient infrastructure and restricted healthcare funding, especially in emerging markets. The gap between demand and supply is expected to increase in the coming years.

To address this challenge, healthcare providers and the industry as a whole will have to transform business models by using innovative technologies to make healthcare provision more efficient while also improving access. To this end, many countries have already embarked on Smart Health initiatives in various forms.

Many of these initiatives aim to move healthcare services for chronic disease management from hospitals to the community, closer to the patient. This will not only decrease overcrowding in hospitals, but make healthcare more affordable, efficient and patient-oriented. This is being enabled by innovation in digital technologies and platforms. A widely used platform is mHealth (Mobile Health), which allows doctors to diagnose patients through the use of smartphones. It is expected that 40 per cent of the doctor-patient consultations in the future will move from face to face to digital mHealth. This also includes remote diagnostics.

Another exciting trend in healthcare provision is Internet Hospitals, which are taking centre stage in the US and China. In this model, the majority of healthcare delivery is provided by digital means, except in the case of surgery or emergency cases where patients will still need to physically see medical professionals in a traditional setting. This is a rapidly evolving trend across Asia Pacific with South Korea and Australia planning similar models.

While many of these models are already being implemented, the rapidly evolving healthcare environment presents both challenges and opportunities. To understand this in greater detail, Roche Diagnostics Asia Pacific recently conducted an extensive study on the future of healthcare in Asia Pacific focusing especially on in vitro diagnostics (IVD).

The study has been conducted through collaboration with numerous stakeholders within and outside healthcare industry and across various Asian markets. The aim was to understand what the ideal healthcare environment – where every individual has access to high quality, affordable healthcare – would look like. The study also delved into what would constitute the patient journey in this “clinical utopia”.

In this “clinical utopia”, we will know much more about a baby through non-invasive foetal testing. By the time baby is born, its baseline healthcare profile will already be established. Before or at birth, the baby will have an embedded sensor. This device will monitor various health parameters in real-time which will be uploaded onto a personalised, highly secure cloud. The person will have control and ownership of his/her profile. Based on the information collected, this person will obtain real-time advice provided by artificial intelligence on how to manage his or her health and lifestyle in order to keep healthy.

In case of sickness, a person will get an alert with crucial information to manage the illness and recommendations from their healthcare providers. What will be truly game-changing is that an individual’s personal intelligence cloud could also feed into a larger population gathering database. This is where the public sector will access information.

In case of serious illness, the person will be sent to a hospital, which will be equipped with the latest technologies and robots and where care will be provided on-the-spot and efficiently. In the clinical utopia environment, a majority of the diagnosis will be done through sensors and people will be kept out of healthcare system thanks to an efficient and preventive healthcare model. We will see a marked shift from the reactive, episodic care we receive today. As a result, there will be a significant decrease in healthcare costs.

Ultimately, our ability to effectively harness technology will determine the future of healthcare. Patients today want easier access to care and demand better service, and this trend is here to stay. With this, patient centricity has become, and will continue to be, a focal point for innovation and healthcare delivery, now and well into the future.

Dr Jozica Habijanic is Country Manager at Roche Diagnostics Philippines and led the study in her former role as Head of Strategic Development at Roche Diagnostics Asia Pacific.

The mother was admitted at 9.30am, the birth recorded at 9.35. Women often arrive in extremis at the Doctors Without Borders maternity hospital in southeastern Afghanistan, one of the most active in the world, with more than 60 babies born daily.

The early hours of the morning are the most feverish for the hospital – affectionately known by the NGO as “the baby factory” – just a stone’s throw from Pakistan’s tribal areas, in Khost province.

The Taleban are active in the region and roads are often dangerous after dark, so when 25-year-old Asmad Fahri felt her contractions begin at night she knew she would have to wait until daybreak to begin the three-hour journey to the hospital.

Finally she is resting, her infant tightly swaddled and asleep between her knees.

On average new mothers are kept in the ward for six hours, but she has asked to leave after just three, to ensure she reaches home before darkness falls again.

Sometimes the mothers have to travel for days, in pain and bleeding, over unpaved, insecure roads in carts or by whatever mode of transportation they can find.

In an opposite wing, the delivery tables continuously welcome newcomers.

Most only have time to lift the long layers of clothing hiding their bodies and wedge their coloured veils between their teeth, too rushed even to change into MSF’s standard red pyjamas.

The Khost Maternity Hospital (KMH) opened at the end of 2012 in a medical desert in the conflict-riven country with one of the highest infant and maternal mortality rates in the world.

It was an overnight success, with nearly 12,000 deliveries in its first full year in 2013.

By 2017 that figure had nearly doubled, to 23,000.

This year the hospital is on track to deliver 24,000 babies, says Dr Rasha Khoury, a Palestinian gynaecologist who is medical officer at the site.

If so that puts it within crying distance of the busiest maternity wards in the United States, where the Northside Hospital in Atlanta delivered 27,000 babies in 2016, the highest number in the country that year.

“Here we are saving lives for free,” smiles Safia Khan, 24, the assistant manager of the midwifery team.

Behind her, a young mother of twins searches her skirts and hands her a folded banknote. It is a traditional gesture of gratitude after delivery, at times required in some hospitals but politely declined here. “It’s forbidden,” insists Khan.

The UN and the World Bank put maternal mortality at around 396 deaths per 100,000 live births in Afghanistan.

But the figure is disputed, with experts pointing out it is an improbable fall from the 1,600 per 100,000 recorded in 2002.

Such a decline would mean Afghanistan would have reached its Millennium Development Goal set by the UN some five years early, a study published in the medical journal the Lancet noted in 2017.

The authors of that study say more credible figures released by the Afghan government in partnership with USAid suggest maternal mortality could still be as high as 1,291 per 100,000 – meaning that giving birth is around five times more deadly for Afghan women than the conflict itself.

If so, it is a staggering figure 17 years after the fall of the Taleban regime, despite billions of dollars in international aid, in a country with one of the youngest, fastest-growing populations in the world.

Dr Khoury says that MSF facilitates around 40 per cent of the births in Khost, which has an estimated 1.5 million inhabitants.

But to make a real dent in the mortality rates in the face of these challenges they would need “three hospitals like MSF”, she says.

On top of war, poverty, and a galloping population, the medical staff face a further obstacle: the Pashtunwali, the patriarchal social code of honour that dictates life in the conservative Pashtun tribal region where Khost lies.

Under the Pashtunwali the genders must be segregated, and a woman must never show her face to a stranger.

As such, medical staff at the hospital are exclusively female, with the exception of some anaesthetists and the director of the neonatology department. Even so, a little persuasion has at times been necessary, says Salamat Khan Mandozai, a respected local figure who deals with security for the hospital and has also acted as a community liaison.

“In this rural environment, some women still prefer to give birth at home,” he notes.

Going to hospital embarrasses them, agrees Safia Khan – birth is a private matter.

Dr Khoury says the hospital is aware that many women are not coming to them, but adds that the families who do come do so “without hesitation”.

For many, she adds, obstacles are not about culture, but finances – namely, paying for transportation – or safety and security, especially at night.

Women must also wait until a man of the family is available to accompany them, she says.

But once inside the hospital power returns to the mothers-in-law who escort the patients until they reach the doors of the delivery room.

“We are really reaching people at the margin of the society in Afghanistan,” says Dr Khoury.

“It’s a success story.”

Undertaken by Jaume I University in Spain, researchers found that adherence to Mediterranean diet improved teenagers’ school performance because of the eating plan’s ability to promote brain development, increased by healthy fats found in olive oil and fish, and overall better sleep quality.

“Academic performance during adolescence has a significant influence on future health and work conditions,” said the research authors at Jaume I University in Castellon, Spain.

In the study, published in Acta Paediatrica, 269 teenagers of an average age of 13.9 were recruited in Castellon, Spain. Analysis of the data showed closer adherence to the Mediterranean diet was linked to better scores in core subjects, language and verbal ability, as well as higher grade point averages.

According to the Centre for Educational Neuroscience in London, nutrition affects children’s performance in school for more mentally demanding tasks, short-term memory, and in the case of children who are poorly nourished in general.

Supporting the research is the fact that the Mediterranean diet is filled with wholesome foods such as fresh fruits, vegetables, whole grains, nuts, olive oil and fish – which provide a beneficial amount of vitamins, fats, and minerals to allow the body and brains of growing students to function at an optimum level.

Thai parents can also support their children’s learning abilities by monitoring diets, which plays a proven part of helping to increase the ability to learn. Incorporating nutrient-rich ingredients found in the Mediterranean diet in easy Thai home-made recipes cooked with olive oil, such as salmon fried rice, stir-fried vegetables, stir-fried noodle with shrimps can easily support brain capacity for Thai children.

“The health benefits of olive oil, such as high antioxidants and the ability to lower cholesterol and protect against heart disease are well-known around the world. The fact that research continues to reveal new ways that olive oil can help support good health, is a testament to its centuries of usage. If the Mediterranean diet and olive oil consumption can help teenagers and children reach their full scholastic abilities, then we are very proud to be able to offer the best quality olive oils to our Thai consumers,” says Alberto Perez Martin, head of Bertolli Thailand.

According to Board Certified Naturopathic Doctor Erica Steele of Holistic Family Practice in Virginia, USA, olive oil’s role in this study is closely linked to brain development.

“The Mediterranean diet has a positive outcome on brain health and brain development due to its high amount of omega-3 fatty acids, which are considered ‘smart fats.’ These fats supply building material for the brain and offer substantial memory-protective qualities.” In a study published in the Neurology Paper, scientists discovered that those with lower blood concentrations of omega-3 fatty acids performed worse on assessments and thinking tests that involved memory and problem-solving. The heart-healthy MedDiet also seems to be good for the brain.”