Promoting workplace health and safety in urban public space: reflections from Durban,South Africa

Abstract

This article is a critical reflection on the Phephanathi Platform, an ongoing collaboration among organizations of informal traders working in the Warwick Junction markets in Durban, South Africa and their support organizations. The purpose of the Platform is to experiment with the extension of occupational health and safety to informal workers working in urban public space through the establishment of an integrated urban health platform. The article is concerned not only with the practical aspects of the Platform, but also assesses the Platform as a political strategy. It focuses on two key pieces of work – the design and rollout of first aid stands into the markets, and the attempt to institutionalize occupational health and safety for informal workers within the local municipality. The article concludes with a meta-reflection on the work, elaborating on some of the important questions that are raised and drawing out the implications for integrating occupational health and safety into the urban environment.

I. Introduction

The problems attendant on urbanization in the global South are often framed in terms of the challenges they pose to housing provision and the provision of basic services to informal settlements. Within the global urban agenda far less attention has been paid to the need to accommodate the many informal workers who earn their incomes from urban public spaces, whether those spaces are located in informal settlements or in more central parts of the city.⁽¹⁾ With some important exceptions,⁽²⁾ this has also been largely true of the urban health literature,⁽³⁾ which often nods to the issue of employment without delving any further into the question of how a focus on livelihoods might alter the shape of proposed solutions to urban health problems. Certainly, when informal urban livelihoods are moved to the centre of the analysis, the argument for integrated urban health planning⁽⁴⁾ takes on an additional dimension. Most notable is the need to add occupational health into the institutional mix alongside basic services, adequate infrastructure and general curative health services. Whilst there are clear overlaps between occupational and environmental health, an occupational health perspective that foregrounds the importance of livelihoods is essential to protecting the interests of informal workers.

This article, written by the project staff, is a critical reflection on a project that began as a means to think through and experiment with extending occupational health and safety to informal workers operating in urban public space. The project is called the Phephanathi Platform (Phephanathi means “to be safe with us” in isiZulu).⁽⁵⁾ It is an ongoing collaboration between street trader organizations working in Warwick Junction, in the inner city of Durban, South Africa, and their support organizations, Women in Informal Employment: Globalizing and Organizing (WIEGO)⁽⁶⁾ and Asiye eTafuleni (AeT).⁽⁷⁾ Both WIEGO and AeT are non-governmental organizations working with the informal economy. The Phephanathi Platform has attempted to link traders to various parts of the health system – local government, occupational health professionals and the public health system – through a number of different strategies. The paper is intended to highlight the key debates and challenges encountered during the process of establishing the Platform. It is hoped to be a means by which to generate greater discussion about how to extend occupational health and safety to informal workers operating in urban public space.

Importantly, the strategies chosen have been informed by an agenda of empowerment and participation of the street traders involved – something that Barten et al. have argued is central to improvements in health equity.⁽⁸⁾ Whilst the Phephanathi Platform is a practical response to the very real health and safety needs of these informal workers, who operate in a highly insecure and often violent environment, it has also been part of a political strategy. Just as residents of informal settlements have had to strategically engage in ways to legitimate their presence in the city,⁽⁹⁾ so street traders have had to legitimate their presence as workers in urban public space.⁽¹⁰⁾ This has been an important issue in Warwick Junction, where contestations between the local government and traders over the use of public space as a workplace are an almost constant feature of the urban environment. Through its health-related activities, which link informal traders to the formal and informal institutions that impact on their health and safety at work, the Phephanathi Platform has attempted to increase street traders’ awareness of their role as workers and economic contributors, and their right to occupy and engage with the public spaces in which they work. In this way the Platform could be seen as an example of Henri Lefebvre’s proposition on operationalizing the “right to the city” through urban praxis and experimentation, where theoretical ideas are “tested against real conditions”.⁽¹¹⁾

This article integrates a discussion of occupational health and safety in the urban environment with these political aspects of the work. As such the article situates itself not only within the literature on urban and occupational health, but within the large and diverse literature on the political strategies of grassroots organizations. It starts with a brief review of relevant literature on this topic, before moving onto a more detailed discussion of the Warwick Junction context and the Phephanathi Platform itself. This is followed by a discussion of some of the key project activities, drawing on both an external, independent evaluation of the project and an internal evaluation conducted by project staff members. The article ends with a meta-reflection on the work, elaborating on some of the important questions that it raised and drawing out the implications for integrating occupational health and safety into the urban environment.

II. Social Movements and Political Strategy

Debates concerning the political strategies of social movements are numerous.⁽¹²⁾ Two key areas have direct relevance for this paper. The first concerns the use by various social movements of strategies that seek to link the informal to formal state institutions through what has been termed “co-production”. This is where grassroots organizations, instead of demanding services from the state, instead choose to “co-produce” them with the state. Such strategies have been used to great effect by both informal settlement dwellers and informal workers around the world to deal with pragmatic concerns around the delivery of basic services, as well as to generate more reliable incomes for informal workers.⁽¹³⁾

As Mitlin points out, however, much of the literature on co-production focuses on the services produced – the end product – and does not engage with co-production as an explicit political strategy.⁽¹⁴⁾ Yet, as she argues, the end products of co-production are the physical manifestations of (often) long political processes, where the less powerful have strategized to engage with the more powerful state institutions that surround them. A large part of this work is about relationship building – establishing trust between grassroots organizations and the state and, where possible, avoiding confrontation, in the hope that practical gains can be made. According to Mitlin, such work assumes a proactive stance – it attempts to move things forward – as opposed to a more defensive stance that seeks to protect relatively powerless communities from further dispossession.⁽¹⁵⁾

Cautions have also been raised about such strategies, which ultimately seek accommodation with the state rather than action against it. There are those, for example, who have expressed concerns about co-production and the shifting of responsibility for service provision away from the state and onto poorer people.⁽¹⁶⁾ Others have argued that because of the unequal power relations between the state and poor communities, a huge amount of work has to be put into ensuring that such arrangements end up favouring the poor.⁽¹⁷⁾ On a more general level, it has been argued that accommodationist strategies, which shy away from direct confrontation and action against the state, may ultimately lead to the “taming” of more radical visions for how society could operate.⁽¹⁸⁾

A second set of debates, which link to the co-production discussion, revolves around the relationship between NGOs and grassroots organizations.⁽¹⁹⁾ Carroll, for example, suggests that NGOs that act as support organizations for grassroots movements are important in a context where such movements lack the time and resources to work entirely independently.⁽²⁰⁾ On the other hand, de Wit and Berner view the alliances between NGOs and grassroots organizations in more negative terms, arguing that NGOs are often guilty of initiating grassroots work as a way to “legitimise their claim to represent the poor”. In doing so they establish and support exploitative and uneven power relations on the ground, where great power is bestowed on a few chosen intermediaries who are able to bridge the gap between the NGO and the communities with which it works.⁽²¹⁾

The issues described in this short review will help to frame the reflections on the Phephanathi Platform as a political strategy, which is an attempt to “co-produce” a workplace health and safety system in an informal place of work, and where NGOs have worked together with informal worker organizations. It must be mentioned, however, that this paper is a reflection on work that is still in its early stages. As a political strategy, it has not yet led to sustained gains for the informal workers – it cannot yet be judged a success story (or not). What a focus on the early stages of the work allows for, however, is an understanding of the political process – the questions that have to be asked, and the choices that are made, attempting to provide some insight into when, where and how such strategies might be catalysed through health interventions.

III. Setting the Context: Warwick Junction and the Politics of Informal Trade

South Africa has a relatively small informal economy, compared to other sub-Saharan countries, with only 33 per cent of all working people classified as informal.⁽²²⁾ Informal trade and work in private households make up the two biggest sectors of the informal economy, with the Quarterly Labour Force Survey from the second quarter of 2010 estimating that more than half a million people work as street vendors in the country.⁽²³⁾ Between 6,000 and 8,000 of Durban’s informal traders work in an area called Warwick Junction, which sits on the edge of the inner city, and is one of the primary transport nodes, mainly serving workers coming into town from the outlying townships. The movement of people through the transport node, as they move from trunk to feeder routes on their way to and from work, has catalysed the development of a vibrant economic hub.⁽²⁴⁾

The relationship between traders in Warwick and the local government authorities who most directly control their place of work has shifted over the years. Whilst apartheid policies were punitive and tried to exclude informal trade in urban public space, there was a change in attitude after South Africa’s first democratic elections in 1994.⁽²⁵⁾ A new spirit of inclusivity and experimentation with more participatory forms of local governance resulted in the Warwick Junction Renewal Project, which invested over 40 million rand (approximately US $10 million at the 1995 exchange rate) in the previously neglected area.⁽²⁶⁾ These post-apartheid developments resulted in the development of Warwick into nine distinct markets, where a diverse mixture of goods are on sale. The Bovine Head Cooks Market sells cow head meat (a Zulu delicacy); fresh fruit and vegetables and Indian spices are sold in the Early Morning and Victoria Street Markets; music, clothing and other everyday goods are sold in the Brook Street Market and the Music Bridge; Zulu traditional medicine is sold in the Herb and the Lime and Imphepho (a type of incense) Markets; mielies (corn on the cob) are cooked and distributed from the Mielie Cooks facility; and intricate Zulu beadwork is on sale every Friday at the Bead Market.

However, in more recent years, there has been a deterioration in the relationship between the city and the traders.⁽²⁷⁾ Skinner argued that the announcement in 2004 that South Africa would host the 2010 World Cup was a key moment in changing the relationship. South African cities began to compete amongst one another to host football matches, and there was a general push in Durban towards “upgrading” public spaces in a manner that was not inclusive of street traders.⁽²⁸⁾ This culminated in a heated legal battle in 2010, where traders from the century-old Early Morning Market (which sits within the Warwick Junction precinct) and their allies successfully took the city to court over its proposals to demolish the market in favour of a mall development. While the court battle was a success for the traders in legal terms, it has resulted in an even more tense and difficult relationship between the traders and the city officials. Sometimes this is expressed passively through neglect – it is a constant battle for the traders to have basic services and infrastructure maintained in the markets, and in some markets these are completely absent despite traders paying rent to the city. Sometimes this difficult relationship is more aggressively expressed through confiscations and harassments. In 2015 the legality of these actions by city officials was challenged through another trader-led court case, where the judge ruled that such confiscations are unconstitutional, and ordered the city to compensate the trader whose goods had been impounded by the Metro Police.⁽²⁹⁾

The tense relationship between traders and local government in Warwick is mirrored in the relationship between trader organizations. Pat Horn, the International Coordinator of StreetNet International, a global federation of street vendor organizations, has discussed the troubled history of trader organizations in Warwick Junction.⁽³⁰⁾ During the period of open governance after 1994, democratic membership-based organizations (MBOs), such as the Self-Employed Women’s Union (SEWU), established themselves and were able to engage the municipality successfully on a number of issues. However, the city’s change of attitude after 2004 made successful engagements more difficult, which impacted on the strength of the organizations. Moreover, the city began to impose rules on street trader organizations, restructuring the Informal Traders Management Board from an independent umbrella body of associations into an umbrella body of municipality-controlled street committees, with questionable democratic practices.⁽³¹⁾ Some of the stronger MBOs collapsed under the pressure, and although new ones have emerged, the municipality-aligned street committees remain in place and are a source of power struggles, disputes and fragmentation amongst traders. Questions around representation and legitimacy are raised frequently amongst trader organizations.

IV. The Phephanathi Platform: Empowerment through Occupational Health

The Phephanathi Platform was designed by WIEGO and AeT as an intervention to address the health concerns of the traders in Warwick Junction, and simultaneously as a means by which to engage with the social and political dynamics described in the previous section. The project design drew on the long experience of AeT staff members, some of whom have worked with traders in Warwick for over 20 years, and on WIEGO’s experiences with extending occupational health and safety to informal workers in different parts of the world. Although the project design was initiated by the NGOs, the intention is that its form will be increasingly determined and directed by the trader organizations as they become more aware of the options available to them.

Health is a key concern for informal workers, because ill health often results in a loss of income. Data from WIEGO’s Informal Economy Monitoring Study⁽³²⁾ revealed that almost 25 per cent of women street vendors and 20 per cent of male street vendors cited poor health/illness as a reason for not working in some of the 12 months of the previous year. In the Durban sample 99 per cent of women and 100 per cent of men stated that if they could not work due to illness, they would not be able to earn anything (i.e. there was no assistant who could take over from them for the day).⁽³³⁾ In their workplaces, traders are exposed to many of the urban health hazards identified by Satterthwaite, including biological pathogens, chemical pollutants, physical hazards, and poor urban infrastructure.⁽³⁴⁾ There are also the ergonomic health hazards associated with work tools and processes, and which often take a significant toll on the musculo-skeletal health of informal workers.

Ultimately the Platform is trying to establish a model for participatory and integrated forms of urban health provision that might serve as an example of how workplace health and safety can be extended to informal workers working in urban public space. Part of the work of the Platform has been to engage strategically with the discipline of occupational health. The question of how to extend occupational health and safety to informal workers has become a concern of the discipline, as it seeks to engage with the world outside of the high-income countries in which it originally developed. By law self-employed workers are responsible for their own health and safety in South Africa. But this does not take into account the poverty of many informal workers, the necessity of self-exploitation in the context of minimal earnings and tiny profits, and the difficulties of promoting individual responsibility for health in a context where basic urban services, such as water, sanitation and waste management, are lacking or inadequate.⁽³⁵⁾

The theoretical idea “being tested against real conditions”, in this case, is the idea that workplace health and safety can and should be brought into conversation with the urban environment and the institutions that govern it. Whilst workers’ self-regulation of workplace health and safety is important, it must be accompanied by supportive policies and practices from the institutions – municipalities – that control the public spaces in which informal workers work, so that workers are enabled to take their health and safety more seriously. In this way, the Platform’s work can be thought of as an attempt at linking the informal with the formal, and even “co-producing” a health and safety system. An important aspect of this has been to use the occupational health interventions to foster better relationships between the traders and local government officials, and to get traders to talk to each other across markets and groupings, in the belief that these relationships are key to building a system based on collaboration.

A key part of facilitating the traders’ participation in the Platform has been the establishment of the Phephanathi Committee, made up of traders’ representatives from each of the Warwick markets. This committee acts as the decision-making body for the Platform’s work, and is considered the equivalent of a workplace health and safety committee. The role of the NGOs is to facilitate connections among the members of the committee and different parts of the health system. The decision to include trader representatives based on the market in which they work (which may or may not be governed by a democratic trader organization), rather than more democratic MBOs (which operate in some, but not all, markets), has caused debate amongst project staff. Some staff members felt that it would be more appropriate to work with one democratic cross-market organization and use the work as a way to develop that organization, whilst others argued that the Platform needed to be as inclusive as possible and encourage unified action across all the Warwick markets, even if it meant working with some problematic organizations. In the end the latter approach was taken, following the reasoning articulated by Mitlin and Thompson that within such participatory projects it is important, where possible, to “turn potential win-lose situations into win-win or positive sum situations where everyone gains and no one loses”.⁽³⁶⁾

The remainder of this paper is dedicated to a discussion of two of the Platform’s activities to date – the participatory design and rollout into the Warwick markets of first aid stands, and the attempt to draw municipal officials concerned with issues such as fire safety and sanitation into supporting the Platform. These initiatives have been chosen because they reflect and highlight the balancing act that has to be performed between the promotion of self-reliance amongst traders, and the necessity for facilitating institutional support. The discussions below draw on data collected during two project evaluations. The evaluation of the first aid stands was an internal evaluation conducted by WIEGO and AeT staff members. It involved an audit of the stands, followed by semi-structured interviews with nine traders (one per market). The second discussion below on institutional strategies draws on project records and the findings of an independent, external evaluation of the Platform, which included semi-structured interviews with traders and local government officials, as well as project staff from the NGOs involved.⁽³⁷⁾

V. Integrating Occupational Health into the Urban Environment through Design Interventions: the First Aid Stands

The Phephanathi Platform has attempted to integrate occupational health into the urban setting in a number of ways. Occupational health and safety training courses were run in the markets, as were health assessments, where medical professionals were brought into the market to assess basic health problems (blood pressure, and blood sugar in particular), as well as respiratory and reproductive health issues related to work. The occupational health practitioners involved in these assessments were exposed to a very different context from the formal workplace environment, and their experiences have been written up in a companion piece to this article.⁽³⁸⁾ Another way the project attempted to address occupational health in the urban environment was the design of first aid stands specifically adapted for use in a public marketplace, as opposed to a formal workplace. In all of this work the common idea has been to draw on ideas derived from formal workplace health and safety systems and to insert them into the context of urban public space.

In 2010, AeT (the Durban-based NGO) distributed the basic first aid kits that can be found in most formal places of work, to traders in the Warwick markets. This was shown to be a successful intervention, particularly in markets such as the Bovine Head Cooks, Mielie Cooks and Herb Markets, where axes, knives and hot stoves are used regularly to chop and pound medicinal herbs, meat and vegetables. However, although the traders had made a great effort to look after the first aid kits, it was clear that the environment in which they work had constrained their ability to do so. Several boxes had been stolen, and some had been damaged by the weather because of inadequate storage facilities. The challenge for the Phephanathi Platform therefore was to design a protective storage device for the first aid boxes.

The design process started with a Level 1 First Aid training course, which was attended by five health and safety representatives from each market, including those nominated to sit on the Phephanathi Committee. Once the training was complete, and traders had a greater awareness of the possible uses of the first aid boxes, they were engaged in the process of designing the stands that would house the boxes and deciding on their location in the markets. In the end, the stands took the shape of wooden, collapsible A-frames, covered by a white plastic sheath displaying a large green cross. The first aid kits fit onto a platform between the legs of the stand, and are protected by the plastic sheath. The kits can be chained and locked to the A-frames, and the A-frames can be locked onto a trader’s table.

The internal evaluation of the stands by the NGO staff was conducted six months after they were placed in the markets. Different markets displayed different levels of engagement with the stands and the boxes. This largely depended on the type of work done in each workplace. In the Bovine Head Cooks and Herb Markets the contents of the first aid kits had already been depleted due to the number of injuries and burns that had required treatment. In other markets where the focus is retail rather than production, usage was predictably much less. However, whether or not the kits had been used extensively, a definite sense of pride was attached to them, embodied in the fact that they had been given their own nickname: “The Green Crosses”. As one trader stated: “This has increased visibility for our market. When visitors and customers come to the market, they are impressed that we have a first aid box, they ask us about it and this makes us proud.”

The placement of the stands in all the Warwick markets has also been important, according to the traders, as it had been a signal to the municipality that they are able to work together across markets, despite the municipality’s “divide and rule” strategy; “…now they know that the traders from all the markets are working together in unison because they see the same first aid stands in all the markets”, said one trader. Yet the visibility of the stands has also been a problem in some markets. In the Brook Street Market, which is situated next to a minibus taxi rank, the stand has been hidden in the stall of a trader, because of the worry that it would attract attention during a recent spate of taxi violence. The concern was that those involved in the violence would see the green cross and assume that they could get medical help, thereby drawing the violence into the market.

On a positive note, the presence of the stands has led to cooperation between the traders and the municipal security guards working in the market. A trader from the Herb Market reported: “The market security officials are helping with the boxes when I am not around. They pack them when the market closes at 6pm and bring them out in the morning. They have been good with that. Sometimes if I am not there to take the boxes out, they would ask me what I have done with them…this shows that they value them as much as we do.” However, several of the Phephanathi Committee members interviewed also complained that they were struggling to negotiate combined responsibility for the stands with the other health and safety representatives from their organizations who had been trained in first aid. “In the beginning we tried to take turns in looking after it, but I found that some of the traders were not fulfilling their responsibility and I always had to check up on them. At the end it was easier just to take full responsibility for it myself”, complained a trader from the Bovine Head Cooks Market. This does lead to questions about the commitment of trader organizations as a whole versus the commitment of a few individuals to maintaining the boxes and stands.

VI. Institutional Strategies: Building Relationships through Joint Activities

Another set of activities revolved around an attempt to improve relationships between local government and the traders, as a way to catalyse a healthier and safer workplace. Whilst the relationship between the traders and the municipality has been generally bad for some years, this is true for some departments more than others. The decision was taken to engage with departments where more positive relationships existed (or could exist), and to keep the engagements as practical as possible – to take the focus away from highly contentious issues and to deal with very practical concerns such as fixing a fire hose or a toilet. The hope was that this practical work would improve and/or consolidate relationships with the departments involved, result in short-term gains for the workers, and have a knock-on effect in terms of improving relationships with departments other than those directly engaged in the work.

A second key decision was to seek out and work with mid-level officials who had previously shown some interest in the Warwick markets, rather than going to the heads of departments to seek approval for the work. Approval from the top may have been theoretically preferable in terms of institutionalizing the Platform, but there was no guarantee that this would be forthcoming considering the existing relationship between traders and the municipality. The idea was to build a network of sympathetic officials – drawing them in through the project activities, and hoping that once they became interested, they would draw in colleagues from other divisions. Once a critical mass was achieved, it was felt that there would be stronger grounds for bringing the Platform to the attention of higher-level officials.

The first “friendly face” was within the Fire Department, and it was a group of three fire safety officials that attended the first activity. This was a joint fire hazard mapping session in the markets conducted jointly by the Phephanathi Committee and the officials (who were joined by a colleague from Disaster Management who they had convinced to attend). What was striking about this exercise was not so much the hazard map that emerged, but the way the activity challenged the nature of the relationship between the traders and the officials. At a preliminary facilitated session prior to the mapping exercise, it became clear that both groups had predefined ideas about one another that had developed in isolation from any meaningful contact.

Traders openly stated that they felt the fire services had been neglecting their needs, citing a previous fire incident in the markets: “It would be very helpful if we could have fire extinguishers because the municipality is not prepared to act, we’ve approached the municipality but there has been no response at all”, said one trader. On the other hand the Fire Department officials related a very different story. They said that they had been asked by the municipality to run a fire safety training course for traders in Warwick Junction. They had sent out pamphlets to raise awareness about the training session, but on the day no one had arrived. The fire officials then went out into the markets to try and give individual training and tips to traders, but found that traders “turned their backs” on them. They were therefore sceptical about participating in the fire hazard mapping process. This seems to have been an example of complete communication failure.

However, with the NGO AeT playing a bridging role between the municipal officials and the traders and helping to facilitate the risk mapping exercise, the fire officials encountered a very different scenario. They were greeted by traders and were able to dispense fire safety tips and advice as the risk mapping progressed. At the reflection session held afterwards, traders expressed their gratitude for the way the fire officials had engaged with them, saying, “We really appreciate the efforts of the fire officials giving out information to the cooks today, especially about where gas should be stored. We really need this information.”

The fire hazard mapping had some important effects. Aside from the imagery of “never before seen pictures of city personnel and traders looking [together] at a broken fire hose”,⁽³⁹⁾ it led to the fire safety officials designing and delivering a fire safety training course aimed at the traders. It also led to raised awareness on the part of the official from Disaster Management. He took it upon himself to arrange for a similar hazard mapping to be conducted with sanitation officials, who then arranged for the toilets in the Herb Market to be repaired. Project evaluation interviews with the participating city officials reflected positive attitudes towards traders: one of the fire officials reported real excitement about developing a relationship with the traders during the project, and another said that he was impressed by the knowledge traders had of the hazards that they faced at work – a very different attitude from the more common assumption that traders have little knowledge about anything.⁽⁴⁰⁾ A before-and-after perception survey of approximately 30 traders also revealed that the traders who had participated in the joint activities rated their relationship with the municipality as better than those traders who had not participated.⁽⁴¹⁾

More difficult, however, was sustaining and building on these nascent relationships. It was very encouraging when the official from Disaster Management appeared, on his own initiative, to become a champion of the Phephanathi Platform from within the municipality. However, the reliance on one individual was also problematic. The impetus behind the work slowed dramatically when a bout of xenophobic violence hit Durban in early 2015 and this official’s full attention was, quite rightly, drawn to dealing with the aftermath of the attacks. At the same time, the court case challenging the confiscation of traders’ goods by the Metro Police was adjudicated in favour of the traders. The case had been facilitated through AeT, and, although it was difficult to substantiate this, there was a feeling amongst project staff that the municipality was now less willing to engage in joint work.

Without the cooperation of an internal person, it was difficult to negotiate the intricacies of the bureaucracy. For example, an attempt to have a drain cleared in the Bovine Head Cooks Market was made very difficult because two departments share the responsibility for drain clearance, and both were able to avoid the work by repeatedly shifting responsibility onto one another. Attempts to have the existing fire safety equipment in the markets fixed ran into similar problems. While some of the Fire Officials maintained that it was the responsibility of the municipality to maintain this equipment, others claimed it was the responsibility of the “occupiers of the building”, meaning that it was the responsibility of the traders.⁽⁴²⁾ Without internal consensus on the matter, it was difficult for an external force to hold anyone responsible.

VII. Conclusions: Reflections on the Phephanathi Platform

Although the Phephanathi Platform is in its infancy, the above reflections do link to some wider debates about political process, strategy, and the integration of occupational health and safety in the urban environment. Political strategies that involve co-production often revolve around infrastructure provision (housing, basic services and so on). As has been pointed out, a critique of the co-production literature is that it focuses too much on the end product (the infrastructure or institutions that are produced), and not enough on the social and political processes that are embodied by the end product.⁽⁴³⁾ Even here, however, infrastructure is commonly thought of as the end point – it is the political processes that produce the infrastructure.

However, the example of the first aid stands shows that the role of physical infrastructure can also be productive of social relations, and of an urban praxis. As Anderson argues in relation to what she calls “activist design”, whilst designers of physical infrastructure “cannot create relationships”, they can “clear the way” for relationships to develop and “give birth to the possible by creating opportunities for praxis to occur”.⁽⁴⁴⁾ This has certainly been the case with the stands, which have, in their modest way, initiated important conversations amongst the traders about their collective responsibility for contributing to a healthier and safer working environment – conversations that will be taken further in future project work, and that have facilitated, in a very visible way, a sense of solidarity among the Warwick markets in their fight to be “seen” by the municipality. This then adds design work into the mix of political strategies that can be drawn on by grassroots movements. And, considering that not all infrastructure guarantees positive praxis (and improved health at the same time), it leads to questions about precisely what it is within the design process and outcomes that allows for more positive outcomes.

The role of design work not only in promoting social relationships, but also in promoting better health, creates an important point of intersection between the “urban” professions that involve an element of design (planning, architecture and so on), and the occupational health profession, where design specialisms such as ergonomics are situated. The possible intersections between the urban and the occupational are not always so clear cut, and would certainly be one area in which closer cooperation between the two professional fields may result in more innovative work that crosses disciplinary boundaries.

Aside from the design work, the activities discussed in this paper have also highlighted a number of tensions that exist within the political strategies of the trader organizations and their supporters. Perhaps most obvious is the tension between the cooperative, conciliatory approach taken by the Phephanathi Platform, which has attempted to move into a proactive space, and the more confrontational legal strategies that traders have been forced to use to defend their goods and workplaces. The legal victories have been very important – potentially precedent setting for the country as a whole in the confiscation of goods case. Yet there are also possible trade-offs involved, particularly in a relatively small geographical area such as Warwick Junction, where both proactive and defensive strategies are aimed at the same local government.

The assumption behind the Phephanathi Platform was that these strategies could, and in reality usually do, coexist. By engaging more accessible government departments, which had not been involved in any legal action, the hope was that it would be possible to move in a proactive direction despite a context that promotes defensiveness. By the end of the first phase of the work, there was a sense of the limits to this approach – that the project could only get so far with its network of supportive mid-level bureaucrats, who would eventually have to seek approval and cooperation from those who had been bruised by the legal action. However, it is also true that the initial hypothesis was not fully tested in this work – with more time, resources and effort, the network may have grown strong enough to make significant gains. It is also the case that Warwick Junction is a relatively small area that has been subject to intensive scrutiny and contestation. The concentrated focus on this one area may mean that there is very literally less room for different strategies to coexist than in more diffuse, dispersed situations. The question then is still an open one: In a context where defensive strategies will always be necessary, how, and under what conditions, can proactive political strategies be successful?

A second tension is that between the aspects of the work that emphasized self-reliance (the first aid kits), and those that emphasized the importance of institutional support for a safer and healthier working environment (the hazard mapping and engagements with local government). Ultimately the goal was to combine the two strategies – traders taking responsibility where they could for maintaining their working environment, but being enabled to do this by more supportive local governance. Unsurprisingly it was easier to make gains on the self-reliance front than in the area of institutional support; the first aid stand intervention was not without problems, but it is certainly easier to say that something positive and concrete has emerged out of the work. Yet the fact remained that the effectiveness of the first aid stands was circumscribed by the environment. The example of the stands being hidden in one of the markets to avoid attracting violence highlights the potential contradictions in the attempt to create small pockets of security within a highly insecure environment.

Yet finding the balance between self-reliance and state support is crucial if the Phephanathi Platform is to avoid becoming “just” another example of occupational health and safety as self-regulation in and by the informal economy and informal workers. The “quick wins” might come from the self-initiated work, and may additionally be a morale booster for traders, but the work to engage with government around a more supportive environment has to be ongoing. As this article has shown, it is difficult to do this. Not only does it take time, it takes someone who is able to negotiate a confusing, complex local government bureaucracy, where trying to fix something as simple as a drain can involve interactions with multiple municipal departments. This is exacerbated by the fact that occupational health and safety has no institutional home within the municipality (apart from that concerned with the health of municipal employees). In order to negotiate for a comprehensive health and safety system in urban public space, one would need to engage across several institutional divisions: fire services, sanitation, waste management and public works at the very least. Negotiations take time; time is very literally money for informal workers, and they are unlikely to be able to spare it in the large amounts needed to negotiate such institutional complexity. It is here, particularly, that the support of an external organization – such as an NGO – is important.

This is not to say that the involvement of NGOs with grassroots organizations is always positive. As Pithouse points out, NGOs are not monolithic entities – they have different political projects and different ways of working.⁽⁴⁵⁾ In this case, however, it would be hard to think of the work progressing without some kind of external support. This does still bring up difficult questions: the initial direction of the project was determined by both of the NGOs involved, rather than the trader organizations. It is possible that in deciding to work across market organizations, despite some of them having less than perfectly democratic practices, the project has further entrenched some problematic relationships. On the other hand, the subsequent shaping of the project work has been increasingly determined by the traders as they become better acquainted with the options open to them. The decision to work across markets has also been useful, as it has allowed a greater sense of solidarity to develop, and an awareness that the problems faced in one market are similar to those of another market.

What is very clear, though, is that the interventions of the NGO would have had to be far less intensive, and the ability of trader organizations to take their own initiative would have been far better enabled, if an integrated urban management system were in place, such as the “integrated area management” approach that was used on a pilot basis in eThekwini (Durban) during the late 1990s and early 2000s.⁽⁴⁶⁾ To have a single point of contact within the municipality – someone whose sole responsibility it is to coordinate across the different services in a particular area – would have made a crucial difference to the project work. It would have set up the conditions for traders to engage with the municipality in an independent way, and made it more difficult for different departments to evade responsibility by continuously handing over to one another. Of course, this is an ideal vision of how integrated management works, and the imperatives of politics may mean that this is not always how it plays out in reality. However, it is difficult to see how attempts at establishing integrated forms of urban health provision that are initiated “from below” by citizens and workers can ever operate optimally without some form of integration being simultaneously institutionalized within the state.