URBAN RENEWAL AS PREVENTIVE HEALTH

Urban renewal in Aba is transforming the city into a healthier environment, argues PAT ONUKWULI

Urban development in Nigeria is usually discussed in the language of contracts, budgets, and politics. Yet its most decisive consequence is seldom framed this way: it shapes who falls ill, who survives emergencies, and who dies prematurely. Long before a patient meets a doctor, the city has already written part of their medical history. Roads, drains, markets, waste systems and lighting quietly determine whether disease will spread or retreat, whether accidents will maim or be averted, whether life will be prolonged or cut short.

From a moral philosophical standpoint, this imposes an ethical burden on governance. Since Aristotle, politics has been understood as a practical science ordered toward the good life, not merely the power struggle. A state that tolerates environments that predictably generate avoidable illness and injury is not simply inefficient; it is morally deficient. It fails in the primary obligation of authority: the duty to organise society in ways that protect and enhance human flourishing.

For decades, Aba’s renowned commercial energy coexisted with severe infrastructural decay. Badly damaged roads slowed emergency responses, increased traffic holdups, and made everyday road travel dangerous. Blocked drainage produced stagnant pools that sustained malaria and allowed floodwater to mix with sewage, fuelling cholera and typhoid. Chaotic markets and refuse dumps expose traders and consumers to food-borne and respiratory diseases. They were not matters of chance, but embedded conditions that silently generated suffering.

However, since 2023, the urban renewal programme under Governor Alex Otti has begun to reverse this landscape, with effects that are as much medical as they are economic. The reconstruction of major arteries such as Port Harcourt Road, Aba–Owerri Road, Asa Road and Faulks Road has improved traffic flow, reduced accident-prone surfaces and shortened travel time to health facilities. In emergencies, minutes are the difference between life and death. Safer roads also mean fewer crashes and less long-term disability. Asphalt, in this sense, becomes an instrument of injury prevention.

Drainage rehabilitation and flood control across the Aba commercial hub represent another layer of population-level medicine. By desilting channels, rebuilding culverts, and managing stormwater, the city is dismantling the ecological niches where mosquitoes breed and epidemics incubate. Fewer stagnant pools translate into lower malaria transmission. Keeping floodwater from mixing with sewage interrupts the pathways of cholera, typhoid and other water-borne infections that typically surge during the rains. Concrete channels and properly graded roads thus perform the quiet labour of epidemiology.

Market reorganisation and sanitation in Ariaria, Ekeoha and other commercial centres address a further determinant of health: food safety and air quality. Structured waste collection and the reduction of open dumping and burning cut down on smoke and particulate pollution, protecting residents from chronic respiratory disease and childhood asthma. Improved hygiene in trading spaces reduces exposure to diarrhoeal illnesses, which still account for a significant share of preventable mortality. Street lighting, often treated as a purely security measure, also reduces nighttime accidents and the psychological stress associated with unsafe public spaces. Visibility, order and cleanliness are not luxuries; they are conditions of bodily safety.

Taken together, these interventions exemplify what public health calls upstream prevention. Instead of waiting for disease and injury to occur and then responding with drugs and surgery, the city itself is being redesigned to block the environmental routes through which harm travels. Roads become safety systems. Drains become anti-malarial infrastructure. Waste management becomes respiratory protection. Markets become controlled food environments. Urban planning, in this framework, functions as large-scale, pre-emptive medicine.

There is a useful classical parallel. In Greek mythology, Asclepius, the god of healing, worked not only through remedies but through the restoration of harmony between human beings and their surroundings. His sanctuaries were built around clean water, ordered spaces and quiet groves, because health was understood as balance, not merely the absence of symptoms. Modern cities, too, require such a balance. When water flows properly, waste is contained, movement is safe and public space is orderly, disease retreats. Governance then assumes the character of a healing art.

The economic implications reinforce the moral argument. Prevention is cheaper than a cure. Every malaria episode averted through drainage saves households the cost of treatment and lost income. Every serious accident prevented by sound road design spares the health system the far greater expense of surgery, intensive care and long-term rehabilitation. Every epidemic avoided through sanitation saves governments the fiscal shock of emergency response. Investment in urban infrastructure, therefore, yields a double dividend: improved quality of life and reduced healthcare burden.

Aba’s experience carries lessons for other Nigerian cities, including Lagos, Onitsha, Ibadan, Port Harcourt, Kano, and the many rapidly expanding urban centres confronting flooding, congestion, unsafe transport, and poor waste management. In all of them, the same principle holds: the most effective health policy may not begin in hospitals, but in the regeneration and maintenance of the urban environment.

First, drainage and flood control should be treated as core public health interventions, not secondary environmental projects. Second, road quality and traffic management must be understood as injury-prevention strategies, central to reducing one of Nigeria’s leading causes of death among young adults. Third, market sanitation and waste systems should be prioritised as instruments of food safety and disease control. Finally, urban renewal should be planned through collaboration between the ministries of works, environment and health, with health impact assessments guiding infrastructure choices and budgets.

At its core, the moral test of governance is whether power is exercised to shield citizens from avoidable harm. The transformation underway in Aba suggests what becomes possible when that ethic of care is taken seriously. Development then ceases to be a mere accumulation of projects and contracts. It becomes the quiet, continuous construction of conditions in which life is less fragile.

In a country where hospitals are overstretched, and preventable diseases still claim too many lives, the deepest form of healing may lie not only in what doctors prescribe, but in what governments build. Under Governor Alex Otti, Aba is showing that, like the healing sanctuaries of Asclepius, when a city is revived to make life more worth living and prevent harm before it tries to treat it, urban renewal itself becomes a form of frontline medicine.

Dr. Onukwuli is a legal scholar and public affairs analyst.

Email: patonukwuli2003@yahoo.co.uk