Book Review #4, Urban Infrastructure: Permanence and Change

Book: Epidemic Urbanism: Contagious Diseases in Global Cities
Part 3: Urban Infrastructure: Permanence and Change

Hello everyone. We meet again, and I am Tom. This week June 12th, 2023, is my turn for the book discussion. If you follow our blog frequently, you will know we have this activity every semester. My colleagues Radi and Loren already presented part I and part II. Today, I will discuss part III of Urban Infrastructure: Permanence and Change of the book “Epidemic Urbanism by Gharipour & DeClercq (2021)”.


This part discusses about the concept of “Urban Infrastructure: Permanence and Change” how it can be related to the idea of epidemics in the context of cities respond to and adapt to infectious disease outbreaks. Urban infrastructure plays a critical role in shaping the response and mitigation strategies with the face of a public health crisis like an epidemic. As the main purpose of this part, we can see two aspects from case studies.

  1. Firstly, the permanence aspect of urban infrastructure becomes relevant regarding the existing physical and social infrastructure systems that must be mobilized to address the health crisis. Healthcare facilities, sanitation systems, and communication infrastructure are crucial elements in managing and preventing disease spread within urban areas.
  2. In parallel, the change aspect in urban infrastructure is equally important because the outbreak of infectious diseases often prompts cities to rapidly adapt their infrastructure systems to meet the new challenges and demands; this may involve temporary changes or additions to existing infrastructure, such as the establishment of field hospitals, the way of dealing with infectious deceased, and the reconfiguration of public spaces to enable physical distancing.

To let everyone see cleary about this concept, I selected three case studies in this part as references:


  • Chapter 21: Social inequity and hospital infrastructure in Puebla, Mexico, 1737. From the beginning, there was a difference in racial hierarchization in colonial Mexico due to the social inequity at that time. Only one group of people, which is called “Spaniards,” can access opportunities, resources, and outcomes among different groups of people within a society known as “native (indigenous), Africans (enslaved people), mestizos (people of mixed ethnic background).” This reason was one issue that led to the spread of infectious diseases. It made the epidemic more severe and rapid due to the limited access to healthcare, urban hygiene conditions, overcrowded and substandard housing, and unequal exposure to environmental hazards (waste disposal from factories and human defecation on the streets). By the end of the 18th century, when it was understood that illnesses propagated in confined and stuffy places, hospital infrastructure had improved through experiences with a variety of epidemics; specifically, the tall ceiling and vaulted wards improved air circulation. In addition, the hospital was the place where providing physical recovery through medical treatment and appropriate health facilities. The hospital was forced to facilitate burying plague victims on the hospital ground instead of the church building due to the overwhelmed city authority’s capacities for containment.

  • Chapter 25: French urbanism, Vietnamese resistance, and the plague in Hanoi, Vietnam, 1885-1910. After the French conquered Tokin in 1883, Hanoi was made the capital of the federation of French Indochina. The colonial state viewed the Vietnamese city with suspicion, deeming it unhealthy and needing modernization. They revive the city’s critical infrastructure to create a modern urban center, such as building state-of-art sewers and a freshwater system. That is to fight against waterborne diseases such as cholera. In the 1850s, it turned out that the city was facing the bubonic plague from Yunnan, China, through transportation infrastructure and ships which caused rats. To determine the potential threat of infection, the white officer was authorized to inspect the home of the deceased; if the corpse showed signs of cholera or plague, police agents would disinfect the residence and dispose of the body in a manner to prevent the spread of the disease. Homes of the deceased were to be sterilized with lye or other solutions, but the poorer victims lived in wood and thatch huts that had to be burned. Family members or others close to the deceased were sent to an isolation hospital. Nevertheless, Vietnamese typical burial practices were ignored by the French colonial state when they took Vietnamese corpses and burned them, which led to angry public protests against the colonial authority. Despite public health authorities’ progress plans, French urban and infrastructural modifications in Hanoi were a focal point for anti-colonial protests.

  • Chapter 26: Building a community on Leprosy Island in the Philippines, 1898-1941. The Philippines has experienced long-term leprosy due to deplorable sanitary conditions, which are causes of constant outbreaks of diseases. In the early 1900s, an American report estimated 5,000 Filipinos were afflicted with leprosy—also, a thousand American military troops. The condition continued to spread and did not diminish the number of infected people with leprosy even if they established hospitals in Manila and other areas. Both feared the disease would overwhelm the country if its spread were not contained. Hence, the segregation plan was required, and until 1901, Culion Island was converted as a leper colony in the Philippines due to many beneficial features of this island, such as a good environment with sea breezes. Finally, Culion Island started as a place of segregation and developed into a community through physical, social, economic, and political infrastructural development.

Lesson learned

  1. From three case studies, epidemic urbanism can also influence long-term changes in urban infrastructure, such as planning and design.
  2. The experience of dealing with a public health crisis can inform future infrastructure development strategies, including incorporating features that enhance resilience to epidemics or other health emergencies; this might involve considering factors like increased healthcare capacity, improved sanitation and hygiene infrastructure.


  • How can communities effectively come together and build a positive and resilient environment during an outbreak or crisis, fostering support, cooperation and a sense of unity among its members?

We cannot ignore the necessity of creating a community during the epidemic because interacting with others and exchanging information appears more beneficial. However, building a pleasant environment for a gathering during an epidemic is more challenging than usual because many different people must adhere to a single rule or guideline that is virtually impossible to satisfy everyone. For instance, the beginning of the outbreak a few years ago separated us from interacting with each other. The infectious people needed to isolate themselves from family and others in the isolation areas such as hospitals or other places approved by the health control department. This situation reflects the permanence of the past from three case studies that humans have learned from several epidemics. At the same time, we can also recognize some changes that isolation areas cannot just be hospitals but also some hotels. It used to be an establishment providing accommodation and other services for travelers and tourists. Then, it can be changed to be an isolated place as well. 

Eventually, no matter what, people learn how to combat or live with it and create the pleasant vibe of the community as it used to be before the outbreak. Modern technology allows people who need to isolate themselves from their families to communicate. Furthermore, the work/school environment shifted from on-site to online to make daily life flow as usual. In other words, that is to get people connected and able to share information. However, as mentioned from the beginning, the definitions of pleasant environments from each other are different, and it is challenging due to their various desires.


Gharipour, M., & DeClercq, C. (Eds.). (2021). Epidemic Urbanism: Contagious Diseases in Global Cities. Intellect Books.