Of torn calf muscles and system failure in cities

Three weeks ago I badly ruptured my calf muscle during a high impact fitness training session.

Recovery has been swift: two weeks into the injury and I am walking again. How is that possible if the injury was supposedly so bad? And, am I at this point really recovered?

Although I can walk, my recovery was far from complete. My superb physiotherapist described a linear recovery process, which I have translated into a simple diagram:

I estimate that I have, two weeks into my injury, recovered about a third of my calf muscle strength.

Recovery can be accelerated by frequently straying a little bit across the diagonal of the ‘lost capacity zone’ (the green area in the above chart): push a little past the calf muscle strength limit, and the very minor muscle damage caused encourages faster healing and prevents scar tissue accumulation. This tactic has risks: push too far and/or too long and risk further serious damage and delay the healing process. I can walk but sharp pain reminds me that I cannot run when I try to.

How can I borrow from my experience to better explain urban resilience as it relates to recovery from system failure?

First, here’s a resilience-based graph of my mobility system over time:

The resilience of my mobility system is defined by key parameters such as:

• intensity of demand on the system over time;
• the demand limits corresponding to different intensities of failure (e.g. small muscle tears to major muscle tears to tendon rupture);
• the probabilities of these limits being reached; and
• the correlation between my mobility system and other key systems that offer support, such as cardiovascular, earning power and access to healthcare (in this case, a physiotherapist who knows their stuff).

In the training sessions shown in the above chart, I felt I was able to push my mobility system further every new session. When what I demanded from my mobility system (and, specifically, my calf muscle) pushed it past a major muscle tear limit (but thankfully not past the tendon tear limit), its capacity plummeted to near zero. After a few days on crutches I graduated to an ankle immobilising boot.

Once my physiotherapist got involved my recovery trajectory steepened, and I saw my injury as an opportunity to improve my mobility system’s long term resilience. By getting expert help I was doing what Winston Churchill famously prescribed, “never [letting] a good crisis go to waste.”

In summary:

1. Tipping point: Long term declining capacity of a system can rapidly deteriorate once a tipping point has been reached
2. Minor stress: Recovery of a system following failure can be accelerated by moderately and often stressing it – this stimulates the repair processes
3. Expanding capacity: Similarly, the ultimate capacity of a system can be increased by continuing to moderately and often stressing it.

Melbourne: coping with climate change

Melbourne’s climate is gradually changing: periods of extreme heat and severe rain storms are becoming more frequent.

Heatwaves overburden hospitals, cause vegetation die-back and encourage forest fires that damage property and vegetation. “Land hardening” through development, urban sprawl and poor ecosystem management means heavy rain is more likely to lead to flooding over time as there is less natural capacity to soak up and store or disperse the rainwater.

The paradox is that it is precisely these systems, the natural environment and flood water disposal systems, which can help Melbourne to be more resilient to climate change. Urban forests reduce urban temperatures through shading and transpiration, and large scale sustainable drainage systems (or SuDS) consisting of soft-landscaped rain gardens, swales, wetlands, porous pavements, and the tree pits of climate-resilient trees, help mitigate flooding.

The long term declining capacity of Melbourne’s natural environment and flood water disposal systems has accelerated in the past decade, as the demand on these systems has increased.

Failure limits have decreased as every heatwave damages the system further. The city needs to either raise the failure limits of, or decrease the demand on, these systems.

The extreme weather events have made Melbourne more aware of its declining failure limits, and the increase in probability of major failures. The barrage of emergency events in the early 2010s were the minor shocks that spurred the city into action, applying to become a member of the 100 Resilient Cities network, through which it was able to appoint a Chief Resilience Officer (CRO).

These moves gave city leaders the momentum and mandate to pull together a network of previously uncooperative stakeholders to generate a unified Melbourne Resilience Strategy, which led to the development and launch of the Urban Forest Strategy earlier this year. Through the Urban Forest Strategy Melbourne is able to strengthen its natural environment and flood water disposal systems to better cool the city and absorb excess rainwater.

In summary, using the same categories as the calf muscle example:

1. Tipping point: The city is proactively addressing the long term declining capacity of its environmental and flood water disposal systems to stave off reaching the tipping point of major failure.
2. Minor stress: The repeated stresses (heatwaves, fires and floods) on these systems have focused attention on the need for repair and have led to new leadership roles, strategies and coalitions. However, now Melbourne no longer has a CRO its challenge is to maintain the momentum in these initiatives.
3. Expanding capacity: Authority-sponsored proxy system stresses such as penalties and incentives should be continually used to further encourage increases to the capacity of Melbourne’s environmental and flood water disposal systems.

Medellin: rapid growth and inequity

Medellin has known extreme violence since the middle of the twentieth century.

Violence contaminates most of the city’s systems, with security, economic participation and development, social cohesion, and access to basic services such as education impacted the most. The below diagram shows — for Medellin’s security system — the relationship between demand for security and the system’s capacity.

Unlike a sudden calf muscle rupture, Medellin’s security system capacity gradually declined during the 1980s due to a complex web of interrelated factors, which are well described in Jose Escobar’s 2010 thesis at MIT, “The politics of peace process in cities in conflict: The Medellin case as a best practice”.

These factors included the long-running social discontent stemming from undemocratic rule by an economic elite, which led to left-wing guerrilla insurgences and were countered by right-wing paramilitary activity, an illegal drugs economy that filled the void left by the weakening of Colombia’s formal economy in the 1970s, the rapid migration to cities by those escaping rural violence, the city’s inability to house them or provide basic infrastructure, their settlement slums on the periphery of Medellin, where a lack of government involvement and authority left voids filled by gangs vying for control and its accompanying financial benefits of being in control. Medellin’s poor were disproportionately affected by the violence.

The ruptured calf patient can rest to help recovery; in contrast, the violence in Medellin did not abate to allow its security system to recover, nor was there an effective leadership response to the extreme strain on security. The city’s security system existed in a state of major failure during the 80s, 90s and first part of the 00s.

Clearly recuperation from a ruptured calf is too simple an analogue to compare with the complexities of Medellin’s long-term decline and recovery from violence. A better comparison would be a persistent lower back condition.

The below table draws some valuable comparisons between the recovery of Medellin’s security system from violence caused by its chronic social-economic and political problems and the recovery of the patient’s impaired mobility system from lower back problems caused by chronic bad habits.

Comparison of recovery methods for human patient and Medellin

Impaired entity	Human patient	Medellin
Impaired system	Mobility system	Security system
Reason for impairment	Lower back condition caused by chronic bad habits	Violence caused by chronic socio-economic and political problems
Recovery Category	Recovery method	Recovery method
Holistic coordinated effort	Cooperation between professionals treating lower back problems: GP; neurologist; physiotherapist; clinical pilates instructor. Recovery coordination by physiotherapist.	Cooperation between various authorities and entities — the city planning department, EDU (Urban Development Company), BID (International Development Bank), CORVIDE (Housing and Social Development Corporation), to name but a few — resulting in a critical mass of coordinated transformation initiatives.
Legitimisation leads to active participation	The patient’s potential to be healthy again should be legitimised through the professionals’ positive and supportive attitude to this effect. Once the patient believes their potential for a full recovery, they are spurred into committing to working hard to achieve it. Active participation by the patient is essential to recovery. This means doing the difficult physiotherapeutic rehabilitation work, rather than relying on passive quick fixes such as pain killers, chiropractic manipulation and/or massage.	Medellin’s authorities formally legitimise the status of slum dwellers by e.g. granting of legal tenure and provision of basic infrastructure such as sanitation and waste collection. This recognition of being part of the legitimate Medellin encourages increased participation in the city’s formal economy — as opposed to the violence-supporting informal economy — which is made easier by improved public transport, micro-lending opportunities and entrepreneurial support, all of which are, of course, provided by the city authorities.
Trust leading to continued commitment	Trust by the patient that the effort they need to put into their own recovery will not be wasted results in a long term commitment to changing habits and doing rehabilitation exercises.	A belief by the community that their participation — in for example Medellin’s City Development Plan — is making an impact leads to ongoing commitment to contributing to the processes of transformation. A prerequisite to this is that the authority in charge is seen as worthy of the community’s trust. The 00s provided Medellin with such a trustworthy figure: mayor Sergio Fajardo, independent from the entrenched two-party system representing economic elite, presided over Medellin’s most successful period of recovery, when demand for security dropped below the system failure limits for the first time in more than two decades.
Tangible results	An accumulation of pain-free weeks and a successful return to normal and even intensive physical activity all point to fundamental change occurring and spur further recovery and strengthening efforts by the patient.	Completion of projects such as Bibiloteca Santo Domingo and the Metrocable cable car and its associated system of parks and street upgrades, and the establishment of entities such as Banco de los Pobres (the municipal microfinance bank) visibly represented a serious commitment by city government, and gave the community reason to trust that the change was real and worth committing to.
Authority re-established	A proliferation of good habits such as Pilates, good nutrition, posture and exercise leaves no space for bad habits such as bad posture, poor nutrition, poor hydration and using quick-fix chiropractors.	The government proliferates and occupies spaces usually occupied by the violent gangs to create safe spaces within communities. Extending city government authority back into areas such as basic services provision, security and transport infrastructure pushes back the ‘authority’ of criminals.

Some of the immense improvements to Medellin’s security system since 1990 have recently been overshadowed by a resurgence of crime and violence. This periodic breaching of the ‘minor disruption’ limit of the security system’s capacity should spur renewed corrective action by Medellin’s authorities. The city’s history requires the succession of different city mayors and governments to work continually to top up its citizens’ trust and re-examine and re-invigorate its strategies in light of the lessons learnt set out above.

Other cities in the region with similarly complex socio-economic and political back-stories to that of Medellin can use the lessons learnt there. The below chart produced by the United Nations comparing the relationship between a city’s homicide rate and population growth rate points to cities such as Santo Domingo, Panama City, San Salvador, Quito and Ascunsion being likely to benefit in this way.

In closing, my parallel investigations into the failures of my mobility system, Melbourne’s environmental and flood water disposal systems and Medellin’s security system has confirmed to me the indisputable value in using the human being — an assembly of complex interacting systems — as a device for generating ideas to address system failures in the city.