Mumbai has the makings of a great cycling city – but it needs to set the wheels in motion

Though lacking in infrastructure, India’s financial capital, shares many characteristics that are at the heart of cycling-friendly Dutch cities.

On September 2, Maharashtra Chief Minister Devendra Fadnavis approved the civic body’s proposal to develop a cycling track in Mumbai. The 39-km and 10-m wide track, called “Green Wheels Along Blue Lines”, will be built on open space created by removing 15,000 encroachments along the Tansa pipeline, which stretches from the eastern suburb of Mulund to Wadala in Mumbai city.

Expected to cost Rs 300 crore, this would be the largest infrastructure project for non-motorised transportation the city has ever seen – but it won’t be the first. The track comes on the heels of several experiments to build dedicated pathways for cyclists in Mumbai, Pune, Bengaluru and other Indian cities. Most of these have not found many takers and have done little to encourage cycling.

The success of Green Wheels depends on learning from the mistakes made in implementing these projects.

Cycling culture

Cycling in India is taking two paths simultaneously. On one hand, tremendous grassroots enthusiasm is finally making authorities see the road from a cyclist’s perspective. In the Mumbai Metropolitan Region, groups, organisations and shops like Buddy Riders (Andheri), the Kalyan Cyclist Club, Cycle Katta, The Smart Commute, and Pro9 Bicycle Studio are encouraging people to navigate the city on two wheels through group rides, seminars and workshops.

For some, recreational cycling has paved the way for them to use the cycle for their daily commute. As a result, they have become unwitting cycling advocates: working under the radar they are convincing recalcitrant building managers to allow bicycle parking, getting the Brihanmumbai Municipal Corporation to re-align storm drains to make them safe for cyclists and campaigning for bicycle parking facilities to be installed near prominent local train stations.

On the other hand, the big picture of cycling in India is troubling. Reports such as TERI’s Pedaling Toward a Greener India highlight the precipitous decline of bicycle commuting in cities like New Delhi and Pune, the lack of planning coordination among government agencies, street design that privileges the tiny minority that owns cars and motorbikes and poor enforcement of traffic rules.

Amit Bhatt, Director of Transport at World Resources Institute, said, “In terms of modal mix, cycling has a phenomenally large share in India.” According to the 2011 census, 9% of all commutes are done by bicycle – an impressively large percentage compared to most other countries. “The problem is that this share is going down.” This decline has been occuring since the arrival of cheap scooters on the market in the late 1970s and early 1980s.

Tracking progress

In light of the declining overall number of bicycle commuters, the solution seems to be simple: build cycle tracks. In 2011 the Mumbai Metropolitan Region Development Authority, the city’s nodal infrastructure development agency, attempted this by creating a 13-km network of tracks looping around the Bandra Kurla Complex, a business district in the centre of the city. But the tracks, built at a cost of Rs 6.5 crore, were barely used. Within months, the paint faded, signs rusted and the space was taken over for parking In 2014, the Mumbai Metropolitan Region Development Authority washed its hands of the project and declared it a failure.

Why did this happen and what lessons does it provide?

Firoza Suresh, founder of The Smart Commute, a cycling advocacy group in the city said that the track never stood a chance of working because of problems of design and last-mile connectivity. “Green paint doesn’t qualify as a cycle track,” she said, referring to the colour commonly used to designate bicycle-friendly places. What matters are the details. Firstly, instead of integrating the track with the city’s transportation system, so that people could ostensibly ride to work, “the MMRDA saw cycle tracks as a leisure thing – expecting people to come with their own cycles and do a few loops for exercise”, she said.

Secondly, the Bandra Kurla Complex tracks had design flaws that matter to a person on a bicycle. For instance, separating the track from the road were dangerous concrete barriers, rather than tall, flexible plastic bollards, bumpy cobblestone-like paver blocks that made the surface uneven, and no provision for bicycle parking. These flaws made the track unappealing even to those few who cycle regularly in the area, let alone to anyone who might come there looking for a cycling destination.

The lessons to learn from this project’s fate is that the success of cycling infrastructure depends on details that often do not make it to marketing images or glossy architectural renderings. What’s crucial is also how authorities and designers look at cycling: is it primarily a recreational activity or a mode of transportation?

Restricting cycling tracks to a business hub that is a world unto itself, cut off from the city and with a homogenous streetscape, sent the message that cycling is a recreational activity best done when separated from the hustle and bustle of Mumbai. But ironically, the qualities that made the Bandra Kuirla Complex seem like an easy and attractive place for a cycling track in the first place – the wide streets and broad encroachment-free sidewalks – were what doomed the project to be a failure.

Is this the future for the upcoming Green Wheels... project as well? The fact that it is being built on land opened up by clearing encroachments – the same land that the Bombay High Court ordered the BMC, in 2009, to clear of slums – suggests that a similar logic may be informing this project as well. “It [the Green Wheels cycle track] looks not so much as a traffic solution than a public space creation solution,” said Divya Tate, a veteran cycling enthusiast and director of Audax India, a popular endurance cycling organisation. “On paper, the plan looks nice – a track on unused land— but, it is not exactly unused land. They’ve displaced people. Unless there is some rehousing, which I doubt will be the case, then it is definitely going to be an elite kind of thing.”

What makes a city cycling friendly?

While in the small city of Nijmegen, Netherlands, attending the annual conference of cycling planners, designers and advocates called Velo-City, I saw a remarkable sight: streets teeming with elderly men and women, teenage girls and boys, middle aged men with babies, children and disabled people – all on cycles. They navigated through an extensive web of smooth paths with parking facilities capable of handling thousands of bicycles, roundabouts with signals that privilege cycling and pedestrian movement, cycling-only bridges, tunnels and even inter-city “highways” dedicated to people on two or three wheels.

This vast and dedicated cycling infrastructure is what planning professionals in India often point to in cities while ruing the poor infrastructure here, or as inspiration to overcome the transportation failures at home (just as their counterparts in the US point to this infrastructure as alternatives to the American obsession with the automobile). That’s where specific infrastructural interventions like bicycle paths come in, because they show the tremendous benefits of transportation design that privileges non-motorised movement.

What is less known is that Dutch cities were not always this way – and therefore, big infrastructure projects are not the only way to promote the use of non-motorised transport. In the 1970s, many city centres looked like what we see in parts of Mumbai or urban spaces across the world: roads choked with traffic, parked cars and devoid of space for people on foot or on a bicycle. The transformation into a cycling paradise required a shift not just in physical infrastructure but the perception of transportation itself: namely, a shift from seeing streets as spaces to move cars to viewing them as spaces for people, a revaluation of cycling from a mode of transportation to a swifter alternative to walking and a rethinking of the bicycle as a vehicle for exercise or fitness to one that is a mobility device.

Urban fabric

Quiet Dutch streetscapes might seem like a far cry from the scene in bustling and chaotic metropolises like Mumbai (or Boston and London). But in this cycling paradise there is, surprisingly, hope for the future of non-motorized transportation in Mumbai.This is because what makes certain forms of transportation possible, convenient, safe or enjoyable is not only the planned infrastructure but also the organic urban form that has evolved over the centuries: the physical arrangement of homes, markets, and institutions, the way people interact as a crowd and unspoken expectations regarding how streets are used.

Architect and Professor of Urban Design Rahul Mehrotra calls this sphere of urban life the “kinetic city.” Paying attention to this unofficial and spontaneous realm of the city shows that, surprisingly, some of the central elements of Dutch cycling-friendly cities are, in fact, commonplace in Mumbai. In fact, the city already has thousands of utility cyclists – such as laundry, egg and milk delivery men and dabbawallahs – who are out on the road everyday.

  1. No-frills cycles: Most bicycles in Amsterdam are heavy, have large upright handlebars, thick saddles, wide tires and squeaky chains. In other words, they are not so different from ghoda cycles, or the indestructible bicycles used by the thousands of delivery men in Mumbai. This shows that you don’t need expensive equipment to move through the city on two wheels. It also reflects an understanding of cycling as a quicker, more convenient alternative to walking rather than a lifestyle choice, sport or political statement.
  2. Density: “Infrastructure is not necessarily the answer,” said professor Ruth Oldenziel in her Velo-City lecture. For a city to be cycling-friendly, it also needs density, mixed land use and a variety of mobility choices. People cycle in places like Amsterdam and Nijmegen because they don’t need to go further than 5 km to access schools, shops, restaurants or train stations. Mumbai’s incredible density is similarly its greatest asset, at least for those who live in the city. There is always a paan stall, kirana shop, vegetable vendor, restaurant or bicycle repair stand within easy walking distance. But Mumbai is a city of contrasts and so, half its population continues to travel numerous kilometres from the far-flung suburbs to the city for work. But for those who have to travel less than 10 km for work, the city lends itself to cycling as commute.
  3. The ballet of the street: Crossing an intersection in Nijmegen or Amsterdam is like joining a giant unchoreographed performance, as the documentary film Why We Cycle, screened at the Velo-City conference, beautifully pointed out. You merge and then disengage from a swarm of people on bicycles without ever touching, talking or often even making eye-contact. While in motion, you read other people’s nonverbal cues to navigate – a gesture, head tilt or reduction in speed – rather than street signs.Urbanist Jane Jacobs famously called this organised chaos the ballet of the street. Most cities have it but perhaps there is none so grand, complex and spontaneous as in Mumbai. For better or worse, navigating Mumbai’s streets is rarely a passive, solitary act and more often means manoeuvring amidst a collective, constantly shifting formation.
  4. Blurred boundaries: One of the more well-known Dutch design innovations is the concept of shared space. In essence, this is traffic calming by minimising the physical separation between sidewalk and road. This counter-intuitive design intervention is premised on the idea that blurred boundaries empower crowds of pedestrians and cyclists to take up more space (of course, this does not apply to highways, where a separation between walking and motorable spaces is necessary).It means designing streets that account for their multiple, overlapping uses – something that in large swathes of suburban Mumbai is the norm by accident.
  5. Cars are one vehicle among many. In the 1970s, cars dominated city centers in Amsterdam and Nijmegen. Changing this required a shift in attitude more than infrastructure. This shift entailed seeing cars as the guests, rather than the kings of the road. Compared to the United States, where empty, wide open roads lull drivers into a state of complacency, Dutch streets compel drivers to be more attentive to their surroundings. In Mumbai, the 5% of the population that commute by car might feel entitled to the entirety of the street but in reality, they need to navigate around a swarm of deliverymen, cart-pullers, auto-rickshaws, pedestrians and hawkers.

Building from existing streetscape

The challenges faced by people who walk or cycle in Mumbai are indisputable and well documented. However, cycle tracks – which are often proposed as the first solution to cyclists’ woes – fail when their design and implementation do not take into account the already existing urban fabric.

Topography, geography and attitude, the idiosyncracies in housing, social interaction and ideas of leisure and the mundane acts of millions matter as much as what is created in concrete, steel and stone. Though lacking in physical infrastructure, Mumbai shares many characteristics that are at the heart of cycling-friendly Dutch cities. Better to build off them than deny they exist at all.

Jonathan Shapiro Anjaria teaches at Brandeis University.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

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Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the marketing team and not by the editorial staff.