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The idea of eliminating poverty is a great goal.

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I don't think anyone in this room would disagree.

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What worries me is when politicians with money

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and charismatic rock stars

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use the words,

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it all just sounds so, so simple.

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Now, I've got no bucket of money today

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and I've got no policy to release,

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and I certainly haven't got a guitar.

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I'll leave that to others.

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But I do have an idea,

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and that idea is called Housing for Health.

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Housing For Health works with poor people.

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It works in the places where they live,

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and the work is done to improve their health.

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Over the last 28 years,

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this tough, grinding, dirty work

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has been done by literally thousands of people

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around Australia, and more recently overseas,

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and their work has proven that focused design

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can improve even the poorest living environments.

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It can improve health, and it can play a part

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in reducing, if not eliminating, poverty.

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I'm going to start where the story began, 1985,

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in central Australia.

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A man called Yami Lester, an Aboriginal man,

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was running a health service.

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Eighty percent of what walked in the door,

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in terms of illness, was infectious disease --

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third world, developing world infectious disease,

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caused by a poor living environment.

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Yami assembled a team in Alice Springs.

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He got a medical doctor.

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He got an environmental health guy.

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And he hand-selected a team of local Aboriginal people

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to work on this project.

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Yami told us at that first meeting, there's no money.

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Always a good start, no money.

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You have six months.

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And I want you to start on a project which in his language

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he called "uwankara palyanku kanyintjaku,"

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which, translated, is "a plan to stop people getting sick,"

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a profound brief.

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That was our task.

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First step, the medical doctor went away

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for about six months,

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and he worked on what were to become

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these nine health goals, what were we aiming at.

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After six months of work, he came to my office

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and presented me with those nine words on a piece of paper.

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[Washing, clothes, wastewater, nutrition... ]

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Now, I was very, very unimpressed.

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Come on.

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Big ideas need big words

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and preferably a lot of them.

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This didn't fit the bill.

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What I didn't see and what you can't see

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is that he'd assembled thousands of pages

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of local, national and international health research

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that filled out the picture as to why these

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were the health targets.

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The pictures that came a bit later

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had a very simple reason.

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The Aboriginal people who were our bosses

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and the senior people were most commonly illiterate,

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so the story had to be told in pictures

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of what were these goals.

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We work with the community,

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not telling them what was going to happen

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in a language they didn't understand.

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So we had the goals, and each one of these goals --

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and I won't go through them all —

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puts at the center the person and their health issue,

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and it then connects them

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to the bits of the physical environment

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that are actually needed to keep their health good.

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And the highest priority, you see on the screen,

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is washing people once a day, particularly children.

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Now I hope most of you are thinking,

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"What? That sounds simple."

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Now, I'm going to ask you all a very personal question.

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This morning before you came,

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who could have had a wash using a shower?

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I'm not going to ask if you had a shower,

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because I'm too polite. That's it. (Laughter)

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Okay. All right.

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I think it's fair to say, most people here

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could have had a shower this morning.

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I'm going to ask you to do some more work.

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I want you all to select one of the houses

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of the 25 houses you see on the screen.

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I want you to select one of them and note

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the position of that house

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and keep that in your head.

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Have you all got a house? I'm going to ask you

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to live there for a few months, so make sure you've got it right.

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It's in the northwest of Western Australia, very pleasant place.

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Okay. Let's see if your shower in that house is working.

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I hear some "aw"s and I hear some "aah."

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If you get a green tick, your shower's working.

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You and your kids are fine.

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If you get a red cross,

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well, I've looked carefully around the room

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and it's not going to make much difference to this crew.

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Why? Because you're all too old.

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And I know that's going to come as a shock to some of you,

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but you are.

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Now before you get offended and leave,

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I've got to say that being too old in this case

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means that pretty much everyone in the room, I think,

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is over five years of age.

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We're really concerned with kids naught to five.

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And why? Washing is the antidote to the sort of bugs,

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the common infectious diseases of the eyes, the ears,

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the chest and the skin

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that, if they occur in the first five years of life,

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permanently damage those organs.

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They leave a lifelong remnant.

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That means that, by the age of five,

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you can't see as well for the rest of your life.

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You can't hear as well for the rest of your life.

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You can't breath as well. You've lost a third

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of your lung capacity by the age of five.

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And even skin infection, which we originally thought

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wasn't that big a problem,

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mild skin infections naught to five give you

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a greatly increased chance of renal failure,

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needing dialysis at age 40.

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This is a big deal, so the ticks and crosses on the screen

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are actually critical for young kids.

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Those ticks and crosses represent the 7,800 houses

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we've looked at nationally around Australia,

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the same proportion.

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What you see on the screen -- 35 percent of those

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not-so-famous houses lived in by 50,000 indigenous people,

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35 percent had a working shower.

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Ten percent of those same 7,800 houses

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had safe electrical systems,

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and 58 percent of those houses

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had a working toilet.

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These are by a simple, standard test:

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In the case of the shower, does it have hot and cold water,

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two taps that work,

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a shower rose to get water onto your head

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or onto your body, and a drain that takes the water away?

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Not well designed, not beautiful, not elegant --

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just that they function.

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And the same test for the electrical system and the toilets.

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Housing for Health projects aren't about measuring failure.

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They're actually about improving houses.

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We start on day one of every project -- we've learned,

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we don't make promises, we don't do reports.

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We arrive in the morning with tools, tons of equipment,

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trades, and we train up a local team on the first day

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to start work.

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By the evening of the first day, a few houses

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in that community are better

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than when we started in the morning.

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That work continues for six to 12 months

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until all the houses are improved

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and we've spent our budget of 7,500

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dollars total per house.

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That's our average budget.

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At the end of six months to a year, we test every house again.

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It's very easy to spend money.

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It's very difficult to improve the function

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of all those parts of the house,

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and for a whole house, the nine healthy living practices,

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we test, check and fix 250 items in every house.

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And these are the results

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we can get with our 7,500 dollars.

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We can get showers up to 86 percent working,

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we can get electrical systems up to 77 percent working,

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and we can get 90 percent of toilets working

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in those 7,500 houses.

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Thank you. (Applause)

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The teams do a great job, and that's their work.

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I think there's an obvious question

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that I hope you're thinking about.

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Why do we have to do this work?

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Why are the houses in such poor condition?

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Seventy percent of the work we do

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is due to lack of routine maintenance,

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the sort of things that happen in all our houses.

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Things wear out.

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Should have been done by state government or local government.

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Simply not done, the house doesn't work.

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Twenty-one percent of the things we fix

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are due to faulty construction,

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literally things that are built upside down and back-to-front.

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They don't work. We have to fix them.

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And if you've lived in Australia in the last 30 years,

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the final cause -- You will have heard always

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that indigenous people trash houses.

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It's one of the almost rock-solid pieces of evidence,

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which I've never seen evidence for,

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that's always ruled out as that's the problem with indigenous housing.

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Well, nine percent of what we spend is damage,

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misuse or abuse of any sort.

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We argue strongly that the people living in the house

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are simply not the problem.

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And we'll go a lot further than that.

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The people living in the house are actually

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a major part of the solution.

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Seventy-five percent of our national team in Australia,

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over 75 at the minute,

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are actually local, indigenous people

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from the communities we work in.

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They do all aspects of the work.

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(Applause)

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In 2010, for example, there were 831,

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all over Australia, and the Torres Strait Islands,

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all states, working to improve the houses

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where they and their families live,

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and that's an important thing.

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Our work's always had a focus on health. That's the key.

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The developing world bug trachoma, it causes blindness.

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It's a developing world illness,

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and yet, the picture you see behind

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is in an Aboriginal community in the late 1990s

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where 95 percent of school-aged kids had active trachoma

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in their eyes doing damage.

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Okay, what do we do?

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Well, first thing we do, we get showers working.

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Why? Because that flushes the bug out.

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We put washing facilities in the school as well,

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so kids can wash their faces many times during the day.

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We wash the bug out.

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Second, the eye doctors tell us that dust scours the eye

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and lets the bug in quick. So what do we do?

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We call up the doctor of dust, and there is such a person.

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He was loaned to us by a mining company.

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He controls dust on mining company sites,

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and he came out, and within a day it worked out

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that most dust in this community was

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within a meter of the ground, the wind-driven dust,

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so he suggested making mounds to catch the dust

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before it went into the house area

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and affected the eyes of kids.

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So we used dirt to stop dust.

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We did it. He provided us dust monitors.

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We tested and we reduced the dust.

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Then we wanted to get rid of the bug generally.

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So how do we do that?

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Well, we call up the doctor of flies,

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and yes there is a doctor of flies.

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As our Aboriginal mate said,

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"You white fellows ought to get out more."

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(Laughter)

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And the doctor of flies very quickly determined

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that there was one fly that carried the bug.

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He could give school kids in this community

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the beautiful fly trap you see above in the slide.

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They could trap the flies, send them to him in Perth.

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When the bug was in the gut, he'd send back

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by return post some dung beetles.

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The dung beetles ate the camel dung,

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the flies died through lack of food,

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and trachoma dropped.

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And over the year, trachoma dropped

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radically in this place, and stayed low.

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We changed the environment, not just treated the eyes.

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And finally, you get a good eye.

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All these small health gains

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and small pieces of the puzzle make a big difference.

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The New South Wales Department of Health,

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that radical organization,

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did an independent trial over three years

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to look at 10 years of the work we've been doing

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in these sorts of projects in New South Wales,

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and they found a 40-percent reduction

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in hospital admissions for the illnesses

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that you could attribute to the poor environment.

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A 40-percent reduction.

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(Applause)

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Just to show that the principles we've used

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in Australia can be used in other places,

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I'm just going to go to one other place, and that's Nepal,

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and what a beautiful place to go.

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We were asked by a small village of 600 people

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to go in and make toilets where none existed.

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Health was poor.

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We went in with no grand plan, no grand promises

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of a great program, just the offer to build

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two toilets for two families.

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It was during the design of the first toilet

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that I went for lunch, invited by the family

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into their main room of the house.

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It was choking with smoke.

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People were cooking on their only fuel source, green timber.

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The smoke coming off that timber is choking,

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and in an enclosed house, you simply can't breathe.

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Later we found the leading cause of illness and death

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in this particular region is through respiratory failure.

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So all of a sudden we had two problems.

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We were there originally to look at toilets

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and get human waste off the ground. That's fine.

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But all of a sudden now there was a second problem.

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How do we actually get the smoke down? So two problems,

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and design should be about more than one thing.

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Solution: Take human waste, take animal waste,

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put it into a chamber, out of that extract biogas,

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methane gas.

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The gas gives three to four hours cooking a day --

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clean, smokeless and free for the family.

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(Applause)

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I put it to you, is this eliminating poverty?

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And the answer from the Nepali team who is working

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at the minute would say, don't be ridiculous,

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we have three million more toilets to build

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before we can even make a stab at that claim.

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And I don't pretend anything else.

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But as we all sit here today,

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there are now over 100 toilets built

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in this village and a couple nearby.

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Well over 1,000 people use those toilets.

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Yami Lama, he's a young boy.

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He's got significantly less gut infection

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because he's now got toilets,

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and there isn't human waste on the ground.

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Kanji Maya, she's a mother and a proud one.

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She's probably right now cooking lunch for her family

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on biogas, smokeless fuel.

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Her lungs have got better, and they'll get better

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as time increases, because she's not cooking in the same smoke.

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Surya takes the waste out of the biogas chamber

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when it's shed the gas, he puts it on his crops.

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He's trebled his crop income,

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more food for the family and more money for the family.

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And finally Bishnu,

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the leader of the team, has now understood

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that not only have we built toilets,

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we've also built a team,

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and that team is now working in two villages

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where they're training up the next two villages

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to keep the work expanding.

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And that, to me, is the key.

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(Applause)

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People are not the problem.

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We've never found that.

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The problem: poor living environment,

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poor housing, and the bugs that do people harm.

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None of those are limited by geography,

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by skin color or by religion. None of them.

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The common link between all the work we've had to do

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is one thing, and that's poverty.

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Nelson Mandela said, in the mid-2000s,

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not too far from here, he said that

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like slavery and Apartheid, "Poverty is not natural.

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It's man-made and can be overcome and eradicated

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by the actions of human beings."

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I want to end by saying it's been the actions

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of thousands of ordinary human beings

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doing, I think, extraordinary work,

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that have actually improved health,

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and, maybe only in a small way, reduced poverty.

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Thank you very much for your time.

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(Applause)