Enivironmental Sustainability

The seventh Millennium Development Goal to achieve is the environmental sustainability. How it can we expect that people will be healthy, while they inhale polluted air, use dirty water and eat food which was grown in these bad conditions ? That’s why it is so important to improve also the environment in which society have to live, instead thinking only about vaccinations, health care systems, or preventing diseases. What is fastening buckle in all these cases is poverty and bad allocation of financial resources.

Seventh goal is divided by four smaller parts:

- Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources

- Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss

- Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation

- By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers

There are five main indicators connected to environmental sustainability:

-          urban transport

-          noise

-          energy

-          water

-          waste

-          green areas

Each of this indicators can show, with how big environmental problem in specified area we have to confront. Urban transport is the cause of the biggest part of air pollution. In Italy the government is promoting effective and environmentally sound transportation system, improving the public transport and also infrastructure. The more available and in good condition public transport is, the more people decide to use this kind of transportation instead using private vehicles. The second problem in urban areas can be noise. That is why there should be noise barriers installed to destroy or at least avoid to some extent acoustic pollution.

Third thing is the consumption of energy – it has a great impact on environment – because from the way of receiving the energy depends how much pollution will it produce. Also very important are water indicators, cause the face us with how big pollution we have to fight. Municipalities are always trying to deliver water demand and water supply and promote eco-using water systems. As the last ones I wanted to show waste and green areas indicators. The first one has a great impact on water, air and landscapes. Governments are trying promote recycling, but also reduce of waste number – cause the most important is awareness of society. It is very hard to change approach, but in long-term period it is the best way to achieve the goal. The last indicator is green areas indicator. With this tool are counted all areas like botanic gardens, free green areas, and staff which is responsible to keep it in cleanness.

Used by writing:

- http://www.youtube.com/watch?v=Ix-1XFQDlUU&feature=player_embedded

- http://www.un.org/millenniumgoals/environ.shtml

- http://siteresources.worldbank.org/EXTENVIRONMENT/Resources/chap3.pdf

- http://www.unece.org/stats/documents/2001/10/env/wp.16.e.pdf

Malaria prevention

In the short movie, during the time of watching 4 children die of malaria (one child per 30 seconds), we could hear, a few ideas how to prevent this disease. What was most important in this movie was the fact that malaria is preventable – so we could avoid many deaths if we had followed some rules. Red Cross and red crescent organizations are cooperating with others partners organizations to distribute insecticide-treated nets where malaria is a big danger. They also train volunteers to teach society, going from house to house, how to hang and use these nets. The organizations also ensure that children under five and pregnant woman have access to nets and provide awareness campaign how prevent this disease.

TB and HIV/AIDS

Also other infectious diseases are very dangerous in African, Asian Countries and Western Pacific Countries. Except malaria, which is the cause of one million deaths per year, but 3.3 billion people are in risk of malaria, the big problem are tuberculosis (TB) and HIV/AIDS. The first one is a contagious disease and it spreads through the air. To become sick person have to inhale only a small portion of TB germs, so it is very easy to catch it. That’s why one person can infect approximately 10-15 people. The data are ruthless – 2 billion people are infected with TB. In the year 2009 1.7 million died because of this disease. The experts all over the world are focusing how to prevent this problem. In year 2006 they launched the program “Stop TB Strategy”. The end of this program is estimated to 2015. There are six points of this strategy:

- pursue high-quality DOTS expansion and enhancement

- addressing TB/HIV, MDR-TB and the needs of poor and vulnerable populations.

- contribute to health system strengthening based on primary health care.

- engage all care providers.

- empower people with TB, and communities through partnership.

- enable and promote research.

Also In Millennium Development Goals there is mentioned the problem of TB:
Halt and begin to reverse the incidence of TB by 2015
To fulfill this aim experts use the DOTS worldwide. 41 million TB patients have been successfully treated in DOTS till this day, so if ill person is being properly treated, it has big chances it will get healthy.

Human immunodeficiency Virus (HIV) makes that immune system of a human get worse, because of destroying its cells. It is very easy to get infected, because of the fact that it is sexual and blood transmitted. In year 2008 there were 33.4 million people living with HIV, and two million died from it. Two thirds of HIV infections were reported in Sub-Saharan Africa.




Used by writing:

Ruxin, J., Paluzzi, J., Wilson, P., Tosan, Y., Kruk, M. & Teklehaimanot, A. 2005. Emerging consensus in HIV/AIDS, malaria, tuberculosis, and access to essential medicines. (pdf) The Lancet, Vol. 365 (12), 618-621.
WHO Fact sheets: Malaria, 10 Facts on Malaria
WHO Fact sheets: Tuberculosis, 10 Facts about Tuberculosis
WHO Health Topics: HIV/AIDS
http://www.youtube.com/watch?v=N5c4kQ5S7qE&feature=player_embedded

Maternal and Child Health

Maternal and Child Health

The numbers

The graphs form Unicef has shown that during years 1990-2008 there was a huge decrease between child mortality under five years. The worse situation was in Sub-Saharan Africa with the number of mortality rates on level 184 children per 1000 population in year 1990 and with a little bit lower number by the year 2008 – 144 cases per 1000. The best situation was is Central and Eastern Europe, Common wealth of Independent States with rates in 1990 on the level of 51 cases and 23 cases per 1000 in year 2008. We can easily see that according to date from year 2008 there was six times less case of child deaths in Europe than to Africa. The gap becomes even widen if we compare rates of deaths in Industrialized to Developing Countries. In 90’ the rates in first case were by 10/1000 but in developing countries it was 99/1000 – so ten times more. In year these rates decreased to 6/1000 in Industrialized Countries and to the level of 71/1000. When we analyze the total number of deaths  under-5 years worldwide, we can observe also a big drop – from 12,5 millions in 90’ to 8.8 millions in 2008 – that is a clear sign that the problem of child mortality is being try to be solved. Unfortunately this numbers are still very high. We should ask what the causes for such high rates are worldwide, what the reason of such big gap between countries is and how we can prevent children and their mothers.

Causes

If there is lack of money and the children are also hungry and cannot give their organisms adequate amount of vitamins minerals and nutritional values, the health of these children is very poor and they can easily become ill.

We can see a few reasons of child and maternal mortality. The biggest single one is pneumonia. Every year there are more than 150 million cases worldwide but 100 of them are reported cases from only 15 countries. The causation of pneumonia are very often malnutrition and polluted air. Also the big problem are diarrhoeal diseases. Plenty of children daying from these reason in developing countries. Interesting is the fact what can prevent children from it – it is breastfeeding.

In African countries the big problem is malaria – almost 2900 childs die from these disease each day – it is like small city or village. Also main causes of child mortality are measles and HIV/AIDS. To avoid these problems, there should meet several conditions. First one is the quality of care while pregnancy period, second is safety delivery by birth attendant and as a third we can have good neonatal care. When we think about the Millennium Development Goal 4:” to reduce the under-five mortality rate by two-thirds by 2015” – it not seems to be easy challenge. It is also not cheap goal – experts are in opinion that it will cost nearly 50 billion $. It is a lot !

Readings

    * Childinfo 2008. Monitoring the situation of children and women. UNICEF

          o Statistics by area / Child Survival and Health

          o Statistics by area / Maternal Health

    * UNICEF 2008. Why are millions of children and women dying?

    * WHO 2008. Fact sheets. Female Genital Mutilation.

    * WHO 2008. 10 Facts on child health.

    * WHO 2008. 10 Facts on maternal health.

    * WHO 2008. 10 Facts about women's health.

    * WHO 2008. What are the key health dangers for children?

Primary Education

Education

The second millennium development goal is - Primary Education for All.  These four words for me personally are so obvious like saying that water is wet or that while staying in the sun makes you warmer. But after reading couple of articles and watching short movies I feel privileged that I can educate not only in primary school, but also in high school and after this go to a college. In my country -Poland -we have compulsory education till we become 18 years old. In meaning of lack of education all over the world - compulsory can mean also that everybody are allowed to learn without any gender or financial restrictions. It is also strange for me that so many children can exist without reading ability.

According to the education table of unicef the smallest number of literacy rate among the youth was in Eastern and Southern Africa with percentage of 75 by males and 64 by females. If we would like to choose the country which has the lowest literacy rate it would be Burkina Faso with percentage of 40 males and 27 females. Comparing to some European countries like Portugal, Slovenia or Italy that all have the same level of 100% we see a enormous gap. These differences could explain the fact, that in less developed countries the primary enrollment ratio is also very low. If the children do not attend to school, they cannot get some basic skills, like reading abilities, which are necessary to develop themselves.

The table shows us also that in East Asia and Pacific the primary school enrollment ratio is the largest worldwide with numbers of 98 for males and 97 for females. The smallest one is in West and Central Africa with percentage of 68 for males and 59 for females. The highest percentage was in Japan, Spain and Canada and the lowest was in Djibouti – in East Africa. As we can see in most of countries are less female students then male students. The cause could be here the tradition of the country – for example that woman should stay at home and take care of it, or also religion, habits. But the more people will be well educated, the more opportunists  their country will have in the future.

“Eliminating gender disparity in primary and secondary education” – was an idea included to the second millennium development goal.  The percentage of enrollments to primary schools between genders in low income countries in 80’ was very uneven.  In those days the percentage gap between boys and girls was at the level  of 38% for  females and 62% for males. Nowadays  the rates are close to 48% for females and 52% for males. This fact shows, that these countries made a huge step to avoid gender gap in education. But still there is a big  gender gap in some countries like for instance  Guinea-Bissau in  West Africa, where only 40% students in primary school are females and others are males. 

Used by writing:

• UNICEF 2008. Basic education and gender equality.
• Education for all
• The big picture
• The World Bank 2008. Education and Development.
• The World Bank 2008. Girls' education.
• http://www.youtube.com/watch?v=hNBvtM1hmzQ&feature=player_embedded

Poverty

Poverty as a huge problem of public health

In the article of Farmer et al (2006) we can see two main topics – the first one is the structural violence which was described by Johan Galtung during the 1960s :

´´ social structures—economic, political, legal, religious, and cultural—that stop individuals, groups, and societies from reaching their full potential´´ As I understood his thought this correctly we cannot treat poverty only as a matter of lack of money, but also as a restricted policies, religion, law or culture. If one billion of people on the whole world try to survive couple of days more because they are starving, it is a enormous problem which cannot be solve only by giving them money, because it can be so, that they don’t have proper infrastructure to use this money. The same will be with treatment or any interventions provided by physicians or public health experts to society – it could fail if they do not know the social aspects of chosen group - and this is a second topic – clinical medicine. Poverty means unfortunately that health level of poor people is much worse than the well-being wealthy person, because they just do not have enough or any money to visit a doctor when they are ill.

Used by writing:

*Galtung J (1969) Violence, peace and peaceresearch. J Peace Res 6:167–191.

*Dying for change. Poor people's experience of health and ill-health. (pdf) WHO & The World Bank. Complete report. (to the appropriate extent) You can also choose applicable parts in this Dying for change.

*Farmer, P., Nizeye, B., Stulac, S. & Keshavjee, S. 2006. Structural Violence and Clinical Medicine. (pdf) PLoS Medicine, Vol. 3(10).

*Poverty in Focus 2006. What is poverty? Concepts and measures. (pdf) (This publication contents many interesting articles on gender equality and poverty, read someone)

*Sanchez, P. & Swaminathan, M.S. 2005. Hunger in Africa: the link between unhealthy people and unhealthy soils. (pdf) The Lancet, Vol. 365, 442-444.

Public Health

Health at global level.

-Public health, as a science which is extracting knowledge from many fields like biology, epidemiology, medicine, demography, economics and many others, is a very important tool, which should be used to keep the society healthy. It also helps to create proper health policies in many countries, which are interested in rising their health level. Is it possible to prevent all citizens all over the world at high level ? Unfortunately not, because of few factors. The most important seems to by the lack of money in poor countries. There are also other factors like social-cultural, environmental and institutional. The influence of all of them decides about the shape of population health.

References used:

• Huynen, M., Martens, P. & Hilderink, H. 2005. The health impacts of globalisation: a conceptual framework. Globalization and Health 1:14. (pdf)
• Kickbusch, I. 2002. Global Health - A definition. (pdf)
• Pan American Health Organization (PAHO) 2002.Public Health: What's it really about?