Vol. 1, Number 4 December 2005 (english) - BVSDE - PAHO/WHO

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Vol. 1, Number 4 December 2005 (english) - BVSDE - PAHO/WHO

BULLETIN OF THE HEALTHY SETTINGS UNITS, AREA OF SUSTAINABLEDEVELOPMENT AND ENVIRONMENTAL HEALTH, PAHO/WHOVolume 1, Number 4December 2005Healthy Municipalities,Cities and CommunitiesThe Executive Committee of the HealthyMunicipalities, Cities and CommunitiesNetwork meets in PeruMarilyn Rice, Regional Adviserin Healthy Municipalities,Cities and Communities,SDE/HS, PAHO/WHOThe Executive Committee ofthe Network of Healthy Municipalities,Cities and Communitiesof the Americas meton December 14 and 15 todevise strategies and an actionplan for strengthening nationalnetworks of HealthyMunicipalities and Communities,as well as the Network ofthe Americas. The meetingwas organized to coincidewith the 3rd National PeruvianMeeting of Healthy Municipalitiesand Communities,that took place from December12 to 14, 2005, in Lima,Peru. The event broughttogether presidents and otherrepresentatives of nationalHealthy Municipalities Networksfrom various countriessuch as Argentina, Brazil,Cuba, Mexico, Paraguay, Peru,Spain, as well as representativesof PAHO from Peru, theUS/Mexico border, and PuertoRico.Among the actions defined forthe next 5 years, the Committeeemphasized the need tostrengthen existing nationalnetworks, as well as to supportthe creation and sustainabilityof new national and local networks.Documentation andevaluation of HMC initiativesand of National Networks isconsidered an essential task inorder to reach this objective.The mission of the HMC Networkof the Americas is to leadthe development and thestrengthening of the HMCstrategy and to position healthpromotion at the top of thepolitical agenda.For more information contactMarilyn Rice(ricemari@paho.org)Marilyn Rice, PAHO/WHOMore than 30 representativesfrom Costa Rica, El Salvador,Guatemala, Honduras,Nicaragua, and Panama metin San Jose, Costa Rica,from November 29 to December1 2005 to participatein the "Central AmericanWorkshop on the HMC Strategyand its ParticipatoryEvaluation." The event offeredthe opportunity to sharenational experiences amongthe participating countries, aswell as the preparation of anaction plan for conductingHMC and participatoryevaluation activities in therespective countries.For more information aboutthe Central-American workshopcontact Marilyn Rice(ricemari@paho.org)Municipalities under the DDT/GEF Project working toeradicate malaria in Central AmericaDr. Alfonso Contreras, SDE/HS, PAHO/OMSThe municipalities in theDDT/GEF project demonstrationsites are achieving suchnotable advances in the reductionof the prevalence of endemicmalaria that the possibilityof achieving its eradicationis already being considered.In this editionIV National Meeting of Healthy Municipalitiesand Communities in ArgentinaHealthy Municipalities in Trinidad andTobago: an exercise to develop a healthyspace and community initiativeA proposal to improve quality of life inUruguayHealthy Housing Regional Symposium:challenges for the millennium in theslums of Latin America and the Caribbean2344The HealthyMunicipalitiesInitiativeadvances inCentral AmericaTo further strengthen itswork, the Operations Committeeof the 8 participatingcountries agreed to incorporatethe Healthy Municipalitiesand Communities Strategy(HMC) into the DDT/GEF project. The HMCstrategy will make it possibleto strengthen key componentsof the project such asgaining political commitmentand developing localpolicies, and having effectiveparticipation from differentsectors in planning collaborativeactivities, establishingindicators for monitoring andevaluation, and recognizingindividual contributions inorder to encourage the successof all.(Continue on page 2)Annoucementns• Supporters of bicycle paths in various cities of the Americas, cametogether in Bogotá, Colombia, on November 13 2005, and created aworking group and the UNITED BICYCLE PATHS NETWORK OF THEAMERICAS. The association of various organizations, private andpublic, and individuals, have supported the creation of bicycle pathsin their municipalities or cities, and are interested in exchanginginformation and providing mutual support for the strengthening ofbicycle paths in the Americas. For more information, visit the UnitedBicycle Paths of the Americas website: cicloviasunidas@ciudadhumana.orgThe Healthy Settings Unit team wishes you a HappyHoliday and a Healthy 2006!


IV National Meeting of the Argentine Network of Healthy Municipalities and CommunitiesOperations Committee of the Argentine Networkof Healthy Municipalities and CommunitiesDuring the 24 and 25 of August 2005, the IVNATIONAL MEETING OF HEALTHYMUNICIPALITIES AND COMMUNITIEStook place in Argentina under the slogan"Social Responsibility in Collectively BuildingHealth", organized jointly by the PAHO/WHO Office in Argentina, the ArgentineNetwork of Healthy Municipalities and Communitiesand the Ministry of Health and Environmentof the Nation. More than 570 peopleattended. Among the participants wereProvincial Ministers of Health, more than 60Mayors, community leaders, representativesfrom various government secretaries (Health,Social Action, Education, and Environment),and other municipal staff members such ashospital directors and community healthagents from the entire country, universitiesand NGOs.The meeting began with the Welcome Statementfrom the PAHO Representative in Argentina,Dr. José Antonio Pages and from theUnder Secretary of Health Relations andHealth Research of the Ministry of Healthand Environment of the Nation, Dr. CarlosVizzotti. The keynote speech for August 24was presented by Dr. Mercedes Juarez, representativeof the Commission on Social Determinantsof Health of WHO Europe. Afterwards,the panel "Collectively BuildingHealth: lessons learned, progress, andchallenges", was presented by the Ministerof Public Health of the Eastern Republic ofUruguay, and the Minister of Housing,Land Management and Environment of thesame country, the Director of Health Promotionof Chile, and the Minister of PublicHealth of the Province of Tucumán.The Opening Session of the second daywas the responsibility of the Minister ofHealth and Environment of the Nation, Dr.Ginés González García, who made a presentationon "The leadership of the Ministryof Health and Environment of the Nationin institutional health promotion capacitybuilding.”Following the opening session a panel onthe "Social responsibility of Universities,Businesses, and Nongovernmental Organizationsin collectively building health",took place with contributions from representativesof each of the following entities:Argentine Business Council for SustainableDevelopment (CEADS),the American Pan EnergyCompany; various municipalities,the Mayor of theHealthy Municipality ofRafaela, the University ofMoron, the Organization ofEcoclubs, and the Health ServicesAuthority.In the afternoon, simultaneousIV National Meeting of theArgentine Network of HealthMunicipalities and Comunitiesforums were held that addressed the topic of"Citizen Participation in Health. The role ofthe municipalities," in which healthy municipalitiesthat are members of the Networkpresented their experiences, followed by discussionamong the participants that resultedin the development of an agreement aboutlocal areas of intervention.During the third day, the Special Meeting ofthe Argentine Network of Healthy Municipalitiesand Communities took place, attendedby 140 representatives of the 104municipalities that are members of the Network.Dr. María Teresa Cerqueira, Chief ofHealthy Spaces Unit, Area of SustainableDevelopment and Environmental Health,PAHO/WHO, made a presentation on "Theimportance of networking as a way ofstrengthening the Region." As a result of thegroup work, which was based on a participatorydiagnosis, the priority problems for regionalmanagement were identified and thelines of action for the Regional Planning2006-2007 were jointly outlined.For more information contact:E-mail: redmunisal@msal.gov.arWebsite: www.msal.gov.arPhone: +54-11+4379-9309Municipalities under the DDT/GEF project working to eradicate malaria in Central America(continued from page 1)The objective of the DDT/GEF project is toeliminate the remaining DDT from CentralAmerican countries, while developing alternativesto pesticides to combat endemicmalaria in the area.The initiative to completely eliminate theuse of DDT came from the Commission ofEnvironmental Cooperation (CAC) whichoperates within the framework of the NorthAmerican Free Trade Agreement. Mexicomade the commitment to eliminate its DDTreserves by 2002.Subsequently in 2003, and under the DDT/GEF project, the initiative was extended toBelize, Costa Rica, El Salvador, Guatemala,Honduras, Nicaragua and Panamaunder the coordination of the Pan AmericanHealth Organization (PAHO) through the`Global Environmental Funds` (GEF) financedby the United Nations EnvironmentProgram (UNEP). After two years of implementation,the 8 countries met in CostaRica in September 2005 to monitor theirachievements and refine their plans to meettheir objectives.During the Second Annual Meeting of theDDT/GEF Project Operations Committeebaseline data documenting the malariasituation was shared. The number of malariacases continues to be reduced in theproject’s demonstration sites despite thefact that the use of of DDT has been replacedwith a strong component of communitymobilization.The countries of Central America are nowcloser to reaching the Millennium DevelopmentGoal number 6 to stop and reverse thetrend of malaria growth in the world. Infact, it is expected that the partnership betweenDDT/GEF and HMC will contributeto furthering the goal of malaria eradicationin Central America.For more information about the DDT/GETProject contact:Dr. Alberto Contreras: contrera@paho.orgPage 2HEALTHY MUNICIPALITIES, CITIES AND COMMUNITIES


Healthy Municipality in Trinidad and Tobago: an exercise todevelop a healthy spaces and community initiativeGina WatsonPAHO/WHO—Trinidad y TobagoThe HMC Initiative in Trinidad and Tobagowas designed within the frameworkof the Caribbean Charter for Health Promotion(First Caribbean Conference,1993) and the implementation andevaluation processes of the NationalHealth Promotion Plan (1996-2000) forthe promotion of healthy lifestyles andreduction of chronic non-communicablediseases (CNCD) and related risk factors.The initiative targeted school children,out-of-school youth, adults, elderly andwomen; with emphasis on school childrenand persons over 45 years of age.The purpose was to develop, in collaborationwith all partners, a Healthy CommunityMovement/Health Promoting School(HMC/HPS) project that would contributeto improving quality of life and emphasizinghealth promotion and CNCDprevention and control.A pilot project was implemented in twocommunities, with the goal of developinghealthy lifestyle practices and healthyenvironments to improve well-being andthe health status of the community. Theinitiative was based on a multisectoralpartnership strategic approach and builton the principles of equity and efficiency.It relied on further developing the currentinterventions at the community level, butin partnership with all levels, to buildinstitutional strengths and skills, communityempowerment and organization,advocacy, information/education andcommunication, surveillance, research,monitoring and evaluation.Five strategies were earmarked for theprocess: policy formulation and implementation,community empowerment,resource mobilization, networking, monitoringand evaluation.The Eastern Regional Health Authority,with support from the national task force,led the technical process in the communityof Plum Mithan, and facilitated thedialogue and consultation with the community.These community consultations identifiedneeds, concerns, and issues perceived asaffecting health status and quality of life invarious dimensions - social, economic,environmental, infrastructure and healthrelatedissues/problems (low immunizationcoverage, CNCD [adults], dental caries,skin conditions, dengue, drug abuse).The community assessed its needs and prioritizedthe following areas:1. Acquiring a reliable potable watersupply system (the community relieson barrels and truck-borne water forsupply).2. Improving access to health services(there is no facility in the community).3. Developing skills among youth (fishfarm training project, developing aself-sustainable youth center, othertraining).4. Creating a safe recreation area forchildren.5. Training community health educationprogrammers (focus onwomen’s health andschool health).6. Developing an ecotourismproject.This further contributed toextending partnership and advocacywith and through theRegional Corporations and the organizationof sub-committees in support of the CommunityVillage Council.As a result of the initiative, this rural communityof approximately 2,000 inhabitantsmainly of East Indian descent, has obtainedapproval for and or implemented:1. A water project (currently communitytanks were installed to ensure potablewater as an intermediate measure).2. Plum Mithan Outreach Health Servicewith a reliable transport/shuttle serviceto the nearest health center, withassigned health personnel (medicalofficer, pharmacist).3. Training programs conducted foryouth and adults (fish farming, computerliteracy and beauty/personalcare).4. Donation of computerized equipment.5. Job training and placement.6. Political and social notoriety.7. Community empowerment withwomen now occupying leading rolesin the community.8. Youth mobilized and working towardscreation of a youth Centre, amongothers.After the process was launched at the nationallevel by the Honorable Minister ofHealth with support of the Mayors’ ToolKit, and with the participation of Mayorsand Chairmen of Regional Corporations ithas:1. Moved on to establishing two otherpilot sites.2. Designed and presented a proposal tothe Prime Minister to improve theSchool Health Program and its approvalhas led to the formationof a NationalSchool Policy.” These communityconsultations identifiedneeds, concerns, andissues perceived asaffecting health status andquality of life .”3. Established qualifiedaccessible hearing andvision screening servicesfor 100% of primaryschools.4. Hosted Caribbeanmeetings related to HCM and sharingexperiences among countries with theparticipation of community representatives.5. Developed local training and materialsfor all Regional Health Authorities anda more integrated approach for riskfactor management of noncommunicabledisease.6. Strengthened the network and partnershipwith Governmental institutions,NGOs, Community-based organizationsand agencies cooperating withthe process.For more information about the HMC initiativein Trinidad and Tobago contact:Dr. Gina Watson—watsong@trt.pa.orgVOLUME 1, NUMBER 4Page 3


A proposal to improve quality of life in UruguayMs. Elsa Ferradini, Coordinator, Areaof Population EducationMr. Horacio Sum – Community Mobilizer,Honorary Commission for the FightAgainst Cancer, Uruguay.As required by the Honorary Commissionfor the Fight Against Cancer in Uruguay,in 1993 the Area of Population Educationwas created with the goal of preventingcancer and encouraging its early diagnosis.The Area of Population Education involvesrevaluing individual and commu-community self-care, taking into accountthe intersectoral nature of health and recognizingthat the health sector is responsiblefor leading the actions in a coherent andorganized manner. This will allow othersectoral and social actors to work in healthpromotion and to adequately guide prevention,care and rehabilitation. The programpromotes the continuity of theeducational process within thedaily lives of the community,stimulating and coordinatingefforts to improve people’squality of life, promotinghealth and contributing tocancer prevention in Uruguay.The programming of the Area of PopulationEducation is based on the results of:1. A survey of national organizations.2. A population survey of knowledge,beliefs, attitudes and practices relatedto cancer.”Our task seeks thecontinuity of theeducational process withinthe daily lives of thecommunity”3. Epidemiological datarelated to the disease inUruguay and around theworld.Nontraditional methodologiesof community workare applied with the(Continue on page 5)Healthy Housing Regional Symposium: challenges for theMillenium in the slums of Latin America and the CaribbeanDr. Marcelo Korc, Regional Adviser forHealthy Housing, SDE/HS, PAHO/WHOFrom 3 to 7 September 2005 the RegionalSymposium "Healthy Housing: challengeof the Millennium in the slums of LatinAmerica and the Caribbean" was held inLima, Peru. The Symposium was organizedby the Pan American Health Organization/WorldHealth Organization(PAHO/WHO), the Economic Commissionfor Latin America and the Caribbean(ECLAC), the United Nations Programfor Human Settlements (A-HABITAT),the Latin American Federation of Cities,Municipalities, and Associations(FLACMA) and the Inter-American Networkof Healthy Housing (NetworkVIVSALUD) at the international level,and, at the national level, by the Ministryof Housing, Construction and Sanitation,the Ministry of Health, the NationalCouncil of the Environment, the PeruvianNetwork of Housing, Environment andHealth and the Peruvian Association ofToxicology.Approximately 120 people from over 10Latin America and Caribbean countriesparticipated in the symposium. Morespecifically, participants represented theNational Health and Housing authoritiesfrom Colombia, Costa Rica, DominicanRepublic, Mexico, Paraguay, and Peru,local authorities from Ecuador and Peru,national and local coordinators of theVIVSALUD Network and internationalcooperation agencies.The purpose of the Symposium was to promotethe synergy of actions in policies,plans, programs and projects related tohousing in slums and the Healthy HousingStrategy to improve health and quality oflife of the population of Latin America andthe Caribbean with the goal of fulfilling thecommitment of the Millennium Declarationadopted in the year 2000 and to improveequity in health as promoted by the WHOCommission on Social Determinants of theHealth created in May 2005.The general recommendation of the Symposiumwas that the countries assume theright to adequate housing as national policy.In particular, it was recommended thatthe policies, plans, programs, and publichousing projects of social interest at thenational and local levels:1. Consider housing in an integratedmanner using rural-urban concepts ofplanning, focusing not only on thephysical environment, but also on thehome and the community environment,and respecting, insofar as possible,people’s culture and customs.2. Include the concept of healthy housing,which incorporates a residentialspace that promotes the health of itsresidents. Healthy housing addressescontrollable and preventable risk factorsand includes agents that promotehealth.3. Prioritize health and well-being byevaluating the impact on the health ofthe affected populations.4. Facilitate the community’s participationin the decisions from the beginningof the process.Based on these recommendations, theVIVSALUD Network developed a regionalaction plan for the period 2006-07 that includes:1. Support for policy-making, plans, programs,and public projects that promotehousing of social interest andhealthy urban development.2. Strengthening of national and localsystems of monitoring of risk factorsand health protection associated withhousing.3. Research concerning the relationshipsbetween health and housing.4. Development of community evaluation-action-participation.5. Development of capacities.6. Institutional development of the Network.For more information contact:Marcelo Korc: korcm@ven.ops-oms.orgVOLUME 1, NUMBER 4 Page 4


BULLETIN OF THE HEALTHY SETTINGSUNITS, AREA OF SUSTAINABLEDEVELOPMENT AND ENVIRONMENTALHEALTH, PAHO/WHO525 23rd St, NWWashington, DC20037www.paho.orgThis bulletin is a trimestral publication of the Healthy Settings Unit, Areaof Sustainable Development and Environmental Health, PAHO/WHO.The content can be reproduced, as long as the source and author(s) arecited.Dr. Luiz A. Galvão, Area Manager, Area of Sustainable Development andEnvironmental HealthDr. María Teresa Cerqueira, Chief of the Healthy Settings UnitMarilyn Rice, Regional Adviser for Healthy Municipalities, Cities andCommunitiesEditor: Maria Cristina Franceschini, Consultant for the Healthy SettingsUnit.Send your suggestions, questions and comments to: francesm@paho.organd ricemari@paho.orgTo submit articles for publication in this bulletin, please contact MariaCristina Franceschini (francesm@paho.org) and Marilyn Rice(ricemari@paho.org).To subscribe to the listserv of the Network of Healthy Municipalities, Citiesand Communities of the Americas:A proposal to improve quality of life in Uruguay(continued from page 4)fundamental objective of generating, inthe existing institutional and human resources,interest in helping to improvepopulation health. Area Personnel ineach department of the country form,guide and support networks of joint workwith the community, trying to transfer toorganizations the capabilities to improvehealth. This is accomplished by transferringinformation and applying the appropriatemethodology to each organizationand community.The objective is to promote activities thatstimulate people to want to be healthy, toknow how to remain healthy, to act individuallyand collectively in order to conservehealth, and to seek assistance whenthey need it. Operational groups for reflection,exchange of knowledge, andexperiences have been formed and havebecome agents of change in their environmentand communities.Information and continuing educationdirected toward sensitizing people aboutlife habits, to motivate social reflectionStudents march during the Tobacco Smoke-freeDayand to promote healthy practices are thepriority topics considered essential forhealth with regards to cancer: periodicmedical exams, keeping knowledge current,taking care of one’s body, balancednutrition, smoke-free spaces and physicalactivity.Encouraging results have been observedthrough the response of hundreds of organizationswith whom the program regularlyworks. Concrete results from twelve yearsof work can be seen in the creation ofbuildings, businesses and tobacco smokefreeevents; the integration of proposals forrecreation, physical activity and healthydiet in educational and social centers; theincorporation of protective measuresagainst the sun’s ultraviolet radiation byspecific groups such as lifeguards, physicaleducation professors and constructionworkers.The commitment made by the organizationsis the result of continuous work thatstrives for complementarity in order topreserve each organization’s profile andidentity. Communication, education andcommunity participation strategies are appliedthat make it possible to involve publicand private institutions, the community,teaching centers, trade associations and themedia in the implementation, execution andevaluation of outreach, promotional andeducational activities.The multiplicity of the agents involved hasmade it possible to constitute a work strategythat enables the participation and jointeffort of different social actors working topromote an improved quality of life.For more information contact:Ms. Elsa Ferradini:e-mail: edupobl@urucan.org.uyPáge 5HEALTHY MUNICIPALITIES, CITIES AND COMMUNITIES

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