CAIRO, 26 January 2010 (IRIN) – The Egyptian government’s decision to cull all of the country’s 300,000 pigs in May 2009 is increasingly being viewed by experts and officials as a gross mistake as piles of organic waste the pigs once ate accumulate in Cairo’s streets, posing serious health hazards.

The month-long cull was ostensibly to stem the spread of H1N1 influenza, but the government later said it was simply a general health measure.

The cull hit the livelihoods of 70,000 former pig farmers and unofficial rubbish collectors and their families in the Cairo area, according to local NGO Association for the Protection of the Environment.

During a recent stormy session of parliament, Cairo Governor Abdelazeem Wazeer called the decision to cull the pigs a “mistake” and legislator Hamdy el-Sayed, chairman of the Doctors’ Association, called it a “national scandal”.

“Our streets are overcome by waste. This is catastrophic,” he said.

“The decision to kill the pigs was wrong and hasty,” Fahti Shabana, an Egyptian medical expert, told IRIN. “There could’ve been better alternatives. The pigs could’ve been moved from their farms in the cities to the desert.”

Shabana warned that some of Cairo’s rubbish-filled streets could become breeding grounds for diseases such as typhoid and cholera. Areas of central Cairo, Giza and Daqahlia on the capital’s periphery are the most affected by the pig cull.

‘Zabalin’ 

In Cairo, the livelihoods of unofficial rubbish collectors – known as ‘Zabalin’ to Egyptians – and pig farmers were very much intertwined as the former collected organic waste from the capital’s streets and sold it to farmers to feed their pigs.

With the pigs gone, the `Zabalin’ have lost a major source of income and have no incentive to collect the waste from the streets, they say.

“Rubbish collectors are poor. Organic waste used to bring them money after they sold it to pig farmers. But now, there’s a market for plastic, paper and glass items only,” said Israel Ayad, a rubbish collector-cum-pig farmer who is also an unofficial spokesman for the `Zabalin’.

Ayad, in his early seventies, used to own around 50,000 pigs which used to “consume thousands of tons of organic waste every day”, he said.


Photo: Amr Emam/IRIN
Cairo produces 25,000 tons of waste a day

Waste disposal, recycling problems

Cairo, which accounts for 55 percent of the country’s waste, produces 25,000 tons of waste a day, Environment Ministry officials say.

Organic waste makes up almost 70 percent of Cairo’s rubbish, while plastic, paper and glass items make up the remaining 30 percent, according to Ahmed Nasar, deputy chairman of the capital’s cleaning authority.

Compounding the problem are ongoing contractual disputes between the government and the foreign companies it has been commissioning to collect rubbish from the capital’s streets for years, according to Mohamed Abdel Raziq, an official from the cleaning authority.

These companies had stopped working pending the renegotiation of contracts, he said.

Members of the ruling National Democratic Party say Egypt needs an initial LE 2.5 billion (US$460 million) to tackle its garbage problem. They say more recycling factories must be built to add to the existing 160, which can only process about a quarter of the nation’s rubbish, according to the Environment Ministry.

Despite the cull, H1N1 has claimed the lives of 230 Egyptians to date and 15,000 people have contracted it, according to the Health Ministry.

According to a 22 January World Health Organization update on H1N1, “Egypt is now reporting a declining trend after increases in respiratory diseases activity throughout December 2009, suggesting a recent peak in activity during early January 2010.”

Source – http://www.irinnews.org/PrintReport.aspx?ReportId=87853

Ahmedabad: The Indian Institute of Management Ahmedabad (IIMA) will help the people in the city’s slums to bring about a positive social change as well as make a living by producing videos on social issues. The initiative is being undertaken along with NGOs Saath, Navsarjan and Video Volunteers.

Under the programme, the NGOs are forming several Community Video Units (CVUs) by training slum dwellers in the city in video production so as to use videos as a means of social change and human rights advocacy. IIMA is now taking part in the effort to enable the CVUs and their video productions sustain themselves by adopting a sustainable model.

The CVUs produce short films which highlight social issues such as ration shops selling at hyped rates, health issues like chewing tobacco and smoking and others issues like education and domestic violence and so on. These short films are screened in various areas of the city to sensitize the people and help bring about a positive social change. Right now, the NGOs and IIMA have started working in Gupta Nagar, Juhapura and Vadej.

Talking about IIMA’s role in the initiative, IIMA faculty Ankur Sarin said, “It will be only through a sustainable fund and income generation that the CVUs will be able to continue with the initiative on their own. With a team of students of IIMA and the institute’s CIIE, we are trying to find such a sustainable model to source their income and enable them to pursue the initiative.”

IIMA has employed researchers and assigned its students for detailed study and research in the area. Sarin said, “We are also seeking to involve the private sector and the government in the sustainable functioning of the CVUs.”

Talking about the importance of the initiative, Saath’s director of urban programmes Chinmayi Desai said, “The mainstream media leaves out many issues of these marginalized people. Through the programme the people themselves will get an opportunity to highlight their own issues which they understand better than anyone else.”

She said, “We have around 10 CVUs and have made 14 such short films till now. We have identified 100 pockets in the city where these films could be screened. We try to come up with a short film every month and screen them in various places after which we take up follow-up action by informing them what to do to sort out these issues and whom to approach.”

Source – http://www.dnaindia.com/india/report_ngos-tie-up-with-iima-to-help-slum-dwellers_1335389

Jan 22 – The Athi Water Services Board (AWSB) has partnered with the French Development Agency and the Swedish embassy to construct 20 bio centers in three informal settlements in Nairobi to help 350,000 people get safe water. The centers which have been constructed in Mukuru, Korokocho and Kibera will serve as water collection points and sanitation blocks for the dwellers. 

The director of AWSB Silverse Anami on Friday said the projects would help contain poverty in the slums as they would be managed by self help groups in the respective settlements. “The bio centers are community projects which will help empower the inhabitants in these places because they will also be used for generating income.

People who wish to get good clean water will have to pay some little money. The money obtained from these payments will support the education and general welfare of orphaned children living in this informal settlement,” he explained.

Speaking during the opening of Stara bio center in Kibera, Mr Anami added that the projects would also protect the residents from being exploited by unscrupulous water dealers whose point of water supply is sometimes untrustworthy. “Over the years residents of informal settlements have had to cope with poor water and sanitation services.

It is estimated that 95 percent of the dwellers get their water from suppliers whose source of water is illegal and therefore unsafe.

Seventy five percent of the population in informal settlements has no toilet facilities within their homes. These projects will help improve these conditions,” he said.

He further explained that the bio centers would also be used to generate cooking gas for the dwellers in addition to saving water as they used minimal water in the sanitation units. “The centers are designed to generate methane gas through the bio degradation of human waste.

The gas is in turn harnessed for cooking use by the concerned group,” he said.

The Deputy Director of the AFD Nairobi Regional Office Olivier Delefosse said the French agency would also construct 80 additional bio centers in three cities adding that the Nairobi projects would cost sh6.4 billion.

“We will work in urban areas to improve the entire water and sanitation system from production of water in dams to transmission lines and distribution including informal settlements. The other ablution blocks whose construction we intend to fund are in Kisumu, Nairobi and Mombasa.

The ones in Nairobi will cost us around €60 million,” Mr Delefosse said. Lawi Obiya who is a representative of the Umande Trust which was charged with the management of the Stara bio center said the project would help residents in other areas of Kibera to get cheap cooking gas and uplift their living conditions.

“We will tap this gas and supply it to everyone who needs it. Our children will not have to go out and buy firewood any more. It is really going to help us,” he said. Mr Anami lauded the French agency for their support and called on other development partners to take part in such initiatives.

“They have helped us with a grant of Sh3 billion which we are using to develop the dams that will bring water to these areas and they have also approved an additional grant of Sh3.2 billion.

We are happy that other development agencies are coming in. We need to work together because there is what the civil society can do with communities that government cannot do. The success of any project depends on such partnerships,” he said.

Source – Capital FM

WHO Bulletin, forthcoming article

Fatal injuries among urban children in South Africa: risk distribution and potential for reduction

Full-text: http://www.who.int/bulletin/volumes/88/4/09-068486.pdf

Stephanie Burrows,a Ashley van Niekerkb & Lucie Laflammec

Objective – To determine the leading causes of fatal injury for urban South African children aged 0–14 years, the distribution of those causes and the current potential for safety improvements.

Methods – We obtained injury surveillance data from the National Injury Mortality Surveillance System 2001-2003 for six major South African cities varying in size, development and sociodemographic composition. We calculated age-adjusted rates, by sex, population group and city, for death from the five leading causes of
fatal injury as well as population attributable risks (PARs).

Findings – The leading causes of fatal injury in childhood included road traffic injuries – among vehicle passengers and especially among pedestrians – drowning, burns and, in some cities, firearm injuries. Large differences in PARs were observed, particularly for population groups and cities. Disparities between
cities and between population groups were largest for deaths from pedestrian injuries, while differences between boys and girls were greatest for drowning deaths.

Conclusion – In the face of the high variability observed between cities and population groups in the rates of the most common types of fatal injuries, a safety agenda should combine safety-for-all countermeasures – i.e. lowering injury rates for all – and targeted countermeasures that help reduce the burden for those at
greatest risk.

WHO Bulletin, forthcoming article

Level of urbanisation and noncommunicable disease risk factors in Tamil Nadu, India.

Full-text: http://www.who.int/bulletin/volumes/88/4/09-065847.pdf

Steven Allender,a Ben Lacey,a Premila Webster, et al. 

 Objective – To investigate the poorly understood relationship between the process of urbanisation and noncommunicable diseases (NCDs) through the application of a quantitive measure of urbanicity.

Methods – We constructed a measure of the urban environment for seven areas using a seven-item scale based on data from the Indian Census 2001 to develop an ‘urbanicity’ scale. The scale was used in conjunction with data collected from 3705 participants in the 2003 WHO STEPwise risk factor surveillance survey in Tamil Nadu, India, to analyse the relationship between the urban environment and major NCD risk factors. Linear and logistic regression models were constructed examining the relationship between urbanicity and chronic disease risk.

Findings – Among men, urbanicity was positively associated with smoking (odds ratio, OR: 3.54; 95% confidence interval, CI: 2.4–5.1), body mass index (OR: 7.32; 95% CI: 4.0–13.6) and blood pressure (OR: 1.92; 95% CI: 1.4–2.7), and negatively associated with physical activity (OR: 3.26; 95% CI: 2.5-4.3). Among women, urbanicity was positively associated with BMI (OR: 4.13; 95% CI: 3.0–5.7) and negatively associated with physical activity (OR: 6.48; 95% CI: 4.6– 9.2). In both sexes urbanicity was positively associated with the mean number of servings of fruit and vegetables consumed per day (P < 0.05).

Conclusion – Urbanicity is associated with the prevalence of several NCD risk factors in Tamil Nadu, India.

Trop Med Int Health. 2010 Jan 11.

Access to a health facility and care-seeking for danger signs in children: before and after a community-based intervention in Lusaka, Zambia.

Sasaki S, Fujino Y, Igarashi K, Tanabe N, Muleya CM, Suzuki H. Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Japan.

Objective – To assess the association of accessibility to a health facility with caregivers’ care-seeking practices for children with danger signs before and after community-based intervention in Lusaka, Zambia.

Method – Health education on childhood danger signs was started in September 2003 at the monthly Growth Monitoring Program Plus (GMP+) service through various channels of health talk and one-on-one communication in a peri-urban area of Lusaka. Two repeated surveys were conducted: in 2003 to collect baseline data before the intervention and in 2006 for 3-year follow-up data. Caregivers who had perceived one or more danger signs in their children within 2 months of the surveys were eligible for the analysis. The association between appropriate and timely care-seeking practices and socio-demographic and socio-economic factors, attendance at community-based intervention and the distance to a health facility was examined with logistic regression analysis.

Results – The percentage of caregivers immediately seeking care from health professionals increased from 56.1% (106/189) at baseline to 65.8% (148/225) at follow-up 3 years later (OR = 1.51, P < 0.05). Long distance to the health facility and low-household income negatively influenced caregivers’ appropriate and timely care-seeking practices at baseline, but 3 years later, after the implementation of a community-based intervention, distance and household income were not significantly related to caregivers’ care-seeking practices. Conclusion Poor accessibility to health facilities was a significant barrier to care-seeking in a peri-urban area. However, when caregivers are properly educated about danger signs and appropriate responses through community-based intervention, this barrier can be overcome through behavioural change in caregivers.

Haiti earthquake health Q&As

Source: Pan American Health Organization (PAHO), 18 Jan 2010

What has been the health impact of the earthquake?

The earthquake has inflicted massive loss of life. The total number of people who have died in the disaster is not yet known but is believed to be in the tens of thousands, with hundreds of thousands injured or homeless.

What health care is available?

The earthquake damaged or destroyed at least eight hospitals and healthcare facilities in and around the capital, Port-au-Prince, and the remaining health facilities have been quickly overwhelmed by large numbers of survivors requiring a wide range of care, particularly for trauma injuries. Before the earthquake, there were 371 health posts, 217 health centers and 49 hospitals nationwide in Haiti. In Port-au-Prince there are 11 hospitals. The total extent of the damage to Haiti’s health sector is still unknown. Many hospitals have sustained damage but can continue to function, often with the help of NGOs. Health services are also being provided at various health centers along Haiti’s border with the Dominican Republic. Some injured are being evacuated to Santo Domingo or to other countries.

Local organizations, including the Haitian Red Cross, are supporting government efforts to treat the injured and ill. Additionally, at least 13 countries from the Americas and a number of countries from other regions are providing health relief, along with United Nations agencies and NGOs.

Why is the coordination of healthcare so crucial? \

Coordination between healthcare providers and first responders is crucial to enable effective and fast life-saving aid. If UN agencies, NGOs and other agencies work together and share expertise, medicines, staff and other capacities, while at the same targeting them to identified and commonly understood health needs, then there is a greater chance of reducing avoidable suffering and death in Haiti. Following previous disasters, including the Asian tsunami of December 2004, intensive efforts to deliver relief aid in some cases were not properly coordinated, resulting in wasted materials and/or materials not well matched to specific needs. Subsequent humanitarian reform efforts produced a new “Cluster” approach,” in which agencies performing humanitarian work are grouped together as clusters in their various areas of humanitarian response. The World Health Organization heads the Global Health Cluster and as such is the international lead for the health response to the Haiti crisis.

Is more healthcare relief needed?

Yes, but it needs to be introduced in a coordinated fashion so as not to overwhelm an already precarious situation characterized by damaged roads and infrastructure. Due to the large number of people needing medical care, more doctors, surgeons, nurses, midwives, and other health workers are needed to help provide medical care.

What are the needs in relation to field hospitals?

Multiple field hospitals are operating and others are being sent to Haiti. The medical needs are great, but it is also important to properly coordinate the delivery of additional facilities so as not to overburden an already over-stretched situation.

How has the earthquake affected WHO activities?

The earthquake severely damaged the PAHO/WHO premises in Port-au-Prince and forced all staff to temporarily relocate their operational HQ to Haiti’s central medicine and vaccine storage warehouse near the airport, while the original HQ building is assessed for structural safety and telecommunications can be restored. PAHO/WHO also is establishing a field office in Jimani, Dominican Republic, located 1 ½ hours from Port-au-Prince, to serve as a bridge for the management of supplies and medical relief teams.

Do dead bodies pose a public health threat?

No. There is no risk of a communicable disease outbreak or any other public health threat associated with the presence of dead bodies. However, there is a clear mental and psychosocial imperative that we have to take into consideration when supporting the fast and proper management of dead bodies. Dead bodies in the streets are being taken to a central location for eventual identification and burial. It is important to avoid mass burials and to respect the rights of families to know the fates of their lost loved ones. For more information, go to www.paho.org/disasters.

What are the health threats?

A preliminary public health risk assessment issued 16 January details the main health threats and actions needed to address them. The assessment identifies the following as the most urgent public health threats: Wounds and injuries. Earthquakes cause high mortality due to trauma, and surgical needs are critically important in the first days and weeks. A significant number of people have suffered multiple fractures, internal injuries and crush syndrome requiring surgery.

The risk of wound infection and tetanus is high due to the disruption of health care and delays in obtaining treatment.

Water, sanitation, hygiene-related and foodborne diseases. Displaced people are at high risk from outbreaks of water-, sanitation-, and hygiene-related diseases, as well as foodborne diseases, due to reduced access to safe water and sanitation systems. Salmonella typhi (causing typhoid fever), hepatitis A and hepatitis E are present and have epidemic potential. Cholera is not endemic in Haiti. Diarrhoea is already a major contributor to the high rates of under-5 mortality; WHO estimates that diarrhoea accounts for 16% of under-5 deaths in Haiti. Leptospirosis is endemic in Haiti (see below, Vector-borne and zoonotic diseases).

Diseases associated with crowding. Population displacement can result in overcrowding in resettlement areas, raising the risk of transmission of certain communicable diseases spread from person-to-person, such as measles, diphtheria, meningococcal, and pertussis, as well as acute respiratory infections. Overcrowding can also increase the likelihood of transmission of meningitis, waterborne and vector-borne diseases in the weeks and months following the earthquake.

Pandemic influenza A (H1N1) 2009 is currently circulating in Haiti. Haiti also has the highest tuberculosis incidence in the Western Hemisphere, with significant incidence of coinfection with HIV.

Vaccine-preventable diseases. Tetanus has a case-fatality rate of 70–100% without medical treatment and is globally under-reported. Reports from the national authorities, WHO and UNICEF indicate 58% measles vaccine coverage among 1-year-old children in Haiti (2007), increasing the risk of measles outbreaks. Diphtheria outbreaks occurred in Haiti in 2004, 2005 and 2009; only 53% of 1-year-olds were fully vaccinated against DTP as of 2007.

Vector-borne diseases and zoonotic diseases. Dengue/dengue haemorrhagic fever, a viral disease transmitted by the A. aegypti mosquito, is endemic in Haiti. High transmission rates of all four dengue viruses have been reported in Haiti, with transmission occurring mainly during April/May through November. Malaria is a serious issue in Haiti and is exclusively due to P. falciparum mosquito, which exists throughout the year in the entire country. Risk in the main urban areas of Port-au-Prince is considered low but may increase in the current emergency situation. Human rabies transmitted by dogs is a priority disease in Haiti. Leptospirosis is endemic, and infection in humans may occur indirectly when the bacteria come into contact with skin (especially if damaged) or mucous membranes. Lymphatic filariasis is endemic throughout the island and is transmitted by the night-biting Culex quinquefasciatis mosquito.

Malnutrition. Earthquake-affected populations are at increased risk of moderate and severe acute malnutrition, especially in vulnerable groups such as young children, pregnant and lactating women and older persons. The risk may be increased by lack of support for breastfeeding and complementary feeding among mothers and caretakers.

Reproductive health is a major issue, with concerns including ensuring safe deliveries through access to basic and comprehensive emergency obstetric care, clinical management of sexual violence and prevention of HIV transmission and sexually transmitted diseases. Skin infections occur not only due to overcrowding but also as a result of a lack of water and reduced hygiene.

Noncommunicable diseases are an important health concern in Haiti. Chronic conditions such as cancer, cardiovascular disease including hypertension, diabetes, chronic respiratory disease and neuropsychiatric disorders account for an increasing proportion of the disease burden. With most of Haiti’s industry located around Port-au-Prince, environmental risks may exist from damaged hazardous installations such as industrial facilities, damaged oil and gasoline depots, warehouses that stockpile agro-industrial or other chemicals as well as damaged technical equipment.

Read more

Urbanization: Out of Balance and Growing, by By César Chelala

NEW YORK—When observing the chaotic, burgeoning growth of the modern city, the more erudite of urban planners will reminisce wistfully on how different it is from its ancient Greek counterpart, the polis, which Italian architectural historian Leonardo Benevolo once described as “dynamic but stable, in balance with nature, and growing manageably even after reaching large dimensions.”

The rapid and uncontrolled sprawl of today’s cities breeds anxiety not only among urban planners and architects. Experts in the field of public health are alarmed as well, for the apparent randomness of the urban dynamic is robbing the population of its basic health and well-being through unregulated environmental pollution, shrinking green areas, inadequate housing, overburdened public services, a mushrooming of makeshift settlements on the outskirts lacking in both infrastructure and services, mounting anomie, and the sheer numbers of neighbors who do not know neighbors.

Beijing, a city of over 17 million inhabitants, exemplifies this social alienation. Until the early 1980s, the Chinese capital was constructed as a multitude of “siheyuans,” or one-story complexes built around a common courtyard that were inhabited by three or four families who shared a single kitchen and water spigot. These courtyards were connected by narrow streets called “hutongs” that formed a grid from north to south and east to west.

This open structure greatly facilitated contact between neighbors, encouraged the sharing of resources, fostered relations between contiguous families, and enabled the elderly to care for children and share with them their passion for songbirds. Because of these characteristics, these almost idyllic structures were described as “collections of small rural villages.”

Until the mid-1980s, only a few skyscrapers disrupted the harmony of the landscape. Today Beijing’s panorama has the look and feel of the ultimate modern city, where, with few exceptions, these “small rural villages” have been supplanted by sterile, towering skyscrapers. This striking change is not limited to external structure; it has also dramatically altered the fabric of human relations.

Physical isolation has led to an increase in crime, destroyed the local sense of solidarity, and contributed to the fragmentation of what were once cohesive family groups. As the distance between home and the workplace has also increased considerably, workers now find themselves devoting what was once valuable family time to exhausting commutes in overcrowded buses or subways.

According to Chen Xitong, a former mayor of Beijing, “the capital is growing increasingly ugly and it is steadily losing its Chinese character. Most of the modern high-rise buildings, with their boring concrete facades, look like dominoes set down in the landscape without plan and without imagination.”

Migration

Rapid urbanization is related in part to population growth and rural migration to large cities. In 2008, the world reached an important milestone: For the first time in history more than half of its human population -3.3 billion people- were living in urban areas. By 2030, their number is expected to swell to almost five billion. Many of the new urbanites will be poor and their future will depend, to a large extent, on decisions made now.

The unchecked growth of the cities is also due to migration—both domestic and external—that many countries are experiencing. The common denominators here are rural poverty, the search for better social and employment opportunities, or flight from political persecution and violence.

An example of the last situation is the urbanization process in Colombia. Unlike the urbanization of most other Latin American countries the process in Colombia was stimulated, and to some extent defined, by episodes of violence, which occurred principally in rural areas. Since the 1930s, violence has been an inescapable fact of Colombian civilian life.

As families were uprooted and displaced by successive waves of violence, they fled en masse to the country’s main cities, where the majority among them now resides in poverty-stricken marginal areas. As a result of the violence either witnessed or experienced first-hand, many of Colombia’s young generation have internalized the culture of aggression into which they were born.

Colombia’s case is certainly not unique. More recently, the rural poor in many other countries throughout the world have been uprooted by violence and forced to flee en masse toward the large urban centers.

Climate Refugees

Large migrations will intensify as changing climate conditions will lead to abandonment of flooded or arid and inhospitable environments. This will lead to serious health problems both from the various stresses of the migration process and from the civil strife that could be caused by the chaotic movement of people. Every year, climate change causes the death of approximately 300,000 people, and seriously affects 325 million, according to the Global Humanitarian Forum.

A climate refugee is a person who is forced to relocate, either to a new country or to a new location within their country, due to the consequences of global warming. Sometimes, climate refugees are classified as environmental refugees. The number of environmental refugees will reach 150 million over the next 50 years, according to Professor Norman Myers of Oxford University.

In Africa, desertification and its consequences in agricultural production is displacing increasingly large amounts of people. Approximately 10 million people in Africa have been forced to migrate over the last two decades as a consequence of desertification and environmental degradation.

In addition, most people in Africa move into mostly marginal urban areas because of poverty, environmental degradation, political persecution, and religious strife. In addition, food insecurity and lack of basic services in the rural areas encourage people’s migration into the cities, where they all too often end up living in marginal areas.

These marginal areas, known as “bidonvilles” in French-speaking West Africa, “ishish” in some Arab countries, “kampungs” in Indonesia, “villas miseria” in Argentina, “favelas” in Brazil, “pueblos jóvenes” in Peru, and “ranchitos” in Venezuela, may contain from 30 percent to 60 percent of the population of many Third World cities, according to Worldwatch Institute.

Among Nations

Many governments attempt to discourage migration from rural areas to the cities, but these measures are by and large unsuccessful. Since large cities enjoy preferential treatment in terms of infrastructure and industrial development, they serve as magnets for the “have-nots.”

Regardless of the big city’s allure, many observers now feel that conditions for the ever-growing numbers of urban poor are most likely worse than for their rural counterparts. The true dimensions of this phenomenon remain elusive, according to World Health Organization expert Dr. I. Tabibzadeh, because the poor are either omitted from official statistics or are not considered separately.

Migrations between countries also continue unabated, usually stimulated by similar factors responsible for internal migration. The Latin American country that has produced the greatest number of migrants is Mexico.

Among Mexicans living abroad, 99 percent can be found in the United States, where income opportunities are greater. In the Southern Cone, Argentina is the main destination for migrants from Paraguay, Uruguay, and Bolivia. In Central America and the Caribbean, the United States is the most frequent destination, although there are also significant migratory flows from the Dominican Republic to Venezuela and Puerto Rico and from Haiti to the Dominican Republic.

Several European countries have attracted a large number of Africans and many Africans form sub-Saharan countries have migrated to north-African countries. In addition, the traditional pattern of migration within and from Africa is changing. A male-dominated process is becoming increasingly feminized.

Migration within and from Asian countries is not a new phenomenon. The current trends and characteristics of migration in the region have been shaped by the political and economic changes in recent decades. It is estimated that more than six million migrants are working in East and Southeast Asia, one third of whom are in irregular situation. Until the recent economic crisis, oil-rich Arab countries had attracted large numbers of Asian workers.

The chaotic growth of today’s cities can no longer be ignored. The great challenge is how to improve the quality of urban life by ensuring harmonious growth. Cities can—and should—learn from the experiences of other cities with similar characteristics. This effort requires not only the participation of urban planners but public health and environmental experts, politicians, and fundamentally, the communities themselves. Only when these actions are carried out will it be possible, perhaps, to reach that almost ideal situation heralded by Hippocrates some 2,600 years ago: a balance between the human organism and its environment.

Dr. César Chelala is a public health consultant for several international organizations.

Source – Epoch Times

Below is a current awareness bulletin of recently published reports and studies. If you would like to be on the Environmental Health at USAID mailing list for current awareness alerts, please send an email to: dcampbell@usaid.gov

 USAID Hygiene Improvement Project

  • Counseling Cards.  Pictorially based tools prepared for home-based care workers to use with clients in the household, including a WASH Assessment Tool (to assess the current WASH behaviors to help identify those that need to be improved) and 23 Counseling Cards (covering hand washing; water treatment, storage and handling; feces management for mobile and bed-bound clients; and menstrual blood management). 

Environmental Health at USAID

ICDDRB

Water and Sanitation Program (WSP)

  • Financing On-Site Sanitation for the Poor – A Six Country Comparative Review and Analysis, 2010. – Public investments of varying forms enable an absolute increase in the number of poor people gaining access to sanitation, varying from 20% to 70%, according to a study of six cases in Bangladesh, Ecuador, India, Mozambique, Sénégal, and Vietnam. This research seeks to identify the best-performing approaches and the relevant factors and issues to consider in designing a sanitation financing strategy. The report offers guidance to sector professionals developing on-site sanitation projects and programs, which play the leading role in providing access to sanitation 
  • Information on improved latrine options – This booklet is really meant to be useful to anyone interested in and working on sanitation programs, and raise people’s awareness of options, create sanitation demand and work on actual construction of latrines. 

IRC International Water & Sanitation Centre

  • Designing evidence-based communications programs to promote handwashing with soap in Vietnam – The paper concludes with practical recommendations for program managers of behavior change programs and includes examples of the communications materials developed for the Vietnam Handwashing Initiative. [Paper written for the South Asia Hygiene practioners’ workshop, 1 – 4 February 2010, Dhaka, Bangladesh]
  • Beyond tippy-taps: the role of enabling products in scaling up and sustaining handwashing – This article summarizes findings from the Water and Sanitation’s Global Scaling Up Handwashing Project and other research that suggest that convenient access to water and soap when and where needed and having a designated place for HWWS are also important determinant for handwashing. Enabling products such as handwashing stations provide such a designated place in addition to an environmental cue to action and a stable context for handwashing, factors that literature highlight as critical for habits to form and be maintained.

WaterAid

Achieving high coverage of larval-stage mosquito surveillance: challenges for a community-based mosquito control programme in urban Dar es Salaam, Tanzania

Source: BioMed Central, 30 Dec 2009

Background – Preventing malaria by controlling mosquitoes in their larval stages requires regular sensitive monitoring of vector populations and intervention coverage. The study assessed the effectiveness of operational, community-based larval habitat surveillance systems within the Urban Malaria Control Programme (UMCP) in urban Dar es Salaam, Tanzania.

Methods – Cross-sectional surveys were carried out to assess the ability of community-owned resource persons (CORPs) to detect mosquito breeding sites and larvae in areas with and without larviciding. Potential environmental and programmatic determinants of habitat detection coverage and detection sensitivity of mosquito larvae were recorded during guided walks with 64 different CORPs to assess the accuracy of data each had collected the previous day.

Results – CORPs reported the presence of 66.2% of all aquatic habitats (1,963/2,965), but only detected Anopheles larvae in 12.6% (29/230) of habitats that contained them. Detection sensitivity was particularly low for late-stage Anopheles (2.7%, 3/111), the most direct programmatic indicator of malaria vector productivity. Whether a CORP found a wet habitat or not was associated with his/her unfamiliarity with the area (Odds Ratio (OR) [95% confidence interval (CI)] = 0.16 [0.130, 0.203], P<0.001), the habitat type (P<0.001) or a fence around the compound (OR [95%CI] = 0.50 [0.386, 0.646], P<0.001). The majority of mosquito larvae (Anophelines 57.8 % (133/230) and Culicines 55.9% (461/825) were not reported because their habitats were not found. The only factor affecting detection of Anopheline larvae in habitats that were reported by CORPs was larviciding, which reduced sensitivity (OR [95%CI] = 0.37 [0.142, 0.965], P=0.042).

Conclusions – Accessibility of habitats in urban settings presents a major challenge because the majority of compounds are fenced for security reasons. Furthermore, CORPs under-reported larvae especially where larvicides were applied. This UMCP system for larval surveillance in cities must be urgently revised to improve access to enclosed compounds and the sensitivity with which habitats are searched for larvae.