WHD 2003: An Overview

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WHD 2003 An Overview

• First WHD Evaluation Workshop
• New Delhi, March 2004
• Presented by
• Alexander von Hildebrand
• Environmental Health Advisor, WHO Regional Office
  for South East Asia

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Environmental threats cause up to one third of
the Global Disease Burden
Over 40 of this burden falls on children under 5
years of age (WHO report 2002)
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Children are the most vulnerable to environmental
threats
More exposed to dangerous conditions Consume more
in proportion to weight Body systems more
vulnerable than adults
More than 5 million children die every year from
environmentally-related diseases
4
Children are not Little Adults

• Childrens central nervous, immune, reproductive
  and digestive systems are developing.

Childrens ability to detoxify and excrete toxins
differs from that of adults.
Exposure to environmental contaminants can
irreversibly damage the normal development of
organs and systems
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Children are not Little Adults

• Young children breathe faster, eat and drink
  more, in proportion

Children absorb more contaminants contained in
air, water or food
They are more vulnerable to acute and chronic
effects of environmental hazards
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Poor Children Suffer the Most
because they face
Poor nutrition, inadequate housing, limited
access to health and social services associated
with poverty and social inequity and
pronounced regional risks (arsenic, fluoride,
etc)
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The Poor face a Double Burden
Classical Risks
Modern Risks
Risk
Low Populations in Society
Middle Populations in Transition
High Industrialized Societies
Income Socio-economic development
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Priority Risks

• Lack of safe water
• Poor hygiene and sanitation
• Air pollution
• Disease vectors
• Exposure to chemical hazards
• Violence and Injuries

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Health impacts from unsafe water
Contaminated water is the source o many
infectious diseases such as diarrhoea, hepatitis
A and E, dysentery, cholera, typhoid fever
Diarrhoea is the second largest child killer,
1.3million premature deaths globally
Of the 600,000 diarrhoea related deaths in India,
most occur in children below 5 years
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Biological contaminants from poor sanitation
practices
More than 200 million people in SEAR do not have
access to safe drinking water

• Only 42 of SEAR population have access
• to proper sanitation

In India, near to 70 have to defecate in the
open, less than 2/3 cannot wash hands thereafter
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Natural chemical contamination arsenic and
fluoride

• Arsenic At least 35 million in Bangladesh at
• risk from contaminated water.
• Estimated 100 000 cases of skin lesions

A global problem found in Bangladesh, India,
Thailand, Myanmar, China, Argentina, Chile,
Mexico and USA.
Fluoride Estimated 28 million people with
skeletal crippling fluorosis from fluoride in
drinking-water, in China alone.
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Man made chemical contaminants
Over a million of different synthetic chemicals
are used in agriculture as pesticides and
fertilizers Industrial chemicals and hazardous
chemicals are used in working places, households
and around schools
Annually, thousands of new formulations are
brought into the markets
Many contaminate water bodies
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DDT for tea
WHO study in SEAR,2000 More than 550 food
samples analysed 117 cereals, 91 pulses, 131
spices, 15 meat products, 50 milk products, 119
vegetables and fruits, 62 tea / coffee, 49 oil /
fats, 30 oil seeds, 34 baby foods, 10 dry foods.
ALL samples contained DDT residues
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BHOPAL, 1984

• The worst accidental chemical incident ever

2-3 December 1984, release of 40 MT of methyl
isocyanate
Union Carbide pesticide plant at Bhopal, India
At least 2,800 killed, 50,000 totally or
partially disabled, 200,000 affected
Poor safety management, lack of community
preparedness
Damage between 350 million and 3 billion US
Union Carbide still to pay close to 500 million
US
Pavati Bai one who lost all her family Source
globalissues.net
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Polluted indoor air
The risk to inhale chemical pollutants present in
indoor air is 1000 times higher than outdoors  
Early and daily exposure
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There are solutions
Ensuring access to smokeless cook stoves and to
safe, clean household fuels for cooking and
heating, reduces indoor air pollution in the home
Making chapatis on an improved cook stove in
India
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There are solutions
Malaria is a leading cause of death in young
children.Sleeping under insecticide-treated
bednets protects children from mosquitoes and
reduces the need for chemical control of malaria
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Steps towards better coordination
Identify major environmentally related health
risks that affect children
Take stock of essential on going CEH
interventions at country level what, where, who,
how
How enhance intersectoral collaboration? GO
bodies, NGOs, Private sector, other.
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For a Global Alliance
To encourage political commitment
To build on complementary strengths of sectors,
stakeholders and partners
To expand and scale up action
To ensure intersectoral action and community
participation
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HECA
Mission to reduce environmental risks to
children's health that arise from the settings
where they live, learn, play, and sometimes work,
by providing knowledge, increasing political
will, mobilising resources, and catalysing
intense and urgent action
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AWARENESS RAISING

• Briefing of the health and environment
  decision-makers (and education, labour, industry
  and agriculture).
• Preparation and dissemination of printed material
  (e.g. brochures, reports, publications).
• Organization of inter-sectorial workshops
• Mass-media presentations (e.g. radio, television,
  press releases).

• WHD celebrations
• Analysis Educational and Awareness Materials
• Movie on children living from wastes

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Research, evidence based data

• Identification and review of existing
  epidemiological data
• Review, adaptation and implementation of
  harmonized case data collection systems
• Preparation of country report(s) on the Status
  of CEH.
• Identification of research needs.
• Recommendation of priorities for action.

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Training

• Training activities (e.g. workshops, seminars,
  courses) for pediatricians, nurses, health care
  workers and other health professionals.
• Identification, assessment and study of the main
  environmental health problems affecting children
  and evaluation of potential solutions

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Action for change

• Providing the evidence for the Status Report on
  CEH,
• Implementing recommendations and solutions
  through pilots (e.g. informing the community,
  environmental rehabilitation, establishing new
  policies, enforcing regulatory measures).
• Promoting childrens and adolescents education
  about environmental health at school/high school
• Evaluation of the impact of interventions
  proposed.

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HECA
Mission to reduce environmental risks to
children's health that arise from the settings
where they live, learn, play, and sometimes work,
by providing knowledge, increasing political
will, mobilising resources, and catalysing
intense and urgent action
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Remember Its together, we are shaping their
future
Thank you!