TUE5.5: Environmental changes and health implications
A new public health concept for risk governance of vector-borne infections
sine-Institut gGmbH, Germany, Federal Republic of
Due to environmental and socio-economic changes, emerging diseases with zoonotic potential will be an increasing challenge for public health in Europe. The risks and the consequences triggered by so-called vector-borne diseases for public health in Europe are just starting to emerge in public awareness. This is clearly shown by recent events such as Chikungunya in Italy and the spread of Crimean-Congo haemorrhagic fever (CCHF) in Europe. The EU-funded project ‘Biology and control of vector-borne infections – EDENext’ is dedicated to these diseases that are transmitted by vectors such as mosquitoes and ticks etc. Within EDENext a holistic, transdisciplinary public health approach towards vector-borne diseases was developed. It defines the term “public health” in the scope of this project and suggests a reconceptualisation of public health by adapting the risk governance framework developed by the International Risk Governance Council (IRGC) for this purpose. The IRGC approach is distinguished from more classical risk governance approaches, inter alia, by an explicit inclusion of a systematic concern assessment (of public concerns and perceptions) as the other part of risk appraisal that is scientific risk assessment. This innovative new risk governance approach towards public health will be introduced and exemplified by a rodent-borne transmitted Hanta virus disease in Germany. First results of a risk perception and risk communication study based on in-depth interviews with risk management and relevant stakeholders as well as focus-group research with the general public in endemic regions in Germany will be shown.
Vulnerability analysis of women's health in natural disasters and proposed strategies for risk reduction
1International Institute of Earthquake Engineering and Seismology (IIEES), Iran, Islamic Republic of; 2Iranian Institute for Health Sciences Research (IHSR), Iran, Islamic Republic of
Women are among the most vulnerable groups of society in natural disasters. In this regard, the aim of the present study is to identify the influential factors of women's vulnerability in natural disasters and proposing strategies to reduce the risk. This study has been conducted in Iran which consists of a narrative review and a qualitative study (focus group discussion) in order to determine the views of decision makers and to propose strategies for improving approaches to reduce women's vulnerability in disasters. The main findings of this study include: lack of women's presence especially in the responsible government agencies, lack of needs assessment regarding women in disaster situations, insufficient legal support of women, need for more credits to be allocated for women in disaster management issues, absence of enough female experts in field of disaster management, constant use of men as relief and rescuers without having women in the team, and lack of specialized centers to train women's relief and rescue efforts. The main strategies that could be suggested in this paper in order to reduce the vulnerability of women in disasters include: increasing public education, activating women's communication networks, reinforcing practical skills for women facing disasters, reinforcing women's NGOs for the purpose of forming its humanitarian activities in crisis prevention, legislation for supporting women, conducting appropriate research and present the results to relevant authorities, allocating roles for women in relevant organizations, defining special positions for women in the headquarter and dispatching teams in disaster regions, and training skills in all areas related to women's health especially in reproductive health in disasters and crisis situations.
Haiti, two years later: What has happened to the injured? Factors affecting social integration of the 12th January 2010 earthquake victims in Port-au-Prince
1LEM UMR 8179, Lille, France; 2ALIMA (Alliance for International Medical Action), Senegal, Republic of
The objective of the study is to determine the factors affecting the social integration of earthquake victims with severe limb injuries according to the type of medical management they received (amputation or reconstructive surgery). The SUTRA² (Suivie et traitement du traumatisme des membres en cas d’afflux massif des blessés dans les contextes difficiles) study involves the management of limb trauma patients during a massive influx of injured (war or natural disaster). The study compares two cohorts of victims of the 2010 Haitian earthquake. One cohort received reconstructive surgery without amputation as the first medical intention and the second cohort were treated with amputation by first intent. A control group was composed of injured who did not receive any surgical intervention. Two sets of interviews were conducted with the victims, the first one year after the earthquake and the second 12 months later, on the 2nd anniversary of the earthquake in January 2012. Medical, functional, psychological and socio-economic data was collected from 306 victims of the 2010 January earthquake. Prior to the disaster, the two cohorts shared the same socio-economic characteristics, with differences emerging after the earthquake. Amputations occurred more frequently between the third and the tenth day post earthquake. Amputation is inversely correlated with level of education. Patients with amputations represent a loss of human capital and a disappearance of family income (after one year, only 19 out of 188 of the amputee cohort earn any income). These differences are are more evident after the second round of interviews. This paper will discuss the factors that contributed to the successful social integration of some of the victims, despite their handicap and the failure of others to do so.
The Global Leptospirosis Environmental Action Network: strengthening the public health prevention and outbreak control strategy
1WHO, Switzerland; 2Health and Climate Foundation
Leptospirosis has emerged to become a major public health problem. Within the last decade, there has been a worldwide increase in the number of reported cases, specifically through post disaster outbreaks. The true burden of leptospirosis outbreaks is likely to be grossly under-estimated due to the non-specific clinical presentations of the disease and the complexity of laboratory confirmation. These factors limit the understanding of the natural history of the disease, and many questions related to the control strategy remain unanswered, particularly in an epidemic situation. Furthermore, the sensitivity of the disease to certain environmental conditions suggests that climate change may impact the nature of the disease and the magnitude and severity of outbreaks. In 2006, the Leptospirosis Burden Epidemiology Reference Group, a World Health Organization partnership was established to determine the disease burden of leptospirosis. The second step was to revise and improve the control strategy of the disease. This involves a comprehensive overview of the disease to understand the relationships between humans, animals, and the environment; the role of domestic animals and agricultural practices; the association between disease burden and human behaviour, and the impact of climate. In response to the many unanswered questions surrounding leptospirosis, WHO and the Health Climate Foundation developed a new approach whereby the knowledge and expertise of the public health challenges and risk factors are integrated through a multi-disciplinary, technical framework. Launched in 2010, the Global Leptospirosis Environmental Action Network gathers representatives from international organizations and foundations as well as researchers. It offers an opportunity to strengthen current public health strategies and mitigate the risk and impact of leptospirosis outbreaks in populations at high risk. It also creates a forum to develop new advocacy and funding opportunities for leptospirosis, and offers further support for capacity building, training and technology transfer, as needed.
Future epidemics of malaria: the potential of climate change induced malaria and its potential mitigation in Sri Lanka
Independent researcher, Sri Lanka, Democratic Socialist Republic of
The paper examines whether climate change will produce malaria epidemics, or a general increase of global incidence of malaria, in the future using Sri Lanka as a case study. The first objective was to assess the impact of climate change on the key factors of ecological transmission. The second objective was to determine whether these impacts in turn will fulfill the components of endemic malaria: (i) suitable Anopheles (mosquito) vectors in sufficient numbers to maintain transmission; (ii) suitable climate for the development of the parasite within the mosquito; (iii) infected individuals with gametocytes in their blood as a source of infection for vectors.