Abstracts
Theme: Health
Panel: Children’s Environmental Health: Concerns and Challenges
Session: I
 Children living in a Conflict Environment: the Palestinian case
Kamal Zaineh*
The current situation in the Palestinian territory can be characterized as a chronic state of hazardous environment for children. To summarize the demographic status, out of an estimated 3.6 million inhabitants of the occupied Palestinian territory (OPT) in 2003, 1.6 million are officially registered as refugees and live both within and outside the refugee camps. In the Gaza Strip alone, 70% of the population is refugees, while 30% of the West Bank of the population is refugees. As many as 53% of the population of OPT, or 1.9 million inhabitants, are bellow the age of 18 years, with a median age of 18 years in the West Bank and 15 in Gaza. To quote the World Bank estimates, the poverty level had reached 59% by the end of 2002, or about double the figure of 2000.
Children's right to health and to life is under serious threat in the OPT. Progress made in children's health since the Palestinian authority took over responsibility in 1994 is declining. Certainly, the turbulent political reality not only intensified the existing causes leading to child mortality, but it also poses new dangers to the survival and health of Palestinian children. The full impact of incursions, border closures and curfews on the health status of children in the OPT will only be reflected in long-term health indicators. Statistics as of January 2005 show that a total of 689 (18%) Palestinians killed were children less than 18 years of age. During the period between 29 September 2000 and 31 December 2003, some 15,000 (39%) children were injured and from among these, 30% were permanently disabled. An estimated 600 Palestinian children have been arrested every year since the beginning of the conflict. Nutritional surveys indicated an acute malnutrition (wasting) of 2.5% children in 2002. A national survey on child labor showed an increase from 10% in 2001 to 23% in 2003 in working children under the age of 18 years.
Moreover, the building of the apartheid wall caused further constraints on access to basic daily needs; including schooling, emergency care and health services, as well as direct displacement of families. Further, the daily humiliation and harassments faced by children passing daily through these gates may result in scars that will hamper the development of any child.
This presentation will reflect well-documented details (national and international) on the impact of the current environmental situation on the lives of our children. The noted threats as well as the psychosocial impact on children will have repercussions for many years to come; therefore collaboration on all levels is needed to call upon implementation of international agreements towards child protection.
*Dr. Kamal Zaineh, MD, MPH, is Director of Primary Health Care Department, Health Work Committees (HWC), Palestine.
Monitoring the Status of Children’s Health: Development and Use of Critically needed Environmental Health Indicators and Benchmarks
A. Karim Ahmed and Audrey R. Chapman
Infants and young children residing in many developing regions of the world not only suffer from diseases caused by hunger, malnutrition and infectious agents, they are increasingly being exposed to a highly polluted environment. Considering that today millions of children in Asia, Africa and Latin America are chronically malnourished and are inadequately immunized against common childhood diseases, the newly emerging environmental health threats significantly add to their current burden of disease. According to recent global health data, some 2 million children below the age of five die annually from respiratory diseases, such as acute respiratory infections, that are caused from exposure to degraded indoor and outdoor air. Through ingestion of bacterially infested and untreated water, 1.3 million children worldwide die each year from a variety of intestinal diseases. In addition, young children that are raised on diets deficient in protein, vitamins and other essential nutrients, are at increased risks to the adverse effects of toxic chemicals that they come into contact with in their homes, schools and playgrounds.
In order to assess the health status of children that live in degraded environments in urban and rural areas of developing regions, there is a critical need to identify and develop environmental health indicators and benchmarks. The rationale and basis for developing such indicators and benchmarks will be outlined in this presentation. It is based on the conceptual framework and findings of a recently published report, Manual on Environmental Indicators and Benchmarks: Human Rights Perspective. The preparation and publication of this document was coordinated by the Program on Science and Human Rights of the American Association for the Advancement of Science (AAAS), which was carried out in conjunction with the National Council for Science and the Environment (NCSE) and the Global Children’s Health and Environment Fund (GCHEF). Using a “human rights” screening criteria, which emphasized the adverse impact of degraded environments on especially vulnerable members of the population – young children, the elderly and the chronically ill – the manual proposes a set of recommended environmental health indicators and benchmarks in the following areas:
(i) air quality
(ii) water quality and sanitation
(iii) vector-borne diseases
(iv) food security and safety
The presentation also examines the need for developing performance-based indices (PBIs) that assists in monitoring the degree to which regulatory government agencies succeed or fail in achieving national environmental standards and/or internationally recognized health-based guidelines. *A. Karim Ahmed, is Director, International Program, National Council for Science and the Environment (NCSE) and Audrey R. Chapman, is Director, Program on Science and Human Rights, American Association for the Advancement of Science (AAAS).
What is Missing in the Government's Overall Approach to Addressing Environmental Health Threats to Children and What Needs to Done?
Rita Pandey*
Children today live in an environment that is vastly different from that of previous generations. Growth in population and changes in consumption and production patterns have resulted in severe pollution of air, water and food. While exposure to environmental hazards affects humans, wildlife, and flora and fauna, children are more vulnerable than adults. One of the main reasons, among others, for this is relatively higher breathing and metabolism rate in children, which results in higher absorption of pollutants in proportion to their body weight. Further, exposure to pollutants in young children when their body organs are still developing, can cause permanent and irreversible damage of vital organs such as nervous system, heart, and lungs. Also, since children are exposed to toxicants at an earlier age than adults, they have more time to develop environmentally-triggered diseases with long latency periods, such as cancer and chronic asthma.
All children are affected by environmental hazards. However, children living in poverty are at disproportionate risk of exposure to environmental hazards. Poverty can compound the adverse effects of exposure to toxicants because it is so often associated with inadequate housing, poor nutrition, and limited access to health care. Further, child laborers in south Asia are often engaged in hazardous industries such as carpets, matchbox, fire crackers, bangles and other glass objects and thus are constantly exposed to worst kinds of pollutants.
Countries in South Asia have substantial legislation for both environmental protection and health care but there appears to be a complete lack of focus on either addressing the environmental hazards that impact the children most or on provision of health care services to children who are at particular risk.
The objective of this study is to:
- Examine what types of exposures affect the children most and which children, differentiated by class/gender, are the most affected?
- Examine whether current environmental legislation adequately addresses environmental health threats to children? In addition, current workplace policies regarding exposures, food standards especially for those consumed by infants, and young children (presence of pesticides and other chemicals is reported in food items consumed predominantly by children) will be examined with a view to assess whether these adequately consider safety and health of children.
- Identify what measures need to be taken to protect children from environmental hazards more effectively and proactively.
Methodology
To address the first objective, available data and literature on environmental health impacts on children will be reviewed with a view to identifying specific pollutants and situations that are more harmful to children. Another focus would be to differentiate between children by economic class and gender. To address the second objective, an analytical framework will be developed to critically examine the current environmental policy. In doing this, relevant yardsticks such as whether the legislation requires agencies to consider children and their unique susceptibilities in standard-setting procedures, in environmental risk assessment of projects and so on. Further, examine whether in setting priorities for addressing type of pollutants/geographic areas/settlements (low income, and slum settlements), children are adequately considered. Informed and effective policy is reliant upon knowledge and understanding of the effects of environmental hazards on children's health. Research that identifies patterns of environmental diseases in children, assesses children's exposures to environmental toxicants, determines developmental periods of vulnerability, and quantifies dose-response relationships will bring us closer to preventive interventions. Research studies supported by governmental agencies to improve our understanding of the relationship between environmental exposures and health outcomes in children could be another measure reflecting importance of these issues in government’s overall approach to addressing environmental health hazards. A number of other indicators will be developed to critically assess the focus of environmental policy on children. Results of this exercise will allow us to identify the gaps in the design of environmental policy and its implementation.
Expected outcome
This study will enable us to identify specific policies and programs that need to be implemented to safeguard children’s health from environmental hazards effectively and proactively. Results of this study will thus inform the policy debate on how and to what extent the governments and the donor agencies should improve the focus on children’s health in addressing environmental health hazards.
*Dr. Rita Pandey is a Senior Fellow (Professor), National Institute of Public Finance and Policy, New Delhi , India. She has a Ph.D. in Economics. Her fields of specialisation are Public Economics, and Environmental and Natural Resource Economics.
Central Asia: Perspectives on Regional Collaboration on Children’s Environmental Health
Muzafar J. Isobaev and David Carpenter*
Central Asian countries face health problems primarily due to poor living environment. There is lack of access to fresh water and clean air leading to anemia in children. The region’s crucial hazardous environmental conditions may be attributed to the Aral Sea disease, which is in other words, can be referred as the Aral Sea Catastrophe. The Aral Sea disease is related to the lack of sufficient feed of water to the Aral Sea basin from the Central Asian rivers. Due to severe drought conditions, enormous amounts of salt in the soil are adversely affecting the health of the people residing nearby.
Projects on children’s health were funded and carried out by sponsors from the U.S.A, Japan and Canada. The objective of the projects was to explore children’s health in the area of ecological diseases. Investigations have been completed and results have been concluded. There is a dire need to improve the situation of children’s environmental health.
A summary of children’s environmental health was drawn out at a conference in Almaty in April 2005. One of the positive outcomes of the conference was the establishment of regional scientific organization called Eurasian Association for Children Environmental Health (EACEH). The association’s task is to perform coordination activity, including financing of common programs and projects among the regional scientists and make their work more productive, efficient and visible. A scientific committee of EACEH is responsible for planning the collaboration among scientists of the member countries.
The composition of EACEH includes representatives from NIS (Central Asia Russia and Caucasus), Iraq, Palestine, Pakistan and other countries of the region.
EACEH established a regional analytical laboratory with the purpose of using common standardized methods and equipments; carry out association website with the EACEH members’ list and providing annual conference and training courses. Besides other work, EACEH will build strong contacts with international scientific organizations such as WHO, EPA (USA), NIH (USA) and JICA (Japan).
It is important to realize that only joint efforts will produce best scientific results and practices and protect children’s health in a realistic manner.
The presentation will discuss the future EACEH’s plans and programs at the regional level. Recommendations brought forth at the Eighth SDC will be taken into account.
*Ms Muzafar J. Isobaeva is associated with the Academy of Sciences, Republic of Tajikistan, Dushanbe, while David Carpenter is associated with the University of Albany, NY, U.S.A.
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