This issue is filled with people going places and doing big things. We begin with a behind-the-scenes look at one of history's most notable undertakings: the construction of the Panama Canal at the beginning of this century. The dream of an interoceanic passage through Central America dates back to the earliest days of the Conquest. Over the next centuries, the idea would engage the likes of Vasco Nuñez de Balboa, Emperor Charles V, Francisco de Miranda, Simón Bolívar, Alexander von Humboldt, and Ulysses S. Grant, among others. All stumbled upon a veritable Pandora's box of political and technological quagmires. In this century--as the French learned at great cost--a knowledge of tropical diseases provided the most formidable leverage, eventually unlocking the secret that enabled politicians and public health specialists to proceed confidently toward fulfilling the dream of four centuries.

Less often told is the large-scale, highly organized public health campaign in Panama that broke the back of tropical disease infection, thus protecting city residents and canal workers alike. Not only did the world receive a canal, but Panama provided a blueprint for preventing epidemics in other parts of the world.

Today, as then, knowledge and action, individual as well as collective, are key to improving health indicators. In two community-based feature stories--one in Bolivia and one in Canada--people are taking holistic approaches to health that are firmly rooted in local customs and traditions but are adaptable to other environments. Bolivia has struck upon a formula that all but erases the geographical barriers other countries may encounter in bringing basic health messages to isolated villages and towns, and it is training a corps of health promoters for tomorrow among its rank-and-file citizens of today. Nova Scotians are using the intermediate goal of heart disease reduction as a springboard to improving overall health and creating healthier environments and healthier public policies. The cornerstones of the Nova Scotia project are exercise and good nutrition. Proper nutrition is the focus of another story. When we think of malnutrition, we tend to think more in terms of missing macronutrients, such as protein, and less about essential substances the body needs only in trace amounts, such as vitamin A, iron, and iodine. Yet this hidden hunger for micronutrients affects more than 2 billion of the world's people, particularly women and children. How can we manage the overall health of children? A new approach gives health workers the tools to recognize danger signs and choose the right treatment.

This issue holds many common human threads--the role of poverty and misinformation in robbing people of health; empowerment through access to quality, culturally appropriate health information; the efficacy of targeting specific population segments and helping them become agents of change; the need to ensure that individual lifestyle changes are sustainable through community support; the potential of cost-effective health interventions to spur positive gains far beyond their initial intended purpose; and the idea that good health practices must start early--even before a child is born, through the practices of the mother.

In 1997, PAHO enters its 95th year of building the bridges of health and development. We invite you to celebrate with us. Send us your letters.