Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 8, Number 1, 2003

Together, shaping the future of life

Environmentalists often cite our obligation to future generations as the most compelling reason for protecting our planet: We owe it to our children to care for the environment they will inherit from us. But as the theme of this year’s World Health Day-"Shaping the Future of Life"—reminds us, we also owe it to our children to provide them the best possible environment now, while they are children. A child’s environment can have a major impact on his or her health and happiness, both now and in the future.

Every year throughout the world more than 5 million children under 14 die from diseases related to their environments. Countless others suffer nonfatal illness, injury or long-term disability as a result of environmental hazards in their homes, schools and neighborhoods. These hazards range from long-standing problems such as contaminated water, inadequate sanitation and household chemicals to newer and emerging risks including outdoor air and noise pollution, ozone depletion and persistent organic pollutants. In Latin America and the Caribbean, an estimated 80,000 children die each year from diseases or injuries related to environmental hazards.

Children are uniquely vulnerable to such risks. Young children breathe faster and eat and drink more in proportion to their weight than adults, thus absorbing more toxicants from air, water and food. As they grow, there are "windows of susceptibility" when their organs and systems are especially sensitive. Children who become chronically ill or who have developmental problems as a result of environmental threats will not grow up to be healthy and fully productive adults.

The point of dedicating this year’s World Health Day to this topic is that most of the environmental threats that harm children are avoidable. In developing regions, many of these threats are related to poverty: inadequate sanitation, contaminated drinking water, poor food hygiene, indoor air pollution and unsafe housing. Eliminating poverty through sustained and equitable economic development would go a long way toward solving these problems, but in the meantime people can be empowered in other ways to reduce environmental dangers to children.

At the individual and family levels, people need to know more about household and outdoor hazards and ways to eliminate or minimize them. Educational campaigns that emphasize such essentials as proper storage of household chemicals, good hygiene and the use of seat belts and bike helmets can give parents and caregivers the information they need to do their job well. At the community level, the challenge is greater but so is the potential reward. As our cover story suggests, one of the best ways to build healthier environments for children is through community mobilization. The success of São Paulo’s Jardim Paraná in improving environmental conditions has been mirrored in other communities throughout the region: the efforts of Huaquillas, Ecuador, and Aguas Verdes, Peru, to clean up the Zarumilla Canal between them, and the work of sister cities along the U.S.–Mexico border to clean the air they share come to mind.

This issue of Perspectives in Health looks at community empowerment in other contexts in a new special section on community public health. Two of the articles hold special meaning for me, as I have personally visited the projects highlighted. The first focuses on El Salvador’s Villa Centenario, a project that might be considered "experimental" in that it starts with the provision of housing to 100 homeless families and tries to build a community from that base. The many challenges this presents are outlined in the article, and the final outcome remains to be seen. But Villa Centenario is clearly a community empowerment project characterized by hope.

Las manzaneras of El Alto, Bolivia, also hold special significance for me. I was in Bolivia around the time the group celebrated their second anniversary, and I was privileged to meet a number of the volunteers. Their unique access to community members has allowed them to carry out effective health education campaigns and bridge the gap between public health services and the clients they are intended to serve.

Community participation has always been a key element of public health campaigns, in sanitation, vaccination, health education and others. I have personally seen how much people can accomplish by working together, defining common needs and joining forces to make just demands of elected authorities. This is essential not only to public health but to our region’s democratic development. Helping people to strengthen their sense of community, and through community, their collective health, has always been and remains one of PAHO’s strongest commitments.

Mirta Roses Periago
Director

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