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A Model for Acting of Peace through Health

A Model for Acting of Peace through Health. McMaster Feb. 27, 2006. Goals. Present the Model View Anti-nuclear activities of IPPNW and PGS through the Model Present development of project on El Salvador How do we evaluate such projects?. Figure 1 Peace through Health Working Model.

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A Model for Acting of Peace through Health

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  1. A Model for Acting of Peace through Health McMaster Feb. 27, 2006

  2. Goals • Present the Model • View Anti-nuclear activities of IPPNW and PGS through the Model • Present development of project on El Salvador • How do we evaluate such projects?

  3. Figure 1 Peace through Health Working Model Stage ofPrevention Secondary Tertiary Primordial Primary Pre-conflict Conflict Post-conflict Altruism - Evocation and Broadening Sensitizing : Putting a human face on suffering Values and Qualities Solidarity - Extension of Dissent and Non-cooperation Diplomacy Public Health - Epidemiology, Prevention, Promotion Psychological - cycles of violence, post traumatic stress, concepts eg. psychic numbing, Knowledge Principles and Practice: Lessons from General Systems Medical Ethics Teaching : Communication of knowledge Personificationof “Enemy” Skills Maintainingstructural integrity for society Healing of communities: Physical, Psychological, Social, Spiritual Superordinate Goals -Construction of Each of the above Redefinitionof the Situation

  4. Adapted from Yusuf et al. and Santa Barbara

  5. IPPNW Mission • “IPPNW is a non-partisan, global federation of national medical organizations in 58 countries dedicated to research, education, and advocacy relevant to the prevention of nuclear war. To this end, IPPNW seeks to prevent all wars, to promote non-violent conflict resolution, and to minimize the effects of war and preparations for war on health, development, and the environment.”

  6. Deterrence TIME September 23,2002 • Reasons to Be Fearful • Charles Krauthammer's argument for invading Iraq in "The Terrible Logic of Nukes" [Essay, Sept. 2] is just that: terrible logic. Iraq wants nuclear weapons to balance Israel's, which built them to balance Arab conventional superiority. Pakistan wanted to balance India, which had to balance China, which had to balance Russia, which had to balance the U.S. and its allies, which had to balance Russia's presumed European-theater superiority. Throughout this balancing act, the world has been no more than 30 minutes away from Armageddon. The only logical way to keep nuclear weapons out of the hands of madmen is to renounce them ourselves. NEIL ARYA, M.D.International Physicians for the Prevention of Nuclear War Waterloo, Ont.

  7. EL SALVADOR SMALL ARMS  PEACE THROUGH HEALTH TRAINING

  8. DECLARATION OF ALMA-ATA • IThe Conference strongly reaffirms that health, which is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity, is a fundamental human right and that the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. • IIThe existing gross inequality in the health status of the people particularly between developed and developing countries as well as within countries is politically, socially and economically unacceptable and is, therefore, of common concern to all countries. • International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978

  9. Ottawa Charter for Health Promotion (1986) Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical mental and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living.Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing. http://www.who.dk/AboutWHO/Policy/20010827_2

  10. OTTAWA CHARTER • Prerequisites for Health • The fundamental conditions and resources for health are: • a peace, • b shelter, • c education, • d food, • e income, • f a stable eco-system, • g sustainable resources, • h social justice, and equity. • CHARTER ADOPTED AT AN INTERNATIONAL CONFERENCE ON HEALTH PROMOTION* • The move towards a new public health, November 17-21, 1986 Ottawa, Ontario, Canada • * Co-sponsored by the Canadian Public Health Association,Health and Welfare • Canada, and the World Health Organization

  11. FromWendy Cukier

  12. CENTRAL AMERICA • El Salvador (Cruz, Beltran) • murder rate similar to Colombia about 90/100,000 • over 75% of these are caused by firearms • over 60% of violent deaths in total are caused by firearms or explosives. • 7% of 13-19 year old admitted carrying a gun to school • vast majority of weapons in the country remain pistols and revolvers.

  13. PREVENTABLE DEATHS? • WHO estimates homicide rates • Japan at 0.6 per 100,000 • United States 7 per 100,000 • Brazil 25 per 100,000

  14. PUBLIC HEALTH PRIORITY? • estimated 200,000 people non-conflict situations Cukier • 500,000 deaths=one death for every minute tuberculosis (2.9 million), HIV/AIDS (2.3 million) and malaria (1.5-2.7 million). youngest and healthiest of society • Represent c. one quarter of the 2.3 million deaths due to violence[i],[ii], 42% are suicides, 38% are homicides and 26% are war-related[iii],[iv] • i]Krug, E.E., ed. World Report on Violence and HealthGeneva: WHO, 2002: • http://www5.who.int/violence_injury_prevention/main.cfm?p=0000000675#Appendix%204. • [ii] United Nations Development Programme (UNDP). UNDP Human Development Report 2000. New York: Oxford, 2000: p. 36: http://hdr.undp.org/reports/view_reports.cfm?year=2000. • [iii] Reza, A., J.A. Mercy, and E.E. Krug. “Epidemiology of Violent Deaths in the World”, Injury Prevention (7), 2001: 104-111: www.injuryprevention.com. • [iv] WHO. “Small Arms and Global Health”, paper prepared for SALW talks. Geneva: July 2001: http://www5.who.int/violence_injury_prevention/download.cfm?id=0000000158.

  15. Homicides rates El Salvador

  16. Evaluation Activities • Needs Assessment • Conditions program is intended to address • Assessment of Program Theory • Conceptualization & design • Assessment of Program Process • Operations, implementation & delivery • Impact Assessment • Outcomes & impact • Efficiency Assessment • Cost & cost effectiveness

  17. Source: CDC. Framework for Program Evaluation in Public Health. MMWR 1999;48(No.RR-11)

  18. End Conflict / Build sustainable, just structures Long-term Outcomes Intermediate Outcomes Initial Outcomes Outputs Activities Inputs

  19. impact evaluation of PTH Ken Bush PhD Pol. Sci. “A Measure of Peace: Peace and Conflict Impact Assessment (PCIA) of Development Projects in Conflict Zones,” IDRC, Ottawa1998. PCIA “A means of anticipating and evaluating the impacts of proposed and completed development interventions on the structures and processes that strengthen the prospects for peaceful coexistence and decrease the likelihood of the outbreak, recurrence or continuation of violent conflict; and the structures and processes that increase the likelihood that conflict be dealt with through violent means.”

  20. Do No HarmCategories of Negative Impacts 1 Worsening divisions between conflicting groups 2 Increasing danger for participants in peace activities 3 Reinforcing structural or overt violence 4 Diverting resources from productive peace activities 5 Increasing cynicism 6 Disempowering local people

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