A Model for Acting of Peace through Health McMaster Feb. 27, 2006
Apr 01, 2015
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?
Redefinition of the Situation
Teaching : Communication of knowledge
Primordial Primary Secondary TertiaryPre-conflict Conflict Post-conflict
Skills
Values and Qualities
Knowledge
Public Health - Epidemiology, Prevention, Promotion
Altruism - Evocation and Broadening
Sensitizing : Putting a human face on suffering
Solidarity - Extension of
Dissent and Non-cooperation
Each of the above
Healing of communities: Physical, Psychological, Social, Spiritual
Maintaining structural integrity for society
Diplomacy
Psychological - cycles of violence, post traumatic stress, concepts eg. psychic numbing,
Principles and Practice: Lessons from General Systems
Personification of “Enemy”
Stage of Prevention
Figure 1 Peace through Health Working Model
Medical Ethics
Superordinate Goals - Construction of
Peace Accords
Post-Conflict Reconstruction
Breaking the Chain of War: Medical Peace Action in a Framework of Prevention
Incidence of Violence
WarRoot Causes
i
i
i
Primordial Prevention
Primary Prevention
i
i
i
i iSecondary Prevention
i Ceasefire
Tertiary Prevention
Peace Accords
Post-Conflict Reconstruction
Figure 2 Breaking the Chain of War: Medical Peace Action in a Framework of Prevention
Incidence of Violence
WarRoot Causes
i
i
iEnvironmental and
Human RightsAmnesty
Physicians for Human Rights ISDE
MSF
Domestic Gun Control
HELP Network CGC
IPPNW
Coalitions Against Weapons Systems
IANSA ICBL
Primordial Prevention
Primary Prevention
i
i
i
i i
International HealthICRC
WHO HPB UNICEFSecondary
Prevention
i Ceasefire
Tertiary Prevention
McMaster Centre for Peace Studies
Relief
Organisations
OXFAM
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.”
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.
EL SALVADOR
SMALL ARMS PEACE THROUGH HEALTH TRAINING
DECLARATION OF ALMA-ATA •
• I
The 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.
• II
The 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
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
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
From Wendy Cukier
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.
PREVENTABLE DEATHS?• WHO estimates homicide rates
• Japan at 0.6 per 100,000
• United States 7 per 100,000
• Brazil 25 per 100,000
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.
Homicides rates El Salvador
0
20
40
60
80
100
120
140
1960-1970
1994-1995
1999 2000 2001 2002 2003 2004 Jul-05
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
Source: CDC. Framework for Program Evaluation in Public Health. MMWR 1999;48(No.RR-11)
Long-term Outcomes
Intermediate Outcomes
Initial
Outcomes
Outputs
Activities
Inputs
End Conflict / Build sustainable, just structures
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.”
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