HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity
Public Health: Developed as a discipline in the mid 19th century in UK, Europe and US. Concerned more with national issues.
Data and evidence to support action, focus on populations, social justice and equity, emphasis on preventions vs cure.
What is global health?
Health problems, issues, and concerns that transcend national boundaries, which may be influenced by circumstances or experiences in other countries, and which are best addressed by cooperative actions and solutions (Institute Of Medicine, USA- 1997)
International Health: Developed during past decades, came to be more concerned with
the diseases (e.g. tropical diseases) and
conditions (war, natural disasters) of middle and low income countries.
Tended to denote a one way flow of ‘good ideas’.
Global Health: More recent in its origin and emphasises a greater scope of health problems and solutions
that transcend national boundaries
requiring greater inter-disciplinary approach
Global health is the health of populations in the global context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide".Problems that transcend national borders or have a global political and economic impact are often emphasized.Thus, global health is about worldwide health improvement (including mental health), reduction of disparities, and protection against global threats that disregard national borders.Global health is not to be confused with international health, which is defined as the branch of public health focusing on developing nations and foreign aid efforts by industrialized countries.Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day.
Determinants of health refer to the various factors that influence an individual's overall health status.
Dimensions of health, on the other hand, represent different aspects or components of health. I
Public Health: Developed as a discipline in the mid 19th century in UK, Europe and US. Concerned more with national issues.
Data and evidence to support action, focus on populations, social justice and equity, emphasis on preventions vs cure.
What is global health?
Health problems, issues, and concerns that transcend national boundaries, which may be influenced by circumstances or experiences in other countries, and which are best addressed by cooperative actions and solutions (Institute Of Medicine, USA- 1997)
International Health: Developed during past decades, came to be more concerned with
the diseases (e.g. tropical diseases) and
conditions (war, natural disasters) of middle and low income countries.
Tended to denote a one way flow of ‘good ideas’.
Global Health: More recent in its origin and emphasises a greater scope of health problems and solutions
that transcend national boundaries
requiring greater inter-disciplinary approach
Global health is the health of populations in the global context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide".Problems that transcend national borders or have a global political and economic impact are often emphasized.Thus, global health is about worldwide health improvement (including mental health), reduction of disparities, and protection against global threats that disregard national borders.Global health is not to be confused with international health, which is defined as the branch of public health focusing on developing nations and foreign aid efforts by industrialized countries.Global health can be measured as a function of various global diseases and their prevalence in the world and threat to decrease life in the present day.
Determinants of health refer to the various factors that influence an individual's overall health status.
Dimensions of health, on the other hand, represent different aspects or components of health. I
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.
Global health is an important new term, and an important new concept. The Institute of Medicine refers to global health as "health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions."
OBJECTIVES OF GLOBAL HEALTH CARE
Why should medical students learn about global health
CONTINUE…
Public health, medicine, and nursing: parts of the same puzzle
CHALLENGES IN GLOBAL HEALTH CARE
THE KEY CONCEPTS IN RELATION TO GLOBAL HEALTH
. THE DETERMINANTS OF HEALTH
CONTINUE..
CONTINUE..
Continue…
2. The Measurement of Health Status
CONTINUE..
CULTURE AND HEALTH
CONTINUE..
4. The global burden of disease
5. Key Risk Factors for Various Health Conditions
CONTINUE..
Trends in Global Deaths 2002-30
HEALTH PATTERNS IN RESOURCE POOR COUNTRIES
HEALTH PATTERNS IN RESOURCE RICH COUNTRIES
Sharing the information.Network formation
REFERENCES
THANK YOU
The field concerned with the study of health and disease in the defined community or group.
Its goal is to identify the health problems and needs of people (community diagnosis) and to plan, implement and evaluate the effectiveness of health care system.
Chapter 1Community and Public Health Yesterday, Today, and ToEstelaJeffery653
Chapter 1
Community and Public Health: Yesterday, Today, and Tomorrow
Chapter Objectives
After studying this chapter, you will be able to:
Define the terms health, community, community health, population health, public health, public health system, and global health.
Briefly describe the five major determinants of health.
Explain the difference between personal and community health activities.
List and discuss the factors that influence a community’ s health.
Briefly relate the history of community and public health, including the recent U.S. history of community and public health in the twentieth and early twenty-first centuries.
Provide a brief overview of the current health status of Americans.
Describe the purpose of the Healthy People 2020 goals and objectives as they apply to the planning process of the health of Americans.
Describe the major community and public health problems facing the United States and the world today.
Introduction
Much progress made over last 100 years in health and life expectancy
Still room for improvement
Achievement of good health is worldwide goal of 21st century
Requires individual actions to improve personal health and organized community actions
20th Century Achievements in Public Health
Vaccination
Motor vehicle safety
Control of infectious diseases
Decline of deaths from CHD and stroke
Healthier mothers and babies
Safer and healthier foods
Safer workplaces
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
Definition: Health
Can mean different things to different people
A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment
Definition: Community
A group of people who have common characteristics
Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds
Characterized by
Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
Other Definitions (1 of 2)
Public health – actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term
Community health – health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health
Population health – health outcomes of a group of individuals, including the distribution of such outcomes within the group
Other Definitions (2 of 2)
Global health – health problems, issues, and concerns that transcend national boundaries
May be influenced by circumstances or experiences in other countries
Best addressed by cooperative actions and solutions
Personal Health Activities Versus Community/Public Health Activities
Personal health activities
Individual actions and decision making that affect the heal ...
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Similar to HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity
Globalization, Global Health and Public Health.
Changing Concepts of Public Health.
Causes, Aspects and Types of Globalization.
Social Changes due to Globalization.
How Globalization affects Public Health.
Globalization of Public Health.
Threats to Global Health.
This presentation describes what is new public health with adapted components from the previous eras of public health. Health promotion and evolution of public health is covered here.
Global health is an important new term, and an important new concept. The Institute of Medicine refers to global health as "health problems, issues and concerns that transcend national boundaries, may be influenced by circumstances or experiences in other countries, and are best addressed by cooperative actions and solutions."
OBJECTIVES OF GLOBAL HEALTH CARE
Why should medical students learn about global health
CONTINUE…
Public health, medicine, and nursing: parts of the same puzzle
CHALLENGES IN GLOBAL HEALTH CARE
THE KEY CONCEPTS IN RELATION TO GLOBAL HEALTH
. THE DETERMINANTS OF HEALTH
CONTINUE..
CONTINUE..
Continue…
2. The Measurement of Health Status
CONTINUE..
CULTURE AND HEALTH
CONTINUE..
4. The global burden of disease
5. Key Risk Factors for Various Health Conditions
CONTINUE..
Trends in Global Deaths 2002-30
HEALTH PATTERNS IN RESOURCE POOR COUNTRIES
HEALTH PATTERNS IN RESOURCE RICH COUNTRIES
Sharing the information.Network formation
REFERENCES
THANK YOU
The field concerned with the study of health and disease in the defined community or group.
Its goal is to identify the health problems and needs of people (community diagnosis) and to plan, implement and evaluate the effectiveness of health care system.
Chapter 1Community and Public Health Yesterday, Today, and ToEstelaJeffery653
Chapter 1
Community and Public Health: Yesterday, Today, and Tomorrow
Chapter Objectives
After studying this chapter, you will be able to:
Define the terms health, community, community health, population health, public health, public health system, and global health.
Briefly describe the five major determinants of health.
Explain the difference between personal and community health activities.
List and discuss the factors that influence a community’ s health.
Briefly relate the history of community and public health, including the recent U.S. history of community and public health in the twentieth and early twenty-first centuries.
Provide a brief overview of the current health status of Americans.
Describe the purpose of the Healthy People 2020 goals and objectives as they apply to the planning process of the health of Americans.
Describe the major community and public health problems facing the United States and the world today.
Introduction
Much progress made over last 100 years in health and life expectancy
Still room for improvement
Achievement of good health is worldwide goal of 21st century
Requires individual actions to improve personal health and organized community actions
20th Century Achievements in Public Health
Vaccination
Motor vehicle safety
Control of infectious diseases
Decline of deaths from CHD and stroke
Healthier mothers and babies
Safer and healthier foods
Safer workplaces
Family planning
Fluoridation of drinking water
Recognition of tobacco use as a health hazard
Definition: Health
Can mean different things to different people
A dynamic state or condition of the human organism that is multidimensional in nature, a resource for living, and results from a person’s interactions with and adaptations to his or her environment
Definition: Community
A group of people who have common characteristics
Can be defined by location, race, ethnicity, age, occupation, interest in particular problems or outcomes, or common bonds
Characterized by
Membership, common symbol systems, shared values and norms, mutual influence, shared needs and commitment to meeting them, shared emotional connection
Other Definitions (1 of 2)
Public health – actions that society takes collectively to ensure that the conditions in which people can be healthy can occur; most inclusive term
Community health – health status of a defined group of people and the actions and conditions to promote, protect, and preserve their health
Population health – health outcomes of a group of individuals, including the distribution of such outcomes within the group
Other Definitions (2 of 2)
Global health – health problems, issues, and concerns that transcend national boundaries
May be influenced by circumstances or experiences in other countries
Best addressed by cooperative actions and solutions
Personal Health Activities Versus Community/Public Health Activities
Personal health activities
Individual actions and decision making that affect the heal ...
Similar to HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity (20)
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1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
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Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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HiAP is an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies and avoids harmful health impacts in order to improve population health and health equity
2. Learning Objective
To understand the link between water,
sanitation and health from a global
perspective.
To understand the environmental,
social, economic and political factors
playing a role in cholera.
3. Definition
What is global health?
• Health problems, issues, and concerns
that transcend national boundaries,
which may be influenced by
circumstances or experiences in other
countries, and which are best addressed
by cooperative actions and solutions
(Institute Of Medicine, USA- 1997)
4. Global Health Issues
Refers to any health issue that concerns
many countries or is affected by
transnational determinants such as:
• Climate change
• Urbanisation
• Malnutrition – under or over nutrition
Or solutions such as:
• Polio eradication
• Containment of avian influenza
• Approaches to tobacco control
5. Historical Development of Term
Public Health: Developed as a discipline in the mid
19th century in UK, Europe and US. Concerned more
with national issues.
• Data and evidence to support action, focus on populations,
social justice and equity, emphasis on preventions vs cure.
International Health: Developed during past
decades, came to be more concerned with
• the diseases (e.g. tropical diseases) and
• conditions (war, natural disasters) of middle and low income
countries.
• Tended to denote a one way flow of ‘good ideas’.
Global Health: More recent in its origin and
emphasises a greater scope of health problems and
solutions
• that transcend national boundaries
• requiring greater inter-disciplinary approach
6. Disciplines involved in Global
Health
Social sciences
Behavioural sciences
Law
Economics
History
Engineering
Biomedical sciences
Environmental sciences
7. Communicable Diseases and Risk
Factors
Infectious diseases are communicable
But..
so are elements of western lifestyles:
• Dietary changes
• Lack of physical activity
• Reliance on automobile transport
• Smoking
• Stress
• Urbanisation
9. Key Concepts in Relation to Global
Health
1. The determinants of health
2. The measurement of health status
3. The importance of culture to health
4. The global burden of disease
5. The key risk factors for various
health problems
6. The organisation and function of
health systems
10. 1. Determinants of Health
Genetic make up
Age
Gender
Lifestyle choices
Community influences
Income status
Geographical location
Culture
Environmental factors
Work conditions
Education
Access to health
services
Source: Dahlgren G. and
Whitehead M. 1991
11. Determinants of Health
PLUS MORE GENERAL FACTORS
SUCH AS:
POLITICAL STABILITY
CIVIL RIGHTS
ENVIRONMENTAL DEGRADATION
POPULATION GROWTH/PRESSURE
URBANISATION
DEVELOPMENT OF COUNTRY OF
RESIDENCE
12. Multi-sectoral Dimension of the
Determinants of Health
Malnutrition –
• more susceptible to disease and less likely to
recover
Cooking with wood and coal –
• lung diseases
Poor sanitation –
• more intestinal infections
Poor life circumstances –
• commercial sex work and STIs, HIV/AIDS
Advertising tobacco and alcohol –
• addiction and related diseases
Rapid growth in vehicular traffic often with
untrained drivers on unsafe roads-
• road traffic accidents
13. 2. The Measurement of Health Status I
Cause of death
• Obtained from death certification but limited
because of incomplete coverage
Life expectancy at birth
• The average number of years a new-borns
baby could expect to live if current trends in
mortality were to continue for the rest of the
new-born's life
Maternal mortality rate
• The number of women who die as a result of
childbirth and pregnancy related complications
per 100,000 live births in a given year
14. The Measurement of Health Status II
Infant mortality rate
• The number of deaths in infants under 1 year
per 1,000 live births for a given year
Neonatal mortality rate
• The number of deaths among infants under 28
days in a given year per 1,000 live births in
that year
Child mortality rate
• The probability that a new-born will die before
reaching the age of five years, expressed as a
number per 1,000 live births
15. 3. Culture and Health
Culture:
• The predominating attitudes and behaviour
that characterise the functioning of a group or
organisation
Traditional health systems
Beliefs about health
• e.g. epilepsy – a disorder of neuronal
depolarisation vs a form of possession/bad
omen sent by the ancestors
• Psychoses – ancestral problems requiring the
assistance of traditional healer/spiritualist
Influence of culture of health
• Diversity, marginalisation and vulnerability due
to race, gender and ethnicity
16. 4. The global burden of disease
Predicted changes in burden of disease
from communicable to non-communicable
between 2004 and 2030
• Reductions in malaria, diarrhoeal diseases, TB
and HIV/AIDS
• Increase in cardiovascular deaths, COPD, road
traffic accidents and diabetes mellitus
Ageing populations in middle and low
income countries
Socioeconomic growth with increased car
ownership
Based on a ‘business as usual’ assumption
20. 5. Key Risk Factors for Various
Health Conditions
Tobacco use –
• related to the top ten causes of mortality world
wide
Poor sanitation and access to clean water-
• related to high levels of diarrhoeal/water
borne diseases
Low condom use –
• HIV/AIDS, sexually transmitted infections
Malnutrition –
• Under-nutrition (increased susceptibility to
infectious diseases) and over-nutrition
responsible for cardiovascular diseases,
cancers, obesity etc.
21. 6. The Organisation and Function
of Health Systems
A health system
• comprises all organizations, institutions and
resources devoted to producing actions
whose primary intent is to improve health
(WHO)
Most national health systems
consist:
• public, private,
• traditional and informal sectors:
23. Trends in Global Deaths 2002-30
Source: World Health Statistics 2007
24. COMPARATIVE DATA (1)
IRELAND DEVELOPING
COUNTRIES
INFANT MORTALITY 7 100-190
RATE
UNDER 5 MORTALITY 10 175-300
RATE
MATERNAL MORTALITY 2 600-1600
RATE
LIFE EXPECTANCY F - 82 F < 50
M - 77 M < 50
but may be
= or > F
25. COMPARATIVE DATA (2)
IRELAND DEVELOPING
COUNTRIES
POPULATION GROWTH 0.3% 3%+
RATE
HIV +ve RATE 0.15% 15%+
AIDS CASES 20/ 400/
100,000 100,000
GNP PER CAPITA $16,000 <$200
HEALTH EXPENDITURE $1,600 $1-$2
PER CAPITA
26. HEALTH PATTERNS
GENETIC FACTORS
ENVIRONMENTAL FACTORS
LIFESTYLE FACTORS
COMMUNICABLE vs NON-COMMUNICABLE
DISEASES DISEASES
27. HEALTH PATTERNS IN
RESOURCE POOR COUNTRIES
INFECTIOUS/COMMUNICABLE DISEASES
PREVALENT:
VACCINE PREVENTABLE DISEASES, e.g. measles
ACUTE RESPIRATORY INFECTIONS (ARI)
DIARRHOEAL DISEASES (cholera)
MALARIA
TB
HEPATITIS
HIV/AIDS
Plus:
MALNUTRITION RELATED CONDITIONS:
- CALORIE DEFICIENCIES
- MICRO-NUTRIENT DEFICIENCIES
TRAUMA/ACCIDENTS
Many of these diseases are treatable
28. HEALTH PATTERNS IN
RESOURCE RICH COUNTRIES
NON-COMMUNICABLE DISEASES PREVALENT:
Causes of death (all ages):
40% Circulatory diseases, e.g. heart disease,
strokes, etc.
25% Cancers
16% Respiratory diseases
5% Injuries and Poisonings
0.6% Infectious diseases
Premature mortality (<65):
25% Circulatory diseases
33% Cancers
16% Injuries (RTAs/Suicides) and Poisonings
1% Infectious diseases
Many of these deaths are related to lifestyle factors
and are preventable
29. HEALTH PATTERNS IN RESOURCE
RICH COUNTRIES
Lifestyle factors affecting physical
and mental health:
Smoking – one third of cancer deaths
related to smoking
Drinking
Healthy eating/nutrition
Physical activity
Substance abuse
34. John Snow and the Pump Handle
John Snow is credited by
many with developing
the modern field of
epidemiology
John Snow and cholera in
1854 London
http://www.ph.ucla.edu
/epi/snow.html
35. London in the 1850’s
• Germ theory of disease
not widely accepted
People lived in very
crowded conditions
with water and privies
in yard (NY 1864: 900
people in 2 buildings
180’ deep x 5 stories
– 1 pump a block
away, privy in yard)
36. John Snow’s Observations
People with cholera developed
immediate digestive problems: cramps,
vomiting, diarrhea
Face, feet, hands shriveled and turned
blue; died in less than a day
Probably spread by vomiting and
diarrhea
Comparison of pump location with
cholera deaths, first 3 days of epidemic
in 1854
38. Cholera Epidemiology
Of 83 people, only 10 lived
closer to a different pump
than Broad Street
Of these 10, 5 preferred taste
of Broad Street water and 3
were children who went to
nearby school
39. Snow Index Case
Index case is first person to
become ill
40 Broad Street – husband and
infant child became ill
Wife soaked diapers in pail and
emptied pail into cistern next to
pump
40. The Great Experiment
Two water companies supplied
central London
Lambeth Company: water
intake upstream of London
sewage outfall into Thames
Southwark & Vauxhall
Company: water intake
downstream of sewage outfall
41. The Great Experiment
Customers mixed in same
neighborhood
Snow went door to door
asking which water
company served home
and compared locations
with cholera data
42. The Great Experiment
# Houses # Deaths
Deaths/
100,000
S and V 40,046 1263 315
Lambeth 26,107 98 37
43. Cholera Epidemiology
Snow convinced
neighborhood council to let
him remove handle from
water pump on Broad Street
The new cases declined
dramatically
Many on council not
convinced by his evidence
44. Cholera in the 1990s
Epidemic in Peru beginning
1991
From 1991-1994
•Cases 1,041,422
•Deaths 9,642 (0.9%)
Originated at coast, spread
inland
47. Why Has Cholera Re-emerged?
Deteriorating sanitary facilities
as larger population moves into
shanty towns
Trujullo, Peru – fear of cancer
from chlorination so water
untreated
Use of wastewater on crops
Africa – civil wars and drought
caused migrations into camps
48. How Has Cholera Re-emerged?
Simultaneous appearance
along whole coast of Peru
Traveled in ship ballast?
Traveled in plankton from
Asia?
Always present in local
zooplankton (copepods) but
dormant until triggered by ???
50. Global Health References
Skolnik R. Essentials of Global Health. Jones
& Bartlett Publishers, Sudbury MA 2008. Chapter
1
Ed. Robert Beaglehole, 2003. Global Public
Health: A new era. Chapter 1
Megan Landon. 2006. Environment, Health
and Sustainable Development
Bonder, B. Martin L. Miracle A. Culture in
Clinical Care
Koplan J et al, 2009. Towards a common
definition of global health The Lancet, Volume
373, Issue 9679, Pages 1993-1995