Presentation at 3rd GRF One Health Summit 2015 Session Education and Capacity Building within One Health

1. Dr Sumitra Sithamparam
PhD, MBBS, MSc, BSc, Dip Cli Hypno
Malaysian Medical Association (MMA)
The TranSAge Project
~ Transforming a street to encompass a Society for all Ages

2. Figure: Sketch map of Malaysia showing its coastline and surrounding seas
Source: http://www.classicbookshelf.com/library/ 2012

3. SWOT review – a Continuum
Scope
Setting the Stage
Areas of Concern
Overriding Principle The
TranSAge
Project
Areas for Consideration

4. Scope
Introducting the street ecosystem as a functional component
Ecosystems are defined by the network of interactions among organisms,
and between organisms and their environment. In this case the street is a
localised entity and a functional unit which is unlimited in its constituents
(such as, people using the street as residents, consumers or passers-by)
and unrestricted in its access (such as, vehicles passing through the street
to its destination within or outside of the locality).
Within this ecosystem lie naturally occurring biotic component (in addition
to the humans, there are living organisms such as the flora & fauna) and
abiotic component (every entity that interacts with the air, water & soil), and
anthropogenic factors (everything that is influenced by human activities)
with spatial (relating to space, position, size, shape, etc.) and temporal
(relating to a particular time or a sequence of time: chronological)
distributions.

5. The 12 principles on which the “ecosystem approach” is based are:
1. The objectives of management of the resources in a locality are a matter of societal choice – this
depends on their own economic, cultural and societal needs.
2. Management should be decentralized to the lowest appropriate level – decentralized systems may
lead to greater efficiency, effectiveness and equity. Management should involve all stakeholders
and balance local interest with the wider public interest. The closer management is to the ground,
the greater the responsibility, ownership, accountability, participation, and use of local knowledge.
3. The managers should consider the effects (actual or potential) of their activities and possible
impacts on adjacent surroundings.
4. To recognise potential gains from management, there would be a need to understand and
manage the locality in an economic context.
5. Conservation of existing structures and their functioning, in order to maintain services, should be
a priority target of this approach – functioning and resilience depends on a dynamic relationship
within the community and between users and the environment.
6. The locality should be managed within the limits of their functioning.
7. This approach should be undertaken at the appropriate spatial and temporal scales.
8. The varying temporal scales and lag-effects should be recognized; objectives for management
should be set for the long-term.
9. Management must recognize that change is inevitable – this approach must utilize adaptive
management in order to anticipate and cater for such changes and events and should be cautious
in making any decision that may foreclose options, but, at the same time, consider mitigating
actions to cope with long-term changes including effects of climate change.
10. This approach should seek the appropriate balance between, and integration of, conservation and
biodiversity.
11. This approach should consider all forms of relevant information, including scientific and local
knowledge, innovations and practices – proposed management decisions should be explicit and
should be checked against available knowledge and views of stakeholders.
12. This approach should involve all relevant sectors of society and scientific disciplines –
stakeholders at the local, national, regional and international level, as appropriate (NRE 2008).

6. Therefore utilizing the ecosystem approach holistically for
management is possible to:

maintain connectivity – linkage of habitats, communities
and ecological processes at multiple scales;

maintain integrity – the integrity of the locality has a
direct bearing on the status of the environment;

maintain structural complexity of habitat stand;

maintain landscape heterogeneity;

Manage disturbances (NRE 2008).

7. Overriding Principle
Risk management should:
•
create value – resources expended to mitigate risk
should be less than the consequence of inaction, or the
gain should exceed the pain
•
be an integral part of organizational processes
•
be part of decision-making process
•
explicitly address uncertainty and assumptions
•
be a systematic and structured process
•
be based on the best available information
•
be tailorable
•
take human factors into account
•
be transparent and inclusive
•
be dynamic, iterative and responsive to change
•
be capable of continual improvement and enhancement
•
be continually or periodically re-assessed

8. Setting the Stage
Strategies to manage threats (uncertainties with negative consequences)
typically include transferring the threat to another party, avoiding the
threat, reducing the negative effect or probability of the threat, or even
accepting some or all of the potential or actual consequences of a
particular threat, and the opposites for opportunities (uncertain future
states with benefits).
Certain aspects of many of the risk management standards have come
under criticism for having no measurable improvement on risk, whereas
the confidence in estimates and decisions seem to increase.
In ideal risk management, a prioritization process is followed whereby the
risks with the greatest loss (or impact) and the greatest probability of
occurring are handled first, and risks with lower probability of occurrence
and lower loss are handled in descending order. In practice the process
of assessing overall risk can be difficult, and balancing resources used to
mitigate between risks with a high probability of occurrence but lower loss
versus a risk with high loss but lower probability of occurrence can often
be mishandled.

9. SWOT review – a Continuum
For the most part, these methods consist of the following
elements, performed, more or less, in the following order.
•
identify, characterize threats
•
assess the vulnerability of critical assets to specific threats
•
determine the risk (i.e. the expected likelihood and
consequences of specific types of attacks on specific
assets)
•
identify ways to reduce those risks
•
prioritize risk reduction measures based on a strategy
•
identification of risk in a selected domain of interest
•
planning the remainder of the process

10. •
The present population - number of older
persons in the community?
•
Can older people function normally? - activities
of daily living - go out on their own? - without
aid/assistance? - is the street conducive for that
to occur?
SWOT: Strength

11. •
How many have co-morbidities
•
How many are dependent on their family?
•
How many are institutionalised?
The street is NOT conducive for older people from
the various angles
SWOT: Weakness

12. •
Is the quality of life for the older person
addressed? – how can they go about the street?
•
In a multicultural setting how do we prioritise &
individualise?
•
Continuum of services – community care
services include Public Health (PH) service
SWOT: Opportunity

13. •
Ecological assessment
•
Social assessment
•
Health assessment
•
Poverty
•
Redundancy
SWOT: Threat

14. Values
 Ecological State
 Economic Inclusion
 Social Attributes
 Community Health
 Individual Well-being
Framework criteria
 Quality
assessment/standard
 Accessibility
 Management and safety
 Facilities and utilities
 Aesthetics and
attractiveness
 Information and education
 Potential impact and
rehabilitation
 Site specific activity
assessment
 Local community

16. Safety & security
Pollution & smoke-free
Cleanliness & hygiene
Greenery & healthy environment
Aesthetics & exercising
Areas of Concern

18. The natural terrain
The built-up infrastructure
Ad hoc versus planned development
The visitor & the community
Children, adults & the elderly
Areas for Consideration

20. As an after-thought …