The term Environment is often considered as merely a palace where people live and work forgetting the biological (eg mosquitoes, parasites, pathogens), physical (eg hazards in the home, workplace), chemical (eg pesticides, cleaning solutions), social (lifestyles), economic (eg industrial pollutions, occupational hazards at work places) and cultural (practices and beliefs) attributes that it carries along with it. These attributes are interrelated in so many ways and hence the need to untangle them so that we can have a better understanding of how the quality of environment is affected by human activity which also adversely impact on human health.
This blog intends to highlight the influence of environment on human health especially in the low and middle income countries for these two broad reasons:
1. they transit through risk transition i.e. moving from exposure to traditional hazards to exposure to modern hazards
2. the public health services in these countries and more especially the sub-Saharan Africa are in shambles bedevilled with multifaceted problems that includes:
• lack of physical infrastructure and effective public health systems and where available, concentration of health facilities in urban areas leaving the rural populations with nowhere to seek care
• ignorance and lack of information, educational and social programs needed to provide adequate public health services creating social stigmas to some health problems with many not being able to turn to the public health system thus resultant consequences to their health and that of others
• lack of sufficient budgetary resources and effective public health policies to ensure that health services are available, affordable and accessible to every citizenry
• lack of political will and commitment from the governments of these countries to make health care spending a priority with greater part of the meagre resources meant for health care often lost to poor spending choices, corruption, pilferages and wastages
• lack of adequate collaboration with NGOs and international donor agencies to restructure the health systems and contain emerging and re-emerging diseases posing threat to the high income countries as well e.g. scourges like HIV/AIDS, malaria and tuberculosis, schistosomiasis, onchocerciasis, and dengue fever etc.
I would like to define environment and health as two separate entities to enable our readers have a better understanding of how the two became interrelated:
• Environment simply means the physical, biological, social and cultural conditions affecting our lives vis-a-vis that of animals and plants as well
• Health is a state of complete physical, mental and social well-being and not just the absence of disease or infirmity.
Until recently, environmental issues have not been given much priority by policy makers especially when it comes to policy formulation and implementation and or developmental planning, and this is more so in the low and some mid income countries.
It is worthy to note that major determinants of the health of people in their environment are the quality of the environment and the nature of economic developments taking place in it.
Health and environment should be considered as two interdependent entities and hence the need for governments and organisations at all levels to ensure that an ecological balance is achieved and economic development is able to meet people’s needs by ensuring sustainable development.
There are various environmental organisations and institutes operating in the middle and high income countries across the globe all targeting public health protection with roles and responsibilities clearly outlined and are supported by government and non-governmental establishments. These organisations work closely to be able to deal with issues related to environment and health. It is disheartening to say that this is not the case in low income countries like Nigeria because of their multi-faceted problems that include lack of commitment from the citizenry, support from the government, lack of skills, information flaw to effectively communicate to the public.
It is well on record that the resultant effects of development, which is basically a human activity (e.g. urbanisation, industrialisation, increase waste, reliance on transport, rising demand for electricity etc), leads to increasing pressure on the environment; these adversely affects our environment and health through air pollution, water contamination and scarcity, soil pollution, problems of waste disposal, ozone depletion and global climate change, loss of biodiversity, disasters, emergence and re-emergence of infectious diseases etc. In view of the economic prospects associated with this development, it is often difficult to remove all risks of harm to health in this situation but to minimize them so as not to distort the economic indices and further deprive society of the goods and services they provide.
It suffices to say that this is still the problem in the third world countries of especially sub-Saharan Africa especially due to the unique problems that they have as they transit from traditional to modern environmental health hazards.
It is a fact that the key point to be observed in all economies across the globe (low, middle or high income countries) is the issue of sustainable development with the view to meeting the needs of the present generation without compromising that of the future generation. It is because of the importance attached to this that ‘Ensuring environmental sustainability’ forms the seventh item on the list of MDGs (millennium development goals) which aims to: integrate the principles of sustainable development into country’s policies and programmes, reverse loss of environmental resources, reducing by half those without sustainable access to safe drinking water and achieve significant improvement in the lives of at least 100million slum dwellers by 2020.
It suffices to say that this is an area for environmental activists, policy makers and governments at different levels to work together to formulate and implement policies with the aim of achieving this goal.
In my next write-up, I intend to discuss water and sanitation especially in the low and mid income countries. I hope to discuss their relationships to health and also provide some web links for further readings.