Oped»
A capital mess
- mental health & society
APR 06 -
Kathmandu is the most polluted city in Asia with respect to air quality. Every year, around 2,000 people die in Kathmandu because of carbon pollution related diseases; and the daily impact of carbon pollution on the population is massive. It affects all irrespective of gender, age, profession, social-economic status, political beliefs or religion. We all know how ugly our city is, but we are behaving as if we are not affected by it. The city has become a victim of political absurdity and intellectual delusion of its residents that undermines the daily needs of the population, and most importantly, our rights to healthy breathing. In such a city, we cannot imagine a healthy and prosperous life without changing its environment. We cannot ignore our health. Urban health matters to us.
Historically, the city has been an engine of economic growth, a centre of culture and a generator of ideas. But while the human potential is infinite, resources are finite. Urbanisation creates problems, but healthy cities can solve them. A billion people now live in the world’s urban slums. The urban population of Asia is expected to double between 2000 and 2030. The health sector needs to take the lead in calling attention to the enormous implications of this growth in the cities for the health of the people who live and work in them.
Therefore, in recognition of the effect of urbanisation on our collective health, the World Health Organisation (WHO) is celebrating World Health Day on April 7 under the theme “Urbanisation and health”. In last year’s World Health Report, urbanisation was cited as one of the biggest health challenges of the 21st century. So, WHO aims to bring this issue into global advocacy to integrate urban health into the public health strategy and most broadly into the urban health policy.
Though health is central to human life and existence, modern international human rights practices are also failing to protect the right to health of the population. Since the adoption of the Universal Declaration of Human Rights in 1948, there has always been tension between the aim of protecting basic individual rights like the right to health and basic needs, and that of protecting international peace and stability. Practically, individual rights are always falling in the shadow of political rights.
The United Nations International Covenant on Economic, Social and Cultural Rights (ICESCR) specifically talks about the adequate standard of living including adequate food, clothing, housing and medical care; free, compulsory elementary education; free choice of employment; just and favorable remuneration; equal pay for equal work; right to join trade unions; reasonable limitation of working hours; and social security. Thus, for example, whereas the declaration speaks of the right to “medical care” which is “adequate for health and well-being”, the corresponding passage in the ICESCR postulates the right to “the highest attainable standard of physical and mental health”.
On the ground of the ICESCR, movements on the right to health are being waged around the world. In fact, the right to health is an inclusive right, extending not only to timely and appropriate health care, but also to the underlying determinants of health, such as access to safe and portable water and adequate sanitation, healthy occupational and environmental conditions, and access to health related education and information. Therefore, in the debate of health rights, access to treatment, care and prevention, all are equally important.
In fact, we need rights to assist our existential goals. Therefore, we move to the cities to seek better lives, and it is always hard for governments to satisfy our needs; but we are dependent on the government to solve our many problems that are beyond our individual control, which can have many negative impacts on our wellbeing. In the context of the developing countries, the cities are not well developed; but they are fast growing. Living in poorly planned cities increases our vulnerability to a number of risks. For example, we can recall the recent tragedy of the Haiti earthquake that shows us the urgency to become aware of our collective risks as urban dwellers and take the necessary steps to prevent a future tragedy. According to WHO, our risks include:
l Environmental risks, such as chemical or biological pollution of the air, water and land.
l Safety risks, including pedestrian, motor vehicle and occupational safety.
l Social risks, such as violence, substance abuse and other risky behaviours.
l Epidemiological risks, inc-luding both communicable and non-communicable diseases related to inadequate sanitation, crowding and modern urban lifestyles.
l Disaster risks, including the vulnerability to earthquakes, floods and mudslides.
In Kathmandu, we share all these risks; and we are prone to collapse anytime if we do not act today seriously for our future protection. Health is not only about hospitals, health professionals and medication. It is an issue of our wellbeing and existence which is reflected in our living condition, society and development. WHO says that there are effective actions and policies in a range of critical areas that can help make cities healthier places to live. A few examples are:
l Human security — policy and programmes that reduce violence, laws and regulations that improve road safety, planning and construction that include walking and cycling paths.
l Healthy behaviours — policies and programmes that help reduce consumption or abuse of tobacco, alcohol and other drugs, encourage physical activity and help “make the healthy choice the easy choice”.
l Healthy settings — initiatives by municipalities, schools, communities, markets and other workplaces that seek to improve the on-site environment and promote health among their members and associates.
l Urban infrastructure — promotion of urban planning, clean public spaces, public transport, recycling, renewable energy, green spaces, water and sanitation.
l Environmental, air and noise pollution — efforts to reduce greenhouse emissions, chemical risks and noise.
l Inclusive urbanisation — policies and programmes that seek to reduce inequities, prevent slums and focus on the most vulnerable people, including homeless adults and street children.
l Emergency preparedness — promoting disaster-safe infrastructure and continuity of vital services in the event of disaster or other emergencies.
l Diseases control and prevention — funding and policies that support public health planning and interventions and ensure affordable, accessible health care.
From the preventive aspects, in our cities, if any disaster or public health epidemic were to occur, we have no option but to wait for a cold death. In dealing with urban health, greater social awareness and integration of the human rights approach to health are particularly important. Obviously, the government has an obligation to respect the right to health of its population by developing appropriate infrastructure and policies; but we are also equally responsible in creating a healthy city. Let’s vow on this day that we will not be merely celebrating World Health Day, but we will be acting
responsibly to make our city a healthy city.
Jagannath Lamichhane
jagannathlc@gmail.com
Posted on: 2010-04-07 07:37
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