Concept of Integration and Sustainability

Integration- Fostering a sense of oneness. An approach that combines all aspects that are relevant to tackle the problems in the environment.
Sustainability- The development that meets the needs of the present without compromising the ability of future generations to meet their own needs.

Integration and Sustainable Development - World Summits

Earth Summit of 1972 in Stockholm- Mrs. Indira Gandhi, former Prime Minister of India had emphatically stated that Poverty is the biggest Polluter. Earth Summit held in Rio de Janeiro in 1992The principle 1 of Rio Declaration emphatically stated that Human beings are at the centre of concerns for Sustainable Development. They are entitled to a healthy and productive life in harmony in nature. World Summit on Sustainable Development or Earth Summit 2002 in Johannesburg, South Africa was convened to discuss sustainable development by the United Nations. The Millennium Development Goals was drafted during the Summit "free all men, women, and children from the abject and dehumanizing conditions of extreme poverty."

Relationship of the Panch Tatva with the Environment

The surroundings of an organism living in its natural habitat is termed as environment. These surroundings include physical, mental and spiritual conditions. Physical or Abiotic environment- It consists of the combination of Earth, Water, Fire, Space and Air the five basic elements (Panch Tatva) which influence life. Living or Biotic environment- It consists of plants, animals ,human beings and micro-organisms. All the environmental factors directly or indirectly affect the life of an organism. These biotic and abiotic components are in a dynamic state i.e. they constantly depend and affect each other and cannot be dealt in isolation. The un-thoughtful use of a resource, pollutes the other environmental factor, which in turn affects the polluting one, as all of them are interrelated and interdependent. This is the fundamental of environmental pollution.

How significant is the impact of environment on health?

Globally, an estimated 24% of the disease burden (healthy life years lost) and an estimated 23% of all deaths (premature mortality) can be attributed to environmental factors.

Among children 0-14 years of age, the proportion of deaths attributed to the environment was as high as 36%.
Disease with the largest absolute burden attributable to modifiable environmental factors included: Diarrhoea, lower respiratory infections, other unintentional injuries, and vector borne diseases like malaria.

Regions of the world where health is most affected by environmental factors

Developing regions carry a disproportionately heavy burden for communicable diseases and injuries. The total number of healthy life years lost per capita as a result of environmental burden was 15 times higher in developing countries than in developed countries. The environmental burden per capita of diarrheal diseases and lower respiratory infections was 120 to 150 times greater in certain WHO developing country subregions as compared to developed country sub-regions. These differences arise from variations in exposure to environmental risks and in access to health care.

Water and Health

About 21% communicable diseases are water borne. 50 million suffer from intestinal diseases eg; diarrhea, cholera, dysentery, typhoid etc. 5 million people die, of which 1.5 million are children below 5. INDIA Total WSH-related diseases 782, 000 % of total deaths 7.5% Total WSH-related DALYs 28. 2 million % of total DALYs 9.4%

Water Safety and Quality

Issues About 25% of water sources are polluted due to bacteriological and chemical contamination 66 mill. at risk due to excess fluoride in DW 14 mill. at risk due to excess arsenic in drinking water. Intensive use of fertilizer in agriculture contaminates GW with nitrate. Excess use of pesticides is contaminates GW/ SW. Some are carcinogenic.

Diarrhoea: An estimated 94% of the diarrheal burden of disease is attributable to environment, with risk factors such as unsafe drinking water and poor sanitation and hygiene.

Air and Health

Issues Ambient Air Quality 1.Transportation and Industries are the major contributors. 2.SPM is reported to be very high and mostly in critical condition. Indoor air Quality 1.Around 6 lakh Indians die due to indoor air pollution. 2.Poor Women, children and elderly are more vulnerable due to overcrowding and lack of ventilation. 3.Incomplete combustion of biomass used in poor homes have very high CO, HC and SPM

Lower respiratory infections: Associated with indoor air pollution due to household solid fuel use and possibly to second-hand tobacco smoke, as well as to outdoor air pollution. In developed countries, an estimated 20% of such infections are attributable to environmental cause, in developing countries it is 42%.

Open Defecation
JMP report 2012: In World total 1053.7 million people are practicing open defecation. Out of them 60 percent are living in India only. Census 2011: India 49.8% of total 122.9 million households practice open defecation. In rural India 67.3% i.e. 113 million households practice open defecation. According to survey done by Sulabh Academy, around 50% of houses lack sewerage facilities in Delhi slums. Most of the people around 41% uses community toilet and 9% practice open defecation. The World Bank Water and Sanitation Programme study The Economic Impacts of Inadequate Sanitation in India (2010) showed that inadequate sanitation (viz. inadequate household access as well as associated poor hygienic behavior and lack of safe confinement and disposal of fecal matter) caused India considerable economic losses, equivalent to 6.4 per cent of Indias GDP in 2006 at US$53.8 billion (Rs.5.4 trillion). The poorest 20% of households living in urban areas bore the highest per capita economic impacts of inadequate sanitation.

Sanitation & Health

Fecal oral infections
Open defecation

major cause of this infection Contaminated fingers, food, domestic flies, soil, contaminated drinking water help in transmission Faecal oral infection cause diarrheal diseases Around 7 lakhs deaths take place due to diarrheal diseases

Sanitation & Health

Soil transmitted Helminthes This bacteria enters the body through skin, when walking barefoot on contaminated soil Hookworms and threadworms use this method of penetration Ingestion is another way of entering for helminthes, roundworm and whipworms use this method A simple way of reducing hookworm diseases is by wearing slippers , while moving around contaminated soil

Sanitation and Health

Studies conducted by Dr. Feachem indicated relative importance of alternative preventive strategies concerning water supply, sanitation and health education revealed that health impact of supplying clean water alone is limited. However carefully designed programmes which combine water quality with improvements in water availability, safe disposal of human waste and hygiene education have the potential to be successful. The All India Institute of Hygiene and Public Health, Kolkata, observed that the mortality and morbidity rates were higher in villages with only tube well water supply facility than at places where only pour-flush water seal toilets had been provided. The best results were found where both the facilities were available.

The worst was where none existed.

Health risks of Solid waste

Solid waste can come into direct or indirect contact with human beings at several stages in the waste cycle- high health risk. Uncollected organic domestic wastes ferment, creating conditions favorable to the survival and growth of microbial pathogens. Organic wastes also provide feeding stock and natural environment for insects, rodents and other animals. Uncollected solid waste can also obstruct storm water run off, resulting in flooding or creation of stagnant water bodies which become habitats and breeding places for water borne vectors of tropical diseases. Direct dumping of untreated solid wastes in river, result in chemical and microbial contamination of water. Landfills are a source of fires, dust, smoke, noise and disease vectors. Incinerators cause air pollution toxic chemicals and heavy metals.

Impact of Climate Change

CO2 (deforestation, decay of biomass, etc), 17.3% CO2 (other), 2.8%

CH4 14.3%

CO2 fossil fuel use, 56.6%

N2O, 7.9% F-gases, 1.1% Global anthropogenic greenhousegas emissions in 2004

Projected Rise in Global Average Temperature

(Source: www.epa.gov)

Rising Impacts of Global Warming

+50c 2080s Extinction of more than 40% of known species ; Global economic losses of up to 5% GDP ; Partial melting of Green land and W. Antarctica Ice sheets ; Eventually raising sea-level 1.3-2 feet.

+40c +30c +20c +10c

2050s
2020s

Substantial burden on health services; Global food production decreases; About 30% of global coastal wetlands lost.
Major changes in natural systems cause predominantly negative consequences for biodiversity, water and food supplies. Widespread coral mortality. Millions more people face flooding risk every year. Increased risk of extinction for 20-30% of known species. Most corals bleached. Increasing mortality from heat waves, floods and droughts Decreasing water availability ; Increasing drought in many regions ; Increasing wildfire risk ; Increased flood and storm damage ; Increasing burden from malnutrition, diarrheal, cardio-respiratory and infectious diseases

2007
Current Warming

Over 1980-1999 Temperature levels

Overview of the health effects of climate change

Expected impacts are mainly for changes in frequency or severity of familiar health risks
1. 2. Temperature-related illness and death Extreme weather- related health effects

3.
4.

Air pollution-related health effects

Water and food-borne diseases Vector-borne and rodent- borne diseases

CLIMATE CHANGE

5.

6.
7. 8.

Effects of food and water shortages

Psycho-social impacts on displaced populations Health impacts from conflicts over access to vital resources

Key Principles of Healthy City

Health should be an integral part of settlement management and development. Health can be improved by modifying the physical, social and economic environment.

Conditions in settings such as home, school, workplace and city profoundly influence health status. Inter-sectoral coordination for health is necessary at local level.

Main Objectives
To reduce the disease burden Help the weaker sections of the society

Introduce community participation and promote self-help

Bring awareness on cleanliness and environmental hygiene Link preventive healthcare and city planning

Promote ecological balance and sustainable development

Integrate sectoral planning and management at the local area level Reorient medical services and health systems away from hospital care towards primary healthcare Promote physical, mental and environmental well-being of the urban dwellers

Qualities of a Healthy City

A clean and environment A stable sustainable safe physical that is

ecosystem

A strong mutually supportive and non-exploitative community

A high degree of participation and control by the public

A diverse, vital and innovative city economy

Retention of ethnicity and heritage

High health Status

"Treat the earth well: it was not given to you by your parents, it was loaned to you by your children. We do not inherit the Earth from our Ancestors, we borrow it from our Children." Ancient Indian Proverb