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| Saturday, 22 May 2004 |
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City of Colombo strives for a clean bill of health! by Fathima Razik Cader A totally new concept in health - perhaps for the first time in Sri Lanka, is being mooted by the Colombo Municipal Council (CMC) with its Public Health Department (PHD) taking on the responsibility of making this not merely a one-off exercise but one which will be a long-term programme to make Colombo a Healthy City. The aim of this programme is to create healthy living conditions in the city through a political commitment from the highest in the country which in turn will facilitate inter-sector collaboration, active participation and support of the community and all stakeholders. The Road Map (a current catch phrase) to achieve this status has a three-phase interactive cycle viz: initial, organizational and the implementation. Each of these phases has been mapped out for a period of three years, However, the citizens of Colombo can continue with the programme from one stage of development to another as they deem fit to reach progressively higher levels of development in the areas of socio-economy and health. The objectives are many and varied and the CMC will strive to work in close co-operation and collaboration with Provincial and Central Governments, non-governmental organizations (NGOs), private sector organizations, community based organizations and similar bodies which might have like-minded goals and aspirations. Yet another objective is to put in place a Health Plan with the participation of all stake-holders including the community. Colombo being the commercial capital of Sri Lanka is also the de-facto administrative capital city in the country with most government agencies being situated within its parameters. According to the last census (carried out in the year 2001), the population of Colombo recorded 642,500 people and it is estimated that around 500,000 others commute to the city daily to work, to school or for other activities. The city has around 100,000 housing units of which 50% are urban slums and shanties which occupy 6% of land area. More than half of Colombo's population live in these under-serviced housing units and the issues that this segment of society faces are manifold - poor housing, poor water supply, lack of proper drainage facilities, lack of solid waste management, the lack of an efficient transport system and inadequate health care services to name a few. In the past, there have been many projects by the CMC to address the issues that the citizens of Colombo face. Such projects have been funded by the Council or through organizations like UNICEF, UNHCS and the UNDP. However, such programmes, though well intended, have not had the desired degree of success. Having evaluated the outcome of these projects, it was decided approach the Healthy Colombo programme from a fresh angle highlighting development for sustainability by creating healthy settings on all aspects to improve the living conditions of the people. The implementation will be through the combined efforts of politicians, the local authority, the community and the participating organizations whilst a small cell called the Project Support Team (PST) will be setup to form the nucleus on which the project will revolve. In addition, City Watch and Advisory Committees will also be set up to oversee vital areas like health, environment and other subjects. These committees will comprise leading citizens with proven knowledge and expertise in such areas. Professionals from the World Health Organization's (WHO) Kobe's Community Development and Welfare Project in Colombo will also be closely associated with the programme. In keeping with the times, a free flow of dialogue with the citizens will be mooted via the launching of the CMC's E-Governance Project in the weeks to come. Salient factors The brainchild of Chief Medical Officer of Health of the CMC Dr. Pradeep Kariyawasam, the Healthy Schools Project has proved an outright success. Dr. Kariyawasam is therefore confident that as a result, the salient factors that governed the implementation of the Healthy Schools Project could be highlighted and parallels, where feasible, could be drawn in implementing the Healthy City programme. Currently, it is those directly involved or service providers who are privy to information on culture, environment, health and education amongst many other issues and it is the view of Dr. Kariyawasam that such information and data should filter down to all citizens in order to keep them updated on present day situations. Similarly, rate payers are not aware how the Council operates and as a result their grievances sometimes end up at the wrong department. This problem will be addressed as a priority so that a correct picture of the problems faced by citizens will emerge. Current situation The Project Support Team, once activated, will make an initial assessment of the current situation with regard to health, economic and social issues, the potential partners, possible political support, the administrative structure and is working mechanisms, how such mechanisms could be improved, the role of the community groups, NGOs, private sector organizations that support the municipality in its activities, in addition to drawing on past experiences in collaborative actions and sources of information available. Quite a task one will agree! A participatory effort will be mooted by the two committees that will be set up. They are the Healthy Colombo Steering Committee and the Healthy Colombo Tasks Force. These two committees will be given separate mandates that would encompass areas of work envisaged in implementing this programme. The Project Support Committee will detail the plan of action with the terms of reference and other vital details necessary in this regard. The entire programme will function directly under Dr. Pradeep Kariyawasam, the Chief Medical Officer of Health who will be the Coordinator for the Healthy Colombo Project. Since Dr. Kariyawasam is also the Project Manager of the UNHCS Sustainable Cities Programme, facilitation and collaboration between the projects and sharing of resources will be unhampered. With stipulated time-frames for each area of work outlined for the project, those responsible will have to deliver and this will ensure that the plan of action will go on at a steady pace. Apart from the CMC, the Department of Education, Universities, Ministry of Health, Director of the National Hospital, Ministry of Transport, Urban Development Authority, Land Reclamation and Development Board amongst other relevant departments will be on board towards achieving Healthy City status for Colombo. Towards this end, the following points will prove useful: The need for political support in improving healthy living conditions in Colombo. The need for a bottom up approach in the planning process of health activities. The need for inter-departmental co-operation at the municipal level and inter-agency collaboration to achieve healthy city status by creating healthy settings. The need to create awareness among community about health and environmental issues that create health hazards and the mechanisms for health education. The city health profile and creation of data bases. The need for capacity building among officers and community leaders in working out solutions for healthy living and to improve communication between them. The need to create good governance practices to address the above issues. To look into health issues especially those concerning the health of mothers and children. To look into diseases and methods of preventing of such diseases. To look into ways of improving the socio-economic status of the people living in under-served settlements in order to generate wealth for self-improvement and acquiring better facilities for themselves. The environmental health and sanitation issues and controlling activities bring on environmental pollution. The following areas are proposed for Healthy Settings: Green Star Homes Green Settlements (for under-served areas) Healthy neighbourhoods (for housing schemes) Healthy schools Healthy markets Healthy parks Healthy sports and recreational centres Healthy and safe roads Healthy libraries Healthy work places Healthy hospitals, clinics and maternity homes Healthy and safe transport services Healthy canals and canal banks Healthy beach front Citizens and organizations interested in particular areas will be encouraged to get actively involved in such areas. All the input so far detailed, will be a natural course of events, bring out the desired results - that of improved conditions in health and the environment at settings that will eventually create a Healthy Colombo City. Improved sanitation and street drainage, solid waste management, good air quality, upgraded housing, safe drinking water, healthy working conditions and community participation through creating awareness on issues and thereby finding solutions to such issues, can be realistically achieved through sharing of information and networking amongst all stake holders. The plan of action, once approved by the Colombo Municipal Council, will prioritize activities detailed in the overall plan. Immediate impact The Task Force is of the view that it would be feasible to start with activities for which funds already exist. Activities that would create an immediate impact and create healthy settings would be given priority. This would result in the private sector and other donors getting interested in the project. In addition, all departments of the CMC would be garnered to support the project in areas that come within the purview of each department. This type of coordination and inter-action amongst departments within an organization will undoubtedly, for starters, create a healthy settings within the organization - a situation that is sadly lacking in most organizations. In addition, key players will be exposed to similar activities undertaken by other Healthy Cities projects in the region in order to adopt and/or replicate good practices. This can also bring about attitudinal changes which will also be a healthy factor. Strong links with the community will be actively promoted and as much as possible "community contracts" will be given out to create a feeling of ownership and bonding. A factor that will not be overlooked is the improvement of mental health within the city. No doubt, creating healthy settings is bound to enhance health, mental health, peace and stability in the city. With constant monitoring and annual evaluating by the participation of officials of the country and regional offices of the World Health Organization, this project seems to be thoughtfully and meticulously outlined for implementation. The sweet smell of success is in the air! Good luck to Dr. Pradeep Kariyawasam, Chief MOH of the CMC whose brainchild it is and every single person associated with the project. The question right now is "When will the other local authorities think of planning and implementing such projects in their respective areas?" |
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