Donor countries adopt resolution in meeting :

Sri Lanka's un-met health needs in built environment

Enabling Environments: Development partners of Sri Lanka at a meeting passed a resolution on July 20 to push for the need to ensure that in all future projects in the country's built environment provides facilities to accommodate unhindered movement for all in the community.

Thus meeting the present unmet health need of the disabled and the aged who suffer mentally owing to denial of that provision to them in the country's built environment at present.

This was disclosed by the World Bank's Office Manager in Sri Lanka, Patrick Vandenbruaene, when he spoke at the Health Quest Special Programme for the Idiriya organisation led by Dr. Ajith Perera, to focus attention of the authorities concerned for this unmet health need prevailing in the country's built environment.

The meeting was sponsored by Janashakthi Insurance Co. Ltd and was held last Sunday (July 30) at Taj Samudra Hotel, Colombo.

He commended Dr. Ajith Perera, a former umpire of cricket in Sri Lanka, who was disabled following an accident 12 years ago and has been confined to a wheel-chair since then, for the agitation campaign he has been carrying on with vigour, for the successes he has achieved so far for this sector in the community for their free and easy movement facilities and health needs.

Social Services and Social Welfare Minister Douglas Devananda in a message explaining the steps that the Ministry is taking to meet this problem said that action is being taken to have a special office ground stairs in all Government buildings to cater to the needs of the aged and the disabled who visit these institutions to official matters.

The message was read by Consultant to the Minister Ms. M. Velautham.

UDA Secretary A. N. R. Amaratunga participating at this meeting said that amending legislation to provide for this facility in the building sector was now with the Legal Draftsman.

He said the new Secretariat being built at Hambantota has provision to meet this need.

Dr. Ajith C. S. Perera of the IDIRIYA organisation stressed what is needed is empathy and not sympathy for them. He also said the fellow community should have the ability to understand the other person's need.

"Architects and builders are the custodians of our living environment. It's their moral duty to take into account, at least now this inevitable drop in human ability, when planning constructions. It will then arrest 'social exclusion' created by man to its own kind, which has already caused a series of gravely rising social problems of National importance".

Quoting his own experiences, Dr. Perera said that Nature is no respector for positions and possessions. "Anyone of us at any moment, could be placed in this situation".

A documentary was shown to the participants which described the difficulties and frustration that a dis-abled person has to endure in his or her daily life when using steps to a public place.

Rapid ageing, the alarming rise of road accidents, man-made and natural diasters, debilitating medical conditions and often invisible ailments cause more and more people to use artificial limbs, callipers, frames, crutches, sticks and white canes to walk and wheel chairs to move.

Dr. Neil Fernando said limitations or dis-ability are not always visible like diabetes, heart conditions, arthritis. Citing his own limitations he said even though his sight was affected from birth was able to make the necessary adjustments in order to lead a comfortable and stress free life.

He said the community has a role to play in the welfare of its fellow citizens with limitations.

"First of all, it is important to understand their needs and their feelings and aspirations. It is important to help disabled people to be less dependant."

He said in order to make them feel normal we need to make certain adjustments ourselves.That is the man made barriers.

Every person can be greatly helped to restore normality by the enforcement of good building design practices.

"A construction becomes successful or not to the extent that the built environment accommodates all people equally, for the purpose which the building and its facilities were designed and meant to be used."

We also have more pregnant mothers, elders with small children and even young parents who are visually or physically impaired. It's a wide and diverse range of people - all with lowered ability to move freely! Chances are very high that each and everyone of us, for different reasons, is certain to spend some of our time living with a reduced ability to move or to maintain a proper balance to walk.

It could be, often or suddenly for a short time or a long time or even for a lifetime. The quality of living you then enjoy will greatly depend upon how accessible, accommodating and user friendly the living environment around you happens to be.

"It was disclosed that an estimated 25 per cent of Sri Lanka's population, is silently fighting an uphill battle for access and accommodation", Dr. Fernando said.

Thanks to the dedicated efforts of the Ministry of Social Welfare, the National Secretariat for the 'Disabled People' and some Voluntary Disability Advocates, 'Regulations for access to public buildings and public places' have now become law. (Gazette reference: 1419/7 of November 14, 2005).

The most encouraging news is, these regulations give guidelines and provide tools that help to implement in our living environment good building design practices, resulting in Enabling Environments, which in turn provide an effective solution to extenuate a series of grievous social problems.

Text by Anjalie Garnier

A major threat to children's health

Chrissy Aloysius, President Doctors wives' Association writes:

I recently had this book on 'Hints on child safety' published by the Swedish Child Environment Council, where they describe how a child's health can be seriously affected in accidents and giving some very useful hints and advice to mothers and the precautions to be taken to save their children from this threat.

Since the publishers say the book could be freely quoted I am referring to some of those useful hints for the benefit of the mothers.

Accidents: A major threat to children's health

As the parent of an infant child, you naturally worry, about your child's health. When he fails to put on weight properly, when he catches cold or goes down with some other illness.

Modern child health care has eliminated many such problems, but have you stopped to think that accidents are one of the biggest threats to children's life and health?

It is the risk of serious injury that has to be avoided. We refer, not to bruises and minor abrasions but to serious, unnecessary accidents. The big danger is the risk of head injuries being caused by falling from a height. The risk of poisoning increases when your child become more mobile.

You are in for surprises!

You and your baby have now been living together for a few months. Your baby has developed a great deal. He smiles at you, flails with his arms when your approach and is almost able to turn himself over.

Before long you will notice that he understands some of the things you say, but do not overestimate him. Children at this early age cannot be taught to avoid danger. We adults have to make the child's environment safer, so instead of restricting your child's movements remove things which may be dangerous.

The nursery

Your baby now moves about more when you are tending him. He turns over and tries to sit up. If you have a nursery table or do the changing on a bed, you must never leave the baby unattended there. Put him down on the floor or carry him with you if you have to go elsewhere. The nursery table must be big enough for the baby to turn over without falling off.

The cot

Make sure that the mountings on the bottom and sides of the cot are intact. Take extra care if you buy a second-hand cot. The bars must not be more than 8.5 cm apart. The sides of the cot must be at least 60 cm high. A solid bottom is better than a slatted one.

Take care to position the bed so that power sockets, venetian blinds and extension leads will be out of the baby's reach.

Mattress and bedding

The cot mattress should not be too soft. If you use a plastic-coated terry towelling underlay to keep the mattress clean, always put a sheet over it an tuck the sheet in properly. This way, the baby will not be able to put the underlay in its mouth.

There is no need for a pillow in a cot. A soft pillow against your baby's mouth and nose is a potential asphyxiation risk. Do not use thick covers in a cot, because they are another asphyxiation risk.

Plastic and plastic nappy holders

Never use thin, smooth plastic in or near a cot! Your baby must always wear trousers on top of its nappy holder, otherwise it can easily reach the knot with one hand, and equally easily, untie the knot. If the nappy holder gets into your baby smooth asphyxiation could result.

The playpen

If you have a playpen, the distance between the bars is just as critical as with the cot. In other words, the bars must not be more than 8.6 cm apart. If the playpen is fitted with an abacus, the balls must be fixed to an iron rod which passes through one of the bars.

Round playpens with floors must not be capable of overturning and they must not have widemesh netting. Any plastic underlay in the playpen must be carefully secured.

The bath

Bathing is great fun. Most children love water and bathing, but make sure the water is not too hot. The best way of checking is with your elbow, because the adult hand is too thick-skinned.

Never leave your child along in the bath! An infant can drown in 10 cm of water. If older children bath together with the baby, an adult must always be present in the bathroom.

The push-chair or sulky

Before long, perhaps you will be replacing the pram with a push-chair or sulky. Makes sure that the collapsing device has an extra safety catch.

During a certain period, all children are extra lively. During this period, walking reins may feel safer. But keep an eye not to get entangled in the straps.

Growing children are more sensitive than adults to toxic exhaust fumes. Take care to keep the push-chair away from these fumes, because your child will be sitting on a level with the tail-pipes. Keep away from busy streets and roads whenever possible.

The dummy and the bottle

When dummies get old and worn, throw them away. A damaged dummy is an asphyxiation risk. If your baby is being bottle fed, hold him in your lap at meal times so that he will not be left on his own with the bottle. Never leave your baby alone in the cot with a bottle! This is a major as phyxiation risk.

Solid food

If you give your child solid food, such as a piece of bread, cucumber or carrot, make sure that he is not left alone with it, because it could get struck in his throat.

Your child will soon be able to move about on the floor, and eventually he will be able to sit up; slide, crawl and stand. Before long he will also be able to pick small things up deliberately and put them in his mouth. He will get more and more curious, and as time goes on his movements will get faster.

Some children are already able to grasp things between thumb and index finger when they are only nine or ten months old. In this way they rapidly get hold of small things which they can put straight into their mouths.

Electric leads and power sockets

The floor is the natural place to play, so remember to check things on the floor and at crawling height above it.

Make sure that there are no electric leads lying around and no extension leads lying around and no extension lead either. Children put everything in their mouths and electric leads are just the thing for biting on.

Don't let this happen! Be extra careful about lead which are used occasionally and then removed afterwards. And be very careful indeed with the electric iron. Put the lead away immediately after use because if your child pulls on a lead which is left dangling, the hot iron may come down on top of him.

Tape recorder leads are a risk if they are plugged in but not connected to the tape recorder. A child sucking on one of these leads can sustain serious internal burns.

It is time now to make sure that the power sockets in your home are tamper-proof.

Make sure that the tamper-proof covers actually work. But don't count on them! Some children can price them away, even if it takes time. Tamper-proof sockets are obtainable in department stores and from electrical dealers, and if you really know what your are doing you can fit them yourselves.

Put away any needles and other narrow metal objects which your child can poke things with. The electricity accidents which do occur are usually very serious.

Tea and coffee

Before your child can sit independently, he will often sit on your knee. Children frequently wave their arms about at the same time as they move the rest of their body. So never drink anything hot, like tea or coffee, with small child in your lap.

Otherwise the child may get scalded, and the resultant burns are painful and slow-healing. Remember that the support you give a child sitting on your knee gives him an unexpectedly long reach. Remind the rest of the family and your friends about this as well.

Front-line drugs becoming ineffective - WHO

Drug resistance is a natural biological occurrence, but one that can kill. Today we live in a world where drug resistance is spreading fast and growing number of front-line drugs are becoming ineffective.

There is indisputable evidence of resistance to medicines used to treat meningitis, sexually transmitted infections such as gonorrhoea, infections acquired in hospital and even to the new classes of antiretroviral (ARV) drugs used to treat HIV.

For example, in several countries tuberculosis strains have become resistant to at least two of the most effective drugs used against the disease.

Elsewhere, commonly used antimalarial drugs have become virtually useless because the malaria parasite has acquired resistance to them.

"This is a problem faced in both rich and poor communities, in industrialized as well as developing countries," said Dr. Heymann. "It has different roots in different societies - overuse of drugs in many developed countries, underuse in poorer nations - but the net result and the imminent danger are the same."

It is a global problem. No country can afford to ignore it, no country can afford not to respond. At the same time, action taken in any one country will have clear and positive results around the world.

Healthier lifestyles may reduce women's stroke risk

NEW YORK (Reuters Health) - Women who abstain from smoking, drink alcohol moderately, exercise regularly, maintain a healthy weight for their height and eat a healthy diet are less likely to experience a particular type of stroke than those with less healthy lifestyles, new study findings indicate.

"Our findings underscore the importance of healthy behaviours in the prevention of stroke," Dr. Tobias Kurth, of Brigham and Woman's Hospital in Boston, Massachusetts, and colleagues write in the Archives of Internal Medicine.

"The benefit depends on the stroke subtype," Kurth told Reuters Health. "We observed a beneficial effect on ischemic stroke, the most common form of stroke, but not on hemorrhagic stroke."

Ischemic stroke results from a blockage of an artery supplying blood to the brain, whereas a hemorrhagic stroke occurs when a blood vessel breaks and causes bleeding into the brain.

Almost a quarter of the approximately 700,000 strokes that occur each year end in death and a similar proportion result in permanent disability. Kurth and colleagues looked at lifestyle factors that may play a role in the prevention of stroke.

Several factors such as smoking, exercise and body weight have been studied individually, but not in combination.