EcoHealth

, Volume 1, Supplement 2, pp SU120–SU130 | Cite as

Building Capacity in Central Havana to Sustainably Manage Environmental Health Risk in an Urban Ecosystem

  • Jerry Spiegel
  • Mariano Bonet
  • Maricel Garcia
  • Ana Maria Ibarra
  • Robert B. Tate
  • Annalee Yassi
Original Contribution

Abstract

In the late 1990s, community officials in the inner city neighborhood of Central Havana consulted researchers at INHEM (National Institute of Hygiene, Epidemiology, and Microbiology) for assistance in evaluating the effectiveness of interventions that were being undertaken to improve the quality of life and human health amid the severe economic crisis that Cuba was experiencing. The ecosystem approach to human health framework was applied through a Cuban–Canadian collaboration to assess whether the measures taken to improve housing, municipal infrastructure, and social and cultural life were effective, and to strengthen local capacity to manage environmental health risks. Household surveys, interviews, and a series of workshops and meetings conducted between 1999 and 2001 indicated that the intervention had been effective and pointed to further needs. The greater capacity to understand and manage determinants of health led to the use of the Ecohealth framework being adopted to help respond to a serious outbreak of dengue fever in Havana in 2001–2002, as well as a follow-up project in 2003 to apply an integrated surveillance approach to more sustainably prevent and control future recurrences of dengue by extending established monitoring of clinical-epidemiological and entomological factors, linking this to more systematic monitoring and control of environmental conditions, and strengthening community participation. The experience in central Havana indicates that application of the Ecohealth framework can play a useful role in strengthening capacities for managing further challenges to a community.

Keywords

urban ecosystem indicators surveillance Cuba 

Notes

Acknowledgments

We are grateful to the International Development Research Centre (IDRC) of Canada for funding this study. We also recognize with appreciation the active involvement of representatives of the Taller Integral de Cayo Hueso, the Consejo Popular of Cayo Hueso, the Consejo Popular of Colón, the Centre Habana Municipality, the Oficina de Rehabilitation y Desarollo of Centro Habana, and members of the Cayo Hueso community who have participated in the project.

References

  1. Bonet M, Yassi A, Mas P, Fernandez N, Spiegel J, Concepción M (2001) Action research in central Havana: the Cayo Hueso project. In: 129th American Public Health Association Annual Meeting, October 21–25, 2001, Atlanta, GAGoogle Scholar
  2. Briggs D (1999) Environmental Health Indicators: Frameworks and Methodologies, Geneva: World Health Organisation, document WHO/SDE/OEH/199.10Google Scholar
  3. Chappotin Aranguren, S (1998) “El taller de transformación integral. Una alternativa más de desarrollo comunitario en Cuba” In: Domíngue, RD (editor), Desarrollo Local y Descentralización en el Contexto Urbano, Universidad de La Habana, Habana, Cuba, pp 105–109Google Scholar
  4. Corvalan, C, Briggs, D, Kjellstrom, T 1996Development of Environmental Health IndicatorsWorld Health OrganisationGenevaGoogle Scholar
  5. Coyula M, Hamberg J (2003) The case of Havana, Cuba. Understanding Slums: Case Studies for the Global Report 2003, UN HABITAT. Available: http://www.ucl.ac.uk/dpu-projects/Global_Report/pdfs/Havana.pdfGoogle Scholar
  6. Fernández, N, Tate, R, Bonet, M, Cañizares, M, Mas, P, Yassi, A 2000Health risk perception in the inner city community of Centro Habana, CubaInternational Journal of Occupational and Environmental Health63443Google Scholar
  7. Forget, G, Lebel, J 2001An ecosystem approach to human healthInternational Journal of Occupational and Environmental Health7S33S38Google Scholar
  8. Garfield, R, Santana, S 1992The impact of the economic crisis and the US embargo on health in CubaAmerican Journal of Public Health871520CrossRefGoogle Scholar
  9. Gubler, D 1997Dengue and Dengue Hemorrhagic Fever: Its History and Resurgence as a Global Public Health ProblemCAB InternationalLondonGoogle Scholar
  10. INHEM (1999) Instituto Nacional De Higiene, Epidemiología y Microbiología, Centro Colaborador de la OMS en el Área de Salud de la Vivienda. Plan de Medidas Ejecutadas por el Gobierno y la Comunidad (PMGC) en Cayo Hueso, 1996–1999, Havana, CubaGoogle Scholar
  11. Kirkpatrick, AF 1997The US attack on Cuba’s healthCanadian Medical Association Journal157281284PubMedGoogle Scholar
  12. Lebel, J 2003Health: An Ecosystem ApproachInternational Development Research CentreOttawaGoogle Scholar
  13. Lloyd L (2003) Best Practices for Dengue Prevention and Control in the Americas, Environmental Health Project strategic report no. 7, prepared for the USAID Bureau for Latin America and Caribbean and Pan American Health Organization, February 2003. Available: http://www.ehproiect.org/PDF/Strategic_papers/SR7-BestPractice.pdf [accessed May 8, 2004]Google Scholar
  14. PAHO (2003) Framework: New Generation of Dengue Prevention and Control Programs in the Americas, Pan American Health Organization. Available: http://www.paho.org/English/HCP/HCT/VBD/dengue-nueva-generacion.htm [accessed May 8, 2004]Google Scholar
  15. Schulz, AJ, Krieger, J, Galea, S 2002Addressing social determinants of health: community-based participatory approaches to research and practiceHealth Education and Behavior29287295CrossRefPubMedGoogle Scholar
  16. Schwab, P 1999Cuba: Confronting the U.S. EmbargoSt. Martin’s PressNew YorkGoogle Scholar
  17. Spiegel J (2002) Applying the ecosystem approach to human health. In: Special Cuba-Canada-U.S. Meeting on Epidemiology, International Population Health Conference; May 2002, Havana, CubaGoogle Scholar
  18. Spiegel, J, Bonet, M, Yassi, A, Molina, E, Concepcion, M, Mas, P 2001aDeveloping ecosystem health indicators in Centro Habana: a community-based approachEcosystem Health71526CrossRefGoogle Scholar
  19. Spiegel J, Pla E, Chang M, Bonet M, Tate R, Yassi A (2001b) Evaluating the effectiveness of interventions to improve health in the inner city community of Cayo Hueso. In: 129th American Public Health Association Annual Meeting, October 21–25, 2001, Atlanta, GAGoogle Scholar
  20. Spiegel J, Bonet M, Yassi A, Mas P, Tate R, Fernandez N (2002a) Action research to evaluate interventions in Central Havana. In: 9th Canadian Conference on International Health (CCIH), October 27–30, 2002, Ottawa, CanadaGoogle Scholar
  21. Spiegel, J, Yassi, A, Tate, R 2002bDengue in Cuba: mobilisation against Aedes aegyptiLancet Infectious Diseases2207208CrossRefGoogle Scholar
  22. Spiegel, J, Bonet, M, Yassi, A, Tate, B, Concepción, M, Cañizares, M 2003Evaluating the effectiveness of a multi-component Intervention to improve health in an inner-city Havana communityInternational Journal of Occupational and Environmental Health9118127Google Scholar
  23. Tate R, Fernandez N, Canizares M, Bonet M, Yassi A, Mas P (2001) Relationship between perception of community change and changes in health risk perception following community interventions in Central Havana. In: 129th American Public Health Association Annual Meeting, October 21–25, 2001, Atlanta, GAGoogle Scholar
  24. Tate, RB, Fernandez, N, Yassi, A, Canizares, M, Spiegel, J, Bonet, M 2003Change in health risk perception following community intervention in Central Havana, CubaHealth Promotion International18279286CrossRefPubMedGoogle Scholar
  25. Waltner-Toews, D 2001An Ecosystem Approach to health and its implications to tropical and emerging diseasesCadernos de Saúde Publica. Reports in Public Health17736Google Scholar
  26. Yassi, A, Mas, P, Bonet, M, Tate, R, Fernandez, N, Spiegel, J 1999Applying an ecosystem approach to the determinants of health in Centro HabanaEcosystem Health5319CrossRefGoogle Scholar
  27. Yassi A, Bonet M, Spiegel J, Tate R (2002) Urban Ecosystem Health Indicators (Cuba) Project: Applying an Ecosystem Health Approach to Evaluating Health Interventions in Centro Havana, International Development Research Centre, Ottawa, CanadaGoogle Scholar
  28. Yassi, A, Fernandez, N, Fernandez, A, Bonet, M, Tate, RB, Spiegel, JM 2003Evaluation of community participation in a multi-sectoral intervention to address health determinants in an inner-city community in Central HavanaJournal of Urban Health806180PubMedGoogle Scholar
  29. Young, AH 1985Comparative UrbanizationUniversity of New OrleansNew Orleans, LAGoogle Scholar

Copyright information

© EcoHealth Journal Consortium 2004

Authors and Affiliations

  • Jerry Spiegel
    • 1
    • 2
    • 3
    • 5
  • Mariano Bonet
    • 4
  • Maricel Garcia
    • 4
  • Ana Maria Ibarra
    • 4
  • Robert B. Tate
    • 5
  • Annalee Yassi
    • 2
    • 3
    • 5
  1. 1.Liu Institute for Global IssuesUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Health Care and Epidemiology, Faculty of MedicineUniversity of British ColumbiaVancouverCanada
  3. 3.Institute of Health Promotion ResearchUniversity of British ColumbiaVancouverCanada
  4. 4.Instituto Nacional de Higiene, Epidemiología y Microbiología (INHEM), National Institute of Hygiene, Epidemiology and MicrobiologyHavanaCuba
  5. 5.Department of Community Health SciencesUniversity of ManitobaWinnipegCanada

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