February 2000 at EHP

Learn about the Emergency Rural Water and Sanitation Program in Nicaragua on the Web. EHP/Nicaragua will use an internal and external web site to manage and disseminate information about project activities. The public site, due to be ready to log on to this spring, will feature mini-case studies of project activities through photos or videos accompanied by brief text. These "visual" narratives will be part of the monitoring and evaluation process of this project, which is designed to award grants to local NGOs/PVOs to reconstruct rural water and sanitation systems destroyed by Hurricane Mitch. (See January 2000 at EHP.) Quarterly updates on the project will also be available on the web in both English and Spanish. Watch this space for the web address.  EHP is providing technical assistance to the Nicaragua project.

As of February 1, grant applications had been received from 15 PVOs; selection of recipients will be made in February.  In March, EHP will hold a workshop for PVOs/NGOs on how to integrate behavior change in their water and sanitation projects. New water and sanitation systems don’t necessarily lead to health results unless people also have good hygiene behaviors -- handwashing at key times, safe water storage, consistent latrine use for the whole family, etc.  

Paraguay Assessment Looks at All-Important Decentralization Issue. Paraguay Assessment Looks at All-Important Decentralization Issue. Decentralization is a hot topic in the water and sanitation sector, and EHP is working in a number of Latin American countries to guide and speed the decentralization process, including in El Salvador and the Dominican Republic. Recently, EHP completed an assessment of potential USAID involvement in the decentralization of the water and sanitation sector in Paraguay. The assessment concluded that USAID could play a valuable role in creating pilot projects in small municipalities and in addressing key policy issues. The USAID mission in Paraguay is considering potential next steps.

In connection with its work on decentralization of the water and sanitation sector, EHP has established an information-sharing network (e-mail [email protected] if you are interested in this network). EHP Activity Reports 65 and 76 discuss EHP decentralization activities.  Activity Report 65 is also available in Spanish.

Environmental and Occupational Health Related to Economic Growth in Ukraine. USAID’s priority goals in Ukraine for the 1999-2002 period are to promote economic growth, consolidate the institutions of a functional democracy, and improve the quality of life. Recently EHP was asked by USAID to examine the links between environmental health (EH) and occupational health and safety (OHS) and these goals.

The assessment concluded that the majority of health problems Ukrainians experience are related to EH and OHS risks. Antiquated industries and inadequate enforcement of regulations contribute to toxic discharges to surface water or soil, and the water and sanitation infrastructure is deteriorating. Protective equipment and procedures for workers are outdated and ineffective. In addition, EH and OHS problems must be addressed in the long-term to attract private investment and donor contributions to Ukraine’s economic development.

What next? USAID’s mission in Ukraine will review EHP’s recommendations for specific ways that USAID could contribute to improved EH and OHS in Ukraine.

Surveillance Activities Beginning to Bear Fruit. Surveillance Activities Beginning to Bear Fruit. EHP has been working with the Ministries of Health of Mozambique and Eritrea to improve malaria surveillance, including mapping through geographic information systems. In both countries the overall objective is to develop data management, analysis, and mapping capabilities within the Ministries of Health. Maps bring together demographic, topographic, epidemiologic, and other data to enable analysis of risk factors. With adequate surveillance, countries can make better decisions about where to place their resources for maximum results.

In Mozambique, malaria cases in Maputo have been mapped. The maps show that a large proportion of the cases are among residents of a relatively small area bordered by wet lowlands. This finding suggests that it might be feasible to reduce vector populations through environmental management.

In Eritrea, the Ministry of Health's malaria control interventions consist of case management, bednets, and residual spraying.   Since September 1999, EHP has provided asssistance to the Ministry for conducting entomological studies at 180 sites across the country's six geographic zones.  EHP is also working with the Ministry to review its vector-control operations, improve its epidemiologic data for malaria, and develop capacity for using geographic information systems and other analytical tools to improve data analysis.  The Ministry will use its enhanced data bases and analytical skills to develop malaria risk stratification maps and to fine-tune its malaria control operations to local conditions, including the trial and use of environmental management interventions for vector control.

USAID missions in Mozambique and Eritrea are interested in developing surveillance capacity to support projects to control malaria and other infectious diseases. In 1998 the U.S. Congress appropriated $50 million per year for a USAID Infectious Diseases Initiative.

Watch this space for information about an EHP malaria surveillance network: still on the drawing boards but coming soon.

The Vector-Borne Disease Training and Research Center in Nepal Passes Important Milestones. EHP is in year two of activities to support the newly-expanded Vector-Borne Disease Training and Research Center in Hetauda, Nepal. The center was originally established in 1979 as a malaria research center. In 1995 USAID support enabled it to expand and modernize, upgrade the skills of personnel, and widen its scope. EHP, in collaboration with several other organizations, is supporting the revived VBDTRC through a program of capacity building . The goal is to create a center that can serve as a national and regional focal point for surveillance, prevention, and control of vector-borne diseases – principally malaria, Japanese encephalitis, and kala-azar. EHP is in year two of activities to support the newly-expanded Vector-Borne Disease Training and Research Center in Hetauda, Nepal. The center was originally established in 1979 as a malaria research center. In 1995 USAID support enabled it to expand and modernize, upgrade the skills of personnel, and widen its scope. EHP, in collaboration with several other organizations, is supporting the revived VBDTRC through a program of capacity building . The goal is to create a center that can serve as a national and regional focal point for surveillance, prevention, and control of vector-borne diseases – principally malaria, Japanese encephalitis, and kala-azar.

The VBDTRC staff has already accomplished a number of its goals. A baseline epidemiological assessment of four districts has been completed and the assessment instruments are being adjusted based on experience so far; the VBDTRC has been granted autonomous status by the government; and a cross-border conference with Indian counterparts is being planned. Such a conference is a logical outgrowth of center activities, since the target diseases do not recognize national borders.  Baseline assessments in six more districts are planned to start in the spring.