Ποιειν Και Πραττειν - create and do

9. Health and Sustainable Development

In Johannesburg it became evident that negative health factors were attributed in general to poverty and in particular to lack of sanitation measures when it comes to accessing water and treatment of all kinds of waste, sewage, pollution and contamination. Almost singularly the pledge has been put forth on almost all political agendas, namely to increase the proportion of the world population when it comes to accessing clean and therefore drinkable water.

Compared to recent  research, effective policy measures and changing public awareness for health issues, it is remarkable that such a single factor orientation prevailed at world level. This can be attributed to the need for some overall symbolic gesture that the policy makers would like to present through the media to the world. According to such a logic, nothing is effective unless it is carried by a consensus of all states of this world.

Definition of a healthy individual

Yet what has to be attributed to different health conditions in the world, that becomes only then evident if health of mankind and of the individual human being is given due consideration within an overall spectrum of factors. As Michel Foucault pointed out, categories of distinctions between the healthy and unhealthy ones is not merely to be reflected upon along the axiom of poverty, but what political notion of health becomes by definition also a need to have a certain type of individual when it comes to fighting in a war against terrorism. The good citizen is then replaced by the good counter terrorist agent – itself a product of a logic of what intelligence unites define as what it takes to face the unknown while capable of working in secrecy.

Reflections on urban conditions of life: an unhealthy life


A simple reflection on how people’s health is affected in such a modern system dominated by fear of the unknown, as reinforced by events since 11th of September, can point out already that many other factors than merely lack of good water are involved. The general state of fear underlines the new risks of survival. For the very poor that means not having any proper diet, improper sleep rhythms, all kinds of diseases, lack of care etc., while added to that are urban squalor conditions that leave a nature at best wounded if not entirely destroyed or at least no longer accessible. In such a world air and water become luxury goods, but even then, those who can afford such treatments and services will face an alienating system as it became evident in the description of Johannesburg as a city (see 2. Urban and Regional Planning). This means long hours spend traveling from home to work while facing modern working conditions that are not conducive to a healthy attitude, mentally speaking, leave people wondering what could off-set all these imbalances. Stress, noise and air pollution, overcrowded transport routes etc. tax both the environment and human relationships once the individual succumbs to these pressures and finds no answers but to flee in all forms of distraction, that turn out in the end to be mainly cheap form of entertainments. Here television figures above anything else as the form of distraction and out of which there develop all the bad habits from fast food to just watching and eating without discussion at the dinner table. In short, an unhealthy life begins were there is no dialogue, no chance to talk about the problems while listening to other opinions. The moment the basic structure at home is no longer strong enough to counter any destabilizing impact of the ‘other’ world – city, business, transport, education, information – then people will suffer in silence until they break down.

Healthy life:  pursuit of happiness and of human values

To be healthy is never self understood while being integrated or not in a healthy society does make a difference to what constitutes health in the first place: happiness. This is not to be attained in pursuit of some pseudo-pleasure, but as Descartes and other philosophers would say, that personal and social needs are satisfied in a way that does not damage the other(s). Hence the famous saying by Adorno, “there cannot be any true in an untrue life.” Briefly said, a healthy life is also the outcome of what human and ethical values people can uphold over time. To understand, therefore, life as pursuit of human values means to re-orientate the system away from its business and profit orientation and to align things with what civic society can uphold free of any violence.

Health systems

At another level, Johannesburg did not even include the need to reform, improve, alter and build up health systems. All analysis thereof was left aside even though, for example, a country like the UK experiences just as much as Third World Countries difficulties in handling rising expenses and, therefore, in having to face new types of constraints when it comes to developing health care systems.

There are no longer suitable guidelines for a workable health care system in place. Privatization but also the problems of maintaining high standards of health care have beset the different approaches taken in both developed and developing countries. It has become difficult to sustain any type of system since there are no conclusive answers to the needs being articulated and even more so left unarticulated by many people left perplexed as the entire system proves to be unsustainable.

AIDS, pharmacy industry and unjust health care systems

Medicine and various systems of health care have seen tremendous changes. Alone the AIDS issue was illustrated when South Africa had to take the pharmacy industry to court in order to obtain such medicine that people affected could afford. The absurdity of any system made available only to those who can afford it, raises the question about health care for those who need it the most and who are by their very condition unable to raise any money to obtain proper treatment. Here it is worthwhile to ponder about how financing a system can sustain also the public character. In Great Britain, until now exceptional in its general approach, has come in recent years more and more under criticism.

Unsatisfactory solutions reinforce the class character of such a system while the loss of standards means health is no longer safeguarded as it used to be.

People without any health care


It is even worse in Third World Situations were in many poverty stricken areas governmental structures do not exist, people there deprived of any kind of medical services. Often only engaged doctors and nurses enter these stricken areas and try their best to monitor the situation as part of a preventive practice while taking on their own shoulders the most severe cases. Sometimes this means taking fully the initiative into one's own hand as often demonstrated by 'doctors without frontiers' when they take a Palestinian back in their own car and pass through all checkpoints in order to get the person to a proper hospital where professional treatment is possible.

The world health agenda


Without knowing yet fully how others review the outcome of Johannesburg with regards to establishing future guidelines for health care in the world, it appears that the political and the cultural consensus do not converge, but that the political agenda seizes as always upon one prestige laden object and by singling it out makes the rest of the world belief if that is taken care, then the deteriorating health situation at global scale will be reversed. In Johannesburg that was clearly the issue with the water as part of that presumed causality between health and the environment.

Identification of Health issues: malnutrition, safe food given agricultural developments, but also AIDS, Mal-nutrition, Pollution, Cancer, Heart Diseases


Information received before and during the World Summit in Johannesburg

1. Letter received via WSSD world network:

Johannesburg, 24-26 August 2002

Co-ordinators for each of the issue areas:
Freshwater: Jasmin Enayati - jenayati@earthsummit2002.org
Energy: Irene Gerlach - igerlach@earthsummit2002.org
Food Security: Claire Rhodes - crhodes@earthsummit2002.org
Health: Gordon Baker - gbaker@earthsummit2002.org
- or contact the Implementation Conference coordinators:
Minu Hemmati - minush@aol.com
Robert Whitfield - rwhitfield@earthsumit2002.org

Action Plans (partnership initiatives) within the areas of freshwater, energy, food security, and health as based on consultation of a wide range of stakeholders, agencies, and governments,  since autumn 2001, in order to identify opportunities for collaboration that contribute to the implementation of sustainable development agreements.


Action Plan

Capacity Building

Operational / development projects

Networking and knowledge building

Research and Policy

Public Awareness Cam-paigns

Type of Sustainable Develop-ment Agreement


‘water wise’ campaigns

Local government capacity building in the Asia Pacific





Good governance for natural resources

Food Security



































We are seeking further engagement from stakeholders, agencies and governments in the partnership initiatives and are open to additional suggestions.

Issue Coordinator: Jasmin Enayati, jenayati@earthsummit2002.org
Action Plans:
1.  Good governance / multi-stakeholder review of water supply strategies
2.  Capacity-building / "Water Wise" campaigns
3.  Local Government freshwater capacity building in the Asia Pacific
4.  Water and Health / Water borne disease eradication in the Limpopo basin
5.  Gender Mainstreaming
6.  Participatory Watershed Management - Create a Global Rainwater Harvesting
7.  Public-Public Partnerships / Strengthen Public Water Systems
8.  Safe Water for All Public Water System (SWaFAS)

Issue Coordinator: Claire Rhodes, crhodes@earthsummit2002.org
Action Plans:
1.  Expansion of the AgLe@rn Initiative, a web-based educational tool; and
developing impact monitoring and evaluation research
2.  Strengthening farmers organisations
3.  Distortive Agricultural Subsidies
4.  Secure access to land
5.  Ecoagriculture / Raising the profile / awareness of the need for
sustainable ecosystem man-agement
6.  Strengthening partnerships between agricultural community and other
7.  Fair and Ethical Trade / SME Development

Issue Coordinator: Gordon Baker, gbaker@earthsummit2002.org
Action Plans:
1.  AIDS in the Workplace
2.  Novartis Institute for Tropical Diseases (Novartis International &
Singapore Economic Development Board)
3.  Malaria prevention
4. Migration of Health Professionals
5.  Nutrition
6.  Media and Development
and Health for Children
Dr Minu Hemmati
Stakeholder Forum for Our Common Future
7 Holyrood Street
London SE1 2EL
Tel + 44 20 7089 4300
Fax +44 20 7089 4310
Mobile +44 7949 777 453
Email: minush@aol.com
Websites: www.stakeholderforum.org and www.earthsummit2002.org


Understanding How Environmental Risks Affect Your Community
DATE: 1 September, 10:00 - 12:00
LOCATION: Global Civil Society Forum (Expo Centre/NASREC), WSSD

Speakers include:
Vanessa Tobin, Chief, Water, Environment and Sanitation Section, Programme Division, UNICEF
Gaudenz Silbershmidt, Executive Director, International Society of Doctors for the Environment, Swiss Office, and Chair, European Health and Environment Network
Susan West Marmagas, MPH, Director, Environment & Health Programs, Physicians for Social Responsibility

Addressing the detrimental effects of environmental degradation on human health is a key part of sustainable development.  Environmental degradation is causing child developmental disabilities, immune disorders, reproductive health problems, and increasing cancer rates worldwide. Research has linked air pollutants to cardiovascular disease, asthma hospitalizations, reduced lung function, and premature deaths. Join experts to learn more about this critical issue, and discuss strategies to address it in the sustainable development context.

For more information on these and other Earth Day Network events at WSSD,
please visit http://www.earthday.net/goals/worldsummitevents.stm or contact
our representatives in South Africa: Leigh-Anne Havemann, Coordinator, WSSD
Activities: 083 528 8992 (local South Africa cell phone) or Kelley Sayre:

Earth Day Network (EDN) is an international environmental not-for-profit organization that works for social change.  Our network consists of 5,000 organizational members in 184 countries.  Network members range from small, grassroots organizations to international networks and from community leaders to government agencies.  Our efforts include ongoing global programs
and campaigns, facilitation of national and regional coalitions, and worldwide capacity building programs.
For more information, please visit: http://www.earthday.net

Serryn Janson | Director, Worldwide Program
Earth Day Network
127 Mast Gully Road | Upwey | Victoria, 3158 Australia
T +61 3 9754 5210 | F +61 3 9754 7981
w w w . e a r t h d a y . n e t

I am pleased to announce the following panel which is organized by the Earth Day Network:

Environmental Health:                  A Community Asset
Date: Sunday, 1 September
Time: 10:00AM-12:00PM
Place: Hall 5, Breakaway Room 2, Nasrec Center

Michael Green, Executive Director, Center for Environmental Health, USA (Moderator)

Vanessa Tobin, Chief, Water, Environment and Sanitation Section, Programme Division, UNICEF

Yasmin von Schirnding, World Health Organisation

Gaudenz Silbershmidt, Executive Director, International Society of Doctors for the Environment, Swiss Office, and Chair, European Health and Environment Network

Susan West Marmagas, Director, Environment & Health Programs, Physicians for Social Responsibility

Adriel Spoeker, Coordinator for Air Quality Project, groundWork, South Africa

John Borrazzo, Team Leader on Health and Environment, USAID

Charlotte Youngblood, Earth Day Network, Australia will give the introduction.

This panel will explore community justice issues looking particularly at South Africa.  Topics:   How do environmental risks affect your health?  Health and the environment: a worldwide problem.  Children’s Health and the Environment.  UNICEF's Programs on Children's Health and Environment.  International Cooperation for Environmental Health.  Environmental Justice in South Africa

The aim of this panel is to:

  1. raise awareness of the critical link between health and the environment;
  2. address the importance of community environmental health in the global sustainable development context; and
  3. introduce participants to local and global efforts to address issues of environmental health and justice.


The goal of the workshop is to build a stronger understanding about the consequences of environmental degradation on public health, providing a rare opportunity for discussion and collaboration. This program is part of Earth Day Network’s Community Environmental Health Initiative – a worldwide effort to educate and build the capacity of groups to forge solutions to complex but often deadly and debilitating environmental problems.
Michael Green

I am sending this to you while I am in Johannesburg at the World Summit on Sustainable Development. After October 5, my best email address will be mgreen@cehca.org.


31 August 2002, 9:00 – 19:00

Room G, Gous Blom, Ubuntu Village CC

Organized by the

World Health Organization and the Department of Health, South Africa

In association with:

United States Agency for International Development

National Institutes of Health of the Department of Health and Human Services (USA)

International Development Research Centre (Canada)

International Society of Doctors for the Environment

Physicians for Social Responsibility

There will be five plenary sessions, commencing with a ministerial roundtable on the theme “Pushing back the frontiers of poverty,” followed by four panel discussions. Keynote addresses will be given


Dr Gro Harlem Brundtland, Director-General, World Health Organization

Mrs Carol Bellamy, Executive Director, UNICEF

Dr Manto Tshabalala-Msimang, Minister of Health, Republic of South Africa

Distinguished panelists will explore key policies and action strategies to address health and sustainable development issues in the following areas: investing in health; children’s health and the environment; research partnerships; and intersectoral action in practice.

Further information: Dr Yasmin von Schirnding, Focal Point: Agenda 21

E-mail: vonschirndingy@who.int

RSVP: Nadia Hilal

+27 11 3019571/72

E-mail: hilaln@who.int

View WHO-WSSD web site for programme and further details:


WHO documents on Health and Sustainable Development are available at Ubuntu Village

Exhibit (Stand: 561-562) and the WHO office in the Sandton Convention Centre.

World Health Organization


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