Can people remain healthy in a world that is sick? Attending the International EcoHealth Forum in Merida, Mexico, Nashwa Abdel-Tawab finds a creative way out of this terrible predicament What sort of environment are we going to leave behind for our children? How can we exploit non-renewable resources without harming our health? Can developing countries rise to an acceptable level of human development without overloading its environment? How can we live in overcrowded cities without poisoning each other? At first glance, the answers to these questions are a clear and simple no. Yet if we give it another thought, we may begin to see that we have no choice but to remain optimistic, despite the increasing availability of disturbing facts and statistics on the condition of our world today. With an integral effort worldwide, an EcoHealth approach may well be the answer to find stability and health for both people and their environments. Many ecological disasters can be directly traced to careless exploitation of the environment, with human beings first acting as perpetrators, and then suffering as victims. The health of humanity closely mirrors the health of our surroundings, and this is the basis of the EcoHealth approach. This approach recognises the inextricable links between humans and their biophysical, social, and economic environments, and that these links are reflected in a population's state of health. Health is not the absence of illness, according to Jean Lebel's text, Health, An Ecosystem Approach. It is better defined as a harmonious participation in the resources of the environment, which allows individuals the full range of their functions and aptitudes. It can hardly maintain itself if we do not assume full responsibility for a vigilant economy. Human health depends highly on the quality of the environment in which people live: for people to be healthy, they need healthy environments. At the beginning of December and for a week the International Ecohealth Forum 2008 (IEF 2008), around the theme EcoHealth: Healthy Environments, Healthy People, took place in Merida, Mexico. Over 550 EcoHealth researchers, community representatives, policy-makers, students and public health specialists from 82 countries from the four corners of the world attended the forum that was held in conjunction with the Second Biennial Conference of the International Association for Ecology and Health. Many of these participants, among them Egyptians and Arabs, presented for four days in the 100 parallel sessions, or shared their work as part of the forum poster display of nearly 300 posters. They tried to address relevant health and environmental problems and the links between them, a challenge that might be definitive for the future of the human race. The National Institute of Public Health (INSP) of Mexico hosted the IEF 2008, in collaboration with Canada's International Development Research Centre (IDRC), the International Association for Ecology and Health (IAEH), the Oswaldo Cruz Foundation, Brazil (FIOCRUZ), the Institute of Ecological Research, Brazil (IP�), the Faculty of Veterinary Medicine and Zootechny of the University of S�o Paulo, Brazil (USP), and the Pan American Health Organisation (PAHO). During the opening ceremony Ivonne Ortega Pacheco, governor of Yucatan, where the forum took place, spoke about how healthy and sturdy ecosystems are the basis of a society's strength since preventing environmental degradation also prevents physical and psychological health problems, highlighting that 40 per cent of the world's diseases can be prevented or buffered by better management of ecological surroundings. In fact Yucatan is the safest state in Mexico, with the prevalence of the Mayan civilisation where its cultural wonders werebuilt on rich natural foundations. The ancient Mayan architects also dealt with the challenge of reorganising society in the face of environmental demands. Vice-President of Corporate Strategy and Regional Management for IDRC Lachlan Munro said the challenge of climate change the world is facing today must be addressed with an interdisciplinary approach. Meanwhile, Vice-Minister of Health Prevention Promotion from Mexico's Ministry of Health Mauricio Hernandez Avila spoke about the urgency of using interdisciplinary measures to avoid further environmental degradation and to improve public health. Avila informed the audience that 1.5 per cent of hazardous gas emissions in the world is generated in Mexico, provoking serious public health problems. Resolving this issue is one of the central targets for stopping and preventing environmental damage and avoiding related health problems. In his keynote address, which opened the International Ecohealth Forum, Carlos Nobre, researcher for the National Institute of Space Research of Brazil, spoke on climate change: challenges and opportunities. He stated that we will most likely get to a point where our generation will need to beg forgiveness from our offspring for not achieving environmental sustainability. Nobre's message focussed on the challenges and opportunities that global climate change implies for our planet. The data presented by Nobre was appalling: every hour, human beings emit 4 million tons of carbon dioxide. Meanwhile, approximately 1,500 hectares of rainforest have disappeared every hour. It is also estimated that every hour three animals or plant species become extinct; this is 1,000 times faster than the natural rate. According to Nobre, critical global issues are the warming of the Arctic and Greenland, ocean acidification and coral reef bleaching. These phenomena will have huge impact on weather, economy and food safety. For example, the surface melt on Greenland is happening much faster than scientists expected: 70 metres thinning in five years. "We are mortgaging our planet at subprime rates," he said and explained that humanity is still trying to change its physical surroundings at a global level. In the long term this could create an environment which would be impossible to live in. For example, these changes are now evident in the Amazon region, where deforestation caused by logging or changes in ground usage is modifying the rainforest, causing its recession and leaving place for savannah grassland ecosystems. This change affects 10,000 to 30,000 hectares of rainforest every year. Nobre also pointed out that in order to stabilise greenhouse gas emissions and reduce the negative effects of climate change it will be of utmost importance for emerging countries to increase their human development levels without making a strong environmental impact through development itself. Of course this needs policies to guarantee its application. Industrialised Northern countries have achieved a high level of human development but at a very high environmental cost. Nobre cited Cuba as an example to follow since it has an acceptable level of human development and low emissions levels. The mood for the forum was set: it was both serious and informative. Leonora Rojas from the Ministry of Environment in Mexico City spoke about fuel efficiency and good practices to avoid hazardous gas emissions making reference to gas emissions studies carried out in Mexico City. "A feasible solution for the problem is the efficient use of high quality fuels and that was what the government was doing to reduce pollution in the most polluted city," Rojas said. Mercedes Pascual, from the Massachusetts Institute of Technology in the US, spoke about malaria in Africa and its relation to climate change and global warming. She informed the audience that there are 111,000 deaths due to malaria epidemics each year, and that 110 million Africans are at risk of contracting diseases such as malaria. "Drug resistance is almost as serious as the climate change itself and rising temperatures and high rainfall, caused by climate change, might double or triple the number of malaria cases in Africa," Pascual argued. She identified Kenya, Uganda, Rwanda and Burundi as malaria hot spots in a transmission model that begins with a loss of immunity, leads to infection, treatment and recovery, when its aftermath is not death. Marilyn Aparicio, from the National Climate Change Programme in Bolivia, said that glaciers are melting and shrinking due to higher temperatures, which are turning snow regions into dry lands. These changes are causing hailstorms and other meteorological phenomena such as ice blizzards and drought, which in turn damage agricultural production and compromise food safety. Aparicio also spoke about biodiversity loss and an increasing number of dry valleys which, along with meteorological phenomena, are causing extreme weather events in Bolivia (and all around the world). These events are leading to an alarming increase in disease rates and death tolls due to the destruction or damage to roads and human settlements. The forum showed some positive achievement for humans and their environment. Mexico abandoned the use of DDT to control the scourge of malaria in Oaxaca in just three years, while also sharply reducing infection rates by one-third. DDT spraying was replaced by mosquito breeding site management. enabling Mexico to meet its North American Free Trade Agreement obligations ahead of schedule. Researchers in Indonesia, Vietnam, Thailand and China are focusing on environmental and agricultural roots of avian flu, such as the role of migratory birds and backyard chicken flocks in its spread. They are also exploring different measures for disease control at the community level. The final plenary ended the forum with hopes and fears. Despite the efforts done, the world is still with limits. Since 1993, summer Arctic sea ice has lost the equivalent of Alaska, California and Texas, and global warming is accelerating. The amount of carbon dioxide in Earth's atmosphere has already pushed past the level some scientists say is safe. New diseases emerged. Wars is everywhere. Tension is unresolved. The Earth which was given to us is destroyed by us. Everyone, in turn, should change one's production and consumption habits and be a stakeholder to the ecosystem approach to preserve a planet. EcoHealth should turn into a movement. It will be always a matter of values as well as facts, a matter of policy as well as science to decide how safe is safe and right is right but it doesn't need policies to tell us to run for our lives. It's basic instinct.
