Healthy Parks, Healthy People

Following the successful inaugural Healthy Parks Healthy People (HPHP) congress in April hosted by Parks Victoria in Melbourne, Australia this initiative, focussed on the health benefits of contact with nature is continuing to expand. A new website, HPHP central, is to be launched in September and the HPHP Global team welcomes your contributions such as articles, research papers, case studies or tips on how to adopt the Healthy Parks Healthy People philosophy into your organisation. Please send contributions to contribute@hphpcentral.com. The Proceedings from the HPHP congress are now available. More than 70 videos from the conference have been posted on YouTube.

Bringing agriculture and health back together

Here we go, the solution to our agriculture, health and nutrition problems. Bringing agriculture and health back together! When exactly were they together to begin with? But a solution is on hand and coming to a corner shop near you soon, courtesy of the LCIRAH and the CGIAR. Somehow I don't think so. The shortcomings of "fragmented development landscapes, language barriers and silos" have been with us so long now. Other sectors have tried to address the same issues without little success. These disconnects are really ingrained and systemic and I have no idea how we might extricate ourselves from such ways of thinking and working. That's not to say there are individuals and organisations working not working actively in these areas. There is much great work going on in terms of organisational learning but sadly much of it is marginalised and far from mainstream when considering these types of problems and issues. Maybe others know what the solution might be. If you have any ideas maybe you can visit the SciDev website and this article and make your views known. Others already have and hurray to Tom Hennessy for his plug on local and indigenous foods.

The burden of proof

Attended a seminar yesterday by Professor Tim Johns, Professor in Human Nutrition at McGill University and former Director of the Centre for Indigenous Peoples’ Nutrition and Environment at McGill. Tim is currently spending a sabbatical period at Bioversity to further develop the Biodiversity and Nutrition initiative and also represents Bioversity on the CGIAR’s Agriculture and Health Research Platform. Tim discussed the evolving Biodiversity and Nutrition strategy in light of work on neglected and underutilized species/leafy vegetables, dietary diversity, public health benefits, market chains, food systems and ecohealth and the unique space that agrobiodiversity occupies between agriculture, health and nutrition and environment. This clearly presents many opportunities which need to be actively pursued, such as the role of agrobiodiversity and HIV/Aids.

The main take home message was the lack of a solid evidence-base for the role of agrobiodiversity in health and nutrition. As Tim highlighted ‘ the case is just not there’ and it needs to be if those of us who work with agrobiodiversity are to change the attitudes of donors and relevant organisations. What is the role of agrobiodiversity in child malnutrition, diabetes, eye health? According to Tim we just don’t really know. There was much talk about building a solid and cohesive body of proof involving convincing cases for the role of agrobiodiversity in nutrition and health. Yes, certainly. But I couldn't help but think that the challenge is even greater than this and one could stress the need to argue the case, or construct a convincing body of proof, for the role of agrobiodiversity in sustainable livelihoods, ecosystem services, agricultural production and stability and resilience of agroecosystems. Data and information certainly exists but wouldn’t it be nice to have it packaged in one form or another that really makes a convincing case so the agrobiodiversity community can counteract the pessimists who argue that such links are tenuous.

By the way, I couldn't help but notice that COHAB was absent from the list of partners, current and potential, in the presentation. I am sure they are in there somewhere, given that Bioversity is a partner in that initiative. Interestingly COHAB currently have a 'request for information' to build a body of evidence for the relationship between biodiversty change and the incidence of certain non-communicable diseases (NCDs).

Healthy Food for All

The Healthy Food for All (HFfA) is an all Ireland, multiagency initiative which seeks to combat food poverty by promoting access, availability and affordability of healthy food for low-income groups on the island of Ireland. The Healthy Food for All Initiative was established in 2004, based on the findings of the research report Food Poverty and Policy, which was published by Combat Poverty, Crosscare and Society of St Vincent de Paul.

Co-operation on health and biodiversity

Here is a very interesting and worthwhile initiative and it is housed in our own backyard, Galway to be exact. The COHAB Initiative is an international programme established to respond to the gaps in awareness and existing policies on issues linking biodiversity with human health and well-being. The Initiative aims to establish an international, inter-disciplinary collaborative framework to support existing activities on international development, biodiversity conservation and population health, and to contribute to the attainment of the Millennium Development Goals.

The Second International COHAB Conference on Health & Biodiversity took place from Monday 25th to Thursday 28th February 2008 in Galway City, Ireland and brought 170 delegates from over 70 countries together, from all disciplines and backgrounds, to collaborate on new approaches for protecting human health and well-being through the conservation and sustainable use of the world's biological diversity.

Those of you with a particular interest in human health and how it depends on biodiversity might be interested in the new publication 'Sustaining Life'.

A working class vegetarian is something to be...

Had the radio (RTE 1) on in the background and my attention was drawn to a debate about vegetable consumption in Ireland. One person on a panel discussion felt that the consumption of vegetables was a class issue and I would certainly agree. Obviously costs and education are big factors. One of my favourite past times is taking the taking the escalator from the top floor of the Jervis centre in Dublin. This gives me a birds-eye view of the little cafe at the bottom of the stairs. You can be certain that about 90% of the finished plates will have the serving of side salad left untouched.

Care farms

The National Care Farm Initiative is a way of offering on-farm health, education and welfare services for people in need. Participants in care farm schemes have experienced improvements to their physical, mental and spiritual health and well-being. Participants connect with a healthy daily structure and meaningful work in a natural environment - gaining social, educational and training benefits. The farming environment can be used to provide significant benefits for a wide range of people including:
-those with learning difficulties
-people with a drug/alcohol history
-disaffected and excluded youth
-people with work-related stress
-those with mental health issues and depression
Care farming is good for rural communities and economies as it enhances the viability of farms, broadens farm business and increases the services derived from the countryside. Farmers receive a deep sense of satisfaction through helping people improve their lives through farming - and having guests of the farm also addresses issues of rural isolation. Care farming places a high value on the knowledge and skills of farmers and seeks to help rural communities become more socially , economically and environmentally sustainable.

Partnership! - huh - what is it good for?

Anyone who has been involved in planning for effective partnership will know what a difficult job it is. While there are many benefits, there are an equal number of challenges and pitfalls. And it is managing these challenges and pitfalls that ultimately contribute to a successful partnership, one that is built on trust, honesty and openness. Further, anyone who has tried to assess and evaluate the impact or success of a partnership will equally know what a difficult task this is too. And all too often, those involved in partnership brokering don't even bother to find out. So while the language and rhetoric of partnership abounds and several such partnerships have been set up in Ireland to address issues of inequality, the effort put into assessing and evaluating the impact and success of such partnerships does not match this.

What is the evidence that such collaborations and partnerships contribute to improved implementation of programmes, to fairer and more equitable outcomes? There is not much I am afraid but that is hardly surprising. Measuring and assessing the impact and success of partnership working is difficult to evaluate. The outcomes are not necessarily tangible or easily measured in terms of number of outputs of physical entities. More often than not, the success or impact of a partnership can be gauged in terms of social capital that is built. And such intangibles may only have physical impact much further down the track.

Recently, the Institute of Public Health in Ireland has come up with a series of useful publications in relation to partnerships. Anyone involved in brokering a partnership or assessing a partnership will surely find the contents of these publications useful. How often have I heard local umbrella community organisations highlight the need for more skills and capacity in these areas of partnership working. Well, there are some useful tools and guidance here.

There are 3 publications:

1. Partnerships: A Literature Review

2. Partnerships: The Benefits

3. Partnerships: Community Involvement and Perceptions of Health Inequalities

I want to focus particularly on assessment of partnerships because the publication Partnerships: The Benefits describes an elegant and useful evaluation tool. This is called the Partnership Evaluation Tool (PET). Although developed in a health context it is practical in any partnership setting. PET involves participatory working with partnership members to identify particular benefits important in the partnership such as connections, learning, actions and impacts. Partnership members then identify a range of indicators that might contribute to realising these particular benefits. Indicators are scored on a scale of 0-5, the data can then be analysed and presented on a typical spidergram (as shown top right) or polygon.

If you are serious about your partnership and wish to avoid perpetuating arm's length partnerships or unequal power relations you might want to consider what is said in these publications and avail yourself of the useful PET tool.

Conference on rural isolated men

'A conference looking at the poverty and social exclusion issues affecting rural men in the Border Region will be held in the Slieve Russell Hotel, Ballyconnell, Co. Cavan on Thursday 14th February 2008. A new policy position paper that identifies the services needed to respond to the social exclusion of isolated men in the central border region will be presented by the Social Inclusion Working Group of the Irish Central Border Area Network [ICBAN].'

International Women's Health Conference in Derry

This conference aims open up debate on the need to improve health status and reduce health inequalities by focusing on the themes of Women and exclusion, maintaining women's roles in determining health and well-being when societies move from conflict to post conflict, and Meeting health needs on a cross border basis. The conference takes place on the 29-30 May 2008 and is hosted by Derry Well Woman.

Partnership Evaluation Toolkit

The Institute of Public Health in Ireland are about to launch a Partnership Evaluation Toolkit.

'A Partnership Evaluation Tool (PET) has been developed to help multisectoral
partnerships to monitor their development, to assess emerging benefits and to
identify areas for further development. Developed as a web-based resource, the
PET will be available on www.partnershiptool.ie for any partnership to use to
support its own assessment and development, and will be showcased at the event.'

Food for life

One of the largest studies of its kind has found that organically grown food is more nutritious and healthier compared to its conventionally grown counterpart. The Quality Low Input Food (QLIF) project, involving 33 academic centres across Europe and led by Newcastle University, analysed the 725-acre farm’s produce for compounds believed to boost health and combat disease.

'While the results show significant variations, with some conventional
crops having larger quantities of some vitamins than organic crops. But
researchers confirm that the overall trend is that organic fruit, vegetables and
milk are more likely to have beneficial compounds.'

According to Professor Carlo Leifert, Team Leader of the QLIF Project,

'the compounds which have been found in greater quantities in organic produce
include vitamin C, trace elements such as iron, copper and zinc, and secondary
metabolites which are thought to help to combat cancer and heart disease.'

Read more here.

For a more global perspective on the links between food, food production and health check out the latest issue of LEISA Magazine, Healthier Farmers, Better Products, available for download here.

Tackling health inequalities, the CDHN

'The Community Development and Health Network as a member led organisation aims to make a significant contribution to ending health inequalities, using a community development approach.'

Visit their site for an interesting range of resources, publications and contacts.

Tackling social exclusion of traveller communities

This recently published report from UNICEF Breaking the Cycle of Exclusion; Roma Children in South East Europe, may well have useful insights and lessons for policy makers and campaigners working on behalf of the traveller community in Ireland, who share similar exlusion, prejudice and discrimination. The report highlights key issues contributing to social exclusion of Roma children in eight South eastern European countries and identifies the most critical issues that, if addressed effectively, can break the intergenerational cycle of poverty and exclusion and create a new cycle of development, opportunity and inclusion.

'The authors argue that exclusion deprives children of their childhood and hinders them from fully developing their capacities to contribute in a substantial way to the economic and social development of their country. Exclusion is a de facto violation of the rights of children and it is with children that the intergenerational cycle of poverty and exclusion can be broken. The report calls for immediate action on social exclusion of children in middle income countries.

A range of recommendations are suggesting including:

• educated Roma should be invited to participate in public life, on radio and television, so that people get to see Roma in other roles
• the Child Ombudsman system should have a section or person supporting the rights of excluded children with special attention to Roma children
• the welfare system should, in coordination with the other social sectors, play an important role in ensuring children and their parents are not excluded from the basic services
• access to health care for Roma children is obstructed by costs, lack of registration and discrimination. All children should be registered from birth.'

Poor health

One of my enduring memories from childhood was the sight of a long line of traveller community caravans along the Cookstown road on the way into Omagh. Now all the travellers in the Omagh district are in fixed housing. It's all part of the learning experience of someone newly returned home. However, one of the most shocking things I have learned more recently was during the field visits at the Rural Community Network annual conference was the appalling level of health and health care among the traveller community here in Ireland, north and south. In a presentation by Connor Keyes, I learned some unpalatable facts such as:

• Travellers have infant mortality rates 3 times higher than the general population.
• Travellers have stillbirth rates double that of the general population.
• Traveller men live on average 10 years less than settled men.
• Traveller women live on average 12 years less than settled women.
• Travellers of all ages have very high mortality rates compared to the Irish population.

It reminded me of the 'Third World' health conditions that Aborigine communities endure in 'economically advanced' Australia. University College Dublin have just commenced an All-Ireland Traveller Health Study 2007-2010 which will provide up-to-date information and hopefully indications that the situation is improving. It will be interesting to see if there are significant differences between north and south in terms of health conditions. Lay health workers have been operating in the south for some time now but a similar strategy is not yet in operation for the traveller community in Northern Ireland. It is hard to understand why not given the known barriers and constraints facing health care among the traveller community. Surely a situation that will change soon I hope.

Improving rural services

I read with interest that Rural Development Minister, Michelle Gildernew MP MLA, recently met with her counterpart Eamon O Cuiv, Minister for Community, Rural and Gaeltacht Affairs (DCRGA) in County Leitrim. Among the many issues they discussed were rural childcare and mental health. In a separate but related story, Praxis Care Group have secured funding that has enabled them to extend their outreach programme for dealing with mental health problems in rural areas of NI.