Abstract
Objective: To build a national Cuban capacity for training environmental health professionals directly linked to the needs of policy-makers and communities.
Participants: The University of Manitoba and University of British Columbia collaborated with an established training centre in Cuba (the Instituto Nacional de Higiene y Epidemiologia–INHEM) and new centres in the Central (Santa Clara) and Eastern (Santiago) regions of the country.
Setting: Cuba
Intervention: In the mid-1990s, a comprehensive curriculum (masters and diploma programs) was collaboratively developed, applying interactive teaching methods, and was delivered through a series of workshops and other interactions in Cuba, and short-term visits to Canada by Cuban PhD students.
Outcomes: The collaboration was successful in fulfilling capacity-building targets (over 50 Masters graduates, 467 Diploma graduates, over 30 trained core faculty in all regional centres as well as new curriculum and new accredited regional programs). Alongside this, a number of collaborative community-based research projects were undertaken in all three regions (drinking water in Santiago; housing and urban renewal, and dengue control in Havana; and tourism-related effects, and effective intersectoral management of population health determinants in Santa Clara).
Conclusion: The collaboration led to adopting new strategies for challenges such as a dengue epidemic in 2002, and new research on the effectiveness of intersectoral management of risks of particular interest to both Cuban and Canadian policy-makers. It triggered an ambitious collaboration between the Canadian-Cuban team and colleagues in Ecuador in order to build a similar national network there, built on South-South and North-South links.
MeSH terms: International cooperation, public health, environmental health, interdisciplinary communication, research, teaching
Résumé
Objectif: Créer à Cuba une capacité nationale de formation de professionnels en salubrité de l’environnement directement liée aux besoins des décideurs et des collectivités.
Participants: L’Université du Manitoba et l’Université de la Colombie-Britannique ont collaboré avec un centre de formation bien établi de Cuba (l’Instituto Nacional de Higiene y Epidemiologia–INHEM) et de nouveaux centres dans la région centrale (Santa Clara) et la région orientale (Santiago) du pays.
Lieu: Cuba
Intervention: Au milieu des années 1990, on a élaboré par un effort concerté un programme d’études global (menant à la maîtrise et à divers diplômes) qui appliquait des méthodes d’enseignement interactives. On a mis ce programme à exécution au moyen d’une série d’ateliers et d’autres interactions à Cuba, et d’une série de brefs séjours au Canada par des doctorantes et des doctorants cubains.
Résultats: Cette collaboration a atteint ses objectifs de renforcement des capacités (plus de 50 détenteurs et détentrices de maîtrises, 467 diplômées et diplômés, plus de 30 membres du corps professoral de base formés dans tous les centres régionaux, nouveau programme d’études et nouveaux programmes régionaux agréés). En parallèle, des projets concertés de recherche communautaire ont été entrepris dans les trois régions (eau potable à Santiago; logement, renouvellement urbain et lutte contre la dengue à La Havane; et effets touristiques et gestion intersectorielle efficace des déterminants de la santé de la population à Santa Clara).
Conclusion: La concertation a mené à l’adoption de nouvelles stratégies pour relever des défis comme l’épidémie de dengue de 2002 et à de nouvelles études sur l’efficacité de la gestion intersectorielle des risques qui intéressent particulièrement les décideurs cubains et canadiens, et elle a été l’élément déclencheur d’une collaboration ambitieuse entre l’équipe canado-cubaine et ses collègues en Équateur, qui veulent construire un réseau national semblable dans leur pays à partir de liens Sud-Sud et Nord-Sud.
References
- 1.WHO. Global Strategy: Health, environment and development: Approaches to drafting country-level strategies for human well being under Agenda 21. Geneva, Switzerland: World Health Organization; 1993. [Google Scholar]
- 2.WHO. Our Planet Our Health. Geneva: WHO; 1992. [Google Scholar]
- 3.Lebel J, Forget G. An ecosystem approach to human health. Int J Occup Environ Health. 2001;7:S3–S36. [PubMed] [Google Scholar]
- 4.Spiegel JM, Yassi A. Lessons from the margins of globalization: Appreciating the Cuban health paradox. J Public Health Pol. 2004;25(1):96–121. doi: 10.1057/palgrave.jphp.3190007. [DOI] [PubMed] [Google Scholar]
- 5.MacDonald TH. A Development Analysis of Cuba’s Health Care System Since 1959: Studies in Health and Human Services. Lewiston, NY: Edwin Mellen Press; 1999. [Google Scholar]
- 6.Kirkpatrick AF. The US attack on Cuba’s health. CMAJ. 1997;57(3):281–84. [PMC free article] [PubMed] [Google Scholar]
- 7.Garfield R, Santana S. The impact of the economic crisis and the US Embargo on health in Cuba. Am J Public Health. 1997;87(1):15–20. doi: 10.2105/AJPH.87.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 8.WHO. Analysis of the Public Health Sector in Cuba. Progress Report. Havana City.: MINSAP/PAHO/WHO; 1995. [Google Scholar]
- 9.García M, Yassi A, Spiegel J, Alegret M, Carrió C. Revista de Salud Publica. 2005. Colaboración cubano-canadiense para desarrollar capacidades en evaluación y manejo de riesgos de Salud Ambiental en Cuba. Submitted t. [Google Scholar]
- 10.Brundtland GH, editor. The United Nations World Commission on Environment and Development: Our Common Future. Oxford, UK: Oxford University Press; 1987. [Google Scholar]
- 11.Lalonde M. A New Perspective on the Health of Canadians: A Working Document. Ottawa, ON: Ministry of Health and Welfare; 1974. [Google Scholar]
- 12.Evans RG, Barer ML, Marmor TR, editors. Why are Some People Healthy and Others Not? The Determinants of Health of Populations. New York, NY: Aldine de Gruyter; 1994. [Google Scholar]
- 13.Yassi A, Kjellström T, de Kok T, Guidotti T. Basic Environmental Health. New York: Oxford University Press; 2001. [Google Scholar]
- 14.Weinger M. Teacher’s Guide on Basic Environmental Health. New York: Oxford University Press; 1999. [Google Scholar]
- 15.Yassi A, Kjellström T, DeKok T, Weinger M. Ecosystem Health. 1997. Teaching basic environmental health in universities utilizing an interdisciplinary holistic approach and interactive learning methods; pp. 143–53. [Google Scholar]
- 16.UPCD. University Partnerships in Cooperation and Development Home Page. 2005. [Google Scholar]
- 17.UPCD. Building Interdisciplinary Capacity in Environmental Health Risk Assessment and Risk Management across Cuba. 2005. [Google Scholar]
- 18.Spiegel J, García M. AUCC-IDRC Research Colloquium. 2005. Links Upon Links: A Canada-Cuba partnership to build sustainable capacity for managing environmental health risks through international collaboration. Presented at th. [Google Scholar]
- 19.García M, Barceló C, Diego F, Fernández N, Junco R, et al. Evaluación del impacto en salud de proyectos de inversión. 2003. [Google Scholar]
- 20.Revista Cubana de Higiene y Epidemiologia. 2004. [PubMed]
- 21.Bonnefoy P. Coping with water crisis in Cuba. Ottawa, ON: International Development Research Centre; 2002. [Google Scholar]
- 22.Yassi A, Mas P, Bonet M, Tate RB, Fernandez N, Spiegel J, et al. Applying an Ecosystem Approach to the Determinants of Health in Centro Habana. Ecosystem Health. 1999;5(1):3–19. doi: 10.1046/j.1526-0992.1999.09902.x. [DOI] [Google Scholar]
- 23.Spiegel J, Bonet M, Yassi A, Molina E, Concepción M, Mas P. Developing ecosystem health indicators in Centro Habana: A community-based approach. Ecosystem Health. 2001;7(1):15–26. doi: 10.1046/j.1526-0992.2001.007001015.x. [DOI] [Google Scholar]
- 24.Spiegel J, Bonet M, Yassi A, Tate B, Concepción M, Cañizares M. Evaluating the effectiveness of a multi-component intervention to improve health in an inner-city Havana community. Int J Occup Environ Health. 2003;9(2):118–27. doi: 10.1179/oeh.2003.9.2.118. [DOI] [PubMed] [Google Scholar]
- 25.Spiegel J, Bonet M, García M, Ibarra AM, Tate RB, Yassi A. Building capacity in Central Havana to sustainably manage environmental health risk in an urban ecosystem. EcoHealth. 2004;1(Suppl2):SU120–SU130. [Google Scholar]
- 26.Yassi A, Fernandez N, Fernandez A, Bonet M, Tate RB, Spiegel JM. Evaluation of community participation in a multi-sectoral intervention to address health determinants in an inner-city community in Central Havana. J Urban Health. 2003;80(1):61–80. doi: 10.1093/jurban/jtg061. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Fernández N, Tate R, Bonet M, Cañizares M, Mas P, Yassi A. Health risk perception in the inner city community of Centro Habana, Cuba. Int J Occup Environ Health. 2000;6:34–43. doi: 10.1179/oeh.2000.6.1.34. [DOI] [PubMed] [Google Scholar]
- 28.Tate RB, Fernandez N, Yassi A, Cañizares M, Spiegel J, Bonet M. Change in health risk perception following community intervention in Central Havana, Cuba. Health Promot Int. 2003;18(4):279–86. doi: 10.1093/heapro/dag401. [DOI] [PubMed] [Google Scholar]
- 29.IDRC. Health: An Ecosystem Approach. 2003. Case Study: Cuba: Housing and Human Capital in Cuba. [Google Scholar]
- 30.Spiegel J, Yassi A, Tate R. Dengue in Cuba: Mobilization against Aedes aegypti. Lancet Infect Dis. 2002;2:207–8. doi: 10.1016/S1473-3099(02)00238-4. [DOI] [PubMed] [Google Scholar]
- 31.García M, Bonet M, Spiegel J, Concepción M, Tate RB, Yassi A. International Forum on Ecosystem Approaches to Human Health. 2003. Applying an ecosystem approach to sustainably prevent and control dengue in Centro Habana, Cuba. Presented at. [Google Scholar]
- 32.Spiegel JM, Labonte R, Hatcher-Roberts J, Girard J, Neufeld V. Tackling the 10–90 gap: A report from Canada. Lancet. 2003;362(9387):917–18. doi: 10.1016/S0140-6736(03)14313-9. [DOI] [PubMed] [Google Scholar]
- 33.Full documentation on this project is available at www.cih.ubc.ca (Accessed on December 10, 2005).
- 34.Romanow R. Globe and Mail. 2005. Now’s the time to stand up for medicare. [Google Scholar]
- 35.McLeod CB, Lavis JN, Mustard CA, Stoddart GL. Income inequality, household incomes, and health status in Canada: A prospective cohort study. Am J Public Health. 2003;93:1287–93. doi: 10.2105/AJPH.93.8.1287. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 36.Lebel J. Health: An Ecosystem Approach. Ottawa: International Development Research Centre; 2003. [Google Scholar]
- 37.Neufeld V, Spiegel J. Canada and global health research: 2005 update. Can J Public Health. 2006;97(1):39–41. doi: 10.1007/BF03405212. [DOI] [PMC free article] [PubMed] [Google Scholar]
