ironically, it was also the first to have tap water supply and gas light.

Ensuring Ecological

Security

It is rather ironical that man in his quest for control over the forces of nature has infficted so much damage upon it that not only modern civilisation is being threatened with destruction, but also hundreds of living species are facing extinction.

Nature has been wantonly exploited in search for resources which are in perpetual shortage to such an extent that the entire man kind has been robbed of "ecological security" provided once by nature itself.

The present global ecological situation is really alarming. Every year more than 20 million hectares of land suitable for agriculture are lost. about six million hectares of ploughland and roughly 10 million hectares of humid tropical forests are destroyed. This, in turn, threatens the livelihood of some 830 million people, most of whom live in the developing countries.

The grotesque dimension that the deterioration of ecological imbalances is assuming also becomes empty clear from the warning of the Global 2000 Report prepared for the U. S. President in this 1980's.

The report points out that if the persent trends continue the world in 2000 will be more polluted, less stable ecological and more vulnerable to disruption. The programme adopted at the Assembly of the International Union for Conservation of Nature and Natural Resources held in the USSR last year also grimly stated that without a resolute turn the future of mankind would be in jeopardy.

It is not without significance that more than 100 countries under the UN

Environmental Programme (UNEP) are closely cooperating to achieve the objec tive of a global commitment to safeguard the environment for present and future. generations of man.

On the occasion of the World Environment Day on June 5 this year also fervent appeals were made by international experts, politicians, social workers all over the world to protect, preserve and improve environmental heritage so that the present and future generations can live in an ecologically safer world.

No less harmful role is played by the multinational corporation (MNCs). The MNCs with their insatiable greed for profit are engaged in savage destruction of forests in several Asian, African, Latin. American countries. They are not ready to shell out even a single penny out of their fabulous profits repatriated from the developing countries for nature conservation and environmental protection programmes.

(Continued on page 41 )

Community Participation & Health For All

By Rajkumar Bansal and

In the pest decade, especially since the adoption of the declaration of AlmaAta on primary health care, community participation has become increasingly recognised as a key element in improving health, particularly among the poor and underserved populations in developing countries. It is concerned not with advanced medical technology but rather with applying tried and tested health care procedures to the health problems of the poor and under privileged1.

Though many definitions of community participation have been suggested1-5, however, a comprehensive definition as suggested by us can be can be "Community "Community participation is a way of living which needs to be inculcated in all the citizens of the world so as to enable and embolden them to actively, collectively and voluntarily diagnose their problems and felt needs; find and implement socioculturally, economically and scientifically acceptable solutions with community Mogistics, either with or without external support so as to eliminate or minimise their problems; fulfill their felt needs; and plan for their future development so as to benefit and enable them to lead a socially, economically and healthly productive life". The aim should be to attain positive health and well being.

Historically since independence the various government programmes show a shift from cooperation to participation with the eventual aim being to move towards the stage of involvement. This trend has been due to two factors mainly :

Ratan K. Srivastava**

with curing disease but forms an integral part of a country's general development policies1.2.

are:

The main advantages of community participation optimal coverage, greater efficiency, more equitable distribution, self reiiance of the community and enhanced effectiveness of a programme, Community perticipation ensures that the health infrastructure is harmonious and supportive to the needs of the people,

There are many successful examples of participatory health approaches throughout the world 7.8. In India the need for community participation is reflected in almost all the plan documents, more so from the sixth plan document (1978-83) onwards. Panchayat Raj and cooperatives were instruments aimed to ensure community participation. The Health Guide Scheme, Trained Dais Scheme and ICDS were especially railored by the government for greater commu. nity involvement in health care ectivities. However participatory methods have largely been encouraged by nongovernmental egencies, some of whom have successfully implemented their programmes with extensive community supports and scant government supports. Table 1 shows the programme indicators of SEWA Rural situated at Jhagadia, Gujarat9. Table 2 shows similar data for Vivekananda Girijana Kelyana Kendra situated at B. R. Hills, Mysore1o. Further a number of such experiments have been documented in Anubhav series and other publications7, notable being the Jamkhed project, KEM project, Health for one million project etc.

Inappropriateness of the 'Western' medical system in our context and underutilization of these services, and Relisation of the fact that public health policy is not only concerned Assistant Professor Department of Community Medicine P. S. Medical College, Karamsad Pin. 388 325, Dist. Kheda, Gujarat.

the developing countries are facing severe In concluding it has to be stated that resource paucity for health care provision including safe water supply, sani

Professor and Head Department of Community Medicine Pramukhswami Medical College, Karamsad, Dist. Kheda, Gujarat Pin Code 388 325.

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