Flood control embankments contribute to the improvement of the health status of children in rural Bangladesh

Every year, Bangladesh experiences major floods that inundate about one-third of the country. Therefore flood control projects that comprise earthen dikes and irrigation/drainage systems are built along the major river to protect the people living in low-lying areas, stabilize the river banks and improve agricultural productivity. However, the adverse effects of these projects are emphasized, such as environmental degradation and reduction of fishing suplplies. The Demographic Surveillance System of the International Centre for Diarrhoea Diseases Reseaarch, Bangladesh (ICDDR,B) was used to assess the effect of a flood control programme on thr mortality of O-4 year-old children residing in the Matlab study area. Adjusted mortality rates were used in comparing four adjacentchild populations residing inside or outside a flood-control embankment and according to the type of health services provided in this area. Between the periods 1983-86 and 1989-92, the crude child mortality in the total study area decreased by 37

from 185.9 per 1000 live births to 117.9 per 1000 live births. Following the construction of the embankment, death rates outside were up to 29

higher in 1-4 year-old children and 9

higher for 0-4-year age group compared to the flood-protected area (P<0.001). Simultaneously, in the same study area, health intervention contributed to a 40

reduction in mortality among children less than 5 year of age in all causes of deaths (P<0.001). Migration patterns and the effect of distances of the hospital are discussed.(AU)

Health and social problems of refugees

Today over 15 million refugees are scattered around the world, most of them in poor Third Wold countries [New Sci., 14-15, September 1991]. But whether they seek'safe havens' in rich or poor countries they continue to suffer from the malaise of being uprooted, struggling to survive in new and alien environments. Their health and social problems extend beyond the obvious emergency short-term phase. It is now clear that the number of refugees has increased beyond expectations and most have stayed long enough to expect final resettlement in their countries of asylum, a process which requires wider, more comprehensive and long - tern management and rehabilitation interventions. This paper will attempt to highlight issues of health and social problems in their wider context, surveying comprehensive and integrated approaches in assessing the needs of refugees, whether they are in developing or industrialised countries, with emphasis on the latter and, when appropriate, using the United Kingdom experience as an example (AU)

La situación actual de salud de los trabajadores en los países de Centroamérica y Panamá / present health situation of workers in Central America and Panama

Se presenta la situación actual de la población trabajadora y su estado de salud en la región. Se analiza la situación de los grupos laborales del sector informal, trabajadores temporarios, mujeres y menores trabajadores y trabajadores agrícolas, así como los indicadores del estado de salud de los mismos. Se discuten las estadísticas sobre accidentes de trabajo, enfermedades ocupacionales e intoxicaciones por plaguicidas. Finalmente, se analizan las acciones normativas y de coordinación, los servicios de salud ocupacional, de información y los recursos humanos. Se resalta el subregistro y en general la falta de información completa que dificulta conocer adecuadamente la magnitud de los indicadores del estado de salud de los trabajadores. Sin embargo, el análisis de los datos disponibles evidencia la gravedad de la situación. Puesto que 1992, ha sido declarado el año de la salud de los trabajadores, se están desarrollando o adoptando los planes de salud ocupacional (AU)