SALW, Health, Development The Public Health Approach

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SALW, Health, Development The Public Health Approach Cathey Eisner Falvo, MD, MPH President, Physicians for Social Responsibility/NYC PSR is the US affiliate of International Physicians for the Prevention of Nuclear War

Premises of This Discussion 1. If the community is not healthy, development will be hindered 2. SALW cause ill health in communities 3. Public health practice methods can reduce the use of SALW in communities

1. Brief background on problem

Small arms and light weapons (SALW) are more portable, violence is more lethal Small arms and light weapons (SALW) include easily transportable weapons such as handguns, rifles and machine guns, portable grenade launchers, and anti-tank guns Guns are violence multipliers Allow assailants to attack in an instant Allow assailants to attack from a distance

Scope of the Problem 200,000-300,000 deaths per year as a result of small arms and light weapons (SALW) more than 600 million SALW are in circulation worldwide;... in 46 out of 49 regional conflicts from 1990-2000 SALW were the only type of arms used; annual global trade in SALW is estimated at $4 billion dollars.

35% 35% 35% 54% Source: WHO 11%

3. What's missing from the current agenda? Visibility of violence prevention programming: content analysis of official international development agency websites from 22 OECD/DAC countries

Harms across development spectrum Vicious circle: violence under-development Health consequences Source: WHO

Armed Violence an Impediment to Health and Development Firearm-related violence: Creates culture of violence Diverts health care resources from disease control, health and nutrition education Creates internal displacement/refugees Encourages human rights and sexual abuse Scares away investment, increases cost of doing business

Violent deaths by country income High income 9% status, year 2002 Low & middle income 91% N = 1.6 million

WHO Statement: Violence is a leading worldwide public health problem Resolution WHA 49.25, 1996

2. Public Health Approach Prevent violence by identifying risk factors and devising interventions - break the chain at the weakest link

Public Health Approach: 1. Surveillance: What is the problem? 2. Risk Factor Identification: What is the cause? 3. Intervention Evaluation: What works? 4. Implementation: How do you replicate it? Problem Response Source: WHO Teach VIP

3. IPPNW s Aiming for Prevention Program

IPPNW has developed the One Bullet Story that documents the Human Face of Armed Violence Costs of injuries are high: Medical Psychological Social Community Economic

Other One Bullet Stories have been documented, such as from Zambia, and Nepal One Bullet Stories of gunshot victims at a Lusaka hospital prove that small arms are a public health threat in Zambia. And in Nepal Before she knew what happened, the innocent 15 year girl felt something pushing her head back wards and to the left It took a while for her guardians to understand that she was injured by a bullet fired by the policemen

AfP Campaign Materials Highlight One Bullet Stories

IPPNW Conducts Injury Research such as.. 5-country African Pilot Study that Documented over 4200 cases in Hospital ERs Puerto Rico Nigeria Uganda Kenya DRC Zambia PI: Diego E Zavala, MSc, PhD, Ponce Medical School, Puerto Rico Project Administrator: Maria Valenti International Physicians for the Prevention of Nuclear War (IPPNW)

Aiming for Prevention in Action: El Salvador Medical student brigade to rural area communities for health promotion. Conducting injury research at Hospital Rosales, San Salvador, on victims of small arms violence

Presenting Injury Research to the Public

Presenting Injury Research to El Salvador President Saca

4. International Programs and Strategies Photo: United Nations Plaza, New York

International Physicians for the Prevention of Nuclear War (IPPNW) coordinates The IANSA Public Health Network To help achieve mutual goals of preventing small arms violence around the globe via education and mobilization of the health community.

IPPNW serves in consultative status to the WHO and is a member of the WHO VPA WHO s Violence Prevention Alliance (VPA) US Centers for Disease Control and Prevention (CDC) International Society for Violence and Injury Prevention

In 2006, a number of states adopted the Geneva Declaration on Armed Violence and Development, now signed by over 100 countries. Recognizing that the fight against the global scourge of armed violence and sustainable development are closely linked, participants agreed to strengthen efforts to integrate armed violence reduction into development frameworks, and humanitarian assistance, emergency and crisis management initiatives.

Get Involved! www.ippnw.org www.psr.org www.iansa.org www.who.int/violence_injury_prevention