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Geneva, Switzerland, WHO, 2000. v, 43 p. (WHO Technical Report Series No. 898)Life expectancy is increasing in many parts of the world, whereby not only are more people living to old age, but more are also living with disabling conditions. These conditions include people who are chronically ill, who have serious disabilities, who have HIV/AIDS, who are mentally ill, who are victims of accidents and disasters, and who are elderly. Many of these conditions need continuing care and support, not simply looking after them but enabling them to live their lives as fully and as rewardingly as possible. This report by an international WHO Study Group examines the options of long-term care. It points to the benefits that home-based care offers to the patient, while stressing that the personal and health needs of caregivers in the home must not be compromised. Families have practiced home-based long-term care for centuries, and family members will always remain a valuable resource for care. This report argues that it is time for health systems to take responsibility for providing caregivers in families and communities with the support they need both to help make their tasks more bearable and to bring a greater share of benefit to the patient.
Development Bulletin. 2002 Dec; (60):8-12.Land is the key to resolving many of the conflicts and problems of Melanesia. Solutions have to involve ways that will work for the majority of the people of the region. A characteristic of the Melanesian South Pacific is that control of the land and virtually all other natural resources is not held exclusively by the state. Only small percentages of the region’s land resources have been alienated to the state. In Papua New Guinea (PNG) it is less than 3 per cent; in the Solomon Islands about 12 per cent, and in Vanuatu all land was deemed to return to its customary owners at independence. These natural resources are held in various combinations of customary group rights and customary individual rights. These rights continue to operate within a range of customary land tenure and land use systems. National constitutions of these countries specifically recognise the validity of these customary systems within the modern state; the majority of citizens want them to continue. Such determination in the face of significant continuing outside as well as internal pressures implies that there is much about these customary tenure systems that is not appreciated by outside forces that try to undermine and destroy them. Why are these systems so important and how can other activities link up with such customary institutions? With these customary rights come expectations and responsibilities in value systems that channel and direct both social and economic behaviour patterns of people living within those systems. Over time the strong links between rights and responsibilities have begun to fade and integrated patterns of beliefs, values and behaviour have become less integrated and more diffuse. Critical areas such as leadership, for example, have taken on new characteristics, expectations and behaviour patterns to such an extent that many modern leaders act with virtual impunity within their ‘fiefdoms’, especially in dealings with natural resources. The conjunction between land, people and governance in Melanesia must underlie efforts to resolve Melanesia’s current problems and malaise. To speak constructively about ‘South Pacific Futures’ the critical importance of land in these societies must be addressed to find forward-thinking ways to resolve Melanesian dilemmas. (excerpt)
HealthLink. 2004 Oct 1; (129): p..“My mother, stop lying to me. You think I don't know my father is dying of AIDS?" It was 1996, and 10-year old Samwel challenged his mother Elsa to accept a harsh reality as his classmates, teachers, and neighbors listened to a discussion rarely conducted in public. Samwel did not care - he could not be silenced. Just 10 years old, his words weighed heavily on his mother, who had recently found out she was HIV-positive, like her husband: "I left perplexed and traumatized. He helped me decide to tell my family." Their story is not an uncommon one in Africa: A dying husband and father, a wife and mother infected by him, children to care for, and a questionable future. But Elsa Ouko is no ordinary woman. A brief conversation between a mother and her son became a turning point in their lives. Elsa and her family live near Eldoret, a small town in northwest Kenya where HIV is widespread, not unlike hundreds and thousands across the African continent. For the first time since finding out she was HIV-positive eight years ago, Elsa is ill. Despite this, she is quick to smile, her short hair framing her face on her slim, but not wasted, 48-year-old frame. Elsa thinks nothing to tell her story again, sitting next to her friend and colleague Margaret, who is also HIV-positive. Margaret is tall and heavy-set, helped by the antiretrovirals she uses most of her meager teacher's salary to purchase. Elsa, and millions like her, cannot afford the medicines. She is unemployed and has worked as a housewife for most of her life. Together, Margaret and Elsa talk passionately about a disease that kills 8,000 people worldwide every day - that is 353 deaths per hour, six every minute, and one every ten seconds - among them Elsa's husband. One thing is clear: they have turned a devastating diagnosis into a positive campaign to fight HIV/AIDS. (excerpt)
POPULI. 1995 Jan; 22(12):4.The theme of World AIDS Day, December 1, 1994, is "AIDS and the Family." It was chosen by the World Health Organization (WHO) because 1994 is the International Year of the Family. According to WHO's Global Programme on AIDS (GPA), nearly 14 million persons were living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) in 1994. Families of persons infected with HIV face losses of income, care, nurturing, stability, and food, as well as emotional loss, when these people sicken and die. The GPA definition of family extends to "any group of people linked by feelings of trust, mutual support, and a common destiny. The concept need not be limited to ties of blood, marriage, sexual partnership, or adoption." All families should protect their members from HIV and care for those who fall ill. 700,000 children in Africa were born to HIV-positive women in 1993. These children will be orphaned or, if infected, die. Unless family members step forward to support these children, they will turn to prostitution to survive and spread the virus further. Almost 50% of newly infected adults are women (WHO). As the traditional care-givers, uninfected women are affected by HIV in the family. In some societies, women widowed by AIDS are rejected and stripped of their belongings. WHO Director General Hiroshi Nakajima states that compassionate families with bonds based on love, trust, nurture, and openness are best able to protect their family members and to care for and support those members who are infected with HIV. GPA Executive Director Michael Merson adds that youth learn about safe behavior and nondiscrimination in families.
Cambridge, Massachusetts, Harvard Institute for International Development, 1990 Aug. v, 51 p. (Development Discussion Paper No. 355)Development planners often disregard the counter development risks of development projects in developing countries. Since they do not acknowledge these risks beforehand and do not take action to circumvent or reduce these risks, some counter development effects cause a considerable unexpected chain reaction. For example, dam construction agencies either underestimate population displacement numbers or do not include the estimates in feasibility reports. The development of Lake Sobradinho in Brazil displaced 65,000 inhabitants. 24,000 were supposed to relocate 800km upstream, but only 28% actually moved there. Many people lost their possessions and animals. Once they arrived at the new location, they had to fend for themselves. A hydropower and irrigation project on the Citarum river in West Java, Indonesia, resulted in a 49% lower household income and a 47% lower land ownership. The Kiambere reservoir project in Kenya caused mean land holding size to fall from 13-6 hectares, a >33% reduction in livestock, and >66% reduction in yields of maize and beans. Thus water resource development programs designed to bring irrigation, flood control, drinking water, energy, and better navigation to the aggregate population often result in impoverishment for the dislocated population. Joblessness, homelessness, morbidity, marginalization, and the disintegration of social and kinship networks also cause impoverishment. Water resource development planners can incorporate preventive and mitigating measures to guarantee adequate resettlement of the displaced persons into these projects via 4 frameworks. The policy framework involves guidelines for forced population displacement. Governments need to develop a legal framework to protect the interests and rights of the displaced people. The planning framework requires resettlement actions plans (ideally to reduce displacement) to be an integral part of planning the project. The organizational framework places resettlement high on the list of priorities.
Culture and human fertility. A study of the relation of cultural conditions to fertility in non-industrial and transitional societies.
Paris, France, UNESCO, 1954 Oct. 510 p. (Population and Culture)The study attempts to develop coherent interpretations of a large mass of diverse demographic, anthropological and other scientific evidence. The committee believes these formulations have value, especially as presenting hypotheses for research and revealing points at which more precise information is needed. Professor Firth, as an anthropologist, and I, as a demographer, have reservations with respect to some of the interpretations. Other scholars who have seen the manuscript support interpretations with which we would disagree. Professor Lorimer himself has indicated that his inferences at many points are tentative formulations. The committee, like the author, presents the study to the public, not as a definitive formulation of the many complex aspects of this subject, but as a significant and valuable, though necessarily subjective, interpretation. The committee shares the author's hope that the publication of this work will lead to more intensive scientific investigations and more definitive knowledge in the future. We believe that Professor Lorimer's work, because it is his own untrammeled product, will accomplish more, both constructively and provocatively, than could be expected at this stage from a study that achieved unanimous agreement by an emasculating compromise. Finally, we wish to express our deep gratitude to Professor Lorimer for the energy, imagination and scholarly dedication with which he has approached his arduous task. (excerpt)