Wednesday, October 24, 2007

WHO publishes new standard for documenting the health of children and youth

24 OCTOBER 2007 | GENEVA/VENICE -- WHO publishes the first internationally agreed upon classification code for assessing the health of children and youth in the context of their stages of development and the environments in which they live.

The International Classification of Functioning, Disability and Health for Children and Youth (ICF–CY) confirms the importance of precise descriptions of children's health status through a methodology that has long been standard for adults. Viewing children and youth within the context of their environment and development continuum, the ICF–CY applies classification codes to hundreds of bodily functions and structures, activities and participation, and various environmental factors that restrict or allow young people to function in an array of every day activities.

The rapid growth and changes that occur in first two decades of life were not sufficiently captured in the International Classification of Functioning, Disability and Health (ICF), the precursor to the ICF–CY. The launch of the ICF–CY addresses this important developmental period with greater detail. Its new standardized coding system will assist clinicians, educators, researchers, administrators, policy makers and parents to document and measure the important growth, health and development characteristics of children and youth.

Children who are chronically hungry, thirsty or insecure, for example, are often not healthy and have trouble learning and developing normally. This classification provides a way to capture the impacts of the physical and social environment so that these can be addressed through social policy, health care and education systems to improve children's well-being.

"The ICF-CY will help us get past simple diagnostic labels. It will ground the picture of children and youth functioning and disability on a continuum within the context of their everyday life and activities. In this way it enables the accurate and constructive description of children’s health and identifies the areas where care, assistance and policy change are most needed," said Ros Madden, Australian Commission on Safety and Quality in Health Care, and, Chair of the Functioning and Disability Reference Group of the WHO Family of International Classifications (WHO-FIC) Network.

The ICF–CY has important implications globally for research, standard setting and mobilizing resources. "For the first time, we now have a tool that enables us to track and compare the health of children and youth between countries and over time," said Nenad Kostanjsek of WHO's Measurement and Health Information team. "The ICF–CY will allow countries and the international community to take informed action to improve children's health, education and rights, by treating their health as a function of the environment that adults provide."

The classification also covers developmental delay. Children who achieve certain milestones later than their peers may be at increased risk of disability. Using this classification, health practitioners, parents and teachers can describe these delays precisely in order to plan for health and educational needs and frame policy debates. The children and youth version of the International Classification of Functioning, Disability and Health (ICF-CY) is launched today in Venice, with international praise:

"The publication of the ICF-CY by the WHO provides, for the first time, a standard language to unify health, education and social services for children," said Dr. Margaret Giannini, Director of the Office of Disability, U.S. Department of Health and Human Services.

"This approach offers a scientific basis for describing each child's functional abilities using a shared language. Further, the ICF-CY has important implications for educational policy, research, and service designs for children and youth with disabilities," said Mary Ruth Coleman Ph.D., President Council for Exceptional Children (2007).

"The ICF-CY is a tool that can be shared by clinical services as well as by schools, community agencies and government entities. Further, with the visibility of an international WHO standard, the ICF-CY can serve to affirm the universal needs and rights of children," said Rune J. Simeonsson, Chair, WHO Work group on ICF-CY Children and Youth; University of North Carolina.

"The approach of focusing on how children and youth function physically, socially and mentally within the context of their development and environment has important implications for special education," said Yutaka Oda, President, National Institute of Special Education, Japan.

For further information, please contact:

Nenad Kostanjsek
Technical Officer
WHO, Geneva
Tel.: +41 22 791 3242
Fax: +41 22 791 4894
E-mail: kostanjsekn@who.int

Lina Reinders
Communications Officer
WHO, Geneva
Tel.: +41 22 791 1828
Fax: +41 22 791 1967
E-mail: reindersl@who.int

Friday, October 12, 2007

Childhood blindness



Definition

Children in Americas
- Download the picture [jpg 314kb]

Childhood blindness refers to a group of diseases and conditions occurring in childhood or early adolescence, which, if left untreated, result in blindness or severe visual impairment that are likely to be untreatable later in life. The major causes of blindness in children vary widely from region to region, being largely determined by socioeconomic development, and the availability of primary health care and eye care services. In high-income countries, lesions of the optic nerve and higher visual pathways predominate as the cause of blindness, while corneal scarring from measles, vitamin A deficiency, the use of harmful traditional eye remedies, ophthalmia neonatorum, and rubella cataract are the major causes in low-income countries. Retinopathy of prematurity is an important cause in middle-income countries. Other significant causes in all countries are congenital abnormalities, such as cataract, glaucoma, and hereditary retinal dystrophies

Magnitude

According to Gilbert and Foster, the prevalence of blindness in children varies according to socioeconomic development and under-5 mortality rates. In low-income countries with high under-5 mortality rates, the prevalence may be as high as 1.5 per 1000 children, while in high-income countries with low under-5 mortality rates, the prevalence is around 0.3 per 1000 children. Using this correlation to estimate the prevalence of blindness in children, the number of blind children in the world is approximately 1.4 million. Approximately three-quarters of the world’s blind children live in the poorest regions of Africa and Asia.

Prevention and treatment

Prevention and treatment of childhood blindness is disease specific. For Vitamin A deficiency, at a cost of only 5 US cents a dose, vitamin A supplements reduce child mortality by up to 34% in areas where Vitamin A deficiency is a public health problem. As vitamin A deficiency manifests often during an outbreak of measles, properly planned and implemented national vaccination programmes against measles has reduced the prevalence of eye complications. In middle income countries, retinopathy of prematurity (ROP) is among the leading causes of blindness, the incidence of which can be reduced through availability and affordability of screening and curative services. Early treatment of cataract and glaucoma can be beneficial, while low vision devices are helpful in children with residual vision.

VISION 2020 role

On an annual basis VISION 2020 partners have been actively involved in distributing millions of vitamin A capsules to those in need. They have also been involved in the development of pediatric eye care services. The Lions Clubs International Foundation, through their "SightFirst" Initiative is one of the major partners with WHO/VISION 2020 in addressing the causes of childhood blindness. Because of its extensive social and emotional burdens, prevention of childhood blindness is generally high on the agenda when countries develop a national VISION 2020 Action Plan. The causes of childhood blindness, amenable to prevention and treatment, receive attention, not only because there are interventions available to handle these conditions, but also devastating consequences if not addressed.

Tuesday, October 2, 2007

Shirin Ebadi

Founder and leader of Iranian Children's Right Society:
http://www.iranianchildren.org/index.php

Nobel Peace Prize winner 2003:
Presentation speech

The great Persian poet, Rumi or Mowlavi as Iranians like to call him, lived in the 13th century. Somewhere in his great work "Mathnawi", there is a short poem about a miserable wretch who came under attack by a ferocious dragon. A heroic rescuer rushed in at the last moment, and Rumi's comment is:

"There are such helpers in the world, who rush to save
anyone who cries out. Like Mercy itself,
they run towards the screaming.

And they can't be bought off.
If you were to ask one of those, "Why did you come
so quickly?" he or she would say, "Because I heard
your helplessness."

Another of the great Persian poets, Saadi of Shiraz, who also lived in the 13th century, says in the well-known work "The Rose Garden" – Golistan – that he who is indifferent to the suffering of others is a traitor to that which is truly human.

Dear Shirin Ebadi,

You and the Iranian people represent the tradition of Saadi and Rumi. You are both guide and bridge-builder. You strive to bring people together across cultures, races and religions! That is your hallmark!

The Norwegian poet, Arne Paasche Aasen, wrote in 1939 the lovely poem "Your youth" – about being young in spirit – where he says:

"Now cries the world: We need your heart,
your gifts, your flaming spirit!
And were you to be given youth to have and keep
Then use it – use all your energy and powers"

Dear Shirin Ebadi,

You are young in spirit. You possess great gifts. You have a warm heart. You are brave. We admire your efforts. The world needs you!

Congratulations with the 2003 Nobel Peace Prize! The Norwegian Nobel Committee is convinced that the Peace Prize has been awarded to the right person, at the right time and in the right place. When the director of the Nobel Institute telephoned Shirin Ebadi's home in Teheran to tell her the good news, her husband answered that his wife was in Paris and would not be easy to get hold of – she had forgotten her mobile telephone at home. Nevertheless, the news that you had been awarded the Nobel Peace Prize reached you very quickly in Paris, and the entire conference broke out in enthusiastic jubilation. Later, we learned that you were not even aware that you had been nominated for the Nobel Peace Prize.

But then, reactions started pouring in. Not everyone knew your name, but the world understood immediately what the Committee meant: All people are entitled to fundamental rights, and at a time when Islam is being demonized in many quarters of the western world, it was the Norwegian Nobel Committee's wish to underline how important and how valuable it is to foster dialogue between peoples and between civilizations. This is a wish that most people share and that is why the reactions to this year's award have been so positive, even though we understand if you had perhaps hoped for a few more congratulations from the authorities of your own home country and region. And now, of course, you have suddenly become quite a world celebrity!

Today you are here, Shirin Ebadi, in Oslo City Hall to receive the Nobel Peace Prize for 2003. And we rejoice together with you, your closest family and friends, many of whom are present here today.

It is indeed a great pleasure for the Norwegian Nobel Committee to award – for the first time in history – the Nobel Peace Prize to a woman from the Muslim world - a woman that the world can be proud of, as can all other champions of human rights around the world.

It is our sincere hope that the people of Iran will feel joy that a citizen of their country – for the first time in history – receives the Nobel Peace Prize. And we hope that the prize will serve as inspiration for all those who are campaigning for human rights and democracy in your country, in the Muslim world and in all countries in the East and West – everywhere where human rights work needs inspiration and support.

Shirin Ebadi has been awarded the Nobel Peace Prize for her efforts for democracy and human rights and, in particular, for her fight for the rights of women and children. She has been very clear in her opposition to patriarchal cultures that deny equal rights to women, who represent half of the population. But mothers must also be aware of their responsibilities. They are the ones who bring up young boys to be men and who raise daughters to become strong women. Shirin Ebadi is the founder and leader of the Association for Support of Children's Rights in Iran, which has some 5000 members. The centre is located in Teheran and it produces information material for use in schools and operates an emergency hot line for children. The Nobel Committee hopes that the Nobel Peace Prize award to Shirin Ebadi will contribute to an increased focus on the rights of children the world over.

In an interview Shirin Ebadi was asked: "Do you have a message to send to Muslim women?" "Yes", she answered, "Keep on fighting". "Don't believe that you are meant to occupy a lower position in society. Get yourself an education! Do your best and compete in all areas of life. God created us all as equals. By fighting for equal status, we are doing what God wants us to do", argues Shirin Ebadi. In this respect, it is worth noting that some 60 percent of the students at the University of Teheran are, in fact, women. At the same time, we must not forget women's legitimate claim for equality before the law. In law and order, we must all be equal, and women must enjoy exactly the same rights as men. On this issue, Shirin Ebadi stands in the front ranks and we can but admire her for her efforts.

Many are those who have drawn benefit from Shirin Ebadi's commitment and capacity for work. She has pleaded the cause of refugees in a region where they are in such great numbers and so desperately need help. Furthermore, she has called attention to the rights of all citizens – also their right to freedom of expression - irrespective of religion, ethnic origin or political opinion.

As a lawyer, judge, lecturer, author and activist, her voice has sounded clearly and powerfully in her native country Iran, and also far beyond its national borders. She has come forward with professional force and unflagging courage, and she has defied any danger to her own safety. She is truly a woman of the people!

The campaign for fundamental human rights is her most important arena and no society can be called civilized if the rights of women and children fail to be respected. At a time of violence, she has staunchly upheld the principle of non-violence. For her, it is fundamental that the supreme political power of a society is founded on democratic elections. She emphasizes that information and dialogue constitute the best avenue toward a change of attitudes and a settling of conflicts. After years of reflection, she has come to the conclusion that revolution never leads to the changes promised by the revolutionaries. The road forward must move in the direction of non-violence and dialogue, law and order.

Again and again, this year's Laureate has stressed that she is an Iranian. "I am proud to be an Iranian. I shall live in Iran for as long as I possibly can," she says. For Shirin Ebadi, this has meant a life in fear, but she has learned to live with her fear and she is optimistic about the future. People insist on ruling themselves. The time when ruling powers could threaten their way to dominion is gone forever. Rulers "will realize that the time for governing through fear is drawing to a close the world over. Why should Iran be an exception?" she says.

The 110 persons and organizations that have been awarded the Nobel Peace Prize over the years are extremely diverse. But the majority of them have one thing in common – they are optimists, unshakable optimists. It is their optimism that gives them the inspiration they need in their struggles. Furthermore, many of the laureates are filled with a courage that we can scarcely understand. Even under the most challenging of circumstances, they keep going – day after day, year after year.

Shirin Ebadi has run great risks. As a lawyer, she brings cases to court that few others would venture to get involved in. Her ideas are spreading in ever-widening circles, and, to quote the Norwegian poet Paasche Aasen: You must be true to your own youth, "so that the field you plough can grow when your work is done."

There are several long lines running through the 102 years of Nobel Peace Prize history. In the last few decades, the most distinct of these has perhaps been the increasing emphasis that the Norwegian Nobel Committee has placed on democracy and human rights. Who was the first to receive the Peace Prize according to this tradition is open for debate. Was it the prize awarded to Woodrow Wilson in 1919 or to Carl von Ossietzky in 1935, or even the 1951 prize to the French union leader, Léon Jouhaux? Although human rights represent one dimension of all these three awards, there were also other dimensions involved. Hence, the first indisputable human rights prize was perhaps, after all, the one awarded to Albert Lutuli of South Africa in 1960.

In the more than four decades since, many such prizes have followed. Some names shine brighter than others: Martin Luther King (1964), Andrei Sakharov (1975), Amnesty International (1977), Lech Walesa (1983), Desmond Tutu (1984), Aung San Suu Kyi (1991) – and she is especially in our thoughts today – Rigoberta Menchú (1992) and Nelson Mandela (1993) and then this year, Shirin Ebadi. It is against this backdrop that we can more easily understand what this year's Laureate has achieved and what the consequences of such a prize can be, when it works at its best.

The idea of human rights and democracy is gaining ground - albeit slowly. Practising human rights is always a challenge; high demands will always be placed on those who wish to live up to their ideals. It is with great satisfaction that we see that the idea of people's right to govern themselves through free elections is gradually prevailing in many parts of the world. By comparison to only 10-15 years ago, all of eastern Europe, Russia and several other countries of the former Soviet Union, many states in eastern Asia and not least in Latin America, as well as a few in Africa have now adopted democratic forms of government. Perhaps the Norwegian Nobel Committee is able to stimulate a development that still has mainly local roots and explanations. Every nation must fight its own battle. But we who stand on the outside looking in can express our sympathy and make our contribution.

Shirin Ebadi is a conscious Muslim. She sees no conflict between Islam and fundamental human rights. Islam is a diverse religion. How the message of justice is to be realized in practice and how human integrity is to be preserved is an essential issue for Muslims of today. We shall listen to all positive, novel interpretations, all proposals of reform. Here too, women have an important role to play; no longer is it for elderly men to interpret the message, argue many Muslim women. "Those who kill in the name of Islam, they violate Islam", says Shirin Ebadi. We know that human rights are being violated not only in Muslim countries. It happens whether regimes our religious or secular, nationalistic or Marxist.

For Shirin Ebadi, therefore, it is not religion that is the deepest root cause of the problem. But, no matter what, state and religion should be separate, is her view, since the political arena should be open to so many diverse interests and views. Shirin Ebadi underlines that the dialogue between different cultures in the world must be founded on the values they have in common. There need be no fundamental conflict between Islam and Christianity. That is why she was pleased that the Pope was among the first to congratulate her on the Peace Prize.

It is possible that the Peace Prize may, in the short-term, have led to more hostilities than peace in the homeland of some Peace Prize laureates. But the Nobel Committee's acknowledgement of democracy and human rights rests on the belief that repression cannot persist in the long run. In the last few decades in particular, we have seen how large parts of the world have abruptly thrown off the yoke of dictatorship. Repression leads to conflict. Most people will simply not put up with the "peace of the graveyard", and one of the most certain findings of modern political science is precisely that democracies do not go to war against each other.

I appeal to all individuals, all peoples and to all nations of the world:

Let us work together for a better world.
Let build peace and prevent war.
Let us make the world a better place to live in for young and for old.
Let us focus on human integrity and human rights.
Let us fight against poverty and disease in the world.
Let justice, respect and cooperation prevail among peoples and nations of the world.
Let us TOGETHER realize the dream of world peace.

As the university man that I am, I challenge all universities the world over to be even more distinct in underscoring the world's need for peace, democracy and social and economic justice.

Dear Peace Prize Laureate Shirin Ebadi,

We admire your efforts for human rights in general and your struggle for the rights of women and children in particular.
We admire your work for peace without resorting to violence.
We admire your work for dialogue between religions of the world.

We hope that the Nobel Peace Prize may contribute to the realization of your dream.

Allow me finally to revert to the great poet Rumi who wanted to expose everything that prevents us from seeing the world as it is – and who also tells us that the vision or dream leads to clear-sightedness. In a poem, whose Norwegian title is "Draumen som må tolkast" - The dream that must be interpreted, Rumi says:

"and although we seem to sleep, there is an inner vigilant voice that steers the dream, that will finally awake us to the truth about who we are."

The great Norwegian poet Olav H. Hauge also had a dream. He has written the beautiful poem "It's the Dream", that I would like to conclude with:

"It's the dream we carry in secret
that something miraculous will happen
that must happen
that time will open
that the heart will open
that doors will open
that mountains will open
that springs will gush –
that the dream will open
that one morning we will glide into
some harbour we didn't know was there."