Denise Milani Car Wash

(76) THE ROLE OF EPIDEMIOLOGY IN BUSINESS ENTREPRENEURSHIP / Alejandro Vargas Gutiérrez

remember well the evening when a group of PAHO experts in Colombia, debating an issue related to the diseases prevalent in childhood, the I attended as a guest, he had been to coordinate a project for the care of children in situation of displacement in Antioquia Urabá and was expected to furnish my ideas with some clarity about the harsh reality of displacement and its negative impact on child health. During the lengthy debate, pediatricians, public health specialists and epidemiologists presented their views on the most complex issues and priorities in child health in the country. Without doubt, the most clearly documented by Dr. Roberto Capote, a Cuban-blooded with clarity and strength of argument, based on years of experience and study have convinced the other attendees of the points that should be prioritized for the Ministry Health from the perspective of the OPS at the time.

few years later, in the city of Montevideo (Uruguay), I went back to A similar debate, but this time related to the priorities of the Center for Perinatology (CLAP / PAHO / WHO) should be defined on resources in research. The overall theme was maternal and perinatal health in the Americas and was on this occasion that the Brazilian Fernando Barros, a pediatrician and epidemiologist with a doctoral level, occupied the time of Dr. Capote. Surely, touch and excellent scientific arguments wielded the north that was owed to award research funding for this important center.

Both Capote and Barros, knew well the secret of good planning in health: the epidemiological priorities. When I interviewed with them and with other experts from Cuba, Brazil, Uruguay and Argentina where I explained the complexity of health problems worldwide, the limitation of resources by governments and private entities and the need to prioritize the most serious, otherwise, the impact of interventions would be minimal. Indeed, the common denominator appeared in these nice discussions Hannon criteria of OPS (frequency, severity and vulnerability of the phenomenon).

Years later, during my career as an epidemiologist routine I have used examples to explain to a mayor, a Secretary of Health, hospital managers and even a Governor in Colombia, only priority public health issues will reach a good epidemiological impact their ideas to invest financial and human resources in the prevention of congenital malformations or campaigns to reduce suicide in adults, or conferences on teen pregnancy is less cost-effective to invest in preventing traffic accidents, acute myocardial infarction, cancer of the cervix or child malnutrition, events that are clearly more frequent, more serious and more involved from a Ministry of Health or from a local hospital.

In all municipalities have known the role of epidemiology in public health is a fundamental tool to select problems and areas of high risk to engage in a period of time. We know that a good surveillance system should be timely, faithful to the truth and preferably georeferenced. However, in our American cities are just a few years ago epidemiological information processing quality, timeliness and maps to evaluate interventions. Gradually, the municipalities already recognize their profiles of morbidity and mortality rates of prevalence compared with similar towns and include time maps actual alert to outbreaks and epidemics way situation room. Examples of these developments can be put in the municipality of Envigado Colombia, which has more than five years with a strong track record epidemiological updated risk maps and targeting of human and financial resources in areas of high prevalence and severity.

However, in my years working with rural communities, have confirmed what authors from many disciplines have told us years ago: almost always poverty, low educational levels and lack of job opportunities are related directly with the high rate of morbidity and mortality. Therefore, in my current practices as an epidemiologist, I am involving variables related to poverty and social development model of epidemiological surveillance. That is, use the social epidemiology as a tool to locate the areas most in need of educational programs, plans for coexistence, entrepreneurship and environmental protection. Not enough to identify for example, areas of higher prevalence of cervical cancer and lead a campaign takes uterine cervical cytology with timely delivery of results and access of patients to colposcopy-biopsy. It is necessary that after identifying these areas of high prevalence of cancer in women, a team of The Mayor and the private sector to move forward with the area and these women (positive cytology or not), a massive training in leadership, cooperative, on entrepreneurship and development of productive projects. Surely in this same area, it is necessary to increase the level of education of girls and reducing the percentage of repetition.

In the municipality of Girardot, Colombia, we know very well where more cases of perinatal and infant mortality and we know the paths to more cases of severe obstetric morbidity. They are also (no coincidence), the most prevalent areas of Pregnancy in adolescents, higher levels of poverty, more geographical distance to urban areas and regions of the municipality with more accumulated social debt. Therefore, the safe motherhood project to advance with the Mayor and the Local Hospital (San Rafael Hospital ESS) includes a series of lectures to pregnant women to improve their self-esteem, community empowerment, leadership, educational level and knowledge in entrepreneurship. Only then, the eternal circle of poverty, disease and death will be closed and epidemiology will advance to a new stage: the stage of targeting risk areas multidisciplinary interventions from public and private sector to ensure a true epidemiological impact.

Add variables to a municipal epidemiological surveillance system that contains items related to the coverage and level of education, quality of housing, water, air, public services, the access roads health centers and other related jobs and entrepreneurship, can create doubts and technical difficulties at first. However, a good epidemiologist, ie, an epidemiologist and public health professionals who hope the people of the XXI century must be able to integrate complex information from the health system and other external systems (education, environment, way, entrepreneurship, etc) in order to guide community interventions that are more comprehensive and cost-effective. Otherwise, we will only address issues of morbidity and mortality health professionals alone will not ensure welfare and quality of life and only serve as a "painkiller" transient structural problems affecting the health-disease process.

Let intent, we begin to gather more information analyze the best interventions and develop entrepreneurship business of our municipalities in those areas where the disease is more severe and frequent . Surely the most striking results are developing sustainable social, quality of life and of course, on public health.

Y EQUALITY IN PERU Discriminación LTGB

Tuesday, May 3, 2011

Denise Milani Car Wash

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