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Introduction: The ultimate aim in the field of environment management and health is to provide for sustainable human development through the rational utilization of global natural resources while being fully conscious of the interaction between the human health and the environmental stressors. The unwise usage of natural resources puts additional stress on the environment and negatively impacts the human health conditions. In the Caspian region the human health in coastal communities is directly impacted by the industrial pollution and by the urban and agricultural waste. It is also indirectly impacted by such stressors as over-fishing and desertification through their impact of food chain and water resources. On the other hand the lower than desired quality of life including human health conditions in the coastal areas does not provide for appropriate conditions for the wise usage of environmental resources and might indeed lead to enhanced stress on the resources. A better understanding of the state of human health in the region and its interaction with the environment is therefore essential for an assessment of the situation with a view to undertake preventive and curative measures. The Steering Committee meeting of Caspian Environment Program (CEP) held in May 1998 in Ramsar, Islamic Republic of Iran, identified 10 major themes as the basis for establishing 10 thematic centres in the 5 littoral countries of Caspian region. Noting the importance of interaction between the human health and the environment the CEP included human health as a major theme and sought to establish a regional centre to deal with this important issue. The Caspian Regional Thematic Centre for Sustainable Human Development started its activity on 20 August, 2000 in Ashghabat with the support of the Ministry of Environment Protection and the Ministry of Health & Medical Industry of Turkmenistan. The Centre is technically supported by the World Health Organization (WHO). A work plan has been developed for the Centre in consultation with the WHO. This plan includes water monitoring activities ; development of a Caspian Demographic Profile and a Caspian Health Profile and conduct of a number of targeted health studies. Water Monitoring: Two potential transboundary problems related to sustainability and health conditions in the coastal communities have been determined in consultation with WHO namely Recreational Waters and Underground Waters supply. With the aim of addressing these problems two training courses have been conducted and three monitoring initiative shave been initiated. The training events dealt with:
The training course on monitoring ground waters quality was held on 23 - 27 April, 2001 in Ashgabat, Turkmenistan. The training course on monitoring recreational waters and beaches was held on 30 April - 4 May, 2001 in Turkmenbashi, Turkmenistan.16 specialists, representatives from five littoral countries, have been trained at these training courses for their further activity in pilot projects. Training was conducted by WHO international consultants. The outcome of these training courses laid the grounds for the three pilot water monitoring projects in Turkmenistan, Azerbaijan and Iran which are now underway with the who technical support and the full involvement of national experts. Monitoring equipment has been supplied by the CEP. Demographic and Health Profiles: The work on the Caspian Demographic Profile is being carried out at the country and the Caspian hinterland levels. The hinterland is being defined as the administrative units adjacent to the Caspian. The data include a wide range of information from community welfare to education level of individuals. The UNDP Global and National Human Development Reports of the littoral countries, World Bank Reports and other materials have been considered when preparing the first draft of Demographic Profile. The work on the final draft of Demographic Profile is continued. Assessing and determining the risk factors of environment and human health interaction is one more priority focus for CRTC activity. The Centre is compiling a Health Profile that is aiming to determine the priority issues and area for decreasing risk factors and improving human health at regional, national and administrative levels. A Health Profile Questionnaire has been developed as the preliminary step to the above activity and shows the variety of gender and cause relations of morbidity and environment for certain periods of time. Targeted studies: These studies in Caspian region are in the planning stage with the aim of identifying cause-impact relations of environment and human health. This activity is proposed by the Centre for the immediate future in close collaboration with CEP Programme Coordination Unit with WHO technical support. Scheduled Activity for the Period of 2001-2002:
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