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Health

The link between health and the environment has been widely recognized, if not fully acted upon, in recent years (Figure 5). Unclean water and untreated sewage are responsible for the spread of water-borne diseases such as cholera and intestinal parasites (Box 7). Limited access to water may be responsible for the spread of germs. Pollutants in the environment (including air pollutants from transport and industry, chemical toxins and heavy metals from industrial processes, and dioxins from waste incineration) pose a constant threat to the human body. Climate change is expected to increase the burden of disease considerably by allowing vectors to breed in latitudes or altitudes where current temperatures prevent them.

Figure 5: Deaths attributable to environmental causes, 2000

Source: WHO 2002


Box 7: Sanitation

Women have a vested interest in promoting sanitation systems, to ensure better hygiene for their families and hence a reduced disease burden. This interest was reflected in a study in Indonesia and Cambodia, which showed that the process for acquiring family latrines was mostly initiated by women. Women's interest was higher despite evidence that the extra work involved in keeping toilets clean and ready for use fell to women alone (Mukherjee 2001).

Men and women are exposed differently to environmental risks, and their bodies may respond differently even to the same threats. For instance, the incidence of respiratory illnesses is considerably higher among women and young children, who are constantly exposed to indoor air pollution, than among men (Figure 6)

Figure 6: Average daily exposure to indoor pollutants from biofuel consumption in rural India (mg/m3)

Source: PRB 2001

Poor nutritional levels can make people particularly vulnerable to infectious diseases, and age and gender may exacerbate this risk. Malaria, for example, is more likely to cause serious problems or death in young children or pregnant women. During pregnancy, it can cause severe anaemia, and it can also harm the foetus, increasing the chances of abortion, premature birth, stillbirth, intrauterine growth retardation and low infant birth weight. Malnutrition, persistent bouts of diarrhoea from unclean water and intestinal worms in the mother can also retard the growth of the foetus by causing anaemia. Estimates attribute 20 per cent of maternal deaths in Africa and 23 per cent in Asia to anaemia during pregnancy (Murray and Lopez 1996).

Scientists now regard certain chemicals such as PCBs, dioxins, DDT and at least 80 other pesticides as 'endocrine disrupters', which may interfere with normal hormone function, undermining disease resistance and reproduction. Some of them may cause declining sperm counts among men, infertility among women, miscarriages, and early puberty in girls (UNFPA 2003b). People of both sexes need to be better informed of these threats, so that they may exert pressure on governments to find safer alternatives, support pre-market testing of chemicals and integrate the precautionary approach into chemicals management policies (Patton 2004).

One of the newest threats to health and social welfare is the spread of HIV/AIDS. Both sexes are affected, but to different extents in different parts of the world (Table 1). Globally, men account for 52 per cent of infected adults. Lack of information among women on how the disease is transmitted confounds the problem in many regions (Figure 7). In sub-Saharan Africa, 55 per cent of those infected are women (World Bank 2003). In this region, women grow most of the food, and women's agricultural labour often shows the first signs of wider community disruption by HIV/AIDS. For example, in Malawi, Mozambique, Zambia and Zimbabwe where women are responsible for most food production, there has been a progressive shift from maize production to less labour-intensive, and less nutritious, cassava production to compensate for the labour lost through HIV/AIDS (De Waal and Whiteside 2003).

Figure 7: Knowledge difference between men and women about preventing HIV

Source: World Bank 2004

A study in South Africa showed that in almost half the households surveyed the primary caregiver for an HIV/AIDS patient has taken time off from formal or informal employment, or from schooling. The primary caregiver is most frequently female. Women and girls may lose as much as 60 per cent of their time from other housework or cultivation tasks, affecting the ability of poor households to grow food for consumption or sale (Heyzer 2004).


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