Riportiamo, di seguito la “Dichiarazione di Lodi” adottata durante il Congresso internazionale di Lodi (ICRH e Ragusa SHWA) del settembre scorso.
The NEW Lodi Declaration on Rural Health
Adopted by
the International Congress on Rural Health (ICRH)
and
the 4th International Conference Safety Health Welfare in Agriculture Agro-Food and Forestry Systems (Ragusa SHWA)
Whereas more than 50% of the world’s population live in rural
areas, with limited or no access to primary health care, basic
occupational health care, clean water and sanitation,
Whereas unsustainable and unhealthy agricultural practices have
influence on the rural population, with potential severe influence on
the environment, wildlife, and urban population, through
contaminated soil, water and food,
Whereas structural system-related determinants accompanied by
unsafe work behaviours causes occupational and work-related
diseases and injuries, disabilities, premature deaths, loss of income,
as well as human suffering and poverty in rural areas,
Whereas children and women working in agriculture are especially
vulnerable to occupational and environmental risks, in addition to
consequences arising from the unavailability of basic health service
and inadequate housing, in particular from household fuel
combustion,
Whereas international, national and local actions, although
significant and honourable, have not been able to respond
successfully to all the challenges put before them,
Underlining that the achievement of the highest possible level of
health for all people is impossible without improving the health of
the rural population, and this is impossible without the involvement
of the public sector as a whole,
Taking into consideration the Declaration of the International
Conference on Primary Health Care, Alma-Ata, USSR, 1978, the
Global Strategy on Occupational Health for All adopted by the
World Health Assembly with Resolution 49.12 from 1996 and the
Global Strategy on Occupational Safety and Health adopted by the
International Labour Conference in 2003, the Safety and Health in
Agriculture Convention, 2001 (No. 184) of the International Labour
Organisation.
Recalling the outcomes of previous international deliberations on
occupational health in agriculture and rural health, such as the
Declaration of the First International Congress on Rural Health in
the Mediterranean and Balkan Countries (Bari, Italy, 2002), the
Agenda on Rural Health (Loni, India, 2002), the Declaration on
Occupational and Environmental Rural Health (Belgrade, Serbia,
2004), the Lodi Declaration on Healthy Villages (Lodi, Italy, 2006),
the Cartagena Declaration on Rural Health in Latin America
(Cartagena de Indias, Colombia, 2009), and the Goa Declaration for
Health in the Global Village (Panaji, Goa, India, 2012),
Recalling the continuing appeal of spiritual and secular leaders and
of scholars and scientists worldwide to a responsible stewardship of
the Planet, to a shared and sustainable access to its natural and
limited resources, to their preservation for future generations,
We, the 250 participants from 52 countries from all continents who
took part in the International Congress on Rural Health and 4th
Ragusa SHWA, held here in Lodi, Italy, from September 8th to
September 11th, 2015, discussed the challenges to providing
adequate occupational and environmental health, food safety, public
health and medical services in rural areas, and
WE DECLARE THAT:
1. We will commit ourselves to help solving occupational,
environmental and public health problems and inadequacies in
access to health care in rural areas, in the frame of the WHO global
strategy on people centred and integrated health service;
2. We will advocate for the elimination of child labour in rural and
remote areas, recognition of informal and migrant agricultural
workers, and abolishment of modern slavery;
3. We call for national and international organizations, as well as
individuals to work on the improvement of the scope and coverage
of primary health care to address better the needs of rural
communities inclusive needs related to health and safety at work
such as agrochemical use, heavy physical work, accidents, heat
stress, dehydration and kidney injuries, cancer due to solar
radiation, biological risk factors and zoonoses;
4. We will work towards providing higher access of workers to
occupational health care with the creation of basic occupational
health services in rural areas wherever necessary,
5. We recognize the need for addressing occupational, environmental
and public health risks in rural areas by working together with all of
the stakeholders, governments, public sector a while, and industry,
as well as the ministries of health, environment, labour, agriculture
and other state agencies, private enterprises and workers’
organizations;
6. We underline the significance of local, regional, national and
international initiatives to protect and promote the health of the rural
population;
7. We encourage the following organizations: The European Rural and
Isolated Practitioners Association (EURIPA), The International
Association on Rural Medicine and Health (IARM), the
International Commission on Occupational Health (ICOH), the
WONCA Working Party on Rural Practice, as well as the
organizations of farmers, agricultural workers, agricultural industry,
and the relevant non-governmental organizations and networks, to
take action to support and promote the development of Rural Health
programmes;
8. We will dedicate a significant part of our scientific and professional
efforts to create useful, accessible, simple and low-cost tools for
occupational, indoor and environmental risk assessment,
communication and management;
9. We call upon the governmental agencies and local authorities to
ensure equal and proper access of people in villages, to information
on public and occupational health and the environment, stimulate
social and environmental justice, as well as to provide means for
empowerment of rural populations to protect and promote their
health, and to improve their working and living conditions. Access
to health care should be treated as a basic human right. Use of ehealth
and telemedicine should be promoted in rural area;
10. We congratulate our colleagues which have been working on
opening reference centres at the local, national and international
level for providing expertise and support to the rural population;
11. We call for the creation of interdisciplinary teams of experts from
the field of human and veterinary medicine, public, occupational,
and environmental health, health promotion, food safety, chemical
safety, agricultural, social and human sciences, and agricultural
engineering which will address the needs of the rural population;
12. We recommend introducing Occupational Health and Safety
concerns in training and educational programmes in all of the abovementioned
disciplines at any level, from health care providers to
rural workers and population, in order to build the necessary human
resources and to provide services of great quality to the rural
population and agricultural workers. Specific country needs and
participatory approach should be addressed;
13. We urge the agricultural sector to realize its responsibility for
healthy working and housing conditions by expanding suitable
measures for workers and farms and by providing financial means
for scientific and educational developments to support such
measures;
14. We are committed to share our practice and experience in devising,
implementing and evaluating educational programs for the
improvement of the health of the rural population;
15. We are committed, as citizens, to advocate peace and justice, and
the pursuit of the common good as the founding of scientific and
professional achievement in our own field of expertise;
We hereby authorize the Congress Presidents, the EURIPA, IARM,
ICOH and WONCA Working Party on Rural Practice
representatives to sign this declaration on our behalf.
Submitted to the Assembly by Stefan Mandic-Rajcevic (Italy and
Serbia)
Signed in Lodi, September 11th 2015
Claudio Colosio, ICRH President
Giampaolo Schillaci, Ragusa SHWA President
Tanja Pekez Pavlisko, President, EURIPA; Vice Chair WONCA Working Party on Rural Practice,
Hans Joaquin Hannich, President, IARM and Shuzo Shintani, Secretary General, IARM
Jukka Takala, President, ICOH and Gert van der Laan, Chair, the ICOH Scientific Committee on Rural Health, ICOH
