Since the Year of the Disabled (1981) and the Decade for Disabled Persons (1983-1992), many questions have arisen about how to understand and deal with disability in a multicultural world. To what extent can programmes developed in one place be successfully implemented elsewhere? What kinds of cultural and social differences matter and how can they be taken into account?
Much of the health infrastructure we now take for granted is the result of determined efforts made in the 1960s and 1970s. The objective was relatively clear: to help build up strong national health systems. But to do that an uncommon amount of energy and imagination was needed.
The cultural and psychological dimensions of organ transplantation are often overlooked in the process of meeting its exacting technical requirements. This new branch of medicine has brought with it new ways of understanding death, human rights, commerce, gift giving, and ethics. It produces strong emotions in recipients, donors and transplanters alike. These factors need to be taken fully into consideration if organ transplantation is to evolve in ways that are felt to be beneficial for all concerned.
The introduction of forms called critical care pathways into the paediatric unit of a hospital in Malawi has strengthened teamwork and helped to increase the efficiency with which resources are employed. They serve the dual function of indicating good management and providing an opportunity to note actions and potential progress.
The evaluation of ambulance services in a rural area of South Africa is described. The approach is affordable and could be applied in other countries. As well as providing valuable information it involves health workers in planning, motivates them to improve service delivery, and lends support to their requests for increased resources.
An outline is presented of action taken during the last half-century to combat the hazards associated with the proliferation of chemicals in the environment. Particular reference is made to the work of the International Programme on Chemical Safety, established in 1980 by WHO, the International Labour Organisation and the United Nations Environment Programme.
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