Risk and Resilience: Understanding the Factors that Influence
Small Arms Violence Ginny Schneider,
This panel discussion was moderated by Dr. Robert Mtonga,
Zambia Health Workers for Social Responsibility and medical director. The panelists
were: Dr. Victor Sidel, professor, Albert Einstein College
of Medicine and co-author of The Global Gun Epidemic,
and co-editor of War and Public Health and Social Justice
and Public Health; Dr. Jennifer Hazen, senior researcher,
; Dr. David Meddings of the World
Health Organization; and Dr. Diego Zavala, Ponce School of
Medicine, Puerto Rico.
All spoke on aspects of the public health approach to SALW. A
public health approach to SALW does not equal a solution that
means more funding for healthcare, according to Dr. David
Meddings. A public health approach is a method of analysis. Dr.
Sidel pointed out that when the PoA was drawn up, there was
no mention of public health. He listed a variety of approaches
to ending firearms violence: legal and regulatory, correctional,
educational, economic, human rights, international treaties
and public health. Dr. Hazen announced that the Small Arms
Survey 2008 has three chapters on public health.
The public health approach is about trying to understand
violence in order to prevent violence.
The public health approach to violence prevention is:
1. Define the problem.
2. Identify risk and prevention factors.
3. Develop and test prevention strategies.
4. Implement strategies.
5. Monitor the effectiveness of strategies.
The Epidemiological Model looks at:
The victim: location and role.
The agent: types of firearms.
Environment: vulnerable.
Global Gun Epidemic Multi-layered Strategy
1. Availability of current and reliable data.
2. Consideration of entire gun supply chain, both legal
and illicit.
3. Reduction of culture of violence.
4. Post-conflict demobilization, disarmament and reintegration
(DDR).
5. International coordination and action.
6. Law.
7. Political participation.
Dr. Zavala spoke about surveillance systems and their role
in identifying risk and risk factors. He used an injury pyramid
to illustrate a way of looking at injuries, which is an excellent
way to visually demonstrate the magnitude of injury.
Dr. Zavala has conducted a multinational injury surveillance
system pilot project. WHO has found many countries lack
injury surveillance data. A surveillance system can indicate
the magnitude of the problem, determine hot spots, facilitate
planning and be shared with policy makers. Mr. Zavala's
project was conducted in Africa: DRC, Kenya, Algeria, Zambia
and Uganda. They chose to conduct the study at the
main hospital in each country over a six month period. They
found six months was not long enough for those collecting
data to set up a consistent and reliable data collection system. The
results showed generally most interpersonal violence occurred
to males between 20-39 at home by blunt force to the head.
It was difficult to determine the relationship between the victim and
any perpetrator that may have been present.
Most officials don't understand the magnitude of the problem. The
public health approach can show this and the associated financial
implications, which is generally of interest to them. Dr.
Meddings called for collaboration of all kinds to prevent
armed violence. Violence is socially determined. Thus,
prevention requires acting on social determinants. The
public health approach provides a common understanding of
an issue.
WHO just published Violence Prevention and What Development
Assistance Agencies Can Do to Help. It lists 10 “Best
Buys” in violence prevention. The top two are: safe,
stable, nurturing relationships between children and parents;
and reduced use and misuse of alcohol.
Challenges to collaboration are:
1. Balancing the desirability for greater coordination
with the reality of different perspectives, mandates and orientations re
addressing the problem of armed violence.
2. Mobilising resoures. There is competition.
We need to frame our proposals in a way the donor likes or
the way our instituions mandate unless multi-partner collaborations
can be formed.
3. Developing more effective learning models. Knowledge
tends to stay fixed. There is a need for knowledge to
shift across all levels from global policy makers to the grassroots.
,
a founding member of IANSA and the coordinator of IANSA's
Public Health Network, gave out a packed of information
which included a CD on A Global Health Campaign to Prevent
Injury and Suffering from Firearm Violence.
