Health » Overview

Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series of seminars to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.


Interviews and coverage from our Health programs

David Anthony – “Play should not be a luxury for children but an integral part of their development and growth”
David Anthony – “Play should not be a luxury for children but an integral part of their development and growth”
Andrea Abellan 
With half of the world population living in cities, there is an urgent need to reflect on the impact of urban growth and the consequences it might have, namely, a lack of basic services, inequality and widening gaps between the poor and the rich. David Anthony, Chief of Sustainability and Policy Action at UNICEF, wants to view these challenges as opportunities to create better-planned cities which have children at the core of their systems. During The Child in the City: Health, Parks and Play, Anthony sat down with Salzburg Global's Andrea Abellan to discuss his views.

 AA: One of the values contemplated in the Convention on the Rights of the Child (CRC), a legal framework for UNICEF’s work, recognizes the right of children “to rest and leisure, to engage in play and recreational activities appropriate to the age of the child and to participate freely in cultural life and the arts.” How does UNICEF work toward the protection of this right?DA: UNICEF has understood how children’s demands have evolved over the years. When we started to work we were focused on offering legal support to children and protecting them against sexual abuses and physical exploitation. However, children’s rights to express themselves, associate, have leisure, and participate in cultural interactions have always been part of the convention. 

In UNICEF we acknowledge that play should not be a luxury for children but an integral part of their development and growth. We are very conscious of the need to promote this right, and we work to create safe and clean environments for children to learn, grow and play that are absolutely vital. We run projects such as the Child Friendly Cities Initiative (CFC) that seeks to provide guidelines and support to transform cities into spaces able to match children’s needs.

 AA. How does UNICEF integrate both developed and developing countries in its campaigns?

 DA: We run programs in 140 countries at all income levels, and we partner with different social agents, from local NGOs to private companies or academic people. I would say that one of the biggest challenges is to plan initiatives that are cost-effective, that allow us to do as best as we can at reasonable costs. We look for projects that can be maintained over time because same solutions might not be practical in different countries. For instance, it is fundamental to have green spaces in urban settlements, but it is equally relevant to consider how these spaces are going to be preserved otherwise they will disappear very quickly. It is not the same to build a park in a tropical environment with highly irregular levels of rainfall than in a Northern Hemisphere climate space. 

We also pay attention to the notion of inequality within the metropolises. Parks are usually located in the centers of the cities. That means that most vulnerable communities, which tend to live in cities’ outskirts, do not have easy access to them. We should put fragile communities on the top of our priorities, so we can effectively look for the best strategies to successfully integrate them. 

 AA: During this session, The Child in the City: Health, Parks and Play, the topic of climate change and how it specifically influences children has arisen several times. What is your perspective on this subject?

 DA: There are approximately 2.2 billion children in the word; two billion of them are affected by the impact of climate change. We are talking about a whole generation of children that grow up suffering the consequences of climate change such as floods and droughts. There are other related issues to consider as well, meaning water scarcity and respiratory infections caused by air pollution. If we continue building unplanned cities and polluting the planet at this rate, we will have more children at risk than ever before.   

At the same, cities themselves have always come up with solutions. Electricity, water supply systems, trade, and community participation are just some of the resources that were developed within the cities. There are many cities starting to be built from scratch in Africa and Asia; I see strong opportunities to influence how they are designed and start making them child-friendly from the beginning. 

 AA: The hardships of prioritizing green areas among other basic needs such as food security or health-related issues have also been discussed during this session. What do you think about it? 

DA: Because health, nutrition and education are such important topics it does not mean that we always have to prioritize them over other subjects. One of the factors fostering problems such as crime or radicalization is the inability to find activities for young people. One of the most cost effective solutions would be to promote leisure amongst young people so they can learn how to use their time wisely.

It is not a matter of health versus leisure; it’s more a question of how to be able to work on every aspect of a healthy development. In my opinion, we should invest in making people more conscious of the benefits of play. In this way, they will create leisure spaces themselves or demand them to the authorities. And when the request exists, the supply aspect tends to be more flexible.
David Anthony was a participant in the Salzburg Global program The Child in the City: Health, Parks and Play, which is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN. The session was supported by the Huffington Foundation, Parks Canada and Korea National Park and the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574
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Alessandro Fodella – Making invisible problems better known
Alessandro Fodella – Making invisible problems better known
Andrea Abellan and Yeji Park 
Alessandro Fodella has always been passionate about nature. The lawyer, who focuses on environmental issues and human rights, says, “When I decided to study it was clear to me that I wanted to do something that would help the common good.” Fodella, who also works as a professor of International Law at Università di Trento in Italy, uses images to raise awareness and attract audiences’ attention to complex topics. One such topic, which Fodella has looked at, is the situation of Cambodian migrants living in Thailand illegally. Fodella spoke about this topic with Salzburg Global while attending The Next Frontier: Transboundary Cooperation for Biodiversity and Peace. During this session, Fodella shared some of the stories behind his powerful images. He says, “With my photos I am [able] to go straight to people’s heart. I don’t aim to appeal (to) their intellect; I just want to make them realize what is happening around the corner.” Fodella’s pictures, which do not show peoples’ faces in a bid to preserve anonymity, are not easy to digest.  Many of them show young women, making their living out of prostitution, who are frequently exploited and sexually abused. For many of these girls, this is the only path they can consider following for them and their families to continue living.

Illegal migration between Cambodia and Thailand is a widespread issue – and one not easy to tackle. The lack of decent employment opportunities in Cambodia, plus the challenges the country is still facing after the Khmer Rouge genocide of the 1970s, leads many Cambodians to cross the borders in search of a better future. Thailand is one of the chosen destinations for several reasons; the relative ease with which one can cross the border is one of them. However, once migrants manage to arrive in the country they are forced to survive under very tough and poor conditions. Moreover, despite being next to each other, the two countries have different cultures. This can make migrants feel isolated and unable to integrate into the new society.

While some women are forced into prostitution, a number of men are frequently employed in the fishing sector working in unsafe conditions. Fodella’s photos aim to portray these obstacles, and how hard it can be sometimes to live a “standard life.” The idea of carrying out this project came to him when he came across staff members working for an NGO during one of his travels.

“Thanks to them I could put faces to the problem I was observing. It was a very tough experience for me. I went back to my hotel room every night feeling upset and uncomfortable for being surrounded by these stories without doing nothing,” he explains.

Fodella was shocked by how normalized prostitution had become and how nobody seemed affected by it anymore. Fodella wanted to create awareness by making this problem visible so other people could be conscious about it as well. Fodella wanted to portray the other side of the issue. To do so, he went to Cambodia to describe how the situation was for immigrants who had decided to go back to their country of origin. There, he learnt many of the women decided to keep working in prostitution as it was the easiest way to feed their families who tended to fully depend on them to survive. He says, “It is extremely hard for them to reintegrate, they have to start again from scratch and they end up returning to prostitution.”

Fodella suggests illegal immigrants in Thailand are seen as “objects” and “ghosts” on the other side of the border.  He says, “Their illegal status does not allow them to ask for any sort of protection, they are left alone and unprotected.” Tackling this issue will need transboundary cooperation between both Thailand and Cambodia – no one country can solve this problem alone.
Alessandro Fodella was a participant in the Salzburg Global session The Next Frontier: Transboundary Cooperation for Biodiversity and Peace, which is part of the multi-year Parks for the Planet Forum. This session is being hosted in partnership with IUCN (International Union for Conservation of Nature), MAVA Foundation, Arcus Foundation, Aga Khan Foundation, German cooperation (Deutsche Zusammenarbeit), Huffington Foundation, Robert Bosch Stiftung, the Whitney and Elizabeth MacMillan Foundation, and others. More information on the session can be found here: http://www.salzburgglobal.org/?id=7583
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Fellows of The Child in the City - Health, Parks and Play to draft statement
Fellows of The Child in the City - Health, Parks and Play to draft statement
Oscar Tollast 
Participants of The Child in the City: Health, Parks, and Play will produce a shared vision concerning a child’s right to nature and promoting greater access to green spaces in urban environments.
Fellows have agreed for a smaller and representative drafting group to pen a statement which will include principles and recommendations on how to move forward. 
This working group will build on the ideas, models, and resources shared during the final plenary session. These recommendations can be shared at the 15th World Congress on Public Health, and other leading international forums.
During the session, participants considered how parks and protected areas could better meet the needs, and be accessible for, children. They also asked themselves how the benefits of these spaces can be maximized, and what difference it would make if children were part of the planning process in urban environments.
On the final day, Salzburg Global Vice President Clare Shine challenged participants to see how far they could take the work forward and to come up with something shareable on different platforms. She asked Fellows, “What will the new normal be?” Shine said there was an appetite now for showing courage and driving things which benefit all of us.
In response, participants broke off into smaller working groups for the final time. This action allowed participants to focus on areas such as potential frameworks, principles, and the overall vision. Fellows who concentrated on the structure said the input and activities related to the subject concerned families and parents, the education sector, the health sector, civil society, government, and the private sector.
Participants said these categories are potential partnerships rather than silos. For example, the planning process could include children, and private sector companies could donate one percent of profits toward improving and maintaining nature assets. This suggestion tied in with a view that more should be done to speak to policymakers so they can understand open spaces from a new perspective. One Fellow said, “We have to stop preaching to priests.”
To communicate this message, participants outlined a problem statement. As part of a draft, one Fellow said too many children in an urbanizing world lack what they need to thrive, and there is no time to waste. 
Other participants focused on potential principles to include a statement. They concluded every child should have easy access to, and be able to enjoy safe nature-rich experiences and places.  Nature should also be embedded in everyday places where children already are. Participants agreed there are clear health and well-being benefits, while nature also helps communities connect and thrive. It strengthens families and provides critical ecosystem services. 
Partnerships can work together to enhance and protect nature, but child-serving institutions also have a role in building wonder about nature. A child’s voice is essential, and we can learn from them as much as anyone else. New technology can be a bridge instead of a barrier, and natural areas could become better connected and form networks.
One working group worked on ideas to include in a vision statement. This group discussed how children need love, shelter, and play opportunities in an urban environment. Children should be able to embrace public life outside every day and have a nature-rich city in all aspects of life. This concept can be enhanced with child-friendly transport, a connected network, safe and playful environments, human-scale design, and places to grow food. The group envisioned a city “that grows with the child.” 
Participants said cities should be desirable, places which embody nature and provide people with a sense of awe. Having a city which is based on human-scale design can be less intimidating, relatable and sensory accessible. 
After listening to this working group, one participant said the nexus of the discussions taking place at Schloss Leopoldskron had concerned the child, the city, and nature. This participant suggested by staying true to these three elements, the group’s final statement would have a better chance of cutting through the mix. 
Following these presentations, participants agreed to collaborate on a draft statement, which would be initially prepared by a smaller working group. Fellows will keep in touch and develop a statement outlining some of the key principles and talking points raised during the session. In addition to this, participants have also made a number of personal commitments linked to the principles discussed.

The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks

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Maria de Kruijf - “We will be able to improve our projects and have a better view of citizens’ demands”
Maria de Kruijf - “We will be able to improve our projects and have a better view of citizens’ demands”
Andrea Abellan 
During discussions at Salzburg Global’s The Child in the City: Health, Parks and Play, participants have debated issues around accessibility, equity, and the need to open up green spaces to everyone. Maria de Kruijf, a participant, and associate at the De Verre Bergen Foundation spoke with Andrea Abellan to discuss how she has previously sought to create stronger communities within a city, and how this may apply to work moving forward. Nearly half of the population in Rotterdam - the second largest city in the Netherlands - have an immigrant background. More than 170 nationalities live together in this metropolis located alongside Europe’s largest port. Concerns related to multiculturalism emerge frequently. De Kruijf, as an associate for De Verre Bergen Foundation, is one of many looking to address these concerns and create a stronger and more equal place to live. De Kruijf started her career as a highschool teacher, a job she decided to leave while looking to get involved in projects that “could have a positive impact not only on certain groups of people but on a whole city.” At De Verre Bergen Foundation, De Kruijf ’s efforts are focused on Rotterdam. De Kruijf says there is a lack of dialogue between the cultures represented in the city. De Kruijf explains, “People who have lived in the Netherlands for years might feel intimidated by recent immigrants. The financial crisis cost many jobs, and there are some groups blaming foreigners for this.” De Kruijf also has concerns surrounding the rising inequality between population groups in the city. De Verre Bergen Foundation, founded in 2011, seeks to overcome these challenges by supporting diverse social ventures. The organization follows a holistic approach designed to foster real integration. One of its latest projects has provided 200 Syrian families with accommodation, language courses, and bureaucratic support. De Kruij feels very positive regarding the outcomes achieved at this session. She says her interaction with other participants has made her reflect on the need to “invest time in talking with different social groups to learn what their demands are. In this way, we will be able to improve our projects and have a better view of citizens’ demands what hopefully will help them to feel greater represented by our programs, especially when it comes to a program about their own public spaces.”
The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks 
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Looking ahead and focusing on outcomes
Looking ahead and focusing on outcomes
Oscar Tollast 
There are multiple paths the conversations surrounding parks, protected areas, cities and children can be taken. Participants at Child in the City: Health, Parks, and Play have been asked to consider several questions to guide their thinking as they look to push forward a new change agenda. The aim is for this agenda to take a form, something tangible which can be shared. To get closer to this goal, participants have asked themselves what children need from green spaces and parks, and how to improve access to these areas. Participants have asked themselves why they want to connect children with nature in cities. It stems from concerns about children’s health to wanting to include the voice of a child in the decision-making process. Children can help create a culture where they can be and feel a part of nature, acting as “stewards.” To provide a stronger connection, participants believe we need to address children’s perception of safety and ensure there are cross-generational solutions. Existing infrastructure can be used to address issues with nature-based solutions. One working group suggested all children around the world are in a situation where their access to nature is at an impoverished level. Wilderness experiences could provide a good solution, but these aren’t practical for everyone. Instead, children could innovate the green spaces they do have access to. Disused pieces of land, such as power line corridors, could be turned into green spaces. Funds could be provided by the power line companies to transform them. Transportation is a barrier to getting people to a park, and into it. Access is a financial issue, as well as a geographical issue. One solution is to promote free travel to a national park on a select day each month. Children have a right to play in nature.Community engagement and co-creation can develop solutions. Basic experiences such as Open Streets or “grow anything” concepts could get people hooked. Cities could also be measured with regard to their nature score, benchmarking themselves against each other. Participants called for children to connect to a “meaningful” nature experience on a daily basis. Outside actors have to address the different needs, and abilities children have. Awareness must be raised among caregivers, and more should be done so children can have a nature-rich experience in a walkable distance. Low-cost transport to nature could exist through partnerships. There can be a greater shared use of existing spaces for the wider community as well. During this session, participants have shared many thoughtful ideas but the time has come to present them in a succinct, crisp, and memorable fashion. They will consider which audience they want to put their message across to and whether they need a preamble which reaches out to more than one stakeholder. One participant concluded a compelling and emotive case is required.
The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks 
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Dima Boulad - “It is necessary for our society to have open spaces where individuals can interact”
Dima Boulad - “It is necessary for our society to have open spaces where individuals can interact”
Andrea Abellan 
During the Salzburg Global Session, The Child in the City: Health, Parks and Play, participants have learned how valuable the role of open space can be in post-conflict countries. Dima Boulad, co-founder of the Beirut Green Project, is one of the reasons behind that. The Beirut Green Project is a social initiative, born with the aim to assemble the concerns of citizens seeking to develop a more liveable city. With 0.8m2 of green space per person, Beirut remains below the Wealth Health Organisation’s standards which recommend every citizen should have at least nine square meters of green space. Boulad says, “Some citizens do not recognize the access to public spaces as a right they can claim, and this is what we aim to change.” To counter this, the Beirut Green Project has run awareness campaigns and organized many social events. The consequences years of war have had on Lebanon remain visible. In some areas, the country lacks basic facilities such as electricity or access to water. Outages of these services remain frequent. Complicated circumstances such as those above make it harder to place the development of green spaces as a priority in the minds of politicians. The goal of non-profit organizations such as the Beirut Green Project is to make clear that in spite of the urgency of meeting basic needs, citizens should not have to waive other civil rights such as the opportunity to enjoy public spaces. Boulad highlights the significance public spaces have in post-conflict areas. Boulad says, “In Lebanon, we grow up in a culture of fear. It is necessary for our society to have open spaces where individuals can interact with others. Accessible public areas might help to change our habits, break the bubbles where we live and therefore, improve our relationships.” Boulad says the work of advocates such as herself is not easy in Lebanon. She says, “It is very hard to have the attention of the government and to manage to get things done. Taking part in a Seminar like this can facilitate our jobs as it allows to create alliances with other countries from which we can learn and get aid.”

The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks

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Incremental change to transformation
Incremental change to transformation
Oscar Tollast 
Ideas and words can change the world, but without the right execution, the majority of people will fail to benefit. With that in mind, participants at Salzburg Global’s session The Child in the City: Health, Parks and Play have received insight into how they can leap from incremental change to transformation.

To help them, participants have heard several case studies taking place in different areas around the world.

Reimagining the Civic Commons is a U.S. initiative supporting placed-based efforts to catalyze lasting change through the creative use of civic assets. It has involved engagement at all levels and has encouraged prototyping. Storytelling is important to its core. Participating cities such as Chicago and Detroit can learn from one another.

How Housing Matters is an online resource which depicts how quality and affordable housing can benefit everyone. It collected the research, refined the message and told the story. It built a bigger boat to bring more people on board.

In 1965, the idea of a Garden City was put forward in Singapore - not a concrete jungle but a place where people wanted to live. People now talk about the “city in the garden.” The first transformation involved reframing the issue. The second concerned housing. The third change involved connected parks. After being expelled from Malaysia in 1965, Singapore survived by transforming itself. To survive, participants heard you need the best resources and best investment.

There is a campaign in the U.K. to make London the first National Park City. The campaign draws on principles visible in national parks but ties them to an urban environment. The campaign has used maps, data, and voices from those in London. It has gained traction through local councilors and is reaching the decision-makers. In two years, it could be a reality.

The Urban Land Institute’s primary audience is the private sector. Materials, messages, and activities are geared toward them. The private sector can fund parks and enhancements and become a powerful ally. Projects like Complete Streets and Vision Zero are based on a core set of shared values, which rely on a coalition of partners. Both started small and scaled upwards. They share the responsibility for action between professionals and individuals.

A speaker said to create a transformation, a list of ingredients is required. This includes setting a goal, having a unique insight, having a value proposition, a theory of change, partners, customization, maintenance, and the ability to learn.

Participants were told to have a bold vision, a coalition of partners, a story to tell, and leverage the evidence.
The Salzburg Global program The Child in the City: Health, Parks and Play is part of the multi-year Parks for the Planet Forum, a series held in partnership with the IUCN and Huffington Foundation. The session is being supported by Parks Canada and Korea National Park. It is being sponsored by the W.K. Kellogg Foundation. More information on the session can be found here: www.salzburgglobal.org/go/574 - You can follow all the discussions on Twitter by following the hashtag #SGSparks
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