Dr. Tawfik A. M. KhojaMBBS, DPHC, FRCGP, FFPH (UK)

Director General – GCC/ HMC

Oman 20-22 Dhul-Qada 1427 H / 11-13 December 2006

Dr. Mohamed S. HusseinDr. Mohamed S. HusseinDr. PH,M.PH,M.ScDr. PH,M.PH,M.Sc..

Head of Studies & Research Division

IN THE NAME OF ALLAH,IN THE NAME OF ALLAH,THE MOST GRACIOUS,THE MOST GRACIOUS,THE MOST MERCIFULTHE MOST MERCIFUL

The term refers to countries that are capitalist democracies, that are technologically advanced,

and whose citizens have a high standard of living. The United States, Canada, Japan,

Australia, and most of the countries of Western Europe are examples of first-world countries.

INTRODUCTION

First WorldFirst World

The term is a phrase that was used to describe the Communist countries within the Soviet

Union's sphere of influence. Along with "First World" and "Third World", the term has been used to divide the nations of Earth into three

broad categories.The term has largely fallen out of use because

the countries to which it referred mostly abandoned Communism, and their mutual

interests, after the 1991 collapse of the Soviet Union.

The other two terms remain in widespread use.

Second World

Countries that have more advanced economies than developing nations but haven't yet gained

the level of those in the First World are grouped under the term Newly Industrialized Countries or

NICs. Current examples includes China, India, Mexico, South Africa or Brazil to name a few.

These are countries that were previously considered developing countries and that now have a more advanced economy, yet not fully

developed.

Newly industrialized countries or NIC

The term Fourth World (as least developed countries) is used by some writers to describe

the poorest Third World countries, those which lack industrial infrastructure and the means to build it. More commonly, however, the term is used to describe indigenous peoples or other oppressed minority groups within First World

countries.

In recent years, as many "developing" countries have industrialized, this term has been coined to refer to countries that have "lagged behind" and

still lack industrial infrastructure

Fourth World

(LDCs or Fourth World countries) are countries which according to the United Nations exhibit

the lowest indicators of socioeconomic development, with the lowest Human

Development Index ratings of all countries in the world.

Least Developed Countries

• low-income (GNI per capita of less than US $750)

• human resource weakness (based on indicators of nutrition, health, education and

adult literacy) and

A country is classified as a LEAST DEVELOPED COUNTRY if it meets three

criteria based on:

• economic vulnerability (based on instability of agricultural production, instability of exports of goods and services, economic importance

of non-traditional activities, merchandise export concentration, and handicap of

economic smallness, and the percentage of population displaced by natural disasters).

• The classification currently applies to around 50 countries. As of 2006, the least developed

country in the world is East Timor.

Least developed countries generally suffer conditions of extreme poverty, ongoing and

widespread conflict (including civil war or ethnic clashes), extensive political corruption, and lack

political and social stability. The form of government in such countries is often

authoritarian in nature, and may comprise a dictatorship, warlordism, or a kleptocracy. The

majority of LDCs are in Sub-Saharan Africa.

Current LDCsCurrent LDCs██ Least Developed Countries

Asia (10 Countries)

Africa (34 Countries)Oceania (5 Countries)

DEVELOPING COUNTRYDEVELOPING COUNTRY

██ High human development ██ Medium human development

██ Low human development ██ Unavailable

Is a country with a relatively low standard of living, undeveloped industrial base, and

moderate to low Human Development Index (HDI). The term has tended to edge out earlier

ones "Third World", which has come to have unintended negative connotations associated

with it.

DEVELOPING COUNTRY

Developed countries , in comparison, usually have economic systems based on continuous, self-sustaining economic growth in the tertiary and quaternary sectors and high standards of living.

Another term synonymous to developing

country is Less developed country (LDC) or Less economically developed country

(LEDC). LEDC is a term used by modern geographers to portray the countries classified

as "developing countries" more accurately, specifying that they are less economically

developed, which usually correlates best with other factors such as low human development.

The ultimate objective of occupational health is a healthy,

safe and satisfactory work environment and a healthy, active

and productive worker, who is free from both occupational and non-

occupational diseases and who is capable and motivated to carry out

his or her daily job and is able to experience job satisfaction and

develop both as a worker and as an individual.

The ultimate objective of occupational health is a healthy,

safe and satisfactory work environment and a healthy, active

and productive worker, who is free from both occupational and non-

occupational diseases and who is capable and motivated to carry out

his or her daily job and is able to experience job satisfaction and

develop both as a worker and as an individual.

Occupational safety and health can be defined as

a multidisciplinary activity aiming at:

Approximately 45% of the world’s population and 58% of the population over 10 years of age

belong to the global workforce, I.e. 60-70% of the adult male and 30 - 60% of the adult female

population of the world.

Occupational safety and health problems

Hundreds of millions of people throughout the

world are employed today in conditions that breed ill

health and/or are unsafe (WHO 1999).

- Annually, an estimated 160 million new cases of work-related diseases occur worldwide,

including respiratory and cardiovascular diseases, cancer, hearing loss,

musculoskeletal and reproductive disorders, mental and neurological illnesses.

- Only 5-10% of workers in developing countries and 20-50% of workers in industrial countries (with a few exceptions) are estimated to have

access to adequate occupational health services. In the USA, for example, 40% of the workforce of some 130 million employees do

not have such access.

- Even in advanced economies, a large proportion of work sites is not regularly

inspected for occupational health and safety.

- The International Labour Organization (ILO) has

estimated that in 1997, the overall economic losses

resulting from work-related diseases and

injuries were approximately 4% of the

world’s Gross National Product.

a) Lack of effective legislation and absence or lack of requests from authorities and

employers make the employment opportunities for such experts minimal .

There is a universal shortage of both expert resources and training in developing and newly

industrialized countries in the South. This is due to three main reasons:

b) The vocational training institutions and universities

have not organized and developed curricula for the

training of experts in occupational health .

c) Training is oriented to clinical occupational medicine only which ,

though important, does not give a full response to the needs for expertise in a

preventive workplace - oriented occupational health service

D) Problems related to

growing mobility of worker

populations and occurrence of new

occupational diseases of various origins.

There is a wide variation in economic structures,

occupational structures, working conditions, work environment,

and the health status of workers in different regions of the world,

in different countries and in different sectors of economies.

There are also special occupational settings and types of enterprises, where work and

workplace deviate substantially from the norm.

The overall exposure pattern

The least developed countries that still employ the major part of the workforce in agriculture and

other types of primary production face occupational health problems that are different

from those experienced in the industrial countries.

In the least developed countries the

occupational factors are aggravated by numerous non-occupational factors such as

parasitic and infectious diseases, poor hygiene and sanitation, poor nutrition, general poverty

and illiteracy.

Cont . .

Work usually takes place in an environment that does not always meet required standards.

Family members of the entrepreneurs and workers, including children, pregnant women

and elderly people, share the work in small-scale enterprises, such as home industries, small farms and cottage industries, particularly in

developing countries.

Improving occupational safety and health standards in the tanning industry in South East

Asia.

Country surveys were carried out in several South East Asian countries by the United

Nations Industrial Development Organization (UNIDO), in connection with its regional

programme for Pollution Control in the Tanning Industry in India, Indonesia, Nepal, and Sri Lanka

. The surveys indicated that the tanning industry’s performance in terms of safety and

health at work and quality management was poor.

Lessons learned:

- Change is best stimulated by starting from the real problems and conditions in the companies

instead of the priorities of outsiders.

- Approaches have to be flexible and informal.

- Exchange of experience amongst entrepreneurs can be used to promote positive

attitude to change.

- Emphasis should be put on local improvement measures which are already in use.

- Highlight “demand driven” concept (designed at entrepreneur’s own initiative).

- Link OSH standards and practices with improved profit, cost savings.

- Involve pro-active entrepreneurs to act as advocates of the cause.

Fighting the pesticide related health problem in Central America.

Despite awareness of the problems associated with pesticide use, they have persisted, and are

even increasing in some regions of the developing world.

Nowhere is this more apparent than in Latin America. The region produces 40% of the world’s

bananas, 60% of the world’s coffee, and 25% of the world’s beans.

Health impact of occupational risks in the

informal sector in Zimbabwe.Information about occupational health in the informal sector is lacking, despite its

size and growing contribution to employment.

Work organization, hygiene and ergonomic problems accounted for a

significant share of inspected and reported workplace risks across all areas

of informal sector work.

The significant under-detection of occupational morbidity is exacerbated by the almost complete lack of coverage of occupational health services

in the informal sector.

There were few built-in safety measures.

Personnel Protective Equipment was used by less than 5% of workers, compared to the 55%

doing work where it was judged that PPE would be needed.

LEARNING TOGETHERTO WORK TOGETHER

FOR HEALTH

United Arab Emirates

SAUDI ARABIA

OMAN

KUWAIT

YEMEN

QATAR

Bahrain

GENERAL FEATURES IN THE GULF COUNTRIES

• Gulf countries have large industrial communities with a great workforce exposed to various hazardous agents in their occupations.

• Occupational health statistics are few

• Reporting is lacking or not available

• Most of the countries have several limitations or constraints hindering occupational health and safety services and programmes at facility, local (municipal) and national levels. The main obstacles are related to :-– lack of enabling legislation

– lack of standards

– Not enough of expertise

– Coordination between concerned authorities is not complete.

– lack of participation of the employers’ organizations, nongovernmental organizations, etc.

– Insufficient budgetary resources or human resources.

– lack of educational programmes. – Conflicts between various authorities

responsible for occupational health and safety services.

– No full coordination between various partners responsible for occupational health program.

– There is considerable under reporting of occupational morbidity, both injury or disease and mortality.

– Policies that comprehensively address occupational health are not enough.

HEALTH MINISTERS’ COUNCIL & OCCUPATIONAL HEALTH IN THE GULF

COUNTRIES The Health Ministers’ Council for the Cooperation Council states issued 3 resolutions in the field of occupational health, as follows:

1. Resolution # 8 issued by the conference 14 of the Health Ministers’ Council held in Riyadh, Kingdom of Saudi Arabia (26 October 1983) which included:

• Approval on the work papers submitted by the General Secretariat in this respect.

• Assigning the General Secretariat to call upon a technical committee involving specialized people from different authorities to study:

A. Setting a platform and clear vision about occupational health programmes in the light of the existing problems , the industrial development projects, and the rapidly increasing development witnessed in the region.

B. Setting a work plan for development of occupational health services according to the recent developments in this regard.

• Organizing a symposium with participation of all concerned departments in the ministries of health and other related ministries and agencies for the purpose of :A. Defining the responsibility of each, and

methods of coordination between various partners.

B. Developing legislations and regulations of occupational health.

C. Human power development necessary for work in this field.

2. Resolution # 1 issued by the Conference 18 of the Health Ministers Council held in Doha – Qatar (21-23 /1/1985), as follows:– Follow up on the occupational health

symposium to discuss specific subjects making full use of the symposium held lately in Iraq in cooperation with WHO.

3. Resolution No. 5 issued by the conference 20 of the Health Ministers Council held in Muscat – Oman (5-8/1/1986) which involved the following:

– Circulation of the recommendations issued by the symposium held in Bahrain (27-29 /10/1989) as well as the reports of the subcommittees.

– Each country of the member states should : Establish a national committee for

occupational health and safety which should define the responsible body for each activity of occupational health and safety as well as methods of coordination among them.

Setting a plan to make

available and train specialized

and technical caders at

various levels to be involved in

occupational health services.

Developing the regulations and legislations of

workers’ health and safety as well as the safety

of the production facilities, work environment

and the surrounding environment.

• Taking necessary actions to make occupational health services available and accessible through primary health care programmes especially for those working in agriculture, small workshops and distant places. Training of physicians, technical middle-level cader should be trained to conduct these services in addition to equipping the facilities to make their work easy.

1. Establishment of a Gulf Committee for Occupational

Health and Safety affiliated to the Executive Board. Each

country should nominate its representative from among

those specialized in the field of occupational health and safety.

The Executive Body in its 65th meeting held in Riyadh (4-6/11/1427 H – 25-27 /11/2006 G)

discussed the subject of occupational health and issued recommendation # (1) which

included :

The committee shall review the working paper presented by Dr. Yousef Al-Nesf – Executive Body members of Kuwait as a

platform for the work of this committee taking into consideration the issue of

setting occupational health strategies in such a way that does not overburden the

Ministers of Health in the Cooperation Council and does not add tasks for which

other governmental sectors are responsible.

2. The Gulf Committee for Occupational Health shall hold its first meeting in Muscat in the second half of 2007 to formulate the vision,

mission and objectives as well as the mechanism of work and responsibilities. In

addition , the Committee is requested to set a strategy / fifth plan for promotion of

occupational health in the Cooperation Council States.

3. Each country has to establish a national committee for occupational health and safety.

4. Calling upon the member states to effectively participate in the Occupational Health

Conference going to be held in Muscat – Sultanate of Oman throughout the period 20-23 Dhul Qada 13427 H corresponding to 11-

13 December 2006.

FRESH STRATEGIES FORA NEW ERA

Recommendations

1. Revival of occupational health programmes and services in the Gulf countries, in such a way that these programmes should include the core services required for strengthening occupational health practices (e.g. preventive, curative, emergency, first aid, research, etc)

2. Stress on coordination among various partners, providers and stakeholders for joint efforts to deliver occupational health and safety services at various levels. These are:

– Formal agencies, such as the ministries of health, labour (and social affairs), and the ministry of the environment; institutions of social/health insurance, other insurance agencies the civil defense, universities, schools and other educational facilities, other education, defense research institutes, interior, etc) and national funds.

– Employers and employees organizations

– Nongovernmental organizations

– Consulting firms.

3. Strengthening the concept of workplace health promotion and implementation of various strategies e.g .

– physical fitness

– healthy nutrition

– smoking cessation

– health heart

– stress free work life

– safe work environment

4. Top level commitment of the Ministries of Health with OHS.

5. Establishing units/departments or divisions and programmes of OHS which should be well designed, staffed and equipped with occupational health laboratories.

6. Good coordination with other related authorities / bodies e.g. : the ministries of industry, agriculture, labour, municipalities, etc.

7. Policies have to be changed appropriately to promote the health of the workers. These policies should be supported with legislations and regulations that should be formulated and implemented followed up and updated.

8. Establishing a database about OHS, its services, indicators, morbidity and mortality statistics, burden etc.

9. Fostering a culture that values and encourages health in the workplace.

10. More communication and networking with relevant agencies and organizations, especially WHO, ILO, UNDP, UNICEF, ISO, IPCS, CCUI Etc.

11. Full coordination with universities and institutions in the field of OHS training and education.

12. Each government should establish or strengthen its national centre for

occupational health and, the network of centres given the responsibility of carrying

out research, information, training, and if appropriate advisory and analytical and

measurement services in support of occupational health practices and safety

situation and effective international collaboration in research should be ensured.

13. Future Perspective & Strategies revitalization of the Gulf Occupational Health Committee to undertake the mission of coordination between the Gulf states proposing programmes and setting policies to promote occupational health and safety.

14. Establishing a Gulf occupational health and safety Institute or Center to undertake the responsibility of training the Gulf national cadres and to assure having the expertise in this field.

15. Utilization of successful experiences in designing, implementing and monitoring of occupational health promotion programmes.

16. Conduction of a series of occupational health & hygiene surveys of existing occupational health hazards, infrastructure and capacity for occupational health in the Gulf countries to determine the current situation of occupational health and safety (situation analysis) with the assistance of WHO and other related institutions in this field . – Workplace health programs that focus on both

risk factors in places of employment and the promotion of healthy life styles to reduce and prevent chronic disease.

– Coordination between occupational health services and overall health services. Occupational health services, consisting of efforts to prevent work related disease and disability as well as to recognize and treat them once they occur, must be coordinated with overall health services.

• Promotion of research in the field of occupational health and safety delineate the epidemiology of these diseases, and address various issues e.g. occupational mortality and morbidity leading to developing strategies for control and prevention.

Keeping PEOPLE Well

Getting PEOPLE Better

Helping PEOPLE Cope

QIQIQIQI

Thank you for your

kind attention

داعيا> الله سبحانه لي ولكمبدوام الصحة والعافية والرضوان