# Presentation: 245949

## Organizing a pilot project	on injury surveillance.Opportunities and Obstacles 

- Diego E Zavala, M.Sc., Ph.D.
- Director- Epidemiology and Biostatistics Core Program
- Public Health Program
- Ponce School of Medicine
- Ponce, Puerto Rico

## Multinational Injury Surveillance Study

- Background
- Initiative emerged out of the last two World Conferences on Injury Prevention and Control
- And pre-conferences on war related injuries...

## Multinational Injury Surveillance Study

- In collaboration with:
- Pan American Health Organization/ WHO
- Alberto Concha, MD, MPH
- Regional Advisor on Injury Prevention
- Centers of Disease Prevention and Control
- Carme Clavel-Arcas, MD, MPH
- National Center for Injury Prevention and Control
- CDC, U.S.

## Multinational Injury Surveillance Study

**El Salvador**

**Colombia**

**Bolivia**

**Brazil**

**Puerto Rico**

**DRC**

**Kenya**

**Uganda**

**Nigeria**

**Zambia**

**PI: Diego E Zavala, MSc, PhD, Ponce Medical School, Puerto Rico**
**Project Administrator: Maria Valenti, **
**International Physicians for the Prevention of Nuclear War (IPPNW)**

## Participating Countries

**LATIN AMERICA & CARIBBEAN**

**Bolivia**

**Population: 8,724,156 (2004)**
**Area: **
**La Paz: Hospital de Clínicas**
**Co-PI: ****	****Eduardo Dominguez- Qhana (NGO)**

**Population: 184,101,109 (2004)**
**Area:**
**Sao Paulo: ****Hospital do Grajaú**
**Co-Pi: ****	****Maria Fernanda Tourinho Peres, PhD**
**	****Vilma Pinheiro Gawryszewski, MD **
**	****Nucleo de Estudos da Violencia**

**Brazil**

## Participating Countries

**LATIN AMERICA & CARIBBEAN**

**Puerto Rico**

**El Salvador**

**Population: 6,587,541 (2004)**
**Area: **
**Ilopango: Hospital Bartolo**
**Co-PI: Emperatriz Crespín, MD -IPPNW**

**Population: 3,897,960 (2004)**
**Area: **
**Ponce: Hospital San Lucas II**
**Co-PI: Carlos García, MD**

## Participating Countries

**LATIN AMERICA & CARIBBEAN**

**Colombia**

**Population: 42,310,775 (2004)**
**Area: **
**Bucaramanga: two public hospitals**
**Co-PI: Marta H León Franco, MD**

## Participating Countries

**DRC**

**Kenya**

**AFRICA**

**Population: 58,317,930 (2004)**
**Area: **
**Kisangani: K.U.T. Hospital**
**Bukavu: Bukavu General Hospital**
**Panzi: Panzi General Hospital**
**Goma/Katwa: Goma & Katwa Gen. Hosp**
**Bunia: Bunia General Hospital**
**Kindu****: Kindu General Hospital**
**Co-PI: Simon Bokongo, MD (IPPNW)**

**Population: 32,021,856 (2004)**
**Area: **
**Nairobi: ****Kenyatta Nacional Hospital**
**Rift Valley: ****Naivasha Di****strict Hospital**
**Eastern Prov: Machakos Provincial Hospital**
** **
**Co-PI: Walter Odhiambo, MD (IPPNW)**

## Participating Countries

**AFRICA**

**Uganda**

**Zambia**

**Population: 26,404,543 (2004)**
**Area: **
**Mbale: Mbale Regional Hospital**
**Kumi: Kumi Hospital**
**Toroto: Toroto Hospital**
**Co-PI: Peter Olupot, MD (IPPNW)**

**Population: 10,462,436 (2004)**
**Area: **
**Lusaka: Univ. Hospital**
**Kafue: Nangonwe Hospital**
**Kalomo:Kalomo District Hospital**
**Co-PI: Robert Mtonga, MD (IPPNW)**

## Participating Countries

**Nigeria**

**AFRICA**

**Population: 137,253,133**
**Area: **
**Dala: Nacional Orthopedic Hosp**
**Kano:Aminu Kano Hospital**
**Co-PI: Ime John, MD (IPPNW)**

## Multinational Injury Surveillance Study

- Phase I:
- Development of Questionnaire
- Retrospective review of 30 cases in last six months
- Presentation of results to ED medical professionals.

## Multinational Injury Surveillance Study

- Phase II:
- Secure funding
- Regional training (TOT)
- Begin 12 month prospective data collection in all sites.

## Multinational Injury Surveillance Study

- Opportunities
- Response to WHO recommendations.
- Interest & enthusiasm.
- Develop experience in international collaboration efforts.
- Foundation for further research efforts.

## Multinational Injury Surveillance Study

- Opportunities
- Response to WHO recommendations/observations in that:
- Many countries, specially in underdeveloped regions lack injury surveillance systems that would provide reliable data on injury.
- Call for enhancing capacity for collecting data on violence at the national level in developing countries
- Lack of data has made multinational comparisons difficult.

## Multinational Injury Surveillance Study

- Opportunities
- Response to WHO recommendations.
- Interest & commitment.
- Develop experience in international collaboration efforts.
- Foundation for further research efforts.

- Obstacles
- Communication
- Funding
- Coordination via internet?
- Local socio-political realities

## Multinational Injury Surveillance Study

- Opportunities
- reliable information on cervical cancer incidence and mortality data that demonstrates the extent of the problem and the financial implications of the disease for the country.
- this information together with provision of technical assistance is needed to develop sustainable cervical cancer prevention initiatives in developing countries
-  for which donors may be more willing to support

- Barriers
- limited availability of funds, particularly from donor organizations;
- absence or deficient infrastructure for cervical cancer prevention;
- lack of reliable data of cancer incidence; and
- limited understanding by health officials about the disease itself and of its impact, specially in older women.

- Herdman, C., Sherris, J., Bingham, A. Bringing about change: Policy development for cervical cancer prevention in low-resource countries. Abstract No. O-49. 19th International Papillomavirus Conference. Florianópolis, Brazil. September 1-7, 2001.

## Multinational Injury Surveillance Study

- Funding:
- FIA application 50%
- IPPNW: Govt. of Canada
- Other ?

## Multinational Injury Surveillance Study

- Output:
- National:
- Hospital
- Government
- Community?
- International:
- Conferences
- Journals

## Puerto Rico