Health Impact Assessment on Tourism and. Recreational Water Policies III MACEDONİAN CONGRESS İ PREVENTİVE MEDİCİNE, OHRİD, 4-7 OCTOBER 2006

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1 Health Impact Assessment on Tourism and Recreational Water Policies III MACEDONİAN CONGRESS İ PREVENTİVE MEDİCİNE, OHRİD, 4-7 OCTOBER 2006 E.Didem Evci Assist.Prof.Dr., MD.,PhD., Adnan Menderes University, Department of Public Health of Medical School, Aydin, TURKEY. Gabriel Gulis Assoc.Prof.,PhD.,University of Southern Denmark, Institute of Public Health,Unit of Health Promotion Research,Esbjerg, DENMARK. Nur Aksakal*,Sefer Aycan**, M.Ali Bumin***,Erdal Beser**** *Lect., Gazi University, Department of Public Health of Medical School, Ankara, TURKEY. **Prof.Dr.,MD.,Gazi University, Department of Public Health of Medical School, Ankara, TURKEY. ***Prof.Dr.,MD.,Gazi University, Head of Department of Public Health of Medical School, Ankara, TURKEY. ****Prof.Dr.,MD., Adnan Menderes University, Head of Department of Public Health of Medical School, Ankara, TURKEY

2 UNEP Deputy Executive Director Shafqat Kakakhel urged the tourism industry leaders to carry out environmental impact assessment studies for all new tourism projects UNEP News Release ROAP 2002/9

3 Social Impact Assessment (SIA) Environmental Impact Assessment (EIA) HEALTH IMPACT ASSESSMENT (HIA)

4 HIA HIA can not be performed without SIA and EIA. But main issue is to document the interrelations with primary and secondary health determinants and indicators. Main rules of SIA and EIA also works for HIA. Health determinants and indicators are probably to be similar between countries. Effects of social and environmental factors on health may differ between countries and the main point here is to document these differences. Via this,, a common methodology can be proposed.

5 HIA NEEDS Social determinants/ indicators Environmental determinants/ indicators Health Impact Assessment Health determinants/ indicators

6 Tourism is one of the fastest-growing industries at the beginning of the 21st century and a reliable indicator of economic growth in both developed and developing countries and a quick and easy solution to combatting economic difficulties.

7 ???? There currently exists no regulatory body or mechanism with which to evaluate the impact of tourism.

8 Tourism *a significant contributor sector to country economies and the biggest mass action in the world *It can easily be effected from the trade competition among the countries *a social event *an important consumption activity *an important industrial event

9 Tourism *an important environmental event *an event with sustainable and measurable features *an important training and management event *a source of employment *a basic component of a sustainable development in many countries

10 Tourism in the World World Tourism Organization (WTO) estimates that the international travels will reach to 1.56 billion by the year billion within the region 377 million from long distances

11 Tourism in the World According to WTO data; tourism sector will reach to billion US Dollars tourism income in 2010 and to 2 trillion US Dollars in Looking at the first ten country based on expectation of tourist entrances in 2020, it can be seen that currently the most visited country France will go down to third place and China will become the most visited country in the world

12 Tourism in the World According to Eropean Union; Tourism is an activity which affects our society in many different ways and has a profound impact on our social, cultural and economic life. It relates to a wide range of areas, to name only a few: employment, regional development, education, environment, consumer protection, health, safety, new technology, transport, finance, taxation and culture. Mission of EU: Ensuring interests of the tourism sector are taken into account Improving knowledge on tourism and contributing to the dissemination of information Stimulating co-operation across the board

13 Effects of Tourism Tourist Tourism Establishment Sector Staff Public Environment They are in interaction

14 Possitive effects *relax and put the stress and monotony of the daily life aside. *in enhanced by the sportive activities, fresh air and sunshine. *relations and friendship among people *support among people

15 Possitive effects * The benefits of tourism to host cultures are often listed as Direct: economic, including generation of foreign exchange, creation of employment, additional revenue for the host government through taxation of tourists, and improvement of local economic structures. Indirect: improved roads, availability of electricity, access to hospitals, improved water and sewage systems, and better health services

16 Negative effects Various public health problems: - Sea water ecology - Coastal water protection - Climate and health - Health of people working in tourism sector - Enteric diseases - Other communicable diseases - Respiratory system infections - Non-communicable diseases - Food health - Life style and quality - Accident prevention and emergency measures - High risk groups

17 Negative effects Environmental health problems - Lack and pollution of water - Problems of treatment of waste -Deficiencies related to accommodation facilities, - Noise problem - Problems related to vector control - Problems related to food sanitation, conditions of food stuff, uncontrolled food supply to meet the fast consumption - Sanitation of public facilities - Accidents

18 Negative effects Insufficiencies in services: - in service providers - in control mechanisms - Insufficient staff - Insufficient training Travel related health problems Other health problems

19 HIA Environmental, social, economic, etc. impact assessments Assessment evaluation Health impact assessment any combination of procedures or methods by which a proposed policy or program may be judged as to the effects it may have on the health of a population

20 HIA Health impact assessment a methodology which enables the identification, prediction and evaluation of the likely changes in health risk, both positive and negative, single or collective, of a policy programme, plan or development action on a defined population. These changes may be direct and immediate or indirect and delayed

21 HIA ON TOURISM AND RECRATIONAL WATER Identification of Instruments of HIA on tourism and recrational water» Identification of key players» key national tourism and recreational water policy documents» collection of epidemiologic literature on the issue» collection of HIA literature on similar issues Identification of a common methodology of HIA on tourism and recrational water

22 How do we select the policy/policy documents which will be the subject of HIA?

23 Source of Info for HIA information about similar proposals implemented elsewhere people with technical and specialist competence views of residents and people with local knowledge views of people with specialist knowledge information from literature on the determinants of health routinely collected local statistics, on health, unemployment

24 Source of Info for HIA opinion surveys literature reviews undertaken for other assessments surveys of local conditions secondary analysis of existing data predictions from models, and resources from research institutes.

25 Which policy do you have on tourism and recreational water in Türkiye? The Ministry of Culture and Tourism (Provincial Directorate of Culture and Tourism in local level) LAW FOR THE ENCOURAGEMENT OF TOURISM Law No: 2634 Date of Passage: 12 March 1982 Official Gazette No: Date of Official Gazette: 16 March 1982 The purpose of this Law is to ensure that necessary arrangements are made and necessary measures are taken for the regulation and development of the tourism sector and for giving this sector a dynamic structure and mode of operation. The regulations under the framework of the Law

26 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism 2010 Tourism Vision and Phase of Second Attack

27 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism (in coordination with Association of Tourism and Health) Life Long Training Tourism Tourism health Health Concept in Tourism Sector is not only contain *Health of Tourist *Traveller Health but also *Environmental Health *Occupational Health *Public Health Regional/international training programs

28 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism The Ministry of Health Local governance Inspection Tourism establishment Clasification Periodical inspection Because of complaint Hygiene, occupational, environmental and tourism health

29 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism Development of New Destinations For example: Historical Silk Road Destination Mardin Destination By intersectoral development model

30 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism The Ministry of Health The Ministry of Environment and Forest Local governance Blue Flag Project The Blue Flag is an exclusive eco-label awarded to around 3100 beaches and marinas in 34 countries across Europe, South Africa, New Zealand, Canada and the Caribbean in The Blue Flag Campaign is owned and run by the independent non-profit organisation Foundation for Environmental Education (FEE).

31 Which policy do you have on tourism and recreational water in your country? The Ministry of Culture and Tourism The Ministry of Health The Ministry of Environment and Forest Local governance Blue Flag Project The Blue Flag works towards sustainable development at beaches/marinas through strict criteria dealing with water quality, environmental education and information, environmental management, and safety and other services. The Blue Flag Campaign includes environmental education and information for the public, decision makers and tourism operators.

32 Which policy do you have on tourism and recreational water in your country? The Ministry of Health The Ministry of Environment and Forest Local governance COUNCIL DIRECTIVE of 8 December 1975 concerning the Quality of Bathing Water (76/160/EEC) COUNCIL DIRECTIVE of 21 May 1991 concerning urban waste water treatment (91/271/EEC)

33 Which policy do you have on tourism and recreational water in your country? The Ministry of Health International Health Regulations Traveler s Health WHO CDC Regional Informations Country informations

34 Which policy do you have on tourism and recreational water in your country? State Planning Institute National Development Plans for Five Years Tourism Sector Health Sector Environmental Sector

35 Which policy do you have on tourism and recreational water in your country? Special policies of Private sector Travel agencies NGOs Projects/Funds Consumer rights International Organizations Etc.

36 Decision of determinants/indicators and outcomes we decide the main determinants/indicators and outcomes which make our work easier

37 AS A LAST QUESTION TOURISM AND RECREATIONAL WATERS have an effect on HEALTH?

38 HEALTH IMPACT ASSESSMENT (HIA) If the answer is YES for TOURISM AND RECREATIONAL WATERS the risks should be determined as soon as possible

39 HOW WHICH WHERE WHEN WHY WHO IT IS NOT MY RESPONSIBILITY

40 What is the risk? CRITICAL POINTS OUTDOOR ENVIRONMENT Garden, dustbin, vectors etc. INDOOR ENVIRONMENT Kitchen Water Rooms Baths, sauna general toilet Laundry

41 What is the risk? CRITICAL POINTS INDOOR ENVIRONMENT Living conditions of staffs Solid and liquid waste Health centre and health records of tourists and staffs BEACH/SEA WATER POOLS SPA Equipment related with winter/summer sport and recreational activities Health Records and Insurance of Tourists Health Care Needs of Tourists

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