Bern, Switzerland, November 2004.
Research on mobility and health has concentrated on northern and high income settings and on issues such as transport and safety, environmental health and the international diffusion of infections. There is little research on issues relating to southern, low-income settings. Most of the research in developing country contexts is confined to issues such as the rural-urban HIV diffusion and ways to mitigate this, and some related research on transport workers, migrants, tourists, the sex trade and on construction workers and sexual promiscuity. Some research has looked at water management issues in the construction of roads and the potential for the spread of malaria, bilharzias and filariasis and on the distance of travel to health care for the treatment of HIV AIDS or TB patients.
Everyone would agree that transport can have both a positive and a negative impact on poor people’s health. Some of these positive and negative impacts are well known. The direct positive impacts of improved transport infrastructure and services on health are to increase access to health services, to enable better servicing of health outposts and to facilitate the movement of health extension workers. Improved access can also help improve water supply, which has positive consequences for the health of communities. These factors in turn contribute to reducing morbidity and mortality, to increasing awareness about reproductive issues, and to improving livelihoods and reducing poverty. The experience with the spread of HIV/AIDS has dramatically shown that improving access and mobility can also have strong negative impacts. Developing transport corridors for long distance goods transport often results in increased sexual activity and the spread of HIV. Many large scale transport sector programmes and initiatives that work on combating the spread of HIV AIDS are now working to address this problem through awareness training of transport workers and sex workers along these corridors.
The workshop held in Bern in November 2004, organised by Transnet (a network of Swiss professionals working in the transport sector in developing countries) in collaboration with the IFRTD and supported by the Mobility and Health desks of the Social Development Division of SDC identified several other gaps in the knowledge on mobility and health. It brought together transport and health specialists to discuss the issues and develop a plan of action that will push this relatively new agenda forward.
A case study of micro-level impacts of the Almondangu-Jiri road project in Nepal showed that, despite many benefits, improved infrastructure had the potential to; exacerbate female poverty through migration of male family members, lead to the importation of harmful substances to hitherto isolated villages, have negative impacts on local trade, and increase the diffusion of infections. A presentation from Ethiopia focused on the transportation of critical and high risk patients in rural areas, and how poor handling and positioning of patients on the different modes of transport used often leads to secondary injuries. A third presentation from South Africa highlighted gaps in the way the transport sector currently deals with the issue of HIV/AIDS and another from Transaid emphasised the importance of transport management in the delivery of health care.
These case studies focused on some aspects of mobility and health in specific contexts, and need to be triangulated and verified with information from other contexts if issues relating to mobility and health are to be more fully understood. Even then, there is still a great deal that is not known. There is, for instance, lack of evidence about the impact of mobility on women’s health status; there is little knowledge on how rural transport planning can design appropriate transport hubs that optimise positive health and mobility impacts; there is a dearth of disability and age-sensitive data; there is a limited perspective on road safety and the lack of knowledge on safety issues relating to infrastructure and transport provision in low-income and rural areas. The main knowledge gap however was that we do not know exactly where existing gaps in knowledge are.
The IFRTD network has made a commitment to fully assess the gaps in our knowledge, make steps to share existing research and generate new research to fill the gaps. We recognise that the knowledge generated needs to be translated into practical guidelines for designing and implementing transport sector interventions that can mitigate the potential negative impacts, and increase the positive contribution to poor people’s health status. The transport sector needs to be proactive in sensitising the health sector to the importance of mobility as a cross-cutting component of health interventions, and work in collaboration with health sector professionals.
The full workshop report and workshop presentations can be downloaded at: http://www.trans-web.ch/transnet/transnet8/default.htm
One of the key outcomes of this workshop has been the development of IFRTD's Mobility and Health international networked research programme. Click here for more information
The Research Programme and Outputs: 
