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Urban Health Meets Soccer

Posted on November 20, 2017

Last week I travelled to Lima, Peru to attend the second annual SALURBAL project meeting.  SALURBAL is an acronym for “Salud Urbana en America Latina” (Urban Health in Latin America) and is an international collaboration spanning ten institutions in Latin America, three in the United States, and two agencies of the United Nations. It is led by the Urban Health Collaborative here at the Dornsife School of Public Health. Funded by the Wellcome Trust as part of its “Our Planet, Our Health” initiative, SALURBAL aims to study the drivers of urban health and environmental sustainability in Latin American cities to draw lessons relevant to cities worldwide.  Ambitious and broad, the project bridges observational studies, natural experiments, complex systems modeling and a variety of dissemination and policy engagement activities.

The SALURBAL meeting brought together over 50 researchers and practitioners from across the region, some established but many just beginning their careers.  We shifted effortlessly between English, Spanish and Portuguese.  We heard about data and all the challenges inherent in comparing cities and countries, we discussed the best ways to evaluate the health impact of a new aerial tram in Bogota or an urban redevelopment project in Buenos Aires, we talked about causal loop diagrams and how the principles of complex systems can help us understand which urban policies may be most effective in promoting both population health and sustainability. We discussed strategies to engage practitioners and policy makers. The last day, in a tradition we have begun to dedicate the third day of the meeting to learning about local challenges and policies, we heard from a panel of policy makers and advocates focused on improving public transportation and enhancing the quality of life for all Lima residents.

Lima is typical of the Latin American megacities. At nearly 10 million inhabitants across the metropolitan area, the city can be noisy, chaotic, ugly, and mired in endless and often dangerous traffic. But it is also full of life, culture, music, and generous and friendly people on the streets. Like other Latin American cities, it is home to enormous social inequalities that are reflected in contrasting neighborhoods: posh apartment buildings in Miraflores overlooking spectacular cliffs over the Pacific (“La Costa Verde” or the “Green Coast”) are close to precarious housing, half-finished brick and cement homes in neighborhoods with unpaved roads, high levels of violence, and no transportation.  Much of Latin America, but Peru especially, is rich in cultural diversity resulting from the intermingling of European (primarily Spanish) and other cultures (Inca, Pre-Inca, African and many others). But it is also marked by a history of conquest, oppression and discrimination that is still very present today (for a terrific and utterly absorbing account of the Spanish conquest see The Conquest of the Incas by John Hemming).

Our meeting was hosted by the local SALURBAL team based at Universidad Peruana Cayetano Heredia led by Jaime Miranda. Miranda is an internationally known epidemiologist whom I had the good fortune to meet when we first convened the Network for Urban Health in Latin America and the Caribbean  in the fall of 2015. The SALURBAL meeting also included colleagues from Argentina and Brazil (several of whom I have known and worked with for nearly 30 years!) as well as from Chile, Colombia, Mexico, Guatemala, and Honduras. Collaborators from Berkeley, the United Nations University, the Economic Commission for Latin America and the Caribbean, and the Brookings Institute in Washington, DC were also present, as well as of course our own Dornsife team (including faculty and terrific staff) and a truly stellar group of students and postdoctoral fellows from Latin America, Spain, Australia, China, and the United States.

As I sat there over the course of the three days, I could not help but be amazed at the untapped power of global collaboration, at all the things we have in common, and in how we can learn from each other and pool our efforts to create something that is much more than the sum of our individual contributions.  It is hard work, and there are many barriers - organizational, institutional, financial, and logistical. But this project, challenging as it is, gives me hope and tells me that it can be done.

Perhaps it is an auspicious sign that our project meeting ended with a truly spectacular celebration: the night of the last day, the Peru national soccer team beat New Zealand 2-0 to qualify for the World Cup for the first time in over 30 years. There had been festivities all day in anticipation of the event: dancers, musicians, a troupe of rapping police officers, and dancing dogs in the Peruvian jersey. But that night the streets of Lima exploded with celebration and joy: chanting, dancing, fireworks, hundreds parading down the streets.

Thirty years ago, I backpacked through Peru on a shoestring, but I did not make it to Lima. I was a medical student eager to see Latin America on foot and happy that I could carry everything I needed on my back.  Much has changed since then.  Many of the towns I visited have expanded into bustling and chaotic cities. I never imagined that I would be in Lima 30 years later, part of a team working to make cities in Latin America, and indeed cities all over the world, healthier for all. In many ways, for me, SALURBAL is like returning home, a way to give back some of all that I have received. For all this, I am so grateful.

If you live in the United States, have a wonderful Thanksgiving. Y para los demás, “¡Vamos Peru!”