1. International Pediatric Environmental Health Leadership Institute: Thinking Globally, Practicing Locally Ruth A. Etzel, MD, PhD

2. International Pediatric Association World Health Association Kenya Pediatric Society Indian Academy of Pediatrics Haitian Society of Pediatrics

4. Pediatricians’ Needs “Just-in-time” information Technical government publications may not be available in medical libraries Clinical relevance of environmental research may not be immediately apparent

5. Purpose Hold 3-day workshops in Kenya, India and Haiti to teach doctors and nurses about children’s health and the environment Offer an examination to pediatricians to demonstrate proficiency in pediatric environmental health Develop a virtual Institute for future education and information exchange between trainees

6. WHO Training Package for Health Care Providers PowerPoint presentations prepared by an international group Intensive peer review by clinicians working in the field of environmental pediatrics Presenters added slides from their clinical experience

7. WHO Training Package for Health Care Providers Why children? Children are not little adults The pediatric environmental health history Outdoor air pollution Indoor air pollution Pesticides Lead Mercury Water Children and chemicals Persistent Organic Pollutants

8. Participants received CD-ROM with all PowerPoint modules Pediatric Environmental Health, 2 nd Edition (AAP, 2003) Children’s Health and the Environment: A Global Perspective. A Resource Manual for the Health Sector (WHO, 2006)

9. Summary of Institute Training (189 unique trainees) PlaceCountries Number of Trainees TrainersLanguages Nairobi, Kenya (2005) 21 African countries 67Benin, Ghana, Ethiopia, Ivory Coast, Kenya, Philippines, Switzerland, US English, simultaneous translation into French Delhi, India (2007) India, Thailand 44India, Switzerland, US English Port-au-Prince, Haiti (2007) Haiti 78Haiti, Switzerland, US French Athens, Greece (2007) Argentina, Bangladesh, Benin, Cyprus, India, Ivory Coast, Kazakhastan, Kenya, Uganda, UK, US, Zambia 24Cyprus, India, Switzerland, US English

10. Expectations of Trainees Present a seminar about Pediatric Environmental History at home hospital or institution Record, file and analyze the Pediatric Environmental History forms from children with illnesses from environmental contaminants and report cases from their practices Propose and discuss a community project Present a 2 nd seminar after the project

11. Examination Held at the International Congress of Pediatrics in Greece in August 2007 60 multiple choice questions with one correct answer 17 diplomates

12. Rash on face, around lips and photophobia

13. Swollen and erythematous scaling palms

14. Pruritic rash over limbs, swollen and erythematous scaling toes

15. Other symptoms Irritability, anorexia, listlessness, pain in leg muscles Redness of tongue and lips Behavioral problems – temper tantrums, breath holding spasms Hypertension

16. Successful Educational Partnership Involving both nurses and doctors Partnering with local pediatric associations Inviting local speakers Working towards special certification Putting knowledge into practice International collaborative network