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Most people find it difficult to infection during labor purchase erythromycin canada recognize the of conserving cultural heritage did not always prove effec- defence line because it is partly hidden in the regular land- tive for giving specifically military objects new functions antibiotics mastitis buy erythromycin australia, scape antibiotic resistance marker genes generic 500 mg erythromycin with amex. The follow- order to antibiotics haven't worked for uti order erythromycin visa raise public awareness and create more public ing projects provide examples: support for the Stelling as a World Heritage site. Private owners, trustees, local housing, studios, an art gallery and a tea garden. The Foundation encour- ages innovative plans for maintaining the objects and landscape of the Stelling and for getting local communities involved. At some of the fortresses, volunteers perform tasks related to maintenance and the preservation of the landscape and natural environment. Together with these participants, the Foundation initiates activities to make the Stelling better known and more accessible to the public. During the first ‘Month of the Stelling’, in September 2003, various aspects of the site will be featured in a spe- cial activity programme for the public. There are also plans for setting up an educational programme for schools and for getting more volunteers interested in working on the the 42 fortresses are the most visible objects of the Stelling Stelling. It is in fact an employment scheme by felt it necessary to make a new long-term strategic plan for which people from different cultural backgrounds who the Stelling as a whole. The plan was drawn up by land- have little or no job experience participate in the mainte- scape designers in 2001, based on research by experts in nance and repair of the World Heritage site. It offers them the fields of cultural history, urban planning and design, an opportunity to prepare themselves for a regular job or nature and landscape preservation, and modern water for further professional training. A journalist was asked to investigate the fighting unemployment among specific target groups cultural and social meaning of the Stelling in the twenty- while at the same time helping to ensure the preservation first century. The site has been copied in other projects in the Netherlands and would be a counterweight to the dynamic city: a public abroad. The Herstelling organizers are now working place where people discover and experience the defence together with the organizers of similar projects in line as a cultural treasure, while enjoying the peace and Copenhagen, Antwerp, Hamburg, Willemstad (Curacao) quiet of the outdoors and participating in social and and Paramaribo (Suriname). Herstelling workers at one of the fortresses, and was reportedly very impressed with the results (Fig. The main objective of the plan is to revitalize the Stelling, converting it into an attractive public space for the benefit 59 of the local communities in the Amsterdam region. In order to achieve this, the Stelling has to be made more vis- ible and accessible to the public without losing its mysteri- ousness and without compromising the intrinsic values of the World Heritage site. This calls for a well-balanced, modest plan that will make the historical military infrastructure more visible in the landscape while at the same time making it useful for a variety of new functions. The integrated plan provides for different kinds of recreational use in combination with Herstelling at work on a fortress water storage, nature and landscape preservation, agricul- tural use, social and cultural functions, and the creation of new neighbourhoods on a very small scale that offer both 5. It is not a restoration plan but rather a flexible framework which allows professionals in the Stelling is situated in the Amsterdam region, one of the fields of planning, design and construction to use their the most densely populated and economically dynamic creativity and imagination (Fig. As a result of globalization and modernization, the Amsterdam region is changing rapidly 60 into a metropolitan area with a multicultural population. It is rather an urban network of old and new towns and cities (including Schiphol Airport City) strung across the typically Dutch open landscape. The main challenge for the future is not only how to sus- tain the World Heritage site in this dynamic environment but also how to have the site contribute to the quality of life of the inhabitants. This calls for a more flexible and open attitude towards the preservation and development of cultural and natural heritage – an attitude that allows for change and the acquisition of new functions where the historical defence line as a planning zone appropriate. In the Netherlands the strategy for integrat- ing the conservation of cultural heritage into regional planning policy is called ‘preservation through develop- Recently the provincial government of North Holland ment’. The national plan for heritage preservation known approved a planning document which declares the Stelling as ‘Belvedere’ (1999) promotes this strategy, particularly to be in a zone of its own for planning purposes. The for the preservation of cultural landscapes and larger boundaries of the zone are based on the interaction with structures such as the Stelling van Amsterdam. Within the zone the closed circle of dykes and the legally protected 127 2 Regional and Case Studies • Etudes de cas et regionales Europe and North America Europe et Amerique du Nord monuments are fixed objects, but the specific use to which Bibliography the open fields are put can be adapted to the needs and demands of different functions. Een langzame not preclude all major transformations of sections of the buitenring (in de snelle metropool), ruimtelijke strategie Stelling, but as decisions are made, the public’s interests voor de Stelling van Amsterdam. Streekplan Noord- the province is now working on a management plan for Holland Zuid. It is an ambi- tious plan that will take at least twenty years and will cost Vesters, P. Provincie crucial to the success of the plan, which is aimed at gain- Noord-Holland, Haarlem. Failure to secure sufficient commitment, active participa- tion and funding threatens the future of the Stelling, but the biggest threat to a sustainable future is that the Stelling could become an isolated relic of the past that has no connection with the needs and demands of present- day society. It is therefore a cause for concern that the predicate ‘World Heritage’ is being used more and more in order to obstruct or prevent new development, change and innovation. Linking Universal and Local Values In the last twenty years, the attention of the provincial authorities has shifted away from the protection and con- servation of monuments and towards the integration of the Stelling as a whole into planning policy. But the Stelling has more to offer society than cultural, historical and nat- ural values which are preserved as though on display in a museum. The challenge for the future is to see how this World Heritage site can make a contribution to the economic, social and cultural development of the multicultural popu- lation of the Amsterdam region. Amid the global dynam- ics of the twenty-first century, the Stelling as ‘a ring of silence’ represents such values as peace and quiet, identity and cultural history. It can be claimed and occupied by local communities as a meeting place, a stage or a showcase for cultural exchange and social integration on different levels. The Stelling zone is a connected place that links universal and local values for the benefit of everyone who wants to participate. It should become a living, vibrant monument that invites everyone to work together to build a new future which expresses and celebrates people’s cultural diversity. Currently, within the geographic region where emphasis on the involvement of Aboriginal peoples. This has historic sites, specifically in regard to Aboriginal peo- created expectations among Aboriginal people with ples. The paper then presents the geographical and regard to operation and management at existing sites and political context in which the Southwest Northwest parks. Finally, the paper outlines Wood Buffalo National Park, Nahanni lessons learned and areas of involvement of National Park and Sahyoue-Edacho Aboriginal peoples in the management of these National Historic Site sites. Two of these sites, Wood Buffalo National Park and Nahanni National Park, are designated World Heritage 1. Sahyoue-Edacho (Grizzly Bear Mountain and Scented Grass Hills) National Historic Site is part of a cul- Parks Canada’s approach to managing its national parks tural landscape, but is not a designated World Heritage and historic sites is contained within a 1998 ‘Statement of site. However, it is included in this paper for the purposes Principles and Best Practices’. This document calls for the of demonstrating inclusion of Aboriginal peoples from the recognition of traditional knowledge, respect for commu- initial proposal of the site to the Historic Sites and nity structures and values, and Aboriginal participation in Monuments Board through to a process for determining the development of proposals for commemoration. The purpose of establishing the park was to in national parks and national historic sites. Geographical and Political Context of Metis peoples hunted and trapped within the area. In northern when creating new parks during those early years of Alberta, a large percentage of individuals in the majority of establishment. The list of hunters and trappers is not seen the communities is also of Aboriginal descent. The birth as complete by some local Aboriginal people and has rate of Aboriginal peoples is 1. This community is, in some cases, only one generation removed from subsistence A second factor that affected the government’s relation- farming, which leads to a strongly rooted feeling of ‘own- ship with Aboriginal peoples resulted from an organiza- ership’ of the land and its resources. Land claims have led to the creation of a num- signified a shift in mandate – from a socio-economic ber of national parks and national historic sites in northern emphasis to the protection of land, flora and fauna. It also Canada, and resulted in agreements with Aboriginal included a move towards hiring staff from the ‘south’, 129 2 Regional and Case Studies • Etudes de cas et regionales Europe and North America Europe et Amerique du Nord often with more training in park management, instead of As at Nahanni National Park, only one Aboriginal group is recruiting local people. A further change was the working with Parks Canada and others on the manage- increased emphasis on science and enforcement of regu- ment issues – the Sahtu Dene and Metis. The Sahtu Dene Metis Comprehensive Land Claim Agreement applies to Sahyoue-Edacho National Historic In 1986, the Mikisew Cree Land Claim Agreement was Sites and the northern area of possible expansion of signed. Land Entitlement Agreement was signed, and the Salt River First Nations Treaty Land Entitlement Agreement fol- lowed in 2002. A Wildlife Advisory Board has been set Involvement of Aboriginal Peoples in the up through the Mikisew Cree Land Claim Agreement.

When obvious reasons for crying have been addressed xorimax antibiotic cheap erythromycin 500 mg online, persistent crying can be a sign of significant illness c infection signs order erythromycin 250mg with mastercard. Infants of this age whose crying is responded to light antibiotics for acne buy genuine erythromycin online timely by parents have been shown to bacteria reproduce asexually purchase 250mg erythromycin free shipping cry less at 1 year and have decreased aggression at 2 d. Be diligent about keeping babies warm and dry to limit hypothermia Page 330 of 385 iv. Infants do not typically roll until around 3-4 months; a history of an infant less than that rolling himself off of a bed or table and sustaining major injuries may indicate abuse iii. Infants of this age begin to identify and respond to facial expressions; approach them with a smile or funny face and a happy, soft spoken voice iv. By 6 months, babies should make eye contact; no eye contact in a sick infant could be a sign of significant illness or depressed mental status 3. Infants explore objects with their mouths which greatly increases the risk of foreign body aspiration; do not give children exam gloves to play with iii. Separation anxiety is best dealt with by keeping the child and parent together as much as possible during evaluation and involving the parent in the treatment if appropriate; if possible, interact first with the parent to build trust with infant iv. With the head beginning to grow at a slower rate than the body, children begin no longer requiring shoulder rolls limiting flexion of the neck when bag-valve-mask ventilating or intubating ix. The rapid increase in language means they will understand much of what you say if simple terms are used iii. School aged children can understand simple explanations for illness and treatments iii. Relationships generally transition from mostly same sex ones to those with the opposite sex d. Respect the patient’s modesty and cover them up after the physical exam Page 335 of 385 iv. Chronic lung disease that usually occurs in infants form born prematurely and treated with positive pressure ventilation and high oxygen concentrations b. Recurrent respiratory infections and exercise induced bronchospasm are complications c. Inhaled medicationsbronchodilators (albuterol, ipratropium, racemic epinephrine) v. Oral and intramuscular medications (prednisolone, dexamethasone)Corticosteroids vi. History (fever, vomiting, diarrhea, urine output, fluid intake, blood loss, allergic symptoms, burns, accidental ingestion) b. Physical findings (heart rate, blood pressure, capillary refill, color, mental status, cardiac murmurs/rubs/gallops, pulse oximetry, 4 extremity blood pressures) c. History (polyuria, polydipsia, weight loss, visual changes, poor feeding, abnormal odors, growth delays) b. Physical findings (heart rate, blood pressure, mucous membranes, mental status, virilization, frontal bossing, blindness) c. Neonatal (swallowed maternal blood, anal fissure, necrotizing enterocolitis, malrotation, Hirschsprung’s disease, coagulopathy) i. School age (infectious enteritis, juvenile polyps, hemolytic uremic syndrome, Henoch Schonlein purpura) iii. History (time of ingestion/exposure, amount ingested, abnormal symptoms, bottles/containers available) b. Specific toxidromes (anticholinergics, cholinergics, opiates, benzodiazepines, sympathomimetics, beta-blockers, calcium channel blockers, salicylate, tricyclic antidepressants) b. Caregiver support Page 343 of 385 Special Patient Population Geriatrics Paramedic Education Standard Integrates assessment findings with principles of pathophysiology and knowledge of psychosocial needs to formulate a field impression and implement a comprehensive treatment/disposition plan for patients with special needs. Normal changes associated with aging primarily occur due to deterioration of organ systems; B. Pathological changes in the elderly are sometimes difficult to discern from normal aging changes. Reduction in renal function due to decreased blood flow and tubule degeneration 2. Peripheral edema is frequently present in elderly patients with or without failure and may signify a variety of conditions 4. Venous access- care should be taken to avoid use of indwelling fistulas or shunt unless necessary in cardiac events. Diffuse tenderness on palpation of abdomen, with distention, guarding, or masses; upon auscultation high pitched noises k. Chronic Renal Failure- is the inability of the kidneys to excrete waste, concentrate urine, or control electrolyte balance in the body. Evaluation of patient treatment through reassessment of disease Page 354 of 385 S. Diabetes Mellitus- an inability of the pancreas to produce a sufficient amount of insulin causing hyperglycemia. Hyperglycemia: plasma levels greater than 200 mg/dl, fasting levels of greater than 126 mg/dl iii. Diaphoresis, pale skin, poor skin turgor; pale, dry, oral mucosa, furrowed tongue iii. Warm, flushed skin, (even though the patient can be hypothermic) poor skin turgor; pale, dry, oral mucosa, furrowed tongue iii. Hypothyroidism-is destruction of the thyroid tissue over time that causes an insufficient amount of thyroid hormone in the blood. Myxedema coma is a premorbid consequence of hypothyroidism in the elderly caused by a recent history of surgery, hypothermia, infection, hypoglycemia, and sedative use. Osteoarthritis- is a progressive disease from repetitive trauma to the joints causing destruction of the cartilage. Rheumatoid Arthritis is an autoimmune disorder that affects the joints of the body. These infections compounded by an inability, due to ageing of the hypothalamus, may not produce a fever in the face of an immunological insult such as a viral, bacterial, or occult infection. Herpes Zoster- a highly contagious virus that is manifested by a painful rash that affects the ganglion of a nerve and appears along the affected nerve pathway. Role of the Prehospital Professional (scene assessment, assessment of the caregiver, communication with the caregiver, documentation, reporting suspected abuse/neglect, safely transporting one or more injured children) 2. It is estimated that 41 million Americans and one-third of people living in poverty have no health insurance, and insurance coverage held by many others would not carry them through a catastrophic illness F. Financial challenges for health care can quickly result from loss of a job and depletion of savings G. When caring for a patient with financial challenges who is concerned about the cost of receiving needed health care, explain the following: a. Free (or near-free) health care services are available through local, state, and federally-funded organizations 3. In cases where no life-threatening condition exists, counsel the patient with financial challenges about alternative facilities for health care that do not require ambulance transport for emergency department evaluation 4. Impaired or insufficient development of the brain that causes an inability to learn at the usual rate (developmental delay) B. Problems after birth a) Childhood diseases b) Injury c) Exposure to lead, mercury, and other environmental toxins v. Poverty and cultural deprivation a) Malnutrition b) Disease-producing conditions c) Inadequate medical care d) Environmental health hazards e) Lack of stimulation c. Patients with extremity and trunk paralysis may require accommodations in patient care b. Paramedics will care for terminally ill patients (patients with advanced stages of disease with an unfavorable prognosis and no known cure) 2. Care of a terminally ill patient will often be primarily supportive and limited to calming and comfort measures, and perhaps transport for physician evaluation 2. Examine the patient for the presence of transdermal drug patches or other pain-relief devices 3. Comprises a group of mental disorders in which the individual loses contact with reality 2.

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Pacemaker-treated patients and electromagnetic interference during cardiac surgery antibiotics buy online generic erythromycin 250 mg with visa. Radiofrequency and ethanol ablation for the treatment of recurrent thyroid cancers: current status and challenges antibiotic lupin 500 buy on line erythromycin. A split-face comparison of a fractional microneedle radiofrequency device and fractional carbon dioxide laser therapy in acne patients antibiotics for uti nz discount 500 mg erythromycin visa. No adverse effects detected for simultaneous whole-body exposure to xkcd antibiotics purchase 500mg erythromycin mastercard multiple- frequency radiofrequency electromagnetic fields for rats in the intrauterine and pre- and post-weaning periods. Physiological and hygienic research on the work of operators of units for high-frequency welding of polymeric materials. An evaluation of self-reported mobile phone use compared to billing records among a group of engineers and scientists. Effect of a superhigh-frequency electromagnetic field on animals of different ages. Electromagnetic fields promote severe and unique vascular calcification in an animal model of ectopic calcification. The physiological mechanisms of the regulation of zoosocial behavior in rats exposed to low-frequency electromagnetic fields. The evaluation of the exposure of seamstresses to electromagnetic fields, emitted by sewing machines. Problems and priorities in epidemiologic research on human health effects related to wiring code and electric and magnetic fields. Estimation of therapeutical efficacy of weak variable magnetic fields with low value of induction in patients with depression. Transcatheter closure of patent foramen ovale without an implant: initial clinical experience. Effects of electromagnetic fields emitted by cellular phone on auditory and vestibular labyrinth. Significance of the determination of lymphocyte subpopulations in the environmental medicine. Zentralblatt fur Hygiene und Umweltmedizin = International journal of hygiene and environmental medicine. Pain, pain intensity and pain disability in high school students are differently associated with physical activity, screening hours and sleep. Exposure to non-ionizing electromagnetic radiation from mobile telephony and the association with psychiatric symptoms. Assessment of the temporal trend of the exposure of people to electromagnetic fields produced by base stations for mobile telephones. The influence of the molecular structure of lipid membranes on the electric field distribution and energy absorption. Absence of synergistic effects on micronucleus formation after exposure to electromagnetic fields and asbestos fibers in vitro. Stimulation of phagocytosis and free radical production in murine macrophages by 50 Hz electromagnetic fields. Quality Matters: Systematic Analysis of Endpoints Related to "Cellular Life" in Vitro Data of Radiofrequency Electromagnetic Field Exposure. Pseudarthrosis after lumbar spine fusion: nonoperative salvage with pulsed electromagnetic fields. When I visited a friend in the hospital recently, I was annoyed that I was not allowed to use my cell phone. The effect of electromagnetic radiation in the radio-frequency range on the health status and morbidity of an organized group. Response to pulsed and continuous radiofrequency lesioning of the dorsal root ganglion and segmental nerves in patients with chronic lumbar radicular pain. Non-ionising radiation human exposure assessment near telecommunication devices in Croatia. Effects of electromagnetic fields generated by mobile phones on the nervous system. Cell phone electromagnetic field radiations affect rhizogenesis through impairment of biochemical processes. Acute Effect of Electromagnetic Waves Emitted from Mobile Phone on Visual Evoked Potential in Adult Male: A Preliminary Study. The immunostimulating properties of erythrocytes subjected to the action of ultraviolet irradiation and electromagnetic radiation during vibration exposure. Extremely low-frequency magnetic fields of transformers and possible biological and health effects. Evaluation of non ionizing radiation around the dielectric heaters and sealers: a case report. Total antioxidant capacity, total oxidant status and oxidative stress index in the men exposed to 1. Inappropriate implantable cardioverter defibrillator shock from a transcutaneous muscle stimulation device therapy. Norms and standards for radiofrequency electromagnetic fields in Latin America: guidelines for exposure limits and measurement protocols. Chromosome aberrations in lymphocytes of high-voltage laboratory cable splicers exposed to electromagnetic fields. Low frequency electromagnetic fields in the working environment-exposure and health effects. The effect of electromagnetic radiation in the meter wavelength on operators of short-wave radio transmitters. Comments on "Extremely low frequency electric fields and cancer: assessing the evidence" by Kheifets et al. Effect of the weak magnetic field of the Earth on cellular composition of spermatogenic epithelium of testes in rats. Implanted devices and electromagnetic interference: case presentations and review. Peripheral nerve stimulation by gradient switching fields in magnetic resonance imaging. Health effects of occupational exposure to electromagnetic fields in view of studies performed in Poland and abroad. Comparison of hair reduction with three lasers and light sources: prospective, blinded and controlled study. Journal of cosmetic and laser therapy: official publication of the European Society for Laser Dermatology. Effect of exposure to an extremely low frequency-electromagnetic field on the cellular collagen with respect to signaling pathways in osteoblast-like cells. Childhood brain tumour risk and its association with wireless phones: a commentary. Mobile and cordless telephones, serum transthyretin and the blood-cerebrospinal fluid barrier: a cross-sectional study. Review of four publications on the Danish cohort study on mobile phone subscribers and risk of brain tumors. Use of wireless phones and the risk of salivary gland tumours: a case-control study. Use of wireless telephones and serum S100B levels: a descriptive cross-sectional study among healthy Swedish adults aged 18- 65 years. Ownership and use of wireless telephones: a population-based study of Swedish children aged 7-14 years. Congenital anomalies in the offspring of rats after exposure of the testis to an electrostatic field. Living near overhead high voltage transmission power lines as a risk factor for childhood acute lymphoblastic leukemia: a case-control study. Treatment of patients with cardiac pacemakers and implantable cardioverter-defibrillators during radiotherapy. Pulsed or continuous electromagnetic field induce p53/p21-mediated apoptotic signaling pathway in mouse spermatogenic cells in vitro and thus may affect male fertility.

Mr Makgolo commented on the apparent contradiction in Zambia bacteria proteus buy cheap erythromycin 500 mg on line, whereby people strive for nomination of a site to antibiotic resistance data erythromycin 250 mg otc the Mr Mujica commented that this statement demonstrated World Heritage List bacteria plague inc 250 mg erythromycin free shipping, yet do not want it declared a national first of all the lack of interest in conservation among local monument antibiotics homemade discount erythromycin generic. He advocated the need for flexibility within the populations if no economic benefits are forthcoming; and Convention to recognize traditional protection. He responded that the World Heritage Convention allows for furthermore commented that this illustrates the benefits flexibility as the Operational Guidelines have made provision of linking sites to research institutions. The current text an example being the Waddenzee, located between the attaches great importance to the identification, documen- Netherlands, Germany and Denmark, where nomination is tation, inventorying and transmission of local values, tradi- opposed by certain states parties. Resolving this contradic- tions and expressions; the preliminary text expresses itself tion is a matter of continued dialogue, and explaining the against the freezing of traditional expressions and repre- concept of World Heritage with all its obligations, benefits sentations, and asks for the protection of the conditions and implications. Dr Fowler remarked that it is clearly very that enable communities and groups to further develop en important that a dialogue takes place before nomination, recreate their intangible heritage. He hoped to work in rather than risking the discovery of divergences and con- close collaboration with the World Heritage Centre in flicts after inclusion on the List. Mr Katanekwa noted that for many people in the Western Dr Fowler noted the importance of defining the idea of par- Province of Zambia fire is an important tool for regrowth ticipation in the process, rather than consultation. Ms of grass, clearing fields, facilitating hunting, and smoking Weninger referred to the idea of the World Heritage out bees. However, uncontrolled and destructive burning Indigenous Peoples Council of Experts as a platform for is a widespread phenomenon. Before independence, nat- information sharing, advice and opportunities for local peo- ural resources were under the jurisdiction of the traditional ple. Concerns expressed by all stakeholders Site Management and Traditional about long-term environmental changes and the impact of Management Systems uncontrolled burning led to the start of a fire management programme initiated by the Rangeland Management Discussion Team, which realized that fire management implemented by local communities was the first step to conserving nat- Dr Fowler invited comments from the floor. Workshops, involving represen- tatives of different users of natural resources, the different Mr Mujica insisted on the importance of facilitating the villages, local government staff, the local councillor, village participation of indigenous communities in international headmen and the area chief, were organized at district platforms (such as the World Water Forum) with the assis- level to discuss burning practices. Ms Maria Jose Curado (Portugal) commented on the diffi- Following the workshops, participants agreed to brief their culty of pursuing traditional management systems in the fellow villagers and initiated the formation of Silalanda Alto Douro wine region, as they are expensive and difficult Natural Resources Committees responsible for further to maintain. How can people be convinced that it may be work on the details of burning policy, awareness-raising important philosophically to maintain these traditional sys- amongst villagers, attendance and supervision of villagers tems of land usefi The first task of the Silalanda Natural Resources Committees was to for- Mr Patrice de Bellefon (France) stressed the need to recog- mulate bye-laws based on the discussions held during the nize that traditional agriculture not only produces food workshops. A meeting with the district government and security, but also guarantees biodiversity. In his view, tradi- traditional authorities was held to ensure that the bye-laws tional farmers must therefore be promoted through a new were compatible with governmental and traditional laws social and educational mission. Subsequently, a meeting was held in for them to bear responsibility, and to be subsidized by which the bye-laws were presented and approved by national authorities and the European Commission. Afterwards, the Committees Dr Jaroszewicz stated that for people to protect their tradi- started an active campaign to make the bye-laws known tions against the influence of potentially damaging external to the entire community and to people from elsewhere forces, people must be made to feel proud of them. For example, Management Issues more grass was available for animals, which were conse- a) Traditional management should always be respected quently in better condition. For example, because it is due to the pressure of globalization and since the arrival of labour intensive, it may be too expensive to survive Christian populations, local people have difficulty in prac- without changing. He stressed the need for respect for b) Traditional land use has often led to a high conservation ideas and values. Dr Fowler noted that although the Operational Guidelines have recognized the validity of traditional management systems since 1992, it is not a logical jump to go from local Plenary Session 5: values to ‘outstanding universal values’ within the frame- Site Management and Capacity Building work of the World Heritage Convention. Dr Titchen responded that the significance of local values is covered Moderator Benedicte Selfslagh (Belgium) opened the ses- by Article 5 (a) of the Convention which states that ‘Each sion by reminding the participants that capacity building is State Party shall endeavour to adopt a general policy one of the four strategic objectives which were established which aims to give the cultural and natural heritage a by the World Heritage Committee at its 26th Session in function in the life of the community’. She raised the question of whether or not sending international experts is sufficient for building the moderator for sessions 3 and 4, Dr Fowler, concluded efficient local capacity. He rather than stable and to involve access to and control believes that only then will we be able to adopt manage- of such basic resources as water. People Issues Dr Smook noted that it is imperative to consider the mul- a) Social structures are vital in traditional land manage- ticultural population of the Amsterdam region and to dis- ment and will almost invariably have to adapt to new cover how the site can have a meaning for them, as well circumstances to continue in a ‘traditional’ mode. This resulted in conflict between local commu- to cities, is also likely to be in progress, with conse- nities and the authorities, resulting in deaths. It is e) Perceptions of ‘heritage’ are likely to be various and imperative that all authorities, including site managers, be strongly held, requiring clear definition. She advocated that the target group for nal ones, needs to be identified and involved in any local empowerment by capacity building should be local com- situation, with respect for traditional views and in the munities. The key to successful conservation in India and expectation that they will be diverse and even conflicting. She noted g) External interest in a local situation, however well-inten- that harvesting in India is a sensitive issue, as there is a tioned, needs to be respectful, patient, personal and visible. She noted that tourism can be beneficial for regions with a programme of concerted action to assess communities, but that local people should be the guides, capacity building, awareness raising and other issues. Consequently, traditional and Heritage Centre for Africa and will shortly be discussed indigenous knowledge and practices must be considered a with the states parties and the advisory bodies. However, they may not finding is that all stakeholders have to be involved in the always be compatible with the scientific approach, as in programme for concerted action. She mentioned that the the case of fire, which is an important aspect of conserva- training strategy must address the needs revealed by peri- tion for traditional peoples, whereas site managers see it odic reporting region by region, sub-region by sub-region. The training strategy is a separate issue at the moment, and education must somehow be incorporated into it. Dr Marine Kenia (Georgia) referred to hundreds of tower houses that were built from the 13th to 16th centuries as Dr Mumma remarked that regeneration of communities is defence posts against invaders in the village of Chazhashi, the way to improve capacity building. Programme, has developed a preservation plan and rec- ommendations for the site management that will also Ms Selfslagh stressed the importance of using existing increase tourism and bring economic benefits. She concluded that her- emphasized that in the case of Upper Svaneti, develop- itage professionals have a responsibility to ensure that her- ment through conservation is the only option for the sus- itage conservation sustains development. She suggested that the World Heritage Centre establish a network of highland World the participants visited Fort Nigtevecht, part of the Heritage settlements, similar that of the cities, which Defence Line of Amsterdam, where the province of North would provide states parties with a platform on which to Holland and the City of Amsterdam are working together exchange ideas. It should emphasize dialogue opportunity to prepare themselves for a regular job or for between site managers and the communities around further professional training. It should be initiated at various levels, both techni- the participants dined at Fort Pampus, another feature of cal and political. Fort Pampus was built in 1895 on resources already existing within local communities. In his view, the main problem is in getting local people to understand the World Heritage Convention, the Plenary Session 6: Operational Guidelines, the Programmes and recommen- Site Management and Partnerships dations of the meetings. The World Heritage Centre could examine the possibility of bringing together groups of Moderator Ms Claudia von Monbart (World Bank, Paris) people and transferring the information to them in ways introduced the session by highlighting the importance of they understand. Mr Munjeri pointed out the gap between ‘what we say’ Discussion and ‘what we do’, and that we do not translate issues dis- cussed into what we do in the field. A lively discussion ensued on questions relating to capac- ity building and management skills, where the emphasis Dr Titchen explained the World Heritage periodic reporting lay on (1) the ability to work with people and on informa- system, which follows a six-year cycle on a regional basis. After having assessed the World Heritage sites, which can primarily be achieved needs outlined in the Africa and Arab States reports, the through ‘empowerment’ and (3) the question of intellec- World Heritage Committee became aware of the necessity tual property rights to the information being exchanged. The chair, Dr Rick van der Ploeg, presented the conclusions and recommendations which had been formulated by the Some concerns were also expressed, such as the risks of drafting group. He invited Ms Benedicte Selfslagh, overemphasizing the importance of involving local com- Rapporteur of the World Heritage Committee 2002-2003, munities as partners in decision making, and the signifi- and the other moderators to comment on the recommen- cance of World Heritage sites, leading to insufficient dations. The participants were then asked to comment attention for the non-listed heritage, and the need to find and to suggest other recommendations. Other debate, it was decided to convene for lunch, while the criticisms included the fact that heritage management at wording of the recommendations was finalized. After technical level often comes from above, from organiza- lunch and having presented a new draft of the recom- tions like the World Bank, without the involvement of local mendations, the chair suggested to the participants that a professionals. A question that was brought up several mandate be issued to the drafting group to come up with times during the discussion was the spiritual value that a final set of recommendations as quickly as possible. Following the approval of this proposal by all participants, the principle of partnership was discussed and partici- Dr Rieks Smeets expressed his gratitude on behalf of the pants remarked that partnership between people in the organising committee to all the participants for their con- cultural and natural field and the scientific world is also tribution to the results of the meeting, and thanked the very important. The general impression was that the natu- Dutch Ministry of Education, Culture and Science for its ral sector was moving much faster than the cultural sector. Professor Gaballa Ali Gaballa expressed his appreciation on behalf of the participants to the Government of the • Heritage conservation needs partnership at all levels. Netherlands and to the organising committee for their • Sharing of experience and information is essential to warm hospitality, and for offering a stimulating environ- conservation. He thanked the all, in order to move away from stringent financing to participants for having come to the Netherlands and con- built-in mechanisms.