The Government and authorities in Brazil were faced with a tragic accident in Goiânia resulting from the misuse of a strongly radioactive medical teletherapy source not under radiation protection surveillance. The present report is divided into four parts: a chronology of destruction of the source, discovery of the accident and initial response; a description of the human consequences and the dosimetry and treatment of seriously exposed and contaminated persons; an account of the assessment of the environmental contamination and the remedial actions taken; and observations and recommendations. Appendices and annexes give an assessment of the effectiveness of international co-operation in the emergency response, and provide further information on: public communications; radiological survey equipment; guidelines for the discharge of patients; radiological protection; chemical decontamination; and the lessons learned.

Hace un extensivo analisis de la situacion de salud y de los sistemas de salud, y concluye con una propuesta operativa para apoyar el desarrollo de los sistemas locales de salud como un camino para lograr la transformacion necesaria de los sistemas nacionales de salud de acuerdo con los principios y valores inherentes a la salud para todos. Los Gobiernos de los paises de las Americas reiteran asi su compromiso de alcanzar la meta de salud para todos, e identifican al proceso de descentralizacion y a los sistemas locales de salud como elementos centrales en la aplicacion de la estrategia de atencion primaria para la transformacion de los sistemas y servicios de salud (AU).

This book explores key metropolitan management issues, presents practical principles of good governance as they apply to the metropolis, and unfolds cases of institutional and programmatic arrangements to tackle such issues.

For the first time in the republican history of Peru, the presidential transition takes place in democracy, social peace, fast economic growth and favorable world markets. In other words, there has never been a better chance to build a different Peru - a richer country, more equal and governable. There are multiple ways to achieve that goal. New reforms must stem from a widespread and participatory debate, one of a common vision conceived for and by Peruvians. This book aims at making a technical and independent contribution to such debate; it summarizes the knowledge available about the challenges to be faced by the new administration. The study does not recommend silver bullets, but suggests policy options. It is based on the analysis of the current reality and in six decades of relationships with Peru, in which the Bank has implemented more than 100 projects and prepared more than 500 technical reports covering the wide range of development topics. When necessary, the study provides lessons that the Bank has learned elsewhere. The study provides a conceptual framework to the analysis of the country's 34 economic sectors and the two historical perspectives behind them. In doing so, it offers a comprehensive reform agenda that sheds light on possible priorities and courses of action.