Guidotti T L, Conway J B
Division of Occupational and Environmental Health, Graduate School of Public Health, San Diego State University, California.
Am J Prev Med. 1987 Sep-Oct;3(5):287-92.
The border between the United States and Mexico presents a number of problems related to health that are simultaneously local and international. Large-scale government-to-government interactions have generally failed to achieve lasting cooperation on important health issues, with a few important exceptions. One reason for this may be that the issues have been complicated by much larger and more complex social, cultural, economic, and political differences. Another is that large organizations must each function according to their own mandates, goals, and procedures and may not mesh well with others, even with nominal counterparts. In 1981 we conceptualized a model for encouraging binational cooperation on small-scale local projects. The model incorporates three elements: a significant and difficult but soluble technical problem affecting both sides of the border (the "technocratic factor"), a mutually respected individual or team whose function is to facilitate communication and prevent misunderstandings (the "human factor"), and the actions of governments or institutions larger than the working groups (the "institutional factor"). Subsequently, we applied the model to water quality and to the distribution of sources of toxic substances in the border area, which met the criteria for the technocratic factor. Two highly respected figures in environmental health, one American and one Mexican, mediated between colleagues on either side of the border and facilitated the development of projects. Finally, after the projects had been under way long enough to have demonstrated their viability and personal interactions among the principals had become trusting and collegial, the institutional factor was admitted and major financial and administrative support obtained.(ABSTRACT TRUNCATED AT 250 WORDS)
美国与墨西哥的边境存在一系列与健康相关的问题，这些问题兼具地方性和国际性。大规模的政府间互动在重要健康问题上总体未能实现持久合作，仅有少数重要的例外情况。原因之一可能是，这些问题因更大、更复杂的社会、文化、经济和政治差异而变得复杂。另一个原因是，大型组织必须各自按照自身的任务、目标和程序运作，可能无法与其他组织良好配合，即便名义上是对等的组织。1981年，我们构思了一个鼓励在小规模地方项目上开展双边合作的模式。该模式包含三个要素：一个影响边境两侧的重大、棘手但可解决的技术问题（“技术专家因素”），一个相互尊重的个人或团队，其作用是促进沟通并防止误解（“人为因素”），以及比工作组更大的政府或机构的行动（“机构因素”）。随后，我们将该模式应用于水质和边境地区有毒物质来源分布问题，这些问题符合技术专家因素的标准。两位在环境卫生领域备受尊敬的人物，一位是美国人，一位是墨西哥人，在边境两侧的同事之间进行调解，并推动了项目的开展。最后，在项目开展足够长时间以证明其可行性，且主要人员之间的个人互动变得相互信任且融洽之后，引入了机构因素，并获得了主要的资金和行政支持。（摘要截取自250词）
