IDRC Book Panel
Ecohealth research can change the world, one action at a time
Climate change, emerging diseases, population growth and globalization: human health is deteriorating because of changes in ecosystems, and the situation keeps worsening. What can be done? With support from Canada’s International Development Research Centre (IDRC), ecohealth research finds and applies solutions to build healthier communities and ecosystems in developing countries. By bringing scientists together with local communities to define a problem, and by engaging those with power over the problem, innovative and permanent changes can be made. Achieving such impacts from research is not easy. Politics, private interests, conflicting priorities, and nature itself set road blocks in front of people seeking change. Should this prevent researchers from engaging in change processes? What are the best roles for researchers seeking change? Join in the discussion around success stories from the field. These stories and others will be profiled in Ecohealth (subtitle to be finalized), a collection of case studies slated for publication later this year by IDRC.
Ecohealth research for development
Presenter: Dominique Charron, IDRC
With ecohealth approaches, scientists collaborate with communities experiencing health problems rooted in a particular ecosystem and the people exerting power over the situation, towards achieving a permanent change that improves people’s health, their lives and the ecosystems they depend upon. This is not run-of-the-mill hypothesis-testing research. It requires scientists to work across disciplines, to engage communities and decision makers, and to consider power and equity by gender and other social divisions. The resulting participatory, action-oriented research can simultaneously improve human health and ecosystem conditions. While development donors and investors around the world are increasingly seeking evidence of the impact of their investments, other experts are pointing to ineffective overcrowding in the development field, particularly in health. Ecohealth is impactful research that responds to today’s complex problems.
Presenters: Lizzy Shumba, SFHC Project, Ekwendeni Hospital, Malawi and Rachel Bezner-Kerr, University of Western Ontario, London, Canada
Twelve years ago, children in northern Malawi were severely malnourished. Families were no longer able to afford the prices of commercial fertilizers, required because of declining soil fertility. Yelds of maize were inadequate to feed the community (Snapp et al. 1998). What began as an idea from a Malawian community nurse and a Canadian soil science student evolved into a highly successful community project that improved soil fertility by including new legume crops, involved communities in farmer field schools, seed banks, recipes, nutritional information, and improved child and maternal health practices. A few dozen farmers initially began intercropping two legume crops (e.g. pigeon pea and groundnut), which together improve soil fertility if the crop residues were buried after harvest. As edible food, the legumes had added nutritional and food security benefits, by adding a better source of protein and micronutrients to the diet. The project delved into gender and power dynamics within households, and how these affected child and maternal health. Now, the community of Ekwendeni and surrounding area boasts better food security, healthier thriving children, and more equitable and resilient community dynamics. Farmers in surrounding areas are adopting the cropping practices and families are developing and using new recipes, and the project now counts hundreds of participants. This level of impact was achieved without policy change. What are the elements of its success? How sustainable is this impact, and can it continue to spread without policy change?
Reducing airborne manganese in Molango, Mexico
Presenter: Horacio Riojas, National Institute of Public Health (INSP), Mexico
The region of Molango in the state of Hidalgo, Mexico has one of the largest manganese (Mn) ore deposits in the world, a metal used in manufacturing steel alloys, batteries and ceramics. Since the 1960 mining has been developed through open pits and shaft mines. Mining has transformed a previously forested landscape with open face ore extraction and additional roads, but it also brought new services and economic opportunities for local communities. However, in the 1980s, health concerns were raised. Developed by a multi-disciplinary team, with participation from the community, and eventually involvement of government and the mining company, this project determined that the average concentrations of outdoor airborne Mn were double of the US-EPA recommended levels (0.10 μg/m3); that inhalation was the main pathway for human exposure; and that 50% of the study population had unacceptably high Mn concentrations in their blood. A significant association between high Mn concentrations in the air (above 0.099 μg/m3) and the poor results of neuro-motor tests was shown. These subtle neurological effects occur even in areas with Mn levels within national allowable levels. The project worked diligently to engage the mining company and communities in understanding and taking steps to reduce exposure, and continues to work with various levels of government to lower the standard allowable concentration of Mn in the air.
Broadening malaria control policies to include environment in Tanzania
Presenter: Leonard Mboera, National Institute for Medical Research, Dar es Salaam, Tanzania
Mvomero district in central Tanzania has perennial malaria transmission, with an overall prevalence of malarial infection of 43%. The district economy depends heavily on crop agriculture, with 80% of adults earning their livelihood from agriculture. Reliable information on environmental risks to health is fundamental for the prevention and control of malaria, for evidence-based guidance of health policy and planning, and for the promotion of intersectoral action for the reduction of transmission. A multi-disciplinary research team worked in collaboration with policy makers, local politicians and other stakeholders to show that malaria transmission and disease burden vary from one agro-ecosystem to another. Irrigated rice farming contributed more highly to malaria transmission intensity and prevalence than other agro-ecosystems. The prevalence of malaria and helminth co-infections was highest among school children from rice farming systems. Only a third of sick individuals sought treatment from health facilities, and the formal health care system reached fewer than half of the individuals requiring- treatment.Self medication is frequent and a significant financial burden on households. Participatory involvement of the community and sectors other than health in developing malaria control strategies at local level contributed to changing malaria control policy, including the National Medium Term Malaria Strategic Plan and the National Malaria Control Advisory Committee to include members from outside the Health Sector, particularly from Agriculture and Irrigation.
Rebuilding urban ecosystems for better community health in Kathmandu, Nepal
Presenter: D. D. Joshi and Minu Sharma, National Zoonoses and Food Hygiene Research Centre Kathmandu, Nepal
Along the Bishnumati river in Kathmandu, traditional slaughter practices of water buffalo and other animals, combined with dogs infected by a tapeworm (echinococcosis or hydatidosis) and other gastro intestinal parasites, were important transmission factors of high gastro intestinal disease occurrence in butcher neighborhoods of the city. Local people were not necessarily aware of transmission patterns. Classical epidemiological studies identified main disease transmission routes, but were not sufficient to interrupt the transmission cycle. Participatory approaches to engage relevant stakeholders for mutual learning and behavior changes – based on a negotiated ecohealth research vision and action plan in community development, proved to be more effective. Mostly from nil experience, stakeholders formed different community-based organizations to work in different activities that lead to a number of interconnected social, economic, and environmental changes. These include new policies on animal slaughtering and meat inspection, local regulations for butchers and meat sellers, stronger organization of several stakeholder groups, and community awareness and pressures for changes to improve health and environment conditions in the neighborhoods. The local landscape reflects these changes – community gardens now replace open air slaughter sites and once degraded riverbanks where cattle was held. Regulated and hygienic slaughtering practices have been implemented. Research and intervention also addressed garbage collection, improvement of basic services (water, sanitation and healthcare), and the strengthening of local governance to implement a healthier and more sustainable form of community planning.