Frédéric Mertens

Network Approach for Analyzing and Promoting Equity in Participatory Ecohealth Research

Effective involvement and equity in participation between men and women and the various community groups are likely to influence the equity in the sharing of the development outcomes of any participatory research project. The CARUSO project, a participatory research based on the ecosystem approach to human health, showed that the inhabitants from Brasília Legal, a small village located on the river banks of the Tapajós river in the Brazilian Amazon, are exposed to mercury through fish consumption; a subsequent participatory intervention based on dietary changes was effective in reducing mercury exposure of the population. In the present study, we focus on equity in participation and analyze the discussion network about mercury and health to measure individual and group involvement in the community. Participation in the discussion network is associated with the awareness of the critical information necessary to allow the individual to change dietary habits toward the preferential consumption of the less contaminated fish species. Our network analysis shows that gender, age, religion, education, subsistence activities, and spatial distribution of the houses are key elements affecting the involvement of the population in discussions about mercury and health. Based on these results, we propose strategies for integrating the research results and the knowledge of the villagers in a new cycle of participatory research in order to address the lack of involvement of some groups and to promote equitable participation and benefit sharing.

Social communication network analysis of the role of participatory research in the adoption of new fish consumption behaviors

The formulation and communication of fish advisories are highly complex because of the potential conflict between the nutritional and toxicological issues associated with fish consumption. Government and organization-sponsored fish advisories have had limited success in changing behaviors. Participatory approaches may enhance the understanding of complex issues and the adoption of new behaviors. Here we used social network analysis to investigate the adoption of dietary changes within the context of a community participatory research project. In the Brazilian Amazon, many communities are highly exposed to methylmercury from fish consumption. A participatory intervention based on dietary changes aimed at reducing methylmercury exposure while maintaining fish consumption was initiated in 1995. In 2001, we collected data on individual participation in the research, on the discussion network regarding mercury issues and on changes in fish consumption from 96 of the 110 village households. More than half of men and women had adopted new fish consumption behavior to reduce mercury exposure. Adoption was associated with participation in the research project for both women and men, and with a higher number of discussion partners about mercury issues for women. Adoption was likewise associated with the presence of a female communication partner in the personal networks of both men and women. At the household level, men and women who considered their spouse as a discussion partner were more likely to adopt than those who did not. Opinion le]adership was associated with change in fish consumption only for women. We discuss the contribution of community participation and communication networks to overcome the difficulties in generating complex messages that take into account both health benefits and risks of fish consumption. We also discuss the relevance of building preventive health programs based on participatory research approaches and the roles and relations specific to men and women.

Emergence and Robustness of a Community Discussion Network on Mercury Contamination and Health in the Brazilian Amazon

Information exchanges, debates, and negotiations through community social networks are essential to ensure the sustainability of the development process initiated in participatory research. The authors analyze the structural properties and robustness of a discussion network about mercury issues in a community in the Brazilian Amazon involved in a participatory research aimed at reducing exposure to the pollutant. Most of the villagers are connected in a large network and are separated from other individuals by few intermediaries. The structure of the discussion network displays resilience to the random elimination of villagers but shows vulnerability to the removal of one villager who has been a long-term collaborator of the project. Although the network exhibits a structure likely to favor an efficient flow of information, results show that specific actions should be taken to stimulate the emergence of a pool of opinion leaders and increase the redundancy of discussion channels.

Redes sociais, capital social e governança ambiental no Território Portal da Amazônia

The article presents an empirical study where social network analysis is used to map social capital among actors involved in environmental governance processes in the Brazilian Amazon. Using interviews, we carried out the mapping of the dialogue network regarding socio-environmental issues among 505 actors from the Amazonian Gateway Territory. The analysis identified 3384 dialogue relationships. Each actor has an average of 6,7 dialogue partners. The analysis of the structural characteristics of the dialogue network was used to build indicators of social capital of the bonding type, based on the mapping of the organization among actors from the same municipalities, and bridging type, based on the identification of relationships among actors from different municipalities. At the municipal level, the distribution of the two types of social capital allowed the characterization of groups of actors according to their differing participation in the environmental governance of the Territory. At the territorial level, the connectivity pattern among the 16 municipalities exhibits a balance between the two types of social capital and reveals the potential of communication and organization among actors, as demonstrated through the example of the local Agenda 21 projects. These results demonstrate how social network analysis can contribute to the definition (or re-definition) of the territories frontiers in order to include a set of municipalities whose cohesion is based on effective social relationships. We also propose governance actions for the Amazonian Gateway aiming at strengthening dialogue processes, reducing conflicts and promoting the sustainable use of natural resources in the Amazon.

Ecology of Rhodnius robustus Larrousse, 1927 (Hemiptera, Reduviidae, Triatominae) in Attalea palm trees of the Tapajós River Region (Pará State, Brazilian Amazon)

BackgroundThe rising number of acute cases of Chagas disease in the State of Pará, reported in the past two decades, has been associated, in part, with the ingestion of juice of local palm tree fruits, mainly açaí berry and bacaba. Near the study area, in Santarém, Pará State, an outbreak of Chagas disease has been notified and investigations suggest the consumption of bacaba juice as the main source of infection with T. cruzi. The purpose of this study is to assess the aspects associated to the ecology of Rhodnius robustus in palm trees of three communities of the Tapajós region, in the State of Pará, Brazil.MethodsPalm trees were cut down and dissected to search for triatomines. DNA from triatomines was extracted to investigate natural infection by Trypanosoma cruzi and T. rangeli. For statistical analyzes, data from infestation of palm trees, as well as the rates of natural infection by T. cruzi and T. rangeli were compared by Chi-square test. Triatomine density values were analyzed by the nonparametric Kruskal Wallis test and then comparisons between each pair of variables were made by the Mann–Whitney test assuming a confidence interval of 95%.ResultsWe dissected 136 palm trees, 60 at the end of the rainy period and 76 at the end of the dry period. Seventy-three of them (53.7%) were infested with triatomines and three species were found, namely: Rhodnius robustus, Rhodnius pictipes and Panstrongylus lignarius. We collected 743 triatomines, and R. robustus was predominant (n = 739). The identification of natural infection of the insects by trypanosomatids revealed that 125 triatomines were infected by T. cruzi, 69 by T. rangeli and 14 presented both parasites, indicating the presence of mixed infection in the same vector.ConclusionThe results suggest that São Tomé is the community with greater density of triatomines and infestation of palm trees; also, it demonstrates the existence of an intense sylvatic cycle in the region, which demands intensive surveillance to prevent human transmission.

[Challenges for knowledge generation in environmental health: an ecosystemic approach].

This article examines opportunities and limitations regarding knowledge generation in the field of environmental health. The contention is that understanding the complexity of factors that determine the health of humans and ecosystems requires a redefinition of the traditional distribution of roles and responsibilities in scientific research. These research practices involve inter and transdisciplinary approaches and the application of an ecosystemic approach (ecohealth). Challenges and opportunities associated to the application of inter and transdisciplinarity in environmental health problems are discussed and illustrated by two case studies that use an ecohealth approach: a project on the contamination and exposure to mercury in the Brazilian Amazon, and another on the urban transmission of echinococcosis in Nepal. In the conclusion, the potential benefits of using an ecohealth approach in overcoming the limitations of unidisciplinary practices and in taking advantage of local knowledge and participation is stressed.

Ecohealth and resilience thinking: a dialog from experiences in research and practice

Resilience thinking and ecosystems approaches to health (EAH), or ecohealth, share roots in complexity science, although they have distinct foundations in ecology and population health, respectively. The current articulations of these two approaches are strongly converging, but each approach has its strengths. Resilience thinking has developed theoretical models to the study of social– ecological systems, whereas ecohealth has a vast repertoire of experience in dealing with complex health issues. With the two fields dovetailing, there is ripe opportunity to create a dialog centered on concepts that are more thoroughly developed in one field, which can then serve to advance the other. In this article, we first present an overview of the ecohealth and resilience thinking frameworks before opening a dialog centered on seven themes that have strong potential for cross-pollination between the two approaches: scale interactions, regime shifts, adaptive environmental management, social learning, participation, social and gender equity, and knowledge to action. We conclude with some future research suggestions for those interested in theoretical and practical applications at the intersection of environment and health. In particular, closer collaboration between these two fields can lead to addressing blind spots in the ecosystem services framework, complementary social-network analysis, the application of resilience heuristics to the understanding of health, and the development of a normative dimension in resilience thinking.

Os desafios da geração do conhecimento em saúde ambiental: uma perspectiva ecossistêmica

This article examines opportunities and limitations regarding knowledge generation in the field of environmental health. The contention is that understanding the complexity of factors that determine the health of humans and ecosystems requires a redefinition of the traditional distribution of roles and responsibilities in scientific research. These research practices involve inter and transdisciplinary approaches and the application of an ecosystemic approach (ecohealth). Challenges and opportunities associated to the application of inter and transdisciplinarity in environmental health problems are discussed and illustrated by two case studies that use an ecohealth approach: a project on the contamination and exposure to mercury in the Brazilian Amazon, and another on the urban transmission of echinococcosis in Nepal. In the conclusion, the potential benefits of using an ecohealth approach in overcoming the limitations of unidisciplinary practices and in taking advantage of local knowledge and participation is stressed.

Quality of life and health perceptions among fish-eating communities of the Brazilian Amazon : an ecosystem approach to well-being

Mercury (Hg) contamination in the Brazilian Amazon constitutes a serious environmental and public health issue. This study is part of the CARUSO Project, which uses an ecosystem approach to human health to examine the sources, transmission, and effects of Hg in the Brazilian Amazon, with a view to developing preventive intervention strategy. To date, studies have focused on measures of Hg exposure through fish consumption in relation to health effects; little attention has been given to quality of life (QoL). The objective of this study was to examine the relations between QoL and health perceptions, Hg exposure, sociodemographics, living conditions, and lifestyle in communities along the Tapajós River. A total of 456 adults from 13 villages were interviewed and provided hair samples for Hg analysis. Results showed that perceptions of QoL and health are relatively positive, despite elevated Hg exposure. Logistic regression analyses showed that a positive perception of QoL was associated with the absence of chronic illnesses, not smoking, fruit consumption, residing on the banks of the Tapajós, and living in an in-migrants’ community. The positive perception of health was associated with younger age, the absence of reported symptoms of chronic illnesses, and drinking alcoholic beverages. Cluster analysis revealed that the group that reported the highest QoL had a traditional lifestyle, involving daily fishing and high fish consumption. However, this traditional lifestyle is associated with elevated Hg levels and early reported symptoms potentially linked to Hg exposure. These findings underline the importance of understanding the factors underlying QoL to develop adequate strategies to reduce Hg exposure and promote well-being.

Integração de políticas e governança ambiental: o caso do licenciamento rural no Brasil

We focus on cross-sectoral policy coordination, based on the study of the relationships between deforestation in land settlement projects and rural environmental licensing. We identified technical and administrative failures, lack of integration and coordination in the implementation of the licensing policies. Efficient initiatives to reduce deforestation involve coordinated and integrated multidimensional actions across various political sectors.