Heidi Hausermann

Buruli Ulcer Disease and Its Association with Land Cover in Southwestern Ghana

Background Buruli ulcer (BU), one of 17 neglected tropical diseases, is a debilitating skin and soft tissue infection caused by Mycobacterium ulcerans. In tropical Africa, changes in land use and proximity to water have been associated with the disease. This study presents the first analysis of BU at the village level in southwestern Ghana, where prevalence rates are among the highest globally, and explores fine and medium-scale associations with land cover by comparing patterns both within BU clusters and surrounding landscapes. Methodology/Principal Findings We obtained 339 hospital-confirmed BU cases in southwestern Ghana between 2007 and 2010. The clusters of BU were identified using spatial scan statistics and the percentages of six land cover classes were calculated based on Landsat and Rapid Eye imagery for each of 154 villages/towns. The association between BU prevalence and each land cover class was calculated using negative binomial regression models. We found that older people had a significantly higher risk for BU after considering population age structure. BU cases were positively associated with the higher percentage of water and grassland surrounding each village, but negatively associated with the percent of urban. The results also showed that BU was clustered in areas with high percentage of mining activity, suggesting that water and mining play an important and potentially interactive role in BU occurrence. Conclusions/Significance Our study highlights the importance of multiple land use changes along the Offin River, particularly mining and agriculture, which might be associated with BU disease in southwestern Ghana. Our study is the first to use both medium- and high-resolution imagery to assess these changes. We also show that older populations (≥ 60 y) appear to be at higher risk of BU disease than children, once BU data were weighted by population age structures.

Contours of Risk: Spatializing Human Behaviors to Understand Disease Dynamics in Changing Landscapes

We echo viewpoints presented in recent publications from EcoHealth and other journals arguing for the need to understand linkages between human health, disease ecology, and landscape change. We underscore the importance of incorporating spatialities of human behaviors and perceptions in such analyses to further understandings of socio–ecological interactions mediating human health. We use Buruli ulcer, an emerging necrotizing skin infection and serious health concern in central Ghana, to illustrate our argument.

‘I could not be idle any longer’: Buruli ulcer treatment assemblages in rural Ghana

Buruli ulcer is a necrotizing skin infection that largely affects poor people in the tropics. In Ghana, federal policies promise free treatment to all individuals with the disease. Yet, this research found there is a tension between official policy narratives and the lived experiences of people in endemic regions. I demonstrate that as top-down government channels struggle to provide sick people with care, new treatment assemblages emerge in rural areas. I use the experiences of two individuals and one group of practitioners—the pirate, hybrid herbalist, and practitioners for profit—to detail the social relationships and practices governing Buruli ulcer treatment. These treatment assemblages reflect diverse knowledge and economic forms and represent lines of flight from official, and exclusionary, systems of disease surveillance. In contrast with existing literature on Buruli ulcer in Africa, I argue rural peoples engagement with “traditional” medicine is often the result of policy failures and the disease is under-represented in national case counts. This work contributes to a growing body of critical political ecologies of health by examining the ways non-humans (e.g. Mycobacterium ulcerans, wild plants, anti-biotics), policy, desire, and prosaic practices combine to shape disease and treatment dynamics.

Situated knowledge of pathogenic landscapes in Ghana: Understanding the emergence of Buruli ulcer through qualitative analysis.

Successfully addressing neglected tropical diseases requires nuanced understandings of pathogenic landscapes that incorporate situated, contexualized community knowledge. In the case of Buruli ulcer (BU), the role of social science is vital to investigate complex human-environment interactions and navigate different ways of knowing. We analyze a set of qualitative data from our interdisciplinary project on BU in Ghana, drawing from participatory mapping, focus group discussions, semi-structured interviews, and open-ended survey questions to explore how people in endemic and non-endemic areas see themselves embedded in changing environmental and social landscapes. We pay particular attention to landscape disturbance through logging and small-scale alluvial gold mining. The results from our participatory research underscore the holistic nature of BU emergence in landscapes, encapsulated in partial and incomplete local descriptions, the relevance of collective learning to distill complexity, and the potential of rich qualitative data to inform quantitative landscape-disease models.

Unintended Developments: Gender, Environment, and Collective Governance in a Mexican Ejido

This article examines the unintended outcomes of a neoliberal program designed to privatize Mexicos communal lands. Although postrevolutionary agrarian law excluded women from official landholding and leadership positions, steps toward land privatization inadvertently increased womens access to land, government resources, and political power. Using ethnographic and survey data collected in a Veracruz ejido, I demonstrate how Mexicos agrarian counterreforms triggered novel subjectivities and practices. While men acted as self-imagined private property owners and decreased participation in traditional governance institutions, women became registered land managers and leaders for the first time in the ejidos history. These interlocking processes stopped the land-titling program in its tracks and reinvigorated collective governance. Even state actors charged with carrying out ejido privatization were implicated in the empowerment of rural women and failure to fully privatize land. This research contributes to nature–society debates by arguing neoliberalism does not always end economic self-determination and communal governance in agrarian contexts. Rather, I demonstrate the ways in which processual policy, subjectivity, authority formation, objects, and environmental narratives combine to produce new political trajectories with positive implications for rural women and the environment.

“Ghana must Progress, but we are Really Suffering”: Bui Dam, Antipolitics Development, and the Livelihood Implications for Rural People

ABSTRACT In late-2013, Bui Dam was commissioned on Ghana’s Black Volta River. The hydroelectric project inundated 444 km2, flooding communities, forests, crops, and a national park. State elites promoted the dam through nationalistic discourses while simultaneously framing rural people responsible for accessing its trickle-down economic benefits. Drawing from critical development literature within a political ecology framework, this article examines tensions between discourses underpinning construction of Bui Dam and the lived experiences of rural people. Drawing from data collected in 82 interviews, the dam’s implications for resettlement, food security, mental health, agricultural production, and fishing livelihoods are detailed. I argue interlocking discourses, laws and processes—from eminent domain and compensation metrics to party politics—combined to work as an “antipolitics machine.” Hydroelectric development renders invisible structural processes shaping inequality and creates new injustices. As Bui Power Authority, the corporation managing the dam and surrounding land-uses has a new CEO, the article concludes with several practical suggestions for improving community members’ everyday lives.