BMC Public Health | |
Easier said than done: challenges of applying the Ecohealth approach to the study on heavy metals exposure among indigenous communities of the Peruvian Amazon | |
Miguel San Sebastian1  Ingvar A Bergdahl4  Anna-Britt Coe2  Cynthia Anticona3  | |
[1] Department of Public Health and Clinical Medicine, Epidemiology and Global Health Umea University, Umeå, SE-901 85, Sweden;Umeå Center for Gender Studies, Umeå University, Umeå, SE-901 87, Sweden;Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umea University, Umeå, SE-901 85, Sweden;Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umea University, Umeå, SE-901 85, Sweden | |
关键词: Challenges; Participatory research; Peru; Amazon; Indigenous; Heavy metals exposure; Ecohealth; | |
Others : 1162244 DOI : 10.1186/1471-2458-13-437 |
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received in 2012-06-18, accepted in 2013-04-26, 发布年份 2013 | |
【 摘 要 】
Background
The renewed interest in community participation in health research is linked to its potential for bridging gaps between research and practice. Its main attributes are the generation of knowledge that can lead to socially robust, long-lasting solutions and the creation of a co-learner relationship between researchers and research users. Following this philosophy, Ecohealth has evolved into a specialized framework for participatory research on the impact of pollution on ecosystems and human health. However, its principles pose considerable challenges. Its outcomes are strongly influenced by contextual factors that are impossible to control for ahead of time.
This paper describes how the Ecohealth principles were applied to an epidemiological study of heavy metals exposure among indigenous communities of the Peruvian Amazon. It illustrates how knowledge generated from participatory research does not necessarily imply solving a public health problem. This study aimed to contribute to the understanding of the benefits and barriers of following the basic principles of the Ecohealth approach, and assist researchers working in similar contexts.
Research process
Based upon their personal experience as participant observers, the authors describe the research process; then, they discuss the most important challenges faced, their implications, and the attempted strategies for resolution.
Challenges
Challenges were grouped into four themes: (1) building trust; (2) one partnership, many stakeholders, multiple agendas; (3) being a researcher; and (4) communicating complex and unexpected findings.
Conclusions
Integrating the principles of transdisciplinarity and participation posed a series of challenges to the research process that were difficult, and sometimes impossible to overcome. However, positive outcomes from this experience were the lessons learned by the different actors. Despite the lack of immediate action, it is expected that useful interventions to prevent and control lead exposure in the Corrientes population will be implemented in the medium term.
【 授权许可】
2013 Anticona et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
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20150413060406904.pdf | 177KB | download |
【 参考文献 】
- [1]Finer M, Jenkins C, Pimm S, Keane B, Ross C: 2008. Oil and Gas Projects in the Western Amazon: Threats to Wilderness, Biodiversity, and Indigenous Peoples. Plosone 1999, 3(8):e2932.
- [2]Orta M: Etnocartografia de impactos de la actividad petrolera en el río Corrientes. Tesis de doctorado. Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona; 2007.
- [3]CENSOPAS (Centro de Salud Ocupacional y Protección del Ambiente para la Salud): Informe técnico monitoreo biológico comunidades San Cristobal y Jose Olaya, cuenca río Corrientes de Loreto, 19 al 26-07-06. Lima: CENSOPAS; 2007.
- [4]Earth Rights International (ERI), Racimos de Ungurahui, Amazon Watch: A legacy of harm: Occidental Petroleum in indigenous territory in the Peruvian Amazon. Washington/Lima/San Francisco: ERI, Racimos de Ungurahui, Amazon Watch; 2007.
- [5]MINSA (Ministerio de Salud del Peru): Análisis de la situación de salud del pueblo Achuar. Lima: Dirección General de Epidemiología, MINSA; 2006. [Serie análisis de situación de salud y tendencias 2006]
- [6]Lu G: The Corrientes river case: Indigenous people’s mobilization in response to oil development in the Peruvian Amazon. USA: Masther thesis. Department of International Studies and the Graduate School of the University of Oregon; 2009.
- [7]Clapp R: Popular epidemiology in three contaminated communities. Ann Amer Acad Polit Soc Sci 2002, 584:35-46.
- [8]Parkes M: Ecohealth and Aboriginal Health: A Review of Common Ground. Canada: National Collaborating Centre for Aboriginal Health; 2011.
- [9]Charron D: Ecohealth Research in Practice. Ottawa, ON, Canada: Innovative Applications of an EcosystemApproach to Health. International Development Research Centre; 2012.
- [10]WHO: Primary health care: now more than ever. Geneva: World health report. World Health Organization; 2008.
- [11]Morgan L: Community Participation in health: perpetual allure, persistent challenge. Health policy plann 2001, 16(3):221-230.
- [12]Leung M, Yen I, Minkler M: Community-based participatory research: a promising approach for increasing epidemiology’s relevance in the 21st century. Int J Epidemiol 2004, 33:499-506.
- [13]Bell E, Brambilla P: Gender and Participation: Supporting resources collection. London: Institute for Development Studies; 2001.
- [14]Harries-Jones P: Making Knowledge Count. London: McGill Queens University Press); 1991.
- [15]Hondagneu-Sotelo P: Reflections on Research and Activism with Immigrant Women Why Advocacy Research? Am Sociol 1993, 24(1):56-68.
- [16]Lebel J: Health an Ecosystem Approach. Ottawa, ON, Canada: International Development Research Centre; 2003.
- [17]Anderson L: Analytic Autoethnography. J Contemp Ethnogr. 2006, 35:373-395.
- [18]FECONACO: Sistematización de experiencias con el programa de capacitación y vigilancia territorial independiente de FECONACO. Iquitos, Peru: ; 2011.
- [19]San Sebastián M: Oil development and rural health in the Amazon basin of Ecuador: the popular epidemiology process. PhD Thesis. UK: University of London for the degree of Doctor of Philosophy in the Faculty of Medicine Department of Public Health and Policy. London School of Hygiene and Tropical Medicine; 2001.
- [20]San Sebastián M, Anticona C: Determinación de las fuentes de contaminación y Factores de riesgo por plomo y cadmio en tres comunidades nativas de la cuenca del río Corrientes. Umea, Suecia: Universidad de Umea; 2009.
- [21]Anticona C, Bergdahl I, Lundh T, Alegre Y, San Sebastian M: Lead exposure in indigenous communities of the Amazon basin, Peru. Int J Hyg and Envir Heal 2011, 215:59-63.
- [22]Anticona C, San Sebastián M: Factores de riesgo, fuentes y rutas de exposición por plomo y cadmio en comunidades nativas del río Corrientes. Umea, Suecia: Universidad de Umea; 2011.
- [23]Christopher S, Watts V, McCormick A, Young S: Building and maintaining trust in a Community-Based Participatory Research Partnership. Am J Public Health 2008, 98(8):1398-1406.
- [24]Cashman SB, Adeky S, Allen AJ, Corburn J, Israel BA, Montano J: The power and the promise: Working with communities to analyze data, interpret findings, and get to outcomes. Am J Public Health 2008, 98:1407-1417.
- [25]Lantz P, Viruell-Fuentes E, Israel B, Softley D, Guzman R: Can Communities and Academia Work Together on Public Health Research? Evaluation results from a Community-Based Participatory Research Partnership in Detroit. J Urban Health 2001, 78(3):495-507.
- [26]Israel B, Schulz A, Parker E, Becker A: Review of community-based research: Assessing Partnership Approaches to Improve Public Health. Annu Rev Publ Health 1998, 19:173-202.
- [27]Jacobs G: Conflicting demands and the power of defensive routines in participatory action research. Action Research 2010, 8(4):367-386.
- [28]Wallerstein N, Duran B: Using Community-Based Participatory Research to Address Health Disparities. Health Promot Pract 2006, 7(3):312-323.
- [29]Edwards K, Lund C, Gibson N: Ethical Validity: Expecting the Unexpected in Community-based Research. Pimatisiwin 2008, 6(3):17-30.
- [30]Ulloa A: The Ecological Native: Indigenous Peoples’ Movements and Eco-governmentality in Colombia. Bogota, Colombia: Instituto Colombiano de Antropología e Historia-ICANH; 2003.
- [31]Mergler D: Worker participation in occupational health research: Theory and practice. Int J Health Serv 1987, 17(1):151-167.
- [32]Savitz D, Poole C, Miller W: Reassessing the Role of Epidemiology in Public Health. Am J Public Health 1999, 89(8):1158.
- [33]Coughlin SS: Environmental justice: the role of epidemiology in protecting unempowered communities from environmental hazards. Sci Total Environ 1996, 184:67-76.
- [34]Morello-Frosch R, Brody J, Frye M, Brown P, Altman R: The Right to Know, the Right to Act, and the Right Not-to-Know: Ethical and Scientific Dilemmas of Reporting Data in Biomonitoring and Environmental Exposure Studies. Montreal, Quebec, Canada: Presented at the annual meeting of the American Sociological Association, August 11–14; 2006.
- [35]Galvez MP, Peters R, Graber N, Forman J: Effective risk communication in children’s environmental health: lessons learned from 9/11. Pediatr Clin N Am 2007, 54:33-46.
- [36]Deck W, Kosatsky T: Communicating their individual results to participants in an environmental exposure study: insights from clinical ethics. Environ Res 1999, 80(2 Pt 2):S223-S229.