Download Health risks awareness among farmers in Hanoi

Health risk awareness among farmers
engaged in wastewater-fed aquaculture
- An anthropological study in
Thanh Tri district, Hanoi
Knudsen, L.G1., Hiep, N.T.2., Vuong, T.A3., Dalsgaard, A4., Samuelsen,
H1 and Konradsen, F1. 1Department of International Health, University
of Copenhagen; Research Center for Gender, Family and
Environment in Development 2; Division of Enteric Diseases, NIHE3;
Department of Veterinary Pathobiology, KVL4.
Introduction
• Anthropological study of farmers
awareness of health risks
associated with wastewater (ww)fed agri-aquaculture culture to
obtain in-dept knowledge on
farmers risk perceptions
• Fieldwork in Bang B village in
Hoang Liet commune, Thanh Tri
district, Hanoi (PAPUSSA site).
• Period: Nov-Dec 2005
Approach and methods
• Qualitative approach
• 1 Vietnamese and 1
Danish anthropologist
• Key informant
interviews with local
authorities and health
staff
Focus group discussions, semi-structured
interviews and informal interviews with aquatic plant
and fish producers
Observations of working practices
Participant observation
Bias – most contacts identified by/from Women’s
Union
9 local terms for water
• Official term is Waste
water/‘Nuoc thai’
• Local term is Smelly
water/ ‘Nuoc thoi’
• Smelly water is harmful
and nutritious
• Detergent/chemical
waste water/’Nuoc sut’
is the most harmful type
of water
Chemical ww is harmful – organic ww is
nutritious
• Sharp differentiation between
chemical/harmful ww and
organic/nutritious ww
• Smelly water -> into the fields ->
harmful chemical substances
sediment in the fields ->nutritious
water
• Local authorities inform about
how to use pesticides and clean
domestic water for irrigation
• No information/guidance
provided on how to work with ww
The importance of production
• Quality of water:
- no influence on use
of measures to protect
health
- influences decisions
on usage of water for
plants/fish!
Importance of water and plants:
“People can survive three days without food,
but vegetables can not survive without water for three
days”
No protective health measures to be taken if they
slow down work and production
Health protective measures –
”Not real hand”
• Gloves and boots are
“difficult to wear” (“vuong”)
• Gloves are “not real hand”
(“không thât tay”)
• Planting Water Morning
Glory, harvesting Water
Dropwort is easier with
gloves
Depends on the work
- Harvesting Water Morning Glory is difficult with
gloves - need fingertips
- Planting Water Dropwort is difficult with gloves need precision
- Water Mimosa and fish harvest is difficult with
boots - water level too high
Women’s health protective measures
• Women’s occupations - aquatic
plant production and cleaning
plants at the ponds
• Long thick, pink rubber gloves: To keep warm, protect against
water. Very difficult to work with.
• Long white cotton gloves with
holes for fingertips:
- Against sun; protect against
dark fluid from Water Morning
Glory, dirty water. Easier to work
with
• Short thin latex gloves: Against
water. Easy to work with – but
break easily
Women’s health protective measures
• Thin rubber boots above
the knees - common
• Thick rubber boots, below
the knee - often used when
cleaning aquatic plants
• Boots - keep warm, protect
against sharp things, keep
clothes clean, and prevent
skin/nail problems
• Mask/scarf – to protect skin
against the sun
Men’s protective measures
• Men’s occupations - fish
production and heavy work
tasks in aquatic plant
production
• Aquatic plant production:
- Sometimes boots, difficult to
walk with boots; Gloves, less
often…
Fish harvest:
In summer, underwear and plastic sandals to protect
against sharp things.
- In winter, more clothes to keep warm
- Water level too high, cannot protect against
water
Women have ’soft hand’ –
men have ’hard hand’
• “More difficult for men to wear
gloves and boots…”
• “Men have to work faster,
walk a lot and have ‘a hard
hand’”
• “Men have stronger health
than women”
• “Women work slowly, carefully and have ‘soft/smooth
hands’” “Women work in the same place”
• “Women are more vulnerable to cold water and cold air”
Health problems – not serious!
• Health problems from
wastewater – cold/flu,
itching skin, eroding
nails/fungi infections,
sore eyes, women’s
diseases
• Nail and skin problems
considered temporary
problems - disappear
after 3-4 days if treated
Personal hygiene –
self-treatment of skin problems
• Vietnamese produced
cheap medical topicants
(lotions, etc) containing
antimicrobials bought from
the local pharmacist – only
contacts to health station
when problems are serious!
• Topicant should be used 2-3 times daily – people
apply only in evenings because they work in the
day time
• People wash themselves with salt and soap when
they return from work
Dirt – the importance of appearance
• Aquatic plant producers
clean hands and feet in
wastewater! Why?
• 2 levels of cleanliness –
clean appearance and
real cleanliness (in a
microbiological/food
safety term)
• Appearance is very important.
• Wash plants in wastewater before selling -> look
’fresh’ (‘non’)
• ’Fresh’ not the same as clean but means a lot for
the price
Summary
• Not enough information
on health risks
associated with ww-fed
agri-aquaculture
• Skin and nail problems
are not considered the
most serious health
problems
• No ideal protective
measures have so far
been identified
• Productivity > health concerns in every day work tasks
• Local understandings of gender -> men use protective
measures less often than women
• The importance of appearance -> to increased health
risks
Acknowledgements
• This study was mainly supported by the Danish
International Development Assistance (Danida)
through a grant to IWMI (International Water
Management Institute), but also from the
ENRECA project “Sanitary Aspects of Drinking
Water and Wastewater Reuse”.
• Staff at NIHE is thanked for their help with project
logistics
• The local authorities, Women´s Union, individual
farmers and other contacts in Hoang Liet
commune is deeply thanked for their hospitality
and positive attitude during study implementation