Health risk awareness among farmers engaged in wastewaterfed aquaculture

1
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.
2
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

3
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 Womens Union
4
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

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Chemical ww is harmful organic ww is nutritious

• Sharp differentiation between chemical/harmful ww
  and organic/nutritious ww
• Smelly water -gt into the fields -gt harmful
  chemical substances sediment in the fields
  -gtnutritious 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

6
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
7
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
8
Womens health protective measures

• Womens 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

9
Womens 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

10
Mens protective measures

• Mens 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
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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

12
Health problems not serious!

• Health problems from wastewater cold/flu,
  itching skin, eroding nails/fungi infections,
  sore eyes, womens diseases
• Nail and skin problems considered temporary
  problems - disappear after 3-4 days if treated

13
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

14
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 -gt look
  fresh (non)
• Fresh not the same as clean but means a lot for
  the price

15
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 gt health concerns in every day work
  tasks
• Local understandings of gender -gt men use
  protective measures less often than women
• The importance of appearance -gt to increased
  health risks

16
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, Womens Union, individual
  farmers and other contacts in Hoang Liet commune
  is deeply thanked for their hospitality and
  positive attitude during study implementation