GRF 2nd One Health Summit 2013: Presentation by David Clement Hall, University of Calgary

1. Ecosystem approaches to improving water health
David Hall, DVM, PhD and Quynh Ba Le, MD, MPH
dchall@ucalgary.ca
GRF Davos One Health Summit 2013
November 18, 2013
Davos, Switzerland

2. Vietnam – quick facts
• Population c. = 91,520,000
• Rapid rise in GDP/person
• $1,130/person (2010)
• high income disparity
• Poverty rate (<$150/yr.) c.15%
• 80% of poor are farmers
• High read/write literacy (94% age 15 and over)
• 70% of provinces, water does not meet WHO coliform std.
Map: University of Texas map library

3. Vietnam – poultry, rice, and water are ubiquitous
Photo: D. Hall

4. 6 Methodological Pillars of Ecohealth
 Recognize complexity of systems
 Transdisciplinary research
 Participatory approach/ Communities
 Gender and social equity research
 Sustainability
 Knowledge to Action
www.idrc.ca

5. “Ecosystem approaches to improved water and farm health in Vietnam”
Photos: D Hall and QB Le unless otherwise noted.

6. A transdisciplinary team
UC Veterinary Medicine
UPEI Atlantic Veterinary College
Hanoi School of Public Health
Water Resources University
Research Institute for Aquaculture No.1
Natl. Inst. of Veterinary Research
Villagers, government, and industry

7. The global health problem to address
Agriculture, water, and emerging infectious diseases (EIDs)
• Integrated agriculture is important
to low income Vietnamese farmers
• Limited health knowledge leads
to increased risk of EIDs
• Waste management is a concern

8. The basic idea (the intervention)
• Water testing is:
• complicated
• time consuming
• expensive
• Results difficult to translate to action

9. The basic idea (the intervention)
•Simplify water testing
•Include basic:
• water health understanding
• livestock management
• public health knowledge

10. Assumption
•
Understanding farmers’ perceptions of water health plus
objective assessment and training is critical to changing
risky behaviour.

11. Study design
Stage 1: Data gathering
•
What is the public health knowledge of small scale
livestock and aquaculture producers?
•
Does this influence their mitigation strategies for
emerging infectious diseases?
•
What is the level of [coliform bacteria] in water used
for aquaculture and for households?

12. Study design
• A cross-section of 600 poor, small scale, mixed
agriculture farmers in Thai Binh and An Giang.

13. Study design
Stage 2: Quantitative and qualitative analysis
•
Is there some association between understanding of
(pond) water health and mitigation strategies?
Examining relations between:
•
Producer perceptions
•
Water health
•
Livestock and aquatic management
•
Mitigation strategies

14. Study design
Stage 3: Develop on-farm training & low cost water test kits
•
Partnering with public and private sector
•
Revisit farms to examine adoption,
change, sustainability issues
•
Implications for policy formulation?

15. Water testing and purification – industrial partners

16. Stage 1 complete (data gathering)
•
•
•
•
•
600 small scale producers
hhld income < $1000 / annum
education c. 7 years
low public health knowledge
some public health awareness
Observations preliminary: not for distribution.

17. Stage 2 underway (data analysis)
 97% of farmers do not “trust” their water quality
• 75% of household water from rain or wells
• lack of trust – relates to some health incident
 identify concern for 2 water related zoonotic diseases
• “worms” (Trematoda sp., ascarids)
• avian influenza
 >85% would welcome training in water public health
Observations preliminary: not for distribution.

18. UN VN Joint Programme – Controlling EIDs
Photos: D. Hall

19. Stage 2 underway (data analysis)
Most think untreated water can be harmful but …
… 95-98% do not have their water tested.
Observations preliminary: not for distribution.

20. Stage 2 underway (data analysis)
Media (TV) a highly important source of (mis?)information (>85%)
Observations preliminary: not for distribution.

21. Ecohealth in Vietnam: preliminary findings
Low level awareness of bacterial pathogens
Chart: Quynh Ba Le

22. Ecohealth in Vietnam: preliminary findings
DRINKING
WATER
80% of samples
do not meet WHO
standard for fecal
coliforms
Chart: Quynh Ba Le

23. Ecohealth in Vietnam: preliminary findings
•
There is some awareness of public health concepts in
principle
•
Coliform bacteria levels in pond or drinking water is
not acceptable
•
Influence on mitigation strategies is not clear
•
Conclusions will inform water policy formulation

24. Ecosystem approaches to improving water health
 water is a complex resource that requires management
 community participation matters
 transdisciplinary approaches are essential
 science informs policy formulation
 addressing underlying health determinants impact on
water health
• e.g., gender and economic equity

25. Cám O’n!

26. Ecosystem approaches to improving water health
David Hall, DVM, PhD and Quynh Ba Le, MD, MPH
dchall@ucalgary.ca
GRF Davos One Health Summit 2013
November 18, 2013
Davos, Switzerland