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 producersObservations of working practicesParticipant observationBias – 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