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EXECUTIVE SUMMARY

THE ISSUE

The Ecohealth approach focuses above all on the place of human beings within their environment. It recognizes that there are inextricable links between humans and their biophysical, social, and economic environments, and that these links are reflected in a population's state of health.

Traditional control methods have, in many respects, failed to improve the health, sanitary conditions, and well-being of large portions of the population in the developing countries of the South. This failure now poses a challenge to scientists, governments, international organizations, and donors, who must revise their programs and policies to look beyond conventional health practices. To begin with, they will need to examine ecosystems in terms that go beyond traditional biophysical characteristics.

The economy, the environment, and the needs of the community all have an impact on the health of an ecosystem. Restricting our focus to any one of those elements, while ignoring the others, risks compromising the ecosystem's sustainability. The Ecohealth approach should be seen therefore as part of the "sustainable development movement." It encourages positive environmental action that will enhance both health and welfare at the community level.

Societies and their leaders often face a difficult choice: resort to simple, quick, and sometimes expensive means of tackling complex problems -- means that sometimes fail in the longer term -- or invest in socially and economically effective, long-term sustainable development.

CASE STUDIES

The Mines of Goa, India

The State of Goa, in India, has been the scene of intensive mining for more than 35 years. The local economy is performing well, thanks to the jobs that mining has created and the services that it has provided. Yet, at the same time, the hills have been flattened and the forests have been razed. People complain about dust-laden air, about dried-up wells, and about the rains that wash mining debris down into their streams and fields.

A survey of the inhabitants of 57 villages, as well as mining companies and government representatives, identified some common areas of concern: inadequate compensation for land, degradation of the air, water, soils, and forests; health problems such as diarrhoea, jaundice, malaria, flu, and persistent cough; the eventual closure of the mines; and the inadequacy of investment in recreation, education, and health facilities.

From this list of concerns, researchers at the Tata Energy Research Institute developed indices for measuring well-being and quality of life, which were then validated and accepted. With IDRC support, they identified environmental and social performance indicators that, for the first time, could measure the economic, environmental, and social costs of mining activity. They also prepared optimum revenue criteria for ensuring the long-term economic viability of the mining industry. It is now clear that the contribution of mining will be positive only if a portion of mining revenues is used to reduce the environmental and social costs for future generations.

Mercury in the Amazon

In the Amazon basin, a research team has been using the Ecohealth approach to identify the source of mercury pollution that is affecting people's health. Using this technique, they have discoved that, contrary to the initial hypothesis, it is not just the gold-recovery process that is responsible but rather (and primarily) it is the continued clearing of the Amazon forest. This has exposed the natural mercury content of the soils, and the mercury has gradually leached into nearby watercourses, contaminating fish stocks, which are the main source of food for the local people.

The community was able to identify simple control techniques, including having people eat less predator species fish. Once again, it was through active participation by stakeholders and through ongoing dialogue between multidisciplinary research teams, the community, and decision-makers that feasible solutions were found. New and more sustainable farming practices are now being considered to address and resolve the problem at its source, where the challenge really lies.

More case studies

RECOMMENDATIONS

1. The ecosystem approach demands patience and perseverance, but its results can typically be implemented in a more spontaneous and natural way, since the community, decision-makers, and scientists are directly involved in defining the problem and identifying solutions.

2. The Ecohealth approach provides municipal, regional, and national policymakers with immediately applicable steps for dealing with situations where the environment impacts on people's health -- steps that can lead to the definition of viable solutions over the longer term.

3. Policymakers need practical, appropriate, feasible, and, wherever possible, low-cost solutions. The search for such solutions lies at the very heart of the Ecohealth approach.

4. For policymakers, the Ecohealth approach offers some very real and promising advantages. Around the core of an environmental or health issue, it can bring together different ministries and groups with divergent and even opposing interests.

5. Ecohealth projects are typically launched through an alliance between scientists and members of the community. This alliance is greatly strengthened if policymakers agree to participate. Authorities need to understand that the participation of their officials is required and need to accept that their staff will be working in a new framework, one marked by transdisciplinarity, participation, and social equity. In practice, Ecohealth initiatives can originate with any partner and, as in Mexico, national authorities are becoming involved in project management.

6. Decision-makers can find comprehensive solutions that take into account the various actors, including those over which they exercise direct authority (public servants) and those over which they don't (citizens' groups).

7. Decision-makers, therefore, have a menu of practical solutions in an area that both families and individuals regard as priority -- their health. The solutions advocated do not deal only with changes in behaviour. They also bear on better understanding the interactions between environmental, social, economic, and political aspects of the problem to be solved. They ensure that the eventual investments in infrastructure and new services will be made in the right places, and in places where people can see immediate results. What's more, the relatively short lapse of time between initiating the process and the first visible results makes it easier to implement longer term interventions.

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