Os desafios da geração do conhecimento em saúde ambiental: uma perspectiva ecossistêmica

Participação e transdisciplinaridade em Ecosaúde: a perspectiva da análise de redes sociais

Resumo A Ecosaúde usa abordagens participativas e transdisciplinares com o intuito de compreender as inter-relações entre os componentes dos sistemas socioecológicos e como estas interações influenciam a saúde das populações humanas. O objetivo do artigo é usar a Análise de Redes Sociais (ARS) para entender o papel das relações de colaboração entre os diversos atores envolvidos nos processos participativos e transdisciplinares em projetos de Ecosaúde. Apresentamos um conjunto de indicadores de ARS para caracterizar a evolução e a equidade de participação e diferenciar a inter e a transdisciplinaridade. A análise foi feita com base na rede de colaboração entre os atores da Iniciativa de Liderança em Ecosaúde para as Enfermidades Transmitidas por Vetores (ETV) na América Latina e Caribe. O processo participativo ficou mais intenso ao longo do projeto, com mais sujeitos envolvidos e um número crescente de colaborações. A cooperação entre os atores das ciências sociais, ambientais e da saúde é pouco equitativa; assim, predominam as ciências da saúde. Os poucos cientistas ambientais presentes estão, porém, ativamente envolvidos em colaborações interdisciplinares. A abordagem tem aplicação ampla para estudar a participação e a transdisciplinaridade em projetos sobre saúde e meio ambiente.

Participation and transdisciplinarity in Ecohealth: a social network analysis perspective

Abstract Ecohealth uses participatory and transdisciplinary approaches to understand the relationships between the components of socio-ecological systems and how these interactions influence the health of human populations. This article aims to use Social Network Analysis (SNA) to understand the role of collaborative relationships between the various actors involved in participatory and transdisciplinary processes in Ecohealth projects. We present a set of SNA indicators to characterize the evolution and equity of participation and to differentiate inter- and transdisciplinarity. The analysis was based on the collaboration network among the members of the Iniciativa Para el Liderazgo y Desarrollo del Campo de Ecosalud y Enfermedades Transmitidas por Vectores (ETV) en América Latina y el Caribe. The participatory process intensified throughout the project, with more individuals involved and increasing collaborations. Cooperation between members from social, environmental, and health sciences is unbalanced and health scientists predominate. The few environmental scientists are, however, actively involved in interdisciplinary collaborations. The proposed approach has wide application to study participation and transdisciplinarity in projects about health and environment.

The social face of Aedes control: women take the floor in a suburban district of Fortaleza, Brazil

Aedes aegypti is currently a critical disease agent and is responsible for viruses such as Zika, Chikungunya and Dengue's four serotypes. This mosquito's relevance to the current social body has come to the fore and triggered urgent EcoHealth investigations since this approach aims to articulate different theoretical fields to understand the historical linkages between nature, society and health. Based on an ethnographic premise, this study considered the unequal and unfair conditions that make women's health vulnerable to dengue, analyzing their practices and perceptions about the potential breeding grounds in the public space. A semi-structured interview and participant observation, as well as a field diary, were used to compose the study. The research included the participation of ten women living in the outskirts of Fortaleza, Ceará, Brazil, from January to August 2014. The category "Social inequality, context and practices in the public space" emerged from the content analysis. The narratives revealed that unstable living conditions and evident social inequality might influence in a context permeated by waste, with great potential for dengue's mosquito proliferation.

An integral approach of ecological sanitation in traditional and rural communities

This article presents an integral approach to work in community projects, based on Guattari's three ecologies and its dialogue with psychosocial theorists, since it involves the need to combine technological interventions with social approaches. These contributions are explored to point out the need for dialogue in the implementation of sanitation actions, mainly in the rural area and in traditional communities, involving the individual, the groups served and their territorial culture. The approach presented was implemented in a joint action with the Caiçara Community of Praia do Sono and the Forum of Traditional Communities of Angra dos Reis, Paraty and Ubatuba (FCT), based on the Observatory of Sustainable and Healthy Territories of Bocaina (OTSS / Fiocruz). It could be verified that the inclusion of the actors in the social mobilization for the sanitation can entail an effective social participation that generates both a subjective change in the conscience of the diverse local actors and structural gains that promote health and quality of life. The panorama covered shows the importance of a global understanding of the problem, but also, of a simultaneous local, territorialized action, adapted to each reality through genuine dialogue and horizontal participation.

Identifying the social and environmental determinants of plague endemicity in Peru: insights from a case study in Ascope, La Libertad

BACKGROUND

Plague remains a public health problem in specific areas located in Bolivia, Brazil, Ecuador and Peru. Its prevention and control encompasses adequate clinical management and timely laboratory diagnosis. However, understanding communities' interaction with its surrounding ecosystem as well as the differences between community members and institutional stakeholders regarding the root causes of plague might contribute to understand its endemicity. We aim at bridging the traditionally separate biological and social sciences by elucidating communities' risk perception and identifying knowledge gaps between communities and stakeholders. This approach has been used in other areas but never in understanding plague endemicity, nor applied in the Latin American plague context. The objectives were to identify (i) plague risk perception at community level, (ii) perceived social and environmental determinants of plague endemicity, and (iii) institutions that need to be involved and actions needed to be taken as proposed by stakeholders and community members. The study was performed in 2015 and took place in Ascope rural province, La Libertad Region, in Peru, where the study areas are surrounded by intensive private sugarcane production.

METHODS

We propose using a multi-level discourse analysis. Community households were randomly selected (n = 68). Structured and semi-structured questionnaires were applied. A stakeholder analysis was used to identify policy makers (n = 34). In-depth interviews were performed, recorded and transcribed. Descriptive variables were analyzed with SPSS®. Answers were coded following variables adapted from the Commission on Social Determinants of Health and analyzed with the assistance of ATLAS.ti®.

RESULTS

Results showed that risk perception was low within the community. Policy-makers identified agriculture and sugarcane production as the root cause while community answers ranked the hygiene situation as the main cause. Stakeholders first ranked governmental sectors (education, housing, agriculture and transport) and the community prioritized the health sector. Social surveillance and improving prevention and control were first cited by policy-makers and community members, respectively.

CONCLUSIONS

The determinants of plague endemicity identified by the two groups differed. Similarly, actions and sectors needed to be involved in solving the problem varied. The gaps in understanding plague root causes between these two groups might hinder the efficiency of current plague prevention and control strategies.

[Temporal analysis of the relationship between leptospirosis and the occurrence of flooding due to rainfall in the city of Rio de Janeiro, Brazil, 2007-2012]

The scope of this study is to examine the effect of the average monthly rainfall on the risk of contracting leptospirosis in the city of Rio de Janeiro between 2007 and 2012. It involves an analytical ecological study conducted in the city of Rio de Janeiro in the 2007-2012 period. The variable for the outcome was the number of leptospirosis cases per month, and the independent variable was the average monthly rainfall recorded by the 32 monitoring stations per year. It was decided to model the relationship between cases of leptospirosis and the effects of rain by building a generalized linear model using negative binomial distribution. The rainfall-lag per month was found to be a strong explanatory factor for the number of cases of leptospirosis. This study indicates that the average monthly rainfall may constitute an indicator that enables the execution of actions in order to prepare the health sector for the probable increase in cases of this disease. Therefore, it is necessary to implement the interaction between the work of epidemiological surveillance, especially by situation rooms in periods of crisis, and the risk management teams of environmental surveillance, to increase the response capacity to natural disasters in the municipality of Rio de Janeiro.

Percepção da qualidade ambiental de localidades próximas ao Complexo Petroquímico do Rio de Janeiro, Brasil

Resumo O artigo tem por objetivo verificar a diferença da percepção de residentes sobre a qualidade ambiental de duas localidades próximas à área de construção do Complexo Petroquímico do Rio de Janeiro. Nove aspectos da qualidade ambiental (serviços de abastecimento de água, esgotamento sanitário e coleta de lixo; áreas de lazer; segurança pública; serviços de saúde; ruas; ar; rios) foram avaliados. Estudo transversal realizado com 240 residentes de Porto das Caixas e Manilha, ambos situados no município de Itaboraí-RJ, Brasil. A análise estatística envolveu o teste do qui-quadrado e exato de Fisher. Área de lazer foi o fator percebido igualmente pelos participantes das duas localidades do estudo com pior qualidade. A percepção da qualidade dos serviços de saúde, segurança e saneamento diferiu significativamente entre os moradores das duas localidades estudadas. A piora da qualidade ambiental foi relacionada por 51% dos residentes de Porto das Caixas à ausência de medidas mitigatórias após a ocorrência de um acidente químico local em 2005. A priorização de intervenções deve ser baseada na percepção de grupos populacionais específicos como estratégia que possa permitir a redução de iniquidades em saúde ambiental em contextos de instalação e construção de indústrias de petróleo e gás.

Bibliometric analysis of phytotechnologies for remediation: global scenario of research and applications

Phytoremediation is often a low cost alternative to conventional remediation. To assess trends, a bibliometric approach using data from SciVerse Scopus, SciVerseHub, and GoogleTM Trends was used. Globally there is a linear increase in publications containing the word phytoremediation as a percent of all published papers in SciVerse Hub, with China, India, and the Philippines concentrating relatively more research in phytoremediation. Furthermore there was an inverse correlation between a country's Human Development Index (HDI) and a country's phytoremediation research output as a percent of total research. Results show a focus on phytoremediation in countries with low HDI values. This suggests that academic experts are available for advancing phytoremediation applications in countries where the majority of the effected population do not have the education, finances, and political leverage to obtain expensive conventional remediation efforts on their land. Phytoremediation can combine expert advice with affected parties commitment and labor to help mitigate the harms of polluted landscapes.

[Health and environment in the rubber-tree plantations in the Bolivian Acre (1870-1903): the role of exogenous factors and processes]

A peculiar situation marks the conditions of human and environmental health in the first major cycle of rubber production in the Acre region of the Western Amazon, whereby the bulk of the boom (1870-1903) occurred in the territory that at that time still belonged to Bolivia. Based on this historical background, this work seeks to describe and comprehend how these factors and processes, which are exogenous to these two fields of analysis mediated the risks that originated in the environment, gave rise to sickness and death in the population of the "Brazilian" rubber-tree plantations established in Bolivian territory. In this manner, the inter-relations between health and environment linked to historically specific configurations of the physical-natural, socioeconomic, political, and cultural conditions, are examined. The work shows that these extrinsic factors and processes to the productive activities exerted an influence not only on its organizational but also functional aspects, while also resulting in the unhealthy conditions observed in the productive regions. It further highlights the fact that the extant infrastructure of the time was sufficient for extractive production and reproduction.

[The applicability of the ecology of knowledge in health and environment and its permeability in the scientific literature]

A new epistemology makes it imperative for different knowledge to be incorporated in order to understand and interact with the complex problems that affect humanity, especially those associated with health and the environment. The study aims to explore the applicability of the ecology of knowledge in the midst of traditional scientific literature, focusing on participatory approaches to questions of health and the environment. The methodology involved a bibliographic review of an international scientific database, with the inclusion of 170 papers that were classified by their participatory approaches as: timely; multi-tool; and ongoing/cyclic. Although timely and multi-tool approaches may be effective in terms of aggregating popular knowledge, which is systematically marginalized by traditional science, it is in the ongoing/cyclic approaches that a higher level of potential dialogue is achieved, since it is possible to identify aspects inherent to more symmetric participation processes, with the prospect of empowerment of the social actors and legitimate incorporation of subjectivity and diversity. This corresponds to the premise that promoting global cognitive justice is indispensable for achieving global social justice.