Snow Day?

When I went outside to take these pictures, I heard some very happy shouts and laughs coming from the house on the hill--I have a hunch that Hartland Elementary had its first snow day of the season.

I used today's snow as an excuse to have a giant cup of hot chocolate.

It's Official

I purchased my plane ticket yesterday, so I guess I'm actually going!

Boston --> London --> Bahrain --> Dhaka

And special thanks to my travel agent Gretchen, who is awesome.

Snow!

It has begun!

Maps

Last night I attended the opening program for Dartmouth's Great Issues in Medicine and Global Health Symposium. This year, the theme is poverty, and as such, the evening's discussion was entitled "Global Health Equity". Speakers included Dr. John Butterly, the executive medical director of DHMC and professor at both the college and the medical school; Tom Ketteridge, the managing director of the Upper Valley Haven; and Dr. Paul Farmer. (As one of Paul Farmer's "groupies", I had little choice but to attend...)

Topics of discussion ranged from rural poverty and homelessness in this area to the implementation of comprehensive care models across the globe. And while I don't plan on going into exhaustive detail , I did think this would be a good place to share one aspect in particular. Dr. Farmer began his discussion by showing two maps from Worldmapper. I took a look at the site today and found an index of over 350 maps--I'll put four here, but I'd encourage everyone to check it out for themselves.

Map 1: Land Area. The "normal" view.

Map 219: Practicing Physicians

Map 213: Public Health Spending

Map 186: Poor (Unsafe) Water

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This last map seemed most relevant for my (hopefully) overarching theme. Bangladesh is visible here--dwarfed in comparison to neighbor India, but larger than both the U.S. and Western Europe. Further, this figure assumes groundwater sources are safe. When such "safe" water sources are also unsafe, what alternatives remain?

The Role of Anthropology: Part IV

While many research initiatives have focused on potential methods to curb the spread of arsenicosis, there have been only a few promising long-term solutions (Anstiss et al., 2001). Many scholars believe that promoting the use of safe community wells would be the most sustainable initiative. Furthermore, because a well’s operation is of community concern, a given population will unite in supporting arsenic mitigation efforts. Such projects have had more long-lasting success than initiatives to make arsenic-contaminated or pathogen-containing water potable—these treatment operations are costly and time-consuming, and only occasionally receive the full attention and support of an affected community (Jakariya et al., 2005).

Some of the interventions piloted by non-governmental development organizations have shown that the mere presence of a water treatment plant in a village serves to mobilize a community (Hadi, 2003; Hoque et al., 2004). This causes arsenicosis to be brought to the forefront of public attention—as the topic becomes familiar, and a point of discussion, the popular desire for safe water sources is increased. Moreover, individuals are more willing to become involved in water-testing and monitoring efforts (Jakariya et al., 2005). Such community mobilization has been brought about by the work of NGO-affiliated community health educators, who travel to each household in a village and instruct residents about the dangers, symptoms, and safety measures associated with arsenicosis.

Community involvement would seem to be widely effective, thus it is of critical significance to continually seek ways to actively engage affected and threatened communities while designing arsenic mitigation programs. This matter is complicated by the findings of some studies. Based on the extent of willingness to pay a portion of household income for safe water, some researchers have concluded that rural inhabitants of Bangladesh place a low value on safe water (Ahmad, Goldar, & Misra, 2005). A different exploratory approach might employ the participatory action (PAR) model, such that community members would have more than a passive role in securing safe water. This model emphasizes the production of knowledge to foster future action, taking local opinions and concerns into consideration (Patten, Mitton, & Donaldson, 2006). This model has been successfully employed in numerous disciplines to accomplish a wide variety of ends, yet has not yet been fully utilized within the context of Bangladesh’s groundwater contamination.

Additionally, future studies might consider utilizing the ecohealth system. The ecohealth system integrates ecological and health concepts to promote responsible stewardship of the environment, while consequently fostering changes in local health conditions (Yacoob, Hetzler, & Langer, 2004). Pilot programs in Bangladesh have shown this to be a promising technique for involving the community by means of educating and providing the needed resources for village-based operation and management of safe-water utilities (Yacoob et al., 2004).


NOTE: If you would like full bibliographic information for any of the above citations, please let me know.

Fight World Hunger

...and improve your vocabulary at the same time!

http://www.freerice.com/index.php

It's completely addictive, and for a good cause. Win-win!

Keeping Busy

Also, I made cookies...

The Role of Anthropology: Part III

Wells are used almost exclusively by women in Bangladeshi communities (Ohtsuka, Sudo, Sekiyama, Watanabe, Inaoka, & Kadono, 2003). The water gathered on a daily basis is used domestically for cleaning, personal hygiene, cooking, and consumption. Consequently, education of women may well prove to be the most successful approach in disseminating information about arsenicosis. Female community health workers have had success in educating at the household-level (Hadi, 2003); future studies might focus on the transmission of such information among families and neighbors and within a village.

Several investigations have focused on the possibility of well-sharing as a viable mechanism for delivering safe water to a large number of individuals. While many tube wells in rural Bangladesh are privately owned, an estimated 80% of these wells contain dangerously contaminated water, and thus a large portion of the Bangladeshi population is at risk for arsenic exposure and, ultimately, arsenicosis (Chowdhury, Rahman, Mondal, Paul, Lodh, Biswas et al., 2001). Initiatives that have installed community wells have found that a single tube well can provide enough water to sustain approximately 500 people (van Geen, Ahmed, Seddique, & Shamsudduha, 2003). Moreover, such community-wide well-sharing efforts have proven successful, thus, in theory, well-sharing among non-kin and non-neighbor groups is a promising possibility in some regions (van Geen, Ahsan, Horneman, Dhar, Zheng, Hussain et al., 2002). Others believe that well-switching behavior will be a viable option for some immediately, but that others will be slower to adopt the practice (McLellan, 2002).

Very little has been written thus far on the nuances of well-usage—this may be because of a high degree of variability in patterns from one village to the next. If broad-based trends do indeed exist, however, an understanding thereof would prove crucial in further discussions of arsenicosis, and must therefore be examined presently. Community dynamics may dictate which tubewells are accessible to whom. If culturally-specific complexities are at the root of well-use and –switching, ethnographic analysis could help to determine the most locally relevant methods for encouraging safe water access.

NOTE: If you would like full bibliographic information for any of the above citations, please let me know.