Mark DuboisResearch Fellow

Policy, Economics and Social Science

at the WorldFish Center

Linking Health and EnvironmentA People Centred Ecology

STEPS Center Annual Conference

Richard FriendSocial Anthropologist

Unprecedented Environmental & Health Changes in the Mekong

40-70% of fisheries

production losses from proposed

dams

>75% of forest land

under concession agreements

Between 80 and 90 percent of diarrhea cases are caused by environmental factors’

Incidence of zoonotic and water borne disease

Can an Eco-Health approach improve human wellbeing and ecosystem health

in Cambodia?

Decision making arenas

Health Resources: Ability to Pay

Yes, Maybe, No! - It depends on the starting point & context

Natural Resources

Land Tenure

Poverty/ Food insecurity

Governance and rights crisis

Most of us have a sense that healthy ecosystems = healthy human systems.

But what of the starting point?

How conservation became interested in people

• From fences and exclusion• Began to consider people

and their poverty……threats!• Persistent argument around

a lack of knowledge of NRs & major threat to conservation.

• Missing the significance of peoples own knowledge and aspirations

How health became interested in natural resources

• Took an essentially biomedical approach

• Fairly narrow interest in ecological aspects focused on the interactions between the disease organisms and their hosts and the implication of environmental degradation and pollution.

• Wetlands as a health threat

Bringing conservation and health together

Contemporary approaches - important areas of commonality:

• Conservation thinking has shifted . . . . people are regarded as custodians of NRs, & their knowledge and capabilities are seen as central for future sustainability

• From the health sector there is a growing interest in the role of natural resources upon which people depend for their food security, nutrition and well being.

• From both, this interest has two clear aspects…….how managing NRs can derive human benefits and how NR deficits can manifest in adverse human impacts.

Increasingly conservation, health and development sectors use similar conceptual approaches:

• Emphasising wellbeing and peoples capabilities and framing interventions in terms of strengthening capacity, encouraging participation in decision making and asserting rights.

• From the perspective of resource users & the nature of local livelihoods, health and conservation can also come together with people talking about and utilising their natural resources as sources of food health and wellbeing.

Striking a balance calls for an operational framework

More effective & responsive

decision-making

Enhancing productivity

and sustainability of natural /

health resources

Generating benefits to people from natural / health resources

Fig. 1 A Simple framework for putting people at the center of development implementation: Adapted after Friend, R. 2008 and MWBP Livelihoods Report

Putting ‘people first’ in practice•Grown out of a social movement (Tai Ban)•Locally driven process •Built upon local priorities (It was villagers who firstproposed a research focuson health and environment)• Based on local Knowledge•Action oriented •Locally owned

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Sesan

Thala Barivat

Stung Treng

Siem Pang

Siem Bouk

Putting ‘people first’ in practice

• A process of social research known locally as Sala Phoum

Country Outline Map [Top]

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Sala Phoum Research Outcomes

Community Produced Media

Insert Scans of VDO cover, fish

book, posters etc

•Medicinal plants• Fish ecology

•Health and disease

• Food behaviour

Not scientific.

No mandate to

conduct research

Research Topics & Results

Creating spaces for change?"Salaphoum research contributed to local capacity building among many villagers. Some

research findings have already been integrated into commune development plans", Man Lihor, O'svay commune chief.

‘In the past, I saw trees differently from the way I see them now. I know how important they are in sustaining the livelihoods of my family and fellow villagers, and I can see the need to be able to conduct research on my own and to learn more about the ways to protect our resources for use as medicines and in supporting local livelihoods’. Mr. Heng Thorn

‘In addition, the findings from the research have been incorporated into the commune development planning process. This means that our research has the potential to

influence decisions on the use of commune funds and on the designation of priority areas for investment.’ Anon.

‘The knowledge we gained through participation in the research has earned us recognition and respect from the other villagers. For instance, Si Chandorn has been appointed

Villages Head and Commune Councillor since joining the Salaphoum project’.

Lessons learned and implications

CAPACITY DEVELOPMENT• Strengthened capacity is only meaningful if it

can be put into action. There are three inter-dependent dimensions to this kind of action. In order for there to be both livelihood and conservation benefits it is essential that the resource base itself is accessible, productive and sustainable.

Lessons learned and implicationsPEOPLE•The starting point is to build on local people’s knowledge, aspirations, values and capabilities in order to strengthen their capacity to assess, plan and manage their resource base

REPRESENTATION IN GOVERNANCE PROCESSES•For people who have historically been largely marginalised from state service provision, this research approach has improved people’s ability to represent their interests.

POWER RELATIONS• Understanding access issues and demands made of the state and possible repercussions.

Lessons learned and implications

DIFFERENTIATION• Preliminary analysis from other areas suggest need for political,

social, economic, spatial differentiation.

INTEGRATED APPROACHES• The approach highlights how from local perspectives, wellbeing

is so closely associated with environmental and human health.• This kind of approach may answer some of the challenges of

translating health research into policy and practice (cf Jonsson et al., 2007).

• But this approach presents challenges, particularly for the conservation and health sectors.

Conclusion

• A key factor in people’s vulnerability and poverty is that poor people tend to be excluded from decision-making processes, particularly those led by the state. When people are better able to represent their own interests and needs, and to do so in a convincing manner, they are more likely to exert some influence on the state and service providers to provide the services that are needed in a way that is needed. This is particularly important for people and resources that still remain marginal to state development priorities.

Conclusion

• Power and politics in Cambodia shape the context and outcomes of processes of social research, with a failure in access, assets and capabilities having the potential to undermine the entire process.

What sorts of shift in focus does this require?

Thank you

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