ENVIRONMENT AND HEALTH IN CHENNAI, INDIA: AN ECOSYSTEM APPROACH TO MANAGING THE URBAN ENVIRONMENT FOR HUMAN HEALTH
by Martin Bunch
Bunch, Martin J., V. Madha Suresh, Dana Wilson, Beth Finnis, T. Vasantha Kumaran, Raj Murthy and Michael J. Jerrett “Environment And Health In Chennai, India: An Ecosystem Approach To Managing The Urban Environment For Human Health” in Martin J. Bunch, V. Madha Suresh and T. Vasantha Kumaran, eds., Proceedings of the Third International Conference on Environment and Health, Chennai, India, 15-17 December, 2003. Chennai: Department of Geography, University of Madras and Faculty of Environmental Studies, York University. Pages 44 – 65.
This paper presents the results of a workshop held in August 2002 in support of an action-oriented program of research... more This paper presents the results of a workshop held in August 2002 in support of an action-oriented program of research that adopts an ecosystem approach to human health in Chennai, India. The workshop brought together stakeholders and potential participants in the research program in a collaborative environment to explore environment and health relationships, identify key actors and stakeholders in managing for human health, and develop a conceptual model of environment and health in Chennai. The workshop also introduced the ecosystem approach to workshop participants and explored the feasibility of applying the approach in Chennai. This paper is intended to highlight the use of a stakeholder workshop within an ecosystem approach, as well as techniques employed in the workshop’s working sessions. Influences on the workshop come from soft systems methodology, adaptive management and participatory action research. Working sessions were oriented to problem identification and framing, system conceptualization and visioning. Workshop participants developed a diagrammatic expression of environment and health in Chennai known as a ‘rich picture.’ Important themes in environment and health were drawn from this expression, such as: slums as locations of most -vulnerable populations and objectionable conditions; surface water quality and water bourne disease (e.g., typhoid, cholera, diarrhea, dysentery); public participation in management of environment and health problems; and malaria. Workshop participants also helped to identify a mixed-methods approach to addressing these issues in slum areas. The workshop results are now being used to direct the broader program of research.
ECOHEALTH AND WATERSHEDS: Ecosystem Approaches to Re-integrate Water Resources Management with Health and Well-being
by Martin Bunch
Parkes, M.W., Morrison, K.E., Bunch, M.J., and Venema, H.D. (2008) Ecohealth and Watersheds: Ecosystem Approaches to Re-integrate Water Resources Management with Health and Well-being. Network for Ecosystem Sustainability and Health (Publication Series No. 2) and the International Institute for Sustainable Development,Winnipeg, MB. Available online at http://www.iisd.org/pdf/2008/ecohealth_watersheds.pdf.
Executive Summary
The links between ecosystem approaches to health, natural resource management and poverty... more
Executive Summary
The links between ecosystem approaches to health, natural resource management and poverty reduction are being identified as important and relevant across an increasing number of disciplines and institutions. However, specific implementation guidance is scant. One promising approach to addressing this gap is the integration of two emergent approaches to environmental management: Ecohealth, which argues that human health and well-being are not only dependent on ecosystems but are also important outcomes of effective ecosystem management; and Watershed-based integrated water resources management (IWRM) which is based on the premise that watersheds are appropriate units for managing ecosystems.
Over the past century, the dominant scientific approach to environment and health relationships has been to examine cause and effect relationships between “proximal” environmental exposures and their health effects. Much progress has been made with this kind of work, but the complex, reciprocal interactions among ecosystems, society and health demand a more integrated and systemic approach. Recent convergence of research, policy and practice that re-links the social and ecological context for health lead us to understand that: in coupled social-ecological systems the same driving forces can result in combined social and environmental health inequities, hazards and impacts; policies that decrease social inequities and improve social cohesion have the potential to improve health outcomes and also to minimize and offset the drivers of ecosystem change; and linked social-ecological actions that address both biophysical and social environments have the potential to create a “double-dividend” that improves health by addressing both its socio-economic and environmental determinants, while also promotingsustainable development.
Traditionally, our understanding and management of human health has been organized spatially on the basis of human constructs such as municipalities, counties, health authorities, and provinces or states. While these boundaries do influence environmental and resource management, they often overlook the structure and function of ecosystems, and create a disjuncture between the objects of management and biophysical processes (e.g., between health and nature). A wide range of international reports have now created a demand and imperative to identify specific ecosystem-based contexts in which linkages among health, ecosystems, development and poverty alleviation can be operationalized.
One response to these challenges has been to recognize and prioritize watersheds as appropriate spatial units around which to organize management for natural resources and health.Watershed management and ecosystem approaches offer useful approaches to water management within the physical “place” of the watershed or catchment. Using key management concepts such as resilience, such approaches have the potential to improve our ability to reduce vulnerability to natural hazards, maintain ecological flows of water and the provision of other ecological services, and to promote the long-term sustainability of coupled human and natural systems. Ecosystem approaches and IWRM almost always cite collaborative decision-making and adaptive institutions as central to their approach.Mechanisms to operate such approaches must navigate overlapping jurisdictions, conflicting mandates and multiple interests, while at the same time adapting and responding to new information and operating in contexts of uncertainty.
The challenge remains to establish frameworks and processes that speak not only to public health professionals, but also to ecologists, water managers, planners and the development community. Despite the potential value in explicitly addressing concerns about human health and well-being on a watershed basis, a myriad of challenges exist—many of which reflect the limitations of restricting focus on separate parts of social-ecological systems rather than the interconnections of human and natural systems. These include the challenges of working across jurisdictions and sectors; of integrating academic disciplines and multiple worldviews; of spatial-temporal scale and the relationship between systems defined at different scales; and of the complexity of issues pertaining to each aspect of these social-ecological systems (including climate and atmospheric processes, land uses, ecological processes, social networks, livelihoods and lifestyles). The table below summarizes key issues identified by this report and offers directions for further work.
Gestión integrada del agua y la salud desde una visión ecosistémica ("Water for life, health and sustainability: An ecosystem approach to reintegrate water resource management with the determinants of health")
by Martin Bunch
Parkes, M., K. Morrison, M.J. Bunch, H. Venema and P. Howitz (2008) Gestión integrada del agua y la salud desde una visión ecosistémica. 2 July 2008. Expo Zaragosa 2008: Water and Sustainable Development. Jun 14, 2008 - Sep 14, 2008 PLaza e España, Zaragoza, Aragon Spain.
The relationship between water resource management and the ‘upstream’ determinants of health is emerging as a new... more The relationship between water resource management and the ‘upstream’ determinants of health is emerging as a new portfolio of research, policy and practice. This development is informed by growing attention to ecosystem management in the context of catchments (also known as watersheds or river basins) and the potential ‘win-win’ of integrated strategies that improve both health and sustainability within these settings. Sustainable and equitable watershed management can be seen as an upstream driver of the determinants of health – with influences ranging from livelihoods and poverty, to cultural values, food security and lifestyles, as well provision of basic water services and infrastructure. Drawing on an integrated framework and the key concepts of ‘living systems’, ‘livelihoods’, and ‘linkages’ between ecosystems and equity, this paper examines integrated catchment management as the basis for an ecosystem approach that promotes water for life, health and sustainability. These concepts will be examined in the context of a community catchment health project in New Zealand, with cross-reference to initiatives in Hawai’i, Ecuador, Canada and the Philippines. Implications will be discussed in relation to capacity building for governance, research and education that values catchment management as a collaborative, cross-sectoral initiative with interrelated benefits for health, ecosystems and society.
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Seen by:Research In Turbulent Environments: Slums In Chennai, India and the Impact of the December 2004 Tsunami on An Ecohealth Project
by Martin Bunch
Bunch, M. J., Franklin, B., Morley, D., Kumaran, T. V., & Suresh, V. M. (2005). Research in Turbulent Environments: Slums in Chennai, India and the Impact of the December 2004 Tsunami on an Ecohealth Project. EcoHealth, 2(2), 150-154.
On December 26, 2004, a tsunami struck coastal areas in the Bay of Bengal. Among the communities affected were... more On December 26, 2004, a tsunami struck coastal areas in the Bay of Bengal. Among the communities affected were Pallavan Nagar and Anju Kudasai slums in Chennai India. These communities have been collaborating, with some success, on a project to manage the urban environment for human health that employs an adaptive ecosystem approach framework, and is heavily influenced by participatory action research methodology. The tsunami resulted in loss of life, shelter, property and livelihoods in these communities. This profile presents an overview of the project, the two settlements, and the impact of the tsunami on the communities. This article also discusses the impact of the disaster on the direction and nature of the ecohealth project.
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Seen by:Promoting Health and Well-Being by Managing for Social–Ecological Resilience: the Potential of Integrating Ecohealth and Water Resources Management Approaches
by Martin Bunch
Bunch, M. J., Morrison, K. E., Parkes, M. W., & Venema, H. D. (2011). Promoting health and well-being by managing for social–ecological resilience: the potential of integrating ecohealth and water resources management approaches. Ecology and Society, 16(1), 6. [Online] URL: http://www.ecologyandsociety.org/vol16/iss11/art16/.
In coupled social–ecological systems, the same driving forces can result in combined social and environmental health... more
In coupled social–ecological systems, the same driving forces can result in combined social and environmental health inequities, hazards, and impacts. Policies that decrease social inequities and improve social cohesion, however, also have the potential to improve health outcomes and to minimize and offset the drivers of ecosystem change. Actions that address both biophysical and social environments have the potential to create a "double dividend" that improves human health, while also promoting sustainable development. One promising approach to managing the complex, reciprocal interactions among ecosystems, society, and health is the integration of the ecohealth approach (which holds that human health and well-being are both dependent on ecosystems and are important outcomes of ecosystem management) with watershed-based water resources management. Using key management concepts such as resilience, such approaches can help reduce vulnerability to natural hazards, maintain ecological flows of water and the provision of other ecological services, and promote long-term sustainability of coupled human and natural systems. Priorities for understanding and realizing health benefits of watershed management include (i) addressing poverty and reducing inequities, (ii) promoting resilience (for health) in watersheds, and (iii) applying watersheds as a context for intersectoral management tools and policy integration. Examples of work linking health and watershed management demonstrate that not only is appreciation of complex systems important, but an effective approach is participatory and transdisciplinary and gives attention to equity and historical context.
Key words: ecohealth; ecosystem approach; environment and health; environmental determinants of health; health promotion; integrated water resources management; resilience; social determinants of health; watershed governance; watershed management
Towards Integrated Governance for Water, Health and Social-Ecological Systems: The Watershed Governance Prism
by Martin Bunch
Parkes, M. W., K. E. Morrison, M.J. Bunch and H.D. Venema (2010). "Towards Integrated Governance for Water, Health and Social-Ecological Systems: The Watershed Governance Prism." Global Environmental Change 20(4): 693-704.
This article proposes a shift toward the integrated governance of watersheds as a basis for fostering health,... more This article proposes a shift toward the integrated governance of watersheds as a basis for fostering health, sustainability and social–ecological resilience. The authors suggest that integrated watershed governance is more likely when different perspectives, including health and well-being, are explicitly understood, communicated, and sought as co-benefits of watershed management. A new conceptual device – the watershed governance prism – is introduced in relation to the multiple facets of governance that characterize contemporary water resources management and examined as an integrative framework to link social and environmental concerns with the determinants of health in the watershed context. The authors assess the diagnostic and communicative potential of such a framework, discussing its utility as a concise depiction of multiple, interacting policy priorities and as a guide to integrate different research and policy domains into the governance of water, health and social–ecological systems.
Book- Ecosystems and human health: A critical approach to ecohealth research and practice -http://www.springer.com/public+health/book/978-1- 4419-0205-4
C.Y. Dakubo, PhD. Ontario, Canada
Ecosystems and Human Health : A Critical Approach to Ecohealth Research and Practice.
The first book to draw on poststructuralist political ecology to give the reader an
understanding of how people-environment relations and health outcomes are shaped
by the interplay of power, culture, globalization, and socio-political forces.
Applies a participatory action research process to the field of ecohealth. Examines the challenges faced by students and researchers in designing and executing an Ecohealth project
and provides some practical tools.
The magnitude of current epidemics, environmental disasters, and extreme weather events is proving that human health... more
The magnitude of current epidemics, environmental disasters, and extreme weather events is proving that human health problems require more comprehensive solutions than conventional biomedical approaches can offer. At the intersection of the public and community health, global health, and environmental fields, Ecohealth advocates improved health outcomes through better ecosystems management. But even as the Ecohealth approach gains acceptance, literature on the subject is scarce. Ecosystems and Human Health introduces Ecohealth as an emerging field of study, traces its evolution, and explains its applications in cross-disciplinary and holistic programs. Its integrative approach not only focuses on managing the environment to improve health, but also analyzes underlying social and economic determinants of health to develop innovative, people-centered interventions. This unique text:
• Expands on the theoretical systems that underlie Ecohealth.
• Examines the relationships between human health and the biophysical, political, cultural, and socioeconomic environments. • Discusses the methodological issues and the participatory action research process associated with Ecohealth.
• Provides detailed case studies illustrating the approach in developing and developed areas of the world.
• Suggests applications of Ecohealth methods to influence public health policy.
• Offers practical tools for readers designing and carrying out Ecohealth projects.
• Proposes a critical approach to Ecohealth research and practice.
Ecohealth holds vital keys to pressing global concerns, giving Ecosystems and Human Health a particular urgency for researchers, students, policymakers, and community and public health practitioners.
Towards a Critical Approach to Ecohealth Research and Practice
Book Chapter- ECOSYSTEMS AND HUMAN HEALTH
2010, Part 4, 207-221, DOI: 10.1007/978-1-4419-0206-1_14
Central to the field of ecohealth is the notion that human beings are integral to nature, yet analysis of the social... more Central to the field of ecohealth is the notion that human beings are integral to nature, yet analysis of the social and political dynamics that produce environmental degradation, resource depletion, and consequently ill health remains undertheorized. Most of the literature adopts uncritical notions of environment and health, and accept a priori notions of ecological causality and change, without questioning the political contexts within which such explanations emerge and become relevant. The concern for rigorous investigation of human-environment interactions and how these produce various vulnerabilities and ill health is at the core of critical theoretical developments, including critical political ecology and critical public health.
Community-Based Participatory Research for Ecohealth
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 2, 57-69, DOI: 10.1007/978-1-4419-0206-1_4
Community-based participatory research (CBPR) is particularly suitable for conducting ecohealth research. As discussed... more Community-based participatory research (CBPR) is particularly suitable for conducting ecohealth research. As discussed in the previous chapter, one primary objective of ecohealth research is to create opportunities for all relevant stakeholders to participate in evaluating the environmental health problem at hand, and to gain sufficient insight to implement the appropriate interventions.
Ecosystem Approaches to Human Health: Key Concepts and Principles
http://www.springerlink.com/content/978-1-4419-0205-4
The previous chapter discussed some of the key milestones leading to the emergence of the ecosystem approach to human... more The previous chapter discussed some of the key milestones leading to the emergence of the ecosystem approach to human health. This evolution occurred in both the public health and natural resources management sectors, and was buttressed by global initiatives seeking to promote sustainable development. Within the public health sector, the conceptualization of health and its determinants evolved from a narrow, individualistic and biomedical perspective to a broader, ecological and holistic perspective. Similar events in the natural resources sector saw a move towards a more integrated approach to natural resources management, with concerns for human health taking centre stage. Globally, there have been a number of initiatives drawing attention to the interdependencies among society, environment and the health and well-being of individuals and communities.
Examining Environmental Problems from a Critical Perspective
http://www.springerlink.com/content/978-1-4419-0205-4/
Since the Earth Summit in Rio, there have been growing concerns about the deteriorating state of the world’s... more Since the Earth Summit in Rio, there have been growing concerns about the deteriorating state of the world’s environment and role human activities play in this transformation. Problems such as climate change, deforestation, biodiversity loss, and desertification have become prevalent. The Millennium Ecosystem Assessment (MA 2005) suggests that over the past half century, human activities have changed the natural ecosystem more rapidly and extensively than in any time in history.
Policy Frameworks on Health and Environment Linkages
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 3, 159-174, DOI: 10.1007/978-1-4419-0206-1_10
The linkages between human health and environmental conditions are well established. Yet the extent to which... more The linkages between human health and environmental conditions are well established. Yet the extent to which environmental actions and health actions are coordinated to jointly respond to environment and health challenges is still limited. This limited capacity to develop integrated environment and health policy frameworks is particularly eminent in developing countries, where many sectors still prefer to develop policies in silos despite the apparent linkages or implications with other sectors. In addition, this challenge is augmented by the sectoral institutionalization and prioritization of health and environment in different regions of the world. For example in Africa, the health sector is highly prioritized over the environment sector (WHO Regional Office for Africa 2009), despite the fact that many of the major killers, including malaria, diarrhoea, and respiratory infections are strongly influenced by environmental factors.
Ecosystem Approaches to Indigenous Health
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 3, 141-158, DOI: 10.1007/978-1-4419-0206-1_9
Many Indigenous communities around the world have strong ties with the biophysical environment. As expressed in the... more Many Indigenous communities around the world have strong ties with the biophysical environment. As expressed in the opening chapter of this book, Indigenous communities see the forests as: “their food bank, drugstore, meat market, bakery, fruit and vegetable stand, building material centre, beverage supply, and the habitat for all of the creator’s creatures.”1 These close ties with the natural environment is reflected in many aspects of the Aboriginal culture, including how health is conceptualized and experienced. Many Indigenous peoples conceptualize health from a holistic perspective and see individual and community well-being to be intricately linked to the health of the “country.” Similarly, many Indigenous populations rely on traditional forms of healing. According to the World Health Organization (WHO), about 80% of Indigenous population in developing countries relies on traditional healing systems as the primary source of care (World Health Organization 1999).
Exploring the Linkages Between Ecosystems and Human Health
http://www.springerlink.com/content/978-1-4419-0205-4/
The linkages between human health and ecosystems are complex, dynamic, and political. For millennia ecosystems have... more The linkages between human health and ecosystems are complex, dynamic, and political. For millennia ecosystems have provided humans with essential services such as food, water, shelter and medicine. At the same time, they have mediated the transmission of many diseases and posed a number of health risks. The vitality of ecosystem services for human health and well-being is well captured by Bernard Abraham, President of Weskit-Chi Aboriginal Trappers Association, when he commented on the importance of forest ecosystems to Aboriginal people. He observed that many Aboriginal people consider the forest as: “their food bank, drugstore, meat market, bakery, fruit and vegetable stand, building material centre, beverage supply, and the habitat for all of the creator’s creatures.”1
Evolution Towards an Ecosystem Approach to Public Health
http://www.springerlink.com/content/978-1-4419-0205-4/
This chapter discusses the key milestones leading to the emergence of ecosystem approaches to public health thinking,... more This chapter discusses the key milestones leading to the emergence of ecosystem approaches to public health thinking, research and practice. The chapter discusses events in three areas that led to public health thinking toward an ecosystem approach. First, the chapter traces evolution of thinking in public health from the “old” public health, through to the “new” public health, and on to the “critical” new public health. The “old” public health is characterized by three phases: the sanitary phase (1840s–1870s), the preventive phase (1870s–1930s), and the therapeutic phase (1930s–1970s). All three phases are associated with the biomedical model of health, with each era defined according to dominant forms of medical knowledge (Brown and Duncan 2002).
Ecosystem Approach to Community Health Planning in Ghana
Published in Ecohealth 1:50-59, 2004
Keywords ecosystem approach - community health - participatory action research - Ghana
An ecosystem approach to community health seeks to investigate human health concerns from an ecological... more
An ecosystem approach to community health seeks to investigate human health concerns from an ecological perspective. The goal is to improve the health of community members by instituting sustainable ecosystem management strategies that will preserve the health of both the ecosystem and its inhabitants. This article reports on a study in a rural community in Ghana that employed an ecosystem approach to community health planning. Adopting a participatory action research approach, a research team comprised of representatives from various local government departments collaborated with local residents to identify major community health problems, their underlying causes, and possible intervention strategies. The findings illustrate the usefulness of the ecosystem approach to mobilizing community-based interventions to addressing environmental determinants of human health.
Planning for a Healthy Community: A Case Study – Phase II
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 3, 109-128, DOI: 10.1007/978-1-4419-0206-1_7
This chapter builds on the first phase of the ecohealth research project that was described in the previous chapter.... more This chapter builds on the first phase of the ecohealth research project that was described in the previous chapter. This chapter presents the findings of a strategic planning process (SPP) that was organized with both men’s and women’s groups to map out their vision of a healthy community. The strategic planning process took community members perceptions of health and their articulation of the factors driving poor health in the community as the basis from which to plan for a healthy community. The process proceeded through a series of community workshops in which the research team used focus group discussions to guide participants through the various phases of the strategic planning process.
Applying an Ecosystem Approach to Community Health Research in Ghana: A Case Study
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 3, 89-108, DOI: 10.1007/978-1-4419-0206-1_6
This chapter discusses an ecohealth project that was conducted in a small rural community in the Upper West Region of... more This chapter discusses an ecohealth project that was conducted in a small rural community in the Upper West Region of Ghana. Ghana is located along the West Coast of Africa and has often been referred to as an “island of peace” because of the longstanding tranquility that exist in the country, compared to others in the west africa sub-region. Ghana has population of about 23 million, with about half the population living in rural areas. The population growth rate is estimated at 2.6% with a total fertility rate of 4.0 (WHO Country Profile).
The Process of Conducting an Ecohealth Research Project: A Participatory Action Research Approach
ECOSYSTEMS AND HUMAN HEALTH
2010, Part 2, 71-85, DOI: 10.1007/978-1-4419-0206-1_5
The previous chapter discussed the theoretical and historical basis of community-based participatory research and some... more The previous chapter discussed the theoretical and historical basis of community-based participatory research and some basic principles of participatory action research (PAR). It also cautioned against the uncritical adoption and use of concepts such as “community”, “participation” and “empowerment”. This chapter moves beyond the epistemology and ontological basis of PAR, to discussing how participatory action research might be used to conduct an ecohealth research project in the field.
Educación e impulso de redes en ecosalud
Final report - Fondo Concursable del Estado de la Educación 2009, Consejo Nacional de Rectores
Recent educational policy in Costa Rica —as elsewhere— has opened the door to an integrated ecohealth approach, and... more
Recent educational policy in Costa Rica —as elsewhere— has opened the door to an integrated ecohealth approach, and the University of Costa Rica is leading a nation-wide program in this subject for in-service training of primary and secondary teachers with all four public universities. This includes at the regional level trainers from the ministries of education, health, environment, agriculture, and public works. The program is well into its fifth year, striving to articulate micro, meso and macro scale personal networks within nested polycentric institutional arrangements. Although this network of networks has survived its first four-year national government administration cycle and is beginning its second, it is now confronted with strong fiscal cuts originating in the ongoing global recession. Public universities are engaging these cuts with concerted yet not uniform strategies, while potent undercurrents begin to surface in all constituencies of this complex political process.
In this context, my case study approaches two related issues of theoretical and practical interest in the field of social network analysis (SNA): how does such a network of networks deal with fiscal and institutional conflicts arising in turbulent new times, particularly in terms of its resiliency; that is, how capable is it to sustain its mission notwithstanding increasingly destabilizing circumstances.
The theoretical and analytical focus of the study is Mark Granovetter’s classic argument about the strength of weak ties (Granovetter 1973, 1983). Does resiliency of Costa Rican ecohealth educational networks rest squarely on low or high density qualities? Or is there in fact something more complex sustaining these networks, having to do both with low and high density, in proportions and operational dynamics to be observed with concepts and tools available to SNA? (In addition to connectivity and density: centrality, betweenness, closeness...)
To illustrate these issues and begin to tackle the finer methodological imprint of the argument, a baseline, current scenario of the selected network is presented, as well as a profile of its previous evolution to this point (in retrospect). This is accompanied by the research design for a longitudinal monitoring process of the network as it responds to evolving challenges within the new national government administrative cycle begun in 2010.
