Peri-urban Areas around Megacities as Testing Ground for One Health Approach

Dr. Sanjay Chaturvedi

There is increasing acknowledgement of the role that cultural and societal drivers of zoonosis play as they coexist with forces of urbanisation, migration, development, gender, livelihoods and zoonotic diseases, in what is a complex and rather haphazard scenario of “rurbanization”. PHFI/RCZI is making a conscious and well planned effort to include the socio-cultural aspect in their research studies, probe multiple layers of knowledge, attitudes and practices that have a strong influence on the environment within which disease emergence and spread take place. This is particularly relevant in the case of peri urban settings and zoonoses.

Excerpts from an interview with Dr. Sanjay Chaturvedi, Head Department of Community Medicine, University College of Medical Sciences, Delhi and Member, PHFI/RCZI EcoHealth Research Core Group. Dr Chaturvedi is a leading researcher in India focusing on social and cultural dimensions of disease prevention and control. He is currently a member of the Steering group that has been formed to lead the Research Initiative on the “Peri-Urban Human-Animal-Environment Interface” (2014-17).

Q 1. Human-animal interface in periurban fringes of cities in India and outside are associated with emergence and spread of zoonoses. How can cultural and social practices and beliefs impact zoonotic disease transmission in the context of peri-urban?

Human-animal contact and interaction is highly dependent on cultural constructs woven around animals. In the specific context of India, animals as small and common as rats to not so common and huge animals like elephants – all are quintessential part of our religious belief-practice systems. Cows, pigs, crows, elephants and rats are revered or tabooed. Peri-domestic canine ecology is constantly shaped by traditional as well as modern social drivers. All this would critically influence public health interventions in the area of zoonoses.

Q 2. What approaches are likely to be best suited to capture and intervene with socio-cultural drivers of zoonoses in the South Asia region?

The best approach is to “talk to people, and engage with people”. Sounds like an unstructured and amorphous way of doing things but in my view, academic methods are unlikely to capture the big picture. Surely, at some stage, we would need scientific methods for making valid inferences and informing subsequent actions. Qualitative research methods can actually talk to people while maintaining an academic framework. They call it talking to stakeholders from client side, provider side, and at societal interface. The only care we need to take is to keep the Glaserian spirit of ‘all is data’ intact. Then, at the action or translational level, we will have to engage with people through interventions that are owned by people as well.

Q 3. What is the suggested way to make cultural anthropology an integral part of zoonoses prevention and control programmes and initiatives?

Organisations that are working in area of zoonoses will have to take a liberal approach, especially with a view to break territorial insecurities. We need to move beyond the orthodoxy of disciplines. Any engaged research and action with the community would largely be drawn upon the terrain of public health anthropology. In that spirit, every health worker is a health sociologist and anthropologist – both in academics and action. For this, one does not need to be a conventionally designated anthropologist. Rather, it is just a matter of intellectual orientation and skill development.

Q 4: Is a strategy needed to address socio-cultural drivers for managing peri-urban settings? Strategies such as institutional networks, capacity building initiatives and stakeholder engagement have been followed to support public health programmes. How relevant are they for programmes targeting different dimensions of peri-urban settings?

There is a general perception that urbanisation would reduce the intensity or closeness of human-animal contact. This may actually be the case in many urban settings. Nonetheless, the scenario may be different in a peculiar zone of rural-urban interface around cities, especially megacities, where people are selling ancestral lands while retaining livestock. For many inhabitants in this zone of unprecedented and unplanned urbanisation, both – selling land and retaining livestock, look profitable. Cultural and societal drivers of zoonosis that coexist with these forces of rapid change make the scenario very complex. Such haphazard “rurbanization” would not result in any reduction of zoonotic threats. On the contrary, it would enhance risk for both – humans as well as animals. Dwindling space, feminisation of workforce, lack of basic infrastructure, health-compromising practices and low level of awareness on zoonoses are some of the major challenges at this “ground zero”.

Peri-urban settings are emerging as a riddle as well as an opportunity to learn and respond in a systematic way. I would place stakeholder mapping and engaging with different categories of stakeholders, especially livestock owners, at top priority. Weaving institutional networks and capacity enhancing initiatives around “existing services” would be parallel activities informed by stakeholders’ feedback. Given the multitude of agencies operating and likely to influence human-animal interface issues, a multisectoral multidisciplinary approach is a strategic imperative. One Health provides us with one such framework. Though a conceptually sound approach, it has to be tested on the ground in peri-urban settings. Identification and assessment of strong and weak components of ongoing human and animal health programmes would be a prerequisite for initiation of the One Health approach in these settings. Peri-urban areas around megacities would provide an appropriate testing ground for One Health approach.

Q 5. How can multi-disciplinary collaborations yield meaningful outcomes? Any examples that you can cite.

For meaningful outcomes, science of multi-disciplinary collaborations has to provide actionable information for cross-sector initiatives i.e. programmes that involve actors from human health, animal health, agriculture and animal husbandry, wild life, entomology, regulatory bodies, and related industry and market. In this context, breaking the disciplinary and sectoral silos is emerging as a huge challenge.
A meaningful attempt that be cited in this context is the formation of the India EcoHealth Research Core Group (ERCG) under the RCZI banner. For last five years, this multi-disciplinary group has been generating knowledge, building capacities, developing partnerships and creating community-based interfaces for better relationship between people and programmes.

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