Presentation at 3rd GRF One Health Summit 2015 Session Water and Health

1. Water public health, Perceptions,
and Disease Mitigation Strategies
in rural Vietnam.
David C. Hall and Quynh Ba Le
Faculty of Veterinary Medicine, University of Calgary
3rd GRF One Health Summit, 2015, Davos, Switzerland

2. Outline
 Background
 Objectives
 Methods
 Results
 Conclusions
2Photos: Quynh B. Le – GCC - IDRC

3. Background
 80% farmers are smallholders
 Rapid sector growth
 Competition for resources
(land, feed sources)
 Other drivers (D for fish)
 Farmer, livestock, environment
interaction (including water)
 Impact on health?
Photos: Quynh B. Le – GCC - IDRC

4. Background to the EcoHealth problem
Photos: Quynh B. Le – GCC - IDRC
Figure adapted from WHO, 2004
On-farm water
environment
Microbial
pathogen
s
Farmers
Livestock
Water
related
zoonotic
diseases

5. Objectives
Is there a relation between:
 water public health
 small scale integrated (SSI)
farming
 limited biosecurity and
 mitigation of emerging
infectious diseases (EIDs)
Photos: Quynh B. Le – GCC - IDRC

6. Methods
 Thai Binh (northern) and An Giang
(southern) province, Vietnam
 600 rural households
 Low income, raise livestock +/- fish, crops
 Questionnaires, interviews, focus groups
 Water tests (on-farm & hi-tech laboratory)
Photos: Quynh B. Le – GCC - IDRC

7. Methods – on-farm water test
Photos: Quynh B. Le – GCC - IDRC
Use of on-farm presence/absence water test for E. coli engaged farmers in the study

8. Data to collect
 Profile of smallholders
—demographics, production, preferences
 Perceptions and mitigating strategies
—particularly waterborne zoonotic diseases
 On-farm water quality
 Factors associated with on-farm water quality
and smallholders’ mitigating strategies

9. Demographics of small-scale integrated farmers
in Thai Binh and An Giang Provinces, Vietnam
Source: Le, Quynh Ba and David C. Hall. Forthcoming, 2016.

10. Annual livestock production on small-scale integrated farms in
Thai Binh and An Giang Provinces, VN (numbers/farm/year)
Source: Le, Quynh Ba and David C. Hall. Forthcoming, 2016.

11.  Multiple water sources
—rain, well, pond, and river water
 Mixed agriculture
—livestock, fish, and crops
 Inappropriate practices
—32% dump livestock waste into
agricultural water sources
 Perception of village water
quality (taste, clarity) is good
—most filter +/- boil drinking water
More detail on smallholders
Photos: Quynh B. Le – GCC - IDRC

12. Profile of small-scale integrated farms
 Intuitive knowledge of public health
 > 90% aware of avian influenza or parasites
 > 37% heard of bacteria such as E. coli
 Gender and economic equality questions
 90% male smallholders 1ry responsibility for livestock and
fish production as well as family health
 20% smallholders lived in poverty

13. Presence of pathogenic levels of E. coli in drinking water
(rainwater and well water) in Vietnam.

14. Presence of pathogenic levels of E. coli in drinking water
(rainwater and well water) in Vietnam.
What factors are associated with on-farm drinking
water quality and smallholders’ mitigating strategies

15. Presence of pathogenic levels of E. coli in drinking water
(rainwater and well water) in Vietnam.
What factors are associated with on-farm drinking
water quality and smallholders’ mitigating strategies
• Probit regression
• Dep var = Presence/Absence of E. coli (binary variable)
• Indep var = demographics, farm, perception, mitigation

16. Association of presence of E. coli in drinking water with
demographics, perception, and mitigation in Vietnam

17. Association of presence of E. coli in drinking water with
demographics, perception, and mitigation in Vietnam

18. Conclusions
 Levels of E. coli in respondents' drinking water
unacceptably high
 SSI farmers have a basic understanding of public
health concepts
—However, in general are not actively mitigating
waterborne emerging infectious disease
 Increased awareness of water public health and
livestock waste management is recommended

19. Conclusions
 Levels of E. coli in on-farm drinking water are associated with:
— Years of farming experience
— Raising poultry
— Perceptions of susceptibility to HPAI and barriers to action
— Self-assessment of ability to manage resources
— Unwanted health consequences
(Significant association of education, income, and other livestock vary with
models)
 Opportunities for action:
— Rural ecohealth policy addressing knowledge, behaviour, community
engagement
— Emphasize livestock management that mitigates waterborne zoonotic disease
— Delivery of animal and environmental health services

20. Acknowledgements

21. Thank you!