Recipient of a 2016 IAEH Small Grant Award

Many media stories have supported claims about both the risks and benefits of fish consumption. This leads to much interest, but also some confusion regarding whether it’s safe to consume fish – especially for pregnant women and for children.

BeneFISHiary is a mobile “app” that helps users make informed decisions about the fish they eat. Developed for Bermudians, who are strongly connected to the marine environment that surrounds them, BeneFISHiary provides the best evidence-based information available on local and imported fish regarding their average mercury and nutrient (omega-3 fatty acids and selenium) concentrations. Users can also learn more on the environmental sustainability of various fish species found in the seas that surround Bermuda.

The creators of this app are a multidisciplinary team including an epidemiologist from the University of Hawai‘i (Dr. Catherine Pirkle), an anthropologist and conservationist (Dr. Philippe Rouja), and a designer who specializes in creating interactive stories powered by technologies (Mr. Tidjane Tall). The inspiration for BeneFISHiary originated from concerns about communication gaps between the Bermuda Department of Health, healthcareproviders on the islands, and pregnant women.

Briefly, research in the early 2000s that was initiated by the team’s late mentor- Dr. Eric Dewailly- found elevated blood concentrations of mercury in Bermudian pregnant women. These levels were high enough to adversely affect the health and development of the children exposed during pregnancy. The researchers found that locally harvested fish species were mostly responsible for the elevated mercury levels. Subsequently, the team sampled several hundred local fish species to measure their mercury concentrations, as well as the beneficial nutrients of omega-3 fatty acids and selenium. The later two nutrients may counteract some of the adverse consequents of mercury exposure. The researchers then created Bermuda-specific fish consumption guidelines that were shared with the Bermuda Department of Health and healthcare providers serving pregnant women. These guidelines highlighted a multitude of local fish species that were low in mercury and high in omega-3 fatty acids and thus safe to eat. These guidelines specifically aimed to avoid scaring women away from fish during pregnancy by providing nuanced information that was species-specific. However, there were communication difficulties and the risks of fish consumption were overemphasized.

In the years following the dissemination of these guidelines, blood mercury concentrations in Bermudian pregnant women dropped five-fold. While this drop was a public health success, there were concerns that overall fish intake was falling. In 2013, Dr. Pirkle and Dr. Rouja conducted a study examining public health messaging about fish consumption during pregnancy. Their work demonstrated that healthcare providers and the Internet were the primary sources of information about fish consumption during pregnancy and that pregnant women and their providers were confused about which fish should or should not be consumed during pregnancy. Some healthcare providers were counseling pregnant women to reduce fish consumption to no more than two servings per week, even though many local fish species could be consumed without restriction. Unfortunately, some of the messages provided by local healthcare professionals may have been depriving pregnant women in Bermuda of essential nutrients found in fish that our important to optimal child development.

Thus, to assist providers and pregnant women on the islands, we created BeneFISHiary. With this mobile app, users can search local species and obtain the most recent information about average mercury concentrations, as well as healthy nutrients. Moreover, the app contains species-specific sustainability details, given concerns about overfishing in the Atlantic. It is beautifully illustrated, user-friendly, and even contains tasting notes for users curious to try new fish in their cooking. The creators of this app hope to scale-it up to other communities with strong local ties to the ocean. To try BeneFISHiary, download it from your local app store or visit: http://benefishiary.com.

 

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Catherine M. Pirkle  |  cmpirkle@hawaii.edu

Dr. Pirkle is an epidemiologist whose interests center on improving the health and well-being of pregnant women and young children around the world. Her activities strive to improve both provider and patient knowledge on the health risks associated with mercury from diets rich in fish and other seafood, as well as balance these with the nutritional benefits that can come with these foods. Finally, she is deeply concerned about the state of the planet’s oceans, which are being overfished at an extraordinary rate, and hopes that her work can better inform consumers about the sustainability of the foods they eat.

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Intensification of crop and livestock production can improve food, nutrition, and income security; however, without sustainable resource management, intensification can also lead to increased agricultural-related health risks, environmental degradation, and biodiversity loss. This is especially true in Southeast Asia, a region facing rapid economic growth. To address this complex challenge, a better understand of the interactions between agricultural practices, human health, and ecosystems are required.

The Field Building Leadership Initiative (FBLI), supported by IDRC, aims to explore linkages between intensive agricultural practices and human health in Southeast Asia.Developed jointly by research centres in China, Indonesia, Thailand and Vietnam, and launched in 2012, this five-year initiative allows researchers and their partners to carry out research, capacity building, policy advocacy and networking to inform agricultural practice and policy. Generating scientific evidence can help mitigate health risks while maintaining the socio-economic advantages of agricultural intensification.

Building regional research

The FBLI’s research process is guided by Ecohealth principles including transdisciplinarity, participation, social and gender equity, and knowledge-to-action. The FBLI team, working with stakeholders from the onset of research for over three years, have generated new knowledge and developed interventions to promote sustainable agricultural practices. As agriculture is an important source for livelihoods in the region, careful consideration was given towards exploring economic benefits associated with changing practices, as well as gender and social equity, and empowerment of vulnerable groups.

Four large research projects involving local and national stakeholders are currently being implemented:

China: In Yuanmou County, Yunnan province, researchers and stakeholders are investigating the impact of chemical pesticides used for vegetable and fruit production on the health of farmers and ecosystems. Pesticide residues were detected in vegetable and fruit samples, soil and water samples, and urine samples of adults and children. To improve the knowledge of farmers on risks of pesticide use and promote safe pesticide use, innovative street plays in six project villages were performed. Further, locally designed calendars and posters were distributed widely in the project site, reaching about 5,000 people. This research also revealed that despite the increase of large-scale vegetable and fruit plantations, agricultural worker’s occupational health was not adequately addressed by current health care policies and services. Researchers are working with these groups to advocate for addressing occupational health risks in healthcare agendas.

Vietnam: In Ha Nam province, the human health risks from exposure to biogas wastewater from pig farms are being explored. Biogas wastewater samples were found positive for four pathogens harmful to humans and exceeded national standards of wastewater. Health risk perceptions and practices of biogas use in the community were also assessed. As biogas systems are a common method to manage animal waste in Vietnam, researchers are implementing a set of interventions to promote good sanitation practices in the study area. Communication tools including booklets and flyers with information on how to best use the biogas have been distributed to 72 farms in the community. Key messages were also promoted in the community’s traditional regulation document “H??ng ??c”.

Thailand: Rubber plantations are rapidly expanding in Thailand and Southeast Asia leading to deforestation, loss of biodiversity, influx of labour workers, and changes in livelihoods. Research conducted in several districts of Chachoengsao province have showed a direct correlation between crop expansion and increased risk of vector-borne diseases (e.g., dengue, chikungunya and malaria) especially among rubber workers. An evaluation of 109 rubber plantations revealed biological and chemical contaminants in groundwater and other natural reservoirs due to heavy use of fertilizers and herbicides. Through collaborating with migrant workers, crop owners, health care providers, and other government officials, the team is developing intervention tools and strategies to mitigate health risks associated with rubber plantations.

Indonesia: Small scale dairy farms are important sources of income for farmers in several districts of Pangalengan, West Java. By applying an Ecohealth approach, researchers and farmers worked together to implement an intervention that converts farm waste into herbal feed supplements, worm casting, earthworm extract, and fertilizers to help support human and environmental health, as well as farmers’ income. These products have been lab and field tested, and are currently being used by livestock and crop farmers beyond Pangalengan. A business incubator has been formed to facilitate product commercialization. These products were used by over 230 farmers, and discussions with government officials are ongoing to promote eco-friendly agricultural products, allowing for sustained benefits associated with these interventions.

Sustaining Ecohealth practice

The FBLI’s capacity building supports the development of sustainable cohorts of Ecohealth practitioners and researchers. Ecohealth curricula have been integrated in four universities in Southeast Asia and a degree program in Ecohealth is currently being developed at Mahidol University in Thailand. The Future Leader Program, an annual program, aims to build leadership skills, global perspectives, and effective multi-sectoral collaboration of multidisciplinary professional groups. Since 2014, over 200 participants from ten Asian countries have participated in the Future Leader Program.

The integration of FBLI research results into agricultural management practices is testimony of the rigorous research efforts and productive engagement with relevant stakeholders. The FBLI also supports policy advocacy, for example through forming policy alliance groups in member countries consisting of mid-level policy makers, senior FBLI researchers and representatives from other regional networks. Future outcomes of FBLI will continue to strengthen the emerging field of Ecohealth research and practice, for the mitigation of health risks associated with agricultural intensification, while maintaining benefits.

For more information, please visit: www.ecohealthasia.net

 

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Steven Lam |  lams@uoguelph.ca

Steven is the Knowledge Translation Coordinator for the Ecohealth Field Building Leadership Initiative in Southeast Asia (FBLI). The FBLI is a five year program (2012-2016), funded by IDRC, that aims to address human health problems associated with agricultural intensification and other challenges in Southeast Asia.

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