UBC Reports | Vol. 51 | No. 2 | Feb. 3, 2005

Researchers take on Ecuador’s Top Health Risks

By Hilary Thomson

Simmering white sugar beaches, lush jungles and crystalline Andean air -- Ecuador is rich with pristine natural environments. But as one of South America’s poorest countries, its people struggle with serious environmental health issues such as poor sanitation and water supply, pesticide contamination and mining pollution. They also regularly battle effects of natural disasters such as earthquakes, volcanoes and flooding.

That’s a scenario Jerry Spiegel and a team of UBC researchers hope to change.

Director of UBC’s Centre for International Health, a part of the College of Health Disciplines, Spiegel is the principal investigator of a $5-million, six-year project to help Ecuador reduce environmental health risks, preventable illness and deaths.

Working with team members from three Ecuadorian universities, institutes in Cuba and Mexico, 10 UBC research centres and institutes, and partner agencies and non-governmental organizations, Spiegel will collaborate with local community groups to build Ecuador’s capacity to manage environmental health risks.

“This project gives us an opportunity to walk the talk -- to achieve impact in communities and to build a sustainable program,” says Spiegel, who is also director, Global Health at the Liu Institute for Global Issues. “It’s exciting because it integrates research and education -- we’ll only be successful if we transfer our knowledge to the community.”

Ecuador was chosen as a target site because of connections made in a similar project Spiegel has been conducting in Cuba. A 2001 Cuban workshop included health educators from Ecuador who were keen to start their own programs.

Ecuador’s multiple environmental health challenges and the potential for exchange of information between Latin American countries made it a fascinating target for education and research, says Spiegel, who last month organized UBC’s first forum on global citizenship and health.

Ecuador has a population of about 13 million and a weak health system infrastructure. Adequate sanitation and availability of clean water are paramount needs. Water problems are made worse by pesticide contamination from banana plantations and cut flower farms. In rainy season, flooding and mudslides aggravate the situation. In addition, inadequate drainage systems and poor sanitation provide breeding areas for mosquitoes that carry malaria and dengue fever.

Ecuador’s gold, copper, lead, magnesium and other mines contribute to soil and water pollution, and direct handling of heavy metals such as mercury also creates environmental health hazards.

Project organizers plan to create a curriculum and core group of local educators who specialize in environmental health. In addition to core topics such as water and sanitation, the curriculum will include courses on disaster preparedness, managing mosquito-borne and other infectious diseases, indigenous health, and building health communication technologies.

The approach is multi-disciplinary and holistic and will produce expertise at four levels:

The team will develop a certificate program to be delivered in person or by distance education to about 150 students, all of whom will conduct community-based environmental health projects such as land clearing or building water tanks, as part of course requirements. This group will include community planners and health practitioners as well as university students.

In addition, a one-day outreach program, or toolkit, will be developed and delivered by the certificate students to about 600 individuals in communities throughout the country.

A master’s program in environmental health will produce at least 60 master’s students at partner institutions of Universidad de Guayaquil, Universidad Tecnica de Machala and Universidad Estatal de Bolivar.

To build a leadership group, the project includes opportunities for Ecuadorian faculty members to study in Mexico, Cuba or Canada. This part of the program will produce four to six PhDs with formal commitments to teach in the three partner universities. The partnership with Mexican and Cuban institutions is part of a strategy to build regional capacity in Latin and South America that will be more sustainable than traditional links these countries have with North America.

“This multi-tiered approach provides a scaffolding for achieving impact,” says Spiegel. “With our partners, we can distribute environmental health education throughout the country and know it will continue after the project is finished.”

In addition to these plans, there will be opportunities for UBC students to participate in local projects.

Science student Nadine Straka will be traveling to Ecuador this summer. A member of the Global Outreach Student Association (GOSA), a part of UBC’s College of Health Disciplines, Straka will be working with several indigenous communities.

“I want to be an active participant in global health,” says Straka. “The opportunity to travel to a different country to try to help and to understand different ways of life was a chance I could not dismiss.”

Straka and other students will present health education regarding nutrition, sexual health, alcoholism and other topics. They will also consult with community members about installing a water purification system.

Oscar Lin, a fifth-year biochemistry student and GOSA president, spent 10 weeks in Ecuador last summer, based in an area surrounded by aboriginal communities.

“These are the warmest people that I have ever met,” says Lin, who helped create a medicinal garden and give health presentations in elementary schools. “Going to Ecuador changed my perspective a lot. It showed me what could be done with more resources and reinforced my interest in practicing medicine in developing countries.”

This month, the UBC project team is conducting a workshop in Havana to evaluate the usefulness of material used in a similar environmental health education project in Cuba and to focus on curriculum that addresses Ecuador’s environmental health priorities. Attendees include 10 UBC faculty and students, eight participants from Ecuador and 20 from Cuba.

Funding for this project was provided by the Canadian International Development Agency’s University Partnerships in Co-operation and Development Tier 1 program.

For more information on the Ecuador project, visit www.cih.ubc.ca.

UBC Centres and Institutes Involved in the Ecuador Project

• Institute of Health Promotion Research
• Disaster Preparedness Resources Centre
• Continuing Medical Education
• School of Occupational and Environmental Hygiene
• Centre for Environmental Research in Minerals, Metals and Materials
• Institute for Aboriginal Health
• UBC Centre for Disease Control Department of Medicine
• Liu Institute for Global Issues
• Institute for Resource, Environment and Sustainability
• Centre for Human Settlements
• Health Disparities Research Unit
• Centre for International Health