People, Patches, and Parasites: The Case of Trypanosomiasis in Zimbabwe

Understanding the socio-ecology of disease requires careful attention to the role of patches within disease landscapes. Such patches, and the interfaces between different socio-epidemiological systems, we argue, have important implications for disease control.We conducted an interdisciplinary study over three years to investigate the spatial dynamics of human and animal trypanosomiasis in the Zambezi valley, Zimbabwe. We used a habitat niche model to identify changes in suitable habitat for tsetse fly vectors over time, and this is related to local villagers’ understandings of where flies are found. Fly trapping and blood DNA analysis of livestock highlighted the patchy distribution of both flies and trypanosome parasites. Through livelihoods analysis we explored who makes use of what areas of the landscape and when, identifying the social groups most at risk. We conclude with a discussion of the practical implications, including the need for an integrated ‘One Health’ approach involving targeted approaches to both vector control and surveillance

The use of indigenous knowledge in development: problems and challenges

The use of indigenous knowledge has been seen by many as an alternative way of promoting development in poor rural communities in many parts of the world. By reviewing much of the recent work on indigenous knowledge, the paper suggests that a number of problems and tensions has resulted in indigenous knowledge not being as useful as hoped for or supposed. These include problems emanating from a focus on the (arte)factual; binary tensions between western science and indigenous knowledge systems; the problem of differentiation and power relations; the romanticization of indigenous knowledge; and the all too frequent decontextualization of indigenous knowledge

Livelihoods, Land and Political Economy: Reflections on Sam Moyo’s Research Methodology

This article focuses on the methodological lessons from Sam Moyo’s scholarship. Sam’s research is characterised by a combination of detailed empirical investigation, deep knowledge of the technical and practical aspects of agricultural production and farming livelihoods, and bigpicture political economy analysis and theory. Sam’s method is an insightful contemporary application of the method originally set out in Marx’s Grundrisse. Many contemporary explorations of agrarian political economy fail to sustain the important tension and dialectical debate, between diverse empirical realities and their ‘multiple determinations and relations’ and wider theorisation of the ‘concrete’ features of emergent processes of change. The implications of Sam’s methodological approach for the analysis of Zimbabwe’s land reform are discussed, especially in relation to the land occupations and the politics of agrarian reform since 2000

Towards a better understanding of global land grabbing: an editorial introduction

ESR

A practical approach to cerebral near-infrared spectroscopy (NIRS) directed hemodynamic management in noncardiac pediatric anesthesia

Safeguarding cerebral function is of major importance during pediatric anesthesia. Premature, ex‐premature, and full‐term neonates can be vulnerable to physiologi‐ cal changes that occur during anesthesia and surgery. Data from studies performed during pediatric cardiac surgery and in neonatal/pediatric intensive care units have shown the benefits of near‐infrared spectroscopy (NIRS) monitoring of regional cer‐ ebral oxygenation (c‐rSO2). However, NIRS monitoring is seldom used during non‐ cardiac pediatric anesthesia. Despite compelling evidence that blood pressure does not reflect end‐organ perfusion, it is still regarded as the most important determi‐ nant of cerebral perfusion and the most relevant hemodynamic management target parameter by most (pediatric) anesthetists. The principle of NIRS monitoring is not self‐explanatory and sometimes seems even counterintuitive, which may explain why many anesthesiologists are reserved regarding its use. The first part of this paper is dedicated to a clinical introduction to NIRS monitoring. Despite scientific efforts, it has not yet been possible to define individual lower limit c‐rSO2 values and it is unlikely this will succeed in the near future. Nonetheless, published treatment algo‐ rithms usually specify c‐rSO2 values which may be associated with cerebral hypoxia. Our treatment guideline for maintaining sufficient cerebral oxygenation differs fun‐ damentally from all previously published approaches. We define a baseline c‐rSO2 value, registered in the awake child prior to anesthesia induction, as the lowest ac‐ ceptable limit during anesthesia and surgery. The cerebral rSO2 is the single target parameter, while blood pressure, heart rate, PaCO2, and SaO2 are major parameters that determine the c‐rSO2. Cerebral NIRS monitoring, interpreted together with its continuously available contributing parameters, may help avoid potentially harmful episodes of cerebral desaturation in anesthetized pediatric patients

Stakeholder narratives on trypanosomiasis, their effect on policy and the scope for One Health

Background This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided. Methods A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors. Principal Findings Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is considered throughout the paper. Conclusions/Significance While there has historically been a lack of One Health working in this context, the complex, interacting factors that impact the disease show the need for cross-sector, interdisciplinary decision making to stop rival narratives leading to competing actions. Additional recommendations include implementing: surveillance to assess under-reporting of disease and consequential under-estimation of disease risk; evidence-based decision making; increased and structurally managed funding across countries; and focus on interactions between disease drivers, disease incidence at the community level, and poverty and equity impacts

Who Drives Climate-Relevant Policies in the Rising Powers?

The future of human life on our planet is influenced increasingly by what goes on in the rising powers. This paper provides a political economy analysis of the climate-relevant policies of China, India, Brazil and South Africa. It shows that alliances play a key role in driving such policies. However, most actors who support such policies have priorities other than climate change mitigation. Their support for such policies comes from concerns with securing energy, building competitive green industries, creating jobs or providing a basis for future public revenue. This insight is not just of analytical but also of political importance. It means that climate-relevant policies can draw on support from a wide constituency – not just those with green convictions. Such analysis provides the stepping-stone for understanding the political feasibility of low-carbon transformations. PLEASE NOTE: this article supersedes IDS Evidence Report: Who Drives Climate-relevant Policies in the Rising Powers? http://opendocs.ids.ac.uk/opendocs/handle/123456789/993