The Mount Polley Mine Spill: An Environmental Scan into Indigenous Holistic Approaches to Environmental Health and the Systems that Emerge in Canada and Australia

The tailings pond breach at the Mount Polley mine on August 4th 2014 is known as the worst disaster in Canadian mining history. The mine is operated by Imperial Metals and is located on the traditional territory of the Secwepemc te Qelmucw (NStQ) and the Xat’sull Soda Creek First Nations people. Despite coordinated protests and an ongoing investigation into the full magnitude of the effects of the spill, the B.C. Ministry of Energy, Mines and Natural Gas has accepted an application to reopen the Mount Polley mine. With reference to the ecohealth approach, this capstone aims to engage with Indigenous teachings about connection to land to promote new ecological ethics and holistic theoretical perspectives within environmentally oriented public health research and practice. This capstone is informed by an environmental scan of research, grey literature and web-based data, to explore how Indigenous communities in Canada and Australia are defining health and environmental health and what Indigenous systems are emerging that embody notions of holism and interconnectedness. The results of the scan show the need for Indigenous-led institutions to develop definitions of environmental health that are rooted in their knowledge base and encompass Indigenous notions of health and well-being. The findings also illuminate the silences in the literature and the powerful implications of silencing ecological losses. The literature search reveals that how we gather data with First Nations peoples in Canada nationally and historically is problematic. This study concludes with the assertion that building on the strengths of both Indigenous knowledge and ecohealth is fertile ground that has the potential to acknowledge the environment as a setting for health and a place for healing and reconciliation.&nbsp

Ecohealth research in Southeast Asia : past, present and the way forward

Ecohealth is a comprehensive approach to understanding health at its human, animal and environmental interface in a socio-ecological systems context. This approach was introduced widely in Southeast Asia (SEA) by the Canadian International Development Research Centre (IDRC) in the late 2000s. Aimed at addressing the problem of emerging infectious diseases (EIDs), numerous such projects and activities have been generated throughout the region. Ecohealth is increasingly converging with the One Health approach, as both movements emphasise a holistic understanding to health. We conducted a scoping review by considering all of the Ecohealth programmes, initiatives and projects that have been implemented in SEA since the introduction of the approach, and also gathered information from peer-reviewed literature. The objective of this paper is to review Ecohealth activities within SEA over the last 10 years to address the lessons learned, challenges faced and the way forward for Ecohealth in the region. Activities range from those focusing purely on capacity, projects focusing on research and projects covering both. Achievements to date include, for example, research contributing to the field of infectious diseases in relation to social ecological factors and associated urbanisation and agricultural intensification. Challenges remain at the project design and implementation level, in the available capacity and coordination to develop Ecohealth research teams in the countries, gauging teams' assimilation of Ecohealth's underlying tenets and their translation into sustainable disease prevention and control, as well as in the ability to scale up Ecohealth projects. We suggest that the way forward for Ecohealth should be from a regional perspective in terms of research, training and policy translation using Ecohealth in combination with the One Health approach

Healthcare providers' perception of the referral system in maternal care facilities in Aceh, Indonesia: A cross-sectional study

Objectives Our study investigates the barriers perceived by staff in the referral systems in maternal healthcare facilities across Aceh province in Indonesia. Design With a cross-sectional approach, two sets of surveys were administered during September to October 2016 in 32 sampling units of our study. We also collected referral data in the form of the frequency of ingoing and outgoing referral cases per facility. Setting In three districts, Aceh Besar, Banda Aceh and Bireuen, a total of 32 facilities including hospitals, community health centres, and private midwife clinics that met the criteria of providing at least basic emergency obstetric and neonatal care (BEonC) were covered. Participants Across the 32 healthcare centres, 149 members of staff (mainly midwives) agreed to participate in our surveys. Primary and secondary outcome measures The first survey consisted of 65 items focusing on organisational measures as well as case numbers for example, patient counts, mortality rate and complications. The second survey with 68 items asked healthcare providers about a range of factors including attitudes towards the referral process in their facility and potential barriers to a well-functioning system in their district. Results Overall, mothers'/families' consent as well as the complex administration process were found to be the main barriers (36% and 12%, respectively). Healthcare providers noted that information about other facilities has the biggest room for improvement (37%) rather than transport, timely referral of mothers and babies, or the availability of referral facilities. Conclusions The largest barrier perceived by healthcare providers in our study was noted to be family consent and administrative burden. Moreover, lack of information about the referral system itself and other facilities seemed to be affecting healthcare providers and mothers/families alike and improvements perhaps through a shared information system is needed