Towards enhancing community health in El-Fayoum, Egypt, using ecosystem approaches

Abstract

Ecosystem degradation caused by factors such as improper natural resources management and contamination with agricultural, industrial, and domestic wastes often results in the creation of an unhealthy ecosystem, a main cause for the prevailing poverty and poor health in many parts of rural Egypt. In collaboration with members of the community in some villages of El-Fayoum province, an interdisciplinary research team is currently employing an ecosystem approach to arrive at an understanding of community health problems with a view to develop resource management interventions and policies aimed at enhancing community health and well-being. Participatory rural appraisal (PRA) and knowledge, attitudes, and practices (KAP) techniques were used to measure the perceptions of the community’s men and women of their health and environmental priorities, and to test their current state of knowledge and awareness of the health-related issues. The results indicate that these perceptions were gender-sensitive and were different from those of Ministry of Health. Spatial and temporal monitoring and assessment of the ecosystem components revealed considerable land and water resources degradation. Presence of water pools and waterways in the vicinity of the residential areas enhanced the risk of water-associated diseases. Although, the disease-carrying vectors of schistosomiasis and malaria were detected in the waterways, the incidence of the two diseases was relatively low in the main village in contrast to the situation in the nearby hamlets. Prevalence of schistosomiasis was substantially higher in these hamlets (20–30% compared to 2–3% in the main village). Such a highly infected community represents a continuous pool of reinfection of the waterways, an issue that needs to be further examined to determine its relation to the hamlets’ specific ecosystem characteristics. A high incidence of hepatitis C and soil transmitted-intestinal parasites were markedly detected. It is concluded that in addition to natural resources degradation, other potential health risk factors were identified including socioeconomic, cultural, and institutional factors. Further studies are being conducted to explore these potential risk factors and their links to human health and well-being.