Establishing a community of practice of researchers, practitioners, policy-makers and communities to sustainably manage environmental health risks in Ecuador

The Sustainably Managing Environmental Health Risk in Ecuador project was launched in 2004 as a partnership linking a large Canadian university with leading Cuban and Mexican institutes to strengthen the capacities of four Ecuadorian universities for leading community-based learning and research in areas as diverse as pesticide poisoning, dengue control, water and sanitation, and disaster preparedness. By 2009, train-the-trainer project initiation involved 27 participatory action research Master’s theses in 15 communities where 1200 community learners participated in the implementation of associated interventions. This led to establishment of innovative Ecuadorian-led master’s and doctoral programs, and a Population Health Observatory on Collective Health, Environment and Society for the Andean region based at the Universidad Andina Simon Bolivar. Building on this network, numerous initiatives were begun, such as an internationally funded research project to strengthen dengue control in the coastal community of Machala, and establishment of a local community eco-health centre focusing on determinants of health near Cuenca. Alliances of academic and non-academic partners from the South and North provide a promising orientation for learning together about ways of addressing negative trends of development. Assessing the impacts and sustainability of such processes, however, requires longer term monitoring of results and related challenges.

La renuncia a la equidad y la domesticación de la salud pública

Under present historical conditions of extreme social inequity, sustained by structural impoverishment, the destruction of living conditions and deterioration of environmental integrity, under the logic of big business, and precisely when the people’s organizations are working intensely in defending creatively human rights and health, academic public health evidences an exasperating passiveness; university departments, local and federal government agencies and even non-governmental organizations, keep implementing ineffective and innocuous health programs -some of them sustained by an expensive propaganda apparatus- that reproduce the same conventional plans, most of which end up reinforcing the rules of the neoliberal game. The present paper seeks to explain this historical surrender of public health; the institutional incapacity to foresee the structural roots of that flourishing pathology of inequity; and its divorce from the struggle of the most progressive social organizations. To accomplish this critique of hegemonic public health, the author analyzes the historical and epistemological roots of that “blindness” and the ideological fundaments of that political passiveness.