As an intern on the research project Watigueleya Kèlê, Aline Desdevises was able to study a particular dimension of West African rural communities’ resilience facing environmental change : resilience regarding health risks and healthcare. To what extent are rural populations resilient to the deleterious effects of environmental change on their health?
The analysis mainly rests on qualitative methods (observation and interviews) in the villages participating in the Watigueleya Kèlê’s project, completed by broader quantitative sources and theoretical readings. The memoir focuses first on how environmental changes impact food security and access to safe drinking water, and to what extent the strategies adopted by populations have a beneficial, neutral or negative effect on their health. Then the study shifts towards the effects of environmental degradation on the occurrence of epidemics and access to health care for populations. Indeed, the existence of traditional medicine methods, essentially based on phytotherapy, are threatened by the disappearance of medicinal plants in West Africa. The extent to which biomedicine represents an effective and sustainable alternative for rural populations is also considered. Finally, the cases of certain social categories whose vulnerability in terms of health is increased is explored. Examples are vulnerability related to age, gender and ascribed ‘slave status’ (a phenomenon of hereditary slavery within West Africa).
Several conclusions emerge from the study of the data collected. First, the consequences of environmental changes on the health of populations can already be observed in West African communities. Warming, rainfall variations, deforestation and loss of biodiversity have a considerable impact on food security, access to drinking water and exposure to epidemics. These are likely to increase due to various environmental changes. Populations in rural communities notice these variations, and all state the diminished productivity in crops for the last twenty years. The consequences on health are mostly visible through the continuing or rising of the occurrence of malnutrition and undernutrition cases.
Access to healthcare is also compromised: the disappearance of medicinal species threatens the existence of traditional medicine. The very transmission of this knowledge, deprived of part of its purpose, is jeopardised. On the other hand, biomedicine represents an imperfect and often inaccessible alternative, due to its cost and geographical distance from rural populations.
Faced with this increased exposure to health risks, rural people adopt various strategies. They use traditional and current agricultural knowledge to compensate for yield losses and to address malnutrition. They implement collective solutions (shared gardens or granaries), with varying degrees of success. Some people are trying to change their activity in order to get access to external sources of food or medical inputs. In response to the disappearance of medicinal plants, some grow a few useful species or introduce non-indigenous plants.
People’s actions do have an effect on their health, and not only a positive one. Some practices can combine with global environmental change to degrade the environment (deforestation, pollution). Other solutions implemented locally may have ambiguous, undesirable effects. However, given the extent of environmental degradation observed, human initiatives at the local level seem too weak to sustain true resilience.
Moreover, the vulnerability of certain populations is further accentuated by inherent circumstances (fragility of children and the elderly) or social circumstances (marginalisation, exclusion). Gender discrimination makes women more vulnerable to the rise of health risks. They are, due to the care dimension attached to gender roles, more exposed to contagion and to other health risks. Their workload is also increased by the necessity to compensate for insufficient crops and to seek for water further. While they are more exposed to health risks, their social position often prevents them from accessing as many opportunities as men. Another example studied is the case of people assigned with ‘slave status’ (a phenomenon studied by the EMiFo project), who suffer from a situation of social marginalisation that makes them more vulnerable to the impacts on health.