Poisoned Communities: Building Environmental Health Practitioners’ Capacity to Promote Sustainable Pest Control in Cape Town’s Poor Communities

Abstract

Introduction | Street pesticides are used in Cape Town’s poor urban areas as pest control. Street pesticides are highly hazardous and illegal chemicals. Exposures and poisonings from street pesticides are a disease burden, particularly for those living in low socio-economic areas, and can lead to deaths in adults and children. Aims | This project aimed to increase awareness of the dangers of street pesticides to communities and provide alternatives for pest control that are less toxic. The project also aimed to build City of Cape Town (CCT) Environmental Health Practitioner / Assistant’s (EHP/As) capacity to communicate these risks to low-literate communities and promote safe alternatives. Research Approach | A Street Pesticide Reference Group (SPRG) was established which consisted of 14 standing members to guide the research and provide specific stakeholder comment. For the development of pesticide alternatives for pest control, establishment of an international technical advisory group, focus group with EHP/As and a global literature review was undertaken, along with consultation from the SPRG. A meeting was held with informal vendors to discuss the health hazards of street pesticides as well as the selling of alternatives. For the development of the health promotion flip chart, consultation was sought with the SPRG, US colleagues who have developed similar risk communication materials for low-literate populations, CCT partners, City-wide input from EHP/As at a workshop (detailed below), the Design for Development material developer team, as well as an informal focus group with community members. A train-the-trainer workshop was developed to communicate the health risks of pesticide poisonings, train the attendees on how to use the risk communication materials and inform attendees of other issues such as notifying a poisoning. The workshop also focused on training methods for the attendees to use when training communities. Discussion | Establishment of the SPRG was successful with active stakeholder engagement and contribution. Four meetings were held during the 10-month project duration. Alternatives to pesticides for pest control were developed for the six pests mentioned in the proposal as well as two additional pests (ticks and mosquitoes) as requested by the EHP/A CCT partners. The informal vendors were interested in hearing about the health hazards of street pesticides and were open to the possibility of selling alternative ingredients. Copy and art briefs of the flip chart that communicates health risks of street pesticides, as well as alternative methods of pest control and methods of preventing pests, have been developed with extensive input from various stakeholders. Illustrations are currently being completed after which design, translation and printing will follow. As part of the process a new symbol for representing an invisible danger (pesticide residue) was designed and integrated into all risk communication materials. A workshop was successfully developed and run with a complimentary training manual also developed and peer-reviewed by the SPRG. Recommendations | As a trustworthy relationship has been established with informal vendors, further funding is necessary for continued engagement and to implement the selling of alternative ingredients in informal markets in low socio-economic areas of the CCT. Owing to the success of the Preventing Pesticide Poisoning Workshop, it is recommended that additional workshops be run in the future and that these workshops be open not only to EHP/As, but others involved in preventing pesticide poisonings. Further research is also necessary to evaluate the efficacy of the risk communication materials developed. Furthermore, future funding should be made available to transition the alternatives into an mHealth sphere in the form of an app development (or USSD) that is compatible with all types of mobile phones.