I first heard the words “meeting under the mango tree” as a euphemism for having a predictable, easy to access process for enabling community members to raise issues and concerns in a safe and familiar place. There is no fixed agenda and no one-size-fits-all for these exchanges. With one company we set up drop-in centres in each local village with a designated community officer in attendance everyday. Another made it known that a company person would be available “under the mango tree” for two hours every market day. I was hoping this blog would achieve something similar – the regular, free and open sharing of ideas and experiences. It hasn't worked so I'm taking a break and having a bit of a rethink. In the meantime I'll be reposting a "best of" selection from time to time.
Why do I need to think about Community Health?
Three simple reasons:
Minimising impacts on the health of local communities
Good International Industry Practice (GIIP) in the context of community health is that companies take the responsibility to avoid or minimize the risks and impacts to community health and safety that may arise from project related activities, with particular attention to vulnerable groups.
Avoiding misunderstanding and misinformation
Communities often lack an understanding of the controls the company will put in place. This can lead to concerns which if not addressed can damage relationships with communities and government agencies. When it comes to addressing concerns whenever there is an information vacuum, misinformation and myth will rule. Failing to address concerns – whether well-founded or not - can result in delays and additional costs.
Minimising impacts of community health related issues on your business
Community health issues can affect business performance and reputation. Diseases such as malaria and acute respiratory infections, have the potential to reduce workforce productivity, adversely affecting the business. Communicable diseases can increase the health care costs of local employees and their families. A rise in the prevalence of noncommunicable diseases such as diabetes, hypertension, cardiovascular, and stress related diseases can have significant productivity and financial repercussions.
On the other hand, direct or indirect health-related support from companies to local communities is usually well received and can have significant reputational benefits. Outreach efforts that improve overall environmental, social, and health quality can turn pre-existing health-associated risks into mutual benefits for companies and communities.
What does good practice community health management look like?
Good practice in relation to community health and safety is to start early and establish a baseline - as with any impact, the sooner you can establish a record of the pre-existing situation the easier it is to demonstrate improvement and to avoid unwarranted criticism.
In the design phase apply a health impact lens – good practice in the context of health is to avoid or minimize the risks and impacts to community health and safety that may arise from company related-activities. By way of example, water storage dams, while necessary for operations can become vectors for malaria and other water-borne disease and also present as a drowning hazard to communities.
When you establish on site - whether initially for exploration or later for construction and operations - avoid adding to the pre-existing burden of illness and disease – don’t bring something new into the community ( different strains of TB, drug-resistant malaria are good examples of diseases you don’t want to introduce).
What can I do to raise community awareness?
Start early with your staff and contractors. Always keep in mind that the community does not start outside the mine gate. You engage with the community everyday through your local employees and contractor staff. They are a captive, easily accessible and influential stakeholder group. A workforce health promotion and education effort can change behaviours and practices in local communities with your workforce taking on the role of “peer educators” to local communities.
Moving beyond the local community, you can share information about potential impacts and company plans for managing the risks that are associated with your project with local and national health agencies. If they understand the situation, they are less likely to be a critic, more likely to be neutral or possibly a valuable advocate.
What are some of the pitfalls I need to avoid?
If the company doesn’t have the expertise in-house, use specialized support or an independent review process to identify gaps or other issues your team might otherwise overlook.
Don’t discount the capabilities of local resources. Excluding Government health agencies, universities and research centres in the design and execution of health baseline studies and the monitoring of health changes will not only make it very difficult (and very expensive) to carry out the necessary studies it will be a missed opportunity to access local knowledge. It will also undermine the credibility of those studies - the very same agencies you exclude are likely to become your fiercest critics.
Following the same theme, you have the best chance of achieving long-lasting results if you implement mitigation measures in collaboration local government agencies and local NGOs. If they do not have the capacity to respond effectively you have two options – work with agencies to develop the required capability or go it alone and take on full responsibility for preparing for and responding to the health impacts associated with your project.
Moving early allows you to design out potential sources of negative health impacts. It also provides you with an opportunity to design in physical, social and economic attributes that enhance or lead to a positive health impact for affected communities.
Where does water and sanitation fit into the picture?
Water and sanitation is a really serious issue
According to the United Nations, as much as 80 percent of illnesses and deaths in the developing world are caused by waterborne diseases.
Access to water and sanitatiton powers a virtuous circle
It is widely recognised within the international development sector that water scarcity, poor water quality and inadequate sanitation negatively impact food security, livelihood choices and educational opportunities for poor families - without clean water, you can’t stay healthy. If you can’t stay healthy, you can’t work or attend school. You can’t build a home. You can’t grow food, and you can’t provide for your family.
Removing barriers to education
Lack of clean water and sanitation also has a massive effect on student enrolment. While it is pretty much self-evident that students can’t attend school when they are sick it is maybe less intuitive that girls in sub-Saharan Africa are twice as likely to gather water for the family than boys and all that time spent gathering water is time not spent in school, gaining the knowledge and skills needed to give the girls a chance to break out of poverty.
Improving farm yields
When growing food, in addition to being more difficult to plant and harvest crops when you are sick it is more difficult to grow healthy crops with dirty water. It also takes large amounts of water - 70 percent of global water usage is used for agriculture and irrigation, compared with the 10 percent used for domestic purposes.
It follows that improving access to water for both personal and agricultural use should lead to improvements in these other areas (or at the very least provide an environment that is more conducive to improvements being possible) and clearly it is an important issue for companies to consider prioritising for impact mitigation and community benefit reasons.
I get it that water and health are linked but what can I do?
Broadly speaking there are three opportunities where companies can play a part:
Boreholes, rainwater collection and surface water dams can all increase the quantity available; efficient water use is about reducing wastage while reducing contamination is, for the most part, about improving sanitation practices to avoid or reduce preventable water and sanitation-related diarrheal diseases. Water, Sanitation and Hygiene (WASH) is a specialised field and has received lots of international attention and funding over many years, a result of which is that many countries have local (in-country) expertise. It is also important to keep in mind that an existing community-based water management committee may simply need a little bit of a lift.
The idea here is that by retaining soil moisture it will be possible to boost both the quantity and quality of agricultural production, with direct flow-on to both food production and income generation. Reducing run-off, increasing water penetration and improving the moisture holding capacity of soils, building the quality of the soil using proven sustainable farming techniques and improving cropping, animal husbandry and aquaculture practices are all opportunities that can be tested.
With water at a premium, it is incumbent on companies to be efficient with the use of what is a shared resource. It follows that the company needs to actively manage its water consumption through efficient use, maximising recycling and minimising wastage. The company should also minimise mine-related pollution by eliminating dumping and release of hazardous chemicals and materials and avoiding the release of untreated wastewater.