Impact of - IDL-BNC @ IDRC - International Development Research ...

ase and intermediate levels of this vertical chain, although control of the
system remained at the professional level. Before establishing the monitoring
program, the problems inherent in such assumptions were revealed and
activities were adjusted accordingly. Most importantly, it was understood that
the information chain could not terminate with the professionals, but had to
feed back to the lower levels (those most intimately involved and affected by
the program), closing the circle of information.
Educational action is equally important for the higher level professionals. The
information concerning cases of death by acute poisoning with DNOC over
the past 5 years, revealed common treatment with atropine. Atropine, the
antidote for poisoning by organophosphates and carbamates, has negative
effects in cases of acute DNOC poisoning for which there is no antidote. This
indicates that medical programs continue to impart information that is
20 years out of date. Worse, rural doctors do not recognize poisoning by
pesticides whose effects and treatment are not known (e.g., pyrethroids and
dinitros). Educational action at the highest level of the health system is
necessary to make prevention and proper treatment possible.
Without validation and refining of the self-diagnosis research, the effort of
installing the monitoring program would not have been warranted. Clearly,
the grower uses judgement with regard to the degree of intoxication. Low
levels are considered normal and medical assistance is sought only in severe
cases.
The formation of groups consisting of villagers, promoters, and doctors began
before the formal establishment of the monitoring program. It was initiated as
part of the education process, which is not simply an intellectual process in
the classroom but aims to promote action in the community. These groups
provide an incentive (directly or indirectly by example) for the creation of
other groups in the larger program-monitoring area.
Although the problem of pesticide intoxication is urgent, an education process
that tries to modify practices and attitudes makes gains slowly. Therefore, it
is not possible to wait until the education process has achieved all of its
objectives before initiating the monitoring program. These two activities are
mutually reinforcing and the education process must be continued if the
monitoring program is to become an effective preventative instrument.
Conclusions
The problems encountered in this research project are not unique. Many
research projects that attempt to use a multidisciplinary approach experience
similar difficulties and challenges. The research strategy of the study is complex
by virtue of its attempt to implement an essential feedback process among
the research, education, and epidemiological monitoring components. It
involves handling a large number of variables, operating at different levels of
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