Mental and spiritual health and well-being
Colonial history and politics are a constant reality in this ex-British colony. A colonial era massacre in East Malaita in the 1920s involving the Australian military had never been resolved. In 2018, a traditional reconciliation ceremony was facilitated between Australian researchers and local Kwaio tribal leaders to acknowledge the events of the past and plan for the future. Pigs and traditional shell money were exchanged in a sacred site near Kwainaa’isi Cultural Centre. This deeply cultural process required an intimate understanding of culture, gender, spirituality, cosmology, economics, ecology, politics, history and indigenous knowledge by all involved and informed by villagers. This holistic One Health approach with embedded social science methods was able to inform historic and contemporary health and well-being activities implemented at local level by health services in partnership with villagers across the human–animal–environment continuum (Flannery, 2019).
Health impacts of climate change
The AHRG also studies the health impacts of climate change. Villagers living on coral atolls or in low-lying villages experience periodic inundation and loss of productive land as sea levels continue to rise. This reduces arable land and impacts food production. In some villages, the surrounding mangroves are used as toilets. During normal tidal flows, human waste is washed out to sea, but during times of inundation, human waste is washed into areas inhabited by humans and animals. Sea level impacts mental health as villagers become increasingly anxious prior to the high tide season, when they know they will be inundated. This impacts both the living and the dead as burial grounds are inundated and eroded. Because people live on tribal land, most are unable to move and so other responses to sea level change are being considered by the communities rather than migration (Asugeni et al., 2017). See also Adapting to Sea level Rise: a Young Woman’s Story, available at: https://youtu.be/VoDCtcIcAOs (accessed 15 July 2019).
Conclusion
The ‘small is beautiful’ and ‘one village at a time’ approach used by AHRG is a One Health social science means to understand the human–animal–environment interface in these remote locations in order to improve health and well-being and the related services in a scientifically sound and culturally respectful manner. It continues to be used by the AHRG locally as well as through their participatory approach to capacity development in other locations in Solomon Islands.
Case study 3 also illustrates how the combined effects of environmental, human and animal behavioural changes create a cycle of changes in the health of each of these three domains.
Medical anthropology has placed limited focus on non-human species in understanding disease and health (Rock, 2016) and on environmental or ecological anthropology (Moran, 2008). There are some studies emerging on interspecies relations in social anthropology in general and especially in the sub-field of research in ecological and environmental anthropology. One example is Ruhlmann’s work (2018) on highly contagious animal diseases and their spread to other animals and humans. This work explores the complex spaces of veterinary and human medical ethnographies of the herders, coexistence between and meaning of the relationships between humans and their animals, political economies, and veterinary public health practices. It is an example that can provide valuable insights for addressing serious infectious diseases that affect production animals, economic value, and transmission to humans. The ‘reverse zoonosis’ pathway, that is of animals being infected by humans is also under-addressed. Yet it could have major economic, animal (including wildlife) and human consequences (e.g. production pigs being infected by ‘flu’ from human carriers working in the industry, and the rarer and fascinating cases of elephant tuberculosis coming from humans) (Laine, 2018). The emerging field of multispecies ethnography provides an opportunity to reorientate social science approaches to better examine human–animal–environment entanglement and ‘revisit theorizations’ of central topics in medical anthropology’ (Brown and Nading, 2019, p. 5; see also Kirksey and Heimreich, 2010).
Designing and Implementing One Health Approaches with Social Science Integration
There remain few descriptions of integrating social science in the planning, implementation, monitoring and evaluation of One Health interventions in the published literature, especially beyond pilot research projects. Case study 2 adds another valuable contribution to address this knowledge gap. In Chad, deliberative integration of social science research in the design phrase enabled the findings to be utilized to develop health-care programmes for nomadic pastoralists (Schelling and Zinsstag, 2015). In Fiji, social science was one of the disciplines engaged in the transdisciplinary process to develop the National One Health Control Programme (Reid and Kama, 2015). One of the barriers to integration remains lack of appreciation of the value that social science can add to the design and implementation of interventions, and their outcomes and impact. Beyond having baseline and endline KAP, there are few descriptions of a fully integrated transdisciplinary approach to a One Health problem. One example is in Nunavik, Canada where the Inuit people, anthropologists and veterinarians started working together to develop more culturally suitable and respectful dog management practices. The aim is for more effective implementation for rabies control and to address other common health issues (Levesque, 2018). Additional examples are included in Chapters 18–27, this volume.
It should be noted that there are also limited published quality evaluations of any One Health intervention around the issue of the integration of social science. However, a review of ‘proof of concept for the One Health approach to emerging disease threats provides evidence that transdisciplinary integration among the sectors of human, animal, and environmental health is feasible’ (Rabinowitz et al., 2013, p. 6).
Rwanda has developed a One Health strategic plan to ‘streamline cross-sectoral and institutional interventions, minimize duplication of efforts, and maximize the use of public resources’ (Nyatanyi et al., 2017, p. 3). Included in this plan is the promotion of interprofessional collaboration in research and innovation and its linkages to programme development and implementation. However, it is early days yet, and although they hope for a broad approach to problems like food security, antimicrobial resistance, animal and human infectious disease outbreaks, it will take time. Some newly announced projects, such as Operationalizing One Health Interventions in Tanzania (UK Research and Innovation, 2018), are designed to incorporate social science into the design, and may provide valuable insights to address this knowledge and practice gap. In Switzerland, One Health plans have been developed by the local government in some cantons to address some priority health issues of non-communicable diseases, mental health and health hazard surveillance (Meisser and Goldblum, 2015).
One way to increase appreciation of and integration of social science into One Health approaches is through engagement and dialogue across disciplines and professions.
