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North-south and south-south
collaborations in OHS issues The 12th International Symposium on Epidemiology in Occupational Heatlh (ISEOH ‘97) took place in Harare, Zimbabwe, in September 1997. It was the first time that the ISEOH was held in a developing country. Two satellite workshops addressed methodological issues for conducting occupational epidemiology and exposure assessment studies in developing countries. Examples from different continents made it clear that national OHS research in developing countries can have an impact. It was also apparent that to produce sound data, methodologies and technologies must be selected according to local circumstances, and that often the necessary research capacity and infrastructures can best be built through collaborations between industrialized and developing countries. A third post-conference workshop entitled "North-South research collaboration: Successes, failures and prospects", was held at the University of Cape Town in South Africa. This meeting specifically examined what attributes can make research partnerships between wellresourced countries (North) and poorly resourced countries (South) successful and increase the potential for impact on worker’s health. The researchers with experiences in North-South collaborations, to evaluate past experiences, to identify future possibilities, and to make arrangements for continued contact and exchange". The Cape Town workshop was attended by participants from Southeast Africa, Latin America and Central and Northern Europe. A summary of the proceedings of the Cape Town workshop was prepared by the organizers (Ehrlich et al., 1997). Furthermore, a comprehensive paper on North-South and South-South collaboration was prepared recently, which is also partially based on keynotes and discussions in Cape Town (Partanen et al., 1998). An extract of the main considerations and conclusions of these two reports are presented here. Global economic changes and internationalization of markets have initiated important changes in the nature of work, including the industrialization of agrarian societies, the transfer of hazardous work processes to countries with weak regulations, migration, and detrimental effects on wages, labor contracts, and worker participation. The adverse OHS consequences of globalization need an international research approach. Besides these new OHS questions, also the more traditional problems persist. Examples of demanding OHS issues in developing countries are health conditions in the informal sector, women and child labor, temporary work, under-employment, migration, risks in agriculture, chemical exposures, dusts, poor ergonomics, violence, infections, and HIV/AIDS policies. North-South collaboration can consist of simple sponsorship, technical support, training, varying kinds of jointly coordinated activities, networks, or technical research support combined with training. Any North-South collaboration should aim distinctly at augmentation of human knowledge and transfer of skills. However, to be successful, North-South collaboration must be mutually beneficial. The South gains by improving the health of the workforce and the capacity to address OHS problems. The North gains by broadening the perspectives of problems similar in industrialized countries, wider variability of exposures, greater diversity of populations, and, in general, opportunities for etiologic research. South-South collaborations faciltate the dissemination of health information relevant for Third World countries, and extend the scope of transfer of skills. South-South collaborations can consist of networks, joint meetings, Southern OHS journals and bulletins, and collaborative research and training. A need for specialized regional centers was identified, for example, OHS or analytical chemical laboratories which should have a research training function. Socioethical aspects must be handled carefully to avoid upsetting mistakes. The Northern counterparts must act with understanding of the cultural and political contexts of the Southern counterparts, and in the case of the South-South collaboration the various Southern partners should be aware of the potential differences as well. An anthropological component in OHS studies may be useful. Whenever feasible, the process of research priority setting should be in accordance with national, regional, or local development agendas. The possibility for fruitful collaboration increases when there exists a national governmental institute that establishes priorities and seeks cooperations. In the formal sector, OHS priorities are likely to be similar as those previously encountered in industrialized countries. On the other hand, the OHS problems related to the informal sector, which dominate the economically active population in most developing countries, require special attention. Priority setting should consider not only the relevance of the topic, but also aspects of form and feasibility of the project. A feasibility assessment should precede any collaboration, including an evaluation of local resources, technical components, social impact, acceptability, and sustainability. Scientific quality needs to be maintained in collaborative North-South research but objectives must be realistic. The specific North-South experiences mentioned as main obstacles were unpredictable field conditions, lack of epidemiological capacity and poor infrastructures in home countries, high turnover of project personnel, and difficulties in preparing publications. Methodologies may need participatory approaches and robust instruments. Field conditions in Third World research require flexibility and creativity but without losing replicability. These are difficult issues and, therefore, a process evaluation should be built into North-South projects as an "on-line" procedure. The results of these evaluations should be made available, for better orientation of future collaborative research efforts. Collaborative research needs to be linked to academic training. Examples are the East African Pesticide Network and the Swedish-Nicaraguan-Costa Rican research collaborations, the latter of which has produced eight master’s and Ph.D degrees in Dutch, British and principally, Swedish academic institutions, each based on Southern data. Particularly successful has been the "sandwich model" (implemented in the collaborations between Swedish academic institutions and Southern partners) in which research in the home country alternates with short periods of training abroad. Development of research capacity should be linked to evaluation of the impact on the worker’s health. Sustainability of the newly acquired capacity is a major concern in North-South collaborations. Long-term support is needed from the Northern counterparts, i.e. at least ten years, to achieve good quality research and some impact on the worker’s health. Serious commitment is required from the Southern investigators; care must be taken in the selection of researchers, but also good work conditions and research incentives should be provided. The active participation of several home institutions decreases the risk for drop-out of key personnel. The gradual involvement of several sponsors and Northern collaborative academic centers as the academic capacity in the South increases, avoids the abrupt ending of funding. In conclusion: collaboration is essential in terms of research, training, and dissemination and utilization of research results. Scientists from the North should start considering the benefits of collaborating with the South, such as joint publications and creation of new OHS knowledge, unique to the South but often universally applicable. Sponsoring agents should be encouraged to support North-South and South-South OHS research.
References Ehrlich R, London L, Clapp D. 12th International Symposium on Epidemiology in Occupational Health, International Commission on Occupational Health. Report on the post-conference workshop, 22 September 1997, University of Cape Town, "North-South research collaboration: Successes, failures and prospects". Manuscript, 1997. Partanen TJ, Hogstedt C, AragÛn A, Arroyave E, Jeyaratnam J, Kurppa K, Loewenson R, Lundberg I, Ngowi VF, Mbkaya CFL, Stayner L, Steenland L, Weiderpass E, Wesseling C. South-North and South Southcollaboration in occupational health research and surveillance. Manuscript, 1998.
Change of names The following institutions recently changed names, in some cases related to organizational changes. In 1995 the Swedish National Institute for Working Life (Arbetslivsinstitutet) was created, integrating the former Swedish National Institute of Occupational Health (Arbetsmiljinstitutet) and the Swedish Institute for Work Life Research (Institutet fr arbetslivsforskning) and parts of the Swedish Work Environment Fund(Arbetsmiljfonden). In 1995 the Swedish International Development Cooperation Agency (Sida), was created, integrating the former agencies of BITS, SIDA, SAREC and SwedeCorp. In 1997 ICOH¥s Scientific Committee on Occupational Health in Developing Countries changed its name to the Scientific Committee on Occupational Health and Development. In 1997 the Swedish Association for Occupational and Environmental Health (UFA) changed its name in English to the Swedish Association for Occupational and Environmental Health & Development. |