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UBC Theses and Dissertations

Discursive and practical challenges in global health : pesticide-related health impacts in Ecuadorian banana production Brisbois, Benjamin Wesley


This dissertation aims to inform more equitable and effective practice in the emerging field of global health. To address this overriding question of how principles of equity and effectiveness can best be implemented, I critically analyze discursive and practical challenges facing Northern researchers as they approach health problems in the global South, and explore solutions to these challenges. This exploration employs a case study on the articulation of a specific problem in a specific, nominally ‘Southern’, setting: pesticide-related health effects in Ecuador's banana-producing El Oro province. I employ three methodological approaches, in three substantive chapters. Chapter 2 uses discourse analysis to understand how Latin American research sites are framed in peer-reviewed pesticide epidemiology articles. These articles often employ geographic representations of Latin America as inexplicably underdeveloped to demonstrate the need for pesticide research and health sector interventions, typically exhibiting ‘mainstream’ (Northern) public health institutional dynamics. I also show how some epidemiologists are pursuing more politically engaged approaches, in an uneasy negotiation with epidemiology's disciplinary norms. Chapter 3 reports on ethnographic pesticide risk perception work in El Oro, drawing on theories from anthropology and human geography. I document how pesticide risk perception narratives reflect El Oro's position in unstable global commodity chains. Scalar elements of these narratives combine individual and structural explanations for health problems in complex ways. In Chapter 4, I describe a political ecology of health explanation of pesticide exposure in El Oro. I employ a modified meta-narrative methodology, complemented by ethnographic fieldwork, to synthesize literature relevant to the pathways – biological, political economic, environmental and cultural – leading to pesticide-related impacts in El Oro. This analysis complements Chapters 2 and 3 in making the case for empowerment-based participatory approaches to pesticide exposure problems (and, by extension, to global health more generally), with special attention to international linkages, environmental complexity and political economy. The introduction, conclusion and 'linking' material between chapters serve to enhance the coherence of the dissertation by providing additional material not appropriate for inclusion in the three chapters, including elements of reflexivity.

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