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Epidemiological study: socioeconomic characteristics: mean of 46 years, mostly female, self-declared Black or brown; married/common-law marriage; low schooling level and insufficient monthly income for family survival; work: began working in fishing, on average, at 14, mean fishing working time of 32 years, no fixed working hours, some worked in other activities to supplement their income and although they reported using Personal Protective Equipment (PPE), this equipment was often improvised; health: just over half reported worse or much worse health, compared to a year earlier, with cardiovascular, respiratory, endocrine, and arbovirus diseases. Most reported not having had COVID-19, but some had not been tested; impacts of the oil disaster-crime: it impacted the lives, income, and harmed the environment, with mobilization for support being done by volunteers or community organizations. They reported that their fishing equipment became dirty with oil and that they had to stop fishing, some for more than 30 days. They did not receive government financial support or staple food baskets and had to consume what they caught. In healthcare, around 70% of the workers found oil while working and some of these workers had contact with their skin but did not seek medical care. Around a third of them participated in the cleanup of oil residues even without any training. Some parts of the body were exposed and displayed symptoms such as severe headaches and joint pain, insomnia, and burning eyes. Around half of the workers met the diagnostic criteria for Post-Traumatic Stress Disorder (PTSD). |
- Social movements: Fishermen’s colonies and associations, Pastoral Fisheries Council (CPP), National Coordination of Small-scale Fisherwomen (ANP), Suape Forum - Education institutions: Federal University of Bahia (UFBA), University of North Carolina (UNC), Federal University of Pernambuco (UFPE) - Municipal Health Secretariats (SMS) (RAS): Health Surveillance, Primary Care, and Family Health teams (eSF) |
- Health cards for small-scale fishing workers delivered to traditional fishermen/fisherwomen; - International course on the impacts of the oil spill in Brazil: intersectoral coping strategies in the community context; - Health actions conducted with health teams. |
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Review: substandard working conditions involving inhospitable and polluted fishing sites, physical overload, inadequate postures and strenuous work rhythms. High prevalence of Musculoskeletal Disorders, Repetitive Strain Injuries, and Work-Related Musculoskeletal Diseases. Mapping: characterization of the oil spill and identification of the socioeconomic, health and environmental impacts that were published in the EJAtlas. Social reproduction matrix - biocommunal: improvised or inadequate PPE used in oil clean-up; possibility of physical illness; cases of PTSD; food insecurity and COVID-19 syndemic; self-awareness and conduct: organizations and solidarity networks affected, with cultural and symbolic territorial transformations and ruptures; technical-economic: impact on tourism; fishing ban, unemployment, and livelihood insecurity. Ecological: several damages to the ecosystems of the affected territories; political: weak government mitigation response, lack of plans to address tragedies and policies to support small-scale fishing. As a result, increased vulnerability of water people was evidenced, influencing the social determination of the health-disease process; the unsustainability of the current development model, and the need for remedial measures in oil spill disasters. |
- Social movements: Fishermen’s colonies and associations, CPP, ANP, Suape Forum - Education institutions: UFBA, UNC, UFPE, Institute of Environmental Science and Technology of the Autonomous University of Barcelona (ICTA-UAB) - SMS (RAS): Health Surveillance, PHC, and eSF |
- Description of socioenvironmental conflicts in the northeastern macro context; - Structuring research based on ecosystem approaches in health; - Support the development of a pilot project for intervention in municipal health management; - Promote training processes on the health issues of water peoples. |
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Metabolic alterations: mean concentrations of malondialdehyde (MDA) (in μM) by municipality: Tamandaré=8.7; Cabo de Santo Agostinho=20.2; Porto de Galinhas=9.3; Barra de Sirinhaém=11.6. These results are well above the reference values of 3.31 μM. Despite this, this phenomenon cannot be attributed solely to exposure to oil, since this same population is exposed to other conditions that can alter enzymes such as MDA. |
- Social movements: Fishermen’s colonies and associations - Education institutions: UFBA, UFPE, UNC, Catholic University of Pernambuco (UNICAP) - SMS: Health Surveillance, PHC |
- Feedback on exams for ESF and participants; - Strengthening of laboratory surveillance; - ESF training; - Basis for studies and creation of protocols for care and monitoring of fishermen’s health. |
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Participatory Mapping: health: symptoms of poisoning, mental distress, lack of knowledge of the impacts and late use of PPE, mostly inadequate, for cleaning the beaches, and lack of a monitoring plan for those exposed; environment: pollution throughout the region, impact on fish sales and consumption by the population, government’s inertia; socioeconomic: government’s negligence towards more impoverished areas, environmental racism, lack of media coverage of discussions on socioenvironmental and health vulnerabilities, impacts on income, with a severe reduction in sales and low coverage of state financial aid. Rapid Participatory Diagnosis: destructive processes in the General domain, socioenvironmental injustice and vulnerabilities such as the economic development model, the Suape Port Industrial Complex, the 2019 oil disaster-crime, the COVID-19 syndemic, difficulty in accessing public policies, loss of local biodiversity and real estate speculation in the region; in particular, exhausting working hours and work overload, use of rudimentary equipment and tools for work and storage, low-cost product marketing, generating the need for supplementary income, and unequal gender, class, and race relationships; in the singular, physical and mental illnesses and deaths. The study highlighted central issues, giving visibility to the reality of water women. |
- Social movements: Fishermen’s colonies and associations, CPP, ANP, CPP, Suape Forum, Center for Comprehensive Care and Development (CADI), Anglican Church of Gaibu, ‘All to the Sea’ women’s group (TPM). |
- Collective construction of social maps about the impacts; - Appreciation of the work and way of life of water women; - Promotion of health care moments (medical care and integrative and complementary practices); - ‘Water Women’s Health’ booklet; - Documentary about the work process of shellfish gatherers on the southern coast of PE; - Film debates in the territory, education institutions, and festivals. |
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Structuring processes for comprehensive community reparation of health and living conditions in the territories: the measures taken have been incipient since the incident in 2019, and urgent actions are needed to restore the dignity of these populations. Rehabilitation: declare a state of emergency; adopt urgent health measures (assistance and monitoring); investigate and monitor people affected by the spill; provide specialized and equitable care for fishermen; promote mental health care. Restitution: develop research and ongoing monitoring to restore the territory’s biodiversity and fishing territory. Compensation: emergency benefit for the spill; guarantee of social assistance benefits; government incentives for income generation. Satisfaction measures: create and guarantee the functioning of the Permanent Monitoring and Action Committee to address spills with the participation of small-scale fishermen; media visibility. Non-repetition guarantee: ensure compliance with environmental laws and hold those responsible for the spill accountable. |
- Social movements: Fishermen’s colonies and associations, CPP, ANP, CPP, Suape Forum, CADI, Anglican Church of Gaibu, and TPM. |
- Culture circles; - Promotion of a moment to receive and listen to participants; - Matrix of Critical Processes of the social determination of health; - Care with integrative and popular practices in health. |
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Review studies: criticisms of the control, mitigation, or prevention of immediate and future damage resulting from disasters, which is an open agenda for social movements in the fight to guarantee a healthy and sustainable environment. Actions to address oil disasters in different countries appear to have been incipient, revealing government incapacity in the face of these situations. Interviews: health management weaknesses (at the state and municipal levels) in disaster mitigating actions, resulting from the lack of preparation of health services and professionals. The lack of instruments and the lack of coordination between federated entities escalated the difficulties, generating disastrous situations in the territory. There is a need to build instruments that guide more efficient and effective actions in these situations. The municipality analyzed had advance organization of the actions to confront the disaster, but the lack of governance in the disaster-crime and the focus of health management on the COVID-19 syndemic were highlighted as difficulties and vulnerabilities in the actions. Continuing education and coordination with fishermen and shellfish gatherers were some of the lessons learned. |
- Social movements: Fishermen’s colonies and associations - Education institutions: UFBA, UFPE, CEPEDES/ENSP Fiocruz-RJ - State and Municipal Health Secretariats: Health Surveillance, PHC, and health teams - State Workers’ Health Network: State and regional worker health center - Ministry of Fisheries |
- ‘Waters’ Health’ Intervention Project: pilot project for a health program for water people in partnership with a SMS and small-scale social movements; - Continuing education plan built from health needs; - Technical cooperation agreement between Fiocruz and the Ministry of Fisheries. |
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A timeline was created linking the arrival of oil on the newspaper articles, analyzing the narratives considering the environmental, socioeconomic and health impacts, where health topic had low visibility of the damage, making it necessary to think about communication practices. Training and popular strengthening processes: Free course on community communication for healthy and sustainable territories; international course on the oil spill impacts in Brazil: intersectoral coping strategies in the community context; course for popular water health workers; workshop on partial results with the small-scale fishing social movement; workshops on the Rural, Forest, and Water Health Policy with health workers; continuing education workshop on water people’s health; creation of ‘Among Us: Network of Popular Communicators’; health cards for small-scale fishing workers; rapid participatory diagnosis/work flowchart; ‘Seminar on the Oil Disaster-Crime on the Coast of Pernambuco and the Water People’s Health’. Academic and scientific dissemination materials: recording and publishing of conflicts in EJAtlas; production of the documentary ‘The Sea that lives in me’; poetry - ‘Nameless stain that doesn’t go away’; photography contest ‘I who inhabit the sea’; ‘ ‘Water Women’s Health’ booklet; production of four published scientific articles, three book chapters in press, three course completion monographs, 10 master’s dissertations, and four doctoral theses in public health, eight submitted articles, |
Social movements: Fishermen’s colonies and associations, CPP, ANP, Suape Forum, Community Communicators Network, Cabo de Santo Agostinho Women’s Center, Anglican Church of Gaibu, CADI, TPM - Education institutions (UFBA, UNC, UFPE, and ICTA-UAB) - Municipal Health Secretariats (RAS): Health Surveillance, Primary Care - Regional and State CERESTS - National and international education institutions - Ministry of Fisheries |
- Conducting training processes in the communities - Publishing conflicts on the EJAtlas platform; - Creating a network of popular communicators; - Conducting courses organized collaboratively with social movements; - Conducting workshops and seminars to disseminate results and developing strategies to improve the health of water peoples; - Producing materials collaboratively with different social stakeholders. |
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one book in preparation with results of the project; technical report ‘Analysis of the inclusion of health in the Environmental Impact Study of ExxonMobil - Offshore Drilling of Oil Wells in the Sergipe/Alagoas Basin’; technical document ‘General recommendations for the health sector in risk management in crude oil spill contexts’; continuing health education plan for health professionals and managers focusing on Water People; ‘The Pernambuco Charter’ and virtual platform for publishing the products and results of the project on the institutional website. |
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