Politics, economics, how about our health? Impacts of large-scale land acquisitions on therapeutic spaces and wellbeing in coastal Tanzania.

One question that has remained unexplored in the global land rush debate is how large-scale land acquisitions affect health and wellbeing of local populations. As part of a larger study, this study advances our understanding in this area by applying the concept of therapeutic landscapes to analyze interviews conducted in two coastal communities in Tanzania where land investments have been prevalent. Our analysis found that local populations perceived traditional lands with sacred sites as therapeutic spaces, which embodied cultural values, and promoted health and wellbeing when protected. Intrusion into these spaces through large-scale land investment is believed to remove their therapeutic attributes, thereby turning them into unhealthy landscapes. Dispossession of these spaces is perceived to heighten community distress resulting in poor psychosocial health. Based on our findings, we suggest that health consequences of land investments should move to the center of the large-scale land acquisition discourse. Health policy should refocus on the psychosocial health impacts of global land investments in Tanzania and other low-income countries. Ultimately local participation in land governance should be strengthened through land reforms in Tanzania and similar contexts, as this may provide a buffer to poor psychosocial health.

Historical Perspective and Risk of Multiple Neglected Tropical Diseases in Coastal Tanzania: Compositional and Contextual Determinants of Disease Risk.

BACKGROUND: In the past decade, research on neglected tropical diseases (NTDs) has intensified in response to the need to enhance community participation in health delivery, establish monitoring and surveillance systems, and integrate existing disease-specific treatment programs to control overlapping NTD burdens and detrimental effects. In this paper, we evaluated the geographical distribution of NTDs in coastal Tanzania. METHODS AND FINDINGS: We also assessed the collective (compositional and contextual) factors that currently determine risks to multiple NTDs using a cross sectional survey of 1253 individuals in coastal Tanzania. The results show that the effect size in decreasing order of magnitude for non-binary predictors of NTD risks is as follows: NTD comorbidities > poverty > educational attainment > self-reported household quality of life > ethnicity. The multivariate analysis explained 95% of the variance in the relationship between NTD risks and the theoretically-relevant covariates. Compositional (biosocial and sociocultural) factors explained more variance at the neighbourhood level than at the regional level, whereas contextual factors, such as access to health services and household quality, in districts explained a large proportion of variance at the regional level but individually had modest statistical significance, demonstrating the complex interactions between compositional and contextual factors in generating NTD risks. CONCLUSIONS: NTD risks were inequitably distributed over geographic space, which has several important policy implications. First, it suggests that localities of high burden of NTDs are likely to diminish within statistical averages at higher (regional or national) levels. Second, it indicates that curative or preventive interventions will become more efficient provided they can be focused on the localities, particularly as populations in these localities are likely to be burdened by several NTDs simultaneously, further increasing the imperative of multi-disease interventions.

Eating the dead in Madagascar.

Cannibalism has been poorly understood and has seldom been studied, since it was often suppressed by missionaries and colonial administrators, and very few societies still practise it. Cannibalistic practices are more complex than was originally thought. They may be supported in societies under stress or in times of famine, to reflect aggression and antisocial behaviour (in cases where the bodies of enemies killed in battle or people who have harmed the family are eaten), or to honour a dead kinsman. It was, for example, noted in Madagascar during the imperial campaigns of Ranavalona I in the period 1829 - 1853. Two types of cannibalism have been described: exocannibalism, where enemies were consumed, and endocannibalism, where dead relatives were eaten to assist their passing to the world of the ancestors, or to prolong contact with beloved and admired family members and absorb their good qualities. This article reviews some of the beliefs and motivations that surrounded the cannibalistic practices of the people of Madagascar in the 19th century.