Essentially, this project sets out to demonstrate the value of cross-disciplinary collaboration between epidemiologists, health practitioners, biostatisticians, geochemists, farmers and local agricultural extension workers. A great deal of interest was created amongst the communities who welcomed the research and could provide useful local knowledge with respect to farming and local health issues.
|Tea estates in Nandi Hills and 800m drop down from Nandi into Kisumu County - sugar belt.|
So what are we collecting?
At each site we capture data on field sheets a range of data relating to the land-use, crops grown, drinking water source/usage and any local health problems (e.g. ESCC, goitre), along with soil, a panel of crops grown and eaten from the garden or farm, drinking water and a urine sample. The latter often results in some giggling, but nearly always enthusiastic participation, despite the potential embarrassment. We had three vehicles out in the field on predetermined routes to coordinate daily collections, often at difficult to reach places, but thankfully the weather held and many roads although difficult were passable. Of course, the entry point led by the PHO’s and often the drivers (they have a wider range of language skills) is invaluable in explaining what we are doing and why, in order to gain permission from participants at each site and can often result in a deluge of local information. In fact, we have rarely experienced a negative response, rather a great deal of interest and help. The challenge will be how we report data back in an appropriate format.
|Sampling in hard to reach places in Nandi hills where rapid changes from forest to farming taking place.|
Wider uses for data
The collection points rather than being led by the location of ESCC case-control sites has taken on a spatial link across each county, simply driven by spatial coverage where safe access is possible or where populations reside in the rural community (e.g. cannot access sugar cane estates, rainforest). In addition, we have incorporated into planning collection sites published soil chemistry parameters. Overall, data will be useful to agricultural extension officers to provide advice to farmers on soil management, to PHO’s in gaining datasets to estimate health status from a sample population within each county (e.g. micronutrient deficiencies, exposure to PHE’s). In the coming years, IARC-Moi University will use the environmental data/dietary intakes to support spot sampling for ESCC-control collection points, utilising the trained field personnel.
|From L-R: Collection of data; One of the field teams (includes Diana Menya).|
|Laboratory training at University of Eldoret.|
Dr Michael Watts is the Head of Inorganic Geochemistry at the Centre for Environmental Geochemistry at the British Geological Survey. Dr Diana Menya is a Senior Lecturer with the School of Public Health, Moi University, Kenya. Professor Odipo Osano is from the School of Environmental Sciences, University of Eldoret, Kenya.
Acknowledgements to wider team:
University of Eldoret: Jackson Masai, Charles Owano, David Samoie, Prof. Odipo Osano, Doreen Meso. Many thanks to student volunteers led by Melvine Anyango and Job Isaboke for help in the field and lab
Moi University: Dr Diana Menya, Esilaba Anabwani - ESCCAPE, Eldoret (Esophageal Squamous Cell Carcinoma Africa Prevention Effort), Amimo Anabwani- ESCCAPE, Eldoret
British Geological Survey: Dr Michael Watts, Olivier Humphrey – CEG PhD student, Dr Andy Marriott
Public Health Officers Many thanks to the PHO’s from Kisumu, Kericho and Nandi Counties, some of whom were volunteer PHO’s serving their community and/or trainees building up work experience.