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Dr Laura J Brown

September 2nd, 2020

Women’s environmental health in Peru

1 comment | 4 shares

Estimated reading time: 15 minutes

Dr Laura J Brown

September 2nd, 2020

Women’s environmental health in Peru

1 comment | 4 shares

Estimated reading time: 15 minutes

Environmental threats not only impact women’s reproductive physiology but also increase their risk of poor mental health and even their chances of experiencing gender-based violence. Dr Laura J Brown discusses environmental issues and their implications for women’s health in Peru.

 

Environmental health threats take many forms, from high-level climate change to low-level exposure to toxins in air, soil and water. Women in the Global South are disproportionately negatively impacted; women who are already in marginalised positions are particularly vulnerable, especially those who are impoverished, indigenous or who live in rural areas. For many women in these contexts, environmental adversity is an embodied experience. Environmental threats not only impact women’s reproductive physiology but also increase their risk of poor mental health and even their chances of experiencing gender-based violence.

Peru provides an ideal case study to explore links between environmental threats and women’s health: it is a megadiverse country both in terms of its geography and its people. Peru is home to 55 different indigenous groups, and three distinct climatic regions, the coast, the Andes and the Amazon, each with their own host of environmental threats. Increasing air pollution in cities and soil and water contamination from extractive industries in rural areas is posing a real threat to Peru’s population health.

 

Air pollution

Lima, Peru’s capital on the coast, has the worst air pollution in Latin America, partly due to its geography but largely driven by dirty fuel and old vehicles. Poor neighbourhoods are the most polluted and often situated near waste dumps and other sources of pollution. Air pollution has clear ramifications for women’s health: with increased risks of infertility, preeclampsia, gestational hypertension and stillbirth, and having low birthweight, small-for-gestational-age and pre-term deliveries. Outdoor air pollution poses a real threat to women’s reproductive health but research looking at this in Peru is lacking.

Indoor air pollution is also a real health concern. Burning biomass fuels (like wood or animal dung) in un-vented stoves and closed rooms produces high levels of pollutants. In Peru, about one third of the population uses stoves like these for cooking or heating, the majority of whom will be women [1], [2]. Peruvian research has shown that women’s exposure to indoor pollutants such as polycyclic aromatic hydrocarbons (PAHs) is greater than men’s [3].

 

Water and soil contamination

In addition to air pollution exposure, toxic chemicals found in water and soil can cause significant reproductive health problems and adverse birth outcomes [4], [5]. Concerning levels of heavy metals such as mercury, lead, cadmium and arsenic are found in many Peruvian water sources used by Indigenous Peoples [6].  There is also an increased risk of exposure for those who live near active mining, smelting or industrial areas [7], [8] and as Valeria Urbina Cordano from DAR will be discussing in Session 2 of our online workshop series, extractive industries have gendered health impacts, particularly negatively impacting women’s sexual and reproductive health. More than 99% of Quechua adults were found to have high levels of lead in their bodies [6] and toxic levels of lead and cadmium have been found in pregnant women living near smelting complexes [3], [9].  Although the placenta acts as a protective barrier, there is still some transfer of heavy metals to the foetus, and high levels of lead and cadmium were also found in umbilical cord blood and breastmilk.

Pesticide exposure poses another environmental health threat in Peru, with high levels of food contamination and widespread pesticide poisoning [10]. It can lead to adverse reproductive outcomes including intrauterine growth restriction, low birth weight [11], and pregnancy loss [12]. A Peruvian study found that pesticide levels were higher amongst pregnant women in Trujillo compared to in high-income countries [13]. Intra-uterine pesticide exposure has a sustained negative impact, with concentrations showing up in offspring 40 years later [14].

 

Climate change and environmental disasters

Many of the aforementioned environmental contaminants are exacerbated by climate change events. For example, the frequency and severity of El Niño, La Niña and the Southern Oscillation (ENSO) is now increasing with knock-on effects for temperature, water availability and air contamination in Peru [15]. Such climate-related disasters disproportionately impact women [16]–[18].  Not only are women more likely to die during natural disasters and female survivors have shortened life expectancies, but women who give birth following disasters have an increased risk of complications such as preeclampsia, bleeding and having low-birthweight infants [16].

Not only are women more likely to die during natural disasters and female survivors have shortened life expectancies, but women who give birth following disasters have an increased risk of complications such as preeclampsia, bleeding and having low-birthweight infants

Ecological crises will also have significant impacts on the mental health and wellbeing of populations. In the third session two Peruvian early career researchers will be discussing links between coastal El Niño flooding in Peru and post-traumatic stress disorder.  In addition to their higher risk of depression and anxiety after disasters, women’s risk of physical and sexual violence also increases, especially for those who are already marginalised.

 

Gender-based violence

Gender discrimination intersects with other forms of marginalisation to increase the risk of domestic violence. Younger women and those of minority ethnic or uncertain migration status are particularly vulnerable [19] – groups who are already more susceptible to environmental insults. Tahseen Jafry will be discussing the interlinkages between climate change, mental health and gender-based violence in the first session of our workshop series.  In many contexts, gender-based violence (GBV), and intimate partner violence (IPV) in particular, can increase in post natural-disaster settings [20].

Peruvian levels of IPV are already high at around 49% and 61% in urban and rural areas, respectively [21]. In addition to the obvious injury risks, IPV is linked to sexual and reproductive health problems [22]. It can also increase women’s long-term risk of chronic pain and disability, drug and alcohol use and depression [23]. Peruvian women who experience IPV are more than twice as likely as non-abused women to have considered suicide [24]. There may be a possible bi-directional relationship between GBV and environmental threats – not only do women suffer increased risks of violence after natural disasters, but violence in all its expressions, limits the ability of women to respond to disasters and isolates them from their support networks [25].

 

Conclusions

Women’s health can’t just be reduced down to reproductive health with a narrow focus on women’s roles in producing children; women’s health needs to be understood holistically and we need to consider environmental impacts on wellbeing and mental health too. Providing a platform for knowledge exchange and an opportunity for early career researchers to show-case their projects, our upcoming online workshop series takes this holistic approach, exploring a range of women’s environmental health issues in Peru and other low and middle income countries.

Whilst interest in environmental health issues is growing, Latin America lacks data on environmental exposures, and data for Peru is particularly scarce. International policies and movements are calling more and more for a gendered approach to environmental health research and policy, yet research explicitly linking environmental threats to women’s health in the region/country is relatively lacking. We are beginning to look into why this is by interviewing women who work in environmental and/or women-focussed Peruvian NGOs. Tune into the last session of our workshop series to hear some of our preliminary findings.

 

References

[1]       Z. Li et al., “Evaluation of exposure reduction to indoor air pollution in stove intervention projects in Peru by urinary biomonitoring of polycyclic aromatic hydrocarbon metabolites,” Environ. Int., vol. 37, no. 7, pp. 1157–1163, 2011.

[2]       S. M. Hartinger et al., “Chimney stoves modestly improved indoor air quality measurements compared with traditional open fire stoves: results from a small-scale intervention study in rural Peru,” Indoor Air, vol. 23, no. 4, pp. 342–352, 2013.

[3]       A. J. Bergmann, P. E. North, L. Vasquez, H. Bello, M. del C. G. Ruiz, and K. A. Anderson, “Multi-class chemical exposure in rural Peru using silicone wristbands,” J. Expo. Sci. Environ. Epidemiol., vol. 27, no. 6, pp. 560–568, 2017.

[4]       T. R. Segal and L. C. Giudice, “Before the beginning: environmental exposures and reproductive and obstetrical outcomes,” Fertil. Steril., vol. 112, no. 4, pp. 613–621, 2019.

[5]       S. Kumar and A. Sharma, “Cadmium toxicity: Effects on human reproduction and fertility,” Rev. Environ. Health, 2019.

[6]       Cultural Survival, “Observations on the State of Indigenous Human Rights in Peru,” 2014.

[7]       M. K. Reuer et al., “Lead, Arsenic, and Cadmium Contamination and Its Impact on Children’s Health in La Oroya, Peru,” ISRN Public Health, vol. 2012, pp. 1–12, 2012.

[8]       B. J. Feingold, A. Berky, H. Hsu-Kim, E. Rojas Jurado, and W. K. Pan, “Population-based dietary exposure to mercury through fish consumption in the Southern Peruvian Amazon,” Environ. Res., no. February, p. 108720, 2019.

[9]       J. Castro, D. López de Romaña, P. Bedregal, G. López de Romaña, and D. Chirinos, “Lead and cadmium in maternal blood and placenta in pregnant women from a mining-smelting zone of Peru and transfer of these metals to their newborns,” J. Toxicol. Environ. Heal. Sci., vol. 5, no. 8, pp. 156–165, 2013.

[10]     J. Delgado-Zegarra, A. Alvarez-Risco, and J. A. Yáñez, “Uso indiscriminado de pesticidas y ausencia de control sanitario para el mercado interno en Perú,” Rev. Panam. Salud Pública, vol. 42, pp. 1–6, 2018.

[11]     R. M. Whyatt et al., “Prenatal insecticide exposures and birth weight and length among an urban minority cohort,” Environ. Health Perspect., vol. 112, no. 10, pp. 1125–1132, 2004.

[12]     Y. H. Chiu et al., “Association between pesticide residue intake from consumption of fruits and vegetables and pregnancy outcomes among women undergoing infertility treatment with assisted reproductive technology,” JAMA Intern. Med., vol. 178, no. 1, pp. 17–26, 2018.

[13]     O. Adetona et al., “Concentrations of select persistent organic pollutants across pregnancy trimesters in maternal and in cord serum in Trujillo, Peru,” Chemosphere, vol. 91, no. 10, pp. 1426–1433, 2013.

[14]     W. W. Hsu et al., “DDE and PCB serum concentration in maternal blood and their adult female offspring,” Environ. Res., vol. 132, pp. 384–390, 2014.

[15]     G. Obregón et al., “Climate Scenarios for Peru to 2030,” Lima, 2009.

[16]     C. Sorensen, V. Murray, J. Lemery, and J. Balbus, “Climate change and women’s health: Impacts and policy directions,” PLoS Med., vol. 15, no. 7, pp. 1–10, 2018.

[17]     S. Sohrabizadeh, S. Tourani, and H. R. Khankeh, “Women and health consequences of natural disasters: Challenge or opportunity?,” Women Heal., vol. 56, no. 8, pp. 977–993, 2016.

[18]     A. Goodman, “In the Aftermath of Disasters: The Impact on Women’s Health,” Crit. Care Obstet. Gynecol., vol. 02, no. 06, pp. 1–5, 2016.

[19]     G. Feder and E. Howarth, “The epidemiology of gender-based violence,” in ABC of domestic and sexual violence, S. Bewley and J. Welch, Eds. Wiley-Blackwell, 2014, pp. 1–4.

[20]     M. E. Zotti and A. M. Williams, “Reproductive health assessment after disaster: Introduction to the RHAD toolkit,” J. Women’s Heal., vol. 20, no. 8, pp. 1123–1127, 2011.

[21]     C. Garcia-Moreno, H. A. F. M. Jansen, M. Ellsberg, L. Heise, and C. Watts, “WHO Multi-Country Study on Women’s Health and Domestic Violence Against Women: Report on the First Results,” Geneva, 2005.

[22]     A. R. Morrison and M. B. Orlando, “The costs and impacts of gender-based violence in developing countries: Methodological considerations and new evidence.” World Bank, Washington, DC, 2005.

[23]     L. Heise, M. Ellsberg, and M. Gottmoeller, “A global overview of gender-based violence,” Int. J. Gynecol. Obstet., vol. 78, no. October, pp. S5–S14, Sep. 2002.

[24]     B. Shane and M. Ellsberg, “Violence Against Women: Effects on Reproductive Health,” Outlook, vol. 20, no. 1, pp. 1–8, 2002.

[25]     M. T. Arana, “Gender approaches in climate compatible development: Lessons from Peru,” 2016.


 

The views expressed in this post are those of the author and in no way reflect those of the Global Health Initiative blog or the London School of Economics and Political Science.

Photo credit: Peru. Photo by Tom Muller. Licensed under creative commons (CC BY-NC-ND 2.0)

About the author

Dr Laura J Brown

Dr Laura J Brown is an ESRC Postdoctoral Fellow based at the Department of International Development at LSE. Her research focuses on links between the environment and women’s health, with a particular focus on maternal and reproductive health and behaviour.

Posted In: Environment

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