Accessing healthcare services in a timely and convenient manner is crucial for the wellbeing and continued good health of populations. Yet, many populations worldwide experience difficulties in accessing healthcare services. These difficulties may stem from a lack of service providers – a problem particularly pertinent in rural areas – services being cost-prohibitive, and legal and cultural barriers that deter patients’ willingness and ability to receive health services (Douthit et al., 2015).
One population that is often neglected and for whom accessing healthcare services can be difficult, are communities that live in emerging settlements centered around an extractive industry, such as gold mining (Glendening et al., 2023). These communities occur globally and may be particularly susceptible to certain illnesses and health conditions. These can include: sexually transmitted infections (Baltazar et al., 2015) and other communicable diseases such as malaria (Moyo et al., 2021; Shanks and Wongruchanalai, 2021), as well as high exposure to mercury and lead poisoning (Bartrem et al., 2014; Bose-O’Reilly et al, 2010).
Yet, despite experiencing a high demand for healthcare, often these types of communities experience very limited access to the very services that could help treat their health needs. There are many reasons for this inaccessibility (Hentschel et al. 2002; Schwartz et al. 2021). Community access to healthcare services may be due to the community’s often geographically remote location, vis-á-vis health services, which may often be concentrated in big cities that are far away. The community’s remote location may also hinder official recognition of it and serve to ‘hide’ the community from decisionmakers, including health agencies or NGOs that may not be aware of the community’s existence and healthcare needs.
These communities may also be perceived to be temporary even when they come to the attention of the necessary authority. This in turn, may hinder the appropriate level of healthcare investment due to perceptions that the populations living there will leave soon, even when the population size is growing rapidly. Similarly, potentially contentious legal statuses of communities based on extractive industry, may also deter official healthcare investment in such settlements and make those living there unable to seek health services in other places. Similarly, the undesirability of extractive work and its externalities may also hinder health service investment (Shanks and Wongruchanalai, 2021).
Overall, this leads to growing populations, many of whom are children, unable to access timely and affordable healthcare. However, ensuring that all people can access diagnosis and treatment services, regardless of their community’s main occupation, is an essential goal of public health world-wide. A goal that we should all strive to achieve.
An initial step of ensuring this, involves identifying populations that may fly under the radar and have an unmet need for healthcare services. This may be difficult and require multiple methodologies, including remote-sensing and GIS methods combined with traditional field investigations. A component of my doctoral dissertation work involves utilizing remote sensing methods to try and identify the population size of remote emerging communities in the Gambella Region of Ethiopia, to investigate potential unmet needs for healthcare services among them. Following identification of these types of communities, attempts need to be made to discuss the community’s health needs with community members to then establish a plan for service provision that can then meet these needs in a sustainable and community-appropriate manner.
References:
Baltazar CS, Horth R, Inguane C, Sathane I, César F, Ricardo H, Botão C, Augusto Â, Cooley L, Cummings B, Raymond HF and Young PW (2015) HIV prevalence and risk behaviors among Mozambicans working in South African mines. AIDS and Behavior, 19(1), 59–67. https://doi.org/10.1007/s10461-014-0941-6.
Bartrem C, Lindern I von, Braun M von and Tirima S (2022) Climate change, conflict, and resource extraction: analyses of Nigerian artisanal mining communities and ominous global trends. Annals of Global Health, 88(1), 17. https://doi.org/10.5334/aogh.3547.
Bose-O’Reilly S, McCarty KM, Steckling N and Lettmeier B (2010) Mercury exposure and children’s health. Current Problems in Pediatric and Adolescent Health Care, 40(8), 186–215.
Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015). Exposing some important barriers to health care access in the rural USA. Public health, 129(6), 611–620. https://doi.org/10.1016/j.puhe.2015.04.001
Glendening, N., Haileselassie, W., & Parker, D. M. (2023). "Chapter 5 A conceptual framework for understanding extractive settlements and disease: demography, environment, and epidemiology". In Planetary health approaches to understand and control vector-borne diseases. Leiden, The Netherlands: Wageningen Academic. https://doi.org/10.3920/9789004688650_007
Hentschel T, Hruschka F and Priester M (2002) Global report on artisanal & small-scale mining (No. 70; p. 67). IIED.
Moyo D, Zishiri C, Ncube R, Madziva G, Sandy C, Mhene R, Siziba N, Kavenga F, Moyo F, Muzvidziwa O, Ncube P, Chigaraza B, Nyambo A and Timire C (2021) Tuberculosis and silicosis burden in artisanal and small-scale gold miners in a large occupational health outreach programme in Zimbabwe. International Journal of Environmental Research and Public Health, 18(21), 11031. https://doi.org/10.3390/ijerph182111031.
Shanks GD, Wongsrichanalai C. Mining-Associated Malaria Epidemics. (2022) Am J Trop Med Hyg. 106(1):33.
Schwartz FW, Lee S and Darrah TH (2021) A review of the scope of artisanal and small-scale mining worldwide, poverty, and the associated health impacts. GeoHealth, 5(1), e2020GH000325.