Paying Progress with Health: Pesticide Use and Potato ...



THE SOCIOLOGICAL DIMENSIONS OF PESTICIDE USE AND HEALTH RISKS OF POTATO PRODUCTION IN CARCHI, ECUADOR1

Verónica Mera-Orcés.

1Paper prepared for presentation at the 2001 Open Meeting of the Human Dimensions of Global Environmental Change Research Community, Rio de Janeiro-Brazil (Octubre 6-8, 2001)

Keywords

Pesticides, Pesticide intoxication, Social Dynamics, Gender, Agricultural Practices and Environmental Change, Perceptions, Health

Abstract

Modernisation of potato production in the Ecuadorian highlands is related to an intensive use of pesticides. This study was aimed to determine the influence of household arrangements, local institutions and social differentiation in the management of production and pesticide use. Social and environmental information was gathered by means of ethnographic methodologies and discourse analysis tools. This studied determined that potato production involves to all household members and generates occupational risks, but also household level accidents. Children and teenagers were identified as the group more vulnerable to intoxication with pesticides. Four social dimensions that integrate pesticides in the local social dynamics were determined: health-beliefs, gender identity, social identity, and economical progress reliance by means of potato production. Intense potato production and comoditisation of nature is contributing to a progressive social stratification, which is causing that a group of peasant households emerges as the poorest group and vulnerable to occupational risks by chronic pesticide exposure.

The Situation

The Andes of Ecuador has been classified as a centre of genetic diversity of potato (Brush, 1999) and still is an important crop and foundation of the Andean diet. Modernisation of potato production in the Andean region is related to fast changes towards high-input commoditised production systems and complex knowledge networks. As a result, the region is confronted with an increasing social change and several environmental problems, especially related to pesticide overuse. During the last years, the northern Province of Carchi has become an important potato producer in the country, where specialised farmers cultivate nearly 40% of national production on only 25% of the area (Crissman et al, 1998). Pesticides are the technological keys of potato agricultural modernisation and are considered essential to maintain production. Recent studies have demonstrated that in Carchi, where the farming system combines potato and dairy production, current methods of potato cultivation exhibit the heaviest pesticide use in the Andes and at large in the country (Crissman et al, 1998, 1994; Cole et al, 2000). Farmers in deal with many different potato plagues, which are combated by means of several pesticide ‘cocktails’. Among others, the insecticide carbofuran, used extensively by potato farmers, is blamed of extremely high neurobehavioral toxicity (Crissman et al, 1998, Cole et al, 1998; Cole and Mera-Orcés, 2001). Potato production in the zone is regarded as a male activity, this view is shared by extensionists, agricultural and health researchers. This is also what farmers (female and male) say at once (Mera-Orcés, 2000).

The Institutional Situation

The use of carbofuran in granulate form is internationally allowed because it is not persistent in the environment, and in developed countries the applications are normally done with proper human protection. However, in developing countries pesticides are usually applied without the necessary precautions. Additionally, in Ecuador like other countries, there are many laws that in theory defend the human health and the well-being of society, but t

here is no institution with the power to implement the law: to regulate pesticide quality and importations. Also there are many c

ontradictions in practice caused by powerful groups with economic interests and strong political connections.

Description of the study place

San Pedro” is a community of Montúfar Canton in Carchi Province. The community is located at 3500 m above see level. By means of a cobblestone path, the community is connected to the Pan-American Highway, which crosses the country from North to South; it takes half an hour by car from San Pedro to San Gabriel (which is the administrative seat in the Canton and an important market).

The farming system in the community principally combines potato production and pasture for dairy purposes. However other crops such as carrot, vetch, maize and green bean are cultivated too. There are around 310 families, but the number of households is always changing due to the high mobility of the inhabitants. Small farms dominate land ownership on San Pedro. Generally, land units tend to be smaller than 10 ha. Land division is arranged mainly by means of land-sales, inheritances, invasions and land-hand-over. When people speak over “their land”, they usually refer to several and different plots.

Methodology

I have made an emphasis on people-oriented approaches (Leach et al, 1999; Berkes et al, 1997; Long, 1997) which focuses on the resource producer and user rather than on the resource itself. Thus, I have focused on potato production institutions, which involve patterns of behaviour among individuals concerning production and household arrangements. This approach permitted me to understand the way resources are managed, but also forms that certain actors are excluded from resources and the way some face health risks. Shared norms and ideas about health were considered as sources of social identification and as social constructions (Berkman et al, 2000), in the extent that both individuals and groups develop ideas about disease and well being.

Throughout the data collection and analysis a gender sensitive approach was followed, by using a flexible ‘gender analysis framework’. This was crucial to understand the integration of household with production dynamics.

After a first stage of the fieldwork, in which open interviews were carried out to get a general situation perspective and to determine the key actors, semi-structured interviews were carried out with key informants (n=21) determined with a purposive or judgement sample. The selection of informants was based on land tenure differences: Households with total area plots of 5 ha or more (n=3), with total plots area of less than 5 ha (n=13) and households with no land (n=5) were selected. Moreover in every group a household where a female farmer controls the farm production was included. With 10 key informants (6 men and 4 women) I conducted an unstructured questionnaire for in-depth oral histories, in order to understand their point of view regarding health, gender relations, changes in their activities. A discourse-based analysis tool was used in order to understand the contrast between what was said among what was observed. Especial attention was paid in the ways in which people reflect on forms of self-identification.

Finally, medical reports and statistics from the main hospital of the zone were revised. There, two kinds of studies were made: A general quantitative analysis of the hospitalisations registered during 1999, and a content analysis of the reports’ texts on pesticide intoxication (from 1997 to 1999). In the Political Intendancy, a general quantitative and a content analysis were made of the reports on abrupt deaths caused by pesticide (from 1997 to 1999).

Results

Potato Production Institutions and risk

Farmers in San Pedro are commercially oriented and they follow several social arrangements concerning potato production and farm labour. In any case household members entail an important and free source of labour. Since potato cultivation is laboured intense, it is common that capitalised farmers contract workers. Wages for these workers are paid on a daily basis, except during the harvest, when the payments are for every bag of harvested potatoes.

Sharecropping is a common institution in the community and is a way to share risks as well. It is important to realise that potato production is a risky activity because several diseases can destroy the entire crop and fluctuation in potato prices can generate high economical losses. Various resource inputs are negotiated in the sharecropping arrangements. The final division of benefits is divided depending on initial arrangements. Many farmers are involved in different sort of arrangements at the same time and are strategies to deal against uncertainty. Therefore, capitalised farmers have more possibilities to diversify their strategies, while peasants with no land or capital are dependent on their daily wage.

Land renting is an arrangement that is usually utilised by capitalised peasants who decided to take the risks and possible benefits of production by themselves or in an agreement with an associate farmer. An informant who rents land said that the management of his own plot is rather different that the management of the rented one. In his own plot he allowed the “land rests”, which implies that he follows a type of crop rotation. While in the rented land, potato is planted immediately after the harvest. He said that he uses to rent one plot until “there is not possible to get anymore from the land”.

Potato Production Practices and Women’s work

Potato production in the community follows an established sequence of activities. Table 1 lists production activities according to sex. This must be seen as a generalisation, because some households could have individual differences, based on family’s life cycle, disposability of capital and land property.

Although there is not an explicit description of children’s activities in table 1, it was corroborate that girls help their mothers and sisters, while boys help their fathers and brothers. Generally men earned 20% more than women per daily wages did, even if both are doing the same activities.

Current literature says that potato farming in this part of Ecuador is predominantly a male activity, opinion that is certain if the analysis considers one or some links in the production chain. Participation of women in farm activities and in commercial potato production has been overlooked in former studies. This has resulted in an incomplete knowledge of the farm and production arrangements, together with a lack of recognition of the importance of female work in productive activities and roles. Thus, conventional studies in the zone resemble those described by Boserup’s ‘male farming systems’ (Boserup, 1970), in the extent that have focused on male tasks and narratives.

In some households farm production as a whole is managed by women. This especially happens in the absence of the husband, or when the family had several daughters. Female farmers considered that they were not educated in agricultural issues as early as their male family members were. This has imposed an extra difficulty for women to obtain information. Some female informants said that even for their own father or mother, it was ‘natural’ to pass agricultural knowledge to their brothers, but not to them.

Making contrast between ‘what was said and what was observed’: The challenge of gender sensitive methodologies

It was not a simple task to get answers from informants on division of labour per gender. On the contrary, this implied a methodological challenge. Many informants (men and women) had no problem answering general questions (what activity is done generally by whom?). But when the answer was directed in a more personal way (what do you do?), the answers were much more diffuse, incomplete, and especially women tended to give ‘value-judgements’ concerning their work. Many women answered “I do not do anything, I just stay at home”. “My husband is the one who works”. This implied two practical complications. First, to talk about female work, implied to talk about work which was under-valorised by women themselves. Second, potato production has a masculine status and the activity is seen as an “activity for men”. Then, some men feel ashamed that their wives dedicate themselves to potato production activities. Generally female work in this production system is seen as a secondary help and not as a real work. It was quite common that in first conversations I had answers like “my wife does not work at all in potato production”. But, in the afternoon I found this woman harvesting in one plot or another woman working with a hoe or pickaxe. In households where the husband is absent for long periods because he works in another place or because she is widow, potato production is entirely managed by her on top of the domestic tasks. This female farmer will refer to herself first as a mother or as a housewife secondly she will refer to her role as producer. This kind of complexities implied that conversations must be continuos. By means of sensible observation it was possible to reformulate themes of discussion with informants.

Livestock and husbandry in the potato-and-dairy-system

People organise their daily activity based on complex set of duties. Domestic work, crop production, animal husbandry tasks and other farm activities need to be done daily. This diverse spectrum of activities is organised following different patterns in every household. According to Crissman et al (1998a) “Typically low-quality mixed-blood animals are use as milk cows producing for home consumption and sale. Farmers also purchase younger cattle for putting on pasture for later sale”. Primarily, the adult women of the household execute milk production tasks. Female farmers said that they prefer low-quality cows because demand less care and produce fatter milk than high-quality races. This also has a nutritional importance, especially when considering that diet fat input is low. School-aged children work in cattle-caring activities after school time. For grazing, animals are moved systematically through several pasture patches. Peasants with plots already sowed, rent other people’s grasslands after a negotiation to set prices. This is potentially a source of conflict among farmers, especially if negotiations fail.

Milk provides cash income, which is managed by women for daily household necessities. Part of the produced milk is kept for consumption. Cattle could be sold for potato planting, land acquisition, or to pay debts. This is a potential conflict source at household level, especially when the sell is made with out consensus. To sell the cattle sometimes means a significant risk for the family’s subsistence. Also near to the houses small animals are kept (such as guinea pig, chicken, ducks, pigs, etc), which are considered the woman’s property and responsibility. She could sell these animals to supply household needs or in emergencies and are prepared as food in especial occasions.

Food preparation for production activities or the ‘invisible giant’

Moser (1993) influenced gender-analysis frameworks with her theory that women have three roles in society: Productive, Reproductive and Communal. An important contribution of feminist research was to set up the invisibility of those roles of women in agrarian research, but also in public-political debate. Current feminist debate acknowledges the fundamental continuity between women’s unpaid (domestic or reproductive labour) and paid (productive) labour, “neither of which can be satisfactorily understood without referring back to the overarching cultural construction of gender difference (Kabeer and Subrahmanian, 1996; Sage, 1993; Ram, 1991).

In almost all houses there are gas-kitchens, but during potato production periods, women use firewood kitchens. This has two reasons: to reduce costs and to have extra space for big pans. Frequently farmers collect firewood from Andean forest remnants. At times, some buy eucalyptus wood that is sold in markets or by brokers in the community. Cooking during potato production activities is a time consuming activity. Generally, it starts with breakfast preparation. Around 11 a.m. women bring the lunch to the fields. Sometimes this means a heavily loaded two-and-halve-hour walk through hilly terrain. Around mid-afternoon workers take coffee with a snack. Some women made two journeys daily.

Food preparation is one of the resources negotiated in sharecropping arrangements and in the setting of wages. In half-half arrangements, the wives of the farmers involved negotiate among them who will prepare lunch or coffee and on which days. Farmers pay to day labourers 15% less “with food” or 15% more “without food”. The example of food preparation highlights that a categorisation of domestic work as a non-productive activity is rather artificial. Overlooking the way the so called ‘reproductive work’ influences productive activities would mean lack of recognition for the amount of work that this division of labour imposes on women, and the importance of these activities for production.

Pullover knitting is an activity that is especially important in households with no land, or when potato production brought economical losses. Usually a woman (adult or teenager) could knit one or two pullovers per week. There are various merchants who provide women with wool and pay them per pullover. In difficult times the household requirements are supplied by means of this activity, this way some households survive until the potato-harvesting period. These examples serve to ‘deconstruct’ the household moving beyond the ‘black box’ conception of a unit collectively engaged in a single form of production (Whitehead, 1981). Rather, the household serves as a locus for supporting simultaneous involvement in various complementary or non-articulated spheres of production. These include both agricultural and non-agricultural activities (Sage, 1993).

Risk, Health Beliefs and Identity

Pesticide use practices and protection

On average each parcel receives more than seven applications with 2.46 insecticides or fungicides in each application (Crissman et al, 1998a). Normally applications are done without the use of any protection, with exception of rubber boots. Farmers use certain clothing, which is considered protective, commonly leather, or a denim jacket. Other farmers do not use any special clothing for applications.

Farmers’ reasons to reject the use of special protective clotting are (1) discomfort and (2) high costs. At this altitude, mid-day radiation of the sun is intense. In agrochemical shops of the zone do not sell appropriate protective items, an opinion about this was: “In stock we have what we know we can sell. Pesticides are good business, but nobody will buy any sort of protection item here”.

The pesticide cocktail is generally prepared in the field; the pesticide is mixed by means of a stick. During the applications farmer’s clothes, hands and body become damp with pesticides, especially on windy days. It was observed that especially young farmers apply pesticides wearing shirts without sleeves. Additionally, many farmers use defective backpack sprayers, which cause continuous losses of the pesticide fluid from the tank.

Field workers eat in the same plot where they were applying pesticides. The majority of them said that they do not wash their hands, because water is not always available and some said that they get so hungry that they just want to eat as fast as possible. It is not rare that some farmers smoke when applying pesticides.

Some farmers wash the pesticide backpack sprayer close to the field, in nearby water streams, but many wash the backpack sprayer at home. It is common that after pesticide applications farmers wash hands and head than to take a shower.

Observations on pesticide storing practices

It is common that pesticides are kept in storerooms, together with other agricultural items. The idea behind these rooms is not just to store pesticides separate from other spaces, but since pesticides are expensive, they are stored secure against burglaries. The necessity to ‘keep an eye on’ pesticides, explains why many people have pesticides close to their social spaces, such as kitchens. Sometimes the pesticides were kept inside the house, while the backpack sprayer was outside the house. According to some opinions this is because the backpack sprayer stinks more than the packaged pesticides and because if someone steals the backpack sprayer it could be possible its further identification.

After applications, pesticide bags and containers are usually abandoned in one corner of the field, or they are thrown in water streams, or left along paths. Few said that they get rid of packages by burning them. Pesticide containers also were recycled at home by transforming them into flowerpots to decorate patios and porches.

Pesticides-related-practices inside the household

Pesticide exposure occurs in many places and can be related to several activities inside the household. For example, some domestic activities bring women (adult and girls) and other household members in contact with pesticides. Many women said that they wash separately the clothes used for pesticide applications. However, when they wash large amounts, they mix the clothes in the same bucket. This is seen as a way to save time and money and they expect that the pesticides “go away with the running water”. One informant said that when she washes the clothes used in pesticide applications her hands itch and become extremely dry and inside her nails remains a pesticide smell. Therefore, she did not mix the clothes, because she hates the smell that remains in her hands, in water or even in the washing place.

The pact with pesticides: Perceptions on pesticide use and health

People accept that their living condition has many contradictions. On the one hand they are immersed in a dynamic market-oriented economy, which forces them to increase or maintain production using as much pesticides they can afford. On the other hand, they know clearly that pesticides are dangerous. There are recurrent histories of human and animal deaths related to pesticide poisoning. Some histories show that disputes among dwellers could end with the poisoning of the cattle or dogs. The perceived risk generates contradictory discourses and ideas on risk among local dwellers. I consider that the discourses on pesticide risk have four main dimensions that evolve in an interrelated and interconnected way. These dimensions are (1) hopes of economical progress, (2) health-believes, (3) gender identity and, (4) social identity.

Expectancies of economical progress obtained by potato production are translated in “lottery-hope discourses”. Farmers know that they can lose their capital and labour. However, they said that there had been many others who had become rich with potato. Then, a hope of a wealthy future pushes farmers (men and women) to keep looking to succeed with potato production. By means of this economic progress, farmers want to increase their social status as well. This influences that farmers are much more conscious of the final earning obtained from potato sales, than of the whole investment. Pesticide applications are seen necessary to remain economically competitive (because there is no widely accepted substitute to agricultural chemicals) regardless of the perceived risk.

Two health-related aphorisms are useful to understand ideas on sickness related to pesticide use: “Fat people are healthier and stronger than thin people” and “Diseases are transmitted mainly by air”. The first aphorism implies that health problems caused by pesticide exposure could be avoided by “eating big quantities of good food”. The following narrative illustrates this: “He is fat, healthy, with pink cheeks and for that reason he never has had problems applying pesticides, while his brother who has to work in the city because he could not stand pesticides was thin, pale and weak.” Only few informants assume that allergies and other problems could be related to pesticides and affirm have experienced this problem (especially after washing clothes that were used in applications). The second believe suggest that toxic effect of pesticides can be minimised when avoiding the smelling or the direct inhalation of pesticides. Pesticides get people sick because pesticides enter the body by air via nose and mouth. This has a relation with the idea that when the strongest the smell, the dangerous the pesticide is. Also some informants said that when one has flu, one is more susceptible to suffer the effects of pesticides.

Pesticides related sicknesses are associated with weakness. There is the concept that a real man has to be strong and pesticides can not affect a strong man. These cultural ideas of masculinity correspond with some theoretical insights of “claming the victims”. Thus, many men who had health-related pesticide problems had been forced to migrate. In this social context, it is difficult to relate with others when labelled as a ‘weak man’.

In order to be a potato grower, it is required to take certain risks, for example be able to live with pesticides: “Potato is our source of live and it is also our source of death.” Since people always have lived from potato, they see them selves as potato growers. Social identity plays a fundamental role in these comments, because this is seen as a way of living as well. Many farmers state that because they always have applied pesticides “they are used to them”.

Farmers have a pact with pesticides, which implies that in order to succeed socially and economically in this context, one must deal with pesticides although one’s own and the family’s health is threatened. This pact might be dissolved when the farmer succeeds to capitalise. Then, he or she can contract field workers for applications, instead of applying themselves. These field workers are the population group that inescapably is more exposed to the pesticide hazard.

There are other differences on discourses concerning pesticide risks. Landowners who contract workers or managers of agricultural shops tend to explain (1) pesticide poisoning as “careless on pesticide use”, and (2) voluntary pesticide intake as “mental insanity”. On the contrary, workers tend to explain (1) pesticide poisoning as “an occupational risk” and, (2) voluntary pesticide intake as a “desperate decision”.

Health, Pesticides and Interpretations

Between accident and gloom: Data and narratives related to pesticide intoxication

People from San Pedro usually go to the nearest hospital in the zone (the State Hospital of San Gabriel) for emergencies or short consultations. However, some go to hospitals of other cities. This means that much information on health in the zone might be dispersed. In the State Hospital of San Gabriel there is a good register of hospitalisations, but there is not a clear registration of consultations due to the difficulty to implement a systematic registration. For this reason I only count on hospitalisation data.

Intoxication represents 11% of hospitalisations and there were four sources of acute intoxication: Pesticides, alcohol, medicines and food. Figure 1 indicates that pesticide intoxication was the principal cause of intoxication for both sexes (from 1997 to 1999). Moreover, here it is presented food intoxication cases with no-enteric symptoms. Therefore, they could be misclassified cases of pesticide poisoning.

It was not easy to find clear differences between chronic exposure, accidental poisoning and suicide attempt. Moreover, for the family of the patient it is difficult to talk about a ‘possible suicide’ of a relative. However, the diagnosis is established by recognisable physical symptoms and pesticide odour in the patient. Therefore, it is possible to find some common patterns in the official medical reports. First, the patient presented a bad physical condition after working with pesticides or being near to pesticides. Intoxication in these cases is because the patient has inhaled pesticide or accidentally ate contaminated food. Secondly, the patient intentionally has intake the pesticide. In this case it was common to find a personal history about the possible cause of emotional depression of the patient.

Figure 2 describes hospitalisation frequencies due to pesticide intoxication broken down by sex and age. The data presented in this figure illustrate that young children and teenagers of both sexes are primarily subject of hospitalisation for acute pesticide intoxication. There are two age classes with more cases: from 0 to 5 years (24%) and from 16 to 20 years (22%).

Figure 3 describes the number of hospitalisations due to pesticide intoxications (by age class) compared to total number of hospitalisations due to sickness in the study zone in 1999. This figure also shows that the age group between 11 to 20 years is the 32% of the total number of hospitalisations due to sickness, which is the highest percentage among all age classes.

Pesticide intoxication of children was related mainly to accidents at household level. Pesticide intoxication of teen-agers mainly was related to suicide attempts and few were related to accidental poisoning. For teenagers (male and female) suicide attempts have three main common causes: (1) family problems and domestic violence, (2) love bitterness, (3) social conflicts with friends. Suicide attempts of adult men were mainly related to economical problems and depression, while suicide attempts of women were mainly attributed to family problems, domestic violence or depression.

First aid of pesticide poisonings in the household

Informants said that it is common to give milk with salt, water with soap or dirty water to the intoxicated person to provoke vomiting. I observed that dogs intoxicated with pesticides were attended by giving them the liquids described before, but afterwards the owner injects the dog with antibiotics. This also reflects the trust that farmers have in western-medicine and have the idea that antibiotic cure different sort of diseases, even pesticide intoxication.

Official data on deaths caused by pesticide use

The total registered data on deaths in the canton (from 1977 to 1999) illustrates that traffic accidents are the principal cause of death in the zone (most of these accidents were related to alcohol consumption). Pesticide intoxication is the second cause of death in the zone. According to the Political Intendance’s officers the deaths related to pesticides are due to voluntary intake of pesticide in the first place, then due to accidental intake or contact and then due to occupational contact with pesticides.

Conclusions

This study has shown that potato production must be seen in connection with social arrangements, household dynamics and macroeconomic forces. This study has highlighted the multidimensional importance of women’s work in potato production, farm management and household maintenance activities. Approaches based only on male work could give an incomplete panorama of the system and re-enforce under-valorisation and invisibility of women’s work. The integrated analysis of potato production systems demonstrated that farmers combine various strategies at household and farm level. These strategies allow farmers to maintain their subsistence in spite of the high economic and health risks involved.

Agricultural decisions are dynamic and are also influenced by externally driven interactions, such as market dynamics, economic politics and the current recession in the country. The community is differentiated and crosscut by social, economical, and power differences that are shaping practices around potato production. The rapid social change and comoditisation of agriculture is contributing to a progressive social stratification, which results in the development of an impoverish group. This peasant group, which depends strongly on its labour force, is most exposed to chronic exposure to pesticides by occupational activities. At the same time, this labour force is facilitating the capitalisation of other farmers with more resources.

Risk and uncertainty are part of the every day live of local farmers, and pesticides are incorporated as one of the elements of this risky way of living. Pesticides are intricately linked with rural live and domestic activities. They do not only generate occupational risks to persons who apply them in the field; they are important sources of accidents at household level and are frequently used for suicide attempts as well. Besides, young children and teenagers of both sexes were identified as primarily subject of hospitalisation for acute pesticide intoxication.

In order to develop strategies for reducing health risks caused by pesticides, farm activities and pesticide use should be seen in the context of complex household dynamics. Next to the men that apply pesticides in the field, women and children also get in contact with pesticides and could suffer from acute voluntary and involuntary intoxication. Therefore, programmes directed to reduce health risks of pesticides strategies must consider the sociological dimensions, which as a spider net, integrate pesticides in the social dynamics of the community are the hope of economical progress by means of potato production, health-believes, gender identity and, social identity.

References

Berkes, F., C. Folke, J. Colding (1997), Linking social and ecological systems. Management practices and social mechanisms for building resilience. Cambridge, Cambridge University Press.

Berkman, L.F., T. Glass, L. Brissette, T.E. Seeman (2000). From social integration to health: Durkheim in the new millennium. Social Science & Medicine, 51, pp. 843-857

Boserup, E. (1970). Women’s role in economic development. NY, St. Martin’s Press.

Brush, S.B. (1999). Genes in the field: on-farm conservation of crop diversity, Boca Raton, Lewis Publishers, 288 p. ISBN: 1566704057.

Cole, D., Mera-Orcés, V. (in press). Intoxicaciones con Pesticidas y su Peso Económico en la Sierra del Ecuador. Chapter. 5., Part 3: Investigaciones en Salud. In: C.C. Crissman and P. Espinosa Eds.), Impactos del uso de plaguicidas en la producción, salud y medioambiente en Carchi: Un compendio de investigaciones y respuestas multidisciplinarias, Ecuador, Abya-Yala Press and International Potato Centre (CIP).

Cole D.C., F. Carpio, N. Leon (2000). Estimating the burden of illness from pesticide poisonings in Ecuador. Pan American Journal of Public Health (Revista Pan-Americana de Salud Publica) 8, pp. 196-201.

Cole D.C., F. Carpio, J. Julian, N. Leon (1998). Assessment of peripheral nerve function in an Ecuadorian rural population exposed to pesticides. Journal of Toxicology and Environmental Health Part A, 55,2, pp. 77-91.

Crissman, C.C., J.M. Antle, S.M. Capalbo Eds. (1998) Economic, Environmental, and Health Tradeoffs in Agriculture: Pesticides and the Sustainability of Andean Potato Production, Dordrech, Boston, London, Kluder Academic Publishers and International Potato Centre (CIP).

Crissman, C.C., P. Espinosa, C.E.H. Ducrot, D.C. Cole, F. Carpio (1998a). The case study site: Physical, health and potato farming systems in Carchi Province. In: C.C. Crissman, J.M. Antle, S.M. Capalbo Eds), Economic, Environmental, and Health Tradeoffs in Agriculture: Pesticides and the Sustainability of Andean Potato Production, Dordrech, Boston, London, Kluder Academic Publishers and International Potato Centre (CIP), pp.87-119.

Crissman, C.C., D.C. Cole, F. Carpio (1994). Pesticide use and farm worker health in Ecuadorian potato production, American Journal of Agricultural Economics, 76, pp. 593-597

Kabeer, N., R. Subrahmanian (1996). Institutions, relations and outcomes: frameworks and tools for gender aware planning, Institute of Development Studies (IDS), Discussion Paper 357, Brighton, IDS.

Leach, M., R. Mearns, I. Scoones (1999). Environmental entitlements: Dynamics and Institutions in Community-Based Natural Resource Management. World Development 27, 2, pp. 225-247.

Long, N. (1997). Agency and constraint, perceptions and practices. A theoretical position. In: H. de Hank, N. Long Eds.), Images and Realities of Rural Life. Wageningen Perspectives on Rural Transformations. the Netherlands, Van Gorcum & Comp. B.V. pp. 1-20.

Mera-Orcés, V. (2000). Agroecosystem management, Social practices and Health: A Case Study on Pesticide Use and Gender in the Ecuadorian Highlands. IDRC-Ecosystem Approaches to Human Health Training Awards with a Particular Focus on Gender. Technical Report. Ottawa, IDRC, pp. 39

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Annex

Table 1. Potato-production activities (by sex).

|ACTIVITY |WOMEN |MEN |

|Ploughing |* |X |

|Harrowing |* |X |

|Tubers cure (with pesticides) | |X |

|Fertiliser application |X |X |

|Planting |X |* |

|Field irrigation |* |X |

|Pesticide spray applications | |X |

|Hand-weeding |X |X |

|Hilling-up |* |X |

|Food preparation and distribution to field workers |X | |

|Harvesting |X |X |

|Harvested tubers sorting |X |* |

|Potato selling |* |X |

X Main responsibility

* Of secondary responsibility or less-frequent enrolment in this activity

Source: (Mera-Orcés, 2000).

Figure 1. Causes of intoxication (by sex) registered from 1997 to 1999 in San Gabriel Hospital

Source: (Mera-Orcés, 2000)

Figure 2. Frequency of hospitalisations (by age and sex) from 1997 to 1999 due to pesticide intoxication in San Gabriel Hospital

Source: (Mera-Orcés, 2000)

Figure 3. Number of hospitalisations due to pesticide intoxications (by age class) compared to total number of hospitalisations due to sickness in the study zone in 1999

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Source: (Mera-Orcés, 2000)

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