DGH in El Salvador: The Health Risks of Pesticide Use By Masaya Kato, Ph.D., MPH

I arrived at Santa Marta, a remote community in El Salvador, on September 4, 2001. My first task was to find the members of my host family. Dolores and Geraldo live with four sons and one daughter, and Dolores' mother, who is 90 years old. Despite my poor Spanish, we tried to communicate, drawing pictures and playing cards. Lots of flowers bloomed in their garden. "I like this family," I felt. So much so that I slept very well, despite being in a strange bed. For four and a half months, I really enjoyed being with this family.

“My mission as a DGH volunteer was to prepare a project to reduce the negative health impact of pesticides used in agriculture. Every year mothers bring their teenage children into the rehabilitation clinic with pesticide poisoning.”

One day, Geraldo and Dolores cooked an armadillo for me. Feeling some hesitation, I ate only a little. Then, Dolores cooked another dish for me. She ate that dish with me, saying, "When I was young, I did not like to eat armadillo. Now, I do not eat armadillo either. But during the war, I had to eat it, because we were so hungry."

During the war, people in Santa Marta had to flee to Honduras. On March 18, 1981, people were crossing the River Lempa to Honduras. It was not an easy cross, especially for parents taking their children. To make matters worse, government military helicopters appeared. About 50 people were shot from the sky. The unforgettable scenes of the massacre are today commemorated in murals throughout the community.

Masaya (center) with local students he trained to do pesticide survey.

My mission as a DGH volunteer in Santa Marta was to prepare a project to reduce the negative health impact of pesticides used in agriculture. It has long been a concern of Brenda Hubbard, a physical therapist originally from the US, who came to live with the people of Santa Marta more than 10 years ago. As soon as she came to the community, she was surprised at how pesticides were used. "No protection and no precaution," she explains with dismay. Children and pregnant women engage in the spraying. Every year mothers bring their teenage children to her rehabilitation clinic suffering from pesticide poisoning.

I worked with Brenda and Denise Zwahlen (a DGH volunteer). Our first step was an assessment, for which we recruited local junior high school students. I started a dialogue with them. "Are agrochemicals used appropriately in our community? If not, what problems do you see?" The students listed their observations, such as: "People wash their spraying tanks in the creek and just down the creek women use the same water for bathing and washing." "People use pesticide containers to store drinking water." "Farmers do not use protective equipment when they spray.

"We worked with the students to transform these observations into a questionnaire, which was then revised and tested amongst themselves. We taught them about sampling, ethics and safety, and we provided interview training. The community radio station announced our study every day for a week before the interviews began. Still, it was a challenge for these young people. One noted afterward, "I felt anxious that people might reject us when we visited them to ask the questions in our interview. But, I learned that there is no need to be afraid in our own community."

“One of the students is very enthusiastic about reading. He particularly likes philosophy. He has only one book on philosophy and reads it repeatedly.”

After the students conducted the necessary interviews, they learned to use computers and entered all the data. They were very excited. For most of them it was the first time they had even touched a computer.

As I worked with them, I was very impressed by the tremendous aspirations and capacities of these young people. For example, Leonel Hernández, 16 years old, does farm work every morning, removing weeds, harvesting beans and carrying corn, all without any machinery. In the afternoon, he goes to school. He also works for a project of ADES, a local NGO, building environmentally friendly cooking stoves with bricks and cement. He is also enthusiastic about reading. He particularly likes philosophy. He has only one book on philosophy and reads it repeatedly. The books are generally neither available nor affordable for kids in Santa Marta. He also studies math in an advanced grade. At times, he would come to ask me questions about things like standard deviation. His dream is to study physics at a university, but he thinks it will be very difficult. He is not even sure if he will be able to go to high school.

Another of the students, Marleny López, 17 years old, spends lots of time working for her family, preparing meals, hand-washing clothes, looking after her young cousin, and bringing food to family members working in the field. In the afternoon, she goes to school. She likes singing and is a member of the church choir. Yet, she was incredibly dedicated to our project. She is very articulate and her work as an interviewer produced excellent examples for our recording questionnaire, as she added her own observations. She also demonstrated her math aptitude in analyzing the survey data. I was very happy to attend her graduation, as she finished the ninth grade while I was there. She told me it is difficult to find resources to pursue education, but her dream is to study business administration so that she can contribute to the development of her community. The other six youths on the team were similarly ambitious, capable and impressive.

At last, after four months of hard work, the results were presented to the community by the students themselves. We had an audience of about 50, including the community council, teachers and farmers. One of the team members described the experience, "I came to feel a little freer when I was presenting the work we did in our group, and also to feel that one person can become more useful in our community."

A high proportion of young boys are engaged in agriculture, spraying hazardous pesticides.

Our survey confirmed the students' initial observations. For example, 29% of farmers discard the contaminated water used to wash the spraying tank in the creek. One out of four farmers (23%) use pesticide containers to store drinking water. Most farmers do not use personal protective equipment. The study also revealed that highly hazardous pesticides are widely used. For instance, methyl parathion, banned in many countries due to its high acute toxicity, is used by 60% of farmers. It also showed that a high proportion of the community's male children work in agriculture, putting them too at high risk of dangerous exposure to pesticides.

The public health impact of pesticide use in agriculture is tremendous in developing countries-99 percent of deaths due to acute pesticide poisoning occur in the developing world (Acute Pesticide Poisoning: A Major Global Health Problem, J. Jeyaratnam). We need to understand the root causes of this health problem. Hazardous pesticides are not effectively regulated in developing countries. Multinational corporations export pesticides to poor countries that are restricted or banned in the wealthy countries, and promote their heavy usage. Protective equipment is too expensive for farmers in poor countries, and what is available is not practical in tropical climates.

The day before my leaving, the students organized a farewell party for me with their own money. We ate pupusas and danced. A very happy time indeed. What also made me very happy was that my host family accompanied me to the airport. When we said goodbye, Dolores hugged me tight and said, "Come back anytime." I now have my new family in a village in El Salvador.

- With financial support from DGH, local farmers have started a pilot project to introduce an alternative way of agriculture to help reduce pesticide use. DGH has also provided some funds for a project started by ADES, to provide high school education in Santa Marta.