Initiating a Dynamic Co-Constructed One Health Project: reflections from Participatory Action Research in the Kahuzi-Biega National Park, Democratic Republic of Congo1
Eloïse Dagneau, Fanny Procureur, Krizia Vieri, Davide Olchini, Louisa Ben Abdelhafidh, Anne-Laurence Franzini
IJAR – International Journal of Action Research, Issue 3-2024, pp. 279-294
Abstract: In an era of interconnected global challenges, the One Health (OH) approach emerges as a beacon of collaborative resilience in the face of emerging pandemics. The implications are particularly profound in the Democratic Republic of Congo (DRC), a known hotspot for infectious diseases. Recognizing this, we employed Participatory Action Research (PAR) as a community-centered approach to implementing the OH framework to address environmental, animal, and human health issues in the Kahuzi-Biega National Park (KBNP) area. Through a structured process of knowledge integration, we enhance our comprehension of underlying issues while establishing a sustained partnership with the community. This approach ensures that solutions are not only contextually relevant but are the product of a collaborative co-construction, thereby reinforcing long-term resilience at the community level. This article explores the application of this approach, detailing the co-construction process and sharing challenges regarding power dynamics, and lessons learned from the project implementation in a humanitarian context.
Keywords: co-construction, community involvement, cross-sectoral collaboration, One Health, participatory action research, power dynamics
El Inicio de un Proyecto One Health Co-construido: Reflexiones desde la Investigación-Acción Participativa en el Parque Nacional Kahuzi-Biega, Repútlica Democrática del Congo
Resumen: En una era de desafíos globales interconectados, el enfoque One Health (OH) emerge como un modelo de resiliencia colaborativa frente a las pandemias emergentes. Las implicaciones son particularmente profundas en la República Democrática del Congo (RDC), un conocido punto crítico de enfermedades infecciosas. Reconociendo esto, empleamos la Investigación de Acción Participativa (IAP) como un enfoque centrado en la comunidad para implementar el marco de OH para abordar problemas ambientales, de salud animal y humana en el área del Parque Nacional Kahuzi-Biega. A través de un proceso estructurado de integración de conocimientos, mejoramos nuestra comprensión de los problemas subyacentes y al mismo tiempo establecemos una asociación sostenida con la comunidad. Este enfoque garantiza que las soluciones no sólo sean contextualmente relevantes, sino que sean el producto de una co-construcción colaborativa, reforzando así la resiliencia a largo plazo a nivel comunitario. Este artículo explora la aplicación de este enfoque, detallando el proceso de co-construcción y compartiendo desafíos relacionados con la dinámica de poder y las lecciones aprendidas de la implementación del proyecto en un contexto humanitario.
Palabras clave: co-construcción, compromiso comunitario, colaboración intersectorial, One Health, investigación acción participativa, dinámicas de poder
1. Introduction
The COVID-19 pandemic has compelled a reassessment of our healthcare strategies to more effectively manage future crises. Outbreaks are expected to escalate as human populations expand into new geographic regions, with increased interactions between wildlife, domestic animals, and their ecosystems (Costello et al., 2011; Lainé&Morand, 2020; Mpandeli et al., 2018). This heightened contact creates more opportunities for pathogen spillover events, resulting in the emergence of zoonoses (Fontanet, 2007; Deivanayagam et al., 2023; Fasina et al., 2021). Faced with the complexity of the challenges we encounter in terms of health and the environment, it is necessary to act through an integrated approach, such as a One Health (OH) approach: “OH is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic and wild animals, plants, and the wider environment are closely linked and interdependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development”. (Adisasmito et al., 2022)
This interconnectedness is most keenly felt by the world’s most vulnerable communities who disproportionately bear the consequences of climate change, despite contributing the least to greenhouse gas emissions. These populations are hit hardest by environmental degradation, extreme weather events, and resource depletion, which in turn deepen poverty and exacerbate social inequalities (Hickel & Slamersak, 2022; Oxfam Report, 2022; Kelly-Hope et al., 2023; Tollefson, 2020). Their precarious conditions and limited resources make them particularly susceptible to the health impacts of environmental shifts, including the spread of zoonotic diseases, decline in crop yields, decreased livelihood sources, … which disproportionately affect regions with limited access to healthcare (Paltriguera et al., 2024) A striking example of this dynamic can be seen in the Kahuzi-Biega National Park (KBNP) in eastern DRC, where deforestation and land use changes have significantly disrupted both human and ecosystem. Since the 1970s, autochthonous populations were displaced from their ancestral lands leading to tensions over land access (Bombwe et al., 2021). This region of South Kivu experiences an annual deforestation rate of 1200 000 Ha/year on average, causing ongoing erosions and landslides that are particularly harmful to natural resources and endogenous species. These events severely affect the socio-economic welfare of the local society (ADMR Bukavu, 2024; C. & T.T., 2023; Kelly et al, 2022). The local populations, already facing high levels of poverty and with 74%dependent on agriculture for employment, are losing their main source of income (Kasaïs & Kivu, 2023). In response to these economic disruptions and income instability, the population engages in behaviors such as poaching and illegal fishing, thereby increasing their exposure to wildlife and associated risks (Kelly et al., 2022).
Increased human-wildlife interactions combined with additional socio-political, economic and demographic factors – such as exposure to war and conflict, difficult access to healthcare, high population density, high levels of displacement and low sanitation levels – the combination of vulnerabilities and risk make this region a hotspot for infectious diseases. To fully grasp these issues, it is essential to adopt a transdisciplinary, integrated and multisectoral framework, as outlined by the OH paradigm. Achieving this necessitates meaningful engagement with communities as it leverages local knowledge, builds trust, and ensures that interventions are culturally relevant and sustainable (Dar et al., n.d.; OHHELP, 2022). To facilitate this connection, Doctors of the World (DotW), Veterinary Without Borders (VWB) and Action for the Development of Rural Areas (ADMR), in close collaboration with local communities, have initiated a pilot participatory action research (PAR) project under the OH approach. This approach encourages collaboration across various sectors and acknowledges that each stakeholder contributes unique insights and knowledge. In this context, PAR emerges as the most effective methodology, integrating diverse perspectives and fostering a holistic understanding of health and environmental challenges.
Encouraging cross-sectoral collaboration and the involvement of the communities directly concerned recognising that each of the stakeholders is both a holder and a producer of knowledge.
The multiplicity of this knowledge (scientific, endogenous, experiential, etc.) cannot be ranked in a hierarchy, but must instead be integrated in a complementary and equitable manner. Embarking on this paradigm shift, which requires a rebalancing of power dynamics and a process of mutual learning, is a long and complex journey. It requires an in-depth rethink of the relationships between stakeholders and the creation of conditions conducive to fair dialogue and the co-construction of knowledge.
In the humanitarian context, which is characterised by emergencies and instability, the paradigm shift proposed by the transdisciplinary research presents considerable challenges. The time lag between the logic of research – often characterised by long, iterative processes – and the demands of humanitarian action, where speed and efficiency are paramount, makes it difficult to integrate these two dynamics. In this region, humanitarian teams and aid beneficiaries are used to interventionist, and this requires a profound change in attitude and behaviour in order to adopt a collaborative research and co-construction approach (Richardson, 2019; Congo Research Group, 2020). This transition requires a critical reflection on the asymmetries of power at work, as well as the implementation of modalities aimed at rebalancing them, whether between the different stakeholders or within the communities themselves. It requires the deployment and experimentation of methods and tools that enable different types of knowledge to be expressed and taken into account.
Based on our OH project implemented into a humanitarian fragile context, this journal paper aims to critically examine the challenges encountered during the first loop of PAR, in order to foster inclusive community involvement and enable a genuine dynamic of co-construction of knowledge and solutions. The complexities inherent in the diverse characteristics of participants, the role of facilitators, the challenging methodology, and the broader contextual factors all contribute to the intricacies of this research endeavour. By thoroughly exploring these elements, this paper seeks to open up avenues for reflection to other professionals, enhancing their understanding of the multifaceted nature of using PAR to tackle complex health and environmental challenges in similar environments.
2. Methodology
2.1 Participatory Action Research (PAR)
PAR seeks to integrate knowledge from diverse sources to foster the exchange of multiple perspectives and build a shared understanding. This approach enriches academic discourse by incorporating the knowledge and lived experiences of local communities, while upholding the standards of scientific rigor (Fals-Borda, & Rahman, 1991, p.148; Sousa Santos, 2008). By valuing both academic knowledge and community-based insights, PAR strives to create a collaborative process through which co-construction is made possible. This method is based on the acknowledgement that “reality” is based on the subjectivity of the perspective and that by gathering the different ways reality is perceived it would create a more accurate representation of reality (Brun, 2018). It involves “unheard voices”, as well as validates and supports the expression of excluded groups. Empowerment is developed through a shift in mindset recognition that all knowledge types are legitimate (Gélineau et al, 2012).
This method addresses the domination relationship in knowledge creation, as it recognizes the hierarchy behind relationships between local communities and researchers (Lainé, 2023; Brun, 2017). In this project, PAR aims to include local stakeholders to engage them in solution building to enhance the identification and prevention of OH issues near the KBNP area, thereby leading to community-driven activities that are more sustainable. As Lainé clearly states “health is still under the hegemony of Western knowledge systems” highlighting the value of integrating local communities knowledge in OH projects (Lainé, 2023; Hayman et al., 2023; Brun, 2017). The holistic characteristic of the methodology also favours the rebalancing of power supporting the move towards reaching an equilibriumat the intersection of multiple knowledge sources – all knowledge is valid. Indeed, traditional knowledge is of considerable academic significance, as it embodies the cumulative insights, perceptions, and beliefs that have been honed over generations through sustained interactions with particular environments within specific cultural frameworks. Integrating such diverse knowledge systems into solution development can significantly enhance the process by offering a multiplicity of perspectives and conceptual paradigms (Vargas, 2019).
Ultimately, this methodology is rooted in the need to produce socially just research, with the aim of reducing inequalities through equitable knowledge production (Gélineau et al, 2012; Lainé & Morand, 2020).
To meet the OH’s project goals, it requires building local capacities in preventing and mitigating health impacts related to zoonotic surveillance and developing locally developed innovative behavioural changes. This behaviour change would build towards creating reflexes in awareness of disease transmission risks. Importantly, the aim for behaviour change does not involve altering the population’s values (Gélineau et al, 2012; Jaques-Hennot, 2012; Saylors et al., 2021).
1 Project financed by the “Direction générale de la coopération au développement et de l’aide humanitaire (DGD)“
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