Erlanger Tobias E, Sayasone Somphou, Krieger Gary R, Kaul Surinder, Sananikhom Pany, Tanner Marcel, Odermatt Peter, Utzinger Jurg
Swiss Tropical Institute, Basel, Switzerland.
Int J Environ Health Res. 2008 Jun;18(3):223-42. doi: 10.1080/09603120701757815.
Hydroelectric projects offer opportunities for infrastructure development and economic growth; yet, if not well designed, implemented and operated, they have the potential to negatively affect the health and well-being of local and distant downstream communities. Remote rural populations are particularly vulnerable to the sudden influx of men, materials and money, and associated population mixing that accompany project construction phases. Two large-scale baseline health surveys, carried out in 2001/2002 in two communities that were affected by the Nam Theun 2 hydroelectric project in central Lao PDR, were analysed. For the population to be resettled on the Nakai plateau it was observed that access to clean water and basic sanitation facilities was lacking. Faecal examinations revealed a high infection prevalence for Ascaris lumbricoides (67.7%), but relatively low prevalences for hookworm (9.7%), Taenia spp. (4.8%), Enterobius vermicularis (4.4%), Trichuris trichiura (3.9%), Strongyloides stercoralis (1.4%) and Opisthorchis viverrini (0.9%). For the population in the Xe Bang Fai downstream area, rapid diagnostic tests for malaria carried out in the rainy season found a prevalence below 1%, which might be explained by the complete coverage of households with insecticide-treated nets (99.8%). Anthropometric measurements in both populations suggest that wasting, stunting and underweight in under 5-year-old children were moderate to high; 15.9-17.5%, 40.4-55.7% and 35.8-55.7%, respectively. One out of six individuals aged above 14 years were malnourished, most likely as a result of early childhood wasting. Moderate anaemia, assessed by age- and sex-specific haemoglobin levels, was present in 43.8% (Nakai) and 54.9% of the individuals examined (Xe Bang Fai). Several indicators were extracted that can be utilised for monitoring changes in health, well-being and equity, as the project is implemented and operated.
水电项目为基础设施发展和经济增长提供了机遇；然而，如果设计、实施和运营不当，它们有可能对当地和下游偏远社区的健康与福祉产生负面影响。偏远农村人口特别容易受到项目建设阶段男性、物资和资金突然涌入以及相关人口混居的影响。对2001/2002年在老挝人民民主共和国中部受南屯2号水电项目影响的两个社区进行的两项大规模基线健康调查进行了分析。对于将在凯山高原重新安置的人口，发现缺乏清洁水和基本卫生设施。粪便检查显示，蛔虫感染率很高（67.7%），但钩虫（9.7%）、绦虫属（4.8%）、蛲虫（4.4%）、鞭虫（3.9%）、粪类圆线虫（1.4%）和华支睾吸虫（0.9%）的感染率相对较低。对于色邦费下游地区的人口，雨季进行的疟疾快速诊断检测发现感染率低于1%，这可能是由于使用杀虫剂处理过的蚊帐的家庭覆盖率达到了100%（99.8%）。对这两个人口群体的人体测量表明，5岁以下儿童的消瘦、发育迟缓及体重不足情况处于中度至高度水平，分别为15.9 - 17.5%、40.4 - 55.7%和35.8 - 55.7%。14岁以上的人中，每六人中有一人营养不良，很可能是幼儿期消瘦所致。根据年龄和性别特异性血红蛋白水平评估，中度贫血在接受检查的个体中占43.8%（凯山）和54.9%（色邦费）。提取了若干指标，可用于在项目实施和运营过程中监测健康、福祉和公平性的变化。
