McMichael Celia, Powell Teresia
School of Geography, Earth and Atmospheric Sciences, University of Melbourne, Parkville, VIC 3010, Australia.
Pacific Centre for Environment and Sustainable Development (PACE-SD), Marine Campus, University of the South Pacific, Suva, Fiji.
Int J Environ Res Public Health. 2021 Apr 20;18(8):4355. doi: 10.3390/ijerph18084355.
In Fiji, low-lying coastal villages are beginning to retreat and relocate in response to coastal erosion, flooding and saltwater intrusion. Planned relocation is considered a last resort as a form of adaptation to the impacts of climatic and environmental change. The health impacts of planned relocation are poorly understood. This paper draws on data from multi-year research with residents of the iTaukei (Indigenous) Fijian village of Vunidogoloa. We used qualitative research methods to examine experiences of planned relocation, including residents' accounts of their health and quality of life. In-depth interviews and group discussions were conducted with villagers living in a site of relocation, at four points in time (2015, 2016, 2019, and 2020). Twenty-seven people in Vunidogoloa, Fiji, participated in in-depth interviews, several on more than one occasion. Six group discussions with between eight to twelve participants were also conducted. Qualitative analytic software (NVivo) was used to analyse interview transcripts and identify themes. Villagers report both health benefits and challenges following planned relocation. Key facilitators for good health include movement away from some environmental risks to health, adequate drinking water and sanitation, food security including through farms and kitchen gardens, livelihood opportunities, improved access to schools and health services, and appropriate housing design. However, residents also refer to unanticipated risks to health including increased consumption of packaged goods and alcohol, disruptions to social structures and traditional values, and disrupted place attachment following movement away from a coastal site of belonging with consequences for mental wellbeing. Therefore, planned relocation has altered the social determinants of health in complex ways, bringing both health opportunities and risks. These results highlight the need for context-specific planning and adaptation programs that include meaningful involvement of community members in ongoing decision making, and call for an understanding of diverse social determinants of health that emerge and evolve in contexts of planned relocation.
在斐济，地势低洼的沿海村庄因海岸侵蚀、洪水和海水入侵开始撤离并重新安置。有计划的搬迁被视为适应气候和环境变化影响的最后手段。人们对有计划搬迁对健康的影响了解甚少。本文借鉴了对斐济伊陶凯（原住民）村庄武尼多戈洛阿居民进行的多年研究数据。我们采用定性研究方法来考察有计划搬迁的经历，包括居民对其健康和生活质量的描述。在四个时间点（2015年、2016年、2019年和2020年），对居住在搬迁地点的村民进行了深入访谈和小组讨论。斐济武尼多戈洛阿的27人参与了深入访谈，其中一些人不止参与了一次。还进行了六次小组讨论，每次有八至十二名参与者。使用定性分析软件（NVivo）分析访谈记录并确定主题。村民们报告了有计划搬迁后带来的健康益处和挑战。促进健康的关键因素包括远离一些对健康有影响的环境风险、充足的饮用水和卫生设施、包括农场和菜园在内的粮食安全、生计机会、改善的上学和医疗服务可及性以及合适的住房设计。然而，居民们也提到了对健康的意外风险，包括包装食品和酒精消费增加、社会结构和传统价值观受到干扰，以及搬离沿海归属感所在地后地方依恋感被破坏，这对心理健康产生了影响。因此，有计划的搬迁以复杂的方式改变了健康的社会决定因素，既带来了健康机遇，也带来了风险。这些结果凸显了制定因地制宜的规划和适应方案的必要性，这些方案应包括让社区成员有意义地参与持续决策，并要求理解在有计划搬迁背景下出现和演变的各种健康社会决定因素。
