After five and a half years of labour, countless sleepless nights, a few panic attacks and Olympic swimming pools of coffee, I am very proud to announce the arrival of Thesis, she was born on Monday 31st of March 2014 at 14.05h at the print shop in Reading, UK.
Thesis was conceived in Rome, Italy and further developed in England, Egypt, The Netherlands, France and Afghanistan.
She weighs about 750 grams and is 392 pages long.
Mother and baby are doing fine although mother feels in need of lots of sleep, a good massage, a few drinks and the company of good friends…
In this thesis, the author set out to investigate the impact of Highly Pathogenic Avian Influenza (HPAI) on the livelihoods and food security of a subset of poor women in the household poultry sector in Egypt. Egypt has experienced one of the worst outbreaks of HPAI outside Asia and is now one of six countries where the virus is endemic among the poultry population. The discovery of the Swine Flu virus (H1N1) in Egypt in 2009 and its present co-existence with H5N1 in addition to the emergence of a new HPAI strain has alarmed the international community. In light of the above the findings presented in this thesis become particularly relevant.
On a global level, there is a realization that efficient H5N1 control cannot be based on epidemiological data alone. Such control depends on a thorough understanding and appreciation of the interconnectedness of epidemiological, social, and economic factors that contribute to H5N1 vulnerability. Therefore, this thesis explored the inter-relationship between the three major influences on HPAI edemnicity in Egypt: poverty and livelihoods, risk perceptions and food security. A mixed method approach underpinned the analysis.
To date, the control of HPAI in Egypt has been challenging. Part of the problem has been a lack of understanding of underlying conditions and motives that influence preventive behaviours at the household level. Indeed, the analysis of risk demonstrated that perceptions of human infection were low and despite recognising the benefits of many bio-security behaviours, the overall adoption of such behaviour was poor. By disaggregating local indicators of wealth and poverty the study was able to ‘reach beyond’ traditional classifications of poultry keepers and explore differences between groups. The ‘package’ approach described in this thesis enabled a more intricate understanding of how marriage/widowhood, education levels and access to resources influenced a wide range of issues such as vulnerability to HPAI, risk perceptions, preventive behaviours, food security and coping strategies. In doing so, the thesis was able to demonstrate the need for more targeted approach to knowledge transfer and awareness at the community level.
The poorest segment of the study set suffered the greatest losses due to HPAI; they had the highest number of outbreaks and were least able to recover in terms of flock size and income. The impact of HPAI was felt on a variety of other levels including social and psychological. The latter, relating to stress, anxiety and loss of autonomy was ranked highest in terms of severity. Explanations for high fear levels relating to flock infections were airborne transmission and loss of food security. Fatalistic views regarding HPAI outbreaks were commonly associated with the very poor. However, over fifty percent of respondents offered the chances of themselves or a family member being infected with HPAI was extremely low. Some women believed only children could be infected.
Not surprisingly, food insecurity scores were highest among the very poor. Likewise the severity of coping strategies increased with poverty level. Erosive coping strategies included sale of assets, taking loans, skipping meals, and decreasing social interaction. The analysis found that marriage was a protective factor against the most severe coping strategies.
The composite risk index developed for this thesis pulled together the main themes and findings resulting in a comprehensive decision support tool based on a variety of epidemiological, livelihood, food security and risk perception factors that were found to contribute to HPAI vulnerability. As such, the composite risk index enables targeting those communities that are likely to be highly vulnerable to outbreaks of H5N1 and where HPAI control and awareness raising efforts are likely to be most effective.