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Arab camel breeders on the move in Karnak, Chad. Photographer Esther Schelling       
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current issue

Volume 75 2010
Number 2 (Special Edition)
Space, Movement & Health: Biosocial Perspectives
Guest Editors: Kate Hampshire and Simon Coleman

ISSN : 2046-0058  

General Editor : Alejandra Núñez-de la Mora  
Contact : SBHA_Editor@biosocsoc.org   
 
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  C o n t e n t s

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Editorial
Alejandra Núñez-de la Mora

art photo
Dunes and Lake Zavkhan, Mongolia. Photographer Craig Janes

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Nomads, Refugees and Repatriates: Histories of Mobility and Health Outcomes in Northern Mali
Sara Randall

art 1 imgRahmatou and her daughters 1982 and 2000. Photographer Sara Randall

Abstract
This paper reviews the different pathways through which mobility can influence health, positively or negatively depending on context, by changing susceptibility, exposure or quality of care. The impact of different forms of mobility on health outcomes is considered empirically through a case study of Kel Tamasheq, a Malian pastoralist population who have experienced diverse forms of mobility and immobility in recent decades. As nomadic pastoralists they were highly mobile before being forced, by conflict, into sedentary refugee camps in the 1990s. After repatriation some Tamasheq remain nomadic, some have sedentarised and some are semi-sedentary. Over the same period many Tamasheq women have transformed from being obese and highly immobile to much greater individual mobility. We reflect on the implications of different mobilities for child mortality (as an indicator of health). Survival analysis of birth histories demonstrates that in any single time period the most mobile groups had lowest child mortality, and that substantial within-population mortality differentials exist, unrelated to population mobility. Over two decades child mortality declined considerably and more quickly than amongst sedentary Malian populations probably as a consequence of improved access to immunization and health care in the refugee camps and decreased obesity and increased individual level mobility of young women. Understanding mobility and its diverse impacts and influences on a population may contribute to general understanding of factors contributing to health and welfare of children, but this research provides no evidence that spatial mobility per se can be considered a determinant of health or ill health.

Key words: pastoralist; mortality; mobility; health; Mali

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Health Research Among Highly Mobile Pastoralist Communities of Chad
Esther Schelling, Mahamat Béchir,
Dougmagoum M. Daugla, Bassirou Bonfoh, Moustapha Ould Tableb, Jakob Zinsstag,
Kaspar Wyss

art photoA Fulani family just before crossing the river Chari between Chad and Cameroon. Photographer: Vreni Jean-Richard

Abstract
Mobility and socio-cultural factors render the access to primary social services of mobile pastoralists difficult. Arid and semi-arid regions regions have been neglected by governments in economic development and establishment of public services. A main cause of increased maternal and neonatal mortality among mobile pastoralists is late medical attendance. Disease frequencies of mobile pastoralists do not differ substantially from those of people in poor and remote rural zones, but periodic exposure due to migration, late response to a disease (also due to pressure to move on), inappropriate information, geographical dispersion of networks and close contact to livestock can lead to increased disease occurrence, for example of tuberculosis. Pastoralists often utilise a combination of formal and informal or traditional and western-type medical services. Even with good quality fixed or mobile clinics, significant barriers to service delivery may prevail, for example owing to the mistrust between health service providers and pastoralists. We describe how interdisciplinary research and stakeholder workshops were the prerequisite for testing adapted health interventions among highly mobile pastoralist communities of Chad. Their experiences, local concepts and propositions were essential in this process. The health of their animals is of great importance to pastoralists. Health care providers can harness the good knowledge of pastoralists on animal diseases. A combination of vaccination service for pastoralist children and women with vaccination of the livestock was tested. Sharing of transport logistics and equipment between physicians and veterinarians reduced total costs. Joint delivery of human and animal health services within a One Health approach was highly valued by pastoralists.

Keyword: Pastoralism, mobility, One Health, health services, arid and semi-arid regions

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Guest Editorial
Kate Hampshire and Simon Coleman

art photo
Arbulag, Mongolia. Photographer Craig Janes

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A Better Life? Migration, Reproduction and Wellbeing in Transition
Catherine Locke and Heather Xiaoquan Zhang

art photoMigrant families and community in suburban Beijing. Photographer Heather Xiaoquan Zhang

Abstract
Mainstream theoretical approaches to migration and reproduction in Asia and elsewhere separate questions relating to reproduction from exploration of economic migration, leading to limitations in current understandings. The tendency to see migratory livelihoods in largely productive terms and to conceptualise the reproductive in terms of consequence or constraint neglects the complex inter-linkages between migration and reproduction in the search for a 'better life'. Addressing these 'missing links' involves taking a broader approach to reproductive behaviour that factors in not only sexual relations and reproductive management but also social reproduction, gender relations between men and women and wider well-being. The transitional economies of Vietnam and China have experienced rapid growth in new forms of migration, in particular rural-urban migration that challenge existing presumptions about migration and reproduction. Not only does marriage migration in this context have strong economic dimensions, economic migration also has clear reproductive dimensions. Prevailing policy and popular stereotypes about how migration intersects with reproduction are being undermined by an increasing diversity of migrant strategies for building and sustaining their own families. Moreover existing institutional and policy constraints mean that these strategies often involve difficult and unpalatable trade-offs for individual and family well-being. In both countries the remaining household registration system and the related structuring of social entitlements lead to social exclusion of migrants and their families in urban areas, and perpetuate rural-urban inequalities, with outcomes detrimental to the well-being of current and future generations of the migrants who are trying to build livelihoods and meaningful lives.

Keywords: Rural-urban migration; Reproduction; Gender; Social entitlements; Well-being; Vietnam; China

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Spatial Mobility and Health in Post-Socialist Mongolia
Craig R. Janes

art photoMeasuring kids, Mongolia. Photographer Craig Janes

Abstract
This paper examines the impact of the post-socialist economic transition on the pastoral population of Mongolia. It summarizes findings from several studies of access to health care, maternal health, and child health undertaken between 2001 and 2007. Together, these studies indicate that recent macroeconomic reforms have reshaped the patterns of movement in the rural countryside, and have led to increasing levels of socioeconomic inequality, insecurity of land tenure, and conflict over spatially desirable resources. These changes are in turn theorized to affect health in two interrelated ways: through determining the spatial and social proximity to health services, and by affecting a household's level of social and economic well being.

Key words: pastoralism; mobility and health; post-socialist development; Mongolia; social determinants of health

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Mobility, Animal Source Foods and Micronutrient Needs Among African Pastoralists
Daniel W. Sellen

art 1 imgMelted ghee and boiled meat are served with maize meal porridge at a meal consumed by Eyasi Datoga men during 1992 in Tanzania. Such meals are consumed less than once a week on average. Photographer Daniel Sellen

Abstract
Many mobile pastoral populations depend on livestock to provide animal source foods (ASF: meat, blood and animal fat, milk and milk products) for direct consumption or sale for income. Relative to other foods, ASF contain high levels
of bioavailable micronutrients such as iron, zinc, iodine and vitamin A, and ASF consumption in moderate amounts has been shown to promote healthy physical and cognitive development and child survival. Nutrition scientists and policy makers have therefore suggested that ASF are a potentially efficient, effective, and sustainable means to reduce major nutrient deficiencies at community and
national level. Historically marginal to global economic development discourse, mobile pastoralist populations have become a recent focus of attention as key
producers of ASF at the local, regional, national and global level. This paper briefly examines selected data on ASF consumption, micronutrient deficiency, household food insecurity and under-nutrition among mobile pastoralists in sub-Saharan Africa and identifies key challenges for micronutrient needs assessment and nutrition programming to boost ASF production and consumption among mobile African pastoralists..

Key words: hunger; pastoralism; micronutrients; Africa; nomads

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