Zoonotic disease dynamics in displacement: A multisite case study in Sindh, Pakistan and Mafraq, Jordan
Complex emergencies are causing unprecedented levels of forced migration, with displacement primarily affecting countries where people are dependent on their animals, with livestock a significant contributor to social and economic output. Animal health is fundamental to human health and wellbeing, including through the provision of food, nutrition and livelihoods. Animal and human health are closely interlinked, as the majority of human infectious pathogens originates in animals. These zoonotic diseases are considered a threat to public health in emergencies and displacement, linked to changes in pathogen and vector environment. Although little is known about the exact disease dynamics due to scarce evidence, the fear of zoonoses has resulted in the exclusion of animals from emergency responses. This doctoral research aims to answer the research question of: how can interdisciplinary theoretical and empirical foundations be enhanced and applied to the problem of the simplified narrative around zoonotic disease dynamics associated with displacement of humans and animals?
Adopting a multisite case study methodology, I investigated zoonotic disease dynamics across three displacement contexts: among survivors of the 2010 superfloods in Sindh province in Pakistan; environmentally displaced populations during monsoons and following sea intrusion in Sindh; and Syrian refugees in Mafraq Governorate in Jordan. I adopted qualitative methods, including literature reviews, semi-structured expert key informant and household interviews, supported by observations, to allow for a holistic consideration of the factors and processes impacting zoonotic disease dynamics during displacement. Among the participants were 30 expert key informants and 26 households in Thatta and Sujawal districts in Sindh province in Pakistan, and 14 expert key informants and 14 households across Mafraq Governorate in Jordan. Data was analysed using a thematic analysis, to construct themes describing the complex elements determining zoonotic disease dynamics in displacement.
The case studies show that zoonotic disease dynamics in displacement, and forced migration itself, are rooted in complex historical, political and socio-economic processes, leading to social marginalisation and vulnerability to disaster and disease. As a result, conventional applications of epidemiological models may be insufficient. Simultaneously, the anthropocentric view on biosecurity and a failure to understand the importance of animals to human lives and livelihoods, has led to their exclusion in humanitarian responses. This thesis proposes a more holistic analytical framework to investigate and address zoonotic disease dynamics in displacement, enabling the examination of these complex processes. This framework includes the consideration of social and economic capital, environmental inequality and policies and practices of exclusion to zoonotic disease dynamics in displacement.
The framework may inform future empirical studies to strengthen evidence-informed policy development and humanitarian responses, enhancing the facilitation and protection of animals in emergencies and displacement, ultimately benefitting displaced communities’ health and welfare. As such, this work contributes to the improvement of strategies for comprehensive emergency and recovery responses, recognising animals as important entry points. Existing local and traditional knowledge, resources, and capacity needs to be strengthened, including disease prevention, veterinary services and institutions during displacement. The framework and its implications need to be further developed and tested for implementation to ensure that displaced populations and their animals are truly integrated in policies and service delivery, for the protection of both human and animal health.