Working With Communities to Save Lives and the Environment

Duke Professor Bill Pan’s efforts in Central and Latin America aim to reduce disease and deforestation.

By OGA Staff

February 15, 2022

Bill Pan’s multiple research projects in Central and Latin America – in Ecuador, Peru and the Amazon – address disease from an interdisciplinary and interconnected approach that relies on partnerships with people on the ground. This close connection can reveal how people’s health can be affected by on-the-ground decisions.

In his work on mining, by looking at environmental decisions made by households, he points to the negative effects of such choices, such as deforestation and mercury poisoning.

In Ecuador, he has worked with a number of different actors – community organizations, local and national governments and non-profit organizations – to develop an early warning system to alert people to the prospect of a malaria outbreak.

Pan and collaborators from Universidad San Francisco de Quito meet with Ashuar Indigenous community leaders near the Ecuador-Peru border to introduce a new malaria study related to migration and environmental change, courtesy: Luis Vasco Estrella

But Pan didn’t start out his academic career thinking he would go to the field to do his work, or access remote communities in the Amazon. He trained in biostatistics, a field where researchers apply statistical methods to health-related research. They usually rely on datasets and their results can be used to guide decision-making.

“I wanted the experience being in the field and getting to know the people who are giving me their information,” said Pan. “When I write about results and try to interpret that data, I have a better context about what that data means for real people.”

But then Pan began to work on land use in Ecuador and how people use land for different purposes (whether for farming, urban development, or perhaps even protection). He used remote sensing to track changes and modeled how individual decisions could determine when and where forests were cut down and why.

Stopping malaria where it starts

This research led to his malaria prevention work. Again, working with partners on the ground, Pan has developed an early-warning system that gives accurate estimates about when and where a malaria outbreak will occur. Pan hopes to pass on technology not only to his Ecuadorean partners but to others in Central America, so that communities and stakeholders can be better equipped to make decisions and prevent future outbreaks.

And with a $3.4 million dollar grant from the National Institute of Allergy and Infectious Diseases (NIAID), Pan will expand his efforts to Brazilian Amazon. There, Pan notes, “most places are so remote or they have such inconsistent access to supplies that they just can’t prevent malaria outbreaks.” Pan will work with communities to build up supply chains to have bed-nets or bug spray at hand when an outbreak is predicted to hit.

Helping families make decisions with good health outcomes

In addition to his work on preventing malaria, Pan focuses on gold mining and how it affects health and the environment. “Honestly, I never intended to study gold-mining. When I came to Duke, we had started a malaria project in the Southern Peruvian Amazon, and we quickly realized that gold-mining was the major problem affecting people on the ground. The first time I went into a mining site, I was shocked at how devastating it was.”

In Madre de Dios, Peru, huge swaths of forest had been wiped clean. And that deforestation meant that forests wouldn’t be able to regenerate for the next fifty to one hundred years.

With the mining came a host of other issues: disease (vector-borne diseases like tuberculosis), but also human trafficking and a decaying social and political order.

Pan with Duke students Danny Tobin (NSOE) and Diana Quintero (Sanford) visiting a hard-rock subterranean gold mine with collaborators from ESPOL and UNDP

One of the biggest issues Pan knew he needed to address was exposure to mercury. Mercury is extremely toxic and gold-mining is the number one reason for mercury poisoning world-wide. Pan and his colleagues conducted a few initial studies, “evaluated the extent of mercury exposure and found that approximately 42% of the population living in the region of Madre de Dios were highly exposed.”

This exposure has profound effects: increased risk of neuro-generative disease, anemia, reduced immune response, and a higher risk of hepatitis, among others. Perhaps most significantly, mercury poisoning meant cognitive impairments in children, who would carry these impediments into adulthood.

Working with faculty across Duke and with universities across the U.S. South, Pan hopes to understand how to reduce the impact of small-scale mining. With that continued focus on community, he and his partners ask why families chose mining in the first place. They hope to mitigate exposure to mercury.

Over time, Pan and his partners want to develop partnerships between communities, industry, government and NGOs. They would work together to create more sustainable mining, such as setting boundaries on where boundaries where mining could be carried out.

Pan stresses that his community focus is a circular way of evaluating health outcomes, one that involves decisions made by individuals and socio-economic forces beyond their control.

In the end, the goal of his different projects is the same, he says, “to give some forethought to ensure that we are not destroying the earth and injuring our communities.”