Community engagement process in Stung Treng, Cambodia

Parts of these bat colonies host the SARS-COV 2 virus. Critical for developing effective solutions that minimize or even eradicate zoonotic risks is the work with communities on the ground as past experiences have shown that top-down solutions are rarely effective.

In early March we conducted the first 2-day workshop in Sam’ang, Stung Treng, Cambodia. 26 community members from Sam’ang and nearby villages participated. In a first step the BCOMING project and its objectives and activities were presented. During this step it was clearly a surprise to most participants that the bats in nearby caves carry the SARS-COV 2 virus, and that this virus has caused COVID among humans. A vigorous discussion unfolded concerning the ways humans could get infected.

In a second step, the BCOMING team, consisting of Dr John Ward (MERFI), Dr Alex Smajgl (MERFI), and Chea Sokha (WCS), conducted a Participatory Systems Modelling (PSM) exercise.

Participatory system mapping (PSM) is a member of the family of practice-oriented network/system analysis tools developed to investigate and support cross-sectoral One Health planning and governance. PSM is a structured and facilitated mapping tool that assists participants to understand, visualise, discuss, and improve situations in which diverse actors either influence One Health outcomes or are affected by One Health decisions.

 

The adapted PSM method started by specifying first the SARS-COV 2 virus as a focal factor. Community members were asked what the direct impacts or direct responses would be.

As a first step, small groups of community participants discussed the main impacts and responses of exposure to a virus zoonotic, documented on yellow sticky notes. Then, notes were placed on a white board and similar impact notes discussed, clarified and combined.

In a next step, participants were asked to think about impacts resulting from the points listed on yellow sticky notes and document these consequences on pink sticky notes.

This defines a step from first-order impacts (yellow) to second order impacts (orange). Once sticky notes were places on the white board and combined the process was repeated for third order impacts (the pink notes in final PSM photo).

The combination of first, second and third order impacts provides a One Health systems map as perceived by the Sam’ang communities. Such a systems map opens up a range of opportunities, including

• the development of a community vision,
• the analysis of causal beliefs held by community members,
• the analysis of possible ripple effects,
• the identification of risks and opportunities,
• the identification of the relative influence different stakeholder groups have, and
• the specification of interception points, strategies and action plans to mitigate risks.

The third step, focused on strategies community members could see that might help mitigating zoonotic risks. Two main “strategies” were identified. First, improved awareness raising and education (teal coloured boxes in Figure 1). Second, community-based surveillance. The workshop ended by breaking down the second strategy into specific actions (bottom of Figure 1 in grey) and their most effective sequence, while including the names of responsible actors.

The next step will be to test the beliefs embedded in the systems map by comparing them with scientific evidence. Further, the proposed action plan will be tested in an agent-based model to assess the likely impact of proposed actions on prevailing zoonotic risks. The modelling will require a range of socio-economic data, in particular behavioural and intentional data, to contextualise the agent-based model and the human-environmental interactions it aims to simulate. Hence, a survey will be conducted to elicit the required data from the relevant villages in Stung Treng. These survey and modelling results will be presented to the communities to refine or revise the proposed risk-mitigation actions.