Water quality and movement, vegetation type and density, abundance of fish and predatory aquatic insects, as well as surrounding vegetation can all drive the abundance and diversity of mosquitoes. Ongoing management, either on improving water quality, minimising the spread of invasive aquatic vegetation, or mosquito control will all influence the risks mosquitoes have on public health. Beyond the wetlands, the design of urban developments can also impact exposure to mosquitoes.
This may increase the relative abundance of mosquitoes and subsequent health impacts. Where new developments encroach on existing bushland or wetland areas, a greater proportion of the community may be exposed to mosquito risk. Notwithstanding the risk of mosquito-borne disease, the impact of nuisance-biting may substantially affect both quality of life and property values.
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Pathogens such as Kunjin virus, and possibly Barmah Forest virus, may be brought to a region with visiting water birds. When it comes to Ross River virus, enhancing conditions for local wallabies and kangaroos can also increase risks. A closer relationship with wildlife points to a closer relationship to the pathogens transmitted between wildlife, mosquitoes, and, unfortunately, people. Rehabilitated wetlands can increase bird populations that may carry pathogens. Image: John Turnbull.
Homebush Bay is rapidly developing around mangroves and wetlands. As people move to the urban fringe, they need to learn to live with wildlife and insects, too. Image: Cameron Webb. Mosquitos in estuarine wetlands will need to be monitored as sea levels rise. Seeing as we plan cities with environmental hazards in mind, why not the pest and public health risks associated with mosquitoes?
The incorporation of buffer zones between developments and existing mosquito habitats can assist in reducing risk. A change to the layout of development with roadways, cycle paths and sporting fields located between residential allotments and nearby wetlands can reduce the dispersal of some mosquito species into and around homes. When new urban wetland projects are planned, as well as having a suitably qualified entomologist review design and management plans, sampling mosquito populations before and after completion will provide the most reliable measure of mosquito risk. This information can identify a problem and help guide the strategic responses to solve the issues if they arise.
Sometimes the problems that arise are not directly associated with a newly constructed wetland, with mosquitoes having the potential to disperse many kilometres from nearby environments, so understanding local risks will be more cost effective in the long-run. Disassociating mosquito risk from a local wetland will prevent unnecessary, and often expensive, mosquito control activities.
A balance will always be required when living with water in cities. Mosquitoes need water and whether it is in a newly constructed wetland or recently installed rainwater tank, they will find a home. He provides advice to local, state, federal and international government agencies on the best practices for mosquito and mosquito-borne disease management associated with constructed and rehabilitated wetlands. Follow him on Twitter. The dialogue will then need to include catchment land use, livelihoods in or around wetlands, property prices, patterns of human movement and transport, human nutrition and its relation to wetlands, and wetlands as sources of beneficial drugs.
Some of these issues are relevant in the short-term future, others in the long term; some are local, others regional or global; and most are influenced by local economies, cultural factors, political structure, and gender- and age-related factors in populations. Compounding factors will occur, such as the impact of climate change on human health issues associated with wetlands and the consequences of fragmented approaches by government Flinders , such as those taken with water resource management and public health. A framework will be useful to constrain this almost infinite list. In addition, it is inevitable that choices will need to be made regarding conflicting outcomes that might be reasonably predicted and that might require a trade-off.
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Some of the starkest current trade-offs are those between wetland hydrology and human health. In this article, we provide a strategy for making these trade-offs explicit. The article is intended to serve as a guide for decisionmaking that more richly encompasses the interaction between wetland ecology and management and human health.
We then deal with the inclusion of ecosystem services in the assessment of the condition of wetland ecosystems and with how ecosystem services might be best recognized in a public-health discourse. There has been a modern tendency to assess the condition of natural resources and the human well-being associated with those resources separately.
For wetlands in the broadest sense of the word as it was originally defined by the Ramsar Convention on Wetlands in , which would include, e. Using the framework adopted by the Millennium Ecosystem Assessment, the term wise use has since been equated to the maintenance of ecosystem benefits or services to ensure the long-term maintenance of both biodiversity and human well-being; the term ecological character includes the combination of the ecosystem components, processes, and benefits or services that characterize the wetland at a given point in time Ramsar Convention Table 1 outlines the breadth of ecological character likely to be included in a description of an assessment of a wetland, including the physical, chemical, and biological components; ecological processes; and an array of ecosystem services, such as provisioning, regulating, cultural, or supporting services.
The categorization as ecological character provides a basis for identifying key issues for management consideration and the role of wetlands in supporting human well-being. It should be emphasized that not all of the categories of information in table 1 apply to all wetlands, and for some—hopefully only a few wetlands—this categorization may not describe them adequately. We note the caution expressed by Fisher and colleagues toward attempts to come up with a single or fundamental classification system, since ecological character will also be determined by complexities introduced by biogeographic and social considerations that are invariably difficult to identify.
Nevertheless, we use this construct to link human well-being with ecological character through the services that a wetland provides so that human well-being is included in wetland assessments figure 1. Health therefore becomes linked with the ecological character of wetlands figure 1. Conceptual linkages: The Millennium Ecosystem Assessment recognizes the links between ecosystem services and human well-being and thereby human health, too. By including the concept of ecosystem services, the Ramsar Convention's definition of ecological character implicitly now includes human well-being.
There are broader implications of this link for the conservation objective of a wetland management agency that adopts this construct. Since conservation equates to the maintenance of ecological character, the conservation imperative relates to protecting ecosystem services and human well-being as much as it does to protecting, for example, species biodiversity.
Health is another way of describing the condition of an entire entity or ecosystem. The term health might be applied in a series of tiers: the health of an individual, the health of a population, the health of an ecosystem, each nested within the next tier. Health might also include the degree of dysfunction, disease, or illness, and the health of one tier is dependent, at least in part, on the health of the other tiers.
For wetlands, this term might apply as much to fish, a species of zooplankton or macroalgae, or waterbirds as to humans, or it might apply to the nested tiers themselves or even to the landscape in which the wetland ecosystem is embedded. The phrase healthy ecosystem acknowledges that humans are an intrinsic part of ecosystems; of course, humans are implicated in activities that degrade ecosystems, but they can also be agents for their maintenance, construction, or restoration.
The health of humans is in some way a reflection of the health of the ecosystem in which they live or on which they depend and vice versa. This reciprocity contradicts any psychological discontinuity between humans and their environment, where nature is distinct from culture—an increasingly discussed dysfunction in Western thinking and an impediment to rational policymaking see Plumwood , Davidson-Hunt and Berkes Various approaches have been used to measure the health of an ecosystem.
They range from a description of the symptoms of ecosystem disruption to the use of indicators of systemic attributes, the emergence of human or animal disease or to qualitative principles. The relationships among biodiversity loss, ecosystem disruption, and disease transmission may be instrumental indications of the health of an ecosystem.
There are well-documented cases of disease emergence associated with land-use change, deforestation, or other forms of ecosystem disruption, and global trends indicate that these cases are increasing in frequency Jones et al. Indeed, both trade and intensive agriculture are known drivers of pathogen emergence and reemergence through host switching and pathogen resistance to antimicrobial compounds. Biodiversity loss can increase disease transmission for important diseases associated with wetlands, such as malaria, West Nile virus, and schistosomiasis Keesing et al.
The incidence rates of vector-mediated diseases and direct zoonoses have been proposed as a bioindicator for underlying disturbances to ecosystems e. In a broader sense, aspects of animal and human health can become an important indicator for the health of an ecosystem, and vice versa, provided that there are clear causal links between the two.
Wetlands and Human Health
Measures of how the delivery of ecosystem services can be enhanced, maintained, or disrupted provide sensitive and useful indicators for the health or integrity of an ecosystem, and specific indicators for a full range of ecosystem services can be examined accordingly Scholes et al. Another set of indicators might be measures of how healthy ecosystems retain their vigor i.
At any level of organization, it might also be argued that the behaviors of a system can be desirable and acceptable if the organization of the system is flexible and adaptive at scales compatible with the temporal and spatial scales of critical ecosystem functions.
The reasoning is that wise use entails the establishment of institutional processes for wetland management to describe ecological character and to develop a management plan to include objectives for particular uses of the wetland and limits of acceptable change that is then implemented and monitored and for which responses are determined accordingly, including interventions to restore particular features of the wetland when that is necessary see Ramsar Convention Numerous examples can be used to show the link between ecological character and human health.
A change in climate or hydrological regime, including a change in precipitation or a change in the volume or seasonal presence of surface water, may cause a change in the population numbers of vectors and may alter the rates of human exposure to pathogens Lafferty , as may changes to the trophic structure of a wetland as a result of overpredation Stauffer et al. Changes in nutrient cycles and trophic status can lead to toxic algal blooms Fristachi et al.
Land degradation and declining productivity in wetland ecosystems can have direct or indirect health consequences for people whose livelihoods depend on them e. In each case, wetland management must be involved in the intervention scenarios. Despite the abundance of evidence for these links, the contributions that an ecosystem's full range of services make to human health have rarely—if ever—been documented. As was shown in the Millennium Ecosystem Assessment MA , the links between broad categories of ecosystem services and the components of human well-being can be mediated by socioeconomic factors, and the strength of the links and the extent of the mediation can vary, depending on the type of ecosystem and the geographical region MA a.
For example, a significant benefit will accrue for humans living in areas in which soils have a high assimilatory capacity for pollutants, through the service of water filtration and purification. This service can be mediated strongly if economic conditions enable access to technologies for sanitation and reliable drinking water or to parts of the landscape where this service is enhanced.
If the capacity for socioeconomic mediation is uneven between ecological services and human well-being, the unevenness is exacerbated by the humans' degree of dependence on the services and the choices people make in and near wetlands. Some groups of people are more dependent on ecosystem services, and the effects of these services' degradation can be shown to be immediate and direct, sometimes reinforced in a cyclical manner Butler and Oluoch-Kosura In other instances, people supplement their livelihoods and incomes and enrich their lifestyles through wetland ecosystem services, which thereby indirectly determine human health by contributing to other forms of well-being e.
Exposure to harmful health effects from insufficient access to wetland ecosystem services is not equally distributed among groups of humans. There will be different priorities for safeguarding the health of wetland communities in poor and rich countries and differences in the vulnerability of wetland communities, depending on the local population's socioeconomic status. Together, the structural determinants and conditions of daily life constitute the social determinants of health.
WHO , p. Again, the consequence for wetland management is clear: Wetland managers are required to help with interventions and to engage with those groups that seek to address the determinants of health. The links among ecosystem services, human health, and their determinants resonate with the Ottawa Charter for Health Promotion WHO , which identified five major strategies for promoting health: 1 building healthy public policy, 2 creating supportive environments, 3 strengthening community action, 4 developing personal skills, and 5 reorienting health services.
Recently, and built on the work of Falkenmark and Folke , among others, there has been a suggestion that watersheds or water catchments can be considered settings on the basis that doing so reconnects health promotion with the ecosystem context Parkes and Horwitz , Bunch et al. One of the strengths of this proposal is that it explicitly puts ecosystem into the parlance of public health, something that has been perceived to be missing from the healthy-settings agenda.
Another strength is that it brings water to the foreground as human society's principal natural resource. We note here Strang's description of the particular qualities of water as one of two important "universalities" that generate cross-cultural themes of meaning that persist over time and we also draw attention to Barbar's idea of "water currency. In July , the United Nations General Assembly formally recognized the right to water and sanitation with a resolution acknowledging that clean drinking water and sanitation are integral to the realization of all human rights.
Commentators argue that although it is nonbinding and a long way from a treaty on the right to water and sanitation, the resolution is still a welcome step in the right direction. Wetlands conform to the construction of settings for health promotion, since they are normally identified as having physical boundaries and since a range of people have designated and defined roles around common meanings and values of water. An organizational structure also exists in the water resource and wetland management sectors, in which health determinants and health inequalities can be addressed.
So far, we have argued that ecosystem services are provided in wetland settings in which determinants of human health exist. Wetland ecosystems and the services they provide, and the ways in which they affect human health and well-being, can be outlined as follows. Contributors to hydration and safe water. The principal supply of renewable freshwater for human use comes from an array of inland wetlands, including lakes, rivers, swamps, and shallow groundwater aquifers, and they play a major role in treating and detoxifying a variety of waste products.
Contributors to nutrition. Many of the world's major food items—core requirements for human health—come from wetland ecosystems or are irrigated by water from wetland ecosystems.
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Rice—a staple food item for almost half the world's population—is grown in a wide range of environments, mostly wetland ecosystems. Wetland ecosystems also have a role in maintaining dietary diversity, which contributes to a multidimensional agenda focused on nutritional and health status, sociocultural traditions, income generation, and biodiversity conservation. Sites of exposure to pollution or toxicants. Human health can be affected by acute or chronic exposure to toxicants, through the media of water, wetland sediments, or even air when sediments become desiccated and airborne or are burned.
These exposures result where ecosystem services have been eroded—principally, when the hydrological services that maintain biological, geological, and chemical processes are distorted by human activities—in particular, the overextraction of water. Drainage and diversions of water are the two activities responsible for the majority of such changes.
Sites of exposure to infectious diseases. Wetlands are loci for communicable disease; microorganisms the pathogens are transmitted through water, people, animals as vectors, surfaces, foods, sediments, or air—any or all of which can be associated with wetlands. Poor-quality unsafe water, inadequate sanitation, and insufficient hygiene are the major risk factors for diarrheal disease, which is the second-leading contributor to the global burden of disease WHO b , WHO—UNICEF An important share of the total burden of disease worldwide could be prevented by improvements related to drinking water, sanitation, hygiene, and water resource management.
Infectious diseases associated with wetlands have profoundly influenced the discipline of public health, and this influence is probably the source of the erroneous oversimplification that wetlands are bad for human health. Settings for mental health and psychosocial well-being.
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Changes to wetlands, to their products, or to their ability to deliver a livelihood or to become a source of toxic exposure or disease can influence a person's mental health Higginbotham et al. These potentialities are increasingly recognized as being part of the wetland manager's and the public-health practitioner's spheres of prevention and intervention Tucker et al. Places where people derive their livelihood. Addressing wetland management as if people's lives, their livelihoods, and their lifestyles depended on it will undoubtedly help improve human health. Livelihoods comprise the capabilities, assets, and activities necessary to make a living.
A wetland manager and a health service provider should seek to sustain the family and community livelihood in the context of the wetland, first by understanding the family and community situations by listening to their stories, hopes, and wishes, and then by acting according to them, within a context of local and traditional knowledge, government requirements, and market forces. Places that enrich people's lives, enable them to cope, and allow them to help others. For those people who live in wetland settings, their different behaviors and activities will be a proximal determinant of their health.
Lifestyle factors are related to the ecosystem services—particularly, leisure, recreation, sporting activities, education, and cultural heritage including the spiritual significance of water —and provide for both physical and mental health, given human affinities for wetlands and watercourses.
Places that help absorb the damage of natural disasters. Climate externalities such as floods, severe storms, drought, and fire and geological externalities such as earthquakes and tsunamis can magnify any of these exposures; in fact, because most people live in or near wetlands, the conditions of the wetlands and their ability to absorb external forces will determine, to a large extent, the degree to which human health is affected. The disease burden following major disaster events include psychosocial issues, infectious diseases, physical injury, and systemic chronic illness.
The pathways to such disease events may be direct or indirect and include a spectrum of community members, including those directly injured; rescuers; people who have lost property, belongings, or the capacity to sustain a livelihood; families of those injured; and from there, the more general population Cook et al. Sites where medicinal and other products can be derived.
Health benefits will accrue to societies in general and individuals in particular, because the products of wetlands can be used for pharmaceutical or other medicinal purposes. Wetland-associated animals, fungi, bacteria, and lower plants algae , some of them living in extreme conditions, provide the most productive sources of new natural products. The medicinal qualities of these are good examples of the continued value of traditional knowledge to health care today. These wetland ecosystem consequences for human health are shown together in figure 2 in the form of layers, inspired by Barton and Grant's determinants of health and well-being in our neighborhoods and Syme and colleagues' "sphere of needs" of water.
As with the emphases in these other conceptual approaches, all of these features influence one another according to the circumstances; what is proximal and distal can become causally connected. Figure 2 shows three examples. Drawing acidic groundwater water for domestic or horticulture results in personal exposures. Nutrient enrichment also exposes residents to hazards, as well as to nuisances such as unpleasant odors, and makes recreational and other uses of the wetland problematic.
Disasters or extreme events can profoundly and unpredictably integrate social determinants and personal exposures and can make the provisioning of hazard-free food and water difficult. Influences on wetlands as settings for human health, showing the proximal factors of provisioning ecosystem services food and water requirements ; personal exposures and risks; and more distally, the broader social determinants of health.
Three examples of cross-cutting are shown, and for each example the extent of the influence is diagrammatically represented by the widths of the "stream" see the text for further elaboration. At first, it might seem that what we have been arguing here equating healthy wetlands to healthy people is a simple linear relationship in which human health declines when ecosystem services are disrupted and in which human health improves so long as ecosystem services are maintained or enhanced, but the truth is more complicated.
These might include the provision of freshwater and food items that have a direct link with human health, as well as other services that support wider economic productivity, poverty alleviation, and increased food security and are a potential source of new natural products. In addition, many wetlands have a well-known insurance value for many people, reducing their vulnerability to extreme events, such as floods, whereas others, such as peatlands, play an important role in carbon sequestration.
In this respect, wetland ecosystem services make tangible contributions to human health and improve the lives of many people at local, regional, and global scales, as has been outlined in recent global assessments Covich et al. Four relationships possible when considering the condition of ecosystem services and human health. In the same assessments, the many direct and indirect consequences for people when wetlands have been disrupted have also been outlined, and the results are degraded or lost ecosystem services through the many drivers of change that have been widely documented elsewhere.
Numerous examples exist, and three are given here: 1 the application of DDT dichlorodiphenyltrichloroethane to wetlands, or their drainage, for malaria control which entails the loss of supporting and regulating services of the wetland in order to decrease malarial infection rates ; 2 conversion of a wetland into a reservoir which results in the loss of regulating services of the wetland in order to provide water for humans during times of seasonal drought or for irrigation for food ; and 3 controlling water flows in rivers as flood mitigation strategies which leads to the loss of regulating services in order to alleviate loss of life or property.
Here are two: 1 Urban wetlands protected for nature conservation with the protection designed to support and regulate ecosystem services can also support the presence of mosquitoes and other vectors, and in so doing, they can expose humans to vector-borne diseases see Malan et al. In addition, the four views in figure 3 still greatly oversimplify the relationship.
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In any wetland ecosystem, on balance, some ecosystem services will be maintained, some enhanced, and some degraded. Likewise, there will always be poor health outcomes for some people, and some will benefit. Furthermore, if the ecosystem services and health outcomes happen to be causally linked, the situation can be complex and layered, displaced in space and time, and dependent on a number of modifying forces.
For example, climate changes can place stresses on agricultural production or on the integrity of coral reefs and coastal fisheries, which, through a chain of links related to changes in harvested volumes, food quality, food storage, and food distribution, might lead to malnutrition or related ailments. Similarly, deforestation may change human population demographics and may alter local and regional climates, potentially affecting disease vector distributions and, therefore, disease patterns over time.
Food security might link to any or all of the following: water quality, household income, plant genetic resources, and fisheries management. These causal chains are often important and complex. They imply that trade-offs among benefits will occur when wetlands are developed or otherwise altered in order to promote or favor one or a few services over others Nelson et al. The wetlands of the Gnangara groundwater system in the northern metropolitan area of the Australian city of Perth provide an illustrative example.
Decisions that have led to the over- use of groundwater for domestic urban purposes and market gardens have also enhanced provisioning services providing water for direct consumption and for the production of vegetables , which thereby yields health benefits associated with hydration, nutrition, and livelihood.
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In the process, however, hydrological regimes have changed, and regulating services e. Surface waters can enhance mosquito breeding in either acidic environments see Ljung et al. All four quadrants of figure 3 can be filled under this scenario. If water use from the groundwater system is allowed knowingly, as it has been, this represents a trade-off scenario: One set of ecosystem services is traded for another, and one set of human health outcomes is traded for another.