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Ripple Effects of the Belo Monte Dam: a Syndemic Approach to Addressing Health Impacts for the Downstream Community of Gurupá Cynthia A

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Ripple Effects of the Belo Monte Dam: a Syndemic Approach to Addressing Health Impacts for the Downstream Community of Gurupá Cynthia A University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School June 2018 Ripple Effects of the Belo Monte Dam: A Syndemic Approach to Addressing Health Impacts for the Downstream Community of Gurupá Cynthia A. Pace University of South Florida, [email protected] Follow this and additional works at: https://scholarcommons.usf.edu/etd Part of the Environmental Health and Protection Commons, Public Health Commons, and the Sustainability Commons Scholar Commons Citation Pace, Cynthia A., "Ripple Effects of the Belo Monte Dam: A Syndemic Approach to Addressing Health Impacts for the Downstream Community of Gurupá" (2018). Graduate Theses and Dissertations. https://scholarcommons.usf.edu/etd/7346 This Dissertation is brought to you for free and open access by the Graduate School at Scholar Commons. It has been accepted for inclusion in Graduate Theses and Dissertations by an authorized administrator of Scholar Commons. For more information, please contact [email protected]. Ripple Effects of the Belo Monte Dam: A Syndemic Approach to Addressing Health Impacts for the Downstream Community of Gurupá by Cynthia A. Pace A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy Department of Anthropology College of Arts and Sciences University of South Florida Major Professor: David A. Himmelgreen, Ph.D. Marianne Schmink, Ph.D. Hilton P. da Silva, Ph.D. Linda M. Whiteford, Ph.D. Rebecca K. Zarger, Ph.D. Date of Approval: March 26, 2018 Keywords: Brazil. Amazon, Public Health, Development, Ribeirinho Community Copyright © 2018, Cynthia A. Pace ACKNOWLEDGEMENTS I would like to begin by thanking my advisor, Dr. David Himmelgreen, as well as the other members of my dissertation committee, Dr. Becky Zarger, Dr. Linda Whiteford, Dr. Hilton da Silva, and Dr. Marianne Schmink for aiding me through the research process. Their collective expertise and support contributed greatly to the successful completion of my dissertation. Thank you to all of the professors in the USF Anthropology Department, through your classes I was able to hammer out my ideas and perfect my research topic. A big thank you to my fellow graduate students, especially Catherine Skefos, Maura Denny, Dr. Kiersten Downs, and Kaniqua Robinson, who sat in the grad lounge with me discussing ideas, working on stats assignments, and keeping my head above water when everything felt just a little too stressful. Thank you to my friends, my extended family and my in laws for providing all the love and support to keep me going and for always reminding me that there is light at the end of the tunnel. I know you all know way more than you want to about dams in the Amazon so thank you for listening. Thank you to my sister, Annie, for encouraging me to reach for the stars. Although you will always be my little sister I’m the one who looks up to you for following your passion and working harder than anyone to achieve your goals. To my parents and my husband, Cesar. I could not have done this without your continual support, your willingness to allow me to complain (a little) and your tough love that kept me on track. My mom, Olga Pace, who taught me to always do things to help others, who made sure our friends in Gurupá checked on me when I was sick, and whose unconditional love kept me going every day. My dad, Dr. Richard Pace, who is my lifelong advisor, thank you for encouraging me to follow in your footsteps and for being there for me every step of the way. Your work in Gurupá has been life changing and I hope to continue sitting on panels with you at the AAA meetings. Cesar, my husband, who probably got the brunt of my trials, tribulations and frustrations, thank you for quitting your job and moving to the Amazon with me. You are an amazing person who stayed with me and even asked me to marry you throughout this whole doctorate process. Completing this dissertation is a success for the both of us. Thank you for your countless nights being my bounce board for ideas and making the things I envisioned in my head a visual reality with your animation skills. Finally, thank you to the town of Gurupá. This research would not have been possible without the support of the community. Thank you for housing me, feeding me and continually helping me to progress further in my research. Spending the summers over the last 10 years in Gurupá have taught me so much and I look forward to coming back and sharing the results of the research with the community. TABLE OF CONTENTS List of Tables ...................................................................................................................... iv List of Figures ...................................................................................................................... v Abstract ............................................................................................................................. viii Chapter 1: Introduction ........................................................................................................ 1 Chapter Overview .................................................................................................... 6 Research Questions ................................................................................................. 7 Chapter 2: Literature Review ............................................................................................ 15 Dam Impacts .......................................................................................................... 16 Non-communicable Diseases ................................................................................ 17 Nutrition ................................................................................................................ 20 Psycho-social Disorders, Social Well-being and Injury ........................................ 24 Communicable Diseases ........................................................................................ 26 Political Economy of Health ................................................................................. 30 Syndemic Theory ................................................................................................... 36 Chapter 3: Research Setting .............................................................................................. 44 Getting to Gurupá .................................................................................................. 47 A Brief History of Gurupá ..................................................................................... 54 Quotidian Life ....................................................................................................... 61 Chapter 4: Methods and Data Collection .......................................................................... 71 i Site Justification .................................................................................................... 71 Research Design .................................................................................................... 78 Sampling ................................................................................................................ 83 Data Collection ...................................................................................................... 84 Limitations ............................................................................................................. 85 Broader Impacts and Ethical Considerations ........................................................ 86 Chapter 5: Public Health ................................................................................................... 88 History of Public Health in Brazil ......................................................................... 88 Public Health in the Amazon ................................................................................. 93 Chapter 6: Quantitative Results ....................................................................................... 112 Health Status ........................................................................................................ 123 Perceptions of Health .......................................................................................... 133 Women’s Health Questions ................................................................................. 137 Food Frequency Questionnaire Results ............................................................... 142 Conclusion ........................................................................................................... 145 Chapter 7: Qualitative Results ......................................................................................... 148 Community Cohesion .......................................................................................... 148 Health and Outsiders ........................................................................................... 156 Drugs and Violence ............................................................................................. 168 Lack of Structure and Organization .................................................................... 172 Chapter 8: Syndemic Model of Potential Dam Impacts .................................................. 179 Chapter 9: Conclusion ..................................................................................................... 195 Recommendations ............................................................................................... 202 ii Future Research ..................................................................................................
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