آسیب پذیری بهداشت عمومی مرزی و پروژه های برق آبی: بررسی موردی سد آبشار یالی

The need for energy due to economic and population pressure has resulted in a great expansion of hydroelectric dam projects around the world, especially in Asia. These hydroelectric projects have resulted in considerable environmental, economic, and social damage. Typically, the economic development—environmental degradation dynamic has been examined. However, rarely has the economic development, environmental degradation, public health connection been made. This paper, using primary data collected from household surveys, completes the economic, environment, public health circle by examining how economic and environmental changes from the Yali Falls dam in Vietnam has impacted the health of people living in three remote villages in Cambodia.

Increased population pressure and energy demand make access to clean freshwater more difficult. This statement is particularly true for Southeast Asia where population growth is among the highest in the world and the need for additional energy supply will lead to increased pressure on water resources as countries move quickly to develop hydroelectric power. For example, due to rapid economic growth in Southeast Asia, the annual energy demand for that region is estimated to be 6% to 8% (Alauddin, 2004 and Alauddin and Quiggin, 2008). International organizations such as the World Bank have made major investments in hydroelectric dam construction in the belief that increasing irrigation and hydroelectric power can stimulate economic growth and lower poverty (Duflo and Pande, 2007). Availability of energy resources is compulsory for economic development projects, such as the improvement of productive sectors of the economy, education, healthcare, and water infrastructure. However, these hydroelectric dams have caused massive displacement of people, impacted the ecosystem, destroyed arable land due to salination and water logging, and altered crop patterns (Duflo and Pande, 2007). Typically, the most affected are the poorest of society, leaving them, among other negative side-effects, vulnerable to infectious disease. The Mekong River and its tributaries, which flow from China through Laos, Thailand, Vietnam, and Cambodia are among the most important water bodies in Asia. The Se San River, which originates in the Central Highlands of Vietnam, flows south into northeast Cambodia, connects with the Sre Pok and Se Kong Rivers, and then runs down to the Stung Treng Province and into the Mekong River, is arguably the most important tributary of the Mekong. More than 60% of the Se San River drains within Vietnam, with the remainder draining within Cambodia (Asian Development Bank, 1995). The Se San is important to Cambodia, for example, the Se San and Sre Pok rivers provide 10.4% of the flow of the Mekong River at Stung Treng (Fisheries Office, 2000, Halcrow, 1999 and TERRA, 1999a), and the Se San, Sre Pok, and Se Kong Rivers contribute 16.7% of the flow of the Mekong River at Kratie (TERRA, 1999b). Therefore, the Se San is one of the top rivers for potential hydropower development in Southeast Asia (TERRA, 2000). For example, the 400 MW Lower Se San 2 hydroelectric dam is a newer controversial project that has been approved by the Cambodian government. This hydroelectric project, combined with the Xayaburi dam and the Don Sahong dam in Laos, are expected to impact more than 50,000 people and have significant social and environmental impacts, such as the displacement of people and a significant drop in the fish stock in the region (Chen and Narim, 2013). The Vietnamese government started the construction of the 720 MW Yali Falls Dam on the Se San River in 1993. The reservoir of the dam began filling up in 1998 (Fisheries Office, Ratanakiri Province and NTFP, 2000) and was fully commissioned in 2000, although some energy was produced in early 2000 (Polimeni et al., 2011). The dam is part of the Vietnamese strategy of developing renewable energy, especially hydropower which the government projects will generate up to 62% of the country's energy supply by 2020 (Sinh, 2008). The two main markets for electricity in Vietnam are the Hanoi–Hai Phong area and the Ho Chi Minh City area, each with a large number of industrial parks serving sectors such as finance and banking, agriculture, construction, and technology. A survey by the Electricity Corporation of Vietnam found that nearly 100 industrial users of electricity consume more than 1000 kWh per day (Energy Probe Research Foundation, 2008). Therefore, a major priority for Vietnam is to produce enough energy to feed their economic engine, as well as to provide electricity to rural households, of which approximately 50% do not have access to (Energy Probe Foundation, 2008). Clearly, the Yali Falls Dam has had some positive impacts for the Vietnamese society and economy. However, there are transboundary issues that must be explored. The dam, currently the largest in the lower Mekong basin (Fisheries Office, Ratanakiri Province and NTFP, 2000), is located approximately 70 km from the Cambodian border and impacts an estimated 100,000 people living in the river basin. These people, largely rural villagers, are heavily dependent upon the river for its services, such as drinking water, water for cooking and agriculture, and fish. Additionally, the floodplain on which they live is a grazing area for their livestock and prime land for growing their crops. The Se San is important for transportation, as well as for bathing and washing clothes. Brown, Magee and Xu (2008) explored the vulnerabilities of the poor due to hydroelectric dams in China. They used interviews and detailed economic profiles to demonstrate the negative effects of resettlement on households in the Nu River area. Moreover, the land downstream from hydroelectric dams, and thus the livelihoods of many individuals, is also vulnerable (Mohammadpour et al., 2008). The effect of the Yali Falls Dam in Vietnam on villagers in three northeast Cambodian villages (Phnom Kok Brao, Phnom Kok Lao, and Pi) is no exception. A majority of the poor in Cambodia live in rural communities, similar to other developing countries. As such, these individuals are vulnerable to even the smallest changes in economic, environmental, and public health conditions. Therefore, village-level primary data, as opposed to national macroeconomic data, is important because the economic structures and dynamics in these communities are fundamentally different from the national economy (FAO, 2005, p. 16). The primary data collected provides information about the three villages. Furthermore, information about households and the impact of the Yali Falls Dam on these households, as well as individuals, was collected. While much of the research on hydroelectric dams focuses on their economic and environmental costs (Goldsmith and Hildyard, 1984 and McCully, 1996), this paper differs by examining how human health is affected through the impact on water quantity and quality. The paper is structured as follows. Section 2 reviews the literature on the impact of dams on public health. Section 3 describes the Yali Falls Dam in Southeast Asia. Section 4 presents the results of the survey of the rural villages of Phnom Kok Brao, Phnom Kok Lao, and Pi, the case studies for the paper. Section 5 discusses those results while Section 6 concludes the paper.

The Yali Falls Dam impacts, both positively and negatively, the people living in the region of the dam and those communities downstream as well. To understand this association requires a multifaceted approach because the dam resides in Vietnam and many of the effects impact people living in Cambodia. As shown in this paper the economic and environmental impacts of the Yali Falls Dam have added to the deteriorating public health conditions of people living in three northeast Cambodian villages, possibly more. The villagers in this area were asked about the incidence of eight diseases before and after the construction of the dam. The occurrences of each of these diseases increased substantially after the dam was built, providing significant evidence of a possible link between the Yali Falls Dam in Vietnam and increased incidents of waterborne disease in Cambodia. A clear link, but not direct causation, of the vulnerability of the people in this region to the Yali Falls Dam has been established by the results of the survey presented in this paper. These findings are important because of the use of primary data to establish an association between the dam and changes in quality-of-life, environmental and economic conditions, and public health. Furthermore, as countries in the region move to build more hydroelectric dams, this study can provide meaningful insight into the potential impacts on the population living downstream. The literature (Polimeni et al., 2008, Scudder, 1999, Mehta and Srinivasan, 1999, Srinivasan, 1997, Cernea, 1996 and Burfishers and Horestein, 1985) has shown that the health of women, in particular, is impacted by hydroelectric dams. Future research on the Yali Falls Dam will examine if gender specific health impacts have occurred. While very significant in their impact, these results should not come as surprising. Even the smallest shocks to an ecosystem and/or economic system will have a large impact on the public health of people in the region. However, the situation presented in this paper which addresses cross-boundary issues, such as water rights and adverse public health effects, is complex. In fact, the effect of the Yali Falls Dam in Vietnam on Cambodians has the potential to severely diminish already strained relations between Cambodia and Vietnam. Therefore, all the stakeholders in the Yali Falls Dam project should be involved in the decision-making processes of the operation of the dam. Such an approach would create local participation in a democratic process of water rights and usage (Bruns et al., 2005). Furthermore, information could be provided to villagers so the effects of the operations of the dam could be known. For example, the dam operators could notify people downstream when water will be released. Thus, a democratic approach involving all the key stakeholders would ensure that all parties are heard and that all the information is publicly available. This type of process would enable the concerns of the villagers to be heard. Although the Yali Falls Dam has already been built and in operation for several years, the adverse effects of the dam can still be mitigated to limit the negative externalities on people in the region, particularly downstream. Ideally, any economic, environmental, and social impact assessment that would be conducted prior to the start of projects, such as the Yali Falls Dam, would also include a public health assessment. An impact assessment of a dam project only examines one aspect, typically either environmental or economics. However, a comprehensive analysis could provide important information on how to reduce the adverse effects of the dam and allow policy-makers the opportunities to understand the environmental, economic, social, and public-health impacts of the Yali Falls Dam. Future research will attempt to develop this modeling tool. This information would provide useful data on the potential impacts of the construction of additional hydroelectric dams in the region.