Overview of Participatory Epidemiological tools used during

Participatory Disease Search Program in Distrct Pakpattan,

Sahiwal, Okara and Toba Tek Singh of Punjab (Pakistan)
Dr Muhammad Rasheed
Inc charge PDS Team (B)
Punjab
Abstr act
The Transboundry animal’s diseases are great threat for the lives of animals/
livestock in the global village (WORLD). In those part of the world where TAD
(Transboundry Animals Disease) Especially Rinderpest still exists, eradication will be
achieved by a process of Participatory Disease Surveillance and intensive vaccination
of infected population if found. The eradication program is in progress in Pakistan
with the coordination of Food & Agriculture Organization (FAO) of United Nation and
European Union (EU). The ministry of Food, Agriculture and Livestock (MINFAL) and
provincial Livestock departments are in action and Participatory Disease Surveillance
Teams are carrying out PDS activities in the Targeted villages of their allocated
Districts. From the month of May, 2003 the PDS team (B) started its activities and
visited the targeted villages (randomly selected by the Data Analyst) of District
Pakpattan, Sahiwal, Toba Tek Singh and Okara till December, 2003. By applying the
different tools of Participatory Epidemiology, the onset of different Livestock diseases
was observed which are shown at next page. The exercise of Proportional pilling with
the local farmers was the actual key to determine the Livestock diseases prevalence
and importance wise. The PDS Team (B) visited 263 villages of 04 Districts and
contacted 4816 Farmers of area while conducting the 266 farmers meetings in the
targeted villages. During this survey 152 Key Informants were interviewed for the
prevalence of any contagious livestock diseases in the area/ village. The PDS team
(B) visited 02 cattle markets for the observation of livestock movement within
Districts and Within Provinces. The PDS team (B) also visited 14 specific area/village
on the direction/report of TADCO or District Livestock Officer concerned to observe
the Disease Incidence and collected 13 laboratory samples. The PDS Team (B) also
visited 54 field veterinary institutions and contacted 176 veterinary staff personals
while conducting awareness meetings. According to the contacted farmers and Key
Informants interviewed, the Transboundry Animal Diseases are not present in the
Districts covered except Foot and Mouth Disease Which was observed during the PDS
activities by the PDS team (B).
The Rinderpest Disease is not present in the area/targeted villages of these
Districts of Punjab (Pakistan)

Introduction
Simply stated, Participatory Epidemiology is the application of Participatory Rural
Appraisal techniques to the collection of epidemiologic information (Jeff Mariner, Andy
Catley, ). In the activity of Participatory Disease Surveillance the participation by the
community or target group is the main aspect. Participation can be defined as a
voluntary process by which people influence or control the decisions that affect them
selves’ by contributing their knowledge, resources and skills. Participatory approach
leads the way we interact with the peoples and this approach of interaction begin and
create / establish a relation ship / trust between the worker and the target group of
people. While working with Participatory approach, the actual issues / data or
information’s could be derived from the people/target group. Participatory
Epidemiology is also a wing of Participatory approach to locate, control and
eradicates any disease from the particular area. In the Participatory approach the
worker/researcher should be aware of attitude / behavior of the target group. The

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attitude / behavior of the target group or community make the research/surveillance
more useful and valuable, so the active community participation is the main key for
success full Participatory Epidemiology or Disease Surveillance. PDS is a rural
community based program, so the PRA techniques were applied according to the
needs of the farmers for their livestock health problems such as housing, feeding,
vaccination and provision of veterinary aids etc.

Brief of the Districts:

The Districts under study are thickly livestock populated area of Punjab (Pakistan)
and famous for the world known SAHIWAL cow and NILI RAVI buffalo breeds. The
basic data of the districts is shown in the table.
Districts Animal Population UC Villages VH VD VC VO VA
Pakpattan 912673 63 765 3 13 27 9 34
Sahiwal 1900488 89 529 5 25 59 23 47
Okara 1557728 114 912 18 17 54 21 67
Toba Tek 1147881 66 531 20 17 67 37 107
Singh
Total 5518770 332 2737 46 72 207 90 255

Livestock Services status of the Districts

The livestock services are mostly provided to the farmers by the Livestock and Dairy
Development Department through its field staff posted at Veterinary Hospital,
veterinary Dispensary or Veterinary Centers. The average animal strength for a
veterinary institution or veterinary worker is shown in the following table.
Districts Per Per Per Per Per Per Per VA
UC Village VH VD VC VO*
Pakpattan 14500 1200 304200 70200 33800 101400 29500
Sahiwal 21350 3600 380100 76000 32200 82600 40500
Okara 13700 1700 86500 92000 28900 74200 23200
Toba Tek 17400 2200 57400 67500 17150 31000 10700
singh
UC (Union Council) VH (Veterinary Hospital) VD(Veterinary Dispensary)
VC (Veterinary Center) VO (Veterinary Officer) VA (Veterinary Assistant)
• One veterinary officer can provide efficient livestock services to 25000 heads
of animals under ideal condition.

Methods and Methodology Used

The Participatory Epidemiology is a main tool to observe the disease incidence in a
particular area as the Livestock keeper always try to get his sick animal recovered
with his own or traditional methods of treatment and the mutual consultation of
farmers leads to the symptoms of those diseases which were prevailing in that
particular area some time.

Selection of Area/villages
The villages were selected randomly by the Data Analyst of Livestock and Dairy
Development Department Punjab, but while working in the Districts/area some
others villages were also selected for Participatory Disease Search activities to get
the actual data/information of Transboundry Animal Diseases.

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Criteria for the selection of villages
• High risk areas
1. The villages in which the livestock Traders are engaged with Karachi and
Peshawar Livestock markets and they are keeping the livestock in the
village /area.
2. The village where the livestock are mainly fed on common grazing area.
3. The villages near the boundary of high risk area/village.
• Other area
1. The village /area far flung from the metal road and veterinary hospitals.
2. The village/area near or in the river belt.
3. The village /area near the livestock markets.

The PDS Teams trained in Participatory Disease Surveillance technique applied the
tools of Participatory Disease Surveillance to get a valuable Participatory appraisal.
The active participation of local farmers/ livestock owners made the activity more
effective and authenticated. To get more and active participation the meeting time
and place was the main consideration of the PDS Team. In every village / area the
Participatory Epidemiology tools were applied with flexible manner according to the
local situation so that the correct information/ data can be collected / complied.
Following main activities were performed in the targeted villages / area as
methodology for Participatory Disease Surveillance.

Conduction of farmers meetings:

Participatory Disease Search is based on the views and thinking of livestock keeper.
The traditional veterinary knowledge with personal experiences could be elaborated
freely in the informal gathering of farmers. The traditional names and variety of
traditional prescriptions for different livestock diseases were intelligently described by
the farmers of the area. The symptoms of Transboundry Animal Disease were also
elaborated by the PDS Team while discussing on particular disease. The farmers
gathering depend upon the time, place, local politics, conflicts and weather. The
primary introduction of PDS Team builds a structure of confidence which leads to a
valuable discussion of Livestock Diseases prevailing in the area.
Following table is showing the farmers meeting detail district wise.

S/No District Villages No of No of Farmers Average

Visited Farmers Participated Participation
Meetings
1. Pakpattan 78 78 1481 19
2. Sahiwal 57 57 1102 19
3. Okara 90 93 1657 18
4. Toba Tek 60 60 1090 18
Singh
5. Total 285 288 5330 18

Proportional Pilling
The use of pictures, charts and banners for the identification of different diseases
makes the things easier for the farmers to participate in the proportional pilling
/scoring of Livestock Diseases prevalence and importance wise.
The use of different types of things such as small stones, tablets, seeds, and beans
etc for pilling creates the interest in the exercise. Generally the farmer/livestock
holder enjoys the talk/discussion for his livestock health and production, and it’s the
secret of a successful Disease Surveillance.

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Use of pictures
Showing the symptoms of disease on picture, cartoons, and outlines confirms the
faded outline of the disease present in the farmers /Key Informant mind. The typical
signs of HS, Red Water, Mastitis, Foot and Mouth disease and diarrhea made the
easier for the PDS team to understand the disease situation of area. In this regards
the local names of different disease were also recorded for proper pronunciation.
The PDS team was very careful while asking questions during farmers meeting or
interviews not to raise farmer’s expectations concerning future services of the
department. Open ended questions were asked making the farmers to think for
answer. These questions were not preplanned and were according to the situation of
the area, hence resulting the valuable data/ information’s. The PDS team also
probed the situation on the symptoms of Transboundry Animal Diseases while
listening carefully to the farmers and gave respect to every individual opinion and
observations with open minded. The data thus derived from the minds of intelligent
farmers are shown in the following table for livestock diseases in targeted villages of
districts under study.

Prevalence Importance
District I II III I II III
Pakpattan HS FMD PPHU HS PPHU FMD
Sahiwal HS FMD PPHU HS PPHU FMD
Okara FMD HS PPHU HS PPHU Mastitis
Toba Tek Singh HS FMD PPHU HS PPHU FMD

Mapping
Mapping is also a very useful method to get the actual information from the farmers
regarding their livestock movement and grazing area. This activity involves the
farmers physically to create a map showing natural resources, such as canal, river,
forest, grazing area, ponds and cattle trespass.
In this activity both literate and non-literate people can contribute to draw a map on
the ground with an ordinary stick. The mapping exercise and the map made by the
farmers can be used for the discussion as well as for participatory analysis. The
mapping method is also useful for follow up questioning and visiting the risk area.
Following graph is showing the mapping of under study districts.

Mapping of the area

8 6 10 4
7 13 11
8 0
2 5 6 6
9 1
11 18
5 12 14
38
23 18 29

PPN SWL Okara TTS

Pond R/Side C/Side F/Side G/Area Nil

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Seasonal Calendar
The onset of different livestock diseases in the particular area can be searched out
through open ended questions to the farmers or Key informants during meeting
/interviews. Seasonal variations and its perceptions of occurrence could be defined
by the farmers by making seasonal calendar. The farmer has indigenous knowledge
regarding the prevalence of disease in that area and by making the seasonal
calendar on the ground the worker/researcher can identify the actual onset of
diseases.
To get the actual situation of disease, the worker/researcher should know or
understand the traditional/local names of season and diseases. While interviewing or
meeting with the farmer, the information regarding the local names can be got for
reference. The use of pictures for seasons and diseases are necessary, so that the
farmers can understand the disease while drawing seasonal calendar
on the ground. By applying /constructing a one year time line on the ground and
placing the picture of disease one by one, the onset of disease can be scored with
small stones under each season. In this way the seasonal calendar grow slowly
showing all information of diseases prevalence in particular area. The farmer can
explain the interesting aspects of diagram / seasonal calendar on the questions of
worker/researcher and by using the probing questions the actual situation/data could
be derived from the diagram made by the farmers. The disease pattern got from the
seasonal calendar made by the farmers during the PE is shown as under.

SL/NO SEASON DISEASES

1. ☺☺☺ HS, FMD, PPHU, Mastitis,

Winter Enterotoxaemia, Pleuropnemonia,
Diarrhea and PPR
2. ♫♫♫♫ FMD, Rheumatism,
Spring Tympny, Ticks,
I/Worms and PPR
3. ☼☼☼ Rheumatism, Prolapsed Uterus and
Summer Abortion
4. HS, Mastitis,
Prolapsed Uterus and
Rainy season Milk fever
5. ☻☻☻ I/Worms, Tympny and
Autumn Impaction

Key Informants Interviewed

In the Farmer community certain local people are known as possessing the
indigenous veterinary knowledge. Such farmers (Key Informants) were identified
during the farmers meeting or visiting the area. The PDS team interviewed the key
Informants and got valuable information regarding the Transboundry Animal Disease
in the area under study. These Key Informants were categorized like, Elder of the
village, livestock Keeper, Siaana of village treating the animals with traditional
prescriptions, Livestock Trader, Butcher, milk man or veterinary practitioners.

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Triangulation:
Participatory Epidemiology could only be beneficial if the data/information collected
by applying different tools are considered to make a decision or diagnosis.
Triangulation is very much useful for the making of diagnosis in veterinary medicine.
The data/information got from different sources, case history of animal, owner
interview, direct observation or clinical examination of effected animals is mentally
combined to provide a provisional or final diagnosis.
PDS Impact on the farmer
The PDS Team during its activities interacts with the field veterinary staff and
livestock owners/farmers. Being the owners of animals, the farmers are the main
source of Information regarding livestock diseases as its prevalence and importance
in their area. The working field veterinary staff is also a good source of disease
reporting. During this study/surveillance following points regarding social behavior
were observed.
• EXPECTATIONS
• FEAR
• DEMAND
Result
• Tools of Participatory Epidemiology are quite helpful to evaluate the disease
situation in the village/area. The interest of the farmers/participants was very
much appreciable while applying the exercise of mapping, seasonal calendar
and proportional pilling.
• Working with the beans/seeds for the exercise of proportional pilling is very
much effective when all the representatives of all groups living in the village
are present and participating in the exercise.
• A reasonable farmers gathering (15-20) in one meeting is more effective
having discussion on every aspects.
• The management and feeding aspects are being ignored by the farmers
causing metabolic disorders in their livestock.
• The livestock diseases such as Hemoglobin urea, Mastitis and prolapsed
uterus are main concern for the farmers.
• The livestock holders of the area/village are well aware about the severity of
Hemorrhagic Septicemia and they are vaccinating their animals
• The Foot and Mouth disease was prevailing in the area/villages 3 months back
but the farmers have no fear about the disease as the disease is not causing
mortality in the livestock.
• The name of Rinderpest Disease is new for the farmers of area/villages, but
the symptoms especially Diarrhea described by the PDS Team leads to think
about the PPR in sheep and Johnes disease in buffalos and cattle.
• The old men of the area/village and the farmer which are selling their animals
to the traders of Karachi were some time agreed with the symptoms of RP but
in Karachi 5-10 year back.

For more Detail:

Dr Muhammad Rasheed
In charge PDS Team (B)
Phone: 0441-50305
Email: vetdr@swl.paknet.com.pk