Contents

• This assignment is based on the following scenario –
• In a paper titled 'Understanding Wicked Problems: A Key to Advancing Environmental Health Promotion', Dr. Marshall Kreuter has suggested that this type of public health issue represents a 'wicked problem' that is not resolvable by conventional scientific means, and can only be effectively addressed by employing population health promotion approaches.
• Dr. Kreuter is best know and the co-developer, along with Dr. Larry Green of the PRECEED-PROCEDE framework for community-based health promotion planning, implementation, and evaluation. Considering that PRECEED-PROCEDE constitutes an "ecological" type of health promotion framework, Dr. Kreuter suggests that it might be a potentially useful approach to the contamination problem in Great Lakes fish.
• The province of Ontario borders on several of the Great Lakes, including Lake Ontario, Lake Erie, and Lake Michigan. In addition to serving as a major source of drinking water, these lakes provide several valuable environmental amenity uses — such as recreational swimming and boating, and as a food source for those engaged in sports fishing. In addition, many First Nations peoples often use the Great Lakes-St Lawrence River ecosystem to obtain a significant portion of their dietary protein intake in the form of fresh water fish, an inexpensive and nutritious traditional "country food". However, serious public health concerns exist regarding the presence of significant quantities of chemical contaminants in many these Great Lakes fish species — these include heavy metals such as organic mercury (methylmercury).
• 40 years on, reserve mercury poisonings worse
• Toronto Star, April 06, 2010
• Richard J. Brennan
• OTTAWA
• Forty years after mercury poisoning gripped remote northwestern Ontario native reserves and captured international attention, the tragic story is still unfolding. Residents, who weren't even born when the province banned fishing on the Wabigoon-English River system in 1970, are showing the effects of mercury poisoning, environmentalists say. Headlines around the world told of the neurological damage or Minamata disease found in the natives who lived on a steady diet of fish from the Wabigoon and English rivers polluted by mercury from the then Dryden pulp and paper and chemical plants. "I remember writing that it would take at least a century to purge the waterway," recalled George Hutchison, then a veteran London Free Press reporter, whose book Grassy Narrows published in 1977 detailed the adverse affects of the mercury poisoning in both the Grassy Narrows and White Dog first nations and Minamata, Japan where mercury poisoning first came to prominence. It has been estimated that between 1962 and 1970 the Dryden pulp and paper mill and related chemical company dumped 20,000 pounds of mercury into the Wabigoon River, with the province's okay. David Sone, of the environmental group Earthroots, said newly translated documents from Dr. Masazumi Harada, a mercury-poisoning specialist from
• Japan, to be released today in Toronto shows health affects are worse now that they were in the 'even though the mercury levels have been going down. Sherry Fobister, a 31-year-old mother of two living Grassy Narrows, told the Toronto Star Monday that her daughter Catherine, 10, has been diagnosed as suffering from mercury poisoning and
• her youngest child Cashis, two, is being watched closely by a pediatrician. "Catherine has three benign brain cysts, she has seizures, speech problems, cognitive problems," Fobister said, adding that when Cashis was a newborn he suffered seizures. Fobister said she has eaten walleye or pickerel fish from the river as long as she can remember because no one has ever told her otherwise. "I is my favourite dish." said Fobister, who has numbness in her feet and hands but when tested for mercury fell slightly short of being compensated.
• The 40th anniversary will be marked in Toronto with the release of the translated results of Harada's 2004 return to the two reserves and Sone said the conclusion is that Health Canada safety guidelines are too low to protect people from the cumulative long-term health impacts of low level mercury exposure. Harada, who played a key role in exposing mercury poisoning in Minamata, Japan, first visited Grassy Narrows and White Dog in 1975. He found people with mercury levels over three times the Health Canada limit in Grassy Narrows, and seven times the limit in White Dog. The (2004) study looked at the people from 30 years ago and with those people they found first of all that none of the ones who had readings above the Heath Canada guideline in 1975 were still alive to test again but of the ones who had levels below the Health Canada guidelines in 1975, 89 per cent of them showed symptoms of mercury poisoning now,"
• Sone said. Sone noted that Harada also tested residents who had not been tested before and of those, some 160, about 70 per cent of them showed signs of Minamata disease, which includes tunnel vision, loss of coordination, numbness in the extremities, tremors, loss of balance, and speech impediments.
• As a result of a 1985 compensation deal, residents of Grassy Narrows and White Dog received $8,000 and those whose mercury poisoning is acknowledged by the Mercury Disability Board receive only $250 to $800 a month. Sone said Health Canada has stopped testing for mercury in Grassy Narrows residents, claiming it's no longer a problem because mercury levels have fallen below the Health Canada safety guideline. But he said Harada's study results indicate that even being exposed under the safety guideline, if prolonged, it could cause Minamata Disease
• (chronic type). According to Health Canada, it conducted testing for possible methylmercury exposure in residents of the First Nations communities of Grassy Narrows and Wabaseemoong over a 25-year period (from 1975-1999) and pointed to a 2004 study, conducted by Dr. Laurie Chan of McGill University, that found levels of mercury in local residents and fish to be lower than reported in the 1970s. A spokesperson for provincial Aboriginal Affairs Minister Chris Bentley said the minister will wait until he sees the latest report before commenting. "There is no doubt it is still in the ecosystem. There are recent sediment studies that show levels of (mercury) haven't gone down at all of the Wabigoon-English river system," Sone said. Mercury pollution to a greater or lesser extent affected much of the Great Lakes basin in the 1970s, forcing the province to close the fishing industry on Lake St. Clair.

Description

This paper answers the following questions on the above scenario –
1. Briefly describe the biological/ecosystem aspects of the methylmercury problem in First Nations populations living in the Grassy Narrows/White God communities of NW Ontario, in terms of the release of mercury into the waterways, bioactivation of mercury to methylmercury, uptake and bioaccumulation of methylmercury contamination in local fish, and consumption by humans in the Grassy Narrows community.
2. Describe the main health effects of chronic methylmercury exposures in adults, children, and in the fetuses of pregnant women. What contributing nutritional/toxicological factors other than methylmercury itself might worsen the effects of methylmercury in this populaiton.
3. Discuss the effects of methylmercury contamination of fish in terms of the economic, psychosocial, and cultural impact of the methylmercury problem in the Grassy Narrows/White Dog community. Discuss how these impacts are relevant (or not) to the concept of Dr. Marshall Kreuter 's conceptual framework of "wicked problems" in environmental public health.
4. Using the conceptual framework of 'wicked problems' (and/or other frameworks such as DPSEEA, etc.), provide a brief analysis of how you think the methylmercury problem in Grassy Narrows could be best addressed, now and in the near future (15 years) by Health Canada, the Ontario government, and other relevant governmental organizations.