Public Engagement Food Festival in Thailand
Published: 12 October 2023
The event explored attitudes and perceptions towards health and diet among the communities most heavily affected by the carcinogenic liver fluke parasite to get a better understanding of how different public health measures will be received and adhered to by the community.
Many regions in Southeast Asia are affected by liver fluke, a parasite acquired from eating raw or insufficiently cooked fish that causes cancer of the bile duct. The resulting cancer mainly afflicts individuals aged 40+ and once progressed is rapidly fatal with limited treatment options. The liver cancer caused by consuming liver flukes (cholangiocarcinoma) is rare in Western countries, but is one of the leading causes of death in Northeast Thailand and neighbouring Laos.
Public health messages from government and health institutions, in the form of awareness campaigns in schools and on television, have led to an improved understanding of the link between raw fish consumption and liver cancer in Thailand. Despite this many people continue to eat raw fish which is a traditional part of the diet. Parasite prevalence and infection intensity has fallen substantially since the 1980s, however hotspots of liver fluke transmission remain.
A 2015 national diagnostic survey found that the prevalence exceeded 40% in several provinces and cholangiocarcinoma incidence in Northeast Thailand remains the highest in the world. Persistent public health campaigns mean that the practise of eating raw fish has become stigmatised, which has contributed to a disconnect between reported behaviour and actual eating habits. The communities most heavily affected by the parasite are lower-income rural households around the Mekong River and its tributaries where the main sources of employment are fishing, rice farming and fish farming. There is therefore a close connection between people’s livelihoods and infection with liver fluke.
To facilitate an open dialogue between endemic communities and researchers, Dr Thomas Crellen who's ongoing research aims to investigate the effectiveness of interventions to halt parasite transmission, worked with Dr Arporn Wangwisatsin from Khon Kaen University to deliver a “Food Festival” embedded within an agricultural market in Maha Sarakham, Northeast Thailand.
The event, funded by Wellcome Trust, consisted of live music, games with prizes, and food vouchers for participants to encourage inclusion from a broad cross-section of society. Around 200 people from the local community attended over two days. During the festival, participants filled out an initial questionnaire then engaged with exhibits and spoke to student helpers from local universities (Khon Kaen University and Maha Sarakham University) about what living a "healthy life” or having a “healthy diet” means for them. Using activity boards and guided by student helpers, participants quantitively rated foods as “healthy” or “delicious”. They also considered and ranked "life aims" and "life risks".
Audio from structured interviews was recorded and transcription of the discussions into Thai and English will facilitate qualitative research and lead to better understanding on the perceived links between food, diet and health.
First published: 12 October 2023
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