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Parcours migratoires et vulnérabilités infectieuses. Enjeux socio sanitaires et innovations méthodologiques au Laos

Pascale Hancart Petitet

Réunion UMI 233. 20.09.18

This contribution proposes to retrace the experience of conducting a research project in Laos

by paying particular attention

- to the specific conditions of knowledge mobility across social and cultural boundaries

- to the encounters between development and scientific research domains

Achieving growth pose great risks to local communities, which mainly depend on a substantive or semi-substantive economy

While half the Laotian population collects food from forests, access to natural resources is increasingly under pressure.

One of the greatest pressures is from Foreign Direct Investment (FDI) via land concessions and expropriations for large scale plantations, hydropower dams, and mines

Local populations do not benefit much from the economic growth . Many local communities are thus forced into wage-labour, and even pushed into opting for migration.

Also many people from rural areas move to the cities to search for a better life, new opportunities, find a new job and experiment "urban life".

Genealogie

IRD-CRF meetings related to component 2 started in 2014

MOA CRF and IRD signed on 25th July 2016

The research theme “Migration and HIV/STI” has been proposed to Research Sub-Committee (RSC) held on 24h March 2016.

Overall research protocol submitted to CHAS on 28th July 2016.

Both PI and Co finalized the research protocol on 7th October 2016 and the direction of CHAS validated it in December 2016.

The protocol was submitted to National Ethical Committee of Ministry of Health on December 2016 and received the Ethical Approval on 9th January 2017.

The Migr Lao project

- Combines both quantitative epidemiological and qualitative anthropological methods.

- Is based on community-based participatory method that involves research partners in the knowledge-production process.

- Involves various people, stakeholders, senior, junior researchers and non researchers

Each is invited to turn one's gaze on a specific issue, to plan his/her field investigations in an already familiar space and where his/her own social network can be mobilized.

The Mig Lao project is a space of knowledge mobility

  • For scientific creativity
  • Negotiated in an authoritarian environment
  • Made possible by a plurality of social ties

  • Based on the reflexive approach imposed by anthropological practice ...

RESEARCH PROCESS AND EXPERIENCE-BASED PROJECT AS PEDAGOGICAL TOOLS

Conducting research as non-researcher

MIGRATION, MOBILITIES AND HIV/STI VULNERABILITIES. AN INTERDISCIPLINARY AND COMMUNITY BASED PARTICIPATORY RESEARCH IN LAO PDR (2015-2018)

IRD / Center for HIV Aids/ Red Cross

Funding: Expertise France

Closing Symposium, Vientiane 19th and 20 th June.

Feedback from the field

Qualitative data processing and analysis: Hands-on Dedoose experience

MigrLao

Research and training about Mobility, migration and HIV

Provide knowledge both from a qualitative and quantitative perspective on how individual trajectory versus social changes and social processes and practices related to migration are linked to vulnerability and HIV/STI infection in Lao PDR.

One lao students conducted her master thesis within the project / research questions has been defined by her

Dr. Kanchana Thilakoun

Co direction with Dr. Pascale Hancart Petitet & Dr. Daniel Reinhartz

Institut Francophone de Médecine Tropicale (IFMT )

Master in Tropical Medicine and International Health

17th Promotion 2015 – 2017

Master thesis "Life trajectories of migrant women living with HIV in Champassak province, Lao PDR" submitted in september 2017.

« EPIDEMIOLOGICAL APPROACH ON MIGRATIONS AND HIV/STI VULNERABILITIES »

Presently PHD student at the University of Laval, Canada

Dr Farid Boumedienne Epidemiologist INSERM - Univ Limoges

Dr Phimpha Paboriboune, CCL

Dr Angkhana Lasaphone

master student

Those counstraints have led to

  • Various methodological adjustments

  • The production of scientific innovations for research implementation and results restitution

Combined qualitative and quantitative / epidemiological analysis

From February to May 2017, the survey was carried out in the 10 ART centers . 664 patients were interviewed

Mobile migrant women

Provincial students / Beer sellers in Vientiane

Publications in process

Vulnerabilities to HIVSTI

Access to HIV/STI / prevention and care

qualitative study

Dr. Vanphanom Sychareun

Dr. Molina Choummanivong

University of Health Sciences,

Dpt Post grade Studies

Data analysis in process

Training

Writings in process

Mobile and migrant Women /

Garment Factories / dormitory

Vulnerabilities to HIVSTI

Access to HIV/STI / prevention and care

Conducting ethnographical research under surveillance in Lao

Case studies

Document how rural-urban migration to factory shape female workers gender identifications, sexual practices, and capacity to negotiate sex safe practices. Ethnographies will be conducted in garment factories in Vientiane and facilitated by various partners CARE, I-CARE, Sengsavang, Village Focus International and UN Act

HIV positive status as a cause for migration

Mobile and Migrants male Construction workers

Lesson learned from our previous project in Laos ( 2013-2015)

Vulnerabilities to HIV/STI

Access to HIV/STI prevention and care

Bringing HIV/STI back home

Estelle Miramond PhD student

and Mrs. Mimi Keomanichan's

Case studies

representatives of CSO Lao Pha and LNP Plus are involved in the research process in order

  • to explore the effects of HIV infection on the life course
  • to examine how and to what extend HIV positive status leads to migration

In the new economic landscape developing after 1986 (New Economic Mechanism) Laos more open to international contacts and investments.

Dr. Nicolas Lainez, Researcher Post doc & Mrs Tam N Guyen, master student Amsterdam University

Involve non researchers in doing research

Publications in process

Conducting research means first negotiating one’s presence in various spaces.

After obtaining authorization from the National Ethical Research Committee, authorizations needed at the district and village levels

Challenge the Classical anthropological methods (prolonged immersion and floating observation)

Dr. Phanoula 2 Master (EHESP Rennes) CSO study

One paper to be submitted to

One paper submitted

pascale.hancart-petitet@ird.fr

Achieving growth pose great risks

https://www.hivresearchlaos.com/

Research Questions

Migratory paths/ infectious vulnerabilities

What to we know about the inner and intimate experiences of those migrants?

How migration experiences shape gender identities, intimacies, sexualities and new form of conjugality ?

A plateform for training

  • Non researchers were involved
  • Junior researchers too

Dr. Kanchana Thilakoun : Women migrants linving with HIV in Champassak

Dr. Phonevilay (IFMT) : migration and chidren living with HIV

Dr. Somvai (IFMT)/ migration and lost for follow up

Dr. Angkhana Lasaphone : Epidemiological data collection

&

Data analysis and valorization

Dr. Souvanxay Phetchanpheng , IRD post doc researcher, UMI 233

Dr. Dimbi Robintson (IFMT)

Dr. Phanoula (EHESP Rennes) CSO study

Mr. Fahane Belayel (University of Lille)

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