Possible illnesses: Assessing the health impacts of the Chad Pipeline Project

Lori Leonard

Research output: Contribution to journalReview article


Health impact assessments associated with large-scale infrastructure projects, such as the Chad-Cameroon Petroleum Development and Pipeline Project, monitor pre-existing conditions and new diseases associated with particular industries or changes in social organization. This paper suggests that illness self-reports constitute a complementary set of benchmarks to measure the health impacts of these projects, and presents data gathered in ongoing household and health service surveys in Ngalaba, a village near a major oilfield in Chad. In an initial 16-week period of weekly data collection, 363 people reported few of the clinically chronic or asymptomatic conditions expected according to health transition theory, and the overall level of illness reporting was low. Illnesses often were described by symptoms or lay diagnoses. Health care practitioners were consulted rarely; when they were, resources for diagnosis and treatment were limited. Clinically acute, short-duration illnesses (e.g. parasitic infections, toothaches, or hernias) were experienced as chronic conditions and were reported week after week. The low levels of illness reporting and lack of clinically chronic conditions are not taken to mean that rural Chadians are healthy. Rather, the patterns of morbidity reflect a particular local ecology in which health services are organized and care dispensed in ways that limit the possibilities for illness in terms of types of illnesses that can be diagnosed and reported, forms illnesses take, and ways in which illnesses are experienced. Illness self-reports are useful adjuncts to "harder" biological measures in HIAs, particularly in the context of large-scale infrastructure projects with explicit development goals. Rather than providing data on the extent to which harm has been mitigated by corporate, state, and donor activities, self-reports show the possibilities of illness in local contexts.

Original languageEnglish (US)
Pages (from-to)427-433
Number of pages7
JournalBulletin of the World Health Organization
Issue number6
StatePublished - Jul 14 2003


  • Chad
  • Chemical industry
  • Chronic disease/epidemiology
  • Data collection/methods
  • Health care surveys
  • Health services accessibility
  • Health status
  • Health surveys
  • Risk assessment/methods
  • Self disclosure

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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