Worm Prevention and Environmental Protection in Dak Lak

themselves; protect, preserve customs, resolve conflicts inside and outside the village through reconciliation and litigation. The village head presides over major ceremonies and festivals of the village, clan, and family (such as ceremonies: worshiping at the water wharf, eating new rice, praying for a good harvest, abandoning graves, etc.). The village head works in a democratic spirit, before deciding on any common, important issue, he discusses it with the village elders, sometimes even asking for opinions from members of the community, then announces the final decision and is responsible to the village. The village head's decisions are strictly followed by everyone. Therefore, communication and education work to achieve good results must have a lot of contribution from the village head.

Relationships in the Ede family: Under the influence of gender division of labor, the roles and status of Ede women and men are different in the family as well as in society. If in the family, women play the main and prominent role as the head of the family (ana go), then on the contrary, their role in society is only secondary. When viewed from a social perspective, the gender role in the traditional society of the Ede is clearly shown as follows: women are the heads of the family, the ones who maintain the race, have two main roles: reproduction (giving birth, raising children) and production, which is mainly associated with the family. In contrast, Ede men also play two main roles, which are production to support their wives and children, creating material wealth for the family and participating in common activities of the community, leading the community. Thus, the marital status shows that the situation of households without husbands not only lacks male labor but is also an important factor that aggravates the poverty level of households with widowed women.

Festivals: The weather in the Central Highlands in general and Dak Lak in particular is divided into two distinct seasons: the rainy season from April to November, the dry season from December to early April of the following year. Labor and production of the people here

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only focuses on the rainy season. Then comes the off-season, when workers rest and enter the "season of eating for the year and drinking for the month". All rituals and festivals unrelated to production are concentrated in the dry season, lasting from the early harvest (worshiping the rice spirit, celebrating the new rice) until the field clearing season in April of the following year. At this time, the corn has filled the warehouse, the feeling of fullness and surplus is clear, this is the time to rest, have fun, meet, thank heaven and earth, entertain friends, show filial piety to parents, welcome a new year,... Therefore, the ceremony is as crowded as the festival, becoming the season of rituals and festivals for every family in the village and the whole region. This is also the time when epidemics often occur, especially digestive diseases and worms. Taking deworming medicine in early March and September every year is appropriate.

Occupational status: Most Ede women work in agriculture, accounting for 98.9%, while 1.1% of women work in trade. This is an inevitable consequence of self-sufficient production, poor infrastructure, underdeveloped economy, and underdeveloped handicraft industries, so there is no social division of labor. This may explain why the rate of worm infection is still high in the Ede community.

Education level of couples : Living in a matriarchal society, the Ede people believe that: " daughters are for breeding " and are the ones who maintain and develop the family and clan lineage, who live with their parents all their lives and take care of them when they are old, who manage assets and run the housework in the family. Therefore, Ede women, whose main job is farming, do not have the opportunity to study, they have to stick to their lives within the village, trying to preserve their ancestral land, customs and practices, endure and sacrifice. Ede women cannot have the conditions to improve their social knowledge, and are limited in absorbing scientific and technological advances to apply in real life. The disadvantage of Ede women is shown in the rate of women who do not go to school in communes is higher than that of men, while they have to take on the responsibility of educating their children. If there is no change, this situation will recur.

in the next generations . The knowledge of Ede women as well as Ede men about worm prevention is limited, so it is necessary to organize information and education on worm prevention many times, with simple content combined with vivid visual images.

Previously, the role of the wife and husband in the development of the family economy of the matriarchal institution: Agricultural production, the main source of income is agricultural products such as wet rice, upland rice, coffee, some households have income from livestock and hired labor. Thus, the source of income of indigenous people is mainly agricultural products but with low level of intensive farming, not applying scientific and technical measures to increase crop productivity, so the income is low, the life of ethnic people is increasingly difficult. Only about 3-5% of ethnic households have applied new and advanced technical measures to increase crop and livestock productivity.

Nowadays, the division of labor in coffee care work shows a clear trend of both men and women participating in the work, the division of labor is progressing, the ratio of both men and women participating in the work is increasing, proving that the role of men and women in indigenous people is gradually becoming equal in the field of labor and household economic development is very clear. In addition to the 8-12 hours of labor in a day, Ede women also have to take on the work in family life, such as raising children, doing laundry, collecting firewood, going to the market, cooking, going to the forest to pick bamboo shoots, picking mushrooms, etc.

Poverty status: In general, the number of poor and hungry households in Dak Lak is still high, such as: Ea Ho commune in 2002 had 3.9% hungry households, 18.3% poor households; Ea Toh commune in 2002 had 7.6% hungry households, 20.2% poor households; Dlie Ya commune in 2002 had 4.8% hungry households, 34.8% poor households [16],[89]. The reason for this situation is that people monoculture coffee, low price, low productivity due to lack of investment, intensive farming, and lack of application of scientific and technological advances, so income is low.

has rapidly increased the rate of poor households. Ede women's access to information through the media is still low, in remote areas, although there is television coverage, some families still cannot receive television signals. Some families do not have the conditions to buy expensive means while life is still very difficult, sometimes hungry, sometimes full. For example, the rate of women who never watch TV is up to 67.0%. Listening to the radio shows that many households are provided with radios, but regular listening accounts for a very low rate among Ede women. The rate of households without radios is 54.9%. Reading books and newspapers is a difficult problem, only a few women who participate in social work have the ability to read books and newspapers. The rate of women who never read books and newspapers is 83.5%. Regularly listening to the radio is 11.0%; Regular radio listening and regular TV watching account for 15.4% [16],[89]. The above reality shows that information and education work through mass media will be less effective in the Ede community in remote areas .

Through studying the identity of the Ede ethnic group in Dak Lak, it can be seen that:

- The Ede culture has factors that inhibit or encourage economic development, and at the same time, are the reasons why people easily become rich or poor. Customs such as weddings, funerals, community activities, etc. can impoverish a family, or push them deeper into debt if they are social customs.

- Nowadays, the Party and the State have implemented many programs in the Central Highlands that have had an impact on changing the matriarchal institution of the Ede people. The National Target Program for Hunger Eradication and Poverty Reduction (Program 133), the Socio-Economic Development Program in Extremely Difficult Communes in Remote and Distant Areas (Program 134), especially the Sedentary Cultivation Program and the impact of the market economy have changed the matriarchal institution of the Ede people.

Ede, from the Long House ( Matriarchal Family ) has gradually been replaced by a new type of family, the small family ( Matriarchal Family ) [16],[89]. The small family is a more progressive form and a great development in family relations among the Ede people such as :

+ The roles and positions between husband and wife are somewhat more equal, stimulating the creative labor ability of each individual in the family, creating conditions for asset accumulation and household economic development.

+ Residence after marriage has also changed because the government grants land to settlers so the husband does not depend on the wife, they are more independent or as at present, due to limited land, the wife or husband, whichever side has land, will go to produce.

+ The family and marriage relations of the Ede people have also changed somewhat due to the internal development of each ethnic group in the face of changes in socio-economic conditions in historical conditions and due to the impact of external factors such as policies and measures of local authorities, so the forms of marriage based on the custom of "continuing the family line" have gradually been eliminated, and on the other hand, they are not favored by the young generation.

+ The gender gap in education is narrowing for the younger generation. The improvement in female education that occurs in the younger generation will make women leave agriculture, have high educational levels, they have the opportunity to earn income from the non-agricultural sector and participate in social work.

+ The inheritance system is evolving from a strict matriarchal institution to a more egalitarian one. Gender bias in inheritance rights has changed, with sons and daughters inheriting property in “converted” households.

+ The development of commodity-monetary economy and cultural exchange among ethnic groups in the region has gradually eliminated the self-sufficient economy.

Matriarchy has different characteristics from before, but the Ede people still respect the customs and practices of traditional society such as the rule that children still carry their mother's surname.

1.6.4. Economy: Dak Lak's main economic development is based on the production and export of agricultural and forestry products (accounting for about 60% of GDP). In addition, the province has potential for eco-tourism. Dak Lak is the province with the largest coffee growing area in Vietnam with over 174,740 hectares. The annual output is about 435,000 tons of coffee beans. In addition, the province is also the place where cotton, cocoa, rubber, and cashew are grown on a large area in Vietnam. Dak Lak is also the place where other fruit trees are grown, especially avocado, durian, rambutan, mango, etc.

Currently, Dak Lak coffee and avocado have their own brand.

1.7. Worm prevention and environmental protection in Dak Lak

Since 1975, the people of Dak Lak as well as the Ede ethnic group have received attention from the Party and the State. Many programs and research topics have been implemented to improve people's lives and health.

1.7.1. Some studies describing risk factors affecting worm infection in Dak Lak

- Research by Vu Duc Vong (1992) showed that the rate of ethnic minority students infected with worms was 80.63%, ear, nose and throat diseases were 27.94%, tooth decay was 27.08%, skin diseases were 23.56%, and respiratory infections were 18.8% [111].

- Research by Dao Xuan Vinh (2000) commented on the pollution status of some water sources: 83.05% of well water failed, 90.14% of stream water failed and 76.36% of lake water failed [110].

- According to research by Nguyen Thi Thanh Que (1992), the Ede ethnic group only has 3 meals a day, the number of people eating with their hands is 20.3%, the rate of drinking plain water is 72.8% and 100% drink rice wine mixed with plain water [71].

- Research by Tran Van Trang (2006) showed that the contamination of soil-transmitted helminth pathogens in the outdoor environment of Buon Ma Thuot city is very serious: worm eggs in the soil are 38.25%, on average there are 4.45 worm eggs/10g of soil, mainly roundworm eggs 42.48%, hookworm larvae/beak

22.87%, hookworm eggs/beak 33.98%. In well water 7.5%, spring water 30%, pond water 37.5%, water in jars - tanks 10% and sewers 76.66%. Pathogens of hookworm eggs in Vietnamese coriander 80%, lettuce 76.66%, bitter vegetables 72.5%, mustard greens 70%, coriander - celery 70% [93].

- Research by Vu Van Vung (2008) shows that the economic status of the Ede ethnic group is quite good at 2.29%, average at 82.81%, poor households at 14.90% and no hungry households. Worm infection is high (in 2004) at 99.07%, the malnutrition rate of children under 60 months old is 35.89% [116].

- Nutritional status of ethnic minorities in the Central Highlands, according to the research results of Dang Oanh (2000), the rate of malnutrition in children under 60 months old is 48.58%, of which malnutrition level II and III is 20.87%. The rate of women with chronic malnutrition with BMI <18.5 is 29.1%. According to the standards of the Institute of Nutrition, the amount of Kcal is only 86.91% (2300 Kcal/person/day). The food of ethnic minorities is mainly Glucid, while protein and lipid are only 0.28g/person. The iron content is very low at 9.18mg (normal daily requirement is 15-20mg/day). The rate of anemic women is very high at 87.50% [64].

- According to the study of Vu Duc Vong (2000), the model of a dug toilet with a vent pipe is suitable because: the groundwater level in the Central Highlands is about 15-30 meters deep. Basalt red soil does not collapse, the project can be used for many years with a septic tank depth of 5-9 meters, there is almost no bad smell, the toilet is pre-cast with a concrete slab covering the mouth of the toilet, and can be moved to another location when the septic tank is full [114].

- Ngo Thi Tam (2005), research on the infection rate of roundworm, whipworm, hookworm/beak and some risk factors in the ethnic community of Lak district. The infection rate of worms in the Ede ethnic group is quite high at 76.36%, of which roundworm is 42.08%, whipworm is 39.22% and hookworm/beak is 29.35%, mainly infected with one type of worm 79.6%, two types of worms 17.86% and three types of worms 2.6% [78].

1.7.2. Some research topics on experimental interventions to prevent worms in Dak Lak

The number of research topics on intervention to prevent worm disease in the Ede ethnic community in Dak Lak is still small, mainly simple intervention trials such as health education communication or treatment:

- Regarding the trial of environmental health education communication in an Ede ethnic village by Vu Van Vung [116] in Buon Trap, Ea Hding commune, Cu Mgar district, it was reported that before the study, the worm infection rate was 99.07% (107/108) and after the study 66.86% (115/172).

- The intervention trial using selective treatment alone in the Ede ethnic community in Ea Knuek commune by Nguyen Xuan Thao and colleagues [83], after 2 years, showed that the roundworm infection rate decreased from 37.7% to 7.2%, and the hookworm infection rate decreased from 34.7% to 9.8%.

- Another study of simple specific treatment intervention by Phan Van Trong [98] after 4 months, the hookworm/worm infection rate decreased from 66.7% to 24.7%.

- The vitamin A supplementation and deworming program implemented in Dak Lak for children under 60 months old in December 2007 reached 96% and in June 2008 reached 98.2%.

- Since November 2005, this thesis has conducted research on health education communication and worm infection treatment for the Ede ethnic community as follows:

+ Hoa Xuan commune is one of 21 communes and wards of Buon Ma Thuot city that applies treatment intervention combined with health communication and education. This is a research model that has not been conducted for the Ede ethnic community in particular and the Kinh ethnic community in general in Dak Lak.

+ Ea Tieu commune is a witness commune to monitor research results.

The research results will be presented in the research results section.

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