Community-Based Health Insurance: An Evolutionary Approach to Achieving Universal Coverage in Low-Income Countries
Community-Based Health Insurance: An Evolutionary Approach to Achieving Universal Coverage in Low-Income Countries
Hong Wang 2 and Nancy Pielemeier 1. Abt Associates Inc. 4550 Montgomery Ave, Suite 800 North, Bethesda, MD 20814, USA
2. Yale University, 60 College St., New Haven, CT 06520, USA
Received: August 16, 2011 / Accepted: October 12, 2011 / Published: March 30, 2012.
Abstract: The WHO World Health Assembly, and the most recent WHO World Health Report, have called for all health systems to move toward universal coverage. However, low-income countries have made little progress in this respect. We use existing evidence to describe the evolution of community-based health insurance in low-income countries through the three stages of basic model, enhanced model, and nationwide model. We have concluded that community-based health insurance development is a potential strategy to meet the urgent need for health financing in low-income countries. With careful planning and implementation, it is possible to adopt such evolutionary approach to achieve universal coverage by extending tax-based financing/social insurance characteristics to community-based health insurance schemes.
Key words: Universal coverage, community-based health insurance, health care financing, financial risk protection.
1. Introduction middle-income ones, have achieved universal coverage by introducing a variety of financial risk
The WHO World Health Assembly of 2005, and pooling systems, most of which include tax-based WHO World Health Report 2010, called for all health financing or/and social health insurance (SHI) systems to move toward universal coverage, defined schemes [3]. In contrast, low-income countries have as “access to adequate health care for all at an made little progress in this regard. Although both affordable price”. A crucial aspect of achieving tax-based financing and SHI schemes exist in universal coverage is to develop a financial risk low-income countries, beneficiaries (breadth) and/or pooling system that provides cross-subsidies in health service coverage (depth) are quite limited [4-7]. systems where ability to pay determines financing Unlike in high- and some middle-income countries, contributions and the use of services is on the basis of the majority of people in low- and middle-income need for care. To expand risk pooling to move toward countries are self-employed, work in the informal universal coverage, user fees and other out-of-pocket sector, or are unemployed, making the formal (OOP) payments must be reduced and the level of economic sector simply too small for tax-based prepayment must be increased [1, 2]. financing or SHI to cover the entire population. Over the past hundred fifty years, many Financial risk pooling systems that are financed high-income countries, as well as some through tax-based financing and SHI schemes are able
to cover only 5%-10% of the labor force and/or Corresponding author: Hong Wang, M.D., Ph.D., principle associate, Abt associate and associate professor, research field:
population in these countries [8]. Their populations health economics. E-mail: hongwang84@gmail.com.
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
still rely mostly on OOP payments (accounting for potential to play a significant role in reaching 30%-85% of total health spending in the poorest
universal coverage, and many doubt that European countries), which are associated with a higher
and Asian success in using the community-based probability of incurring catastrophic health approach to universal coverage can be replicated in expenditure and impoverishment [9]. Health-related
low- and middle-income countries [23, 24]. As a expenses remain the most important reason for
result, scholars and practitioners have expended households being pushed below the poverty line [10,
substantial effort on investigating the effectiveness 11] — it is estimated that globally around 150 million
and sustainability of CBHI schemes, the challenges people suffer financial catastrophe annually because
they face, the solutions for improvement, and the they pay OOP for health services. As a result of
potential role of CBHI in a national financing strategy weaknesses in the health financing system, many of
to achieve universal coverage in low-income the world’s 1.3 billion people on very low incomes
countries.
still lack access to effective and affordable drugs, Based on the rich evidences of CBHI practices surgeries, and other interventions [12].
around the world, we summarized the development of One alternative to covering poor people in the
CBHI as a way to achieve universal coverage in informal sector is community-based health insurance
low-income countries through three stages: the basic (CBHI) schemes [13-14]. Rather than waiting for
model, the enhanced model, and the nationwide model. top-down tax-based financing or SHI development,
We describe the characteristics of each model, as well bottom-up CBHI has been introduced to low-income
as its potential for and challenges to achieving countries over the past two decades [7, 15-17].
universal coverage. We also discuss the strategies and The results, however, have been mixed, especially
measures that could improve CBHI’s effectiveness, in Africa. Initially, proponents hoped that traditional
efficiency, and sustainability. Finally, we introduce small-scale health insurance schemes resembling
the potential of using CBHI to achieve universal coverage by incorporating tax-based/social insurance
those in Germany, Japan, and Britain in the 19th characteristics into CBHI schemes.
century, which operated much like today’s CBHI schemes, would eventually enable universal coverage
2. The Three-Stage Process
in these low-income countries [6, 18, 19]. In addition, Our findings in this review are that to reach implementers believed that the decentralization universal coverage, CBHI needs to be an integral part
process occurring simultaneously in many of the same of a national health financing strategy. Small and countries would empower lower layers of government
independent CBHI schemes must gradually evolve and the local community, thereby reinforcing the
through the three stages, from basic model, to CBHI movement [20, 21].
enhanced model, and eventually to a nationwide After twenty years of implementation experience,
model, along the way addressing the inherent however, many low-income countries, with the
limitations of CBHI. Certainly, not all low-income exception in Ghana and Rwanda, still face tremendous
countries must start CBHI development with the basic challenges in initiating, sustaining, or scaling-up
model and experience the three-stage process. A CBHI. The great majority of current schemes have
country can start at any stage, based on its development enrolled only a small proportion of the eligible
“environment”, which includes its political, social, population. Given their small size and limited
financial, and technical capacity. The key to success is financial protection, few survived for long [22]. As a
how to successfully integrate the characteristics of result, people have become skeptical of CBHI’s
tax-based financing and social insurance schemes into
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
CBHI development. user fees for government health care services, collapse
2.1 The Basic Model of CBHI, although Difficult to of government health care services in certain countries,
Sustain, is the Prototype of Bottom-up Financial and the difficulty of expanding formal health
Protection for the Informal Sector insurance to the informal sector [18]. Both foreign aid
agencies and national governments hope that CBHI CBHI has been defined in various ways [14, 15, 18,
will serve as a mechanism for the transition to 25], and its specific characteristics vary. Nevertheless,
universal coverage [24, 29-31].
these schemes share certain basic features, including The key characteristics of a basic model of CBHI community initiation and operation, voluntary are summarized in Table 1. Countries that developed membership, and prepayment membership contribution.
this model in the early stage of CBHI development Although CBHI has been considered as an
include China, Kenya, Philippines, Tanzania, and innovative financing mechanism for the poor, it is not
Uganda [16, 21, 32-34].
that new. Today’s SHI systems in Germany, Japan, Since CBHI was introduced in low-income and Belgium, and tax-based financing scheme in
countries, its potential has been recognized. This Britain grew out of small-scale community-based on
potential includes: (1) Making financial risk schemes that would meet the definition of CBHI [4, 6,
protection mechanisms available to the informal
18, 26]. In some Asian countries, such as Thailand sector and to the close-to-poor segment of the and China, CBHI initiatives came about independently
population, thus increasing equity by reducing the in the 1960s, 1970s, and 1980s to help fill gaps in
social protection gap with the formal sector; (2) coverage of public financing mechanisms. These
Raising awareness and knowledge of the value of schemes provided improved access to services and
insurance; (3) Fostering and facilitating prepayment income protection measures for people in informal
from informal sector workers; (4) Reducing patients’ sectors in both rural and urban areas. Some of these
OOP spending; (5) Increasing health service countries have reached or almost reached universal
utilization; (6) Improving cost-recovery in health coverage in terms of depth (benefit coverage) and/or
care facilities; (7) increasing resource mobilization breadth (population coverage) of the coverage.
for health from general population through a Rather than being locally initiated by the informal
prepayment mechanism; (8) Creating experience in sectors in Asia, or by the associations of industrial
managing risk pooling arrangements; and (9) workers or employers in Europe, CBHI schemes in
Building confidence in risk pooling among Africa are mostly the imported interventions of
participants through their direct experience in foreign aid agencies or national governments [27-28]
limiting abuse and fraud through strong community that are trying to mitigate the effects of increases in
control mechanisms [7, 18, 23, 35-37].
Table 1 Key characteristics of a basic mod el of CBHI.
Community supports At the community level defined by geographic, professional, or ethnic groups
Participation
Voluntary
Revenue collection
Source of revenue
Membership prepayment
Health financing
Participants within a local community functions
Risk pooling
Risk pooling
Fund management
Managed by community committee or local health provider
Outpatient or inpatient or both at local level Service purchasing
Service coverage
Purchase mechanism Fee-for-service, capitation
Country examples China, Kenya, Philippines, Uganda, Tanzanie
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
Despite this potential, researchers and implementers collapse or evolve into the enhanced model of CBHI have also pointed out critical shortfalls that affect the
[16, 21, 32-34].
effectiveness, efficiency, and sustainability of this
2.2. Enhanced CBHI, although still Difficult to Scale model, which include: (1) The bottom-up initiation of up, Provides an Effective and Sustainable Model of most CBHI schemes means they may not be
Health Financing for the Informal Sector recognized (supported politically or/and financially)
initially by governments at the regional and national Most lasting CBHI schemes have modified the level. The absence of political endorsement, characteristics of the basic model by adopting legitimacy, and financial and management supports
enhancement strategies (Table 2). Local government may undermine a scheme’s stability; (2) The model
political endorsement, including the poorest of the starts small (with as few as 500 members), thereby
poor through government subsidies, and building undermining its potential to provide broad benefit
networks for scheme management and service coverage and financial risk protection; (3) Voluntary
delivery are some of the new key characteristics. participation can lead to adverse selection that
Countries that have developed this model include undermines the financial sustainability of the scheme;
Rwanda (before institution of a nationwide model), (4) Because the informal sector’s ability to pay is
Mali, Senegal, Uganda, and China [6, 44-49]. relatively low, scheme reliance on membership
In addition to offering the benefits of the generic financing limits scheme funding levels, and in turn
CBHI model, the enhanced model has potential for this limits benefit coverage, scheme attractiveness to
additional advantages: (1) Government political participants, and finally their rate of participation; (5)
endorsement increases CBHI’s political Even a small membership payment (premium) can
stability/legitimacy; (2) Government and/or other exceed the capacity to pay of the poorest of the poor,
donors’ subsidies increase scheme capacity to reach who are then left out of the scheme; (6) Most CBHI
the poorest of poor, thereby increasing the equity of schemes cannot afford professional management,
CBHI coverage; (3) Government also may provide which can lead to the instability of the scheme; and (7)
financial support or a re-insurance mechanism to
A limited scheme—with little funding and few protect against expenditure fluctuations and maintain members—makes it hard to link with formal provider financial sustainability; (4) Small schemes form a
networks to negotiate lower-cost and higher-quality regional or national network that can provide services [23, 35, 38-43].
professional technical and managerial support on The basic CBHI model exists mostly at the early
design and management. A network can also facilitate stage of scheme development. Then, most schemes
re- insurance and political advocacy; (5) A group
Table 2 Key characteristics of the enhanced model of CBHI.
Community supports At multi-community/regional level with local government political and financial endorsement
Both non-poor and poor in a local community Revenue collection
Participation
Source of revenue
Non-poor pays premium, government subsidy for the poor or/and financially support re-insurance mechanism
Possible cross-subsidy among communities with Health financing
Risk pooling
functions Risk pooling
re-insurance mechanism
Fund management
Community management by a network of technical support
Service coverage
contract with provider network
Service purchasing
Purchase mechanism
Start to introduce capitation, case-based payment, in addition to fee-for service payment mechanism
Country examples Rwanda (before nationwide model), Mali, Senegal, Uganda, and China
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
enrollment requirement will reduce adverse selection; and (6) Introduction of other payment mechanisms to control costs, and case management techniques, will limit expenditure fluctuations [41, 44, 47, 50-53].
All of these efforts make the enhanced CBHI scheme relatively more effective, efficient, and sustainable, but there still are challenges to the enhanced model being scaled up to a nationwide scheme and made part of a national health financing strategy that achieves the goal of universal coverage. Some of these challenges are similar to those faced in the basic model, though they are less severe. These challenges include the following: (1) Lack of political, financial, and technical commitment and stewardship at the national level prevents isolated schemes from scaling up to that level; (2) Fragmentation of a large number of separate small funders (many small insurance schemes) limits broader risk pooling; (3) Financial risk protection is still constrained by limited membership contributions from low-income informal sector members (scheme reimbursement covers only about 30%-40% of total spending) [54]; (4) Contribution capability and benefits may not be consistent across schemes, which leads to the inequity in health financing and service access; (5) Though networks may increase scheme management capability and service availability, lack of professional and standardized management limits scheme efficiency and effectiveness; and (6) Ability to ensure the availability of the service, to improve the quality
of service, and to control the cost of service remains limited [6].
2.3 Nationwide Scheme: A Top-down Consolidation Strategy Makes Full CBHI Scale-up Possible
Conceptually, the nationwide CBHI approach is consistent with the linkage approach [13, 55] or extending approach [56, 57] proposed by the international social security society. This stage identifies the links between CBHI schemes and public financing, lays out the strengths and weakness of each category of financial risk pooling mechanism, and proposes to strengthen CBHI by extending to it, the characteristics of tax-based financing or social insurance schemes. New characteristics of a nationwide scheme are summarized in Table 3; government political commitment, stewardship, legislation, and funding support, regional-level professional management, and continuing community-level supports are a few of the key characteristics. Countries that have developed a nationwide model include China, Ghana, Rwanda, and Thailand [16, 47, 58, 59].
Adopting these characteristics makes this third-stage CBHI a national health financing strategy for achieving universal coverage in low-income countries. Its potential can be summarized as follows: (1) Political commitment, stewardship, and guidance, along with legislation and regulation backup and
continuing strong community supports in terms of
Table 3 Key characteristics of a nationwide model of CBHI.
Community supports
Political commitment and stewardship at national level with legislation backup
Health financing functions
Revenue collection
Participation Majority of the targeted population nationally, with continuing community-based supports
Source of revenue Government financial subsidy to the scheme for administration and/or service coverage
Risk pooling
Risk pooling
Cross-subsidy within community with risk-equalization mechanism
Fund management Professional management with the strength of community participatory roles
Service purchasing
Service coverage
Standardized comprehensive benefit package
Purchase mechanism Capitation, case-based payment, Global budget, or/and performance-based payment
Country examples China, Ghana, Rwanda, Thailand
Community-Based Health Insurance: An Evolutionary Approach to Achieving Universal Coverage in Low-Income Countries
resource mobilization and fraud and abuse controls, enable scale-up of CBHI nationally; (2) Increasing the size of risk pools at the regional or higher level and establishing risk equalization mechanisms to allocate the resources across insurance schemes allows for cross-subsidy between high-risk and low-risk regions. Government function of resource redistribution ensures equity of benefits across rich and poor regions; (3) Government regular budget support makes additional financial resource available and sustainable. It is unlikely that rural or informal sector populations enrolled in CBHI schemes have sufficient funds to fully finance their own care, and accordingly CBHI should be supplemented by the government health care budget rather than displacing government health care financing. This regular government budget support is needed to continue to subsidize the CBHI premium for the poor, in order to increase the benefit coverage and participation rate of the targeted population; (4) Increased government leadership and financial and technical support enhances CBHI management capacity and helps control overhead costs; (5) Strategic service purchasing makes the scheme more effective and efficient; and (6) Government establishment and implementation of monitoring and evaluation systems ensures scheme performance makes the scheme more sustainable [1, 6, 18, 22, 35, 47, 60-62].
Though this nationwide model displays the potential that is scaling up CBHI for achieving universal coverage, it still faces challenges that could affect its long-term sustainability. It must devise ways to: (1) Continue to increase enrollment rate by reaching hard-to-reach populations without introducing mandatory mechanisms; (2) Control the costs of health services; (3) Ensure long-term financial sustainability; and (4) Integrate CBHI with other existing health insurance schemes, such as tax-based or SHI covering formal sector populations.
3. Discussions
3.1 CBHI Development is a Potential Strategy to Meet the Urgent Need for Health Financing in Low-Income Countries
The WHO member states have endorsed universal coverage as an important goal for the development of health financing systems. Nevertheless, there is no “one size fits all” strategy for achieving this goal. In addition, most low-income nations see achieving universal coverage as a long-term task, whereas they have immediate need for flexible short-term responses to their urgent health financing protection problems. Indeed, the approach that each country takes will be determined partly by its own history and how its health financing system has developed, as well as by social preferences relating to concepts of solidarity [1].
International experience has shown that many developing countries, such as Colombia, Mexico, and the Republic of Korea, have reached or nearly reached universal coverage with top-down public health financing approaches, i.e., tax-based financing and/or social insurance schemes, without experiencing CBHI development. However, these approaches have been successful only in the countries that have reached a relatively high level of economic development, are more urbanized, and have wage sectors larger than the informal sectors [37]. In addition, even where public financing schemes are established, the self-employed, unemployed, and destitute were only covered at a later stage [13]. Consequently, these countries may not be the most relevant models for today’s low-income countries, especially in Africa. Furthermore, in Africa in particular, public financing constraints may prevent tax-based financing and SHI from extending coverage in the short run.
Based on systematic review and analysis, this paper suggests that although CBHI, especially in its initial stages, may be limited in terms of efficiency, effectiveness, and equity in financing and service delivery, as well as sustainability, it might be the most
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
feasible starting point from which to approach the goal Thailand and China, and low-income countries such of universal coverage in low-income countries. That is,
as Ghana and Rwanda, have already passed through rather than wait for the top-down approach of
these stages and successfully transformed their expanding formal public health insurance to the
community-based scheme to full or near achievement informal sector, the bottom-up approach of CBHI can
of universal coverage.
help accelerate the achievement of universal coverage. It is worth repeating that not every low-income country must pass through every stage. Countries
3.2 A Three-Stage Process of CBHI Development has could introduce the enhanced model or nationwide
the Potential to Lead toward Universal Coverage model from the beginning, if the required
To become an integral part of a nation’s health development “environments”, including political, financing strategy, CBHI has to evolve from the basic
social, financial, and technical capacity, already exist. model to an enhanced model, and eventually to a
3.3 Community Participation Plays an Important Role nationwide model. Introducing the characteristics of
Even in the Nationwide Model
tax-based financing and social insurance, such as government/employer financing, mandatory As we have described, to reach universal coverage, enrollment, and professional management at the
small and independent CBHI schemes likely evolve regional/national levels rather than at the community
through the three models, addressing limitations along level, is the key to a successful transition (Fig. 1).
the way until they become a nationwide model that This paper provides practical recommendations on
incorporates the characteristics of tax-based financing how to adopt characteristics that are inherent in the
and social insurance scheme. Some people may argue public financing models to transform fragmented
that nationwide model no longer belong CBHI CBHI initiatives toward achieving universal coverage.
category. Regardless, the local community continues Many high-income countries such as Germany, Japan,
to play a critical role. Similar to a formal sector and the Britain, middle-income countries such as
employer, the informal sector community links people
Nationwide model
ev •Government political el commitment,
stewardship, legislation,
and funding support
or
Generic
•Government political
•Regional level
professional management
to c •Government subsidy
•Community level
om
•Community initiation
to the poor and to
mobilization, abuse and
fraud control
and operation
catastrophic risk
it y
•Voluntary
•Network for
participation
management and
service delivery •Membership contribution
Tax-based/social insurance characteristics
Fig. 1 Three-step evolution process using CBHI to achieve universal coverage.
Community-Based Health Insurance: An Evolutionary Approach
to Achieving Universal Coverage in Low-Income Countries
into a “group” using its “social capital”, i.e., the Connor, Christine Ortiz, and Sheila O’Dougherty for degree to which it shares values and is prepared to
helpful comments on earlier drafts. support communal structures and pool resources.
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Comparison of GFR by Creatinine Clearance with Estimated GFR by Various Prediction Equations in a Bangladeshi Population
1 2 3 Muhammad Saiedullah 1 , Muhammad Rezwanur Rahman , Md. Aminul Haque Khan , Shoma Hayat and Shahnaj Begum 1
1. Department of Biochemistry & Cell Biology, Bangladesh Institute of Health Sciences (BIHS), Dhaka 1216, Bangladesh 2. Department of Biochemistry, Delta Medical College, Dhaka 1216, Bangladesh 3. Department of Biochemistry, Enam Medical College, Dhaka 1340, Bangladesh
Received: August 16, 2011 / Accepted: October 12, 2011 / Published: March 30, 2012.
Abstract: Glomerular filtration rate (GFR) is considered as the best marker of kidney function. Evaluation of various prediction equations to estimate GFR is rare in our population. The aim of this study was to compare GFR estimated by various prediction equations with GFR by creatinine clearance (GFR cr ) in Bangladeshi population. Serum creatinine and 24 hours urinary creatinine concentrations were measured in 216 adult Bangladeshi subjects (100 males and 116 females). Creatinine clearance rate was calculated
and adjusted for body surface area to obtain GFR cr . GFR was also calculated by CKD-EPI, MDRD 4 , Cockcroft-Gault, Jelliffe, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations and compared with GFR cr . Results were expressed as mean ± SD and compared by two-tailed paired t-test, precision (r 2 ) and receiver-operating characteristic curve. Mean ± SD of age of the total subjects was 57.15 ± 10.96 years. The mean GFR cr was 42.41 ± 22.95 mL/min/1.73m 2 . Estimated GFR (eGFR) by CKD-EPI, MDRD 4 , Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations were 8.19 ± 13.80, 5.30 ± 13.61, 11.54 ± 16.86, 8.66 ± 18.64, 17.25 ± 19.98, 10.86 ± 22.48, 14.60 ± 17.92, 12.18 ± 16.42, 39.86 ± 21.96 and 20.47 ± 20.49 mL/min/1.73m 2 higher than GFR cr (P < 0.001). The precision (r 2 ) of eGFRs were 0.7114, 0.6924, 0.6431, 0.4802, 0.5048, 0.5921, 0.6286, 0.6158, 0.1635, and 0.5586 for CKD-EPI, MDRD 4 , Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai and Mayo Clinic prediction equations, respectively. The area under receiver-operating characteristic curve was the lowest for MDRD 4 equation. This study revealed that GFR estimated by standardized MDRD 4 variables equation is closer to creatinine clearance rate in the study population.
Key words: Glomerular filtration rate, estimated GFR, creatinine clearance rate, CCR, MDRD.
1. Introduction inulin in GFR measurement is disadvantageous because measurement of inulin clearance rate requires
Glomerular filtration rate (GFR) is considered as the constant intravenous infusion to maintain plasma best marker of kidney function. The recommended steady state level, analysis of inulin is technically time gold standard method to measure GFR is the inulin consuming, labor intensive, costly and unsuitable for clearance rate [1]. Inulin is a polymer of fructose, outpatient use. Infusion of non-radio labeled contrast metabolically inert, can be freely filtered by media (iothalamate/iohexol) has also been used to glomerulus, and is neither reabsorbed nor secreted by measure GFR [2-4]. Cumbersome measurement makes renal tubules and cleared only by the kidney. The use of it unsuitable for clinical practice. A number of
51 125 Corresponding author: Muhammad Saiedullah, M.Phil.,
I DTPA) senior scientific officer and lecturer, research field:
radio-labeled compounds ( Cr EDTA,
have also been used to measure GFR [5, 6]. These biochemistry. E-mail: md.saiedullah@gmail.com.
Comparison of GFR by Creatinine Clearance with Estimated GFR
by Various Prediction Equations in a Bangladeshi Population
chelates cannot be used routinely due to radiation, cost for Windows and Pearson’s correlation coefficient and specialized settings of gamma camera and skilled
between variables were determined by STATISTICA personnel. A less cumbersome method to measure GFR
version 8 for Windows.
is the creatinine clearance rate (CCR). This method is
3. Results and Discussions
advantageous because creatinine is an endogenous marker and its renal tubular reabsorption is negligible
Two hundred and sixteen subjects were included in and produces similar results to inulin clearance rate.
this study. Of the total study subjects, 100 (46.3%) But 24 hours total urine collection makes it subjects were males and 116 (53.7%) subjects were incompatible. Hence several prediction equations to
females. Mean ± SD of age of the total subjects was calculate GFR using serum creatinine, age, sex, race
57.15 ± 10.96 years. Of the total study subjects, etc., have been developed and are being used in
cr ≤ 60 mL/min/1.73 m . The mean population based studies and in clinical practice.
79.63% had a GFR
value of serum creatinine was 1.61 ± 0.77 mg/dL and Evaluation of various prediction equations to 2 GFR
cr was 42.41 ± 22.95 mL/min/1.73 m . estimate GFR is rare in our population. The aim of this
The mean ± SD of eGFRs were 50.60 ± 25.55, 47.71 study was to compare GFR estimated by various
± 23.86, 53.95 ± 28.21, 57.01 ± 29.40, 54.59 ± 26.22, prediction equations with GFR by creatinine clearance
82.27 ± 15.72, and 62.88 ± 30.53 mL/min/1.73m 2 (P < (GFR cr ) in Bangladeshi population.
0.001) for CKD-EPI, standardized MDRD 4 , Cockcroft-Gault, Jelliffe 1, Jelliffe 2, Mawer,
2. Materials and Methods
Bjornsson, Gates, Apollo-Chennai and Mayo Clinic The study was conducted in the Department of
prediction equations respectively. The correlation Biochemistry and Cell Biology, Bangladesh Institute
coefficients of eGFRs with GFR cr were 0.8434, 0.8321, of Health Sciences (BIHS), Dhaka, Bangladesh during
0.8019, 0.6930, 0.7126, 0.7695, 0.7928, 0.7847, the period of February to December 2010. Serum
0.4043 and 0.7474 (P < 0.001) for CKD-EPI, creatinine and 24 hours urinary creatinine standardized MDRD 4 , Cockcroft-Gault, Jelliffe 1, concentrations were measured by Vitros 250 Jelliffe 2, Mawer, Bjornsson, Gates, Apollo-Chennai Chemistry System (Ortho-Clinical Diagnostics, Inc.,
and Mayo Clinic prediction equations, respectively. USA) in 100 males and 116 females of adult
Mean difference between GFR cr and eGFR Bangladeshi subjects. The calibration of creatinine was 2 (GFR
cr -eGFR) and precision (in terms of r ) were traceable to isotope-dilution mass spectroscopy presented in Table 1. ROC curve, sensitivity,
(IDMS), the reference method of creatinine specificity and area under ROC curve (AUC) for measurement. CCR was calculated and adjusted for
CKD-EPI and MDRD 4 were shown in Fig. 1 in the total body surface area to obtain GFR by creatinine (GFR cr )
study population.
[7]. GFR was also calculated by CKD-EPI (traceable to eGFRs calculated by all prediction equations were IDMS, omitting the factor for black) [8], standardized
5.30 to 39.86 mL/min/1.73m 2 higher than GFR cr in the MDRD 4 (omitting the factor for black) [9], total study population. The differences were Cockcroft-Gault (adjusted for body surface area) [10],
statistically highly significant (P < 0.001). Mean Jelliffe [11, 12], Mawer [13], Bjornsson [14], Gates
difference between GFR cr and eGFR was the highest [15], Apollo-Chennai [16] and Mayo Clinic [17]
for Apollo-Chennai equation (bias ± SD: -39.86 ± prediction equations and compared with GFR cr . Results
21.96, P < 0.001) and the lowest for standardized are expressed as mean ± SD, compared by two-tailed
MDRD4 variable equation highly significant (P < paired t -test, precision (r 2 ), receiver-operating 0.001). Precision (r 2 ) of the CKD-EPI equation was characteristic (ROC) curve using GraphPad Prism 5.03
higher than MDRD 4 equation (0.7114 vs. 0.6924). But
Comparison of GFR by Creatinine Clearance with Estimated GFR
by Various Prediction Equations in a Bangladeshi Population
Table 1 Comparison of eGFR with GFR cr .
eGFRs
Mean difference (GFR -eGFR) r 2 cr
MDRD 4 -5.30 ± 13.61***
Mayo Clinic
S e 0.4 Sensitivity 0.2454 Specificity 0.7963
e 0.4 Sensitivity 0.2778 Specificity 0.7963
AUC=0.5712; 95% CI: 0.5173-0.6252; 0.2 P=0.0003
AUC=0.6003; 95% CI: 0.5471-0.6534;
1 - Specificity
1 - Specificity
Fig. 1 Receiver-operating characteristic curves for CKD-EPI (A) and MDRD 4 (B) equations in the total study population. Sensitivity and specificity were determined at the cut-off value of 60 mL/min/1.73 m 2 of GFR.
CKD-EPI was higher than the difference between eGFR prediction equations had been compared and GFR cr and MDRD 4 (-8.189 ± 13.80 vs. -5.304 ± 13.61
evaluated in different populations. Study carried out in ml/min/1.73m 2 ). It was evident from the ROC curve
African [18], Indian [19], Pakistani [20], Japanese
[21-23], Korean [24], and Thai [25] populations CKD-EPI equation (0.5712 vs. 0.6003). Since the
that the AUC value for MDRD 4 was lower than that of
showed that prediction equations were needed to be mean difference between GFR cr and eGFR were higher
modified or developed to estimate GFR in their own than the mean difference between GFR cr and CKD-EPI,
population. Since significant differences between and precisions were lower than other equations, so that
eGFRs and GFR cr were observed in this study, did not analyze the ROC curve for those equations. The
prediction equation should be validated or modified or sensitivity value of the CKD-EPI equation at the
developed using gold standard method. But the cut-off value of GFR (60 mL/min/1.73m 2 ) was higher
MDRD4 variables equation (standardized to IDMS, for
non black) can be used to estimate GFR from serum (0.2778 vs. 0.2454). Hence, in respect to least mean
than the sensitivity value of the MDRD 4 equation
creatinine, age, sex in our population.
difference, AUC and sensitivity, standardized MDRD 4
4. Conclusion
variable equation appeared to be more accurate than CKD-EPI and other prediction equations to estimate
GFR calculated by various prediction equations was GFR in our population.
significantly higher than GFR by creatinine clearance
Comparison of GFR by Creatinine Clearance with Estimated GFR
by Various Prediction Equations in a Bangladeshi Population
rate and standardized MDRD 4 variables equation
estimation of creatinine clearance from unstable serum creatinine levels, age, sex, and weight, Mathematical
appeared to be more accurate than other prediction
Biosciences 14 (1972) 17-24.
equations in the population studied. [12] R.W. Jelliffe, Creatinine clearance: Beside estimate (letter), Annals of Internal Medicine 79 (4) (1973)
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The International Research Group in Geophysics Europe Africa: A Laboratory without Borders in the Earth Science and Environment
Christine Amory-Mazaudier LPP/UPMC/Polytechnique/CNRS, 4 Avenue de Neptune 94107 Saint-Maur-des-Fossés, France
Received: August 30, 2011 / Accepted: October 14, 2011 / Published: March 30, 2011.
Abstract: It was in 1995 that, at the end of the international project IEEY (International Equatorial Electrojet Year), African and European scientists decided to create the IRGGEA (International Group in Geophysics Europe Africa) in order to pursue the scientific work started during the IEEY project. The main objective of IRGGEA was to introduce new fields of research in Africa and built teams of African scientists recognized at an international level in these new fields. To reach this goal, we developed days after days methods to manage smoothly a large network of scientists from developed and developing countries. After a short introduction on the field of research developed in the IRGGEA, we present the organization of the work based on sharing practices and the results obtained in terms of scientific publications and socio-cultural aspects as the increase of the number of women and positions for students in their countries. Such an experience is easy to reproduce.
Key words: Scientific network, ethical rules, geophysics, sustainable research, Africa.
1. Introduction electromagnetic waves in the Earth’s environment), magnetometers (measurements of the Earth’s
It was at Vancouver, in 1987 that Interdivisional magnetic field), ionosondes (measurements of Commission for Developing Countries (ICDC) of electronic densities in the Ionosphere altitude 90 km International Association for Geomagnetism and to 500 km), meteorological stations (atmospheric Aeronomy (IAGA) planned an international campaign pressures, temperatures, winds …), satellites (various on the equatorial electrojet (1992-1994) [1]. geophysical parameters), etc. [2]. In 1995 a research group (IRGGEA) involving Later in 2005, scientists from Vietnam and Burkina African and European scientists was created to pursue Faso joined the IRGGEA to participate to the the work. The fields of research of the IRGGEA are International Heliophysical year (IHY) [3-6]. More dynamics, electrodynamics and electromagnetism in recently, in 2010, scientists from Egypt, Congo the Earth’s environment (from 50 km deep in the Brazzaville and RDC joined the IRGGEA to ground up to 1,500 km height) and the following cooperate in the framework of the International Space various disciplines of external and internal geophysics:
Weather Initiative (ISWI) [7].
atmospheric dynamics, ionospheric studies, the This paper relates the story of this group which Earth’s magnetic field, telluric electric fields etc.We increased during the two last decades by a factor of use high technology tools as radar HF (propagation of
10 (20 →200). Four sections composed this paper. The first one is devoted to the method used to
Corresponding author: Christine Amory-Mazaudier, Ph.D., organize the work, the second section to the senior scientist, research field: science of the planet. E-mail:
christine.amory@lpp.polytechnique.fr. scientific projects and scientific results obtained by
The International Research Group in Geophysics Europe Africa:
A Laboratory without Borders in the Earth Science and Environment
the students, the third one to female scientists in the 1990, after thirty years, there is no team of African IRGGEA, and the last one gives the composition of
scientists working in external geophysics in West this group in June 2010.
Africa. This is due to many sociological and political factors, but also to the organization of the work. If it is
2. Method: Work Based on Ethical Rules
difficult to change quickly the sociological and political
and Sharing Practices
parameters, it is easier to change the organization of the We have to take into account the fact that we are all
scientific work through international projects. dependent on each other (see the recent eruption of the
Table 1 [8] gives the factors preventing a good Eyjafjöll volcano in Iceland which disturbed air flight
development of research in the Earth’s environment at traffic over Europe and as a consequence over the
the planetary scale. These factors can be overcome world), this fact implies that research on the Earth’s
with sharing practices.
environment must be developed at a planetary scale We have to organize the scientific world in order to taking into account factors concerning south countries
help all scientists to participate in advances in as well as north ones.
knowledge.
The method developed to organize the work was Table 2 [8] presents the organization of the work. derived from the analysis of the situation in the
Scientific teams in developing countries received African countries colonised by France, before 1960.
instruments from scientific teams or institutions from From 1960 until 1987, French scientists were involved
developed countries and they share data and results in geophysics studies in West Africa, and finally, in
(Fig. 1).
Table 1 Factors Preventing a Good Development of Research in the Earth’s Environment.
Taking into account several facts concerning research in Taking into account several facts concerning research in developed countries
developing countries
The need of observations over the whole world to do global The impossibility to stay in their country to do research in studies
particular fields
creation of observatories in the Southern hemisphere to develop research in developing countries The fact that satellite and ground observatories are
The lack of data to do research in their country complementary
creation of observatories in the Southern hemisphere creation of observatories in the Southern hemisphere
sharing practices between developed and developing countries The constant increase of research fields
The need of books, reviews, computers etc... more researchers in the Southern hemisphere
sharing practices between developed and developing countries For all disciplines the multitude of tools
the difficulty to publish in an international scientific journals sharing practices between developed and developing countries sharing practices between developed and developing countries The constant increase of data base and our impossibility to analyze all the data
Etc...
sharing practices between developed and developing countries A change is needed
Table 2 Organization of the Work.
The method to maintain the project is developed day after day in accordance wither the situation We organize training in several disciplines in the project
teaching in management and data base organization teaching in history of geomagnetism and aeronomy we follow the students and help them to enter in the international community the students are involved in the project and can propose new development we maintain communication with a newsletter and keep contact with all the participants We consider that we are in the same laboratory: “ An International Laboratory without frontiers” We share knowledge, books, financial support etc.
The IGRGEA has no direct financial support. The IGRGEA establishes and maintains connections between research teams in different laboratories in Europe and Africa. The IGRGEA organize scientific projects, data base, research, training and teaching, communication between the research teams.
The International Research Group in Geophysics Europe Africa:
A Laboratory without Borders in the Earth Science and Environment
Work in an International Laboratory :
Table 3 proposes some ethical rules to apply in the
International programmes
Observation of the whole planet (satellite and ground measurements )
framework of international scientific projects in order
We organize
to balance the North and the South contribution to the
Campaigns of measurements
world evolution.
at places where data are
The first objective of the IRGGEA is to develop
Many data bases
instruments
scientific teams of research excellence in developing
with gap in specific areas
No Experiment in
countries. To reach this objective, the students are
specific area
trained in the framework of international project and read their Ph.D. when they have published several
papers in international scientific journals.
Large data bases with a good coverage of the whole planet
There is a necessity for global studies in Earth’s environment
The IRGGEA is an interdisciplinary group of
Work in an International Laboratory : LWB
scientists and the Ph.D. subjects are chosen at the
To share data and knowledge
frontiers of different disciplines as for example
• Personnel in an open structure of existing laboratories
external and internal geophysics or solar and
ionospheric physics etc.
Scientists
Scientists students students
3. Scientific Projects and Scientific Results
The IRGGEA was involved in two international
L6 1 student
projects and is presently participating to a third one:
Research managing team Communicating informations (letter)
3.1 IEEY: International Equatorial Electrojet Year
Driving individuals, Solving problems
The first scientific project was the international
Fig. 1 Organization of the scientific network.
Equatorial Electrojet Year (IEEY 1992-1994) [1]. The It is a necessity for all scientists working on the global
scientific topics were the study of the equatorial system, to have access to large planetary data in the
electrojet (electric current circulating along the Earth’s base of study physical processes acting in the Earth’s
magnetic equator at the altitude 100-120 km), environment at the scale of the planet. In the
ionospheric dynamics and ionization (spread F), framework of heliophysics (introduced during the IHY)
ionospheric irregularities, telluric electric field, we need data base at the scale of our solar system.
electromagnetic coupling between the pole and Fig. 1 illustrates the network: scientists from
equator, etc.
various countries and various disciplines work
3.2 IHY: International Heliophysical Year together in the framework of international scientific
projects. A team manages the network, solves the The second project was the IHY (2007-2009) [4] problems and informs (by a quarterly letter) all the
(http://ihy2007.org).
participants of the development of the project.
The scientific topics were:
In each country there is a leader (small star, Fig. 1) “* To understand the processes and drivers that who participates with a local committee to the
affect the terrestrial environment and climate; development of the research in his country.
*To provide a global study of the Sun-heliosphere Sometimes there is an isolated scientist: he connects
system outward to the heliopause; other scientists and can participate to the training of
* To foster international cooperation in space students in developing countries.
science now and in the future;
The International Research Group in Geophysics Europe Africa:
A Laboratory without Borders in the Earth Science and Environment
Table 3 Ethical rules.
This kind of human experience can be reproduced by many researchers in various countries, various disciplines by following the following proposals:
To develop scientific projects with developing countries by campaigns of measurements in developing countries; To create observatories in developing countries supported financially by an ‘international laboratory without frontiers’; To introduce ethical rules and sharing practices in scientific projects: as 20% of the financial support of the project for training
and teaching in developing countries; To organize research at a planetary scale by researchers including the participation of researchers from developing countries in all steps of organization; To develop access to data base for researchers in developing countries (computer, internet ...); Twining of Universities to share knowledge and projects; International scientific journals free for Universities in developing countries; Etc…
It is not necessary to change everything, just to introduce new practices.
* To communicate the unique scientific results of scientists from the southern countries who are from the IHY to the scientific community and to the public”
seven countries (Benin, Burkina Faso, Côte d’Ivoire, [5, 6].
Egypt, India, Senegal and Vietnam). The four Ph.D. in the Northern countries was read in France and Spain.
3.3 ISWI: International Space Weather Initiative Table 5 gives the variations of the number of
The third project is the ISWI (2010-2012) publications. It shows clearly an increase of the (http://www.iswi-secretariat.org).
publications in the international journals from 12 for The main objectives are [7]:
the period 1990-1995 to 29 for the period 2005-2010.
“Develop the scientific insight necessary to This table also highlights that the number of understand the science, and to reconstruct and forecast
publications with the first author from Northern near-Earth space weather: instrumentation, data countries is quasi the same (11, 11, 12, 9), and on the analysis, coordinate data products to provide input for
other hand the number of publications with a first physical modeling, coordinate data products to allow
author from the Southern countries increases (1, 4, 7, predictive relationships to be developed;
20). This is explained by the fact that the training is Education, training, and public outreach: university
mainly assumed by scientists from Northern countries and graduate schools and public outreach”
who are introducing new fields of research in southern ISWI as IHY and IEEY projects is based on ethical
countries. They are helping their students to publish as rules and sharing practices; the deployment of
Table 4 Publications.
scientific tools over the world is pursued. ISWI as
1st author 1st author IHY is sponsored by United Nations Committee on
Type
Total:
North + South South North the Peaceful Uses of Outer Space (http:// Paper 75 32 43
0 19 www.oosa.unvienna.org).
Proceeding 19
14 4 The results obtained by the IRGGEA scientists lead
Ph.D. 18
Reports 404 to the publications of 75 papers in international
journals with reviewers, 19 proceedings, 18 Ph.D.
Table 5 Percentage North/south (first author).
Period North South North + concerning 16 students (two students defended two South
1 12 Ph.D.) and four technical reports.
1990-1995 11
4 15 Table 4 gives the contribution of the scientists from
1996-2000 11
7 19 the Southern countries: they signed 32 papers as first
2001-2005 12
2005-2010 9 20 29 author (42, 6%). Fourteen Ph.D. were read by
Total 43 32 75
The International Research Group in Geophysics Europe Africa:
A Laboratory without Borders in the Earth Science and Environment
the first author. It is also important to recall here that In June 2010, 17 Ph.D. were in progress in Burkina the scientists for Northern countries are working part
Faso (4), Côte d’Ivoire (7), Vietnam (5), and Senegal time in the IRGGEA.
(1), and there are four female students and 13 male From 1995 until 2010, 18 Ph.D. were defended by
students i.e. 23, 5%. The female students are in students from different countries (Benin, Burkina Faso,
Burkina Faso (1), in Senegal (1) and in Vietnam (2). Côte d’Ivoire, Egypt, Spain, France, India, Senegal,
The scientist women from Burkina Faso and Vietnam and Vietnam), 16 have a position in their countries,
had already a position in their countries. The CNRS and there are seven new positions (the other has the
(French National Research Centre) employs 11,595 position during their Ph.D.). Two young scientists left
researchers in all the disciplines and 3,035 in our field geophysical research after their Ph.D. to do computer
department (http://www.cnrs.fr). Women scientists in sciences. Only two female students read Ph.D., one in
geophysics are 27%. The IRGGEA was successful France and one in Egypt.
during the past decade to increase the number of In June 2010, 17 Ph.D. were under progress, eight
young scientist women in geophysics and nearly students have already a position in their country. The
reached the CNRS level.
subjects covered by the Ph.D. and articles are:
5. Composition of the IRGGEA—June 2010
* Vietnam monsoon, * Long term variations in the equatorial ionosphere
Tables 6 and 7 give an overview of the increase of
at the magnetic equator and on the tropical ionization
Table 6 Students in IRGGEA.
crests in Asia, Country Males Females * Long term variations in magnetic activity,
Algeria
* Total electron content during maximum and
Benin
Burkina Faso
minimum sunspot cycle,
Cameroon
* Solar action on geomagnetism,
Egypt England
* Equatorial electrojet,
France
* Regular variation of Sq magnetic field in
Gabon
Vietnam,
India Italia
* Ionosphere disturbance dynamo,
7 * Terrestrial movements of the Earth’s crust
Côte d’Ivoire
Niger
14 5 stations in South-East Asia,
deduced from continuous measurements of GPS
* The Franco-Egyptian year, space weather, 1
* Use of GPS data to estimate the water vapor
Russia
content of the troposphere,
1 * Climatology of gravity waves activity,
Rwanda
Senegal
* Equinox transition at the magnetic equator, etc. South Africa 41
Spain
Six African students have been appointed as
1 University professors in Ivory Coast, Benin and
Uganda
USA
Burkina Faso. The perenniality is assured.
Vietnam
Bold underlined: Ph.D. in progress (17);
Bold: students who follow a training organized by the By the past, from 1992 until 2009, there were two IRGGEA (21); Italic: students who follow a training of a teacher of the
4. Progress of the Number of Women
female students (12.5%) and 14 male students. IRGGEA (training not organized by the IRGGEA).
The International Research Group in Geophysics Europe Africa:
A Laboratory without Borders in the Earth Science and Environment
Table 7 Professors in IRGGEA.
IRGGEA after their Ph.D. (two of them left their Country Males Females
country). On the 16 students trained in the IRGGEA, Algeria
12 12 are now scientists in their countries in geophysics. Benin
1 Seven students obtained a new position after their Cameroon
Burkina Faso
2 Ph.D. (Benin: 1, Egypt: 1, France: 1, Côte d’Ivoire: 3, Egypt
2 1 India: 1), for the other they had their positions when England
1 they did their Ph.D..
1 5. Conclusions
India 1 +1 Italia 1
The IRGGEA created in 1995 still exists. This is Côte d’Ivoire
due to the organization of the work. It is an open Niger
1 laboratory without well defined geographic and RC
Nigeria 2 +3
3 thematic borders and the projects are adapted to the RCI
request of scientists from southern countries. During RDC
21 the last few years, the IRGGEA increased and became Russia
Rwanda planetary, this is the result of the international projects Senegal
as IHY and ISWI. Indeed in the framework of these South Africa
31 projects many workshops and schools were organized Spain
1 in Africa (http://kuiper.colorado.edu/, http:// Uganda USA
5 ww.ihy2007.org) and isolated scientists joined the Vietnam
IRGGEA network. Another interest of such project is Bold: Professors in the IRGGEA (37);
the participation of well known scientists of other Bold underlined: student who obtained a position in research
groups to the training of students of the IRGGEA after their Ph.D. and are working now in the IRGGEA (12);
during workshops.
Bold, in brackets: students who left after their Ph.D. (3);
Bold with a *: student who died after the Ph.D. (1). The IRGGEA was successful in the increase of scientist women in developing countries but also in the IRGGEA. In 2006, the IRGGEA included nine
the development of teams of research in Africa. countries [6]; today scientists from 24 countries are
Recently, at the end of 2010, the group of Space connected to the IRGGEA. Tables 6 and 7 give in
Weather of Helwan University joined the IRGGEA. In bold the number of students and professors who are
this team 75% of the students are females (13 among training or trained in the IRGGEA. The numbers in
17): the proportion of female students in the IRGGEA italic are given the number of students and professors
increases and approaches now the parity. connected to the IRGGEA in the framework of the
The starting country for the IRGGEA was the Côte international projects (as students trained by d’Ivoire and at the present time there is a team of 13
professors of IRGGEA or professors training students scientists at the University of Abidjan. Then the of the IRGGEA during international schools). Table 6:
IRGGEA extended to Vietnam (Asia) in 2005 then to the bold numbers underlined correspond to Ph.D. in
Central and North Africa.
progress.
Acknowledgments
Table 7: the bold numbers underlined correspond
to student who obtained their Ph.D. and are now This scientific network was and is still supported by working in the IRGGEA. Three students left the
African Universities, French Foreign Agency, French
The International Research Group in Geophysics Europe Africa:
341
A Laboratory without Borders in the Earth Science and Environment
embassies of the different African countries, [5] Davila, J., N. Gopalswamy, H.J. Haublod, B. Thompson, International Heliophysical Year 2007: Basic space CNRS/DRI, United Nations, MICROSOFT, IUGG, science initiatives, Science Direct, Space Policy 23 (2007) AUF, NASA, CNES, and all the laboratories of the
121-126.
different participants to this scientific network see
C. Amory-Mazaudier, M. Le Huy, Y. Cohen, V. http://www.girgea.org.
[6]
Doumouya, A. Bourdillons, R. Fleury, et al., Sun Earth System Interactions over Vietnam: An international
References
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Weather Initiative, Oct. 4, 2009. Year: The African sector, Brazilian Journal of
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[8]
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[3] B. Thompson, N. Gopalswamy, J.M. Davila, H.J.
C. Amory-Mazaudier, Women in an international Haubold, Putting the “I” in IHY, The United Nations
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geophysics research laboratory without borders, in: Report for the International Heliophysical Year 2007,
International Conference on “Women’s impact on Springer Wien New York, 2009.
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Journal of Life Sciences 6 (2012) 342-347
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
Nickolay Pechurkin and Lydia Somova Institute of Biophysics SB RAS, Siberian Federal University, Krasnoyarsk 660036, Russia
Received: July 19, 2011 / Accepted: September 02, 2011 / Published: March 30, 2012.
Abstract: Exponential increase of anthropogenic impact (human population number, some technological parameters) becomes menacing for biosphere functioning. Anyway, we should be able to estimate quantitatively limits of our impact on functional parameters of the biosphere. Considering biosphere as a natural life-support system (LSS), we can receive the helpful information for working out and creation of artificial LSS of various types. Big biotic cycle induced with flows of a solar energy, is a basis of functioning of the biosphere and its basic cells-ecosystems. It’s possible to summarize briefly the main functional and structural properties of the biosphere: integrity, closure, substance cycling, steady state, energy dependence and biodiversity. These properties of the biosphere, as a LSS, ensure potentially everlasting life under the conditions of a limited quantity of substrate suitable for the life on the planet. Ecological Footprint (EF) as a quantitative measure of anthropogenic impact on biosphere functioning is discussed in the paper. The index of the ecological reliability (IER) is introduced as a quantitative ecological indicator of different territories. The comparative dynamics of the United Nations’ Human Development Index (HDI) and EF is discussed. The vital goal of sustainable human development: all humans can have opportunity to fulfill their lives without degrading the biosphere. To support sustainability, we should try to develop each nation and the mankind as a whole with a high HDI and a low ecological footprint. It means to have high level of HDI at low level of EF. But current tendency of economical and social development shows that the higher HDI is, the bigger EF is. EF of mankind is growing menacingly. Now actual pressure of the human civilization of our planet (2010) upon 50% exceeds its potential possibilities biological capacity (BC), measured on the area “global” green hectares). It means that we need 1.5 planets of the Earth’s type. It leads to ecological incident in the scale of biosphere. Our biosphere is the large, multilevel, hierarchically organized system, and our civilization is only a part of it. This part is not central; it can disappear for ever, if we do not cope to be included in the biosphere as a great system.
Key words: Biosphere, ecological footprint (EF), biological capacity (BC), human development index, index of the ecological reliability.
1. Introduction biosphere. A real basis for functioning of the biosphere and its basic cells-ecosystems are biogeochemical
As a component of the biosphere, the mankind cycle induced with continuous flows of a solar energy. became the most powerful and active link recently. The biosphere has very high factor of closure of Exponential growth of anthropogenic impact of human substance circulation. It’s possible to summarize population number and of many technological briefly the main functional and structural properties of indicators of its development becomes menacing for the biosphere: integrity, closure, substance cycling, steady (stationary or close-to-stationary) functioning of steady state, energy dependence and biodiversity [1]. the biosphere as a single whole. We are to be able to Integrity : The biosphere possesses properties of a estimate quantitatively limits of possible single system as the organisms included in it are all anthropogenic impact on functional parameters of the related to each other through intensive material exchange.
Closure : Material exchange of the basic biogenic Corresponding author: Nickolay Pechurkin, Ph.D.,
elements, carbon, in particular, is almost absolutely professor, research fields: ecology and environment protection.
E-mail: nsla@akadem.ru.
confined to the biosphere.
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
Cyclicity : Material exchange in the biosphere goes with planet Earth’s BC to regenerate [2]. EF represents on in essentially closed cycles. For different elements
the amount of biologically productive land and sea area the degree to which the cycle is open can vary, but it
needed to regenerate the resources a human population does not exceed a fraction of a percent for a cycle.
consumes and to absorb and render harmless the Steady state : Rates of cyclic processes are in mutual
corresponding waste. BC refers to the capacity of a equilibrium, so that current values of live biomass and
given biologically productive area to generate an essential biogenic element concentrations of the
on-going supply of renewable resources and to absorb environment vary about equilibrium constants over
its spillover waste. It is measured in Global Hectares long periods.
(GHa). GHa is a hectare with world average productivity. Energy dependence : The biosphere which is far
Unsustainability occurs if the area’s ecological from equilibrium in terms of thermodynamics can exist
footprint exceeds its biocapacity. BC and EF can be only because solar radiation energy in the optical range
measured per capita, per region, per country, per flows through it continuously. This energy is captured
planet. Using this assessment (human EF versus BC in photosynthesis and then, after a number of
of the Earth), it is possible to estimate how much of transformations in living and bio-inert bodies, is
the Earth (or how many planets of Earth’s size), it dissipated into heat.
would take to support humanity if everybody lived a Biodiversity as a structural property is the degree of
given lifestyle.
variation of life forms within a given ecosystem, biome, In particular, EF per capita, represents the sum of six or an entire planet. Biodiversity in ecological and
components: (1) the area of an arable land for grain social systems is a form of resilience (key component
cultivation, (2) the area of pastures for production of of adaptation). Biodiversity is one measure of the
animal product, (3) the area of forest for wood and health of ecosystems as LSS (The United Nations
paper manufacture, (4) the area of the sea for fishing declared the year 2010 as the International Year of
and seafood, (5) the territory occupied under habitation Biodiversity). The period, since the emergence of
and an infrastructure, and (6) the “green” area (for humans displayed is ongoing reduction in biodiversity,
example, forest) for absorption and utilization of waste is caused primarily by human impacts, particularly the
(for example, emissions of СО 2 ). destruction of plant and animal habitat.
EF method allows comparing the actual pressure of a These properties of the biosphere, as a LSS, are to be
society upon the nature and possible (admissible) studied and properly used to ensure potentially
pressure from the point of view of potential natural everlasting life under the conditions of a limited
resources and assimilation processes. Regularly, global quantity of suitable substrate on the planet. But the
footprint network calculates the EF of the world’s selfish mankind is able to destroy harmonic adjustment
nations and humanity as a whole, and compares that of this unique natural mechanism.
with biocapacity, the amount of resources nature is able EF is to be a quantitative measure of anthropogenic
to produce. According to these reports [3-5], the global impact on biosphere and its basic cells-ecosystems
ecological footprint reached the Earth’s limit in the last functioning.
half of the 1980s, and is continuing to rise each year.
2. Results and Discussions
Some data for 2006 are presented in the Table 1. According to comparative values of EF and BC, all
2.1 EF and BC countries can be divided into two big parts: resource
The EF is a quantitative measure of human demand demand nations and resource supply nations. Now on the Earth’s ecosystems. It compares human demand
actual pressure of the human civilization of a planet
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
(2010) upon 50% exceeds its potential possibilities Negative (per capita) IER indicates the condition of (biological capacity, measured on the area “global”
the overshoot for many regions and for the world as a green hectares). It means that we need 1.5 planets of
whole. According to ecological definition, “overshoot” the Earth’s type. EF of the average consumer from the
is a situation where resource consumption and waste developed countries of the world in 3-6 times exceeds
production is higher than the Earth’s carrying capacity. corresponding indicator of the consumer from the
Overshoot is only possible because we deplete resource countries with low per capita incomes.
stocks that the Earth has accumulated in the past at vast different environmental conditions. Mainly, oil, gas,
2.2 The Index of the Ecological Reliability (IER) and coal were accumulated as a result of incomplete
The IER can be introduced in the quantitative form: closure of “previous biospheres” action. Now we IER = (BC – EF)/BC
utilize these stocks with the rates much quicker than the It can be characterized by some features: (1) The
rates of their accumulations. The ecological axiom says index (IER) is dimensionless. (2) It becomes negative
that: overshoot leads to decrease in the carrying if the EF exceeds BC. (3) On its size, it is easy to
capacity. It means that turning resources into waste estimate to compare quantitatively the impact of
faster than waste can be turned back into resources different technologies. Some quantitative indicators for
leads to depleting the resources on which our life big regions of our planet are presented in the Table 2.
depends. In accordance with EF definition, inevitable
Table 1 Comparative data on EF and BC values for different countries.
Countries EF (hectares/capita) BC (hectares/capita) BC is less than EF (resource demand nations) United States
Japan 4.89 0.60 Germany 4.23 1.94 China 2.11 0.86 Vietnam 1.26 0.80 India 0.89 0.41 BC is greater than EF (resource supply nations) Australia 7.81 15.42 New Zealand
Canada 7.07 20.05 Sweden 5.10 9.97 Russian Federation
Chile 3.00 4.14 Venezuela 2.81 3.15 Gabon
Table 2 Some quantitative ecological indicators for big regions of the Earth (2006).
(BC-EF)/BC Region
Index (2006) EF BC BC-EF
EF/BC
(global Ha per capita) (global Ha per capita) (global Ha per capita) (demanded number of planets) (IER)
The world
1.44 -0.44 Africa 1.4
1.5 -0.5 North Am.
3.0 -1.5
1.52 -0.53 Lat. Am + Caribes 2.4
8.7 5.7 -3.0
0.44 +0.56 Oceania 5.8
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
results are harp decreasing fisheries, diminishing forest HDI and EF. First, HDI is a measure of country’s cover, depletion of fresh water systems, and the buildup
average achievements in the areas of economy and of carbon dioxide emissions, which creates problems
social development: health, knowledge, and standard like global climate change. These are just a few of the
of living. It tells us that an HDI higher than 0.8 is most noticeable effects of overshoot. Overshoot also
considered “high human development”. When HDI is contributes to economical and social tragedies: resource
less than 0.5 the level of development is unsustainable. conflicts and wars, mass migrations, disease and other
Second, EF is an indicator of human impact on the problems. In general, it’s decreasing Human nature. For example, an EF less than 1.8 global hectares
Development Index (HDI) and increasing the poverty. per person makes a country’s resource demands
2.3 HDI globally replicable. If EF is higher than 1.8 global hectares per person, the country is a resource demand
The United Nations’ HDI is a measure of country’s nation and its existence is a danger for the sustainability average achievements in the areas of health, knowledge,
of other nations of the planet. The ultimate goal of and standard of living. It measures longevity, volume
sustainable human development: all humans can have of knowledge and level of economy, necessary for each
opportunity to fulfill their lives without degrading the individual for development of his (her) possibilities (It
biosphere. Comparison and identification of these two is the weighed sum of these three items. It cannot
indicators can help us to find minimal conditions for real exceed unit and each item cannot exceed 1/3).
sustainable human development. Direct comparison of Concepts—human development and HDI as a EF and the UN HDI shows significant variations in method of its measurement—have been entered United footprint among countries that have achieved high Nations Development Program in 1990 in “The Report human development. There is a positive correlation
on Development of the Person” [6]. The concept of between them: the higher HDI is, the greater EF is. But
human development is focused on the person also if we plot country’s EF against the HDI a wide spectrum
proclaims well-being of the person the basic and the
of data can be received (Fig. 1).
unique purpose of development. The idea of development consists in expansion of possibilities of a
The curve can be represented in the form of the choice by the person, instead of in reception of the
exponent or ascending hyperbola which income by it. Use of a complex indicator human
mathematically directs to infinity at HDI equal unit. At potential allows dividing the countries on groups with
the left end of the spectrum, below a horizontal line, various level of human development. Without strict
there are countries that we can consider as dependence from level of economic development (be it
“unsustainable,” with a low EF and a low HDI (mainly, industrial or developing countries) to the countries with
Africa countries). This is a type of the “social”
a high level of human development concern in which unsustainability. On the other (right) end, there are HDI is equal to or higher than 0.8; to the countries with
countries with both a large EF and a high HDI (OESD an average level of human development, those, in
countries, USA, Japan). These too can be considered as which 0.5 < HDI < 0.8; to the countries with low level
“unsustainable” because of their high footprint. This is of human development in what HDI < 0.5.
a type of the “ecological” or “environmental” unsustainability. In the middle part of the spectrum are
2.4 Comparison of HDI and EF countries that may be called “quasi-sustainable”. Now
Considering the biosphere of the Earth as a LSS for they have relatively small footprint at mid-range HDI mankind, we should compare these two main indicators:
values. But many of them are on rapid way toward the
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
y = 63,348e 0,1296x
Fig. 1 EF, global Ha per capita x 100 of different countries versus their HDI × 1000. Below a horizontal line there is an area where EF is less, than BC. To the right of a vertical line-area, where HDI is above, than 0.8. The small area on the right below, is a sustainable development zone.
upper right, environmentally unsustainable area. we consume and how we produce and use energy” , Mankind as a whole, having EF the equal 2.6 and HDI
said Jim Leape, Director General of WWF the equal 0.624, also is in the instability area. The
International. “And why our EF is growing sustainability area, with high HDI (not more low than
menacingly”, can we add. We should understand that
0.8) and small EF (not above 1.8 global hectares per discussed problems are in many respects the problems person) is empty. It will be practically empty if we cite
of a survival of our civilization. And many of them are data on all countries of the world. To support
not the problems of the biosphere. Voluntarily or not, sustainability, we should aim to develop each nation
the mankind interferes in big biotic cycle and modifies and the mankind as a whole with a high HDI and a low
it. For example, extracting mineral fertilizers for ecological footprint.
cultivation of agricultural crops, we return in circulation lost before substances, type nitric, potassic,
3. Conclusions
phosphoric salts, limiting growth of a green link of the According to UN projections for population growth,
biosphere. Burning fossils of organic carbon (oil, gas, consumption and climate change, by 2030 humanity
coal), we return carbon into cycling and raise will need the capacity of two Earths to absorb carbon
concentration of carbon dioxide in atmosphere. dioxide waste and keep up with natural resource
Increasing emission СО 2 , we raise biosphere’s consumption. “Somehow we need to find a way to meet
biocapacity. The melting of permafrost connected with the needs of a growing and increasingly prosperous
activity of mankind is capable to lead to excretion of population within the resources of this one planet. All
other greenhouse gases, in particular, methane. Even of us have to find a way to make better choices in what
additional emission of the greenhouse gas dangerous to
The Effect of Anthropogenic Increase on the Earth as a Life-Support System for Mankind
347
us, methane leads to returning in cycles of the Reducing Human Impact on the Earth, New Society Publishers, 1995,
biosphere the carbon before preserved in permafrost. [3] Living Planet Report, http://wwf.panda.org/about_our_ea
The biosphere is the large, multilevel, hierarchically rth/all_publications/living_planet_report/living_planet_re organized system, and our civilization is only a part of
port_timeline/lpr2006/.
it. This part is not basic; it can disappear for ever, if we [4] Living Planet Report, http://wwf.panda.org/about_our_ea rth/all_publications/living_planet_report/living_planet_re
do not manage to be included in the biosphere as a
port_timeline/lpr2008/.
super system. “We are jeopardizing our own [5] Living Planet Report, http://wwf.panda.org/about_our_ea livelihoods and well-being”, said Wackernagel who
rth/all_publications/living_planet_report/2010_lpr/. introduced the term “Ecological Footprint” [7]. The
[6] United Nations Development Program, Report on Development of the Person, 1990.
biosphere is not aimed to be transformed into trivial LSS [7] M. Wackernagel, C. Monfreda, D. Moran, P. Wermer, S.
for the selfish humankind. We should develop more Goldfinger, D. Deumling, et al., National Footprint and intensively the interdisciplinary science “Biospherics”
Biocapacity Accounts 2005, The Underlying Calculation [8-10]. So, we need to “think inside the box”.
Method, Global Footprint Network, 2005. [8] J. Allen, M. Nelson Space Biospheres, Synergetic Press,
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[9] N.S. Pechurkin, Biospherics as a new science, Life [1]
I. Gitelson, G. Lisovsky, R. MacElroy, Manmade Closed Support Biosphere Sci. 1 (1994) 85-88. Ecosystems, Taylor and Francis, London and New York,
[10] N.S. Pechurkin, Quantitative criteria for the estimation of 2003, pp. 1-399.
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Res. 35 (2005) 1507-1511.
Journal of Life Sciences 6 (2012) 348-352
A Note on the Current Status of Arin, a Yoruba Traditional Game Played with the Seeds of Dioclea Reflexa
Toye Ekunsanmi Department of Biological Sciences, University of Wisconsin, WI 53095, USA
Received: August 29, 2011 / Accepted: October 13, 2011 / Published: March 30, 2012.
Abstract: One of the traditional games played among the Yoruba people of South Western Nigeria utilizes the seeds of Dioclea reflexa. An investigation into the current status of the game was conducted to determine the extent to which it is still played. Although results indicate that the game is still being played in the rural areas, it also shows that it is steeply decreasing in popularity. About 6.6% of respondents interviewed have never heard of the game, while about 77% have played, or still play the game. Overall 17% of all respondents, or 22% of those who have ever played, still play the game. About 26% of respondents are optimistic about the game surviving their generation. The decline in popularity is attributable to decreasing proportion of youths in rural areas due to rural-urban migration, emergence of computer games, and scarcity of the seeds. Cultivation of D. reflexa plant for the game, food and medicinal purposes is recommended.
Key words: Dioclea reflexa, seed, game, Agbaarin, status.
1. Introduction
important traditional means of entertainment, especially in the evenings.
The use of plants for recreational purposes is a Though quite interesting and entertaining, much global practice. However, one of the least visited areas less is known about the Arin game which is played in this respect is the use of plant materials for games. with the seeds of Dioclea reflexa. Unlike Ayo, Arin The Yorubas, of South Western Nigeria share a game which is played more by the elders, is more commonly played with the seeds of Caesalpina bonduc with many played by children and young adults. There is, parts of the Africa, Asia and some other parts of the however, no age restriction and spectators are usually world. The board game locally called Ayo in Yoruba, is of all age groups. While Ayo is more mentally an example of games played using plant seeds. The Ayo challenging, Arin is more a game of physical skill. game is a member of the family of games generally According to J.M. Dalziel [3], the game is also played known as Mancala [1]. The game, or any of its variants, in other countries of West Africa. The plant—Dioclea is known by a variety of names in other place. For reflexa Hook f., or D. hexandra. Ralph (Mabb), example, it is known as Oware in Ghana [2]. Although commonly called Sea Purse or Horse Eye, which has the game is played using a variety of objects, including been reported by Smith [4], has originated from Asia, stones, the seeds of Caesalpina bonduc are used among moved to the Caribbean islands and subsequently the Yorubas. Until the present time, it remains an dispersed by sea to tropical countries. The seeds are
known to be common in coastal areas [3]. They are Corresponding author: Toye Ekunsanmi, Ph.D., associate
found particularly interesting by beachcombers. professor, research fields: antimicrobial and general
ethnobotany. E-mail: toye.ekunsanmi@uwc.edu. Nonetheless, the plant seems to have become well
A Note on the Current Status of Arin, a Yoruba Traditional
Game Played With the Seeds of Dioclea reflexa
established hundreds of miles inland, even though the interesting when very few or just one seed is left name “Sea Purse” implies that the plant grows in
standing on each side. The marksmanship as well as the coastal areas.
amount of spinning motion achieved by a player is The game is usually played on plain, preferably
considered the hallmark of his skill. The first side to smooth and bump-free terrains, by two opposing teams,
knock off the last standing seed wins. or rarely individuals. Both teams share equal number of
In the past few decades, the popularity of the game seeds, which are then arranged in identical patterns at
seems to be declining in all parts of Yoruba land. The opposite ends, eight to nine meters apart. In one of the
possibility of its complete extinction is becoming more styles, a tiny seed is placed in front of a single row of
apparent. This study was undertaken to investigate the the other seeds and is regarded as the “guard”. A team
current status of the Arin game, and to explore its starts with a single spin of a seed in the direction of the
possible continued existence by future generations in opposing team. Only one seed could be taken off
this region.
through a hit scored by the spin, even if multiple seeds
2. Materials and Methods
were displaced. The knocked off seed is then added to the seeds to be tossed, causing the number of seeds
Seed specimens were collected during the months of being tossed to and fro to increase progressively, as the
January and February, from farmlands in Ilesa suburbs number of seeds in the rows dwindle. Consequently,
in Osun state, South Western Nigeria. Fig. 1 shows the the gaps between seeds in the row widen, make it more
pods and seeds of Dioclea reflexa. Interviews and difficult to score hits.
questionnaires were administered to determine the In order to score a hit at this stage, it is important for
number of individuals in rural and urban areas who had the players, not only to aim properly, but also to
played or still played the game. Data were collected achieve a spinning motion which makes it more likely
from the individuals about their age, occupation and for a hit to occur. The real suspense is achieved when a
place of residence-rural or urban. Other factors spun seed spins back and forth on the ground and
investigated included whether or not the subjects had eventually knocks off one of its targets in an almost
ever played Arin. If they had ever played it, they were dramatic fashion. Thus, it becomes even more
asked about how long and how often they played, or if
Fig. 1 The pod and seeds of Dioclea reflexa used in Arin game.
A Note on the Current Status of Arin, a Yoruba Traditional
Game Played With the Seeds of Dioclea reflexa
they still played the game. Their opinions were also available in the rural areas, since the rain-forest type of sought about what could have contributed to the
vegetation which supports the growth and maturity of apparent decline in popularity of the game in their
Dioclea reflexa was still available there. locality. Finally, subjects were asked to express their
Only 18% of all the respondents still played the optimism or lack of it for the continued existence of the
game, which amounted to 22% of those who had ever game, and what could be done to revamp it.
played it (Fig. 3). An expected age-related analysis indicated that 69% of people below age 40 had ever
3. Results and Discussions
played the game, whereas 85% of those above 40 had. From the data obtained, Arin was still played in
This showed that the members of the younger many parts of Yoruba land, especially in the rural areas.
generation were less exposed to the game. In fact, all the subjects living in rural areas has either
Considering those who still played the game, the played or still played it. In contrast, only 28% of those
result portrayed the habit as being age-related. Among living in urban areas had ever played the game. This + the 40 group, only 7% responded as still played the
was not unexpected, since the game had always been game, while about 29% of those under 40 years old more popular among suburban populations. A still did. summarized distribution of the respondents’
Overall, it was clear from the results that the game experience of Arin game was shown in Fig. 1.
was declining in popularity. Reasons given by Although only 77.36% of respondents had ever
respondents for this trend included lack of time to play, played the game, 100% of those who lived, or still lived
declining number of youths in the rural areas and in the rural areas had participated in the game at one
emergence of alternatives, including electronic games. time or another. Obviously, the existence of the game
Others included the unwillingness to crouch on the in rural areas was still sustained. One reason might be
ground with the consequence dirtying of apparels. A that the terrains suitable as venues for the game could
summary of individual’s responses was given in Table 1. still be easily carved out (Fig. 2). As earlier mentioned,
rural areas where it was still played until now. The the ideal site for playing was smooth, compact plain
game had been gradually supplanted by other games ground without concrete or other forms of paving.
even before the advent of electronic games. For Concrete grounds were less adequate for sustained and
example, playing soccer in the evenings, either as smooth spinning of the seeds, which made the game
schools or as community teams, could be more much more interesting. Also, the seeds were more
attractive to the active youth than the sedentary Arin
Fig. 2 Simulation of how Arin game is played (distance is shortened here for photograph purposes).
A Note on the Current Status of Arin, a Yoruba Traditional
Game Played With the Seeds of Dioclea reflexa
Ever heard
Fig. 3 Arin game encounter among respondents.
Table 1 Individual Reasons for Decline in the Playing of Arin
enhance its popularity.
Game.
Only about 26% of those who were familiar with the Individuals’ reasoned opinion for decline
in the playing of Arin game
game expressed the optimism that it would survive Lack of time
Respondents (%)
52 their generation in their local areas, while the majority Existence of other options
72 thought that it would not. Other games played with Do not find game interesting
Seeds no longer available
53 plant seeds, as mentioned, had been converted to cyber It is out of date
34 games. The possibility of doing this also existed for the No adequate space
21 Arin game. This, however, might not be the best
game. Some of the reasons given by respondents were alternative from a sociological point of view, such as would be expected in a society, where
considering that the traditional form of the game rural-urban migration had been ongoing for more than
always served as a means of bringing a good fraction of
a century. The reasons included lack of time to play, the members of the community together. While which was characteristic of the urban living style.
computerization might preserve its awareness and The game was very popular in the typical farming
history, it might not reflect the original fervor and sense communities. It was one of the recreational activities in
of community the game usually creates. However, since the seeds themselves were used as soup
the evenings after the day’s work. thickeners in some parts of West Africa [5] , in addition
One reason for declining interest in the game expressed by only 3% of the respondent was,
to having some medicinal uses [6], preserving the plant nonetheless, considered important. This group itself became as important as preserving the game. At complained that playing it “soils their garment”.
present, the plant was rarely, if ever cultivated in West Obviously this was one of the shortcomings of the
Africa or elsewhere, and the possibility of extinction game, since the player had to either knee or stoop low
was quite high, due to deforestation and other human on a dirt ground to spin the seed. This obviated a need
activities. Cultivation of the plant would increase the to introduce some modernization to the game, if it was
availability of the seed for game, medicinal or food to continue being played in the traditional way.
purposes. The leaves of the plant had also been shown Creating a clean, dirt-free arena for the game might
to have a broad spectrum of antimicrobial activity [7].
352
A Note on the Current Status of Arin, a Yoruba Traditional
Game Played With the Seeds of Dioclea reflexa
4. Conclusion
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139.
and widespread with adequate modifications. For [4] R.J. Smith, Botanical beads of the world [Online], 2003, p. recreational purposes, it was also possible to make
76. http://www.botanicalbeads.com/. synthetic replicas of the seed, which could be used
[5] A.I. Akinyede, I.A. Amoo, A.F. Eleyinmi, Chemical and instead of the natural seeds. The plant could then be functional properties of full fat and defatted Dioclea reflexa seed flours, Journal of Food Agriculture &
cultivated for its variety of other uses, including food, Environment 3 (2) (2005) 112-115. medicinal and ornamental purposes, while still [6] A.A. Yusuf, A.A. Lasisi, Compositional analysis of
preserving the heritage of the game. horse-eye (Dioclea reflexa) seed flour and its cake, Agricultural Journal 1 (1) (2006) 28-31.
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