Malaria in the Dominican Republic: A spatial analysis of risk and vulnerability

During the 1990s, the Dominican Republic experienced economic growth which reached a high of 6% per year by 2000. At the same time, malaria incidence dramatically increased, rising two- to three-fold in different parts of the country. This paper examines the relationship between development and malaria vis-à-vis the dynamics of social and environmental change in a southeastern province of the Dominican Republic over the last decade. Two distinct approaches to development serve as the departure point for this exploration. Socio-environmental factors including land use and the extent of land cover change associated with sugarcane monoculture and tourism are explored in relation to malaria distribution by using remotely-sensed data and GIS techniques. Analyses are conducted using statistical and geo-spatial methods, and interpreted through a qualitative framework. The process of developing tourism, specifically the construction that serves as a precursor, introduces factors that heighten the malaria risk to the surrounding populations without providing resources to mitigate the threat. Malaria dynamics in and around resort communities show two marked trends. During the initial construction phase, malaria cases peak. These peaks are quickly controlled and overall vulnerability to malaria declines for those within the resort communities, but malaria does not end. The risk is pushed to proximal communities. These communities lack the resources to respond to the malaria danger, and thus prove highly vulnerable to sustained transmission. The hazard stems from environmental and social change. In contrast, risk in the agriculturally-based communities has changed little over the course of ten years. These populations are less vulnerable to malaria than communities which are near tourist facilities. The most vulnerable communities, however, consist of migrant laborers found in both agricultural and tourist settings. These pockets of vulnerability are created largely through social inequity. This analysis is undertaken with an end goal being the formulation of policy to address immediate and long-term vulnerabilities.