Chainat: a case study in occupational health and safety promotion for farmers.

The high rates of occupationally related injuries, accidents, and deaths in rural Thailand are of particular concern to public health officials, as well as the residents and workers living in these areas. In response to specific concerns raised by local residents and local health officials in Chainat Province, Thailand, the Work Improvement in Neighborhood Development (WIND) programme was introduced and implemented by means of the local Primary Care Unit (PCU). The objective was to improve farmers' knowledge of methods to improve occupational safety and to reduce the occurrence of occupationally related injuries, accidents, and deaths in the area. Local farmers, public health officers, and health volunteers from the PCU played a primary role in the programme, serving as trainers in the initial training of trainer session. Major activities included visiting a local farm to carry out a check-list improvement activity and active discussion among participants about potential improvements. Following the implementation of WIND in Chainat, a number of significant improvements in work conditions were noted, including construction of resting corners, plans to build toilets in the fields, improved knowledge about the dangers of chemical fertilizers and pesticides, and increased use of personal protective equipment. Furthermore, participants began making organic fertilizer and had independently developed an organic anti-snail pesticide. This integrative approach, achieved by including many different members of the community, in combination with government support and diligent follow-up, has proved to be particularly successful.