Abstract

Background Divers and fishermen in Chile’s small-scale fishing communities lack basic occupational safety and health. We aimed to evaluate potential long-term effects on cognitive function among divers in southern Chile and to address occupational health problems at the community level. This approach was then part of a pilot training project on basic occupational health for rural communities of Latin America. Methods Quantitative and qualitative research methods were applied. Publication one refers to the participatory approach in diagnosing working conditions and health in the fishing community. The second contribution is a cross-sectional study on the evaluation of the executive function of shellfish divers and its relationship with the history of decompression illness. The last publication reports on the implementation and evaluation of the pilot training project which was applied in four rural communities of Latin America. Results Failures in executive function of divers were related to their history of decompression illness. A network built by the former paramedic of the rural post connecting fishermen, authorities and stakeholders was recognized by the community as the driving force to avoid fatalities due to the disease in the past. Having health personnel trained in handling and preventing the disease is a current community’s need. After implementing the pilot training project, the lack of occupational health knowledge among rural health workers, intersectorality in addressing multiple health-related factors in rural areas, and local public policies addressing occupational health in primary care were the major findings. Conclusion Community participation and involvement of primary health care are essential to provide basic occupational safety and health for workers in small-scale fisheries and other rural communities. To make this feasible and sustained, an integrated vision of human health and the training of health professionals in such vision, along with public policy integrating workers’ health into primary health care are needed in Latin America.