Protecting our Health from Climate Change: a Training Course for Public Health Professionals Chapter 3:Population’s Health and Climate Change in South East Asia

Outline

   

South East Asia is disaster prone The most vulnerable Climate-sensitive health outcomes Exacerbating current burden of disease

South East Asia Region

130°0'0"E 70°0'0"E 80°0'0"E 90°0'0"E 100°0'0"E 110°0'0"E 120°0'0"E 140°0'0"E DPR KOREA INDIA NEPAL BHUTAN BANGLADESH MYANMAR THAILAND SRI LANKA MALDIVES INDONESIA 70°0'0"E 80°0'0"E 90°0'0"E 100°0'0"E 110°0'0"E 120°0'0"E TIMOR-LESTE 130°0'0"E 140°0'0"E

The Region is Vulnerable to Climate Sensitive Health Stressors

     

44% of all disasters, globally 1996-2005: 57% of people killed globally in natural disasters were from SEAR countries Indonesia, 2007: 3 flood events; 4 landslides; 2 tornadoes Maldives, May 2007: high tide floods Bangladesh November 2007: Super cyclone SIDR: 4,000 dead, millions affected Myanmar, May 2008: Cyclone Nargis, 135,000 perish

Photo: http://cache.daylife.com/imageserve/02fAd1d1tWeAW/340x.jpg

Population Estimates for 2025 in Southeast Asia Country

Bangladesh Bhutan Democratic People's Republic of Korea India Indonesia Maldives Myanmar Nepal Sri Lanka Thailand Timor-Leste SEA total UN Department of Economic and Social Affairs, 2009

2025 (thousands)

206,024 819 25,228 1,447,499 271,227 411 55,374 38,855 20,328 68,803 2,011 2,136,579

% of world population

2,6 0,01 0,3 18,5 3,4 0,005 0,7 0,5 0,3 0,9 0,03 27,1

“Adverse health impacts will be greatest in low-income countries. Those at greater risk include, in all countries, the urban poor, the elderly and children, traditional societies, subsistence farmers, and coastal populations (high confidence).” (IPCC AR4, 2007)

Global Warming Impacts on Climate and Risk Factors

      

More extreme weather events: storms, cyclones Heat waves: more frequent, more intense, and longer Air pollution: increase in levels of ground ozone, more allergens Rapid glacier melting: landslides, flash floods, and reduced water availability Disturbed rainfall patterns: more droughts, more extreme precipitation events, floods, and disrupted water supply Warmer temperatures: warmer minima Sea-level rise: inundation, saltwater intrusion, loss of land

Climate Change Impacts on Health: Increase in Climate Sensitive Health Outcomes

     

Injuries, disability, drowning Heat stress Water and food-borne diseases Malnutrition Vector-borne diseases Psychological stress

Photo: http://southasia.oneworld.net/ImageCatalog/climate-picture.jpg

More Injuries, Disabilities, and Drowning from Extreme Weather Events

Photo: ©Abir Abdullah/Still Pictures Photo: ©Abir Abdullah/Still Pictures 9

Adding to the Existing Burden

Myanmar: Nargis 2008 India: “Super-cyclone” 1999 shattered lives and livelihoods of 12 million people in Orissa Bangladesh: Cyclone SIDR, 2007 Photo: xanthis.wordpress.com

http://media.economist.com/images/20080906/3608AS2.jpg

Drowning: A Leading Cause of Child Death in Many Asian Countries

  

More than 175,000 children and teenagers die from drowning each year Children under the age of 5 years are most at risk Most child drowning events happen in and around the home

World Health Organization, 2008c

More Heat Waves and Heat Strokes

Photo: © T. Balabaadkan UNEP / Still Pictures Refugee Study Centre (RSC), http://www.rsc.ox.ac.uk

 

2003 Andhra Pradesh, India heat wave, with temperatures of up to 54 least 3,000 lives o C, took a toll of at The number of heat strokes was not recorded

More Respiratory Infections



Air pollution: Meeting increasing energy demands by greater use of fossil fuels will increase in ground ozone levels and allergens

Photo: © Deb Kushal -UNEP / Still Pictures

Rapid Glacier Melting = Less Freshwater

http://msnbcmedia3.msn.com

Himalayan Major River Basins

The Water Tower of Asia

River Indus Ganges Brahma Irrawaddy Salween Mekong Yangtze Yellow Tarim Total Area sq km Mean discharge (m 3 /s) % of Glacier melt in river flow 1,081,718 1,016,124 651,335 413,710 271,914 805,604 1,722,193 944,970 1,152,448 5,533 18,691 19,824 13,565 1,494 11,048 34,000 1,365 44.8

9.1

12.3

unknown 8.8

6.6

18.5

1.3

40.2

Population x1,000 178,483 407,466 118,543 33,097 5,982 57,198 368,549 147,415 8,067 1,324,800 ICIMOD, 2008 Population density 165 401 182 80 22 71 214 156 7 Water per person m 3 /year 830 ~2500 ~2500 18,614 23,796 8,934 2,265 361 754

Glacier Mass Balance



Himalayan glaciers are shrinking more rapidly than anywhere else on the globe

Dyurgerov and Meier, 2005

Glacial Retreat Example

Source: Laboratory of Cryosphere Variation, Nagoya University http://snowman.hyarc.nagoya-u.ac.jp

The Temperature Increases Faster on High Altitude

Liu and Chen, 2000

Rapid Melting of Imja Glacier, Nepal 1956

(Photo: Fritz Muller; courtesy of Jack Ives) www.unforum.org

2006

(Photo: Giovanni Kappenberger courtesy of Alton C Byers)

Glacial Lake Outburst Flood

 

Excess melt water leads to Glacial Lake Outburst Flood (GLOF) or “mountain tsunami” In 2007, two hundred glacial lakes in the Himalayas were at risk of bursting Photo: Nare glacier GLOF hits Pangboche village, Nepal, 1977

21

More Water Borne Diseases



In 2005, diarrhoeal diseases accounted for 20.1% of deaths in children less than five years

Photo credit: © Shehzad Noorani/Still Pictures

Weaker Monsoons

Science Daily, 2009

Scarcity of Food = Malnutrition

Photo credit: © Shehzad Noorani / Still Pictures

Malnutrition: First Cause of Children Mortality Proportional mortality among children under five years of age



World 2002

Underweight and Stunting among Children in Bangladesh, 1990 to 2005

Prevalence of underweight and stunting (height-for-age <-2 Z-scores) among children under five years of age in rural Bangladesh, 1990 to 2005

Spread of Vector Borne Diseases

Aedes aegypti

 

Warmer temperatures and disturbed rain patterns could alter the distribution of important disease vectors Combined with altered rainfall patterns, hotter conditions may increase the spread of disease, such as malaria, dengue, and chikungunya, to new areas

Dengue

Photo credit: © Shehzad Noorani /Majority World / Still Picture  

In 2005, the estimated number of population at risk from dengue in the South East Asia Region was 1.3 billion This is 52% of the global estimated 2.5 billion at risk.

Sea Level Rise Risks in South East Asia



IPCC, 2007: “Coastal areas, especially the heavily-populated mega deltas regions in South, East and South East Asia, will be at greatest risk due to increased flooding from the sea and, in some mega deltas, flooding from the rivers”

Robert A. Rohde / Global Warming Art

Sea Level Rise Enhances Cholera Outbreaks

Space.com, 2000

Sea Level Rise: Bangladesh

Psychosocial Stress Will Affect the Health of Communities and Individuals

Photo credit: © Gil Moti / Still Pictures

Selected Health Impacts of Climate Change

Mortality attributed to climate change impacts on malnutrition, diarrhoea, malaria, and floods Patz et al., 2008

Mountain People at Risk Altitudinal Distribution Impact on Biodiversity (Land-use and Vegetation) and ecological zones

Climate zones are shifting

Alpine-meadow Tree-line

Species extinction

Agro-pastoral

Land use patterns and livelihood may shift

Agriculture and Settlement Riverine

ICIMOD, 2007

Land Use Change in Northern Himalaya Dingri County, Tibet. 4300 m Dried-up wetland Nomad Shift

ICIMOD, 2008

Sedentary

Feminisation of Rural Mountain Areas

ICIMOD, 2008

Urgent Action is Needed Adaptation for health sector: strengthen prevention, surveillance and early warning systems pertaining to climate sensitive diseases Natural

processes and forcings

Human pressure on environment Human society:

• Culture, institutions • Economic activity • Demography

Global Environmental Changes, affecting:

•

Climate

• Water • Food yields • Other materials • Physical envtl. safety • Microbial patterns • Cultural assets

Adaptation: Reduce impacts

• Impacts on human society: • Livelihoods • Economic productivity • Social stability

Health Mitigation: Reduce pressure on environment Mitigation for health sector: to promote and support initiatives that protect health by reducing greenhouse gas emissions

World Health Assembly adopts Global Action Plan, May 2009

    

Aim: to scale up WHO's technical assistance to countries to assess and address the implications of climate change for health and health systems. It has four objectives: advocacy and awareness raising; engagement in partnerships with other UN organizations and sectors other than the health sector at national, regional and international levels; promoting and supporting the generation of scientific evidence; and strengthening health systems to cope with the health threat posed by climate change, including emergencies related to extreme weather events and sea-level rise.

Conclusions

   

The SEA region has a large population that is currently vulnerable to a number of climate sensitive health stressors These stressors are already having a significant adverse health impacts in the Region Climate change is likely to increase the risks linked to these stressors, and introduce new sources of risk going forward Without adaptation and mitigation climate change could result in a dramatically increased health burden in the Region