The growing number of heatwaves, cyclones, and floods which bring forth fresh casualties everyday are all manifestations of the widespread adverse impacts from human induced climate change. Even though the wellbeing of all living things depends on a sustainable ecosystem, global warming is disrupting this system faster than anticipated, and with unequal impacts across geographical regions.
While Bangladesh aims to achieve Universal Health Coverage by 2030, the direct and indirect health hazards related to climate change will make such well-intentioned targets less attainable. Unfortunately, climate driven rise in non-communicable diseases and new pathogens threatens to diminish the accomplishments of years of public health effort in lowering communicable diseases.
As a result, amidst the framework of adaptation and mitigation efforts, an inclusive climate resilient health system that addresses health crises arising from both rapid and slow-onset climatic effects is essential to improve health equity.
What are the direct and indirect adverse human health impacts from climate change?
The World Health Organization (WHO) estimated that around 12.6 million people die annually from climate change and environmental pollution.
Bangladesh suffers from high risk when it comes to climate related health hazards, predominantly due to being a climate hotspot and a majority of the population being dependent on the primary sector. A collective study initiated by Amader Gram Cancer Care & Research Center, Bangladesh observed the health and economic challenges in the coastal regions resulting from high salinity of water and soil, driven by the rising sea-level, tidal inundation, floods, and cyclones. Their work also revealed how the consumption of saline water is directly increasing, among other health issues, the prevalence of pathogen induced diarrhea, dysentery, skin-eye infection, and pregnancy complications. An epidemic of hypertension was also detected along with risks of respiratory problems from the moldy indoor environments.
Furthermore, the scarcity of fresh water for drinking, growing crops, raising poultry and fish is threatening food security. Salinity reduces farmland and homestead biodiversity, leading not only to dietary deficiency and malnutrition but it also causes greater rates of migration due to the lack of sustainable livelihood from agriculture. The study also links adaptation strategies of rainwater harvesting in plastic containers to a high incidence of breast cancer in the region. The already worsened conditions are further affected by the direct loss of life from drowning, injury, and displacement within the coastal region. The Intergovernmental Panel on Climate Change (IPCC) reports that the map of Bangladesh may change from a loss of approximately 11% of its land by 2050, affecting around 15 million people in the coastal region.
Hence, a looming concern within this century will be food and safe water security. The number of people suffering from hunger increased from 797 million in 2016 to 821 million in 2018. High atmospheric concentrations of carbon dioxide not only reduce the nutritional quality of wheat, rice, maize, and other crops but a rise of only 1 degree Celsius can drastically reduce the yields as well. Unfortunately, the entire food chain cycle emits a high concentration of all kinds of greenhouse gases (GHGs)which creates a negative feedback mechanism, and in the long-term can have detrimental effect on all recorded health indicators.
It is not surprising that the findings of such a study is not exclusive to Bangladesh. Heatwaves have been the major weather-related cause of death in the US in the last 30 years. The outdoor workers' productivity and working hours are dwindling due to heat. Exposure to high concentration of particulate matters like ground level ozone and black carbon are affecting respiratory and cardiovascular systems in regions where wildfire and droughts are common. Changes in rainfall variability and high temperature are altering the patterns and distribution of vector-borne diseases like dengue and malaria.
The unpleasant reality remains that the social impacts of climate change pose more risk for the lower-income groups by worsening poverty, inequality, and resource scarcity. While climate change has immense repercussions within the physical world, statistical records also indicate that around one billion people around the globe are living with mental health conditions due to climate deterioration. As issues such as those mentioned above become increasingly intertwined with people's daily lives- depression, anxiety and generally suicidal tendencies could rise to an epidemic level.
UNSPLASHFacts which further emphasize the severity of the climate change impact:
The World Meteorological Organization (WMO) recently reported that there is a 98% possibility of global temperatures exceeding the threshold of 1.5 degrees Celsius above pre-industrial levels in the next five years
Globally, the first half of 2022 saw $35 billion of insured losses from natural catastrophes which is 22 percent more than the previous ten-year average
Bangladesh was ranked the seventh most climate-vulnerable country in the world with an alarming record of 185 extreme events and 0.38 fatalities per 100,000 inhabitants in the last two decades
A predicted 1.5°C increase in temperature and annual increase of 74 millimeters of rainfall by 2050 threatens to expose an additional 7.08 million people to significant storm surge damage in coastal regions
As such we are long overdue to implement adaptation and mitigation processes which will curtail and eventually avoid the rising loss and damage from climate changes.
A question often asked: What is the way forward?
Globally, health systems are poorly resourced, especially in their capacity to respond to climate sensitivity. The scenario is worse in developing countries where investments in the health sector are even poorer. Although, the Green Climate Fund (GCF) has invested in adaptation projects for cyclone shelters, safe drinking water, improved cooking stove, cooling system, flood, and a combined approach to reduce GHG emissions in Bangladesh, more direct investments in the health service delivery are needed.
Formal documents such as Bangladesh's 8th Five Year Plan and those from the Ministry of Health and Family Welfare address the adverse impact of climate change on the health sector. However, most policies, strategies, or plans in both the documents do not either recognize nor do they prioritize specific health issues related to weather or climatic hazards.
Yet, experts believe that Bangladesh is already leading the way in locally led adaptations. Hundreds of pilot projects combating climate change related issues were successfully deployed by private sector, government agencies, and civil society bodies. To mitigate the onslaught of disasters some of these successful measures can be strategically scaled up.
As working conditions for tea harvesters resemble that of a live furnace, warnings of imminent heatwaves which will be more frequent and long lasting become quite clear. Countries such the United Kingdom have developed a multi-sectoral approach to address heatwaves, on the other hand China has implemented heat-health warning system. These constructive cases in points may direct Bangladesh to build its very own heat-wave alert system. Afterall it is essential to employ evidence-based protocols to manage heat exhaustion and heat strokes and use affordable options to prevent more heat related mortalities.
Fast-growing and densely populated urban cities, such as Dhaka, especially need faster adaptation actions by the city corporation. From increasing tree cover, parking lot shades, water treatment plants to the use of safe wastewater, green building technologies and cooling materials, the list of mediating actions are endless. Not to mention that a dengue-prone Bangladesh is now in dire need of coordinated disease mapping, early warning systems and vector control systems similar to those of Singapore or the Philippines.
Rurally, adaptation measures like building houses on stilts or having retention ponds around farms in low land areas can help avoid flood water inundation and reduce displacements. A noteworthy example in this case would be how an NGO, Friendship Bangladesh, had introduced schools in boats and floating hospitals in communities to build climate resilient char areas.
In fact, in order to induce life-long behavioral changes, awareness programs introduced at school can instill the severity of climate change impacts on young people. This approach could successfully promote climate resilient food habits by encouraging a greater incorporation of plants and whole grains within the daily diet and at the same time, alleviate the development of non-communicable diseases such as hypertension, diabetes, cardiovascular diseases and so on.
At the end of the day, setting up innovative climate technologies to reduce GHGs is the ultimate mitigation process. Transitioning towards renewable energy sources like wind, solar power and hydropower, provided they are sustainable, can further reduce the detrimental effects of climate change. Since adequate food for the masses remain an integral point of concern, drought and salt water resistant crops could be a game changer in ensuring food security. Whereas, the simplicity of embankments and sea walls can provide physical protection against the most notorious floods.
When the question of finances come into play, it is instrumental to remember that an estimated global $1.8 trillion investment in adaptation and mitigation could generate $7.1 trillion through a combination of avoidable costs, and social benefits.
It is undeniable that Bangladesh will require large funds to protect itself from the wrath of climate change and so the government needs to focus on negotiation processes to persuade major emitters to contribute financially and technologically. Additionally, it has to earnestly explore leveraging the loss and damage fund, address public health hazard in the climate finance space, promote local interventions, and continuously advocate for itself in the global arena for a sustainable future.
Maliha Mannan Ahmed is an entrepreneur and public health communicator. She is the Founder and Managing Director of Organikare Limited. Jarin Tasneem Oyshi is an Erasmus Mundus Scholar and researcher at Centre for Climate Change and Environmental Research (C3ER), Brac University and Youth Policy Forum (YPF). Her area of expertise includes climate change adaptation, climate finance, environmental sustainability and policy analysis.
