Chapter 3:Population’s Health and Climate Change

in South- East Asia

Protecting our Health from Climate Change:

a Training Course for Public Health Professionals

Outline

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

disease

South East Asia Region

INDIA

MYANMAR

THAILAND

INDONESIA

NEPAL

DPR KOREA

BANGLADESH

SRI LANKA

BHUTAN

TIMOR-LESTE

MALDIVES

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

Population Estimates for 2025 in Southeast Asia

Country

2025 (thousands

)% of world population

Bangladesh 206,024 2,6

Bhutan 819 0,01

Democratic People's Republic of Korea 25,228 0,3

India 1,447,499 18,5

Indonesia 271,227 3,4

Maldives 411 0,005

Myanmar 55,374 0,7

Nepal 38,855 0,5

Sri Lanka 20,328 0,3

Thailand 68,803 0,9

Timor-Leste 2,011 0,03

SEA total 2,136,579 27,1UN Department of Economic and Social Affairs, 2009

“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 (highconfidence).” (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

9

More Injuries, Disabilities, and Drowning from Extreme Weather Events

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

Adding to the Existing Burden

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

Photo: xanthis.wordpress.com

Myanmar: Nargis 2008

Bangladesh: Cyclone SIDR, 2007

India: “Super-cyclone” 1999 shattered lives

and livelihoods of 12 million people in Orissa

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

2003 Andhra Pradesh, India heat wave, with temperatures of up to 54oC, took a toll of at least 3,000 lives

The number of heat strokes was not recorded

Photo: © T. Balabaadkan UNEP / Still Pictures

Refugee Study Centre (RSC), http://www.rsc.ox.ac.uk

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

http://msnbcmedia3.msn.com

Rapid Glacier Melting = Less Freshwater

Himalayan Major River Basins

The Water Tower of Asia

River Area sq km

Mean discharge (m3/s)

% of Glacier melt in river flow

Population x1,000

Population density

Water per person m3/year

Indus 1,081,718 5,533 44.8 178,483 165 830

Ganges 1,016,124 18,691 9.1 407,466 401 ~2500

Brahma 651,335 19,824 12.3 118,543 182 ~2500

Irrawaddy 413,710 13,565 unknown 33,097 80 18,614

Salween 271,914 1,494 8.8 5,982 22 23,796

Mekong 805,604 11,048 6.6 57,198 71 8,934

Yangtze 1,722,193 34,000 18.5 368,549 214 2,265

Yellow 944,970 1,365 1.3 147,415 156 361

Tarim 1,152,448 40.2 8,067 7 754

Total 1,324,800

ICIMOD, 2008

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

2006

(Photo: Giovanni Kappenberger courtesy of Alton C Byers)

1956 (Photo: Fritz Muller; courtesy of Jack Ives)

www.unforum.org

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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

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

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

Aedes aegypti

Dengue

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.

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

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

Patz et al., 2008

Mortality attributed to climate change impacts on malnutrition, diarrhoea, malaria, and floods

Selected Health Impacts of Climate Change

Riverine

Agricultureand

Settlement

Agro-pastoral

Tree-line

Alpine-meadow

Altitudinal Distribution(Land-use and Vegetation)

Impact on Biodiversity and ecological zones

Species extinction Species extinction

Land use patterns and Land use patterns and livelihood may shiftlivelihood may shift

Climate zones are shiftingClimate zones are shifting

ICIMOD, 2007

Mountain People at Risk

Land Use Change in Northern Himalaya

NomadDried-up wetland

Dingri County, Tibet. 4300 m

ShiftSedentary

ICIMOD, 2008

ICIMOD, 2008

Feminisation of Rural Mountain Areas

Urgent Action is Needed

Global Environmental Changes, affecting:• Climate• Water• Food yields• Other materials• Physical envtl. safety• Microbial patterns• Cultural assets

Natural processes and forcings Impacts on human

society: • Livelihoods• Economic productivity• Social stability• Health

Human society: • Culture, institutions• Economic activity• Demography

Adaptation:

Reduce impacts

Human pressure on environment

Mitigation: Reduce pressure on environment

Mitigation for health sector: to promote and support initiatives that protect health by reducing greenhouse gas emissions

Adaptation for health sector: strengthen prevention, surveillance and early warning systems pertaining to climate sensitive diseases

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