CLIMATE CHANGEAND HEALTH NEWS

ISSUE NO. 1 SERIES OF 2012

DOH AO - 0005 S.2012 SIGNEDThe Department of Health

Administrative Order No. 0005 series of 2012 - National Policy on Climate Change Adaptation for the Health Sector, was signed by DOH Secretary Enrique Ona on March 2012. The Administrative Order gives the overall direction on how climate change and health activities will be pursued by the health sector.

The National Policy on Climate Change Adaptation for Health Sector will provide the Department of Health (DOH) direction for developing climate change and health impacts initiative. The AO was established to develop and implement Climate Change for Health programs that supports the achievement of Universal Health Care and Millennium Development Goals directed to increase the capacity of these health programs in managing the impacts of Climate Change on Health. This will lead to

• Strengthen early warning and surveillance systems for climate change sensitive diseases.

• Strengthen emergency and disaster preparedness and response for effects of climate change.

• Enhance knowledge and skills of health workforce on prevention and management of climate change sensitive diseases and mitigating and adapting to Climate Change.

• Increase public awareness and action on prevention of CC-sensitive diseases.

• Document best practices on health adaptation strategy to climate change and develop a template for replication/up scaling.

WHO’s Actions on Climate and Health

WHO is committed to work with Member States and other partners to protect and promote health in response to the threat of climate change.

Why climate change matters to health:• Besides environmental and economic

damage, the ultimate impact of climate takes a toll on our most precious resource - human lives and health.

• The responsibility for protecting lives and well-being ultimately falls on the health sector. Investing in health protection and adaptation can save lives now and increase resilience to climate change.

• Well-designed mitigation policies in sectors such as energy and transport, can bring large immediate co-benefits for public health.

• Health sector activities and infrastructure are energy intensive. Reducing their environmental footprint can play an important role in reducing global greenhouse gas emissions.

mainstream and integrate CC into the existing DOH programs for ease of understanding and sustainability.

The signing of the administrative order is one of the outputs assisted by the Climate Change Adaptation for Health (CCAH) Project with MDGF 1656 assistance. The project is a collaboration of the Department of Health, the World Health Organization along with selected Local Government Units (LGUs) in the National Capital Region (NCR) and the Bicol Region.

R E G I O N A L A N D L O C A L H E A L T H O F F I C E S G I V E SO R I E N T A T I O N O N C L I M A T E C H A N G E A D A P T A T I O N

The Center for Health and Development (CHD) in the National Capital Region cascaded the Climate Change Adaptation in Health (CCAH) to staff of the Environmental Cluster. They, in turn, oriented the sanitary inspectors at the local level.

The CHD NCR has strengthened its assistance to the LGUs in the campaign against dengue by developing and issuing its own Dengue Policy. Also, treated bed nets were distributed and continuous fogging activities were carried out.

Part of the LGUs support to mitigate the impact of climate change are : a) turning off of lights during lunch break; b) turning on air condition units only at 9am and turning them off at 4pm; c) changing of fluorescent lamps to CFL and computers monitor /screen to LCD; d) leaking pipes in their offices were fixed; and e) waste segregation is also being practiced.

Under the new CHD director, Dr. Eduardo Janairo, a Climate Change Unit (with 4

identified staff) has been specified under the proposed Engineering and Civil Works Center as part of the functional restructuring done by the CHD in support of Kalusugang Pangkalahatan thrust of the DOH.

The Provincial Health Officer (PHO) in Albay also shared the learning with the rest of the PHO employees during the regular conference. The Climate Change and Health Module was integrated into the Barangay Health Workers (BHW) Training Design with one batch of BHW training conducted in Barangay Manito. Officers of the BHW Federation were also oriented during their quarterly meeting.

In Pateros, Manila, education and information campaign on climate change has reached several stakeholders. A total of 27 community leaders assigned in the urban poor areas received CCAH orientation, who in turn, oriented a total of 100 members of the Urban Poor Association in Pateros. . . . .

continuation on page 2

MDGF in Health Objectives

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The Municipal Health Office’s (MHO) current program on Batang Emergency Response Teams also conducted a CCAH orientation in all schools in Pateros covering a total of 80 elementary and 20 high school students.

The MHO ensures that CCAH will be included in disaster management trainings after the successful orientation given to the more than 85 municipal employees.

REGIONAL... from page 1

Albay Governor Joey Salceda stressing the importanceof CCA to prevent future disasters

ALBAY ORIENTATION In Sto. Domingo, Albay climate change

orientation was integrated into the 2 batches of training conducted among barangay officials. The midwives and sanitary inspectors were able to cascade what they learned to their respective BHWs during the staff meeting.

In Guinobatan, Albay, the mayor issued an executive order in support to climate change and a resolution was also passed by the Sangguniang Pambayan in support of the same.

A project of the Department of Health in collaboration with the World Health Organization

with funding support from MDGF

CLIMATE CHANGE AND HEALTH NEWS

© Department of Health & World Health Organization 2012

The preparation and publication of this document was made possible through the assistance of the Millennium Development Goal Funds (MDG-F) 1656 Climate Change Project.

This document is published by the Department of Health and the World Health Organization (WHO) for general distribution. All rights reserved. Subject to the acknowledgement of DOH and WHO, this Newsletter may be freely abstracted, reproduced or translated in part or in whole for non-commercial purposes only. If the entire work or substantial portions will be translated or reproduced, permission should be requested from the Climate Change Unit of EOHO –NCDPC, Department of Health, San Lazaro Compound, Rizal Avenue corner Tayuman, Sta. Cruz, Manila.

The Department of Health (DOH) and the World Health Organization (WHO) does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damage incurred as a result of its use.

CLIMATE CHANGE AND HEALTH PROJECT REACHES FINAL STAGE OF IMPLEMENTATION

The Department of Health in collaboration with the World Health Organization along with selected Local Government Units (LGUs) in the National Capital Region (NCR) and Bicol Region implemented the Climate Change Adaptation for Health (CCAH) Project with MDGF – 1656 assistance.

According to Dr. Cecile Magturo — DOH Program Manager for Climate Change, “one of the best outputs assisted by the project is the development of the Department Administrative Order on Climate Change and Health signed by the Secretary of Health on March 2012.

The Administrative Order gives the overall direction, approaches and strategies on how climate change and health activities will be pursued by the health sector.”

Policy Development on Climate Change and Health

Since the enactment of the Philippine Climate Change Act of 2009, the Department of Health has developed policies that will support its activities towards strengthening the health sector’s response to the impact of climate change. Such activities include the following:

A Department Circular was issued in 2010 indorsing the DOH National Framework on Climate Change and Health Adaptation.

A DOH Personnel Order was passed on creating a Technical Committee on Climate Change and Health and the formation of the Climate Change Unit in support of the program.

A DOH Administrative Order on Mainstreaming

Climate Change into Health Programs was issued in 2012. An Operational Guideline to implement the Administrative Order was drafted and expected to be signed before end of 2012.

All relevant policies on Climate Change and Health were compiled in a handbook intended for the use of LGUs and their health workers.

Impact of the Climate Change and

Health Project on DOH Management

The Climate Change and Health Project has influenced the programs of the Department of Health.

A Climate Change Unit under the Environmental and Occupational Health was created to oversee and manage all activities related to climate change. The Technical Committee on Climate Change was formed as a venue of coordination for implementing the national strategy.

Moreover, DOH allocated funds to CHDs to support training activities for 2012. Such activities will include topics related to the science of climate change and health vulnerability and capacity assessment.

Health Promotion Through Awareness and Advocacy Campaigns

For the climate change information and education campaign, advocacy kits were prepared for local chief executives and health service providers, both of which contained climate change sheets. These sheets defined climate change, explained the Climate Change Act, gave examples on how to counteract the effects and also described the possible consequences of climate change on health.

For health service providers, these sheets defined climate change, explained the Climate Change Act and presented charts on the links with health and DOH programs.

Posters and flyers on climate sensitive diseases such as cholera, dengue, leptospirosis and measles were disseminated.

The flyers describe the particular sickness, how one can get it, ways to prevent it, symptoms and cures. The posters cited ways of how to prevent these illnesses. Additional posters on disaster management were made and printed. These gave warnings on floods, health effects, and the danger of living near water bodies as well as encouraged readers to follow the advice of local governments during times of calamities.

V U L N E R A B I L I T Y O F M E T R O M A N I L A C I T I E S O N T H E H E A LT H I M PA C T O F C L I M AT E C H A N G E

An assessment on the Impact of Climate Change on Health conducted for DOH, NEDA and WHO revealed that many cities in Metro Manila are vulnerable to vector and water-borne diseases; such as dengue, typhoid, cholera and leptospirosis, that are triggered by climate change. Four cities and a municipality in the National Capital Region, namely: Taguig, Pasig, Marikina, Quezon City and Pateros were covered in the study.

The climate change and health impact study investigated the distribution of aforementioned climate-sensitive diseases over time and space in Metro Manila and related them to climate variability. The most susceptible populations were identified as well as their adaptation capacity. The results of the study served as the bases for the formulation and adoption of policies and action programs to mitigate the impacts of climate change in spreading the diseases, inform and educate residents, improve health care

The “News Bearer” Barangay Captain of Legaspi City

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CLIMATE CHANGE AND HEALTH PROJECT REACHES FINAL STAGE OF IMPLEMENTATION

A DOH Personnel Order was passed on creating a Technical Committee on Climate Change and Health and the formation of the Climate Change Unit in support of the program.

A DOH Administrative Order on Mainstreaming

Climate Change into Health Programs was issued in 2012. An Operational Guideline to implement the Administrative Order was drafted and expected to be signed before end of 2012.

All relevant policies on Climate Change and Health were compiled in a handbook intended for the use of LGUs and their health workers.

Impact of the Climate Change and

Health Project on DOH Management

The Climate Change and Health Project has influenced the programs of the Department of Health.

A Climate Change Unit under the Environmental and Occupational Health was created to oversee and manage all activities related to climate change. The Technical Committee on Climate Change was formed as a venue of coordination for implementing the national strategy.

Moreover, DOH allocated funds to CHDs to support training activities for 2012. Such activities will include topics related to the science of climate change and health vulnerability and capacity assessment.

Health Promotion Through Awareness and Advocacy Campaigns

Posters and flyers on climate sensitive diseases such as cholera, dengue, leptospirosis and measles were disseminated.

The flyers describe the particular sickness, how one can get it, ways to prevent it, symptoms and cures. The posters cited ways of how to prevent these illnesses. Additional posters on disaster management were made and printed. These gave warnings on floods, health effects, and the danger of living near water bodies as well as encouraged readers to follow the advice of local governments during times of calamities.

V U L N E R A B I L I T Y O F M E T R O M A N I L A C I T I E S O N T H E H E A LT H I M PA C T O F C L I M AT E C H A N G E

An assessment on the Impact of Climate Change on Health conducted for DOH, NEDA and WHO revealed that many cities in Metro Manila are vulnerable to vector and water-borne diseases; such as dengue, typhoid, cholera and leptospirosis, that are triggered by climate change. Four cities and a municipality in the National Capital Region, namely: Taguig, Pasig, Marikina, Quezon City and Pateros were covered in the study.

The climate change and health impact study investigated the distribution of aforementioned climate-sensitive diseases over time and space in Metro Manila and related them to climate variability. The most susceptible populations were identified as well as their adaptation capacity. The results of the study served as the bases for the formulation and adoption of policies and action programs to mitigate the impacts of climate change in spreading the diseases, inform and educate residents, improve health care

systems and strengthen capacities of health centers to respond to emergency situations.

In the assessment of the capacity and readiness of the health facilities and systems in the five cities to respond to climate change sensitive diseases, the following findings were reported:

Pateros – level of adaptive capacity to dengue, typhoid, cholera and leptospirosis is high.

Pasig – level of adaptive capacity to the four diseases is high Taguig –

level of adaptive capacity to dengue and leptospirosis is high but to typhoid and cholera it is medium.

Marikina – level of adaptive capacity to dengue is high; to typhoid and leptospirosis is medium; and to cholera is low.

Quezon City – level of adaptive capacity to all four diseases is high.

A grade of high is given if the health

system is well equipped to respond to the disease and has the ability to prevent transmission. A grade of medium is given if the health system is equipped with the basic features in the three key areas of technology, information and skills and institution (gaps could include lack of equipment and/or computerized systems for reporting). A low grade is given if the capacity is lacking in all the parameters of technology, information and skills and institution (additional gaps could include lack of trained personnel, no information available and/or no policies in place).

The “News Bearer” Barangay Captain of Legaspi CityBarangay Captain Teresita R. Alisago

was awarded as the most outstanding barangay captain, she is now in her third term in Barangay 3 Em’s Bo. East in Legaspi City. Her barangay is one of the four selected barangays designated to host the Event –Based Surveillance and Response in the Community (ESRC . There has been no difficulty convincing the barangay captain and her staff to accept the hosting of the ESRC unit after having been oriented on the importance of the ESRC. As part of the barangay’s commitment to sustain the project initiative, a budget was allocated to the monthly maintenance for internet

connection to enable in uploading of cases detected and verified for reporting to the CESU level onto the project website center at DOH-Manila.

SMALL ACTIONS, BIG IMPACTTo illustrate the Barangay Captain’s

bold initiative there were three cases of dengue detected and verified, Brgy. Capt. Alisago and her secretary immediately proceeded to the neighbourhood where the cases were reported. After checking the surroundings, she ordered a clean up of the area and made a call to maintain a clean surrounding which permeated to her constituents. In addition, using old calendars and manila papers, they adapted the Dengue poster developed by the DOH and came up with their own locally-made IEC materials, posted in several houses and establishments in the neighbourhood.

The Barangay Captain knows that for community-based surveillance to be effective, everyone has to be a “News

Bearer” for events, symptoms and illnesses for verification and immediate action. Being a small-sized barangay with only 56 households, she knows her constituents and has the habit of asking the whereabouts of her people. This action of knowing the condition of her constituents resulted to appropriate medical help.

Brgy. Capt. Teresita Alisago’s leadership will surely be missed and definitely remembered. Her leadership should be an example for other communities.

“By taking action on climate change, you are protecting Human Health.”

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Preparation of Research Studies and Instructional ManualsThe following study reports and manuals

were produced through the demonstration project• Study on the Use of Climate Change

Variables to Predict Dengue Cases. This study established the effects of temperature, humidity and water on the spread of dengue.

• Study on “Assessment of Vulnerability and Adaptability of Albay and Metro Manila on the Impact of Climate Change on “Health” was completed as part of the tool development objective of the demonstration project.

• Event-based Surveillance and Response System for the Community (ESRC) developed an Operations manual and ESRC web manual. The ESRC is part of the DOH’s Philippine Integrated Disease Surveillance and Response (PIDSR) system.

ESRC is a community event-based surveillance system for early detection of epidemic prone diseases and other public health threats. It involves an informal gathering of data from the barangay communities and other local institutional sources.

• Surveillance in Post Extreme Emergencies and Disasters (SPEED) system produced a field operations manual for use of health institutions and their workers. SPEED is intended for use of Health Emergency Staff of DOH. SPEED is an early warning system for diseases monitoring after a disaster for the purpose of mobilizing logistics. The system is web-based and mobile phone based.

SPEED was developed through AusAID funding applied in pilot areas of NCR and Albay and expanded to the entire Bicol region.

NOTABLE OUTPUTS 1. Design and installation of the Model

System for Early Warning and Surveillance (EWS) for climate-related diseases in Marikina and Legaspi City

2. Development of three (3) protocol manuals as guide in the operationalization of the event-based surveillance and response system with the core function of case detection, verification and response

3. Vulnerability assessment and identification of gaps of hospitals in NCR and the Bicol Region after the training of 61 public and private hospitals as part of DOH Safe Hospital Program.

LESSONS LEARNEDA number of lessons learned were drawn

from the 3-year implementation and these can be summarized as follows:• The design and pilot of CCAH initiatives

demanded an iterative process before these can be ready for roll out, hence adopting alternative options and making adjustments in the process with extended implementation period are necessary for successful pilots;

• Designs and mechanisms should be responsive to local needs and peculiarities. Consultations in design, planning and implementation of initiatives are necessary to generate ownership;

• Concepts, frameworks and policies to mitigate climate change impacts in health takes time to be operationalized into concrete measures and actions thus requiring further deliberations;

• There is a need to integrate CCAH into an existing promotion activities of the various health programs, during disaster management and environmental meetings at all levels of operations since these

served as avenues where CCAH can be cascaded to the different stakeholders;

• Monitoring the initial results of MDGF activities is a critical step to ensure that these translate to better outcome, and to act on operational issues that may be hindering ground implementation;

• The training video on impacts of climate change can be an effective tool in mobilizing support for CCAH;

• Resources from various donors and development partners are vital to enhance national and local government’s capacities to adapt to climate change;

• Optimize the use of resources by avoiding duplication of similar initiatives being undertaken parallel to each other, also , avoid delayed submissions of deliverables and non-utilization of project outputs as originally intended.

THE WAY FORWARD• Update the DOH Action Plan on Climate

Change and incorporate the Sustainability Plan developed at the end of the project..

• Fast track and concretize the on-going formulation of implementing guidelines on CCAH to a level that gives clear direction and guide for the national, regional and local health offices.

• The DOH should specify the office under which CCAH will be subsumed with steps that lead to designation of staff to handle the program.

• Once the 2012-2016 Strategic Plan has been developed with estimated investment requirements, it is important for a high level advocacy among top DOH management, DBM and the legislative bodies for the allocation of government funds to support the program; and

• Mobilization of resources for CCAH must encompass donor community, development partners at the national and international level including the private sector. LGU contributions must also be defined particularly in the actual operationalization of the various components to the CCAH program.

References:1. Villa, Eireen (2012). Documentation

of Climate Change and Health Project prepared for WHO and DOH.

2. UP-Planades (2012). Documentation of Health Component of Climate Change Project prepared for NEDA.

3. Paraso, Glen (2011). Health Vulnerability and Capacity Assessment Report prepared for WHO and DOH.