One of the key characterizing features of the South Asian region is its Monsoon rainfall, which not only is the giver of life in this region; with many parts of the region relying on rain fed agriculture for their sustenance, as well as providing respite from the scorching heat of the summer months. In the Indian-Pakistani subcontinent, there is strong socio-cultural significance of water and rainfall, particularly amongst indigenous peoples who live off the land. In consideration of the dependence of the people of South Asia on not only the monsoon, but weather in general, it is alarming to learn from the Intergovernmental Panel on Climate Changes’ Fifth Assessment Report (AR5) that the region has experienced significant warming over the 20th century and into the 2000’s. Under a high emissions scenario, temperatures in the region could exceed a warming of 3 degrees centigrade, which exceeds the levels identified as being ‘safe’, i.e. 2 degrees centigrade.
Increasing temperatures mean increasing risks, particularly to human security, and most notably to human health. The IPCC suggests that the Asia region as a whole experienced the most weather and climate related disasters between 2000 and 2008, suffering 27.5% of global economic losses. In the case of Pakistan, the country has experienced recurring flood, drought and extreme temperatures, which has not only eroded the development of the country but has also had dire consequences for public health.
The current flooding in the country, now a recurrent incident associated with annual Monsoon rainfall, is an example of the havoc wreaked by disaster, leading to displacement and epidemic. News reports suggest that gastroenteritis, diarrhea, malaria, typhoid, dengue fever, scabies and other diseases are on the rise amongst flood affected people in Chitral in particular, but also through the rest of the country. As of 5th August, 2015, 151 people are reported to have died, 101 persons have been injured as a result of these floods: with a total of 818,044 persons directly impacted by the situation. Whilst disease outbreaks are an emerging threat, the immediate risks to human life due to collapsed housing and infrastructure pose serious questions about efforts undertaken so far to ensure human security.
Another example from this year relates strongly to Pakistan’s status as one of the most rapidly urbanizing countries in the world. Pakistan’s largest and most populous city, Karachi, suffered this year from a massive heat wave that killed up to 2000 people. Whilst this may in part be attributed to serious gaps in the response and preparedness of government and health institutions, much of it may be attributed to the ‘Urban Heat Island’ effect- leading to heat related deaths and exacerbated toxic compounds found in the scarce drinking water.
Worryingly, it is the most marginalized groups in society, particularly women, children and the elderly who are the most at risk from climate related disasters. Women often face higher levels of psychological and emotional distress following disasters, as well as decreased food intake and increasing incidences of domestic violence. Children and the elderly are at a higher risk due to their lower mobility and susceptibility to infectious diseases, as well as reduced caloric intake and social isolation. In particular, young children are extremely susceptible to diarrhoeal diseases caused by contaminated water during floods, whilst the elderly face death from heat stress, droughts and wildfires.
The failure to effectively address the increasing health risks associated with these increasingly frequent disasters are rooted in the lack of capacity of health, disaster and climate related departments at the local and at the national level to pre-empt disaster and climate related health issues. Both the National Climate Change Policy of Pakistan and the Disaster Risk Reduction policy fail to highlight the particular threats to health in Pakistan from climate related disasters, promoting a reactive rather than proactive response to health emergencies. Whilst realistically, for health institutions budgets and finance will remain a challenge, for many of the health concerns arising from disasters, solutions may be simple, as is demonstrated by the active role civil society played in mitigating the impacts of the heatwave in Sindh, through the provision of clean drinking water.
In the wake of events such as these, Catherine Thomassan, Executive Director of Physicians for Social Responsibility has called Climate Change “the greatest threat to public health in the 21st Century”. Events such as these are only expected to rise: However, on the flipside, recent research by the Lancet Commission on Health and Climate Change suggests that “responding to Climate Change could potentially be one of the biggest public health opportunities of the 21st century.”
Indeed, for Pakistan, disaster related health issues may prove to be the factor that revolutionizes the approach towards disaster response, particularly towards healthcare. In the case of the heatwave in Sindh the galvanizing of civil society and a strong volunteer movement to overcome the threats posed to health was exemplary, it also opened up avenues for discussion on what is being done wrong: by both healthcare providers and by disaster management institutions. The need for policies and actions that transcend institutional boundaries and to imrprove existing public health systems to respond to emergencies has been highlighted. At the end of the day, the demands of the climate change community match the goals of public health services- the demand for cleaner water and better access to it, cleaner air and less pollution, and more sustainable and healthier lifestyles. The challenge now is to work out the modalities of how this is to be achieved- the time for Pakistan to do this is now, following the countrywide devastation from the floods, an opportunity to ‘build back better’.
Image Courtesy: UNTV
The blog is written by Anam Zeb, a development practitioner based in Islamabad.