Importance of Climate Resilient Health Systems!

Through this article, you will get to know the following:

• Effects of climate change on human health
• Rapidly spreading diseases in Sri Lanka due to climate change
• Risk assessment, vulnerable age groups in the country
• Major gaps and barriers in the health system
• Climate resilient health system, Adaptation techniques  

Background

Sri Lanka is a country that provides free healthcare to people, and due to the prevailing economic crisis, the provision of these free services has become difficult. Moreover, climate change is worsening this issue further. It was identified that deaths due to extreme weather, the spread of infectious and vector-borne diseases, and nutrition problems as the main challenges faced by the health sector of Sri Lanka at the moment. Sri Lanka’s Ministry of Health has also focused on a climate-resilient health system and adaptation plans, while the world’s attention has also been focused on this through COP27.

Influence of climate change on human health

So many health issues have arisen with climate change, yet necessary attention is not often directed at this topic. Sri Lanka is also severely affected by climate change-induced health problems.

Spread of diseases and deaths caused by extreme weather

The main problem caused by increased rainfall is the risk of inland river floods. There are nearly 15 major rivers in Sri Lanka, over 100km in length, and many minor rivers inland. The banks of many of these rivers have been eroded, posing a risk of flooding. World Health Organization estimated that by 2030, an additional 25,700 Sri Lankans might be at risk of river floods annually due to climate change. Flood water often contains a variety of contaminants; in some cases, floods enter wastewater treatment systems. Subsequently leading to the spread of pathogenic bacteria, parasites, and other unhealthy pollutants threatening food security.

The country has to afford the cost of treating these diseases. Even though the hospitals have adapted to this situation with the economic crisis, it has been decided to import only essential medicines into the country, risking many lives.

On the other hand, WHO estimated that an annual average of about 65,600 people globally are projected to be affected by floods caused by sea level rise between 2070 and 2100. Significant investments will be essential to adapt to this situation. Adaptation alone will not offer sufficient protection, as sea level rise is a long-term process. High emissions increase the adverse impacts of climate change worldwide, and countries must fight together regionally and globally to control it.

Spread of infectious and vector-borne diseases caused due to precipitation and temperatures.

Researchers found that climate change induces over half of all human infectious diseases worldwide. Vectors like mosquitoes, ticks, and fleas spread wide due to climate change. Mosquito-borne diseases such as dengue, malaria, and rat fever are seen to increase rapidly in Sri Lanka due to climate change.

Flash floods increase the potential mosquito breeding grounds, leading to the spread of dengue, malaria, and other mosquito-borne diseases.

In the previous article, we discussed the dengue issue in our country in detail. When concluding that rainfall and ambient temperature are considered macro factors are influencing dengue spread. The weather impacts dengue’s temporal and geographical reach. The full article can be read below.

How is Climate Change Contributing to the Spread of Dengue?

• Global warming on the spread of food and waterborne diseases.

Diarrheal diseases have also been found to occur more frequently in conjunction with unusually high and low precipitation. 

As the earth’s temperature rises, surface water temperatures in lakes and oceans also rise. Warmer waters create a more sociable environment for some dangerous algae and microbes to grow. When seas get warmer, certain marine bacteria that make humans sick are more likely to survive and thrive. For instance, a CDC research study says, “Vibrio parahaemolyticus and Vibrio vulnificus grow rapidly in warm ocean water and cause diarrhoea and vomiting.”

Also, diarrheal diseases, such as salmonellosis and campylobacteriosis, are more common when temperatures increase. It is sad to say that you are in danger when swimming in the warmer sea because Vibrio parahaemolyticus causes serious infections through contact with contaminated water while swimming. Read how warmer water and flooding pose risks of illness here Archived.

• Wildfires, Air pollution and respiratory issues

Prolonged drought conditions and strong winds lead to wildfires, and smoke containing carbon monoxide, nitrogen oxides, and various volatile organic compounds (ozone precursors) also significantly reduces air quality. Smoke exposure increases respiratory and cardiovascular problems.

Respiratory diseases have a significant impact on the Sri Lankan Health System. Together, chronic respiratory diseases and pneumonia caused the highest number of hospital deaths in 2017, which accounted for 39.3 (18.0%) out of 218.5 deaths per 100 000 population. In Dr Yasaratne’s article Letter from Sri Lanka here, Archived

• Climate change’s effect on food security leads to severe health problems

Climate change induces food loss and food poisoning by developing severe pathogens. According to WFP, 6.3 million people in Sri Lanka are “food insecure”. This can lead to lower metabolism, gastritis, and mental problems, severely affecting children’s physical and psychological health.

Furthermore, more than 60 per cent of families eat cheaper and less nutritious food. This mainly affects children, pregnant women and older people at high risk of health issues. 

Also Read: Impact of Climate Change On Food security – A Sri Lankan Perspective

Whose health is at risk most due to climate change?

The global population has now reached 8 billion. Children are one of the most vulnerable groups, due to the effects of climate change, as they are more susceptible to heat stress and dehydration. Children’s health deteriorates due to a lack of nutritious food and fresh water. Their immune systems are not fully developed, putting them at significant risk.

Pregnant women are also at increased risk of heat stress during heat waves due to the physiological demands of pregnancy. Mothers and their unborn babies are susceptible to exposure to air pollution.

According to UN data, the global population of 65 and above is projected to rise from 10 per cent in 2022 to 16 per cent in 2050, and as compared to many regional countries, Sri Lanka is also predicted to have an increased percentage of the elderly population in coming decades. Older people are also vulnerable to climate change, and people with pre-existing medical conditions are more prone to dehydration, heat stress, infections and heart and lung disease exacerbation.

People living in rural or remote communities or along the coast and central water bodies are also at risk from extreme weather events such as floods, hurricanes, wildfires, droughts, storms and sea level rises.

Significant gaps and barriers in the Sri Lankan health system

• Institutional and coordination gaps: An appropriate mechanism for coordinating different actors is necessary.
• Resource mobilisation gaps: The government is burdened with financial difficulties finding extra resources for climate adaptation interventions.

These gaps act as barriers to successful adaptation, reducing the adaptive capacity and increasing the vulnerability of individual citizens and the nation.

According to the national action plan 2016-2025, the health sector is categorized as a critically important sector in Sri Lanka regarding its vulnerability to climate change impacts and the necessity of adaptive actions. It considers climate-altering pollutants, disease spread and outbreaks, hazardous events, and heat/thermal stress as central issues.

Overcoming the existing gaps will help increase adaptive capacities and reduce the vulnerabilities of stakeholders. Resource mobilisation is an important aspect in this regard. It helps build partnerships among local communities, especially with the private sector and global resources, strengthening and expanding health services.

Research and development are essential factors in the health system to identify disease behaviour because many pathogens adapt to changing climates. Critical research needs to identify new disease varieties, as mentioned in the adaptation plan 2016-2025.  Improved medical facilities, funding, skills and training are required to combat these health challenges. Also, education, training and awareness are needed to change people’s behaviour to adapt to diseases.

The national action plan mentioned another aspect of adaptation strategies: Climate-induced disaster risk management. In the World One Health Congress, Minister of Health in Sri Lanka, Keheliya Rabukwella stated, “food security, food safety and micronutrient deficiency related issues are expected to be more prevalent and need to make the health system more resilient to the adverse impacts of climate change.” It shows that the government is aware of this issue. According to National Action Plan, the Health sector needs disaster management facilities, plans, and coordination closely with the existing agencies, research facilities, and communication standards to create a resilient health system.

In a nutshell

Climate change affects our health system through extreme events, poor air quality, the spread of diseases, food and water insecurity, and nutrition problems, damaging our physical and mental well-being. Children, pregnant women, and older and sick people are among the most vulnerable parties. Resource mobilisation and coordination with all related stakeholders are needed for the health sector of Sri Lanka to become more resilient to climate risks. The Sri Lankan government has already drawn attention towards more climate-resilient health systems, as mentioned in the World One Health Congress, with plans to increase research and development, awareness, communication, and cooperation with local and international parties in order to strengthen the health system to fight climate change impacts.