How climate change sends more people to hospitals ... and even to graves
The gods of the rain have visited Kenya. Before then, scientists had sounded a warning, saying that an El Nino phenomenon would make its presence felt this year in the region during the short rains season from October to December. The season started with less vigour. Many, including President William Ruto, played down the predictions from three different scientific organisations: the World Meteorological Organisation (WMO), the Intergovernmental Authority on Development (Igad) and our own Meteorological department. When we got to the peak of the season in November, it became business-unusual. Homes were submerged, animals displaced, health systems shut down, roads cut off, cholera in coastal counties like Lamu came up, and by the time this article went to press, more than 160 people had died from the El Nino floods. While releasing the State of Climate Report 2023, WMO Secretary-General Petteri Taalas twice mentioned Kenya’s flooding during the ongoing El Nino as an example of how climate change aggravates natural disasters, resulting in unprecedented impacts on people’s health. Such effects go beyond the disasters witnessed to include the disruption of human and animal lives. According to COP28 Climate and Health envoy from the UAE, Dr Maha Barakat, health is the human face of climate change. The ongoing El Nino events are a perfect embodiment of health crises caused by the impacts of climate change. Simply put, our health needs will be overstretched in the wake of the climate crisis. This was the resounding message from delegates who represented the health caucus at the Conference of Parties (COP) climate gathering in the United Arab Emirates city of Dubai. Unlike previous years where health concerns took a back seat, this year’s deliberations thrust them into the spotlight. The discussions, once sporadic, now painted a vivid picture of the profound impact of climate change on our wellbeing. A day dubbed “Health Day” was set aside to provide solutions to reduce carbon emissions, limit air pollution, and prevent premature deaths around the world. Kenya was among the critical champions of the day and early adopters of a new health declaration. Amref Health Africa CEO Gitahi Githinji, one of the climate and health envoys for COP28, was present. “We already have a fragile health system. We are trying to build it and protect it. A climate crisis will dismantle it and make our work even more difficult. It’s a frontline human crisis,” he said. The catalyst for this lies in the myriad climate-related devastations that have happened just this year alone. The Intergovernmental Panel on Climate Change (IPCC) estimates that 3.3 billion people worldwide are highly vulnerable to climate change and face greater health risks. A new report published by Global Tipping Point shows that this number could increase as the earth is on the verge of other catastrophic climate change tipping points. When he stood to speak up during the opening plenary of the “Health Day” on December 3, World Health Organisation (WHO) Director-General Tedros Adhanom said the discussions on climate and health are long overdue. “Health stands as the most compelling reason for taking climate action. The threats to health resulting from climate change are immediate and present. However, for too long, health has been a footnote to climate discussion,” he said. Messages about the dire times we live in were not confined to the podium. A diverse cadre of healthcare professionals conveyed the urgency of the climate crisis. Drawn from different corners of the globe, they formed the largest delegation of medics assembled at a COP meet, collectively weaving the narrative of a year when global temperatures and greenhouse gas emissions have shattered records. Health ministers have rarely participated in climate discussions in the last 27 years. Only this year, about 50 ministers joined the climate bandwagon by physically attending the COP to present pressing health issues in their countries. The December 3 health ministerial convening brought together about 70 health ministers. Ms Khumbize Chiponda, who is Malawi’s Health minister and one of the frontline climate and health envoys at COP28, told Healthy Nation that experiences in her country propelled her to actively take part in conversations on how climate exacerbates health risks. “There are many impacts of climate change and health, but now we are on the receiving end. We have to do something about the people who are sick. We have to offer extra services to them. That is why we need to be part of this conversation,” she said. In August, Malawi hosted the first-ever meeting to identify Africa’s common position on the nexus between climate and health ahead of the Africa Climate Summit. The deliberations reached during that conference were brought to the summit and later at COP28. They were shared during the climate-health ministerial. “We cannot afford at this point to operate in isolation. It will not work. We all need to have the same objective,” said Ms Chiponda. Even as the drumbeats for the Health and Climate nexus now sound louder, there exists a gap in funding for research inclined to health, especially in countries located in the global south like Kenya. Mr Aloyce Urassa, the chairperson of the youth advisory council of the African Leaders Malaria Alliance and a climate and health researcher, told Healthy Nation that funding remains a big challenge in addressing the impacts on the ground. “Clear evidence on the baseline of my research shows that many countries have Health National Adaptation Plans as well as other policies that have been put up to respond to climate change and health. But there is near zero action that is taken,” he said. “Perception is also a challenge. Some people don’t really see if there is a direct connection between climate change and health. That could be one of the things that hinder the implementation of policies,” he added. Mr Diarmid Campbell-Lendrum, who was a coordinator of the climate and health crisis at a side event during the “Health Day” said that even when we don’t have complete evidence on the link between climate and health, that does not mean that we should not act. Ms Jess Beagley, the policy lead for the Global Climate and Health Alliance, explained in the sidelines of COP28 that since health systems are often the first to bear the brunt of climate change, linking health-focused outcomes in national climate plans will ensure that we are prioritising a safe, healthy and an equitable future. So, how exactly does climate change cause health risks? A study published last year in the scientific journal Nature Communications highlighted this linkage by showing that more than half of human pathogenic diseases were made worse by climate change. The study showed that when species move from their usual geographical areas because of our warming planet as well as changes in precipitation, there is a likelihood of expansion of vector-borne disease like malaria. “Warming at higher latitudes allowed vectors and pathogens to survive winter, aggravating outbreaks by several viruses (for example Zika and dengue),” said the study. “Habitat disruptions caused by warming, drought, heatwaves, wildfires, storms, floods and land cover change were also associated with bringing pathogens closer to people,” the study said. In some instances, viruses jump from animals to people in what scientists call spillovers. When Ebola or Nipah virus came about, the study shows that they were linked to either bats, rodents or primates hovering around to get safe spaces where there is food and minimal wildfires. “Likewise, reductions in snow cover caused by warming forced voles to find shelter in human habitats, triggering hantavirus outbreaks,” explained the study. “Warning was also related to melting ice and thawing permafrost, exposing once-frozen pathogens. Genetic analyses of an anthrax outbreak in the Arctic circle suggest that the bacterial strain may have been ancient and emerged from an unearthed animal corpse as the frozen ground thawed,” said the study. The study showed that climate change can also make diseases more hostile to the human body. “Heat waves were also suggested as a natural selective pressure towards ‘heat-resistant’ viruses, whose spillover into human populations results in increased virulence as viruses can better cope with the human body’s main defence (that is, fever),” the study indicated. Another study published in the journal Eco-Environment and Health shows that the African population is more likely to experience more mental health disorders than before because of experiencing natural disasters that lead to loss of property and sometimes, lives. The study explains that to lessen the burden on health from climate change, there should be improved surveillance, information dissemination, as well as having more health research. On the sidelines of COP28, the Welcome Trust Foundation, which supports scientific research around the world, announced that they had set aside about 100 million Euros to support scientists from the University of Oslo to enable them to delve into research topics on climate and health.