Masters in Public Health (MPH)

Occupational and
Environmental Health
Assignment
Public Health Issues Arising From Climate Change in Low
Income Countries

INTRODUCTION
"We simply must do everything we can in our power to slow down global warming
before it is too late. The science is clear. The global warming debate is over." On 26th September
2006, Arnold Schwarzenegger said this during the bill signing ceremony for Californias strict
anti-emissions law. The issue of climate change and global warming are not considered as local
issues anymore. A large scale ecological change globally is needed in ensuring the survival of
human and the earth.
The Intergovernmental Panel on Climate Change (IPCC) is a scientific intergovernmental
body organized by two United Nations organizations, the World Meteorological Organization
(WMO) and the United Nations Environment Programme (UNEP)
1
. It was established in 1988 to
provide comprehensive scientific assessments of current scientific, technical and socio-economic
information worldwide about the risk of climate change caused by human activity, its potential
environmental and socio-economic consequences, and possible options for adapting to these
consequences or mitigating the effects. Based on the latest report on climate science, the Fourth
Assessment Report (AF4) released in 2007, they indicated that during the 21st century the global
surface temperature is likely to rise a further 1.1 to 2.9 C for their lowest emissions scenario and
2.4 to 6.4 C for the highest depending on the global emissions
2
.
Human activity, mainly in industry and agriculture, causes an increase in the amount of
heat retained by the planet, a term known as the greenhouse effect
3
. Fossil fuels burning for
transportation, heating, cooking, electricity, and manufacturing effectively moving carbon more
rapidly into the atmosphere, ultimately causing atmospheric carbon dioxide concentrations to
increase. Also, by clearing forests to support agriculture, carbon from living biomass is
transferred into the atmosphere. These factors had an adverse effect on earth, where it was shown
by the record of the 13 warmest years since 1880, 11 were the years from 2001 to 2011
2
.
One of the well-known effects of global warming on earth is the increase number of
extreme weather conditions developed each year in the last century, as sea-surface temperature
rises. Hurricane Katrina in 2005 was an example of one of the deadliest and most destructive
hurricanes that took 1833 lives and estimated property damage of USD81 billion
4
. Just recently
in October 2012 Hurricane Sandy that hit Florida and New York claimed 253 lives and estimated
damage of USD65.5 billion. The other important outcomes of global warming are health
problems related to heat stress, natural weather disasters, changes in vector distribution and,
consequently, infectious disease patterns, unreliable crop production, and flooding
5
.

PUBLIC HEALTH ISSUES
The World Banks main criterion for classifying economies is gross national income
(GNI) per capita. Based on the GNI per capita, every economy is classified as low income,
middle income (subdivided into lower middle and upper middle), or high income
6
. Examples of
countries classified by the World Bank as the low income countries are Afghanistan,
Bangladesh, Myanmar, Nepal, Somalia, Kenya, Uganda, Zimbabwe, and many others. The
problem with global warming effects on these low-income countries is more serious since these
countries will have difficulties in coping with the financial constraint to help their citizens to
survive the ordeal of climate change. Most of the time aid from the United Nations (UN) and
other developing and developed countries were given to these low income countries in events
like war, conflicts, and natural disasters.
In a low income country, the demand for foods which is the most important basic human
needs is usually coped by development in agriculture. For example, agriculture is still an
economic mainstay of many Sub-Saharan African countries, employing about 60 per cent of the
workforce and contributing an average of 30 per cent of gross domestic product
7
. With the
projection of global warming of at least 3C, expected prolonged drought and scarcity of rain
will affect crop productions and livestock distribution. Even until now hunger is still a major
problem in low income countries and the future of agriculture and food security is uncertain with
the current climate change estimation. It was reported that the number of people at risk from
hunger has never been higher; it increased from 300 million in 1990 to 700 million in 2007, and
it is estimated that it may exceed 1 billion in 2010
8
. Furthermore, social, economic and political
processes which are also a usual issues in these low income countries need to be addressed to
make sure the vulnerability and food insecurity can be handled well. When the issue on food
security cannot be handled well by these countries, nutritional problems will arise where there
will be malnutrition among infant and toddler which may affect the Infant Mortality Rate and
Under Five Mortality Rate, poor quality diet, poor health status that may predispose to infections
and chronic diseases, and may also affect maternal and fetal health during pregnancy.
If global warming happen as what predicted by the Intergovernmental Panel on Climate
Change (IPCC), another consequence that may arise from it is the emerging diseases related to
climate change. The distribution of plants and vegetation would change drastically in a short
period of time, relative to the past rate of change on earth. There will be expansion in the
geographical range of insect vectors of human disease, including that of anophelene and colicine
mosquitoes
3
. As a result, there will be a rise in viral hemorrhagic fevers such as yellow fever,
dengue, malaria, and viral echephalitis. In the low income countries, a rise in these
communicable diseases will increase burden to their already constricted financial status. For
example, experts estimated that there will be an increase in the number of malaria cases from the
current 400 million annually to about 500 million annually by the year 2100, based on the global
climate change models and the substantial geographical widening of the malaria zone associated
with a 3C increase in global mean temperatures
5
. Apart from malaria, the researchers in the
IPCC concluded that climate change would increase the burden of diarrhoeal diseases.
Childhood mortality due to diarrhoea in low-income countries, especially in Sub-Saharan Africa,
remains high despite improvement in care
10
. They have also projected that climate change would
increase the burden of diarrhoeal diseases in low-income regions by approximately 2 to 5% in
2020. The increase in disease burden in these countries will surely affect the morbidity and
mortality of communicable diseases and more efforts will be needed in controlling it.
The disruption of ocean currents and estimated rise in sea level as a result of global
warming may increase the frequency and severity of violent weather disturbances such as
hurricanes, tornadoes, typhoons, floods, and blizzards
3
. A Global Climate Risk Index published
at the end of 2011 by Germanwatch stated that the most affected from climate change based on
extreme weather such as hurricanes and floods are from the low income countries like
Bangladesh, Cambodia, Myanmar, Honduras, Nicaragua, Haiti, and Vietnam
9
. The problem with
extreme weather in low income countries is that they do not have enough resources and financial
backup to deal with it. Extreme weather like prolonged drought and flooding usually are related
to problem with hunger and emerging communicable diseases like dengue and cholera. Issues
like malnutrition, hunger, communicable diseases, sanitary and hygiene matters, and maternal
and child health problems are few of the public health issues related to extreme weather
disasters. In Cambodia, the extreme rainfalls in 2010 resulted in the worst floodings in decades
killing about 250 people just as destroying houses and ruining rice crops and in Myanmar, where
more than 95 % of the damages and fatalities occurred in 2008 through cyclone Nargis. These
are some of the impacts of extreme weather had on low income countries
9
. To avoid similarly
disastrous events, these countries need to invest substantially into its own adaptive capacity
regarding adaptation to climate change. However, without aid from other countries or the United
Nations some could not control further impact resulted in increased fatality post-event. Problem
in getting clean drinking water and proper sanitation will result in spreading of diarrheal diseases
like cholera and typhoid. In total, more than 530,000 people died as a direct consequence from
almost 15,000 extreme weather events, and losses of more than USD2.5 trillion (in Purchasing
Power Parity) occurred from 1992 to 2011 (USD 1.68 trillion overall losses in original values)
9
.
As a result of climate change, there was evidence across a range of observed changes,
including increases in global average air and ocean temperatures, widespread decrease in glaciers
and ice caps
11
. This contributed to observed sea level rise and it is expected to continue for
centuries. The Intergovernmental Panel on Climate Change (IPCC) projected that during the 21st
century, sea level will rise another 18 to 59 cm (7.1 to 23 in)
11
. This future climate change will
bring wetter coasts, drier mid-continent areas, and further sea level rise. Because of shoreline
erosions, river and coastal flooding, migration is expected and this could further bring some
other public health issues to the already affected low income countries. The demand for clean
drinking water will increase; there will be a need to make sure proper sanitation and drainage
system are in place, and human settlement need to be safe from landslide and future floods. High
migration rate could affect health status of the populations where problems with immunization
coverage, increased risk of infectious diseases, and could become a source of political and
even military conflict
12
.
In the other aspect of global warming, changes in climate have implications for
occupational health and safety in low income countries. Heat stress due to high temperature and
humidity is an occupational hazard that can lead to death or chronic ill-health from the after-
effects of heatstroke
10
. An ideal working environment is not an important issue with worker in
low income countries. Working in hot environments increases the risk of diminished ability to
carry out physical tasks, diminishes mental task ability, increases accident risk and, if prolonged,
may lead to heat exhaustion or heatstroke
10
. Examples were the occurrence of heatstroke in metal
workers in Bangladesh and rickshaw pullers in South Asia
10
. Although occupational health
issues only affect certain population, worsening of global warming could mean more workers in
low income countries may be affected and it could become a big problem if not control
thoroughly.
Scientists suggested that it is global warming is primarily caused by increasing
concentrations of greenhouse gases, namely water vapor, carbon dioxide, methane, nitrous
oxide, and ozone. It is produced by human activities such as the burning of fossil fuels and
deforestation. And the fact that the contribution to the climate change pollutants is largely caused
by the same activity that causes the air pollution. Projected climate changes could lead to
exacerbation of respiratory disorders associated with reduced air quality in urban and rural areas
and effects on the seasonality of certain allergic respiratory disorders
10
. In low income countries,
increase in respiratory disorders due to air pollution could cause serious public health problem as
it may affect not only the elderly and children, but also healthy individuals. These increase risk
of illness due to air pollution could mean hospital admission and mortality to be much greater in
low income countries compared to developed countries.

CONCLUSION
Climate change is already having a serious negative impact on the low income countries
and most vulnerable people. It is affecting growing conditions and causing more hunger. It is
expanding the areas where diseases such as malaria can spread. It is raising sea levels and
affecting access to clean water supplies. And it is causing more frequent and more severe
extreme weather events. These countries are most affected by climate change and yet are least
responsible for it. The build up of carbon dioxide and other greenhouse gasses which cause
global warming can mostly be traced back to the world's richest countries. The top 10 countries
in the world emit 67.07% of the world total carbon emissions and none of it is coming from a
low income countries13. China leads the list followed by the United States.
The solution to the problem of climate change is simple but difficult to achieve; to reduce
the generation of greenhouse gasses, particularly of carbon dioxide, and increase the capacity of
the sink for carbon dioxide by stopping deforestation and increasing forest growth3. The Kyoto
Protocol, a protocol to the United Nations Framework Convention on Climate Change
(UNFCCC) that set binding obligations on the industrialized countries to reduce their emissions
of greenhouse gases is one of the global efforts in reducing the effect of global warming14.
Reducing the amount of future climate change or mitigation of climate change by both
developing and developed countries could result in substantial reductions in CO2 emissions.
These combined efforts could help the low income countries in coping with the future of climate
change.
(2121 words)

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