Public Health Challenges in India
On the Road (3): Home
I want to finish this series motivated by my trip to Goa, India to a conference on public health and climate change in India. In this one I will give an overview of some of the issues that were discussed at the meeting; that is, how people are thinking about the public health impacts.
There were a series of talks that focused on malaria
and water borne diseases, air pollution, and extreme weather events. As someone coming from a physical climate background there was a lot for me to learn.
The interface of climate change to problems of public health brings, yet another, level of complexity to be addressed. With a disease like malaria, for instance, there is large sensitivity in the transition regions that separate wet and dry climate zones. In regions that are normally dry, flooding rains lead to outbreaks of mosquitoes, and the possibility of malaria outbreaks. There are also the oft cited issues of malaria moving into regions where it is currently too cold for the mosquitoes and protozoan parasites that cause malaria to live. Of note in India, this means that higher altitude regions become more vulnerable. What was most new to me was the realization that the life cycle of the protozoan, itself, was temperature dependent – it can reach maturity faster at higher temperatures.
Also of special note to those interested in climate change is the fact that the bacteria that causes cholera is sensitive to the salinity of water. Cholera is usually transmitted by consuming contaminated water or food. Issues of climate change and cholera bring attention to the coast, intrusion of salt water into river deltas, and coastal inundation associated with sea level rise and extreme storms.
When I was growing up, I was schooled about the importance of public health to very fabric of society in the United States. Much of this schooling was on sanitation and how efforts of basic sanitation in the U.S. in the early part of the 20th century led to reduction of many diseases and afflictions. I am in fact old enough, and Southern enough, to remember being lectured about hookworm
. The national effort for polio vaccinations was a big deal, and we were so happy when there were Sabin sugar cubes, rather than needles. I bring the role of the practice and execution of public health forward because it helps to place the role of climate change into context.
If you look at differences between the U.S. and India, or if you travel to different parts of India, even different parts of New Delhi, one is struck by the manifest importance of clean water. Many people in India are exposed to contaminated water. Even in the presence of contaminated water, families can help control water borne diseases using personal filtration and treatment; hence, highlighting the importance of education, availability of tools, and training in how to use the tools. This is true today, right now, and developing the capacity to address public health problems today helps to build the capacity needed to address changes that might come from climate change.
It is this development of societal resilience and/or adaptive capacity that is the focus of those who are planning for expected impacts of climate change. In many places, planning for climate change becomes linked to planned or needed development projects; that is, projects that are needed to develop basic infrastructure and the capacity to address existing problems. This linkage between development and adaptation to climate change is a growing concept; it makes sense, and does not appear as a risky investment.
This is an approach that works in the case where climate change poses an incremental change to an existing problem. A more difficult problem is when climate change might lead to vast changes or the emergence of new problems. For example, there are many millions of people in South Asia who live and grow their crops in low lying river deltas. There will, with certainty, be more intrusion of salt water into these regions, which will not only displace people, but it will ruin agricultural land. There are also diseases such as dengue fever
, for which explosive spread might be possible. (Here’s a link to dengue in Mexico
to bring it a little closer to home.)
This trip to India changed my perspective on climate change – it made it far more real. For the country as a whole, Indian agriculture is highly sensitive to the climate and the onset of the monsoon. The bulk of the water comes in a relatively small number of days of precipitation. River flow is highly seasonal, and it will become more seasonal, higher high flows, and lower low flows, because of changes in snowpack in the northern mountains. This natural sensitivity sits together with a large population and a large portion of this population that is highly vulnerable to their environment. This vulnerability ranges from exposure to contaminants and pathogens, to sensitivity to crop failures, to exposure to extreme weather and coastal flooding. The consequences of climate change in India, Pakistan, and Bangladesh will be significant and will have international consequences. Tough problems will be made tougher.
posted from Ypsilanti.
Figure 1: Here is a greeting card sent to meeting participants by Dr. Ashwani Kumar of India’s National Institute of Malaria Research (ICMR). Credit for the figure is Bayer Environmental Science.
Here is a .pdf to a good article on climate change and public health, with a emphasis on the U.S. Lead author is Howard Frumkin, who gave a great overview talk at the meeting. Frumkin et al.: Climate Change Public Health
. From American Journal of Public HealthPrevious blogs in this series:On the Road (1)On the Road (2)