The past month, I attended the START- Regional Workshop on Southeast Asia Climate Change and Health Issues in Taiwan with representatives from about 15 different countries, mostly South East Asia. Here I reflect the synthesis of my understanding during the event.  My background in natural resource management and recent work research interest in climate change adaptation kept me conveniently aligned with impact on land and water dynamics, inadvertently discounting the climate change impact on human health. Mankind evidently is bearing the burden of climate change along with other global challenges like increasing population, poverty, hunger, AIDS, war and disasters These all somehow intricately link both on the context of ‘cause’ and ‘impact’ with humankind. Dr. Louis Verchot, Scientist from Center for International Forestry Research, Indonesia puts it as ‘… climate change seems an additional stress to an already overtaxed system’.

Climate predictors reflect a 1% increase per year in CO2 and 3-3.5 mm sea level rise (relative to 1880) per annum (Hadley Centre for Climate Prediction and Research) that may impel thermal expansion resulting in polar ice melt, salt water intrusion and will possibly contaminate fresh water resources, lead to land-use change practices and reduced productivity from natural resources. The physical impacts of climate change viz., rise in global average temperate, sea level rise, present day atmospheric CO2 concentration rising beyond 390 ppm, glaciers melting as the result thermal expansion, increased frequency of storms, rain and wind and the change in the ecosystem characteristics together compound the impact on ecosystem health.  

The ecosystem health refers to a combined impact on natural and human resources. Talking about the human heath component, the impacts are graded as primary; that result in mortality/illness due to heat and cold waves, heat stress, injuries, floods, fires, infrastructure damage. The secondary impact takes account of increase incidence of vector and water-borne disease and infections, allergies. The tertiary impacts are famine, war, displacement, refugees, and development failures. The discussed impacts can also be characterized as physical and mental, depending on the pathway of impact. While the primary and secondary impact pathways are more physical in nature, the tertiary is relatively psychological or mental. The common physical impacts leads to renal disorder, cardio-vascular and cardio-respiratory disease especially associated with air pollution event or increase in the incidence of vector borne disease such as malaria. For example, in epidemiological understanding, renal impairment is associated with greenhouse gas accumulation; whilst low work productivity is an anticipated psychological impact of extreme weather conditions or climate abnormalities. 

The inequity in climate market where the northern hemisphere contributes billion tons of carbon emission and while southern hemisphere reports high mortality per million populations. Climate Change stands as a ‘MORAL’ issue demanding righteous tradeoffs. Dr Margaret Chan, the Director-General World Health Organization (Dec 2007) expressed his concern over climate change impact on public health saying “I believe that climate change will ride across this landscape as the fifth horseman” .While heath impact is primarily associated with greenhouse gases, the overall impact on public health is a lot more complex bringing into picture factors such as atmospheric brown cloud (aerosols), solar variation, deforestation and land use change. 

Natural episodes such as gigantic forest fire of Canada or bush fires in Australia and anthropogenic driven peat fires for land clearance in Indonesia render the carbon pool more vulnerable to global warming. In wake of the above argument, the IPCC (Working Group 11 in 2007) prefigure 1 million at risk of human displacement by 2050 in extreme condition such as war and disasters.  The palpable mental impact of displacement and war is loss and grief, post traumatic stress, anxiety and global inequality. Quoting some example from both worlds, the Heat Index Summer in 2003 reported 70,000 deaths in 11 days in Europe. Mostly health impacts post disaster condition is much worrying; yet, occupational health is another concern. In developing countries, primarily in the tropical areas, thermal stress related to outdoor working and increased exposure to air pollution result in reduced physical (physiology and productivity) resilience.

Analyses of global public health strategies to cope with changing climate provide clear understanding on change in geographical and seasonal boundaries of possible infectious disease transmission, alteration in vector number, habitat and behavior, change in vector-pathogen-host ecology. It is likely that variation in rain, humidity, temperature may lead to increase incidence of vector borne disease such as malaria and dengue fever. The land cover changes resulting from deforestation, clearance for infrastructural need such as urban settlements, dams, and canals alters the vector habitat. In addition, migration of infected populations, increase case of drug resistance by the pathogen, poverty driven used of pesticides act as confounding factors for climate change-associated shifts in infectious disease pattern.

Different regions are experiencing increased incidence of extreme weather events. What has been worrying is to see not only hundreds of thousands being displaced by each event, but a number of poor getting poorer, and entering into unsustainable survival pathway. The post Kyoto global mitigation attempts have by and far not met the set standards and further reasoning that rate of changing climate far exceeds the rate of mitigation attempts, adaptation seems an immediate option of soften the climate change impact especially for the poor.  

Regionally appropriate and locally applicable adaption policy is vital for dealing with the inevitable impacts of climate change, but it has been under-emphasised in many countries. To fill the knowledge gap, understanding vulnerability in varied ‘socio-eco-epidemio-logical’ environments is primary. The focus on short-term fluctuations is pertinent to address immediate needs, but a long terms strategy to understand in-depth changing pattern of temperature, frosts, winds, sea level, rainfall, changing salinity at multiple scales is vital for integrated climate governance. The combination of adaptation and mitigation attempt will help provide the provision of sustaining the ecosystem heath and is certainly one path to the sustainable future.  

Before we sit too contentedly on our development and technology accolade, we also recognize that we are headed for new challenges. While simpler adaptation measures like construction of sea walls or wise use of ecosystem resources such as water, wetlands are cost effective and viable alternatives. We know it isn’t easy to provide the right options to balance the changing change; understanding the  multidiscipline and cross boundary nature of  impacts, exploring public-private partnerships, strengthening regional collaborations and joining our skills we could aim to confront the issues jointly.