Some Positive Outcomes of Rio+20

The widely reported failure of Rio +20 to produce substantive directives can be viewed as especially disheartening given the current state of perpetual humanitarian crises.  However, Rio +20 can also be viewed as a success in raising awareness on a number of fronts.  It raised the issue of the people of the Sahel region who are suffering from the effects of extreme drought and being targeted by WFP and its local partners who are trying to feed 10 million people, many of whom are also being displaced by conflict.  The fact that that this and past humanitarian response efforts have been chronically under-funded was one of the many challenges facing the Rio +20 stakeholders who took up the challenge of pre-empting further disasters of this kind through responsible agricultural development.

Rio + 20 benefitted from the many side meetings that gave scientists the space in which to present new information on topics such as Climate Change, Vulnerability and Human Mobility.  It also gave António Guterres, the UN High Commissioner for Refugees the possibility to say of African migrants, “they did everything they could to stay at home, but when their last crops failed, their livestock died, they had no option but to move, movement which often led them into greater harm’s way.”

Sharing comments like this was one of the accomplishments of Rio+ 20 and a reminder that the effectiveness of conferences such as Rio+ 20 will always be mediated by the willingness of key actors, countries and international agencies to speak out and share their observations and their knowledge.  The agreements outlined in the Rio +20 outcome document are just another sign of this and the ability, albeit often with hesitation, of all parties to come together around the protection of our most vulnerable human and environmental assets.

Mr. Guterres also described the confluence of problems that often complicate and constrain sustainable development efforts.  He mentioned rampant and unplanned urbanization, uncontrolled population growth, increasing water scarcity, food insecurity and climate change as “defining features of our time.”

The failure of countries to address these challenges preemptively would be far more disastrous than the inability of Rio+ 20 and other international conferences to reach earth-shattering decisions.

-Dylan Freeland

The Lost Count: Malaria Quantification and People on the Move

Live Savers: Mosquito nets help protect the most vulnerable, including pregnant women and infants. © UNHCR/Zalmaï

In the global efforts to combat malaria, accurate assessment of the public health burden of the disease and its distribution is central to monitoring, control, and decision-making. In an article published this month in The Lancet found that, the 2010 Malaria World Report released by the World Health Organization (WHO) underestimated global malaria mortality by 50 percent. The study led by Dr. Christopher J L Murray from Institute for Health Metrics and Evaluation (IHME) in Seattle estimated the 2010 malaria mortality to be 1.2 million compared to 655 thousands reported by WHO. The study used subnational population data to analyze trends in malaria mortality from 1980 to 2010. The study also found that there has been a systematic underestimation of global malaria mortality. Some of the limitations cited in the paper were the lack of representativeness and misclassification of deaths in the subnational data due to the variability in intensity of malaria transmission, incompleteness, and inconsistency of surveillance data. In addition, results from time-trend and time-series data analysis, which was used in this paper, can be affected if there is migration within the population under review.

We believe at ICMHD that this raises the problem of how to quantify malaria incidence, prevalence, and mortality when there are very large numbers of people on the move who do not fall within national health registration systems. The 2011 World Development Report estimated that by the end of 2009 there were some 42.3 million people displaced globally as a result of conflict, violence, and human rights violations. Of these, 27.1 million were internally displaced persons (IDPs) while 15.2 million were refugees outside their country of nationality or country of habitual residence. The United Nations and the United Nations World Tourism Organization has projected that by 2020 there will be 50 million environmental refugees and nearly 1.6 billion international tourist arrivals.

These figures make evident the urgency in developing more consistent methods on measuring malaria distribution and identifying populations at risk. The different approaches that have been used in determining malaria incidence, prevalence, and mortality have led to highly variable results. Moreover, many malaria trends analyses rarely factor in migrating populations.

At ICMHD we think that unless the international community is willing to pay more attention to migrants and other people on the move, malaria control efforts will fail.

By Talubezie Kasongo

Climate Change: A health hazard?

Pakistan 2010 Floods (Daniel Berehulak/Getty Images)

In November 2011, a group of ministers and senior representatives of governments from Africa, Asia, the Caribbean, Latin America, and the Pacific met in Dhaka, Bangladesh, to discuss the threat of climate change and the growing vulnerability of countries to the prospect of global warming. The Secretary General of the UN, Ban Ki Moon, was also present. The conclusion of the Climate Vulnerable Forum Dhaka Ministerial Meeting was to call for more concerted action to help countries adapt to the impact of climate change and take steps to mitigate its impact by creating carbon sinks, disseminating environmentally sound technologies and establishing a balance in the energy mix by focusing on renewable and alternative energy.

The emphasis the Dhaka ministerial meeting placed on limiting global warming, in this case to 1.5 degrees Celsius above pre industrial levels and progressively reducing greenhouse gas emissions, is symptomatic of the challenges facing the response to climate change. For while reducing greenhouse gas emissions will remain an essential goal to achieve, this will be difficult in an era of economic crisis and the felt need by countries to stimulate new industries and employment at the cost of greenhouse gas emissions.

As we move further into what is already a serious situation, it would be perhaps more important to address the fact that climate change is displacing millions of people and is expected to uproot and forcibly move some 250 million people in the coming years. At a time when countries everywhere are raising barriers to immigration and making life more difficult for refugees, asylum seekers, and economic migrant workers of all kinds, the prospect of up to 250 million people moving in search of human security portends massive social, economic, political and health challenges. This is where we should be placing our attention and finding ways of preparing for what may be involved.

Accommodating displaced people will constitute, if it does not already do so, a massive challenge in terms of availability of land, of housing, of sound water and sanitation, social and health services. At ICMHD we believe that a large proportion of the people who will be displaced will move towards large towns and cities either within their own countries or in neighboring ones. Many of these towns and cities are already overwhelmed. Unplanned and poorly coordinated rural urban migration has outpaced the capacity of many of them to absorb and provide the conditions needed for healthy life. The vastly overcrowded shantytowns and slums that now characterize many cities in developing countries are not only making the protection of health difficult, but are actually producing the conditions that facilitate disease.

ICMHD believes that far more attention should be given to this part of the climate change challenge than it has received to date. This is where meaningful action is probably possible in a shorter time frame and could help avert a major global disaster.

By Manuel Carballo

Pakistan: Forced Displacement and Climate Change

Pakistan: Forced Displacement and Climate Change

Manuel Carballo

In the space of little more than 3 weeks, more than 5 million people in Pakistan have been displaced from their homes, their farms, their villages, their communities, and their livelihoods. Predictions are that over the course of the next few weeks, the situation could become even worse and hundreds of thousands more people could be displaced. It will be many months, or even years, before we are able to assess the full extent of the human wastage and damage done, but already a number of assumptions can be made that call for urgent action.

Mohammad Sajjad, Associated Press

The first of these assumptions is that many families will have been disrupted and that many community structures will have been disorganised. In the case of the current situation in Pakistan, this means that millions of families are being affected in ways that will make coping all the more precarious and that will limit the capacity of individuals and groups to begin the difficult, but necessary, process of recovery and reconstruction.

The second assumption is that most of the communities or locations where people are moving to, or being moved to,  are ill-prepared to deal with this influx of women, men, and children of all ages. The load this will place on the healthcare system in these locations will be huge, and it is unlikely that in the absence of massive external assistance, they will be able to respond to the needs of this new population of displaced people.

The third assumption that can be made is that within the ranks of these displaced people, many were already in poor health even before the crisis happened. Pakistan has never been a wealthy country, and as many as a third of its people were struggling to live on less than $1 per day. Malnutrition was widespread, tuberculosis was rampant, and malaria common. Maternal and infant death rates were among the highest in Asia, and life expectancy among the poor was very short. Many of the diseases and health conditions these populations suffered from, now risk being aggravated and spread to other parts of Pakistan.

Associated Press photo

From a psychosocial perspective, the process of displacement will also have affected millions of people in far-reaching ways. Many, irrespective of age or gender, will have been traumatised to such an extent that their capacity to cope will have been lessened. Losing homes, farms, communities, and local cultures will inevitably have introduced a sense of hopelessness and despair that could debilitate the capacity to cope and prepare for a new life. Tragically, there is also reason to believe that the incidence of rape and other forms of gender-based violence will have gone up as well.

All these problems will be made worse by the fact that many of the people concerned are poorly educated and unfamiliar with disease prevention principles and with the healthcare systems that hopefully will become available to them in the coming months. Unless comprehensive and well-coordinated relief and recovery programmes are put into place quickly, Pakistan could be faced with a complex range of new and worsened old health problems.

Tragically, the crisis in Pakistan may be a foretaste of things to come on an equally large scale, and over a wider geographical region. For no matter what global warming and climate change is due to, the fact remains that extreme weather conditions, including heavy and seasonally unpredictable rains, are becoming more common in some parts of the world, while in others, extreme drought and lack of water are becoming common.

K.M.Chaudary/Associated Press

The response to the crisis in Pakistan has been slow in coming. Even now, it is clear that more funding is being proposed from the World Bank, the International Monetary Fund (IMF), and regional banks, than is coming from voluntary contributions. These loans will have to be paid back, and for the foreseeable future, Pakistan will move into a process of long-term indebtedness that will undermine the country’s economy even more so, and place vast numbers of people into greater poverty.

If the international community cannot respond in a more forceful fashion than it has done to date, this will bode ill for Pakistan’s people and their health. It will bode equally ill for all the other countries and the hundreds of millions of people who could be exposed to equally disastrous climatic events in the future.

Related Articles

• Clinton Links Pakistan Floods to Climate Change (foxnews.com)
• Is the Flooding in Pakistan a Climate Change Disaster? (scientificamerican.com)
• NASA images capture extent of Pakistan flooding (photos) (news.cnet.com)
• Pakistan flood health crisis talks‎ to be held (BBC)

Climate Change, Migration, and Health

A Changing Universe:

Climate change, especially global warming, will affect human society in many ways. Massive displacement of people will be one of the main ways, and mass migration will in turn bring it far-reaching ramifications for health and development. Migration is not new. It has been one of the ways in which human beings have always responded to social, economic, political and environmental threats. In the context of accelerating global warming, however, the magnitude of the climate change- related population displacement could go beyond anything that has been seen before and introduce new and far-reaching ramifications for health and social development.

The Impact:

Desertification and drought in some regions, rising sea levels and flooding in others, could turn 200 million people into ‘climate refugees’ by the middle of the century.

Although global warming is likely to affect all parts of the world, some regions stand to be more affected than others. Tragically, it will bet the poorest parts of the world that will probably have the greatest difficulty coping with climate change in ways that would make it less necessary for people to move.

Many of these regions have long been climatically challenged and they are also the ones with the least access to the technology needed to mitigate climate stress. Some are already critically short of water, and further shortages will make even the most basic subsistence agriculture impossible. In other regions, such as coastal areas and river deltas where periodic flooding has long made life precarious, survival will become even more difficult. A million or more people could well be displaced for every centimetre of rise in sea level.

A Global Problem:

Drought, desertification, sea-level rise, coastal flooding and the deterioration of living conditions will not be limited to the poorest parts of the world, however. Many parts of Europe, North America, and countries such as China and India stand to be confronted by these changes as well. What will differentiate some regions from others will be their capacity to manage the impact of climate change and reduce the need for people to move, but flight in the wake of climate change will occur everywhere to some degree. How many people will be forced to move, how far they will have to flee before they find security, what will be the social and health impact of their migration, and how most countries will prepare for and accommodate the impacts involved are questions that must be urgently taken up.

source: http://www.unicef.org.uk

A Changing Political Landscape:

Although the exact parameters of what will eventually occur can not be predicted with precision, a number of options can be foreseen. Each carries with it different political, societal and health implications.

Massive migration from rural areas to towns and cities is one of the options that will inevitably emerge. Urban centres have always been seen by people as a safe haven, and many people will inevitably follow what is now a well-trodden rural-urban migration pathway. Unfortunately, cities in most developing countries are already over-populated and incapable of providing residents with even the most basic services needed to sustain healthy life. If these cities are further challenged by massive numbers of climate refugees, public health will become more fragile than it already is.

Internal migration will not be the only answer, however. Millions of ‘climate refugees’ will seek safety across national borders and try to enter other countries where they feel the quality of life can be more assured. As they do, they will confront the resistance to international migration and migrants that is already intensifying all over the world, and which is making social insertion and healthy life for migrants more difficult.

Forced Migration and its Complications:

Other complications will emerge simply because forced migration is a complex process. It involves difficult choices as to who and what to take as people move. This means deciding who and what to leave behind.  Not all people, especially the elderly and disabled, are able to move easily, and when they cannot, families are quickly broken up in ways that traumatize those who go and those who are left.

source:http://www.greendiary.com

Climate change-related migration, moreover, will occur at a time when natural resources such as water and arable land are becoming scarcer, even in temperate zones and richer parts of the world. When and where this occurs, competition for water and land will be exacerbated and could degenerate into open social and political struggles.

Migration, of course, has other implications for health as well. Climate refugees, like all migrants, will move with their ‘health prints,’ or medical histories and health beliefs. They will also develop new ones according to the circumstances under which they move and the socio-geo-ecological terrain they cover and communities they pass through. The further they have to move, the more they will be exposed to health risks and problems that will potentially have a profound impact on their own health and that of the countries they move into. Some climate refugees will move with diseases that are poorly understood in receiving communities and certainly where there is little herd immunity against them. Local medical practice will be equally unprepared for some of these diseases and be incapable of responding quickly. Other climate refuges will be forced to move to zones where they will be the ones exposed to health threats they have not previously encountered, and for which they have little or no preventative or therapeutic memory and experience. Everywhere the impact on health care needs and demands will call for fundamental reforms and a new way of thinking that is difficult to generate.

Conclusions:

In summary, climate change of the magnitude that is being talked about promises to produce massive forced displacement that will have major implications for social and political stability. Public health will become more challenged, especially but not only, in the poorer parts of the world. Understanding the underlying dynamics of these events, and then planning and preparing for them in a timely and comprehensive way has become urgent. To neglect these issues any longer will open the door to even greater problems in the future.

Bjorn Lomborg talks here in a video created in 2005 about how climate change, health, and poverty are of extreme importance.

Related Articles

• Video: Climate Refugees, The Human Face of Climate Change (thegreengirls.com)
• Africa’s Youth Face Unjust Realities of Climate Change (conversationsforabetterworld.com)
• http://www.thedailystar.net/newDesign/news-details.php?nid=139838
• http://www.focus-migration.de/Climate_change_and_m.6239.0.html?&L=1