“Whoever wishes to investigate medicine properly, should proceed thus: in the first place to consider the seasons of the year, and what effects each of them produces, for they are not all alike, but differ much from themselves in regard to their changes”.
- Hippocrates; On Airs, Waters, and Places
In this era of globalization, the planet earth is facing multiple crises - the recent financial, food and fuel crisis (the ‘three Fs’) and the two ‘slow burn’ crises – the climate change crisis and the crisis of development (Sengupta n.d.). All these crises acts through different channels and finally converges to impact the health and general well-being of the people. Among that, the ultimate impact are heaped on the poor and marginalized sections of society as they are at the receiving end of every tragedy that the human race is destined to face. The crisis caused on account of unpredictable climate variations is the most devastating of all as a spate of disasters in the recent past exemplifies.
Climate change is nature’s expression of anxieties and anguishes in the event of undue pressures heaped over it by unscrupulous elements. When it becomes unbearable, nature erupts in fury destroying even civilizations. The crisis of climate change, which is part of the larger human induced environmental change, is a serious threat to health compared to others due to its direct and indirect impacts and its social and environmental manifestations (McMichael, 2013). The health impact due to climate change is currently a hot topic and is extensively studied and documented. A three way classification of risk categories and associated causal pathways has been represented in Table 1 (Butler and Harley, 2010).
A study on climate change and its health impacts leads to the question of who mainly causes it and more importantly who is at risk. Climate change is mostly the result of the wrong policies and priorities of the developed nations. Their developmental priorities are often at odds with the sustainable development pattern that meets the needs of the present without compromising the ability of future generations to meet their own needs. While carbon emissions from Northern production may have been reduced, the carbon footprint of Northern consumption has been increased tremendously. In this context we should remember Mahatma Gandhi’s words- “Earth provides enough to satisfy every man's needs, but not every man's greed”.
The primary effect of the climate change crisis is mainly affecting in populations living in diverse social, economic and geographic conditions. The World Health Organization has also acknowledged that, the underdeveloped and developing nations with commonly weak health infrastructure, will least cope with these challenges due to climate change.
Low-income and remote populations are more vulnerable to physical hazards, under nutrition, diarrheal and other infectious diseases, and the health consequences of displacement. As per World Bank estimates, it has been reported that child stunting is projected to increase by 35% by 2050 compared to a scenario without climate change in India (World Bank, 2013). Populations on low-lying islands and in coastal areas, such as Bangladesh, are vulnerable to increased storm surges and flooding as the sea level rises. In arctic circumpolar regions, communities may undergo enforced changes in diet as land and marine animal populations migrate or decline and as access to traditional food (McMichael, 2013). The poor and developing nations in the tropical and sub-tropical belt are at the receiving end of vector borne disease epidemics like Malaria, dengue and chikungunya.
Children and women (especially pregnant women) in particular, who are living in developing & under-developed countries, are among the most vulnerable category to the consequential health risks accompanying climate change. It will also be more severe for elderly people and people with infirmities or pre-existing medical conditions (WHO, 2017).
Health is the only material wealth that a poor person possesses. Hence, we should understand its importance and come up with sustainable livelihood models for adaptation and mitigation of climate change impacts which protect our mother earth and reduce human induced climate change variations. The strategy against health impacts due to climate change needs to focus more on environmental health rather than only on disease management that is patient-centered, largely curative and chemical/medicine intensive.
Dr. Adithyan GS is a public health practitioner and state consultant in National Health Mission, Tamil Nadu