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How is climate change affecting our health? a manual for teachers

31 décembre 2008 Organisation mondiale de la santé

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t h WOR L DH E AL T H DAY 7 Ap r i l 2 0 0 8 P R O T E C T I N GH E A L T HF R O MC L I MA T EC H A N G E

H o wi s C L I MA T E C H A N G E a f f e c t i n g

Ou r H E A L T H ? AMa n u a l f o r T e a c h e r s

P h o t oc r e d i t : ©T . B a l a b a a d k a nU N E P / S t i l l P i c t u r e s

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Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change Change

WORLD HEALTH DAY 7th April 2008 Protecting Health from Climate Change

How is CLIMATE CHANGE affecting

Our Health? A Manual for Teachers

Photo: A. Shinde; www.who.int

Regional Office for South-East Asia

© World Health Organization 2008 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Any queries regarding this guide should be addressed to: sde@searo.who.int Designed and Printed in India by: Macro Graphics Pvt. Ltd.

Contents

Introduction.........................................................................................................................................................................................iv Climate Change in Our Region.......................................................................................................................................................1 Impacts of Climate Change: How does it all relate to me?................................................................................................ 11 What can we do to make a Difference?.................................................................................................................................... 21 Annexes............................................................................................................................................................................................... 25 Word Search...................................................................................................................................................................................................... 26 Case Studies...................................................................................................................................................................................................... 27 Activities............................................................................................................................................................................................................. 29 Details about the diseases........................................................................................................................................................................... 31

Glossary............................................................................................................................................................................................... 33

Introduction

limate change is often associated with ecosystem destruction and disappearing species. This is all true, but climate change affects our lives in a more direct way: our health. Unfortunately, the impact of climate change on human health isn’t generally acknowledged. The fact that human-made changes in climate affect human health, in an indirect or direct way, needs to be disseminated among our communities, particularly among the youth who hold in their hands the power to change the future. This manual is an attempt to sensitize growing adults about the importance of the linkages between climate change and human health. The students will learn the reasons behind the changes going on, how they affect each one of us in one way or other, the current and future effects and how we can respond to them. The complete resource material consists of two manuals: one for teachers and one for students. The teachers’ manual is a training resource to support spreading the information via interactive classroom activities. The student’s manual is for them to take home, study and share information about climate change and its impact on human health with their families. The manuals were field tested with 300 children and 15 teachers in several schools before printing of the final version. WHO wishes to thank all those who collaborated in developing the manuals, notably Paula Alvarado, Angela Rey, Dr. Jonathan Patz, Dr. Jenny Pronczuk and Dr. Andy Reisinger.

Climate Change in Our Region

Did you know that…? l

Eighteen heatwaves were reported in India between 1980 and 1998. A heatwave in 1988 caused 1 300 deaths, while another one in 2003 caused more than 3 000. In 2001, heatwaves in Bangladesh caused deaths among metal workers and rickshaw pullers due to heat stroke. In 2005, there were floods in Rajasthan and droughts in northeast India. In 2006, Bhutan reported loss of life from more frequent flash floods and landslides due to melting of glaciers. In 2007, four monsoon depressions double the normal number caused severe floods in Bangladesh, India and Nepal causing death, loss of livelihood and displacement of millions. Twelve of the last thirteen years (1995–2007) rank among the warmest years since 1850.The years 1998, 2005 and 2007 were the warmest on record. The glaciers in the Himalayas, the “Water Towers of Asia”, are melting rapidly. They are receding at an average rate of 10 to 50 meters per year. The Himalayas contribute crucially to the water supply of 1.3 billion people, feeding into nine of Asia’s greatest rivers.

The Sunderbans in Bangladesh and in India face threats from the rise in sea level. The Sunderbans are the only mangrove tiger habitat and they support the largest tiger population in the world. In 2001, over 45% of tourist resorts in the Maldives reported Beach Erosion. Tourism is a major source of revenue for Maldives. In Indonesia, cases of dengue fever have risen by close to 50% between 2006 and 2007, likely due to temperature increases during and after the annual rains.

Photo: Basuki; www.who.int/phe

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Indonesia’s Environment Minister said global warming was to blame for the devastating floods that hit the capital Jakarta in November 2007, forcing thousands of people to flee homes.

The major mechanism behind climate change is the increased “greenhouse effect”, by which the Earth’s atmosphere traps energy from the sun just like a greenhouse. The natural greenhouse effect which warms our planet to support life—is being heavily disturbed. The energy from the sun warms land, water, and air. In turn, the warmed-up land, water, and air give off heat, which rises up towards the sky. Gases, such as water vapor, present in the Earth’s atmosphere capture some of that heat and prevent it from escaping into space. This heat trap keeps the Earth warm, and like a warm blanket makes our planet a habitable world for all the various animal and plant species to survive in. Without this heat trapping system, the Earth’s surface would be about 15 degrees Celsius colder than it is now. This process is known as the greenhouse effect. It is a natural phenomenon mainly driven by water vapor, and other greenhouse gases (or GHGs) present in the atmosphere. Adding more greenhouse gases increases the warming effect to the point that it is no longer beneficial but has negative consequences for life on Earth.

It appears that the phenomenon of global warming is upon us all! What’s happening? We first need to realize that there is a difference between weather and climate. l

Weather consists of those meteorological events, such as rain, wind, and sunshine that can change day by day, even hour by hour. Climate is the average of all these events over a period of time, like a year or several years.

... and what is climate change? Our planet’s climate is always changing. In the past it has altered following natural causes but at the present the changes have accelerated as a result of human behavior. Nowadays the term “climate change” is generally used when referring to changes in our climate, which have been identified as occurring since the beginning of the mid-19th century. Figure 1: The Greenhouse Effect

Solar radiation powers the climate system.

The Greenhouse Effect SUN Some of the infrared radiation passes through the atmosphere but most is absorbed and re-emitted in all directions by greenhouse gas molecules and clouds. The effect of this is to warm the Earth’s surface and the lower atmosphere.

Some solar radiation is reflected by the Earth and the atmosphere.

ATMOSPHERE

EARTH About half the solar radiation is absorbed by the Earth’s surface and warms it. Infrared radiation is emitted from the Earth’s surface.

Source: www.global-greenhouse-warming.com/

Climate Change in Our Region

Table 1: The six main greenhouse gases Name Water vapor Carbon dioxide (CO2) Methane (CH4) Nitrous oxide (N2O) Ozone (O3) Description Is one of the most abundant gases in the atmosphere and builds up with the evaporation from water bodies on Earth. Is produced by the combustion of fossil fuels and from forest fires. Animal husbandry, irrigated agriculture and oil extraction release important amounts of this potent greenhouse gas. Is a by-product of burning fossil fuels and is also released when ploughing farm soils. Main element of the protective layer in the upper atmosphere, which shields the Earth from the sun’s harmful ultraviolet radiation. Ozone is both a natural and a man-made gas. Produced in excess as a result of smog and severe air pollution, it becomes harmful to human health. Chlorine-containing gas used for refrigerators, air conditioners, aerosol sprays propellants and cleaning agents. Chlorofluorocarbons cause depletion of the atmospheric ozone layer.

Chlorofluorocarbons (CFCs)

For over 10 000 years, the Earth has had relatively stable temperatures. But scientists have noticed that for the past 150 years our planet has been warming up fast. This phenomenon is called “global warming”. It is basically due to the increased amount of greenhouse gases in the atmosphere that have intensified the greenhouse effect. This change is the result of human activities that release GHGs.

How do people produce the greenhouse gases? Carbon dioxide (CO2) is produced mainly in the burning of fossil fuels such as coal, oil and gas in industry, in electricity generation, in transport and for heating purposes. In the incineration of waste, a great deal of carbon dioxide is released as well.

Figure 2: Atmospheric concentration of CO2 between 1870 and 1990 Atmospheric concentration of CO2 Parts per million (ppm) 360

340

320

300

280

260 1870 1890 1910 1930 1950 1970 1990

Source: © UNEP/GRID-Arendal; http://maps.grida.no/go/graphic/global_atmospheric_concentration_of_co2_1870_1990

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Figure 3: Atmospheric concentrations of carbon dioxide (CO2) between 1957 and 2007 Atmospheric CO2 concentration (ppm) 380 360 340 320 300 1957 1967 1977 1987 1997 2007

Source: © Hugo Ahlenius, UNEP/GRID-Arendal; http://maps.grida.no/go/graphic/ atmospheric-concentrations-of-carbon-dioxide-co2-mauna-loa-or-keeling-curve

Methane (CH4) is released mainly by cattle (digestive processes and manure), in waste treatment (fermentation on landfills), through leaks in the distribution of natural gas and in combustion processes. Nitrous oxide (N2O) or laughing gas, is released especially in the burning of fossil fuels (mainly in traffic), in a number of processes in the chemical industry and in agriculture. Chlorofluorocarbons (CFCs) and similar substances and their substitute products (HCFCs and PFCs) are used chiefly as refrigerants, air conditioners, as propellants in aerosols and in the production of foam plastic. Ozone (O3) as such is not put into the atmosphere directly by man, but is generated there via a series of chemical reactions involving Nitrogen Oxides (NOx), Carbon Monoxide (CO) and Volatile Organic Compounds (VOC). These ozone precursors, as they are called, are produced mainly by the transport and industrial sectors. Urban settings are the biggest emitters of GHGs; they produce the maximum amount of industrial and car emissions. Mega-cities produce a “Heat Island Effect”. “Heat islands” refer mainly to urban settings where buildings and asphalt roads absorb and thereafter release more solar energy and thus increase the surrounding air and surface temperatures. Although they do not directly contribute to

global warming, this effect would increase the demands for air conditioning, thereby increasing the emissions of greenhouse gases. Some greenhouse gases occur naturally in the Earth’s atmosphere. But scientists measuring the gases have found their amount has increased especially in the past few decades. l

Carbon dioxide (CO2) is the most important human-generated (or “anthropogenic”) GHG. Its annual emissions grew by about 80% between 1970 and 2004. The amount of CO2 in the atmosphere reached 385 parts per million (or “ppm”) in 2006, an unprecedented level in the past 650 000 years. The increase of GHG in the atmosphere is mainly human driven and is linked to the burning of fossil fuels such as coal or gas, but also due to forest fires. Scientists believe CO2 levels will rise another 30% during the next 50 years.

The amount of CO2 in the atmosphere grew by about 80% between 1970 and 2004.

Climate Change in Our Region

Figure 4: National carbon dioxide (CO2) emissions per capita.

CO2 Emission in 2002 Tonnes per capita 20 United States Saudi Arabia 19 Australia 18 17 16 15 Canada 14 13 High income average 12 11 10 9 8 7 6 5 World 4 average 3 2 Low 1 income average 0

Czech Republic Norway Russian Federation United Kingdom Germany Japan

South Africa Ukraine Malaysia France Sweden Iran Mexico Argentina Turkey Thailand Gabon Egypt China Brazil GNP per capita,PPP Uruguay (International $) Indonesia India more than 20000 Philippines 10000 to 20000 Guatemala 5000 to 10000 Pakistan 2000 to 5000 Yemen less than 2000 Togo Nigeria Bangladesh Ethiopia Montague Uganda Mali 0 Source: UNEP/GRID-Arendal; http://maps.grida.no/

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Those countries that have historically contributed to global warming will not be the ones that will suffer the most

from it. The two figures below show the unethical balance between emitters of GHG and victims of climate change.

Figure 5: Cumulative emissions of greenhouse gases

"ILLION4ONS#ARBON Source: Patz et al, Ecohealth, December 2007

Figure 6: WHO estimates of deaths per million people, attributable to the climate change that occurred from 1970s to 2000.

70 120

Mortality Per Million Population

Source: Patz et al, Ecohealth, December 2007

Climate Change in Our Region

Figure 7: Global average temperatures 1850–2007

Strong global warming observed since 1975 Global Average Near-Surface Temperatures 1850–2007 Temperature Difference (0c) with respect to the end of the 19th century 1.0 0.8 0.6 0.4 0.2 0.0 -0.2 -0.4 1880 1900 1920 1940 1960 1980 2000

Topics recap 1: What is climate change? 1. Create your own folder on climate change and human health! Collect newspaper articles or look up the web for recent information and news articles on climate change impacts in your region. You will be surprised how many there are! Save them for later reference. 2. Ask older members of your family what the weather was like when they were of your age, and compare it to today. 3. Explain the difference between weather and climate. 4. Why is the greenhouse effect so important? 5. Why is climate change also an ethical issue? 6. By how much has the concentration of CO2 risen in the last 150 years? Check it out for yourself! You can try this easy experiment at home: Take two jars and put a teaspoon of water in each jar. Put a lid on just one jar. Place both jars in a sunny spot. After a few hours, check on the jars. You will see that the open jar hasn’t changed, but the closed jar will be steamy and hot inside. What happened? The heat from the sun could not escape from the closed jar.

The Intergovernmental Panel on Climate Change (IPCC)was established in 1988 by the World Meteorological Organization (WMO) and the United Nations Environment Programme (UNEP). Its role is to assess the scientific, technical and socio-economic information relevant for the understanding of the risk of human induced climate change. The Fourth Assessment Report of the IPCC, the result of 3 years of collaborative work by a group of 3 600 scientific experts was released in 2007. Its findings state: ”Global atmospheric concentrations of CO2 , methane and nitrous oxide have increased markedly as a result of human activities since 1750 and now far exceed pre-industrial values determined from ice cores spanning many thousands of years.” l

Because greenhouse gases trap heat, their increase is expected to raise the average global temperature by 0.2 degrees Celsius per decade over the next 100 years. Because GHGs are persistent, even if the concentrations of all greenhouse gases had

www.ipcc.ch

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Figure 8: Sea level rise prediction according to various scenarios Sea Level Rise Projections in the IPCC: 2001 and 2007 1.0 A1B A1Fl A1T A2 B1 B2

TAR

AR4

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Sea level rise (m)

0.6

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0.2

0.0 1990

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2040 Year

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Source: © Center for Science and Technology Policy Research, University of Colorado, USA

been kept constant at year 2000 levels, a further warming of 0.1 degree Celsius of global temperature per decade would be expected. This may not seem much, but this is the same as the global average temperature rise that occurred over the last century. The IPCC research teams addressed the inherent complexity in the study of climate change by developing Integrated Assessment Models (IAM) for predicting greenhouse gas emissions and their effects on global temperature. A1. The A1 storyline and scenario family describes a future world of very rapid economic growth, global population that peaks in mid-century and declines thereafter, and the rapid introduction of new and more efficient technologies. Major underlying themes are convergence among regions, capacity building and increased cultural and social interactions, with a substantial reduction in regional differences in per capita income. The A1 scenario family develops into three groups that describe alternative directions of technological change

in the energy system. The three A1 groups are distinguished by their technological emphasis: fossil-intensive (A1FI), non-fossil energy sources (A1T), or a balance across all sources (A1B). A2. The A2 storyline and scenario family describes a very heterogeneous world. The underlying theme is self-reliance and preservation of local identities. Fertility patterns across regions converge very slowly, which results in continuously increasing population. Economic development is primarily regionally oriented and per-capita economic growth and technological change is more fragmented and slower than in other storylines. B1. The B1 storyline and scenario family describes a convergent world with global population, that peaks in midcentury and declines thereafter, as in the A1 storyline, but with rapid change in economic structures toward a service and information economy, with reductions in material intensity and the introduction of clean and resourceefficient technologies. The emphasis is on global solutions to economic, social and environmental sustainability,

Climate Change in Our Region

including improved equity, but without additional climate initiatives. B2. The B2 storyline and scenario family describes a world in which the emphasis is on local solutions to economic, social and environmental sustainability. It is a world with continuously increasing global population, at a rate lower than A2, intermediate levels of economic development and less rapid and more diverse technological change than in the B1 and A1 storylines. While the scenario is also oriented towards environmental protection and social equity, it focuses on local and regional levels. Warmer temperatures also translate into warmer seas, which in turn create conditions for more intense and more frequent tropical storms and cyclones. The large amount of variation between predictions of the different scenarios underlines the complexity involved in making such predictions and the large amount of uncertainty inherent in climate change models. A warmer atmosphere also disrupts wind and rain patterns leading to excessive floods and/or prolonged droughts. As warmer seas expand, the sea level will rise, threatening residents along the coastlines and on low lying islands.

in salinity; fresh water is less dense than salt water and therefore takes up slightly more space than an equal mass of salt water. Relying on data from satellites and floats (mechanical devices drifting in the ocean), a group of oceanographers announced in June 2006 that sea level rose, on average, 3 millimeters (0.1 inches) per year between 1993 and 2005. Warmer temperatures will also accelerate the melting of glaciers, leading to flash floods first, and to water shortages later.

The IPCC projections state: “By the 2050s, freshwater availability in Central, South, East and South-East Asia, particularly in large river basins, is projected to decrease; l

Coastal areas, especially heavily-populated mega delta regions in South, East and South-East Asia, will be at greatest risk due to increased flooding from the sea, and in some mega deltas, flooding from the rivers; Climate change is projected to compound the pressures on natural resources and the environment, associated with rapid urbanization, industrialization and economic development; Endemic morbidity and mortality due to diarrhoeal disease primarily associated with floods and droughts are expected to rise in East, South and South-East Asia due to projected changes in the hydrological cycle.”

Topics recap 2: Global warming 1. Explain what global warming is. 2. By how much will the temperatures have increased by 2100? 3. Why does the sea level rise? 4. Name four natural events that will be accelerated because of global warming. Increasing sea-levels will lead to costal erosion Photo: ©Greenpeace/Jeremy Sutton-Hibbert

5. Study the statement of the IPCC and explain it in your own words.

When sea level rises, it can do so for a few reasons. It can rise due to thermal expansion—the tendency of warm water to take up more space than cooler water. It can rise due to the addition of water, for instance from melting glaciers. It can also rise due to changes

The morbidity rate is the number of cases of people with a disease in a population. The mortality rate is the number of deaths in a population over a year.

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Changes in the Glacier at Shrong Himal, Nepal over 26 years.

Source: Laboratory of Cryosphere Variation, Nagoya University http://snowman.hyarc.nagoya-u.ac.jp

Impacts of Climate Change: How does it all relate to me?

When we talk about global warming the first picture that comes to our mind is generally of ecosystem destruction and loss of wildlife habitat... but, what about us, humans? A lot of attention has been given to the impact of climate change on our environment, ecosystems and on various plant and animal species. However, climate change will also have major direct and indirect impacts on our health. Indeed, the most recent report of the IPCC highlighted a wide range of implications for human health: l

Climate change can cause death and disease through natural disasters, such as heatwaves, floods and droughts. In addition, many important diseases are very sensitive to changing temperatures and precipitation. These include common diseases such as malaria and dengue fever; as well as other major killers such as malnutrition and diarrhoea. Climate change already contributes to the global burden of disease, and this contribution is expected to grow in the future.

Photo: www.allposters.com

The various potential health effects of climate change, both direct and indirect, are summarized in Table 2.

Photo: © Abir Abdullah / Still Pictures

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conditions related to circulatory, respiratory and nervous-system problems. An increase in heat waves, particularly in urban areas, could significantly increase deaths. Higher overnight temperatures during heat waves are also a concern for human health, as cooler temperatures at night offer much-needed relief from the heat of the day.

Respiratory diseases Respiratory diseases are a condition in which breathing becomes difficult and the oxygen level in the blood abruptly drops lower than normal. Photo: © T. Balabaadkan UNEP / Still Pictures

In more detail: The climate change impacts on your health Climate change will not only bring a warmer world, it is setting the scenario for an unhealthier one. Heat strokes Higher temperatures are expected to increase the occurrence of heat-related illnesses such as heat exhaustion and heat stroke, and exacerbate existing

Respiratory diseases are a leading cause of mortality in developing countries, and one of the most common causes of illness in children of developed countries as well. In 1990, respiratory diseases were the leading cause of disabilities and illnesses worldwide. By 2020, respiratoryrelated diseases are projected to rank among the top ten causes of poor health globally. In fact, the prevalence of asthma since the 1980s in a number of countries has increased four-fold. Respiratory diseases, such as asthma and allergies, are caused by combinations of different factors. These

Table 2: Health concerns and vulnerabilities due to climate change Weather events Warm spells, heatwaves and stagnant air masses Warmer temperatures and disturbed rainfall patterns Heavy precipitation events Impacts on human health w Heat stroke, affecting mainly children and the elderly. w Increase in respiratory diseases. w Cardio-vascular illnesses. w More exposure to diseases like malaria, dengue, Japanese encephalitis and other

diseases carried by vectors such as mosquitoes, rodents and ticks (known as “vectors”. These diseases are therefore called vector-borne diseases.

w Increased risk of diseases related to contaminated water (water-borne) and to unsafe

food (food-borne). Depletion of safe water supplies and poor sanitation will increase the incidence of diarrhoeal diseases such as cholera.

Droughts

w Malnutrition and starvation particularly affecting children’s growth and development. w Reduced crop yields causing stress for farmers and their families (known as

“psychosocial stress”), who may be unable to pay their debts during extended and repeated droughts.

Intense weather events (cyclones, storms)

w Loss of life, injuries, life-long handicaps. w Damaged public health infrastructure such as health centers, hospitals and clinics. w Loss of life, loss of property and land, displacement and forced migration due to

disasters will bring about psychosocial stress affecting mental health. cause potential social conflicts, affecting mental health.

Sea level rise and coastal storms Source: WHO, 2007

w Loss of livelihoods and disappearance of land will trigger massive migration and

Impacts of Climate Change

Photo: © Deb Kushal -UNEP / Still Pictures

Photo: © Abir Abdullah / Still Pictures

factors are linked to the genetic background and the lifestyle of a person as well as the environment they live in. Heat speeds chemical reactions and consequently may worsen pollution from ozone. It may also spur pollen production by some plants, which could in turn worsen asthma and allergies in some people. Long-term exposure to air pollution, both inside the home and outdoors, is known to increase the risk of respiratory illness in children. Key air pollutants that can affect human health are ozone, nitrogen dioxide and sulphur dioxide. This pollution is mainly linked to road traffic or industrial processes. Air pollutants from fossil fuels have global impacts that are not just a local, national or regional concern because they can be transported thousands of miles away. The continued emissions of GHG will worsen air pollution levels.

Runoff from fields (bearing pesticides), landfills, septic fields, sewer pipes and residential or industrial developments can also contaminate surface water. This also occurs during floods. In developing countries many illnesses are caused by waterborne diseases, with diarrhoea being the leading cause of childhood death. The global picture of water and health has a strong local dimension; some 1.1 billion people still lack access to improved drinking water sources and some 2.4 billion to adequate sanitation. In India, over 70% of the population has no access to proper latrines! Contaminated water and food are the single most common way by which people become infected. Warmer temperatures will raise the risk of flooding, increasing diarrhoeal illnesses such as typhoid, cholera and other waterborne illnesses. Floods cause sewage and drinking water systems to mix, and that water if ingested can lead to diseases such as cholera, diarrhoea and typhoid. The lack of sanitation would make the problem worse. Overall, climate change is expected to increase the burden of diarrhoea, mostly in developing countries, by 2 to 5 percent by 2020.

Waterborne diseases Waterborne diseases are any illness caused by drinking water contaminated by human or animal faeces, which contain pathogenic microorganisms.

By 2020, respiratory-related diseases are projected to rank among the top ten causes of poor health globally.

Also, algal blooms could occur more frequently as temperatures warm, particularly in areas with polluted waters, in which case diseases such as cholera that tend to accompany algal blooms could become more

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frequent. Such infectious disease outbreaks would affect all sections of society, both the rich and poor.

Vector-borne diseases The current diversity of infectious disease threats facing humanity is unprecedented. Infectious diseases are now the world’s number one killer. Scientists suspect that many diseases transmitted by insects and animals (known as vector-borne diseases) will become more common, although there is more uncertainty about this than other consequences of global warming. Climate change may increase the risk of some infectious diseases, particularly those diseases that appear in warm areas and are spread by mosquitoes and other insects. A change in climate will be more favorable to the growth of “vector organisms” like mosquitoes and rodents. These vector-borne diseases include malaria, dengue fever, yellow fever and encephalitis. Other diseases that may become more prevalent are chikungunya and yellow fever (both also carried by mosquitoes), schistosomiasis (vector: land snails), leishmaniasis (sand flies) and Lyme disease (ticks). Higher temperatures, in combination with favorable rainfall patterns, could prolong disease transmission seasons in some locations where certain diseases already exist. In disease-free locations, climate change could enhance the introduction of certain vector-borne diseases.

Malaria kills over a million people every year; a large percentage of them are children under five, mainly in Africa. Malaria mosquitoes could be controlled with efficient drainage because they all depend on water to complete their life-cycles.

Malnutrition Malnutrition is a general term for a medical condition caused by an improper or insufficient diet. It most often refers to under-nutrition resulting from inadequate consumption, poor absorption or excessive loss of nutrients. The world’s poorest countries face a dramatic rise in deaths from disease and malnutrition as a result of climate change, which is driven by wealthier, more industrialized and more polluting countries. In 1990, worldwide there were 520 million people at risk of hunger, according to a study by British and American scientists published in 2005. In the absence of global warming, that number was predicted to fall to 300 million by 2080. With global warming, it is expected to fall only to 380 million. Food production would be severely affected by climate change, especially cereal crops. A change in climate would change temperature, rainfall patterns, soil moisture and soil fertility. Crop pests could find ideal conditions to thrive. Food security problems would lead to widespread malnutrition. This would reduce child growth and development. Malnutrition and hunger would affect adults’ health too. Greater variability in weather patterns along with higher temperatures may lead to droughts and water shortages. Today, 1.7 billion people (about one-third of the world’s population) live in places that have periodic water shortages. That number is expected to increase to 5 billion by 2025.

...rainfall patterns, could prolong disease transmission seasons in some locations where certain diseases already exist. Photo: © Shehzad Noorani /Majority World / Still Pictures

Impacts of Climate Change

Figure 9: Causes of child mortality (WHO, 1996) Malaria 5% 32% Other Malnutrition 55% 19% 7% 18% Perinatal Causes Measles Acute respiratory infections

19% Diarrhoea

Causes of mortality among children less than 5 years of age in developing countries, 1999 *Malnutrition affects 54% of all children less than 5 years of age, and it makes them vulnerable to acute respiratory infections, diarrhoea, malaria and measles. Source: Adapted from WHO/FCH/CAH/00.40 [WHO Geneva, Department of Child and Adolescent Health and Development (CAH).Model chapter for textbooks-IMCI-Integrated Management of Childhood Illness], 2001

Food security problems would lead to widespread malnutrition.

A decrease in water availability as a result of changes in the rainfall pattern, forcing people to drink unsafe water, would add to the health problems related to diarrhoeal disease outbreaks. Water and food scarcity would bring havoc to subsistence farmers, possibly triggering mass migration to urban centers. Decreasing river flows, rising salinity of estuaries, loss of fish and aquatic plant species and reductions in coastal sediments are likely to damage fisheries, a key source of protein for coastal and riverside populations, possibly as early as 2020. Floods in Andhra Pradesh in October 2005 killed over 120 people and injured many more. Source: www.rmtbristol.org.uk

Injuries Changes in the frequency of extreme weather events such as heatwaves, cold spells, hurricanes, cyclones, floods and storms would result in injuries and deaths.

These injuries can result in major trauma, such as the loss of limbs, and minor injuries (broken bones and cuts and bruises), but also lead to deaths from drowning. Flooding is the most common weather disaster, responsible for the deaths of about 100 000 people and the displacement of 1.2 billion from 1992 to 2001, globally. The devastating impact of the 2007 floods in Nepal, Bangladesh and India and of the super-cyclone Sidr in Bangladesh killed over 4 000 people and made millions

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Number of events per year 450 All disasters 400

Trends in number of reported events Much of the increase in the number of hazardous events reported is probably due to significant improvements in information access and also to population growth,but the number of floods and cyclones being reported is still rising compared to earthquakes. How, we must ask, is global warming affecting the frequency of natural hazards?

350 All disasters include: drought, earthquake, extreme temperatures famine, flood, insect infestation, slides volcanic eruption, wave / surge,wild fires,wind storm.

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Source: © Emmanuelle Bournay, UNEP/GRID-Arendal; http://maps.grida.no/go/graphic/trends-in-natural-disasters

homeless. Particularly vulnerable groups include children, women (especially pregnant women) and the elderly. Women have the added burden of earning for the family in cases where their husbands have to migrate to cities in search of a livelihood after a natural disaster.

affect their well-being. Stressful situations may arise due to natural disasters, traumatic events, crowding or isolation. Natural disasters not only lead to destruction, but also to displacement. Survivors of such disasters have to cope not only with physical injuries, but the pain and stress of loosing their family members, homes and livelihood. Witnessing such traumatic events could have a devastating impact on their mental health— sometimes, forever.

Psychosocial stress Psychosocial stress occurs when acute or chronic events, of psychological or social in origin, cause a major disruption in an individual’s day-to-day life and

Impacts of Climate Change

Artist: Meetu Singh, 13 years old, Student

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Figure 10: Linkages between climate change and human health

Modulating influences

Health effects Temperature-related illness and death Extreme weather-related health effects Air pollution-related health effects Water and food-borne diseases Vector-borne and rodent-borne diseases Effects of food and water shortages Mental,nutritional, infectious and other health effects

Regional weather changes � �

Microbial contamination pathways Transmission dynamics Agroecosystems, hydrology Socioeconomics, demographics

Heatwaves Extreme weather Temperature Precipitation

CLIMATE CHANGE

� �

Health-specific adaptation measures Research needs

Evaluation of adaptation

Source: http://www.who.int/globalchange/en/

Impacts of Climate Change

Individuals who experience a catastrophic event may develop ongoing difficulties known as Post-Traumatic stress disorder (PTSD). The stressful or traumatic event involves a situation where someone’s life has been threatened or severe injury has occurred. A person’s risk of developing PTSD is related to the seriousness of the trauma, whether the trauma is repeated, the proximity to the trauma, and his/her relationship to the victim(s). Following the trauma, those affected may initially show agitated or confused behavior. They also may show intense fear, helplessness, anger, sadness, horror or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma. This is called dissociation. Children with PTSD avoid situations or places that remind them of the trauma. They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings. The symptoms of PTSD may last from several months to many years. Climate change may also contribute to social disruption, economic decline and displacement of populations in certain regions due to effects on agricultural production, already-scarce water resources and extreme weather

events. These issues are likely to be more severe in developing countries, and may worsen human health and well-being in affected regions. It is imperative to have a better understanding of the relationships between climate change and human health. Indeed, it is high time that health concerns move up front in the decision-making processes about mitigation and adaptation to global warming and climate change.

Topics recap 3: Why should health be at the heart of climate change discussions? 1. Why do you think that little attention has been given to the impacts of climate change on human health? 2. How are respiratory illnesses related to global warming? 3. Which are the six main health impacts from climate change? 4. What are waterborne diseases and how do they relate to climate change? 5. Study the WHO graph on climate change and health linkages, and describe its contents in your own words.

Artist: Abhay Solanki, 13 years old, Student

What can we do to make a Difference?

There are two basic ways to deal with the health problems of climate change: l

Examples of mitigation Through encouraging personal action, we can do our part to dramatically reduce greenhouse gases and begin turning back the clock on climate change. We can make small but significant contributions towards preventing and reducing the effects of climate change simply by making a few changes in our daily lives. For example, some measures that will reduce our household GHGs emissions include:

Reduce the causes of climate change and its consequences on human health—known as “mitigation”; and Improve the capacity to cope with the health risks by being better prepared—known as “adaptation”.

1. 2. 3. 4. 5. 6. 7. 8. 9.

Use AC and water coolers less. Use low-energy light bulbs and switch them off when leaving the room. Save water by not letting it run while brushing your teeth. Turn off computers, TV and other appliances when not in use. Improve insulation systems in our homes by designing our houses better. Walk or cycle more—use the car less! Use public transportation more often. Share ride to school with friends and neighbors. It’s also fun! Implement the “Three Rs principle”: Reduce, Recycle, Re-use!

10. Home water purification treatments can prevent water borne diseases. 11. Sleeping in mosquito nets can protect us from being bitten by mosquitoes carrying diseases such as malaria and dengue. Fixing wire netting on windows, using mosquito repellent creams and wearing long-sleeved clothes and trousers are also useful in avoiding mosquitoes.

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Mitigation: Any action taken to permanently eliminate or reduce the long-term risk to human life, property, and function from the hazards of climate change. Without good and early mitigation, the difficulty and costs of adaptation will grow rapidly. Adaptation: An adjustment in behavior that responds to actual or expected climatic effects. Various types of adaptation can be distinguished, including anticipatory and reactive adaptation, public and private adaptation, and autonomous and planned adaptation. Successful adaptation builds on local knowledge, local capacity and willingness to act.

These are things you can do yourself. But to bring about a wider change in our society in relation to climate change it is important to involve communities around us. For example, we and our neighbors can get rid of sources of breeding sites of mosquitoes by encouraging people to fill in pools and puddles of stagnant water with sand and by asking local government and authorities to provide a good drainage system. All countries have the responsibility to achieve the emissions targets set under the Kyoto Protocol. They are binding for those countries that have ratified this international agreement. The private sector has an obvious role to play in cutting greenhouse gas emissions by using more energy-efficient technologies that could dramatically reduce our dependence on fossil fuels. Plantbased “bio fuels” could represent an alternative as long as they don’t cause deforestation, threaten food supplies or make climate change even worse. The health sector should emphasize the health benefits of reducing greenhouse gases by encouraging the use of public transportation such as rapid transport system which will reduce air pollution and decrease the rate of traffic injuries. Having cleaner air and leaving the car at home will also encourage more physical activity and thus reduce obesity.

Examples of adaptation Public health policies need to deal not only with the current burden of disease but also to take measures to reduce and prevent disease in the future. Improving the response to disease and surveillance is thus vital. Fortunately, much of the health risk is avoidable through existing health programmes and interventions. Concerted action to strengthen key features of health systems and to promote healthy development choices can both enhance public health now and reduce vulnerability to future climate change. Governments should actively work with local communities, notably in rural and remote areas to empower them with knowledge about local solutions to protect themselves from diseases. For instance, it is important for them to understand the need to have a system that ensures safe drinking water and to have the necessary knowledge to maintain it. Other measures that reduce the negative impacts of climate change include the use of crop varieties with greater drought tolerance; adoption of irrigation methods that use less water or use it more efficient and preparing for rising sea levels with better flood defenses and ensuring no settlements are in vulnerable areas. Both adaptation and mitigation are needed (now) as effective response measures to climate change. We need to “avoid the unmanageable and manage the unavoidable”.

We can make small but significant contributions towards preventing and reducing the effects of climate change simply by making a few changes in our daily lives. Rapid Transport System

What can we do to make a Difference?

Case Study A: Most households in Bhutanese villages suffer from water scarcity during the dry season. Village elders tell that many rivers have dried out in recent time. In 2006-rooftop rainwater harvesting systems were provided to various communities. A reservoir tank with the capacity to hold enough water throughout the dry period, gutters and down pipes to channel water into the tank were given to each household by the government. The local community provided the labor for installation and was trained to ensure sustained operation and maintenance. These rooftop rainwater harvesting systems have changed lives and increased climate change resilience.

Case Study B: Sri Lankan children are observing mosquito larvae in water containers. They learn to identify the larvae of the various mosquitoes that breed in the paddy fields around their village. By understanding the life cycle of the disease vectors and the importance of environmental factors such as water and temperature, villagers become experts in Integrated Vector Management or IVM. IVM allows local communities to be better prepared to address the health impacts of climate change and to keep healthy.

Personal action “A to Z” tips on what YOU can do NOW, to help reduce the adverse health impacts from climate change

Enjoy the sun! Fit solar panels on the roof of your home. Why not turn your home or office into a clean power station? Solar power is renewable and plentiful!

Act Now! Buy energy

Fridge: Don’t leave fridge doors open for longer than

efficient appliances: Make informed choices. If you’re buying a washing machine, refrigerator, dish-washer or oven, buy the most energy-efficient model you can afford. They might be more expensive but they pay for themselves through lower energy bills. The same is true for procurement of office equipment, such as computers, photocopiers and printers.

necessary; let foods cool down fully before placing in the fridge or freezer; defrost regularly and keep the appliance at the right temperature. Where possible, don’t place cookers and fridges/freezers next to each other.

alculate your personal carbon footprint and cut your greenhouse gas emissions. See for example: 3w.earthday.net/footprint/info.asp or at http://www. carbonfootprint.com/ ebate, discuss, and distribute leaflets, brochures and posters on climate change and environmental health issues. Useful information is available at: 3w.unep.org/wed/2007/ english/; http://unfccc.int/; 3w.who.int/globalchange/ climate/en/index.html; www.climatecrisis.net/

environmentally friendly one. This will save you money and keep more CO2 from going into the atmosphere. Make sure that your tires are inflated correctly—this can save you 5% on the cost of your petrol. Share car journeys with your work colleagues or friends. Make more use of public transport, such as the metro, and the train for longer journeys. For short trips and local shopping, try walking or use a bicycle. It keeps you fit and is fun too! More at: 3w.worldwildlife.org/climate/involved/ individuals.cfm

Go Green! If you have to buy a car, buy a fuel-efficient,

Halve your emissions by moving your air conditioner

thermostat up by 5 degrees Celsius in summer. Almost half of the energy we use in our homes goes to cooling.

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Maintain the filters on your air conditioners by cleaning them regularly. A clean air filter can save pounds of carbon dioxide a year. More at: 3w.greenpeace.org/international/ campaigns/climate-change/take_action

groups are doing around your locality or region; if there are no groups, start one!

Involve your family, friends, children and neighbors! Use less energy, and conserve more of it! Do not Join an environmental group. Find out what action waste water—close your tap while brushing your teeth, Kick start an environmental campaign in your neighborhood. and while soaping clothes, body or dishes. Repair leaky plumbing fixtures; prevent overflowing of tanks. Energy is used for pumping and treating water. Save water to save energy!

10 and 60% of the power when in “stand-by” mode. Turn off computer screens and photocopiers when you take a break. Also turn off lights when you don’t need them,— it saves energy after a minute or two. Unplug electronic items when you’re not using them.

Lamps: Replace the bulbs you use most with compact inimize the use of toxic chemicals. Use non toxic, biodegradable, water- or plant-based paints, cleaners and pest repellents.

Value

fluorescent lamps or CFL bulbs. More information on CFL at: http://www.energystar.gov/index.cfm?c=cfls.pr_cfls

M N

wastes! Do not dump your home wastes everywhere. Heaps of garbage left in the open emit methane and contribute to global warming. Segregate your wastes so they can be recycled and/or reused and where possible use organic waste for composting.

Write

etwork with specialized agencies, non-profit organizations and engaged communities. More at: http:// www.cseindia.org/html/eyou/climate/index_climate.htm ffset your carbon footprint. There are many costeffective energy saving and carbon reducing steps anyone can take. See more at: http://www.carbonfund.org/

letters about the health impacts of climate change to the local newspapers. This is a great way to keep the issue in the public mind. It also sparks a debate and allows us all to understand what the real issues are. your concerns on environmental health issues and solutions and stay informed. Read widely and understand what we are dealing with.

Xpress

Your president, prime minister, parliamentarian or

(UNEP) has launched a major worldwide tree planting campaign, aiming at planting one billion trees around the globe. http://www.unep.org/billiontreecampaign/

Plant trees: The United Nations Environment Programme

local leader needs to know about the impacts of climate change on health. Write letters to them asking for policies to ensure greenhouse gas emissions fall by at least 3% each year from now on.

Quit using plastic bags. Carry your own bag with you when going shopping.

Recycle, repair and reuse materials. Tips, tricks and

ideas for sustainable living. See: www.ban.org/main/ marketplace.html; www.geda.org.in/e_conserv/ec_ov_ tds.htm; http://www.regeneration.org/tips-downloads/

oom in on reducing emissions: It is the best way forward! Our countries need new national legislation and laws to help ensure that we develop cleaner cars and cleaner power plants and to help us get government rebates on installing solar power, solar hot water, or wind power in our homes. See also: http://www.climatecrisis.net/t

Topics recap 4: Get Involved, now! 1. The most obvious step towards reducing the adverse impacts from climate change on human health is mitigation. Explain. 2. Adaptation to climate change is as important as mitigation. Explain why? 3. List 10 key actions that you are prepared to do to reduce your greenhouse gases emissions.

documents on screen before printing. Instead of making a copy for each person, route one copy around. Do not discard one-sided printed pages; use them to make scratch pads.

Save paper: Print on both sides of the paper. Proofread

Turn off televisions, videos, stereos and computers

when they are not in use—they can consume between

Annexes

Food for Thought (See answers on page 33) 1. In 2000, how many people, globally, have been estimated to die annually due to climate change? a. 10 000 b. 20 000 c. 60 000 d. 160 000

2. How many people could be made homeless due to global warming by the year 2050? a. 5 million b. 1 million c. 150 million d. 1 billion

3. How many people in Asia could be facing a major water shortage if current rates of carbon emissions continue?

a. 1 million

b. 10 million

c. 50 million

d. 1 billion

4. Which lighting option produces the least amount of greenhouse gases?

a. Candles

b. Compact fluorescent light bulbs

c. Normal light bulb

5. If you turn your lights off when they are not in use you could save on average:

a. 10% of your energy bill

b. 8% of your energy bill

c. 15% of your energy bill

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Word Search Word Search W A R M E R S M A L A R I A D C Q T A E H P L N H E H Y U D I S E A S E S R I L U F N S L D O R O U A Z B N L U X J E R O S A I F T V L W I Z I T J R T M Z F F E T J U E C R M W G J E T K O E L K P R H L M C Y S G I A E R A R E L A D W N L G L A C I E R S C H R R G U H T P B G U V Q E S R V Q S P C R H T U B Y A G O E U I Y P O U B E D S S Z C O A S J O Z A S N E U T Y R Q M F S R W O L X C L B N N S L X E E A I W J F M R K Z I F L O O D S I S E A R I S E M D S M R O T S J F

Look for: Fossil fuel Diarrhoea Hurricane Injuries Sea Rise UNFCC Droughts Malaria Weather Floods Warmer Ozone Glaciers Storms Heat IPCC Gases Carbon Climate Diseases Mitigation WHO Fires Dengue

Annexes

Case Studies Case Study 1: Climate Change and Human Health: Responding to the new threat to global health security At the Twenty-fifth Meeting of Ministers of Health in 2007 (Thimphu, Bhutan) the most important health authorities in the South-East Asia Region concluded that climate change poses a major threat to health security, and requested World Health Organization (WHO) to “support the formulation of a regional strategy to combat the adverse health impacts of climate change”. WHO’s is therefore supporting country programmes to combat infectious disease, improve water and sanitation services, respond to natural disasters, and is helping them reduce health vulnerability to future climate change. The organization also works directly to build capacity to adapt to climate change. This includes workshops in the most vulnerable countries, to raise awareness of the health implications of climate change and related weather patterns, and to support intersectoral policies to reduce health vulnerability, now. Such activities aim at improving health conditions today, while simultaneously laying the ground for more future adaptation measures to climate change.

have no way of rebuilding. Estimations are that were the Earth to warm by just one degree Celsius, 11% of Bangladesh would be submerged, putting the lives of 55 million people in danger. The recently published Bangladesh National Adaptation Programme of Action recommends strategies focusing on coastal forestation, provision of drinking water to coastal communities, education, the protection of urban infrastructure, and scientific research and development to protect crops.

Case Study 3: Bhutan to address adverse health impacts from climate change Though Bhutan’s contribution to the total greenhouse gases responsible for global warming has been very small, or practically irrelevant, the country is currently facing adverse impacts from climate change. l

Since 2000, it reports unusually prolonged droughts, erratic rainfall patterns, and floods. At least 25 glacial lakes have been identified as posing a major risk of bursting, from excess glacial melt water, in the near future. According to the International Center for Integrated Mountain Development (ICIMOD) annual average glacial retreat of glaciers in the country has doubled from 20m to 40m since 1990. Two lakes are expected to burst in 2010 and extremely costly measures are needed to build spillways to protect the downstream riverside communities and ecosystems. Given that 80% of Bhutanese are subsistence farmers, climate change will have direct consequences on food security, health and livelihoods.

Case Study 2: Bangladesh is paying a cruel price for the west’s excesses— excerpts By Veena Khaleque; December 7, 2006, The Guardian Bangladesh is one of the world’s largest deltas, formed by a dense network of 230 unstable rivers; most of the country is less than 10 meters above sea level. It is also one of the poorest countries in the world. A low economic capacity, inadequate infrastructure and a higher dependence on a naturalresource base exacerbate its vulnerability. Climate change in Bangladesh will take form in floods, salinity intrusion and droughts, all of which will drastically affect crop productivity and food security. The last two decades have witnessed ever more frequent and intense flooding. In 2004, 38% of our country was ravaged by floods, which destroyed more than three quarters of crops, left 10 million people homeless, and in their wake diseases such as dysentery and diarrhoea. The poor are hit hardest by climate change, and poverty forces people to live in makeshift homes; when disaster strikes they

Case Study 4: UN breakthrough on climate change reached in Bali IPCC, Bali, 15 December 2007. Source: http://unfccc.int/ 187 country representatives gathered in Bali last December and agreed to start negotiations towards a crucial, and strengthened, international climate change deal. The decision includes a clear agenda for the key issues to be negotiated up to 2009. These are: action for adapting to the negative consequences of climate change, such

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as droughts and floods; ways to reduce greenhouse gas emissions; ways to widely deploy climate-friendly technologies; and financing both adaptation, and mitigation, measures. Concluding negotiations in 2009 will ensure that the new deal can enter into force by 2013, following the expiration of the first phase of the Kyoto Protocol. Indonesian Environment Minister and President of the conference Rachmat Witoelar said: “We now have a Bali roadmap, we have an agenda and we have a deadline. But we also have a huge task ahead of us and the time to reach agreement is extremely short, so we need to move quickly,” he added. Earlier this year, the UN’s Intergovernmental Panel on Climate Change (IPCC) declared that the world’s average temperature, if left unchecked, could rise by as much as 6 degrees Centigrade by the end of the century, causing serious harm to economies, societies and ecosystems worldwide. “This is a real breakthrough, a real opportunity for the international community to successfully fight climate change,” said Yvo de Boer, Executive Secretary of the

United Nations Framework Convention on Climate Change (UNFCCC). “Parties have recognized the urgency of action on climate change, and have now provided the political response to what scientists have been telling us is needed,” he added. While a new global deal is expected by 2013, countries also agreed on a number of steps that need to be taken immediately to further implement the existing commitments of UNFCCC Parties. These issues are particularly important for developing countries. The conference was attended by around 11 000 participants, among them the Secretary-General of the United Nations and six Heads of State.

Topics recap 5: Study of the annexes 1. What should be considered as priority actions to reduce adverse human health impacts of climate change? 2. Some say the issue of climate change is an ethical one. Explain why? 3. Has Bhutan initiated new programmes to address the challenges posed by climate change? 4. What were the main achievements at Bali in 2007?

Annexes

Activities Here is a brief outline for two interactive activities which should be conducted in the classroom with the help of peer leaders to preserve student’s interest in ”Climate Change and its Impact on Health” and also facilitate the process of learning.

Activity No. 2: Climate change and vector-borne diseases Suggested time: 60 minutes Objectives

Activity No. 1: Poster-making Suggested time: 60 minutes Objectives 1. Students will understand the concept of climate change. 2. Students will become aware of the impact of climate change on health.

1. Students will learn about vector-borne diseases. 2. Students will understand how changing climate affects the life-cycle of vectors. 3. Students will explore how social factors affect the occurrence and spread of diseases. 4. Students will understand how they can contribute to reduce vector-borne diseases.

Activities Day 1 Brain-storming session. Ask the students, 1. 2. 3. 4. What is climate change? (5 minutes) Why does it happen? (5 minutes) How does it impact on us? (5 minutes)

Process and material required Blackboard to note down the spontaneous responses of the students to the questions. Complete the list of the weather events that climate change will worsen (Heatwaves, disturbed rainfall, floods, droughts, cyclones, sea level rise).

Expand on the health aspects and relate the main six health Which are the most important impacts on health? outcomes with the weather events (see relevant page of this manual): (10 minutes) l l l

Expected results: 1. It becomes clear to all that greenhouse gas emissions cause the problem and that global warming triggers climate change.

Respiratory diseases; Malnutrition Injuries; Diarrhoeal diseases Dengue & Malaria; Psychosocial stress

At the end of the session, distribute the photocopy of the table The linkages between climate change and health are on page 18. clear. Announce the poster-making competition.

Activities Day 2 Topic for the poster-making competition: Draw a scene on climate change and a clear link to: l l l l l l

Process and material required Drawing sheets, pencil, erasers, crayons. The posters should be collected and judged by the school staff as per scoring sheet: l l l

Respiratory diseases and/or Malnutrition and/or Injuries and/or Diarrhoeal diseases and/or Dengue and Malaria and/or Psychosocial stress

Is it a climate change related event? How well does the link with human health come out? Artistic value

Keep the best posters for later use.

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Activities Day 3 Inform students how diseases are spread by vectors. Discuss how climate change with warmer temperatures and erratic rainfall could create better breeding conditions for disease vectors. Discuss how displaced populations (climate change refugees) would contribute to the spread of vector-borne diseases. Distribute the attached sheet and ask the students to match the vectors with the diseases.

Material required Use the information provided on page 14. Mention the following: Lack of personal protection (no bed nets, no mosquito coils); poor sanitation with water ponds ideal for mosquito breeding; sick migrating people act as “reservoirs” as they carry the disease inside themselves; health services are unable to reach them; and displaced populations more vulnerable. Photocopies of the worksheet. “Match the disease with its vector” for each student.

Worksheet Match the Disease to the Vectors Disease Vector l l l l l l l l l l l l

1. Dengue fever l 2. Dracunculiasis l 3. Hantavirus pulmonary syndrome l 4. Japanese encephalitis l 5. Malaria l 6. Leishmaniasis l 7. Lyme disease l 8. Onchocerciasis l 9. Plague l 10. Schistosomiasis l 11. Scrub Thyphus l 12. Yellow fever l

Aedes mosquito Anopheles mosquito Black flies Culex mosquito Culex mosquito Culex mosquito Culex mosquito Mites Cyclops Fleas and rodents Ticks Sand flies

Answers to Match the Disease to the Vectors Disease 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Dengue fever Dracunculiasis Hantavirus pulmonary syndrome Japanese encephalitis Malaria Leishmaniasis Lyme disease Onchocerciasis Plague Schistosomiasis Scrub Thyphus Yellow fever Vector Aedes mosquito Cyclops Rodents Culex mosquito Anopheles mosquito Sand Flies Tick Black flies Fleas and rodents Water snails Mites Culex mosquito

Annexes

Details about the diseases Dengue fever Dengue viruses are transmitted to humans through the bites of infected female Aedes mosquitoes. Mosquitoes generally acquire the virus while feeding on the blood of an infected person. After virus incubation for 8–10 days, an infected mosquito is capable, during probing and blood feeding, of transmitting the virus to susceptible individuals for the rest of its life. Dengue is found in tropical and subtropical regions around the world, predominantly in urban and semi-urban areas. Dengue hemorrhagic fever (DHF), a potentially lethal complication, was first recognized in the 1950s during the dengue epidemics in the Philippines and Thailand, but today DHF affects most Asian countries and has become a leading cause of hospitalization and death among children in several of them.

the most common tick-borne disease in North America and Europe. In man, the disease is manifested by rashes with a subsequent arthritis, neuropathological manifestations and cardiac involvement. It is also known as early summer meningoencephalitis.

Malaria Malaria is a parasitic infection transmitted to humans through the bites of infected female Anopheles mosquitoes. The resulting disease in humans can be devastating. After spreading rapidly through the bloodstream to the liver, the parasite emerges again into the blood-stream, finally to settle in the red blood cells, where it multiplies and emerges in bursts of new organisms. These parasites, because of their large numbers, can cause particular damage to the nervous system, liver and kidneys.

Dracunculiasis Dracunculiasis is an infection due to a nematode worm. It is caused by drinking water containing water fleas (Cyclops). It is also known as Guinea worm disease (GWD).

Onchocerciasis (River Blindness) This parasitic disease caused by the filarial worm Onchocerciasis Volvulus. It is transmitted through the bites of infected black flies of Simulium species.

Japanese Encephalitis (je) JE is a disease caused by Flavivirus and transmitted by bites of Culex mosquitoes. The virus is maintained in nature by mosquitoes and non-human vertebrates, and humans become accidentally involved. Pigs can carry the JE virus. JE has made part of Asia as its home. Outbreaks are reported during rainy season. Vaccination of children in endemic areas is important for prevention.

Plague Plague is an infectious disease of rodents and humans caused by a bacterium named Yersinia pestis. People get plague from being bitten by the oriental rat flea. Xenopsylla cheopis carrying this bacterium. Bubonic plague occurs naturally in Indonesia, India and Madagascar. Pneumonic plague can be transmitted directly from human to human.

Leishmaniasis This is a disease caused by protozoan parasites that belong to the genus Leishmania and is transmitted by the bite of sand flies, namely Lutzomyia and Phlebotomus. There are three forms of leishmaniasis: cutaneous, muco cutaneous and visceral. Dogs, rodents and squirrels may act as animal reserviors for cutaneous leishmaniasis. This disease is also known as kala-azar.

Schistosomiasis Schistosomiasis, or Bilharzia, is a parasitic disease caused by trematode flatworms of the genus Schistosoma. Larval forms of the parasites, which are released by freshwater snails, penetrate the skin of people in the water. In the body, the larvae develop into adult schistosomes, which live in the blood vessels. The females release eggs, some of which are passed out of the body in the urine or faeces. Others are trapped in body tissues, causing an immune reaction. In urinary schistosomiasis, there is progressive damage to the bladder, urethras and kidneys. In intestinal schistosomiasis, there is progressive enlargement of the liver and spleen, intestinal damage, and hypertension of the abdominal blood vessels.

Lyme Disease Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of infected black-legged ticks or deer ticks. Lyme disease is

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Scrub Typhus A zoonotic infection, first described from Japan, now known to occur over most of southeastern Asia, India, Maldives and Sri Lanka. Larvae of the vector mites, known as chiggers (the only parasitic stage in the life cycle of the mites), acquire the infection by feeding on infected rodents. A lesion or “eschar” develops at the site of the infected chigger bite in most human cases.

main route of human infection is through the bite of an infected mosquito.

Yellow Fever Yellow fever is a viral disease that has caused large epidemics in Africa and the Americas. Monkeys are natural reservoirs. It can be recognized from historic texts stretching back 400 years. Infection causes a wide spectrum of disease, from mild symptoms to severe illness and death. The “yellow” in the name is explained by the jaundice that affects some patients. Although an effective vaccine has been available for 60 years, the number of people infected over the last two decades has increased and yellow fever is now a serious public health issue again.

West Nile Virus This is a virus of the family Flaviviridae; part of the Japanese Encephalitis (JE) antigenic complex of viruses, it is found in both tropical and temperate regions. The

Glossary

Adaptation: Adjustment in natural or human systems to a new or changing environment. Adaptation to climate change refers to adjustment in response to actual or expected climatic stimuli or their effects, which moderates harm or exploits beneficial opportunities. Various types of adaptation can be distinguished, including anticipatory and reactive adaptation, public and private adaptation, and autonomous and planned adaptation. Successful adaptation builds on local knowledge, local capacity and willingness to act. Anthropogenic Climate Change: Anthropogenic means “human-made”. In the context of climate change it refers to greenhouse gases, or emissions that are produced as the result of human activities. These include fossil fuel burning for energy, deforestation and land use changes that result in net increase in emissions. Atmosphere: The gaseous cover surrounding the Earth. The dry atmosphere consists almost entirely of nitrogen and oxygen, together with a number of trace gases such as argon, helium and radiatively active greenhouse gases such as carbon dioxide, methane and ozone. In addition, the atmosphere contains water vapor, clouds, and aerosols. Biofuels: Fuels made from cellulosic biomass resources. Biofuels include ethanol, biodiesel, and methanol. Replacing fossil fuels with biofuels for energy production could bring environmental and health benefits by lowering greenhouse gas emissions. But using land to produce biofuels essentially competes with using land for food production. Also converting rainforests, peatlands, savannas, or grasslands to produce food-based biofuels could release up to 420 times more CO2 than the annual GHG reductions these biofuels provide by displacing fossil fuels. Carbon dioxide (CO2): A naturally occurring gas as well as a by-product of burning fossil fuels and land-use changes and other industrial processes. It is the principal

greenhouse gas which affects the Earth’s radiative balance and the reference gas against which other greenhouse gases are measured. In March 2006, CO2 levels stood at 381 parts per million (ppm)—100ppm above the pre-industrial average. Carbon footprint is the measure of the amount of carbon dioxide or CO2 emitted through the combustion of fossil fuels in carrying out a process or makes a product. The scope of a carbon footprint analysis can vary and may/ may not include all GHGs. When it includes all GHGs, the footprint is expressed as a “CO2 equivalent units”. It is key for measuring the performance of the corporate sector. The carbon footprint for an individual reflects activities under her/his control—eg. home energy use, personal transport and consumption patterns. Carbon Sink is the natural mechanism that removes carbon dioxide from the atmosphere, such as the absorption of carbon dioxide by growing trees and/ or protecting existing forests. Climate change: Refers to a statistically significant variation in either the mean state of the climate or in its variability, persisting for an extended period (typically decades or longer). Climate change may be due to natural internal processes or external forcings, or to persistent anthropogenic changes in the composition of the atmosphere. The UNFCC defines climate change as ‘a change of climate which is attributed directly or indirectly to human activity that alters the composition of the global atmosphere and which is in addition to natural climate variability observed over comparable time periods’. El Niño: A term used to describe the extensive warming of the central and eastern Pacific that leads to a major shift in weather patterns across the Pacific. The 1997–98 El Niño had significant social and economic implications for Indonesia.

A Manual for Teachers

Greenhouse Effect: Natural and human-made (anthropogenic) gases in the atmosphere that absorb and emit infrared or heat radiation, causing the greenhouse effect. Greenhouse gases (GHGs): Those gases in the atmosphere which absorb and emit radiation at specific wavelengths within the spectrum of infrared radiation emitted by the Earth’s surface, the atmosphere and clouds. Water vapor, carbon dioxide, nitrous oxide, methane and ozone are the primary greenhouse gases in the atmosphere. Methane warms the earth 23 times and nitrous oxide 296 times as much as the same mass of CO2. Global Warming: An increase in the average temperature of the earth’s atmosphere, especially a sustained increase sufficient to cause climatic change. Intergovernmental Panel on Climate Change (IPCC): A group of experts established in 1988 by the World Meteorological Organization (WMO) and the United Nations Environment Programme (UNEP). Its role is to assess the scientific, technical and socio-economic information relevant for the understanding of the risk of human induced climate change, based mainly on peer reviewed and published scientific/technical literature. Kyoto Protocol/UNFCCC: The internationally binding agreement under the UNFCCC that set GHG targets for signatories to abide by. Drawn up in 1997 and came into effect in 2005, it requires developed countries to reduce emissions by 5 percent, compared with 1990 levels, by 2012. Most of the world’s countries agreed to the Protocol, but some nations chose not to ratify it. Mitigation: In the context of climate change, it is any action taken to permanently eliminate or reduce the

long-term risk to human life, property, and function from the hazards of climate change. Without good and early mitigation, the difficulty and costs of adaptation will grow rapidly. National Adaptation Programmes of Action: NAPAs provide a process to identify priority activities that respond to their urgent and immediate needs with regard to adaptation to climate change. The NAPA takes into account existing coping strategies at the grassroots level, and builds upon that to identify priority activities, rather than focusing on scenario-based modeling to assess future vulnerability and long-term policy at state level. In the NAPA process, prominence is given to community-level input as an important source of information, recognizing that grassroots communities are the main stakeholders. UN Framework Convention on Climate Change (UNFCCC): Convention signed at United Nations Conference on Environment and Development in 1992. Governments that become Parties to the Convention agree to stabilize greenhouse gas concentrations in the atmosphere at a level that would prevent dangerous anthropogenic interference with the climate system. UNFCCC Nairobi Work Programme: The NWP is an international framework developed to help countries improve their understanding of climate change impacts and vulnerability and to increase their ability to make informed decisions on how to adapt successfully. Vulnerability: The degree to which a system is susceptible to, or unable to cope with, adverse effects of climate change, including climate variability and extremes. Vulnerability is a function of the character, magnitude and rate of climate variation to which a system is exposed, its sensitivity and its adaptive capacity.

Answers to “Food for Thought” 1. According to WHO an estimated total of 160 000 people died as a direct result of climate change. This is due to an increase in frequency of natural disasters such as heat waves and floods. 2. One billion people would be made homeless due to global warming by the year 2050. 3. In Central, South, East, and South-East Asia freshwater availability is projected to decrease, which along with population growth and increasing demand from higher standards of living, could adversely affect more than 1 billion people by the 2050s. 4. Fluorescent light bulbs are the most energy efficient, whereas candles when burnt release carbon dioxide directly. 5. If you turn your lights off when they are not in use you could save on average 10% of your energy bill.

Glossary

Some useful web links for educational materials on climate change http://epa.gov/climatechange/kids/index.html http://www.ecokids.ca/pub/index.cfm http://climatechangeeducation.org/ http://news.bbc.co.uk/1/hi/education/4123884.stm http://managenergy.net/kidscorner/en/o11/o11.html http://tiki.oneworld.net/global_warming/climate_home.html http://www.town4kids.com/town4kids/kids/science/environment http://www.greenhouse.gov.au/gwci/households.html http://edugreen.teri.res.in/explore/climate/change.htm

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Informations clés

Organisation Organisation mondiale de la santé (OMS)

Type de document Publications

Date d'adoption 31 décembre 2008

Source Organisation mondiale de la santé