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Too Little, Too Much: Perspectives On Climate Change and Healthcare.

Have you met Arlene, Irma, Ophelia, Maria, Selma, Katia, and Rina? No, these are not the hopefuls for the Most Beautiful Girl in Nigeria Beauty Contest 2017 neither are they characters off of a new telenovela. You have probably heard at least two of these names being thrown around the media stratosphere over the last couple of weeks. You will also probably know that they have not been attributed to beautiful women (apologies to all the beautiful Marias, Irmas and Ophelias out there!) but rather have been akin to tempestuous winds and tropical winds affecting the lives of people resident in the Americas. The aftermath of this leading to the displacement of families and loss of economic livelihood.

This piece does not seek to attempt to incite the Great Debate as to whether these hurricanes can be directly linked to the anthropogenic effect of man on the environment; there are many thoughts and opinion pieces online as regards this, one being the article called Hurricanes: A perfect storm of chance and climate change? penned by Matt McGrath and featured on the BBC website. According to him, most researchers who study extreme events like hurricanes agree that climate change is most likely making the impacts of these events much worse. Based on the pictures seen and the stories told over the last couple of weeks, it is a convincing argument.

There are some obvious impacts of hurricanes; this includes extensive damage to property and businesses suffering too. It also affects the health of victims. On the hidden health impact of flooding penned by Jen Christensen, she used Hurricane Harvey to describe how hurricanes can affect health. The issues raised ranged from floodwater contaminated with sewage and chemicals, which can also hide shrapnel. The sewage may cause boils and rashes on the body of those submerged for extended periods. Exposure to contaminated water may also cause diarrhoea. There may also be respiratory related issues due to mould and increased cases of mosquito-borne diseases such as Zika and West Nile Fever.

The story that often goes untold is the mental health concerns that are attributed to hurricanes and flooding. This can lead to anxiety, depression, and stress. There have been several studies on the impact of natural disasters such as Katrina, Irma, and Harvey on the mental illness of the survivors who may face psychological trauma from displacement and the loss of homes, property and their loved ones. The link between a hurricane and mental health struggles has been documented through research on the survivors of Hurricane Katrina, which devastated Louisiana in 2005. A year after the storm, the Resilience in Survivors of Katrina (RISK) Project found that nearly half of the 392 low-income parents they studied reported symptoms consistent with post-traumatic stress disorder. Colby Itkowitz is able to vividly paint the first-hand experiences of how hurricanes can affect the mental health of a person through her piece on the Washington Post. She tells a story of Iashia Nelson who survived the Hurricane Harvey but had grim stories of loss, death, and despair to live with.

My colleagues and I, in our fleeting moments of selfishness, are sometimes thankful that in Lagos we do not have tropical storms of this intensity. Our biggest fears are that despite being one of the fastest growing cities in Africa, we do not have the systems to adapt and mitigate the impact if they hit. We are characterized by fragile structures which  deepen our socio-economic challenges. But this does not mean we have not begun to witness heavier rainfalls and flooding around parts of Nigeria. It does not also mean we have not felt the impact of climate change on healthcare through other paths. Developing countries are likely to be affected the most, and be least able to adapt quickly.

The United Nations Economic Commission for Africa has provided a detailed paper on Climate Change and Health in Africa.  In this study, they have stated that Climate Change is expected to alter temperature, air movement, and precipitation in various ways and to varying degrees across Africa; with consequences for human health which may impede the development of the African Continent. The paper discusses direct and indirect relationships between climate change and various facets of healthcare.

The paper draws our attention to spikes in communicable diseases due to environmental factors such as temperature and moisture which can affect pathogen proliferation. These factors may also affect the density and ability for vectors to survive.  This could mean more bouts of Malaria and an increased prevalence in water-borne epidemics which will affect mostly children. It reminds us of the importance of good nutrition and how climate change can exacerbate malnutrition. Change in environmental patterns can affect farmers and coastal communities and those who an upward increase in the price of food means fewer meals.

Interestingly, people living with HIV are also at an increased risk of communicable diseases and those who are malnourished may also be at greater risk of HIV. Exposure may incresa on the premise that climate change may generate more migrants as people search for security, whether it is for food, water, safety, or health care. As populations are forced to migrate as a result of climate change, HIV infection rates would increase in certain regions, as people from different areas mix or if sex work becomes a means of sustenance for rural/farmer migrants who are forced to make a life for themselves in the city.

Climate change induced health issues may spiral into various socio-economic and political crises if not properly managed. As resources become scarce, people scramble and struggle for what is left. This may result in violence and armed conflict. Pondering and reflecting on the intricacies and interrelation between climate change, health and socio-economic issues, one may be filled with despair. However, there is hope, a small glimmer but hope all the same. Hope because more people are having conversations on the effect and adaption to climate change today.

Perhaps this is because when we peel back the layers and deconstruct the scientific jargon, climate change, and its impact; it is really about a person like you and I. It is the family displaced by the hurricane and trying to put pieces of their lives together. It is that woman in Sudan who walks kilometres in search of potable water for her children. It is the farmer whose yield has reduced drastically because the rains did not come in April this year.

Frightfully it could be you or me walking in their shoes hoping that someone would tell our stories.