5th CBA conference: 29 March 2011, Dhaka

Climate change impact on human health: Experiences and initiatives of

Bangladesh

Climate Change & Health Promotion Unit (CCHPU)Ministry of Health & Family Welfare

Dr. Iqbal Kabir

Asst. Professor (Epidemiology), NIPSOM

Coordinator,CCHPU, MOHFW

Climate Change, Livelihood, Health…???

Extreme events!SIDR, AILA…The Innocent Victims

Food and Water Security

Disaster

Diarrhoea

Typhoid, ARI, COPD

Dengue, VBD

MalnutritionIllness/Disease

Burden

ClimateChange

Vicious linkage of Health with Climate Change

Women and Children the most vulnerable group

Health is directly linked with Food, Water, Shelter and Livelihood crisis in extreme events of climate change

Sea L

eve

l R

ise

Cost estimation for climate attributable diseases (2010-2021)

Approaches in Addressing Health Impacts of Climate Change

• Documentation of the risks and vulnerability within and between populations

• Development of health protection strategies

• Identification of health co-benefits

• More investment and resources for strengthening health systems

• Estimation of the financial costs of action

• Community based PHC approach

A model best practice for LDCs

Climate Change and Health Promotion Unit

Ministry of Health and Family WelfareGovernment of the People’s Republic of Bangladesh

Goal of the CCHP Unit

To build capacity and strengthen health systems to combat the health impact of climate change and to protect human

health from current and projected risks due to climate change.

Objectives of the Unit

1. To coordinate all Climate Change and Health Promotional activities of Intra and Inter Ministerial initiatives.

2. To increase awareness of health consequences of climate change;

3. To strengthen the capacity of health systems to provide protection from climate-related risks through innovative approaches using e-Health and Telemedicine;

4. To ensure that health concerns are addressed in decisions to reduce risks from climate change in other key sectors;

5. To conduct research, evaluate and monitor programmes related to health promotion and climate change;

6. To coordinate emergency medical services and school health promotion to reduce health hazards during disasters and emergencies.

CCHPU Office Location in G-Earth

web site is www.cchpu-mohfw.gov.bd

We have installed a solar panel at our office roof as a token step of GREEN Initiatives

Current project from MOEF Trust Fund

Risk reduction and adaptive measures in the context of climate change impact on health

sector in Bangladesh.

Broader Objective: To conduct research and monitor disease patterns and develop effective adaptive

measures in the context of climate change impact on

health.

Conceptual Framework on Impact of Climate Change on Health

Eco-system

Human Health

Health and Nutrition

A) Inadequate food ,unsafe WatSan

B) Metabolic disorders

C) Malnutrition

D) Infection

Disease

Climate Change

Disaster

Risk reduction through research and awareness

building

Climate change adaptive

measures Healthy

population

Capacity building on adaptive measures on Health and Nutrition

Innovative and appropriate technology to strengthen community participation

Health care providers

Local government

Community Group (CC)

CBO, NGO

Current Project areas of MOHFW

Cyclone prone Costal areas • 7 Upazials of Satkhira District total 175 community clinics• 9 Upazials of Bagerhat District total 153 community clinics.• 5 Upazials of Barguna District total 105 community clinics. • 2 upazilas of Cox’s bazar total 30 community clinicsSalinity prone areas• 9 Upazials of Khulna District total 153 community clinics.River erosion and flood prone areas • 9 Upazials of Serajganj District total 275 community clinics.• 9 Upazials of Faridpur District total 166 community clinics.• 2 Upazials of Chittagong District total 51 community clinicsUrban areas for research comparison :• 6 District town in 6 Division.Gopalganj in Dhaka, Jessore in Khulna,

Chapainawabganj in Rajshahi, Rangamati in Chittagong, Sunamganj in Sylhet, Patuakhali in Barisal Division.

NAPA update and Bangladesh Climate NAPA update and Bangladesh Climate Change Strategy and Action Plan 2009Change Strategy and Action Plan 2009

Bangladesh prepared NAPA update on August 2009Bangladesh prepared NAPA update on August 2009

Some new priority activities have been identified in the Some new priority activities have been identified in the NAPA update NAPA update

Bangladesh prepared Bangladesh Climate Change Strategy Bangladesh prepared Bangladesh Climate Change Strategy and Action Plan (BCCSAP) 2008 and revised in 2009and Action Plan (BCCSAP) 2008 and revised in 2009

BCCSAP has been highly appreciated nationally and BCCSAP has been highly appreciated nationally and

internationally internationally

It is built on six pillars, under which 44 programs are listedIt is built on six pillars, under which 44 programs are listed..

BCCSAP 2009BCCSAP 2009

Under thematic area 1 Under thematic area 1 (Food security, social protection and health)(Food security, social protection and health) some some programs and actions have been identified on health sector, namely:programs and actions have been identified on health sector, namely:

Research on the impact of climate change on health Research on the impact of climate change on health (including the incidence of malaria and dengue, diarrheal (including the incidence of malaria and dengue, diarrheal diseases, heatstroke) and the cost to society of increased diseases, heatstroke) and the cost to society of increased mortality, morbidity and consequent fall in productivitymortality, morbidity and consequent fall in productivity

Develop adaptive strategies against outbreaks of malaria, Develop adaptive strategies against outbreaks of malaria, dengue and other vector borne diseases, and invest in dengue and other vector borne diseases, and invest in preventive and curative measures and facilitiespreventive and curative measures and facilities

Develop adaptive strategies against diarrheal and other Develop adaptive strategies against diarrheal and other diseases, which may increase due to climate change, and diseases, which may increase due to climate change, and invest in preventive and curative measures and facilitiesinvest in preventive and curative measures and facilities

The health care network of

Bangladesh

Domiciliary Workers

Outpatient static facility

31-50 bed hospital

50-250 bed hospital

Medical college/tertiary

hospitalDivision (6)

District (64)

Sub-district (482)

Union (4,498)

Ward (13,394)

Villages (87,000)

National

Super-specialty hospital

Level

Type of Facility

Community Clinics (PHC)

Domiciliary Workers

Outpatient static facility

31-50 bed hospital

50-250 bed hospital

Medical college/tertiary

hospitalDivision (6)

District (64)

Sub-district (482)

Union (4,498)

Ward (13,394)

Villages (87,000)

National

Super-specialty hospital

Level

Type of Facility

• In Ward level, there were lack of static health facility

• Community Clinics will fulfill this lack

Why Community Participation is Important to Address the Health Impacts of Climate Change

• Cost Effective• Higher Acceptability• Early Warning• Rapid Feedback• Direct Communication• Reality Check for both service recipients and service

providers• Community Empowered (CBO, NGO,GO Mix)• Community Choice Reflected

CCHPU Steps Vulnerability assessment

• Meeting with the Ministry of Health and Family Welfare and technical agencies done

• IEDCR- Institute of Epidemiological Disease Control and Research will conduct the assessment with the technical support from WHO

• IEDCR & WHO has organized a workshop and training on vulnerability assessment

• Technical committee formed

Consultative workshop to prepare school manual on Climate Change & Health Safety

• We have prepared a school manual on Climate Change & Health Safety to create awareness among the Parents, students and teachers based on WHO guidelines 2008.

• We are in the process of adaptation of the manual with our National School Curriculum

Training manual on Climate Change & Health for Model School Health and Community

Clinics using PHC approach

• Experts in climate change, manual development, representatives from MOEF, MOHFW, DGHS, NIPSOM, IPH, IEDCR, ICDDRB,BHE, NGO, civil society and Member and Senior Specialists of the National Curriculum & Text Board (NCTB) of MOE attended the two workshops to prepare the manual.

Community Radio Initiative for Climate resilience and effective early warning system

in costal belt• Community Radio for building

awareness on early warning system and climate resilience on public health for the costal population.

• PPP Model- MOHFW and NHCHF (Nolta Hospital & Community Health Foundation, Satkhira) will on- air 2 hour radio program every day on early warning system and climate resilience on public health with edutainment approach using folk media and local languages

One pack of ORS…..????Many Hands…..?Resilience

Vulnerable people (climate refugees) cluster in and around cities of Bangladesh and cause water logging resulting breeding place of mosquitoes and ends up with Dengue, Malaria, Typhoid and

Diarrhoeal diseases

Migration to city slums

South Asia regional high level meeting: Dhaka Declaration 2010

We need to be prepared for the Health of these people

(The area was visited by DG WHO)

Way Forward

CoordinationMinistry

ResponseCommunity Group

PreparednessLocal Government+ Health

CBAYOUTH+ School students+ CC+ CBO

Youth Climate ChampionsThe Future

Thank you

www.cchpu-mohfw.gov.bd