ASSESSING THE IMPACT OF CLIMATE CHANGE ON HEALTH

1. ASSESSING THE IMPACT OF CLIMATE CHANGE ON HEALTH RESEARCH TEAM: • OlakunleOdumosu • Adebayo O. Ajala • Sunday Alonge • AuduWadinga Nigerian Institute of Social and Economic Research, Ibadan

2. The Problem • Climate change is an emerging risk factor for human health. • There is now widespread consensus among the scientific community that the earth is warming, mainly due to human activities and that this will continue for several decades. • It is also clear that weather and climate exert a major influence on human health, both through direct effects of extreme events such as heatwaves, floods and storms.

3. Also, it acts more through indirect influences on the distribution and transmission intensity of infectious diseases and on the availability of freshwater and food. • It is therefore important to obtain the best possible assessment of the likely health impacts of climate change.

4. Expectations are that by 2030, the number of climate-related diseases would lead to increase in: • heat-related deaths caused by heart failure; • respiratory disorders; • the spread of infectious diseases; and • malnutrition from crop failures.

5. Objectives of the Study • examine the extent of climate change; • examine the impact of climate change on health status; • examine the impact for particular vulnerable groups (by age, gender, ethnicity, disability, livelihood); • examine the responses of particular communities and vulnerable groups to the risks associated with climate change; and • proffer policy recommendations to mitigate the impact of climate change.

6. Methodology • The research built on and extended some of the pre-existing panel data collection efforts. • The study included primary and secondary data collection from particular locations prone to climate change. • The study was carried out in three states where climate change impacts are more apparent. These are: Lagos State (coastal areas), Plateau State (high plateau areas) and Borno State (Maiduguri, the Lake Chad region and desert areas).

7. The data collected include meteorological data, data on health (incidence of notifiable diseases) and well-being. It also include data from qualitative data of community responses in the selected locations. • The quantitative technique made use of structured interviews with dummy Tables while the qualitative approach was in-depth interviews (IDIs), with key informants.

8. Data Sources • In each of the sites visited, IDIs were conducted with the following people: officers of the Nigerian Meteorological Agency, officers of the Ministry of Health and the Public Health Departments, officers of the Ministry of Environment, community leaders, women leaders, youth leaders and religious leaders.

9. Secondary information was collected from the National Bureau of Statistics, Federal Ministry of Health, Federal Ministry of Environment, Nigerian Meteorological Agency. • Data were also collected from the respective state ministries of health.

10. Data Analysis • In analysing the climate situation and climate changes, climate data were collected for a period of 30 years, 1976 to 2005. This is because climate change refers to long-term changes in average weather conditions over a given place. • The data collected were monthly data from which annual monthly averages were computed. • The climate data includes maximum temperature, sun hours and rainfall. • Averages were computed for the various climate indicators. • Graphs and trend lines were used to analyse the climatic changes in weather and its implications on health.

11. FINDINGS: Lagos State • Lagos is Nigeria’s largest and fastest-growing city, located on the coast and therefore vulnerable to sea-level rise. It is also exposed to the more frequent severe floods. • Weather becomes more extreme with climate change largely because warming speeds up the water cycle (the process by which water vapour rises into the atmosphere and condenses as precipitation). • Sea levels around the world will rise because increasing temperatures cause sea water to expand as it warms (this thermal expansion is believed to have been a major influence on past changes in sea levels).

12. Climate Situations in Lagos (1976 to 2005) • There has been a continuous increase in the maximum temperature over the years under review and there is the likeness that this will continue to increase. Average maximum temperature in is 30.2oC. • Average rainfall over the period under review is 143.96 mm. The trend indicates that rainfall has been on the increase. • There has been an increase in the average sun hours over the period under review and the trend line indicates that this is likely to continue in this direction.

13. In examining the linkages between climate change and health, graphs were plotted to indicate the incidence of diseases such as cerebro-spinal meningitis (CSM), measles, pneumonia and malaria with maximum temperatures, rainfall and sun hours. • Incidence of CSM is directly proportional to sun hours. The fact that the sun hours in Lagos State is likely to be on the increase, gives an indication that the incidence of CSM might be on the increase in the state. • There is no fixed pattern in the incidence of measles and maximum temperature.

14. There is corresponding increase in incidence of measles and sun hours. • The incidence of pneumonia is inversely proportional to maximum temperature. • Incidence of pneumonia is directly proportional to rainfall. • Incidence of malaria is found to be inversely related to maximum temperature. • Incidence of malaria is directly-proportional to rainfall

15. Issue of Rising Sea Level • Respondents reported that in the past ten years in Lagos State, there has been a rise in sea level, resulting in flooding in many parts of the state. • It (rising sea level) is already affecting us. Lagos State is basically below sea level as a coastal state. In fact there is a prediction that if nothing is done about the rising sea level, the whole of Victoria Island, Ikoyi and Lekki axis will be submerged and this state government is not taking anything into chances. They have started the bar-beach reclamation project and among all other projects taking place in Lagos State (Official of Ministry of Environment, Lagos State).

16. The issue of rising sea level and flooding is said to be affecting availability of potable water. • In fact there is no potable water in this place at all. Some people have boreholes but they can’t drink it. In fact, we are thinking of sinking borehole in our own compound but because I’ve asked two, three people that have boreholes and they can’t drink it (Religious leader, Lagos State). • Storms and floods can facilitate the spread of infectious enteric diseases that cause diarrhoea in young children.

17. Air Quality in Lagos State • It (air quality) is more than poor (NIMET official, Lagos State). • Sure, of course you can see this green house emission. There is hardly any house now that doesn’t have a generator. Some houses have 3 to 4 and so on. So all these generators run fossil fuel, diesel, the impact is better imagined (Official of Ministry of Environment).

18. Plateau State • The climate of the plateau is its most striking characteristic.  Although Jos can be described as having a tropical rainy climate with an average humidity of about 60 per cent and heavy rains between June and August, it also has a temperate feeling with an average temperature of 22oC and temperatures as low as 8oC to 10oC recorded during the Harmattanseason between December and February.

19. Climate Situations in Jos (1976-2005) • Average maximum temperature in Jos is 27.68oC. A review of the trend indicates that there has been a continuous increase in the maximum temperature over the years under review and there is the likelihood that this will continue. • The average annual maximum temperature in Jos has been above 27oC. • Rainfall has been on the decline • There has been a decline in the average sun hours over the period under review and the trend indicates that this is likely to continue

20. There is no clear pattern between the incidence of CSM and maximum temperature over the years under review • The incidence of CSM is, however, directly proportional to sun hours in the year for the period under review • Incidence of measles is found to be directly proportional to the maximum temperature over the period 1998 to 2000 as well as 2004 to 2005 while an inverse relationship holds for the period 2001 to 2003 • Incidence of pneumonia is found to be inversely proportional to the maximum temperature over the period 1998 to 2005, with the exception of 2001 when there was an upsurge in the incidence of pneumonia

21. The incidence of malaria is directly proportional to the maximum temperature experienced in Jos over the period 1998 to 2002, thereafter an inverse relationship exists for the other period under review, with the exception of 2005 when there was increase in the incidence of malaria and maximum temperature • According to the respondents, Jos was said to be almost free of mosquitoes in the past, but at present, the presence of mosquitoes could be felt everywhere in the state.

22. The noticeable changes during the past ten years is that there seem to be draughts and floods. Just of recent we had floods in Langtan where a lot of houses were destroyed, farmlands were also flooded with water. We also discovered that our wells run dry earlier than expected. And also it seems as if it has some effect on the pattern of disease these days because we are now having disease these days that are related to scarcity of water. Scabies and the rest of them and then at the same time during this flooding we have diseases that are associated with disruption of population. We are now having diarrhoea diseases most especially during the rainy seasons. And also there seem to be pollution these days. (Official of Ministry of Health, Plateau State).

23. Surface and Underground Water Issue • Respondents asserted that it is in a precarious situation. Wells and streams which a lot of the people depend on in the past are drying up • We just noticed that some of the wells we are using, we cannot use them throughout the year because they get dry earlier than expected (Official of Ministry of Health, Plateau State).

24. Actually we are now having more outbreaks of water-related diseases and this could be associated with the climate itself because where you have enough water there are certain diseases that are not prevalent, like trachoma. Usually the main cause of trachoma is where there is shortage of water – people having such diseases. The diseases seem to be on the increase now. Certainly in Jos, these diseases were not common; we are now beginning to notice them during our surveys, like in the upper part of the state. We are now having increased prevalence of diseases like trachoma and scabies. These are related to shortage of water (Official of PHC, Plateau State).

25. Air Quality in Plateau State • Respondents reported that air pollution is one of the major problems resulting from climate change in Plateau State

26. Certainly we have better fresher air some years back. If you move into our city you will find out that the environment is cloudy in the first place because of the emission of various forms of gases. Emission from generators, vehicles that should be off the road but are still on the road emitting all kinds of smokes that contaminates the air. And a few of our industries dump their waste anyhow and there are some areas if you are passing you feel like holding your breath because of the smell… And also you find that the temperatures are also rising, it also affects the air that we breathe in. All these things definitely are not as good as they were a couple of years back (Community leader, Jos).

27. Borno State • The climate of the area is characterised by a short rainy season between June and September with a mean annual rainfall of about 279 mm. April to October with average daily temperature of 30.2oC is the hottest period of the year. November through March is cooler with average daily temperature of 23.0oC. The wind is frequently strong and dusty especially during the harmattan months of October to February when the dry northeasterly winds blow from the Sahara Desert.

28. Climate Situations in Maiduguri (1976-2005) • A review of the trend indicates that there has been a continuous increase in the maximum temperature over the years under review and it is likely to continue. The average annual maximum temperature in Maiduguri hovered around 35oC • Trend in rainfall in Maiduguri reveals that there has been an increase over the years, though this increase is submerged by the impact of desertification and other negative impacts of climatic changes due partly to short duration of rainfall.

29. Incidence of CSM is inversely proportional to both maximum temperature and sun hours from 1998 to 2000, 2003 to 2004 and directly proportional from 2001 to 2002 as well as in 2005. The slight exception holds in 2004 when an inverse relationship holds between CSM and sun hours. • The relationship between incidence of measles and maximum temperature, rainfall as well as sun hours remains a puzzle. In view of the fact that the data shows that while maximum temperature and sun hours are reducing, incidence of measles is increasing. Also while there is a marginal increase in rainfall there is an increase in incidence of measles.

30. There exists an inverse relationship between the incidence of pneumonia and maximum temperature for the years 1998 to 2000 as well as 2004 to 2005; in the other years it is either incidence of pneumonia and maximum temperature are reducing or increasing in the same direction. Also, there is a direct relationship between the incidence of pneumonia and rainfall in Maiduguri for the period 1998 to 1999 and 2002 to 2003; for the other years under review an inverse relationship exists.

31. The incidence of malaria is somewhat directly proportional to maximum temperature over the period under review except for the period 2000 and 2004 where an inverse relationship holds. As for the relationship between rainfall and incidence of malaria, an inverse relationship holds for the period 1998 to 2001, thereafter a direct relationship holds.

32. Reported Noticeable Changes in Climate in Borno State • Respondents reported that the state is becoming hotter than ever before. They also talked about increase in desertification in the area as well as reduction in water from Lake Chad. Also, rains are coming very late and falling for a short period. All these were attributed to changes in climate in the State.

33. There have been so many changes … When you look at the desertification … And when you look at the heat level here, there is increase in heat waves which has affected or is affecting many people in this part of the country. With regards to the rains, from what we predicted for 2009 we had an onset of the rains to be around the first week of June but very unfortunate it came in the middle of July, this could have been some of the impact of climate change (Official of Meteorological Agency, Maiduguri).

34. Surface and Underground Water Issues • Respondents are of the opinion that both the surface and underground water are drying up. Lake Chad is said to be drying faster than can be imagined and it is causing a lot of concern among the residents of the area because it is a major source of livelihood to the people of the area. Wells are also said to be drying up in the State.

35. Air Quality in Borno State • Almost all the respondents talked about the dust that normally accompanies the air in the state. To the respondents, this dust makes the air unsafe for breathing. • The breeze is now getting bad, even if you are under a tree, you will not enjoy it, because of this climatic change you cannot even have fresh air for your breathing. During the harmattan season, it becomes worse (Youth leader, Maiduguri).

36. During the periods of high temperatures there are real risks that an increase in heat waves will cause an increase in incidence of heat rashes, exhaustion and even stroke - which can lead to death. Elderly people and those with poor cardiovascular health and low physical fitness are at highest risk. • Other health problems likely to increase include asthma and respiratory problems associated with an increase in bush fires (caused by higher temperatures) due to higher levels of air-borne particulates, as well as the direct health risk of the fire itself.

37. Adaptation to Climate Change in Lagos, Plateau and BornoStates • Lagos • Environmental sanitation • Construction of culverts by govt • Behaviour change through IEC • Plateau • Cooperative societies and communal groups to act together • Harvesting rain water • Digging wells • Building dams • Migration

38. Borno • Communal help • Digging of boreholes • Migration

39. Recommendations • Lagos • Periodic clearing of drainage channels and widening of some channels are required • Improved protection through improvements in housing quality and flood protection • Plateau • Undertaking vulnerability studies of existing water supply and sanitation systems and ensuring that new systems are built to reduce vulnerability • Borno • Use of seasonal forecasts as part of an early weather-based warning system

40. Conclusion • The study found that populations vary in their vulnerability to health impacts and in the resources available for adaptive responses. The health status of many communities is likely to be adversely affected by climate change in a number of direct and indirect ways. This reflects both the vulnerability of communities to environmental change and their reduced adaptive capacity. This situation presents a challenge to local, state and federal governments to provide adequate levels of advance planning, management and care to reduce climate-related risks.

41. These respiratory diseases can be exacerbated by changing ecosystems that result in vegetation loss and increases in wind blown dust. • Indirect impacts of temperature change can also have significant impacts on incidence of communicable diseases such as bacterial diarrhoea, more common in hot dry conditions, which may increase, unless additional preventive actions are taken.

42. THANK YOU FOR LISTENING