Think of the medical consequences of disasters like last year's earthquake and tsunami off Japan or Hurricane Katrina in 2005. I bet you can almost feel an uptick in adrenaline. Now, try to picture the health effects of climate change. If you’re like me, your mind froze to a soporific stupor because it’s hard to picture concrete health consequences from such a large, abstract disaster.
Not any more. The health effects of climate change are growing more concrete every day. Some examples crossed my desk this week, with hints about the roles doctors could play.
Climate change is expected to bring increasingly frequent weather disasters during the next 100 or 200 years. Disaster response models used in the past are no longer sufficient for the coming onslaught, Dr. Mark Keim of the Centers for Disease Control and Prevention (CDC) said recently at the Governor's Conference on Extreme Climate Risks and California’s Future, called by Gov. Edmund G. Brown, Jr. (D-Calif.). You can see Dr. Keim's talk here, about three quarters of the way into Part II.
"We as Americans shouldn’t think we can sustain a model for disaster response that increases every year over the next 200 years," said Dr. Keim (or, as he is known on Twitter, @DisasterDr). He received distinguished service awards for co-leading the CDC’s emergency operations during 2001 World Trade Center and anthrax letter emergencies and later during Hurricane Katrina.
Picture a century-long parade of extreme weather events worldwide. Storms, floods, and landslides. Heat waves, drought, crop failures, and wildfires. And the consequences -- like the 30,000 deaths ("upwards to 80,000 in the newest estimates") from one summer heat wave in Europe, Dr. Keim said. Plus injuries, loss of clean water and shelter, increased pests and vectors, and toxic exposures carried by flood waters or in the air of fire storms.
Courtesy Wikimedia Commons/NASA (ISS Photograph)/Public Domain
Puluwat Atoll, Caroline Islands, Pacific Ocean
"In the U.S., many of the deaths from disasters are due to exacerbating chronic diseases: worsening of heart attacks, strokes, emphysema, COPD, etc," he said, and these will increase as climate change increases. Studies have shown that even 5 years after flood survivors return to their homes, they have higher stress hormone levels and higher death rates compared with non-flooded populations.
Still too abstract? Consider the rising sea levels that already are bringing starvation to Micronesia, which Dr. Keim and his team reported in 2006. "The idyllic Pacific, where life is easy and food is plentiful" until rising sea levels flood the taro fields and breadfruit trees that have sustained the islanders, poisoning the soil with salt, he said.
You can see a more personal version of that scenario in this video by Steve Goodall, an activist, filmmaker, and sailor who is trying to help some indigenous people on disappearing Pacific atolls transfer their community and their culture to safer land. His award-winning documentary "Someplace with a Mountain" will screen Jan. 13-15, at the Wild and Scenic Film Festival in California and on March 18 at the Environmental Film Festival in Washington, D.C. Goodall is trying to raise funds from the public through a Kickstarter project by Jan. 17 for a second documentary following the story, "The Last Utopia."
But efforts to move people to higher ground will not be enough, Dr. Keim said. "What we will see in our generation and our children’s generation is people starving in the Pacific islands as people hold on to the last thread of their existence in their own home countries," he predicted. Others in the Pacific and in coastal regions of the U.S. and elsewhere will become refugees as sea waters claim the land.
Rather than think we can respond and recover from so many disasters, we need to prepare by reducing exposure to the disaster and lowering susceptibility, Dr. Keim said. Disasters take their greatest toll on the most vulnerable people -- the weak, the poor, the infirm. They have neither the means to get out of the way of disasters nor the strength to withstand them.
"Anything we can do to promote health and reduce poverty reduces susceptibility" to disasters, Dr. Keim said. Reducing health disparities is emergency preparedness. Community clinics, hospitals, and preventive services are key parts of the emergency team.
Communities can best identify their vulnerable populations and the locations (such as flood plains) where people will be most exposed to disasters, and work to reduce exposure and vulnerability. "Disaster reduction occurs at the community level," he said.
---Sherry Boschert (on Twitter @sherryboschert)