Supporter call: climate and WASH

On a supporter update call, Dr Martin Muchangi, Director of Population Health and Environment, Amref Health Africa and James Mturi, WASH programme manager, Amref Tanzania discuss the linkages between climate change and health, the impacts this has on communities in Kenya and Tanzania, and the interventions that Amref is leading with those communities to build climate resilience. 

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Climate change is the greatest threat to health

Its effects are already taking hold, disproportionately affecting low and middle income countries, but no country or community will escape its negative impacts.

It is already a major disrupter of health services. Increasing temperatures leading to extreme weather events impact communities, disrupting food systems, destroying community, education and health infrastructure. Without these resources, facilities and services, communities do not have sufficient access to food, education, shelter, and health services, leading to myriad health issues from malnutrition and childhood stunting, to increasing infectious diseases and chronic conditions.

We are already seeing an increase in vector-borne and water-related (WASH) diseases, such as malaria and cholera, after extreme flooding. Flood waters are an ideal breeding ground for mosquitoes, and increasing temperatures mean malarial mosquitoes can thrive in high altitudes and spread into new areas. They can fly 6km further in warmer air than they can in cooler air.

By mapping diseases that are climate sensitive and ensuring we have reliable data at the community level, we can work with governments and other partners to build predictions about spikes in disease. This ensures we have preparedness and response plans in place, and can train the health workforce so they can respond effectively to these crises.

A set of actions can help communities to bounce back

When extreme events happen, they force major disruptions into to the way people live. Amref Health Africa works to address both the immediate impacts of climate change, and to build community resilience for the long term.

Our work focusses on three core areas:

1. Government engagement. We work with governments at the local, national, and regional levels to ensure we are co-creating solutions that are impactful for communities, and so we ensure all partners are working in synergy. We are focussed on ensuring the voices from Africa are unified, represented, and heard at global fora including the Conference of Parties (COP) and other platforms where together we can bring health into the climate change discussion.
2. Working with communities. We know that action and empowerment happens in the communities; they are the key to a sustainable future. Health workers based in communities - both trained volunteers and skilled health workers at local facilities - are the driving force of climate change adaptation and resilience building. They work to spread awareness of the effects of climate change, and share knowledge, information, and skills to help communities adapt to their changing contexts. We also work to ensure that people are trained or re-skilled to deal with these changing contexts through programmes focussed on strengthening livelihoods, for example for pastoralist communities to diversify to ensure a reliable income even during drought or other extreme weather events.
3. Strengthening health systems. Community-based health workers (CHWs) are the backbone of the health system across Africa. In our work to strengthen health systems, they are trained to collect and process the data that is needed to run innovative resilience tools such as the Early Warning Systems. CHWs collect climate and health data from weather monitoring tools and from their house-to-house visits. They are trained to input this data into platforms that then transmit the data to us, to then be integrated into national-level government systems. This powerful chain helps governments to make decisions based on real-time data. Our digital platforms, including M-Jali, are used to ensure communities are both able to input data and extract information that will help them respond to extreme weather events such as drought, or floods.

We follow the One Health approach 

To date, most climate change interventions have been siloed; addressing the single effects of climate change without considering the wider context and its interlinkages. This is not efficient in cost or impact.

We know that addressing environmental, human, and animal health together is critical to fully understand the impact of climate change on health and to develop mitigation and adaptation strategies that work.

In the contexts in which we work and live, if animal health isn't good, then diseases from animals can be transmitted to humans. Bringing in the agricultural and veterinary sectors is helping to address common community health problems in Kenya and South Sudan.

For example, we work with pastoralist communities who are traditionally nomadic. They use migration routes to search for pasture for their livestock upon which they rely for milk, food and income. By mapping migration routes, we can see where these communities will pass through and set up mobile health outreaches to intersect with their migration. At these 'container' units, vets treat animals and health workers see human patients - ensuring an integrated approach to health.