Climate Change in Bangladesh: Waterborne Diseases and Public Health

Gwen Mercep Professor MacPhee Environment Health Brief 11/13/18 All over the world, individuals are experiencing significant changes in weather and climate that pose serious threats to our population and existing environment. While being a controversial and global phenomenon, climate change is undoubtedly causing major changes to our temperature, precipitation, and other climatic parameters. Climate change is caused by greenhouse gases forming a layer around Earth that “leads to increasingly rising global temperature over time and numerous, often adverse, environmental changes.” This is caused mostly by human activity producing excess waste, primarily carbon dioxide.

The major health consequences of climate change are as follows: exacerbated air pollution, temperature-related death and illness, vector-borne diseases, malnutrition, dehydration, and waterborne diseases. Waterborne diseases, in particular, are caused by microorganisms found in a contaminated and untreated water supply and have to be ingested to be considered waterborne.

Global Weather Patterns and Waterborne Diseases

Global warming, also known as climate change, affects weather patterns making them unpredictable and intense all over the globe. Climate change is creating larger storms with more downpours.

The major problem these storms cause is flooding, and in many areas of the world where disease is majorly attributed to poor waste and hygiene practices, excess water can be detrimental. “WHO estimated that 842,000 deaths and 1.5 percent of the global burden of disease were attributed in 2012 to poor waste, sanitation, and hygiene”. Excess water from these intense dour pours and storms would ruin any fresh water available and intensify any waterborne disease already occurring, especially in regions that are coastal and have poor sanitation practices. Many prevalent human diseases are linked to climate fluctuations, such as flooding and increased precipitation, usually combined with increased temperatures.

Haines explicitly states climate change will have a range of effects on factors important for human health, including water-related diseases, which will drastically alter the quality of drinking and recreational water. As water sources are disrupted as a result of climate change, the concentration of contaminants increases, making them more likely to affect human health. “Today, one-sixth of the world’s population lacks safe drinking water, and more than double this number lacks even basic sanitation facilities.” This statistic shows how climate change can cause a plural of concerns due to these preexisting conditions for many parts of the world, especially undeveloped areas.

Waterborne Pathogens and Climate Change

Many of these communities are already at a major disadvantage when it comes to their infrastructure, and the effects of climate change will devastate them even further. Research from the Millennium Development Goal (MDG) stated the progress made on water and sanitation had a significant impact on the transmission of infectious diseases (WHO- MDGs 2015). This demonstrates how proper water quality lessens the capacity for transmission of disease and how the opposite reality can impact health negatively. There are three categories of waterborne pathogens, which are and will continue to be greatly exacerbated by climate change. The first category is enteric protozoal parasites which include but are not limited to Giardia intestinalis and Cryptosporidium parvum. Bacterial enteropathogens take the second category, including, Salmonella and Escherichia coli.

The final category, viral pathogens, includes Enteroviruses, Adenoviruses, and Noroviruses. These pathogens are associated with diarrhea and a multitude of other gastrointestinal problems. They often lead to severe diarrhea and dehydration. Some of these pathogens can harm a human in recreational water through a cut or lesion in the skin, though this is not as common as illness from ingestion of waterborne pathogens. These pathogens, nevertheless, can be especially deadly to those who are immunocompromised, including the very young and very old. The first vulnerable population I want to discuss are the communities in Southern Bangladesh which are largely coastal. A government official, during a semi-formal interview, described Southern Bangladesh as geographically cursed, stating, “One-fourth of the land is less than seven feet above sea level, and they endure a four-month rainy season” (A Dangerous Future 2014). It was explained that rain is necessary, but in the past few years, the rain-affected by climate change has become “disastrous” (A Dangerous Future 2014). By 2100, 20 million residents of Southern Bangladesh will be forced off their land due to the destructive rising sea levels contributing to contaminated water.

Vulnerable Populations

Bangladesh is known for being an economically challenged country with poor methods of sanitation and hygiene. Many of their homes consist of man-made tents or shacks. They have no plumbing or running water, so the spread of disease, especially diarrheal disease, will be heightened through the repercussions of climate change. These rising sea levels and a “disastrous” four-month rainy season adds to an abundance of contaminated drinking water which inevitably leads to the devastation of public health. In a 2018 article written by the International Institute for Environment and Development, a cyclone in 2007 left many Southern Bangladesh residents without the fresh water they needed for drinking. Today, relocated to higher land, these communities are supplementing new technologies to harvest rainwater to prevent their water from becoming contaminated again. The next population who is at risk of contaminated water are the people of the Toineke Village located in East Nusa Tenggara, the poorest Indonesian province and one of the poorest regions of the world. Hornidge and Scholtes describe the Toineke village as a society at risk as they lose the certainty surrounding their environment and struggle with climate change.

The village is located at the mouth of the Noemuke River into the Indian Ocean, which makes their region prone to flooding in such a coastal location. Similar to the Bangladesh region, the Toineke people are used to the rainy season, but as climate change has interrupted their weather patterns, problematic floods are being introduced as the new norm. The rain is now falling in short, abrupt phases, followed by arid days. This is often accompanied by drastic floods due to the arid soil and vegetation. Due to these large downpours, within thirty minutes, the water has risen up to 1.8 meters in some areas. For months, the single-story houses made of wood and branches were standing in stagnant murky, warm sediments filled with waterborne diseases. These events occurred in the early 2000s, and it seems from an article written in 2018 by researchers that data from 2017 showed these communities still struggling in their location with the effects of climate change and their access to clean, non-contaminated water. As the effects of climate change are expected to increase in magnitude, strategies need to be implanted for the short and long term on the basis of both local and global efforts.

Educational and Advocacy Strategies

While education at the local level is often not a feasible solution because it often fails due to cultural beliefs or lack of resources to implement change, I believe an attempt at education should be a strategy not overlooked. I state this with the support of information from Hornidge and Scholtes’s research on how the Toineke people believed the drastic change in weather were signs of or even challenges posed by God. By explaining these issues the world is facing due to a state of warming, we may be able to implement long-term strategies, such as relocation, by explaining these challenges and environmental changes that will worsen for both of these vulnerable populations. With education, we can teach not to ingest or recreationally use stagnant or contaminated water from the environment after flooding has occurred, both locally and globally.

The major way to prevent waterborne illness and disease exacerbated by flooding in the short-term coping approach is to be prepared. The communities of Bangladesh and Toineke need to have safe drinking water stored and accessible in the case of a major flood. This water needs to be sterilized properly with the possible use of chlorine in some more advanced water systems or, at the least, boiling to eliminate harmful pathogens. This water needs to be stored securely on higher ground to eliminate the potential of it becoming contaminated. I believe there also needs to be proper surveillance and methods of predicting when flood conditions are approaching to be better-prepared communities at the local level.

By supporting indigenous people as advocates for themselves, we can create solutions in harmony. I believe these communities are incredibly adaptive, and with access to preventative strategies such as knowing when to save clean drinking water for future use and knowing when to expect these flood conditions, they will be much better off. The crucial long-term prevention of waterborne illness needs to include the relocation of vulnerable communities. They are too close to the sea level, which doesn’t allow the rainwater to run off. Instead, the water remains still and harbors disease. Being coastal also entails the body of water surrounding the community to progress on the land with rising sea levels and storm activity to contaminate these communities even further. Access to land further uphill has become crucial to prevent illness and injury for both communities. There will be less risk of stagnant water and water from rising sea levels. While I recognize there are many obstacles and stakeholders in the possibility of moving uphill, we need to seriously consider, in the decades to come, how devastating life will be for the communities of Southern Bangladesh and Toineke without intervention. Long-term global efforts need to aid in these climate refugees’ placement in an environment less impacted by climate change and waterborne disease.

References

1. Cameron, James. 2014. A Dangerous Future: Years of Living Dangerously. Film. Showtime Productions. From MDGs To SDGs: General Introduction. 2015. Haines, Andy. 2012. ‘Sustainable Policies to Improve Health and Prevent Climate Change.’
2. Elsevier. Hornidge, Anna-Katharina, and Fabian Scholtes. 2011. ‘Climate Change and Everyday Life in Toineke Village, West Timor: Uncertainties, Knowledge and Adaptation.’ JSTOR, 151-175.
3. Lassa, Jonatan, Yos Boli, and Yulius Nakmofa. 2018. ‘Twenty Years of Community-Based Disaster Risk Reduction Experience from A Dry-Land Village in Indonesia.’ Scielo. 
4. Norton, Andrew. 2018. ‘Snapshots of A Changing World – Climate Change Impacts in Bangladesh.’ International Institute for Environment and Development.
5. Patz, Jonathon, Campbell-Lendrum Diarmid, Tracey Holloway, and Jonathan Foley. 2005. ‘Impact of Regional Climate Change on Human Health.’
6. Nature. Singer, M. and Erickson, P. (2013). Global Health An Anthropological Perspective.
7. Long Grove, Illinois Waveland Press, INC. Skolnik, R. (2016). Global Health. Burlington, MA: Jones & Bartlett Learning.

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