The potential changes on health, impacts of extreme weather events due to climate change in coastal areas of Bangladesh Dr. Russell Kabir, PhD Senior Lecturer Department for Allied and Public Health Anglia Ruskin University UK.

Global Perspective of Climate Change Climate Change is global phenomenon; Average global rise in temperature of 1.4 degree C to 5.8 degree C between 1990 and 2100; Changes in sea levels; projected to rise between .09 and .88 meters by 2100 relative to 1990 Climate change is very likely to increase the frequency and magnitude of extreme weather events such as cyclones drought and floods. Its negative impacts are more severely felt by poor people and poor countries;

Bangladesh the worst sufferer Negligible gas emissions - worst victim. Bangladesh emits a minuscule of GHG, in 2010-11 terms,- 0.053 to 0.045 billion tonnes Developed countries -20.0 billion tonnes in 2010-11. Bangladesh is one of the most vulnerable countries because of its geographic location; flat and low-lying topography; high population density;

What Bangladesh facing A meter rise of sea level would inundate a quarter of our landmass; - displacing over 20 million people by 2050; creating enormous humanitarian and political crisis beyond its national boundaries; melting glaciers would further contribute to erratic weather pattern with prolonged monsoon floods, cyclones and droughts leaving 40 million people without livelihood; C.C. conditions costing the national economy 1% of the GDP annually for over the last decade.

Cyclones in Bangladesh Frequency of cyclones has increased significantly due to Climate change Major cyclones in 1970, 1985, 1991 and 1997 resulted in over 500,000 deaths. Cyclone Sidr 2007 responsible for > 3,178 deaths. Cyclone Aila 2009 responsible for > 190 deaths Up to 36 million people are physically exposed periodically and 15 coastal districts are cyclone prone EPR from Health Sector

The Coast of Bangladesh The coastal region of Bangladesh is situated in the South of the country. The total length of Bangladesh coast line is 710 Km long. Coastal area covers 32% of country’s total areas. 40 million people/ 28% of country’s population live in the coastal areas. Source: Banglapedia (2012). Islam and Gnauck(2010) Mohal et al (2006) Pender (2008)

Aim The study aims to assess the impact of extreme weather event like cyclones on health of the coastal population of Bangladesh.

Methodology Study Design: Descriptive Cross-Sectional Study Study Place: South West coastal part of Bangladesh . Target Population: Coastal population. Sample Size:1000 households Data collected using Questionnaire Survey.

Methodology (Continue…)

Methodology (Continue..)

Methodology(Continue..) Cyclone Sidr Barguna District Amtali Upazila Baliatali Village 500 households Cyclone Aila Khulna District Koyra Upazila Barabari Village 500 Households

Findings About 52 % respondents are from cyclone Sidr affected areas and 48.2% respondents are from cyclone Aila affected areas. A vast majority household heads (36%) age is over 50 years of age and only 22.6 % are below 30 years Among them 43.5% respondents have studied up to primary level and 25.2 % respondents have completed their secondary education. About 44.2 % respondents have/had been living in the affected areas from 21 to 40 years and 15.6% respondents have/had been residing in the area for 61 to 80 years.

Findings Main occupation of the respondents –agriculture(30%) and fishing (17%). 83% women of these households look after their families and children. Average monthly income of these households are between in US dollar 25-65. In both the areas the main source of drinking water is deep tubewell. Most of the households use pit or slab latrine and some of them use open latrine.

Statistics of Natural disasters in the affected areas Variables Total Sidr Aila   Frequency Percent Types of natural disasters faced in the last 10 years Cyclone Floods Riverbank Erosion Droughts Earthquakes Extreme Heatwaves Storm surge Water salinity Others 960 964 861 518 204 173 513 542 9 98.7 99.1 88.5 53.2 21.0 17.8 52.7 55.7 0.9 499 398 249 40 269 146 4 99.0 79.0 49.4 7.9 1.8 53.4 29.0 0.8 461 465 463 164 244 396 5 98.3 57.4 35.0 52.0 84.4 1.1 Recently the scale of disasters has increased Yes No Don’t Know 961 6 98.8 0.6 0.4 494 98.0 1.0 467 1 99.6 0.2 Local area hit by natural disasters very frequently 956 11 493 7 97.8 1.4 2

Health Problems comparison by area Variables Categories Survey area Sidr Aila Total   Frequency Percent Diarrhoea No 1095 51.3 420 21.7 1515 37.3 Yes 1038 48.7 1513 78.3 2551 62.7 Chi-square and - p –value 380.2; p <0.001 Food Poisoning 2084 97.7 1468 75.9 3552 87.4 49 2.3 465 24.1 514 12.6 Chi-square and p –value 434.7; p <0.001 Mental health problem 2052 96.2 1763 91.2 3815 93.8 81 3.8 170 8.8 251 6.2 Chi-square and p –value 43.7; p <0.001 Skin disease 1398 65.5 422 21.8 1820 44.8 735 34.5 1511 78.2 2246 55.2 Chi-square and p –value 38.0; p < 0.01 2133 52.5 1933 47.5 4066 100.0

Health Problems before and after the disaster   Variables Categories Odd ratio (95% C.I. for Odd ratio) Occurrence of health problems before the disaster Occurrence of health problems after the disaster Age of household member <5 yr 1.00 5-17 yr 6.31 (4.03-9.87) 2.53 (1.80-3.56) 18 yr + 7.89 (5.10-12.22) 2.72 (1.99-3.71) Gender of the member Male Female 0.88(0.77-1.00) 0.78 (0.64-0.95) Religion of household head Muslim Hindu 0.72 (0.60-0.86) 1.76 (1.26-2.44) Access to Television No Yes 1.20 (0.87-1.66) 0.34 (0.22-0.54) Access to Radio 1.18 (0.96-1.46) 1.15 (0.82-1.62) Electricity connection in the household 0.71 (0.59-0.87) 1.33 (1.00-1.78) Household monthly income <=3000 >3000 0.81 (0.70-0.92) 0.65 (0.53-0.80) Number of children living in the family None 1 Child 1.35 (1.10-1.65) 1.11 (0.83-1.48) 2 Children 1.40 (1.14-1.72) 1.38 (1.03-1.84) 3 Children 1.27 (0.99-1.62) 1.30 (0.92-1.85) Level of education of household head Primary 0.70 (0.60-0.83) 1.02 (0.80-1.30) Secondary 0.66 (0.55-0.79) 0.93 (0.71-1.21) Mobile Phone 1.14 (0.97-1.33) 1.29 (1.03-1.61) Survey area Sidr Aila 1.11 (0.94-1.31) 1.92 (1.48-2.48)

Findings Income status of the household has important impacts on the health problems. The higher is the income the lower is the probability of health problems. The number of children in the households is positively associated with health problems. The higher is the number of children the higher is likelihood that they will suffer from health problems. Males are more vulnerable to health problems after the disaster. Comparing to Sidr area, respondents from Aila area had 2 times higher risk of getting health problems after the natural disaster.

Concluding Remarks The coastal population of Bangladesh already facing devastating effect of extreme weather events. Natural disasters affecting their livelihoods, destroying the agricultural land and forcing them to change their jobs and indirectly affecting their food consumption and overall health. Immediate adaptation and mitigation measures should be adopted to help these people and including strengthening the infrastructure at coastal areas to combat with these kind of natural calamities. Future research can be conducted to find out the direct impact of extreme weather events on health of the coastal people.