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Protecting health from climate change in southeast Europe,
central Asia and the Russian north
Dr Bettina Menne,Programme Manager,
Climate change, sustainable development & green health servicesWHO Regional Office for Europe
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Vulnerability Index (WB, 2011)
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
To promote population health within a changing climate
Uzbekistan
Dust storm early warning system
Respiratory diseases
Nutrition under a changing climate
Tajikistan
Water related diseases
Water for health care
Injuries and mortality from extreme events
Kyrgyzstan
Energy security in district hospitals – installation of solar panels
KazakhstanInfectious diseasesInjuries and mortality from extreme events Early warning systems
The former Yugoslav Republic of Macedonia:Heat wave plan
Communicable diseases
Energy efficiency
Albania:
Air quality monitoring
Improve surveillance (IHR)
Health system capacity
Russian North:
Health system strengthening in remote areas
Uzbekistan
Dust storm early warning system
Respiratory diseases
Nutrition under a changing climate
Tajikistan
Water related diseases
Water for health care
Injuries and mortality from extreme events
Kyrgyzstan
Energy security in district hospitals – installation of solar panels
KazakhstanInfectious diseasesInjuries and mortality from extreme events Early warning systems
The former Yugoslav Republic of Macedonia:Heat wave plan
Communicable diseases
Energy efficiency
Albania:
Air quality monitoring
Improve surveillance (IHR)
Health system capacity
Russian North:
Health system strengthening in remote areas
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Core activities for all countries• Impact vulnerability and adaptive capacity assessment• Health adaptation strategy/action plan• Communications and awareness rising• Education and training
Country 1 2 3 4 5 6 7 8 9
KAZ X X X
KGZ X X X X
TJK x X X X
UZB X X X X X
Specific adaptation measures1. Emergency preparedness2. Water safety plans and sanitation3. Infectious disease prevention4. Energy efficiency and renewable energy for
hospitals5. Air quality monitoring6. Heat health action plans7. Assessment of nutrition and food security8. Dust storm and respiratory disease reduction9. Strengthened public health services
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Support from WHO Euro provided
Vision
The nature of
the problem
Identify intervent
ions
Prioritize
Develop a plan
Evaluate and
share learning
• Vulnerability assessment tool• Vulnerability Risk assessment mapping
(VRAM)• Hospital safety index• Heat health action plan• Public health emergency management
(PHEM)• IHR• Health damage and adaptation costs tool• Health protection strategies tool• Energy efficiency assessments tool• Small scale water plans• Air quality standards• PAL
Menne and Nurse, 2012, forthcoming
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
The Countries:Challenges and Achievements
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Health severely affected
• Deaths and injuries from natural disasters are increasing;
• Increased projections for cardio-vascular diseases - by 10,5% by 2100; life years lost for man from climate change are higher than for women
• Increased projections for intestinal infections among children under one - by 18,2% by 2100
• The areas of high potential risk for malaria will increase• Spread and increase of tick borne infections projected
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Health protection is possible
Programme of the health sector of the Kyrgyz Republic on Climate Change Adaptation for 2011-2015Health Adaptation working group: • 18 members from MoH and 11 members from
government agencies; 24 meetings were hold in 2009 – 2011
• 11 priorities were recognized in the Program• Order of Minister of Health №531 as of 31,
October 2011 for 2011-2015• Funds necessary: 8,411,040.00 USD• Funds available: 5,429,345.00 USD
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
How does climate change affect you?
• 1400 Village Health Committees covering 2.500.000 people i.e.70% of the country’s population took part in the communication campaign
• 57 seminars with participation of 1151 representatives of Rural Health Committees and 1029 primary health workers were carried out
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Installing solar panels in 5 hospitals
• Solar energy technology transferred within 5 health care facilities (solar collectors, solar panels)
• Assessment of effectiveness of use of alternative energy source carried out
• Managers of health facilities increased awareness of alternative energy sources and technologies
• Video broadcast nationally• Two methodical guides on use
renewable energy sources / efficient technologies in health sector
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
to reduce the burden of respiratory diseases, through early warning and early case detection and management;
0
10
20
30
40
50
60
70
80
90
Aug Sept Oct Nov Dec Jan Feb
PM10 PM2.5
Monthly means of PM10 and PM2.5
WHO AQ Guidelinesannual mean
PM10
PM2.5
most of the daily PM10 concentrations exceeded 50 μg/m, but mostly less than 75 μg/m3 (monthly average about 70 μg/m3);the general ratio PM2.5/PM10 was about 0.4 in Tashkent (short period – more data available)two dust storm events in Nukuswinter in Tashkent, clearly showing the effects of combustion with high PM2.5.
Two stations in Tashkent and Nukus equipped with samplers for PM10 and PM2.5 dust particle monitoring. Staff trained
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
to reduce the burden of respiratory diseases, through early warning and early case detection and management
• 307 medical doctors and 23 district coordinators have been trained on PAL• 26 specialists from hospitals have been trained on the operation of
respiratory equipment• 90% of first – level health facilities have at least one doctor trained on PAL• Health care facilities provided with basic equipment to implement PAL
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Early Warning System on dust storm developed
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
North(Akmolinsk, Kostanay,
North-Kazakhstan,
Pavlodar regions)I
East(East-Kazakhstan
region)
II
WestMangystau, Atyrau,
West-Kazakhstan, Aktyubinsk
regions)III
Central(Karagandy region)
IV
South(Kyzylorda, South-
Kazakhstan, Zhambyl, Almaty regions)
V
1. Less vulnerable to CC
2.Cold3.Fires
4.Transboundary rivers (Irtysh)
5. Precipitations amount increase 6.Abnormal
temperatures7.Lack of foodstuffs
8.Migration
1.Floods and mudflows
2.Air quality (industrial
enterprises, test site)
3.Lack of water4.Unfavorable
weather conditions
5.Heat (fires and droughts)
1.Heat >40C- drought, Wind load
2.water quality and amount, including
drinking water,3.Atmospheric air
quality4.Fire threat
5.Decrease of agricultural land
areas6. Development of oils
and gas resources7. Change of sea and the
Ural River level
1.Extreme events2.Lack of water
including drinking water
3.Drought and fires4.Air quality (industries,
mines)5. Lack of foodstuffs
6.Aggravation of sanitary and
epidemiological conditions
7.Migration of population
8.Social conflicts (closing of mines, marginal groups)
1.In the south-east area:High air temperature (in
summer it is over 50 С)Droughts, dust storms,
salinity, fire threat)2.Lack of water (irrigation,
drinking water)3.Lack of food
4.Aggravation of air quality5. Migration of population
Vulnerability by Region
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Health impactsAn increase of ambient temperature by 1°C is associated with: • increase of deaths from cerebrovascular
diseases from 1.2% to 2.7%. (Women more at risk)
• Increase of daily deaths from external causes (accidents, homicides).
• a 5.3% increase in the number of cases of salmonella.
Increased risk of changes in distribution of some climate sensitive infectious diseases (plague, CCHF, malaria, tick borne diseases..)
Many health care facilities at risk (99 mapped) from extremes, and many hospitals show big gaps in capacity of managing risks
An example on setting priorities
Recommendations World Health Organization
1. Creating mechanisms for interagency coordination to protect public health in a changing climate and environment
2. Creating an environmentally-friendly healthcare system and providing resilience 3. To strengthen the human and scientific potential of the healthcare system of the
Republic of Kazakhstan 4. Raising awareness and environmental literacy among the public and healthcare
workers 5. Strengthening the system of epidemiological monitoring and surveillance for
climate-dependent infections 6. Inclusion of the issues of climate change into the list of priority scientific
research, as well as to ones, funded by the Science Foundation 7. Identification of the major health indicators to monitor impact of climate change
on health routinely
22
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Priorities
In general• V&A provides basic
information for the development of the adaptation measures and sustainability
• Particular vulnerable populations such as women and children
V&A priorities
In descending order:• Water and sanitation• Food security• Reproductive Health• Communicable diseases• Cardiovascular and
respiratory diseases
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
NCCHASAP 2012-2020
Main activities1. Improvement of legislative
bases.
2. Interventions to reduce vulnerability and socio-economic damage.
3. Enhancement of adaptive capacity of the population
4. Institutional and capacity building.
5. Public awareness.
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Improve water security and safety for health care institutions
• 80 % of health facilities in country do not have adequate quantity of running water
• 2 pilot sites chosen for developing Water Safety Plans
• One hospital site having water safety plan, including repair and installation of safe water delivery system
• Training on water safety planning • Workshop for facilitators team of 13
professionals from Ministry of Health, for Water Safety Plan in pilot villages
• Training of trainers for hospital plumbing• National advocacy seminar for 40 decision
makers and potential donors
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Focus groups in Rudaki
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Before introduction to WSP
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
After implementing Water Safety Plan
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Media, people and information
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Water awareness rising
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
The importance of this initiative
• The multiplier effect– From 1 to 4
• The leapfrog effect– Innovation and technology
• The political effect– Health in the UNFCCC– In the WHA
• The economic benefits of adaptation– Disease averted; absenteeism avoided
• The environment benefits– GHG savings
• The health benefits
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Priorities for the EU – CAR cooperation
Support to implement the health adaptation strategies/action plans
• Strengthen public health and health services, workforce development
• Infectious disease early identification, mapping, control, surveillance
• Develop early-warning systems and strengthen health sector engagement in emergency planning
Particular focus on vulnerable regions/populations
• Mother and child health development
• Men
Leap-frog developments: sustainable and green health services/systems
Health in NAMA’s and in general mitigation action
Almaty, EU-CAR meeting
14 September, 2012
Dr Bettina Menne; [email protected]
Thank You!
Dr Bettina MenneProgramme ManagerClimate change, sustainable development & green health services
WHO European Centre for Environment and [email protected]
+49 2288150422
