As part of the World Health Organization (WHO) and UNDP, global project on public health adaptation to climate change, the "Piloting Climate Change Adaptation to Protect Human Health in Bhutan" worked to strengthen national capacity to identify and prevent adverse climate change related health outcomes.
This pilot project provided better information and surveillance of climate change related health risks in Bhutan. Improved data collection will allow the country to monitor and receive early warnings and thus the opportunity to prepare and respond to potential health risks. The project also provided training and development of tools for health providers to understand the influence of climate change and variability on the transmission of vector borne diseases, extreme weather events and other health issues.
Bhutan is one of seven countries which took part in this global pilot. The seven countries, Barbados, Bhutan, China, Fiji, Jordan, Kenya and Uzbekistan, together represent four distinct environments (Highlands, Small Islands, Arid Countries and Urban environments,) and their related health risks.
The objective of this first global project on public health adaptation to climate change was to “increase adaptive capacity of national health system institutions, including field practitioners, to respond to climate-sensitive health risks”. This contributed to the broader goal of ensuring that “Health sectors are able to cope with health risks resulting from climate change, including variability”.
Key Health Concerns and Vulnerability to Climate Change
Bhutan suffers from high rates of a series of climate-sensitive health burdens. Projected temperature rise (higher in mountainous areas than elsewhere in the world) is likely to increase the probability of Glacial Lake Outburst Floods (GLOF); increases in the geographic range and incidence of vector-borne diseases, particularly malaria and dengue; and increase in the incidence of water borne diseases. With an estimated 2,674 glacial lakes in Bhutan, and 24 considered potentially dangerous, GLOF’s represent a major climate change concern in the country. Major incidents of glacial lake outbursts have been documented 1957, 1960, and 1994. Flash floods and landslides are also common during the monsoon period of June to August.
Vector borne diseases are becoming more prevalent in Bhutan due to the increasing temperatures. Two types of malaria are prevalent in Bhutan: the more severe Plasmodium falciparum (30-60% of cases) and Plasmodium vivax with over 50% of the population residing in malarial areas. Dengue is an emerging infectious disease in Bhutan. Dengue was first documented in Bhutan in 2004 and is now endemic during the monsoon period.
Diarrhoeal diseases represent a significant cause of morbidity in Bhutan for the last decade and contribute to about 10-15 % of the morbidity cases. Climate change has also influenced water resources due to drying up of water sources or contamination due to flooding, increasing incidences of diarrhoeal disease.
Results and Learning:
This pilot project will provide better information and surveillance of climate change related health risks in Bhutan. Improved data collection will allow the country to monitor and receive early warnings and thus the opportunity to prepare and respond to potential health risks. The project will also provide training and development of tools for health providers to understand the influence of climate change and variability on the transmission of vector borne diseases, extreme weather events and other health issues. To be able to do this effectively the following areas of adaptive capacity have been identified to be particularly targeted by the project:
- Metrological and surveillance data - Bhutan has very limited metrological data and sparsely located metrological stations. There is also very limited surveillance for climate-sensitive health outcomes, resulting in insufficient data and lack of awareness of the possible health impacts of climate change across all government sectors including health.
- Resources - There is a lack of sufficient national capacity in terms of human and financial resources for incorporating climate change risks into all levels of health activities.
- Climate change mainstreamed - National Programs dealing with the climate sensitive diseases like the National Vector borne Disease Control Program (VDCP), ARI and Diarrhoeal Disease programs, Water and Sanitation programs do not currently take climate change into account.
- Improved coordination - A new Environmental Health program has been formed in the Ministry of Health to coordinate and take through the climate and health initiatives.
Key results and outputs
The greatest national benefit envisaged in the implementation of this program will be the enhanced awareness and capacity of health workers and the community at large.
Additional benefits include:
- Helping to plan and sustain the Vector borne Disease Control Program take into consideration the impact of climate change on the increase of malaria, DHF and vector diseases in the country.
- Contribute towards improvement in rural water quality and community sanitation.
- Help create awareness on the health impacts of climate change.
- Improved rural water quality and community sanitation.
- Climate change and health early warning and planning systems
- Institutional and technical capacity to manage climate change health risks
- Demonstration Measures to reduce vulnerability
- Regional Cooperation to address climate change health risks
Outcome 1: Risk Assessment and integrated surveillance enhanced for effective management of climate sensitive health risks.
- Vulnerability and impact assessment determines high-risk areas and populations, and establishes the disease burden (baseline) of climate sensitive diseases.
- Integrated surveillance and alert network system piloted across high-risk (riverine and highland) areas to monitor and provide early detection of changes in climate sensitive diseases and health risks.
Outcome 2: Community and health sector institutions have improved capacity to respond to climate-sensitive health risks.
- Professional skills and health system strengthen in areas identified to have higher risks of extreme weather events or disasters, and epidemic diseases by providing training, capacity building and institutional support.
- Strengthened awareness of climate relevance to health amongst national policy makers, and improved multi-sector health coordination improves effectiveness of prevention, monitoring and management of health risks.
- Increased community awareness, capacity and empowerment helps communities prepare for and cope with increased stresses on the community posed by climate change or emergencies.
Outcome 3: Emergency preparedness and disease prevention measures implemented in areas of heightened health risk due to climate change.
- Implementation of Health sector Emergency Contingency Plan.
- Scale up and targeting of community level interventions for control of water and vector borne diseases, mental health and nutritional issues.