In many climate disaster related conversations, there is a villain that often flies under the radar. Communicable diseases are not at the forefront of climate change discussions. Island shores disappearing, dwindling water supplies, intense storms, air quality, and pollution all occupy disproportionately loud voices in the climate change conversation. Even this blog fails to cover the infectious disease aspects of climate change and climate related disaster. This is an oversight on the part of climate related sciences for the following reasons. First, communicable diseases account for three of the top ten causes of death according to the WHO. Second, infectious diseases have a larger impact among countries that are low and lower-middle income. Lastly, disasters often exacerbate existing problems that weakened medical infrastructure is no longer equipped to handle, this is particularly true of floods and mesquite born illness.
Table 1. Table of disease outbreak and associated disaster
In order to remedy this, I will post three part series discussing the impacts of climate change on infectious disease as it relates to Oceania. The series may change as I develop it, but I plan to discuss infectious disease from three perspectives. The first section will discuss how climate change related disasters can increase the breakout of infectious disease for small islands such as those in Oceania. The second will discuss the infrastructure and capacity of Oceania states to handle an infectious disease outbreak. The third and last section will assess what data indicators that may be helpful to profiling and mapping which Oceania states are at greater risk for climate disaster related infectious disease outbreaks.
Part 1: Disaster and Disease Outbreak In Oceania
I first need to dispel the notion that climate related disaster immediately puts a population at risk of disease out break. The evidence out there suggest that there is not a strong correlation between a disaster happening and disease immediately breaking out. The concept of mass disease out break immediately following a disaster is often a hyperbole of media. For example, despite the vast number of corpses in Haiti and Japan’s earthquakes did not result in disease outbreak. The microorganisms involved in decomposition are not actually pathogenic in and of themselves.
Rather, it is appropriate to view climate disaster related disease outbreak within the context of the disease which are either A) characteristic of the region, B) the result of a nexus of issues that lead to the contamination of essential services, C) the mass exodus of a population into cramped camps, and D) time. The highlighted disaster risks are premised that climate change will follow along the ICCP 5th report, whereby rain events will be fewer but more intense and sea levels will rise and endanger infrastructure, leading to displacement of populations and the destruction of critical infrastructure.
Climate Disaster Disease: Regional Disease Outbreaks
When considering the disaster related outbreak of a disease characteristic of a geographical area. In other words, climate disasters do not import new diseases. Rather, disaster related disease outbreak should considered within the context of destroyed, or over extended, prevention infrastructure.
Take malaria for example. It is common among lower income countries located in sub-tropical environments to be at risk for malaria outbreaks. In most cases, countries have enacted programs, such as mosquito netting, and the stocking of anti-malarial drugs. When these sub tropical regions are hit by hydro-logical disasters such as flooding or hurricanes, the risk of a malaria outbreak increase over time if the appropriate steps are not taken. The effect is not immediate, but the increased standing water allows for the proliferation of mosquitoes, which in turn increases the probability of a malaria outbreak. The delayed timing exacerbates this effect as international response teams and resources roll off over time. Destroyed preventative measures and strapped resources increase the risk of outbreak for existing diseases.
In the case of Oceania, what will determine a sub-national populations ability to combat existing diseases will largely be based on the access to medical services on each island, the ability of these medical services to restart after the disaster, and their ability to rebuild preventative infrastructure. If a sub-national population cannot achieve any one of these things quickly, the risk of an acute disease issue increases.
Climate Disaster Disease: Contamination and Sanitation
The other major source of disaster related disease stems from contamination and compromised sanitation. For example, diarrheal diseases account for 40% of disaster related diseases. Outbreaks of these types of disease are often the result of fecal contamination of water sources, contamination of water during transportation, and cross contamination from shared water containers. This is often exacerbated existing poor water sanitation and sewage systems. Vibrio cholorae broke out after an earthquake and hurricane struck Haiti, resulting in a a high case-fatality rate of 6.4%.
The breakdown in water sanitation also increase the risk of animal contamination. Leptospriosis, a rare bacteria that causes diarrhea, fever, and vomiting, broke out in India after floods in the year 2000. The bacteria is spread when water is contained by infected rodent urine (leptospires). The aftermath of the floods helped in the proliferation of the rodent population which lead to the spread of leptosipres into the human population.
In Oceania, these types of disaster related diseases will be particularly problematic. For one, islands are not characterized by diverse water resources. Should the primary freshwater resource become contaminated with a disease, the islands will be dependent on outside water imports, which risks exposure to contamination in and of itself. Second, if a rare animal bacteria somehow contaminates food or water resources, it is unlikely that smaller islands will be readily equipped to handle them. This would mean a delayed response with a corresponding increased risk of fatality.
Climate Disaster Disease: Refugee Camps
This section will largely play into the issues discussed into the prior two sections, but is worth discussing how climate disaster displaces people and where they go. Climate related disaster does not need to be result of a single event. Rather, climate disaster an be the culmination of deteriorating living conditions (i.e. prolonged famine from water supply changes) that force people to leave their homes and become refugees. Countries and cities receiving refugees are rarely equipped to handle them in permanent structures. Instead, they gather them in semi-permanent refugee camps. These camps often become overcrowded, lack sufficient medical facilities, and have poor sanitation practices, making them hot-beds for disease outbreaks. The spectrum of diseases can be broader in camps. Not only could there be an outbreak of malaria and diarrheal diseases, but also the rapid transmission of sexually transmitted disease, meningitis, measles, TB, flu, and airborne pathogens.
Climate Disaster Disease: Time
As previously stated, diseases outbreaks do not happen immediately after climate disaster and are not directly associated with a disaster. Rather, disease outbreak is the result of a confluence of problems that may result from climate related disaster. That said, climate disaster related disease is applicable when you add the consideration of time. It is common to see an uptick in disaster after international response teams leave because basic hygiene and infrastructure facilities are still unavailable.
Table 2. Disease Vulnerabilities and Time
The factor of time will be of particular concern for Oceania nations affected by climate related disasters. With relatively small economies, a climate disaster will likely pose a large economic burden. Furthermore, some Oceania states can be characterized as a chain of disconnected and/or mountainous island, making it difficult to launch broader infrastructure repair plans.
That said, island states do have one notable advantage against time, size. Presumably (but subject to further study) island states will have simply have less, and simpler, infrastructure to begin with. This may make it easier to bring a sufficient amount of infrastructure online before the departure of response resources.