Transcript Climate change and public health adaption in Indonesia

CLIMATE CHANGE AND PUBLIC HEALTH
ADAPTATION IN INDONESIA
Budi Haryanto
Department of Environmental Health
Faculty of Public Health – University of Indonesia
The Nautilus Institute Workshop on Mapping Causal Complexity
in Climate Change Impacts and Adaptation,
Melbourne, 21-22 November 2008
INTRODUCTION
Climatic changes have already affected numerous damaging
impacts on human health.
Spreading infectious disease, longer and hotter heat waves, and
extreme weather claim thousands of additional lives
nationwide each year.
Warming climate is creating the ideal conditions for spread of
infectious disease, putting millions of people at risk.
Climate change has lead to increase the outbreaks and spread
of Dengue Hemorrhagic Fever (DHF), malaria, cholera,
encephalitis, hantavirus, and other diseases all over the
world.
Ironically, the countries which have less contributed to the
global warming are highly susceptible and more outbreaks of
diseases and deaths due to global warming impact
OUTLINE PRESENTATION
1.
2.
3.
4.
5.
Introduction
Climate change and health impacts
Research in Indonesia
Public health adaptation
Strategic idea for public health
adaptation in Indonesia
Moderating
influences
Health
Health
effects
Effects
Temperature-related
Temperature
-related
illness and death
Extreme weatherExtreme
weather
related (floods,
storms)
relatedeffects
health effects
health
Environment
Impacts:
Climate
Change
Air pollution-related
pollution -related
health effects
Regional weather
changes
Microbial
changes:
Contamination
pathways
Contamination paths
•Heat waves
•Extreme weather
•Temperature
••Precipitation
Transmission
Transmission dynamics
dynamics
•Sea-level rise
Water
Water and
and food-borne
food -borne
diseases
diseases
Vector
Vector -borne
borne and
and
rodent
borne
rodent borne diseases
diseases
Changes in agroecosystems, hydrology
Effects of food and
water shortages
Socioeconomic and
demographic disruption
Mental, nutritional,
infectious-disease and
other effects
EXTREME EVENTS HEALTH IMPACTS (DoH, WA)
Potential health impacts of gradual climatic changes
Potential health impacts of gradual
climatic changes
Potential health impacts of gradual climatic changes
Potential health impacts of gradual climatic changes
19
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07
Trend of Temperature and DHF Cases
in Indonesia 1968-Sept 2007
26,6
26,4
250000
TEMP
DHF
26,2
25,2
24,8
200000
26
150000
25,8
25,6
100000
25,4
50000
25
0
Tahun
2010
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IR dan CFR
Incident and CFR Dengue
Indonesia, 1968-2007
60
40
20
0
IR/100.000
CFR(%)
Dengue’s principal vector: Aedes aegypti
Principal vector is female Aedes aegypti mosquito. Infected
mosquito remains infective for life.
Indonesia: reported dengue cases doubled in 2007 vs. 2005.
Malaria Cases
Trend of Confirmed Cases of Malaria
2000-2006
3.50
3.14
3.00
2.67
2.85
2.50
2.00
1.47
1.50
1.42
0.98
1.31
1.00
0.50
0.00
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Malaria Endemic Areas
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Non Endemis
1 dot = 100 kasus
1 dot = 500 kasus
Effects of Temperature Rise
on Dengue Transmission




Shorten viral incubation period in
mosquito
Shorten breeding cycle of mosquito
Increase frequency of mosquito
feeding
More efficient transmission of dengue
virus from mosquito to human
IMPACTS CLIMATE CHANGE ON
HUMAN HEALTH IN INDONESIA
Direct effects:

Increasing of injuries associated with extreme
weather events
Indirect effects:


Increasing of vector borne diseases (malaria,
dengue, filariasis) associated with increasing of
temperature, rainfall, humidity, and vector density.
Increasing of water borne diseases (diarrhea,
cholera, typhoid, leptospirosis) associated with
decreasing of water quality and water supply as well
as floods and droughts.
Indirect effects…




Increasing of malnutrition cases is related to food
production and land use shifts
Increasing of cardio cerebral vascular diseases,
hypertension, and mental disorders are associated
with urban stress, life style, displacements and
conflicts.
Increasing of influenza (ARI) and respiratory
diseases (asthma, pneumonia) are associated with
increasing of air pollution outdoor as well as
indoor
Increasing of food borne diseases is associated
with contamination, food handling, and poverty.
MAIN CONCERN:
SPREADING OF DISEASES
Unique transmission pathways
Specific for every single disease outcome
Once the impact occurred, the disease will spread from infected
person to others and from the new infected people to
broader population as snow ball phenomenon
The spread of disease may not be controlled directly even by
manipulating or modifying the environment
Analysis of each of these steps allows a logical determination of
vulnerability and subsequent development of adaptive
measures that aim to decrease vulnerability
It will need specific discipline of technology, method, and
expert such as public health/environmental health, medical,
and pharmacy to deal with the impacts.
CURRENT RESEARCH & REVIEWS

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
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

Rainfall and rain date in Jakarta associated with Incidence Rate and Case Fatality
Rate of Dengue Infection in 2002-2006 by Nainggolan L et al., UI ‘07.
Aedes aegypti density in Jakarta associated with climate change by Sungkar S et
al., UI ‘07.
The influence of climate change to the spreading of dengue virus serotypes and
the increasing of cases in Jakarta by Adriansjah et al., UI ‘07.
Pulmonary tuberculosis and climate change in Indonesia by Burhan E et al., UI ‘07.
The incidence of leptospirosis and its risk factors in Jakarta by Nainggolan L et al.,
UI ‘07.
Mental health of adolescents associated with climate change by Ismail RI et al., UI
‘07.
Increasing morbidity and mortality caused by air pollution associated with climate
change in City of Bandung 2002-2006 by Soemirat J & Dirgawati M, ITB ‘07.
Occupational dermatosis incident associated with climate change in Surabaya by
Martiana T et al., Unair ‘07.
Lung disorders associated with climate change in Jakarta by Andarini S et al., UI
‘07.
Research …








Lung cancer associated with climate change in Jakarta by Syahruddin E et
al., UI ‘07.
Predicting the increasing of malaria cases in endemic area caused by
climate change 2002-2003 by Yudhastuti R et al., Unair ‘07.
Approach and method of studies on health and infectious diseases-related
to climate change by Haryanto B, UI ‘07.
Early warning system for malaria outbreak by Subirosa BS et al., UI ‘07.
The pattern of malaria distribution as impact of climate change in Pacitan
regency 1998-2002 by Chatarina UW et al., Unair ‘07.
Global warming ad public health impact in Indonesia by Sutomo S, UI ‘07.
Climate change and DHF in Tanah Laut District of South Kalimantan
Province 2001-2006 by Basuki H et al, Unair ‘07.
Climate change and voice of public health association in Indonesia by
Indonesian Public Health Association 2007.
Health impact assessment






to evaluate the impact of climate variability and change in a
range of areas and populations;
to evaluate possible threshold effects;
to evaluate the effects of multiple stresses, including changes
in socioeconomic systems;
to evaluate uncertainty and its implications for risk
management;
to evaluate the effects of reducing emissions, such as by
comparing impact under scenarios with business-as-usual and
stabilization of emissions; and
to measure coping capacity, especially under different
socioeconomic futures and in the context of sustainable
development.
PUBLIC HEALTH RESPONSE AND
ADAPTATION IN INDONESIA






Infectious disease surveillance
Health action in emergencies
Safe drinking water
Integrated vector management
Environmental health capacity building
Healthy public policy (healthy housing,
school, forest, industry, city)
WHO Adaptation Focus






Health security
Strengthening health systems
Health development
Evidence and information
Delivery
Partnership
PUBLIC HEALTH ADAPTATION
IDEAS IN INDONESIA







Empowering ecological-diseases surveillance system and developing
public health early warning system
Development response to disaster effects of climate change
Enhancing capacity building for government, private sector, and civil
society on managing prevention and control climate change on
human health
Increasing political awareness on climate change human health
Empowering public health services system for disease prevention
and control
Generating research and method on epidemiology and medicine to
find out the approach in breaking the disease transmission chains
Preventing and eradicating climate change vector-related diseases
Impacts, Vulnerability, Adaptations
Characteristics of exposed group
(location, wealth, resources, health status, culture, etc.)
Adaptations
Vulnerability
Learning
of group
Exposure
Mitigation:
Reduced
exposure
Health
Impact
BREAKING TRANSMISSION
CHAINS
Actions in
response to
impact