By Fithriyyah Iskandar and Joshua Belayan
Exploring the intersection of climate change and health in Borneo from adversity to resilience
In the heart of Borneo, where the lush green canopy of the Kalimantan’s rainforest was caught in a devastating forest fire, a tragedy borne out of the depths of human-induced activities and aggravated by the unrelenting force of climate change. Our story unfolded in Pontianak in September 2019, where I was a medical student embarking on a journey of learning and healing. Freshman year at the medical faculty was supposed to be a time of excitement and new beginnings but instead, it was gray and suffocating, quite literally. For two long months, the sun remained an elusive entity, shrouded by the thick, acrid smoke that enveloped the city. The transboundary haze was not just a local catastrophe; it was a monster that leaped over borders, suffocating Singapore, Brunei Darussalam, and Malaysia.
As the days melded into one long, gray blur, the news echoed with stories of the disaster. Reports flooded in, painting a picture of devastation - vast tracts of forest and land, consumed by flames, wildlife perishing, and biodiversity lost in the inferno. The economic repercussions were staggering, with industries reeling under the impact. Politically, the haze sparked dialogues and debates, challenging leaders to confront the environmental crisis head-on. Education, too, bore the brunt of this calamity. Schools closed, exams postponed, and the rhythm of academic life disrupted. The crisis underscored the fragility of health and the environment.
This reality is not only faced by me, but many youths around the Asia-Pacific region are also going through the same dilemma. A study recently reported that children born in 2020 are expected to experience a higher frequency of extreme climate calamities in their lifetime compared to a person born in 1960. This includes encountering twice as many wildfires, about 2.8 times the number of crop failures and river floods, more than 2.6 times as many droughts, and 6.8 times as many heatwaves. These calamities also prompted two out of five youths to reconsider starting a family due to climate change. Coupled with ongoing pollution in urban areas where most youth demographics reside, their living environment is proven to be increasingly less ideal.
Climate boiling and more extreme weather
It has been declared now, that we are no longer using the term, “global warming”to show our earth’s climate condition, instead, ‘global boiling’ was introduced by the middle of 2023, after July 2023 was awarded as the hottest month ever recorded since 1880. The World Meteorological Organization (WMO) predicts there will be record-breaking global heat in the next five years, driven by greenhouse gasses and the El Niño phenomenon. The annual average near-surface global temperature between 2023 and 2027 has a 66% chance of exceeding 1.5°C above pre-industrial levels for at least one year. The probability that at least one of the next five years, and the entire five-year period, will be the hottest ever recorded is 98%.
The most prominent negative impact caused by these extreme temperatures is the increase in human morbidity and mortality affected by heat-related illness, as new findings suggest that 37% of deaths from heat exposure are due to human-induced climate change. This brings risks to vulnerable groups of people such as women, elders, low-income individuals, refugees/migrants, and especially children. According to UNICEF, around 559 million children are currently exposed to heatwave threats which makes them susceptible to respiratory and cardiovascular problems.
It has also been reported that 58% of known infectious diseases are likely to worsen due to climate-related events. The World Health Organization (WHO) predicts that climate change will result in 250,000 additional deaths annually between 2030 and 2050, along with direct health costs of $2-4 billion. Furthermore, human activities are causing other health issues. For example, over 10 million hectares of farmland are lost each year to degradation, heightening the risk of global hunger. Antimicrobial resistance (AMR), which might cause 10 million deaths per year by 2050, is closely linked to different Earth systems.
Moreover, the climate crisis increases the risk of some infectious diseases, such as Lyme disease, water-borne diseases (such as gastroenteritis, and leptospirosis), and vector-borne diseases (such as malaria and dengue fever transmitted by mosquitoes), becoming more prevalent. The risk of pandemics also escalates, due to many of the root causes of climate change, especially deforestation which mostly occurs for agricultural purposes, the main driver of habitat loss globally. The destruction of the habitat compels animals to migrate, increasing the chances of contact with other animals or humans and facilitating the transmission of viruses, bacteria, or parasites, commonly known as zoonoses.
In light of increasing health and environmental challenges from the above-mentioned situations, there's an urgent need to invest in strengthening health systems to make them more resilient to natural and human-made disasters. Adopting a comprehensive, interdisciplinary approach is crucial in tackling these health impacts of the climate crisis. The lens of planetary health, which deals with understanding and addressing the effects of human activities on Earth's natural systems and their impact on human health and all life, could be a pivotal solution for achieving a sustainable and equitable future in global health and ensuring universal health coverage.
The field of planetary health is an emerging concept that acknowledges the complex interaction between the deterioration of the Earth's natural systems due to human activities and the interconnected effects on human health. By embracing this holistic perspective, we can navigate the complex relationships between our changing climate and the health of communities worldwide. It's not merely an environmental challenge; it's a call for collective understanding and action to safeguard the health and resilience of our global community.
The solution: climate adaptation and mitigation
It is imperative to tackle this climate crisis with multiperspectivity and collaboration across the stakeholders, nationally and internationally. Climate change risks have proven to pose a greater threat to the Asia-Pacific region than to other parts of the world, due to its reliance on the natural resources and agriculture sectors, high population density in coastal areas, weak institutions, and widespread poverty among a large segment of the population. In fact, people in this region are six times more likely to experience disasters than those in other locations. Hence, having proper climate adaptation and mitigation programmes is the ultimate weapon to tackling the negative impacts of current climate boiling.
Bhutan: linking the climate data with epidemiological surveillance
Bhutan, as one of the seven pilot countries in the “Piloting Climate Change Adaptation to Protect Public Health'' initiative has recognized its public health vulnerability to climate change. Furthermore, they established an innovation to link the climate data with epidemiological surveillance by monitoring and recording cases of diarrhea, acute respiratory infections, malaria, dengue, visceral leishmaniasis, and Japanese encephalitis from six combined health/meteorological centres throughout Bhutan. As a result, Bhutan has a strong database on the interconnectedness between meteorological variables and public health to support its health system. This has improved their resilience to face climate change and provide early warning for climate-sensitive diseases.
What we need now: a call to action for governments in Asia and the Pacific
In a world where the climate crisis looms large, the Asia-Pacific region stands at a crossroads. Here, a diverse tapestry of nations faces a shared threat that demands a unified response. The story unfolding is one of urgency, innovation, and collective action. Imagine a future where the governments of the Asia-Pacific unite in a grand coalition for planetary health. Together, they embark on a journey to weave a safety net for the planet, harnessing global cooperation and the power of technology. They pour resources into research and digitalization, crafting strategies that reach even the most secluded communities.
At the heart of this narrative are the youth, vibrant and tech-savvy, stepping forward as champions of change. They are not just participants but leaders, guiding the region towards sustainability with their fresh ideas and boundless energy. Their voice is a clarion call for action, resonating across borders. Yet, the road is fraught with challenges. An implementation gap yawns wide, threatening to swallow progress. The story takes a turn as heroes emerge, bridging this divide with knowledge transfer and collaborative spirit. They ensure that no country is left behind, and the benefits of innovation reach every corner of the region.
Amidst this, a silent barrier looms—youth participation is stifled by skepticism and systemic obstacles. But resilience shines through as new policies emerge, empowering and elevating the role of young voices in shaping a sustainable future. The narrative arcs toward a vision of a climate-resilient health system, where every policy is viewed through a climate lens. This system is inclusive, gender-sensitive, and just, ensuring everyone, from the youth to the marginalized, has a seat at the table.
Community empowerment becomes the cornerstone of this new era. Policies are not just made for the people but with them, ensuring that every action taken reflects the needs and strengths of the Asia-Pacific's diverse population. This is more than a story of survival; it's a tale of transformation. The Asia-Pacific region, through unity, innovation, and inclusivity, turns the tide on the climate crisis, charting a course towards a sustainable and resilient future. It's a call to action for all—a reminder that together, we can overcome even the greatest challenges.
Fithriyyah Iskandar has been a medical doctor and environmental youth activist since 2015. She was a fellow in the YSEALI Academic Fellowship Program 2021 at East-West Center, USA on Environmental Issues. She was championing the Right to a Clean, Healthy and Sustainable Environment as ASEAN Youth Forum’s (AYF) Youth Rights Ambassador. She is also part of the Youth Advisory Group at the London School of Hygiene and Tropical Medicine Centre for Climate Change and Planetary Health. Now, she currently serves as a Program Associate at AYF and represents them to the ASEAN Environmental Rights Working Group on behalf of the youth group representative.
Joshua Belayan is the Country Co-Director of the ASEAN Youth Advocates Network (AYAN) Brunei and YSEALI Next Executive Steering Committee on the Environment for the US Mission to ASEAN and a consultant working on Meaningful Youth Engagement in Climate Governance.