TURN DO WN THE H E AT: C L IM AT E E X T RE ME S , R EGION A L IMPA C TS, A N D TH E C A SE FOR R ESILIENCE
variability, in particular, is a key risk factor, as outbreaks tend to occur after a long dry spell followed by an intense rainfall event (Caminade et al. 2011). In light of projections of increased rainfall variability in the Sahel, RVF incidence in this area can be expected to increase. Caminade et al. (2011) identify northern Senegal and southern Mauritania as risk hotspots, given these areas’ relatively high livestock densities. Rift Valley fever can spread through the consumption or slaughter of infected animals (cases of the disease in Burundi in May 2007 were believed to originate from meat from Tanzania; Caminade et al. 2011). Because of this, RVF outbreaks can also have implications for economic and food security as livestock contract the disease and become unsuitable for sale or consumption. An outbreak in 1997–98 for example, affected five countries in the Horn of Africa, causing loss of human life and livestock and affecting the economies through bans on exports of livestock (Anyamba et al. 2009). Africa has the largest number of reported cholera cases in the world. Cholera is an acute diarrheal illness caused by ingestion of toxigenic Vibrio Cholerae and is transmitted via contaminated water or food. The temporal pattern of the disease has been linked to climate. The relative significance of temperature and precipitation factors remains somewhat uncertain in projections of future incidence under climate change. Past outbreaks of cholera have been associated with record rainfall events (Tschakert 2007), often during ENSO events (Nyong 2009). The risk increases when water supplies and sanitation services are disrupted (Douglas et al. 2008). This occurred during the severe flooding in Mozambique in 2000, and again in the province of Cabo Delgado in early 2013 (Star Africa 2013; UNICEF 2013), when people lost their livelihoods and access to medical services, sanitation facilities, and safe drinking water (Stal 2009).
Repercussions of Health Effects The repercussions of the health effects of climate change on society are complex. Poor health arising from environmental conditions, for instance, may lower productivity, leading to impacts on the broader national economy as well as on household incomes. Heat extremes and increased mean temperatures can reduce labor productivity, thereby undermining adaptive capacity and making it more difficult for economic and social development goals to be achieved (Kjellstrom, Kovats, Lloyd, Holt, and Tol 2009). Child undernutrition also has long-term consequences for the health and earning potential of adults (Victora et al. 2008). The educational performance of children is also likely to be undermined by poor health associated with climatic risk factors. An evaluation of school children’s health during school days in Yaounde and Douala in Cameroon found that, in the hot season, high proportions of children were affected by headaches, fatigue, 54
or feelings of being very hot. Without any protective or adaptive measures, these conditions made students absentminded and slowed writing speeds, suggesting that learning performance could be undermined by increased temperatures (Dapi et al. 2010). Child stunting is associated with reduced cognitive ability and school performance (Cohen et al. 2008); in addition, diseases such as malaria have a significant effect on children’s school attendance and performance. Sachs and Malaney (2002) found that, because of malaria, primary students in Kenya annually miss 11 percent of school days while secondary school students miss 4.3 percent. The complexity of the range of environmental and humancontrolled factors that affect human health is considerable. Among them, land-use changes (including deforestation, agricultural development, water projects, and urbanization) may affect disease transmission patterns (Patz et al. 2008). Moreover, population movements can both be driven by and produce health impacts. Forced displacement, often in response to severe famine or conflict, is associated with high rates of infectious disease transmission and malnutrition; this can lead to the exposure of some populations to new diseases not previously encountered and against which they lack immunity (McMichael et al. 2012). People who migrate to poor urban areas, are possibly also at risk of disaster-related fatalities and injuries (McMichael et al. 2012), especially in slum areas which are prone to flooding and landslides (Douglas et al. 2008).
Population Movement Projections of future migration patterns associated with climate change are largely lacking. However, the observed movements outlined below illustrate the nature of potential patterns and the complexity of the factors that influence population movement. Migration can be seen as a form of adaptation and an appropriate response to a variety of local environmental pressures (Tacoli 2009; Warner 2010; Collier et al. 2008). Migration often brings with it a whole set of other risks, however, not only for the migrants but also for the population already residing at their point of relocation. For example, the spread of malaria into the Sub-Saharan African highlands is associated with the migration of people from the lowlands to the highlands (Chaves and Koenraadt 2010). Some of the health risks to migrants themselves have been outlined above. Other impediments faced by migrants can include tensions across ethnic identities, political and legal restrictions, and competition for and limitations on access to land (Tacoli 2009); these, can also, potentially, lead to conflict (O. Brown, Hammill, and McLeman 2007). In turn, migration is a common response to circumstances of violent conflict (McMichael et al. 2012). Migration can be driven by a multitude of factors, where notably the socioeconomic context also plays a key role (Tacoli 2009).