Water and Health: Impact of Climate Change in 6 Hotspots of Bangladesh

The adverse effects of climate change are undoubtedly linked with water. The rise in temperature and erratic weather patterns causing unpredictable rainfall, floods, and droughts, have already impacted the availability and the quality of freshwater.  This has had far reaching and adverse consequences on the health and livelihood of the affected populations. Each year about 525,000 children, under the age of 5, die from diarrhea alone, largely due to lack of access to clean water supply and poor hygiene conditions globally. 

The World Bank Group’s Country Climate and Development Report (CCDR) highlights the costs of climate change impacts in Bangladesh: As one of the most vulnerable countries to the effects of climate change, it is primarily driven by its geographic location, flat and low-lying topography, high population density and rates of poverty, and weak health system infrastructures. With a myriad of climate impacts on the horizon, the Government of Bangladesh has committed to identifying and prioritizing investable sectors for action to reduce climate risks and environmental losses in the vulnerable areas of the country.

The government’s Bangladesh Delta Plan 2100 (BDP 2100) disaggregates Bangladesh’s 64 districts into six ecological zones based on hydrological characteristics and climate risks. This plan deems 58 districts to be “extremely vulnerable” to climate change. According to a recent analysis, the six ecological hotspots across the country face unique health challenges and merit urgent attention. In our background paper, as part of the CCDR, we summarized the effects of the change of water on health in each of the hotspots and found the consequences are particularly pronounced for women and children.  There are substantial regional variations in the effects on health, driven by the country’s topological attributes, such as ground water depletion in north-western drought prone areas and salinity in drinking water in the southern coastal regions. The hotspots are:

1. Urban areas: In the urban areas, poor water, sanitation and hygienic conditions and practices, and inadequate access to waste and refuse disposal continues to result in outbreaks of water-borne diseases like cholera , and seasonal outbreaks of dengue and chikungunya.

2. Barind: In the northwestern Barind and drought-prone region, depleting groundwater levels in the summer months significantly reduce cropped land areas and food production, exacerbating poverty rates and food insecurity. 
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3. Coastal region: In the southern coastal region, salinity levels in the natural drinking water sources have been associated with increased diarrhea related morbidity and mortality.  Over 30 million people living along the coast, who rely heavily on rivers, tube wells, and ponds for washing, bathing, and obtaining drinking water, are now affected by varying degrees of salinity, which has been associated with high rates of miscarriage, and increased risk of (pre)eclampsia and gestational hypertension among pregnant women.

4. Haor region: In the Haor region – a wetland ecosystem – in the northeast, the available days for cultivation have reduced to an average of 15–20 days, compared to 30 even a decade prior.  This has progressively affected rice production resulting in increased poverty, heightened risk of food insecurity along with scarcity of safe drinking water. In parallel, they are frequented with flash floods that cause contamination of water sources with pathogens and microbes, and unhygienic sanitary conditions.

5. Riverine areas: According to government reports, about 50,000 Bangladeshi households, on average, become homeless each year due to river erosion.  Recent trends in the riverine areas indicate an increased frequency of floods. The result is loss of productive lands and other natural resources of the riverine households, and the associated threat to their livelihoods and food security. As with most water-related disasters, poor rural women are more adversely affected than their male counterparts, as they lack equal access to basic rights and opportunities for self-protection, social protection, and social capital.

6. Chittagong Hill Tracts: The Chittagong Hill Tracts (CHT) is geographically distinct from other parts of Bangladesh and is mainly characterized by very steep and rugged mountainous terrain. Most of the population lives in small, scattered habitats, which are difficult to access because of the hilly and remote terrain. Some literature indicates that climate change and related weather events profoundly impact the psychological well-being and mental health conditions of the CHT population.  It is important to gather further evidence on the health impacts, because of high vulnerabilities of those living in ecologically sensitive areas. 

To address these devastating impacts, it is imperative for agencies such as the Institute of Epidemiology, Disease Control and Research and the Ministry of Health and Family Welfare (MoHFW) to build research capacity  and upscale comprehensive disease surveillance systems to monitor trends in existing and emerging communicable and non-communicable diseases and to rigorously evaluate the efficacy of disease prevention and control programs. Lastly, a set of zone-specific health policies and actions, underpinned by evidence, need to be formulated  under the aegis of the MoHFW in collaboration with relevant stakeholders such as the Bangladesh Bureau of Statistics, academics, practitioners, and policy makers.

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