A small change in my normal body weight (between 70–75 Kg) either a decrease or an increase unsettles me. I feel like I’m too sick if as little as 2 Kg is lost or when I gain weight I feel fat and sedentary. That’s how sensitive I can be. The planet we live in is so sensitive and by taking care of it we take care of ourselves and prevent countless diseases and deaths.The 21st Century Problem
“Every century has its public health challenges, climate change is our century’s challenge” — Dr Margret Chan, Former WHO Director General
The academics at the Resilience Center, Stockholm, Sweden specializing in sustainable development and environmental issues always stress the point that there are planetary boundaries and when these boundaries are crossed we have unfavorable conditions which may not be suitable for our normal daily lifestyles.
Before our modern history as we know it started, there were unstable weather and fluctuating climate conditions throughout earth history before a stable period called the ‘Holocene’ period were we could generally tell when it was summer, spring or autumn meaning there was climate stability. Agriculture flourished then the industrial revolution that led to the ‘great acceleration’ around the 1950s. With more oil explorations, deforestation, expansion of the world’s population and creation of dynamic settlements, some of the planet’s boundaries have been constantly crossed and the resilience systems which the earth naturally has, have been stretch leading to acidification of water bodies, loss of biodiversity, depletion of the ozone layer to obvious signs like melting of ice caps. The list is endless.
The world’s population is projected to be 9.7 billion by 2050(UN report) and there would be more people leaving in urban cities than we have today. This will put pressure on the available resources we have and if not well manage may have catastrophic consequences on health systems making it impossible to cater for people’s needs.
With the advent of free trade across border between countries and people, wars and technology to help us be more connected, we now share a joint responsibility in determining the future of the world. This is a period during which human activity is the dominant influence on climate and the environment (Anthropocene period). This sounds like a superhero movie were the destiny of the world rests on the superhero’s shoulders.
In our recent past it was thought that if there were low yield of crops in a particular farm, it wasn’t really significant or if a tree is cut in a forest it doesn’t really matter but putting this in context in our globalized world, if a particular country continually pollutes the environment, another country — a small island, will pay for it and at times it causes humanitarian disasters. This also holds true for economic crisis, uprisings, poverty e.t.c. To get the big picture we need to understand how different systems interrelate.
In 2011 I woke up to hear that the Egyptian government was toppled by it’s citizens but closely examining this sudden crisis in Egypt it was seen that the undemocratic regimes in the Middle East/North Africa had little resilience to withstand outside shock (The Boston Globe, 2015) which meant events like droughts which affected crop produce in another country could rile up it’s citizens. In this case it lead to a spike in price of food (bread), people getting enraged by the inability of the government to provide their basic needs — along with freedom and justice — riots broke out. Now technology had a role to play in it’s success as many people in Egypt flocked to groups on Facebook to meet and discuss. The government knew how communication was so important that they blocked the internet for about 24 hours. This furthermore infuriated the masses and brought to the end of that government regime.
We can see by this example that a natural occurrence due to climate change or bad crop yield led to economic crisis and toppling of a government regime. The world is connected so are Its systems.
What do the numbers say?
There were 140,000 estimated deaths since the 1970s to 2004 — WHO
250,000 additional deaths per year expected between 2030-2050 — WHO
These numbers are speaking and they are saying that if we don’t build resilient public health systems with the available resources, we might not be able to achieve good health in rural and sub urban communities.
For example; heavy rainfall could lead to flood based on environmental conditions causing flood damages. In this situation we could see increased disease vectors (e.g Mosquitoes) breeding mediated by a natural system which may also lead to increased prevalence of malaria in the social space. This puts pressure on the government to provide treatment on time to save it’s citizens. I don’t need to explain how Nigeria was able to kick the Ebola virus out. There was quick response, adequate dissemination of information on prevention, teams were working at their best — The Nigerian government finally worked.
In aWelTel Kenya1 trial, clinic nurses in three Kenyan clinics sent weekly SMS messages to adult clients who had recently begun antiretroviral therapy (ART).
How it worked:
- The messages asked patients how they were doing, and patients were required to respond within two days.
- The clinic nurses called patients who did not respond or who responded that they had a problem.
- Patients who received the text messages had significantly higher self-reported ART adherence and improved rates of viral suppression compared to the group receiving standard care.
In most countries in Africa, health care delivery determines if a patient will survive a health crisis or not and I believe and it has been proven that technology can be the game changer for public health interventions to rural areas.
We could strengthen public health systems by using technology in health to improve Social and Behaviour Change Communication, Work Force Development and support, improve service delivery, Financial Transactions and Incentives, Supply management, and information systems. (http://www.globalhealthlearning.org,mHealth basics: Introduction to mobile technology for health)
Climate change and other factors continue to bring up new challenges and opportunities to tackle problems in the society. Would you take the challenge to help strengthen public health care systems? There are many systems that affect the health of citizens and if they strike, we must have built a resilient and adaptive health care system to adequately tackle these complex situations. Politics isn’t off the hook as people in government would need to sit down and make laws that are environmental and health friendly.