Sylvester St.ville Senior Environmental Health Officer

National Focal Point Climate and Health

Dominica Climate Change and Health

Vulnerability & Adaptation Assessment

GOVERNMENT OF THE COMMONWEALTH OF DOMINICA

ASSESSMENT OF CLIMATE CHANGE AND HEALTH VULNERABILITY AND

ADAPTATION IN DOMINICA

2016

Outline

• Background to Assessment

• Methodology

• Assessment constraints

• Preliminary Findings

• Next steps

Background

Concept of V& A discussed with Sally Edwards PAHO

Health Canada Brought into discussion in Mexico in 2013

Recommendations out of GFCS National Stake holder consultation

Key advisors Adrian Trotman (CIMH) Joy Guillimot (WMO) Peter Berry, (Health Canada)

Assessment lead by the Min of Health Employed services of a consultant

Background

PAHO WHO

51st DIRECTING COUNCIL 63rd SESSION OF THE

REGIONAL COMMITTEE

STRATEGY AND PLAN OF ACTION ON CLIMATE CHANGE Strategic Area 1: Evidence:

Strengthening the generation and dissemination of knowledge regarding health risks associated with climate change and about the appropriate public health response to this phenomenon.

Policy direction

• Dominica’s Low Carbon Climate Resilient Strategy

• “The real effects of climate change on human health in Dominica will likely be dependent on the vulnerabilities resulting from economic, environmental, social, and health related impacts that will determine the populaces ability to ability to react and adapt”.

Vector-Borne Diseases

Food Safety Food Security

Waterborne Diseases

Assessment’s Priorities Health Areas

Specific objectives

• To determine the association between climate variability and change and three priority areas

• To generate evidence of the risk presented by climate variability on health and develop adaptation plans to reduce the impact.

• To establish baseline data and identify priorities in program planning to reduce the transmission of diseases through the various pathways.

• To inform the development of a climate change strategy for health

• To identify information and data gaps and inform future research

Methodology

Assessment informed by:

– WHO guidelines for V & A (2012)

– Literature review (Desk Review Report)

– Other V&A Assessments

– Expert consensus (Advisory Group)

– Site Visits

– Stakeholder consultations

– Focus group discussion

– interviews

Assessment Steps

Step 1- Frame and Scope the Assessment Activity timelines Plan stakeholder engagement Stocktaking of available data on climate and climate-sensitive

diseases

Step 2- Conducting Assessment Identify vulnerable groups, sectors and regions Current adaptive capacity Stakeholder engagement

Step 3- Understanding Future Impacts on Health Climate projections for Dominica Health modeling for priority health risks

Step 4- Develop Adaptation Plan Public health policy options Resources for implementation of adaptations

Data Collection

• Mixed-methods approach used: quantitative and qualitative elements

• Expert interviews and consultations

• Access to available data bases; Health Agriculture, tourism, national Statistics

• Active data collection

Data Collection Data Category Required Data Data Sources

Health • Historical health data for vector, water and food- borne diseases (disease rates and pathogen density)

• Health utilization data (number of visits, diagnosis)

• Household sanitation, water quality and storage

• Health Information Unit: climate-sensitive disease surveillance data

• Health Facilities

• Ministry of Finance: 2011 National Population and Housing Census

Climate • Historical climate data for

Dominica (T°, precipitation, extreme events)

• Downscaled climate projections for Dominica

• Dominica Meteorological Service

• Caribbean Institute for Meteorology & Hydrology (CIMH)

Adaptation • Current adaptive capacity • Implemented interventions • Available resources

• Stakeholder workshops and consultations

Assessment Challenges

• Gaps identified in existing data sets

• Stakeholder overuse

• Travel for consultant

• Tropical storm Erica

• Low response rate for adaptive capacity

• Time constraints

• Other responsibilities

• Capacity (modeling)

Assessment strengths

• Disease surveillance data

• Weather data

• Expert advisory group consisting of authors of WHO (2013) Methodology for V &A local and Regional advisors

• Adequate funding for Assessment

Preliminary Findings GI <5 (Source HIU)

0

50

100

150

200

250

200

6-0

120

06

-08

200

6-1

520

06

-22

200

6-2

920

06

-36

200

6-4

320

06

-50

200

7-0

520

07

-12

200

7-1

920

07

-26

200

7-3

320

07

-40

200

7-4

720

08

-02

200

8-0

920

08

-16

200

8-2

320

08

-30

200

8-3

720

08

-44

200

8-5

120

09

-05

200

9-1

220

09

-19

200

9-2

620

09

-33

200

9-4

020

09

-47

201

0-0

220

10

-09

201

0-1

620

10

-23

201

0-3

020

10

-37

201

0-4

420

10

-51

201

1-6

201

1-1

320

11

-20

201

1-2

720

11

-34

201

1-4

120

11

-48

No

. of

case

s

Year-week

Weekly Trend of Acute Gastroenteritis (AGE) With Outbreak Years, Dominica 2006 - 2011

Norovirus GII

Rota virus

Norovirus GII

Models showing GI and dry and rainfall effects

Time series comparing GI cases, mean rainfall temp, 1993-2008

Modeling for climate factors for GI<5

• An association of gastroenteritis in children under 5 years old with average weekly rainfall was found to be non-linear and varies over the short term (0-6 weeks).

• Extreme dry conditions are associated with a significant short-term increase in gastroenteritis risk (lag 0-2 weeks).

• (3771 cases of gastro over a twelve year period)

• Study did not take into account pathogen and other confounding factors.

Dengue Fever

• 95% of all cases found to occur between July and December

• Association between Dengue and rainfall

• Assessment analyzed cases from 2000- 2014

Seasonality of Dengue fever

23.0

24.0

25.0

26.0

27.0

28.0

29.0

30.0

31.0

0.0

100.0

200.0

300.0

400.0

500.0

600.0

Jan-07 Jan-08 Jan-09 Jan-10 Jan-11 Jan-12 Jan-13 Jan-14

Tem

pe

ratu

re (

de

g. C

)

Re

po

rte

d C

ase

s/R

ain

fall

(mm

)

Monthly Rainfall

Reported Dengue Cases

Monthly Temperature

Next Steps

• Development of a methodology for Caribbean states using Dominica case study as an example

• Prioritizing climate and Health as a development issue in the Caribbean

• Development of an adaptation plan for implementation

• Early warning system for vector, food and water borne diseases

It is well-established that the countries of the Caribbean are among the most vulnerable to global climate change (IPCC, 1995, 1997, 2001, 2007). While the severity of the impacts will vary from country to country, there is a suite of priority concerns directly linked to climate change that is virtually ubiquitous across the region

(Climate Investment Fund 2009)

Climate Change is an inconvenient truth for health!

Thank You