Health issues from El Niño and climate change

Last week, I was invited to speak at the El Niño Summit organized by the Department of Health (DOH), aimed at aligning strategies and plans to address the health impacts of the El Niño season. The Philippine Atmospheric, Geophysical, and Astronomical Services Administration (Pagasa) predicts that El Niño will intensify in the coming months.

Discussions bounced repeatedly between El Niño and climate change, which are two different but related phenomena. Related to the geography of the Pacific Ocean, El Niño (“little boy” in Spanish) is a cyclical yet natural phenomenon occurring every two to seven years and characterized by the warming of the ocean’s surface waters, thereby affecting wind patterns. (The opposite is La Niña or “little girl,” which is marked by ocean cooling.)

Meanwhile, climate change is a long-term and largely human-induced or “anthropogenic” phenomenon, characterized by major shifts in temperatures and weather patterns. It is mainly driven by the accumulation of greenhouse gases such as carbon dioxide as generated by human activities like fossil fuel burning, among others. These gases trap heat around the Earth, destabilizing the global climate system that results in a cascade of ecosystem changes—from the melting of ice caps to ocean warming, hotter weather, and more frequent typhoons.

While being two separate phenomena, scientists believe that climate change will intensify the effects of El Niño in the long run. The question is how our health will be affected. More typhoons will bring about disability and even death, more outbreaks of dengue and water-borne diseases are anticipated, and heat exhaustion and heat stroke are expected as the dry season nears. Our health system must be ready to address the emerging health effects of global environmental change. A basic understanding of these interconnections is necessary now more than ever.

During the summit, many challenges were raised by DOH officials from across the country—from unreliable access to clean water to potential disruptions in the food supply. Both El Niño and climate change can make these necessities—essential for health-care provision and ultimately human survival—more scarce in the coming years. But some promising solutions were also shared, with local health leaders innovating despite limited resources and technology—from rainwater catching systems to backyard vegetable gardening, among others.

There are three areas where we can start to enhance our health system’s ability to combat El Niño and climate change. First is to ensure the quality, precision, and timeliness of our data and advisories, starting with announcements regarding impending typhoons and high-resolution heat maps to help public health professionals act effectively, using easy-to-understand and updated information on environmental risks and their health effects. This requires greater transdisciplinary collaboration between health professionals and climate and environmental scientists, with DOH joining forces with Pagasa and other like-minded agencies to establish a climate, environment, and health observatory that integrates and monitors environmental indicators and health outcomes.

The second area is to strengthen the capacity of our subnational health systems from regional to the barangay level, with capacity enhancement going beyond disaster-proofing of physical infrastructure such as hospitals and clinics. Our health workers must not only be technically trained but also adequately compensated and equipped with enabling work conditions. Different local plans of municipalities such as the Local Climate Change Action Plan, National Disaster Risk Reduction and Management Plan, and Local Investment Planning for Health must be tightly aligned and well-resourced to be truly implemented.

The final area is to ensure the clarity and adaptability of technical guidance, protocols, and algorithms coming from the DOH and other agencies. There is a growing demand for more information on how to make local health systems climate-resilient and environmentally sustainable, with policymakers and researchers collaborating to develop a “menu” of interventions for local health systems to choose from. Thankfully, the DOH has started with the Green and Safe Health Facilities Manual which must be widely disseminated and urgently implemented.

As one of the world’s most climate-vulnerable countries, the Philippine health sector must brace itself for expected public health threats. It must go beyond the traditional emergency response approach and move toward preparedness and prevention. These emerging challenges must be seen as opportunities to achieve our dream of universal health care that is not only accessible, of high quality, and equitable, but also crisis-ready, climate-resilient, and respectful to the planet.

Renzo R. Guinto, M.D., is a member of the National Panel of Technical Experts of the Climate Change Commission, and chair of the committee on environmental health and ecology of the Philippine Medical Association.