As disasters wreak havoc all over South Asia, health impacts have increasingly emerged as a major concern for communities and governments in the region. It underscores the need for concerted efforts towards building synergies between the Paris Agreement, the Sendai Framework for Disaster Risk Reduction and the 2030 Sustainable Development Agenda, particularly now, in the post-disaster reconstruction phase, to ensure “building back better” and future disaster prevention.

Monsoon-related incidents in South Asia have claimed hundreds of lives and affected millions of people. The situation is still grim in most parts of the region, especially with concerns of disease outbreaks looming large. Since many parts that are now reeling under the effects of flooding were drought-stricken until recently, the pressure on water and sanitation has been compounded.

The Sustainable Development Goals (SDGs) 3 and 6 on good health, well-being, clean water and sanitation, remain a priority for national governments and the international community. However, the increasing frequency and intensity of disasters, coupled with socio-economic factors (including inequity and inadequate infrastructure), is rendering these goals even more difficult to achieve. In fact, disasters are eroding developmental gains made by South Asian countries even further: between 2000 and 2018, the disaster-related economic damage among South Asian countries amounted to 6% of their GDP.

Implications of floods for water, sanitation and health

As the flood waters recede in India, the local governments and civic bodies are now grappling with pollution, waste accumulation and water-borne diseases, including in relief camps. During monsoons, food and water-borne illnesses are known to peak, with “acute diarrhoeal diseases, food poisoning, chickenpox, measles and dengue” identified by the Integrated Disease Surveillance Programme (IDSP) as “the leading recorded outbreaks of infectious diseases in 2019.” These are mainly caused by a lack of hygiene, water contamination and poor sanitation. Water supply and sanitation structures have also been badly damaged during recent events of flooding, further exacerbating the crisis. At the same time, health facilities are under-resourced and in poor conditions to respond to such a large-scale crisis.

In Bangladesh, more than 20,000 people are said to be affected by “post-flood diseases”. In Nepal too, thousands of households have been displaced, after floods caused severe damage to water and sanitation infrastructure. In Karachi (Pakistan) alone, more than 10,000 children are reportedly affected by diseases such as hepatitis, diarrhoea and gastroenteritis. Water in the region is already known to be highly contaminated with chemicals such as arsenic. Floodwaters are much more contaminated as they carry excreta, dead animals and chemicals previously buried in land/soils, as well as household and industrial chemicals, increasing the risk of diseases and irreversible damage to water bodies and groundwater, even acting as breeding ground for disease-carrying insects.

Climate change acts as a risk multiplier in water, sanitation and health sectors

Climate-related disasters act as risk multipliers in the three critical sectors of water, sanitation and health. For instance, in India, even though great strides have been made with the launch of the Swachh Bharat Abhiyan (Clean India Mission), under which millions of toilets have been and are still being installed across the country, including in parts that are flood and drought-prone, their maintenance has become a huge challenge. Climate-related disasters have the capacity to erode results of well-intentioned policies like these, if implemented without taking into consideration the vulnerabilities of a particular area and if measures for safe waste disposal are not adopted. Ironically, the mission’s guidelines prescribe dry toilets that are suitable for such areas, but are not necessarily implemented everywhere, partly due to misperceptions among the population and partly owing to the lack of training, follow-up and support for maintenance.

Cox’s Bazar (Bangladesh), the world’s largest refugee settlement and a reported climate hotspot in South Asia, has emerged as a central point of “communicable diseases and outbreaks” due to “poor environmental conditions and extremely high population density coupled with a pre-existing lack of health services.” In the recent floods too, Cox’s Bazar was one of the most affected districts, wherein cases of cholera, diarrhoea and skin diseases were prevalent.

Can the UN Climate Summit go beyond the rhetoric?

It is beyond doubt that with climate change, there has visibly been an uptick in disease outbreaks in South Asia, and these are, more often than once, linked to disasters. In recent years, governments in the region have largely been able to get the situation under control. However, the risks are further multiplying due to rising temperatures and warming water bodies and difficulties in access to freshwater, in areas that never saw them until recently.

Since the UN Secretary General Antonio Guterres has asked leaders to bring plans and not speeches, one area that could be focussed upon is the streamlining and aligning of the Paris Agreement, the Sendai Framework and the Sustainable Development Agenda. As a reconstruction process that aims for increased resilience and the revitalisation of livelihoods and economies, “building back better” could act as a useful framework in this direction. It can help free national governments out of the trap of prolonged humanitarian response mode and put them on a path of planning and budgeting for a smooth transition towards reconstruction to support disaster risk reduction and preparedness. For instance, the Sendai Framework Monitor launched by the UN Office for Disaster Risk Reduction (UNISDR) in the Pacific helps “assess progress against the Framework for Resilient Development in the Pacific, as well as the SDGs and the Paris Agreement.” There is no one-size-fits-all solution to these interconnected problems; and hence, individual countries need to design context-specific and people-centred solutions for risks posed by climate-related disasters, specifically to human health.

Dr. Dhanasree Jayaram is Co-Coordinator at the Centre for Climate Studies and Assistant Professor at the Department of Geopolitics and International Relations, Manipal Academy of Higher Education, Karnataka, India.

[The views expressed in this article are personal.]