We work in some of the most climate-vulnerable settings in the world, responding to many of the world’s most urgent crises – conflict, natural disasters, disease outbreaks, and displacement. These are settings where people already lack access to, or are excluded from, basic healthcare. These people are also the least responsible for the emissions that generate climate change. But the climate emergency aggravates some humanitarian crises and their subsequent healthcare consequences, which impact on people in these vulnerable settings the most.
As a medical organisation, it is beyond our field of expertise to define what causes many of the events that we then respond to. And while our teams in some places have noticed changes over the years, existing scientific evidence clearly points out that we will be seeing further rising temperatures and sea levels, and more frequent and intense extreme weather events.
Increased rains seem to be increasing the number of people with vector- (insect) borne diseases, such as malaria and dengue fever. In Angumu health zone, Democratic Republic of Congo, malaria is the main cause of death among children under five. In recent years, our teams have observed what appears to be a trend of heavy rains and have treated a high number of malaria patients in the area. In 2018 and 2019 in Honduras, considered a climate change hotspot, we responded to the country’s worst outbreak of dengue fever in 50 years, following a prolonged rainy season.
Drought and floods are thought to already have had an impact on malnutrition in some of the areas we work. In Niamey, Niger, where rains have brought floods and wiped-out crops, our teams have observed and responded, over the last two years, to increases in malnutrition cases. Conversely, in the desert regions of southern Madagascar, three consecutive years of drought have severely affected harvests and access to food, in a context now marked by the COVID-19 pandemic, which has led to a drop in seasonal employment and other sources of income.
Across the Sahel, in sub-Saharan Africa, climate change has contributed to an imbalance of land available to livestock herders and farmers. The competition over resources and the authorities’ inability to negotiate access to land have resulted in conflict between the two groups, adding to the violence and insecurity across the region, to which we respond to the consequences of by providing medical care. Conflict, in turn, often causes people to become displaced.
Climate change is increasingly influencing human mobility as more places become uninhabitable. Millions of people are currently on the move and the conditions that create such displacement will likely be exacerbated by climate change. In 2020, our teams provided medical care to people in Honduras, displaced by Hurricanes Eta and Iota ─ which were the worst storms to hit Central America since hurricane Mitch in 1998.
Climate change affects all of us
Climate change - or the climate emergency - affects all of us, in direct and indirect ways. It impacts diseases such as malaria and malnutrition, and can contribute to conflict and displacement. The climate crisis is also a health and humanitarian crisis.
In late 2020, the highest-ranking MSF bodies – including the International Board – signed The Environmental Pact. The pact is a recognition of the environmental impact of our humanitarian duties – which is still essential to carrying out our work – yet is also a commitment to adapt our activities to significantly reduce our carbon footprint. Measures to achieve this are now incorporated in all main MSF entities’ strategic or action plans from 2021 onwards, including mechanisms for accountability.
We are working to ensure an efficient and socially responsible supply chain, in order to reduce, reuse and recycle medical materials and equipment. For example, in Uganda, we have launched a project to replace the millions of plastic bags we use each year to distribute medicines, with ecologically sustainable bags using local resources made by local communities. We are also reducing medical waste in our hospitals and clinics, including exploring options to move away from single-use products where appropriate.
We are developing new energy solutions, such as using solar panels to power some of our medical activities, as well as innovative approaches that respond to the environments we work in. For example, in Pakistan, we installed solar panel systems at the facilities we support in Dera Murad Jamali, Chaman, and Kuchlak, all in the country’s Balochistan province. Supplemented by grid or generator electricity, these systems provide uninterrupted power for lighting, air conditioning, fans, and water pumping and cooling.
We are reducing our international travel by air, for example attending meetings or workshops virtually rather than in person. We are also sourcing medical supplies closer to the places where we work. These changes have also accelerated because of the impact of the COVID-19 pandemic on international freight and personnel travel.