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 Democratic Republic of Congo, malaria causes four times more deaths per year than conflict, meningitis, cholera, measles and respiratory diseases combined. In recent years, our teams have observed what appears to be a trend of heavy rains and a high number of malaria patients in the area. In South Sudan, for example, heavy rains and flooding bring with them peaks in malaria cases.
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 past two years, to increases in malnutrition cases. In southern Madagascar, consecutive years of drought have severely affected harvests and access to food, causing an acute food and nutrition crisis, leaving thousands of children severely ill and pushing entire families into extreme poverty.
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.
More frequent and serious extreme weather events increase the risk of injury, infectious disease, and food insecurity. A severe consequence of weather events like flooding, hurricanes, and cyclones is displacement. As people lose their homes or their homes become uninhabitable because of extreme weather, they will be forced to go on the move. Millions of people are already on the move because of conditions that have been exacerbated by climate change. In September 2022, our teams responded to unprecedented flooding in Pakistan, which inundated one-third of the country and left at least 33 million people affected, many of whom lost their homes.
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. In 2022, we pledged to reduce our emissions by at least 50 per cent compared to 2019 levels by 2030. Measures to achieve this are now incorporated in all main MSF entities’ strategic or action plans.
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 a project that aims 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, showing that a shift to environmentally responsible practices is possible even in low resource settings. In Kenema, Sierra Leone, we are powering a 182-bed hospital with solar panels, providing energy to an inpatient unit, laboratory, imaging suite, blood bank, emergency room, and a maternity ward. Not only is this reducing our carbon emissions, but we are also saving approximately €40,000 on diesel per year. We also support three solar-powered hospitals in remote areas of Democratic Republic of Congo.
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.