“Man has the fundamental right to freedom, equality and adequate conditions of life, in an environment of a quality that permits a life of dignity and well-being, and he bears a solemn responsibility to protect and improve the environment for present and future generations […].” states the first principle of the Declaration of the United Nations Conference on the Human Environment (UNEP, 1972). Nevertheless, extreme weather events, resulting from changes in the global climate, have an incremental impact on human health. Injuries and mental health disorders are a particular burden of disease, which is broadly investigated in high-income countries. However, most distressed populations are those in less developed countries.
Therefore, our study investigates mental and physical health impacts arising from extreme weather events in these populations. We conducted a systematic review on Post-traumatic Stress Disorder (PTSD), injury, anxiety and depressive disorders, caused by weather extremes in people of developing countries. We found evidence that there is an increased burden of psychological diseases and injury. All identified studies (n=17, comprising 70,842 individuals) show this rise in disease, compared to the reference data. Increase ranges from up to 53 % for PTSD, and 37 % for injury. These findings should be incorporated into activities of prevention, preparedness and general health care of those developing countries increasingly experiencing extreme weather events. We also identified a predominant heterogeneity of health assessment tools and a gap in research in African countries in this field. All identified studies were conducted in South America and Asia. Furthermore, no studies on droughts and heatwaves were identified.
Implications for practice
We encourage Public Health decision makers to both act now and address adaptation strategies in the long run. These should encompass: the establishment of strong health infrastructures, empowering communities to achieve effective disease surveillance, acquisitions and training of extra personnel, and implementation of disaster communication infrastructure. In order to sustainably meet the needs of disaster-affected populations, the detection of regions with increased risk, outlining of roles that actors will play in case of an emergency, training of responders, and the identification of vulnerabilities should be enhanced. Preparedness also includes the solid (re-)construction of health care facilities, infrastructure, as well as water and sanitation systems in which cultural and gender aspects should be carefully considered.
Implications for decision makers
Previously, legal acts have been developed after disasters occurred in order to prevent repetitive harm. Several codes of conduct have been established which are, however, non-binding and therefore weak. The international community should aim at developing and adhering to stable measures that are preventive, fair, and future-oriented. Decision makers at country and regional level should encourage the improvement of mental health care infrastructure. Most countries are dependent on external assistance to meet post-disaster health needs. Due to national or ethical strife towards
Previously, legal acts have been developed after disasters occurred in order to prevent repetitive harm. Several codes of conduct have been established which are, however, non-binding and therefore weak. The international community should aim at developing and adhering to stable measures that are preventive, fair, and future-oriented. Decision makers at country and regional level should encourage the improvement of mental health care infrastructure. Most countries are dependent on external assistance to meet post-disaster health needs. Due to national or ethical strife towards neighboring countries, conflicting political interests or poor coordination, many disasters have not been successfully dealt with. External support often does not match the local need which is especially true for the existing national mental health care systems, which do not meet the demand of post-disaster mental health problems.
Thus, recommendations for required international assistance include, that assistance should involve partners who work in ways that are complementary to each other, engage the affected community, plus be evidence-based and transparent. Our review shows that the growing number of extreme weather events also leads to an increase in displacement of thousands of individuals. A range of additional health issues is associated with dislocation. Currently, about 60 million people worldwide are displaced, more than 85 % find refuge in developing countries [UNDP]. Many of them have not been able to return to their home countries for decades. The number of involuntary migrants is expected to increase and hence, requires a human rights-based response. This should include the development of adjustment instruments which should also incorporate financing plans both at the national level as well as on behalf of the international community, plus the provision of a refugee status for those who fled their country due to environmental damage.
Link to the primary research paper
Rataj, E., Kunzweiler, K., & Garthus-Niegel, S. (2016). Extreme weather events in developing countries and related injuries and mental health disorders – a systematic review. BMC Public Health, 16(1), 1020. DOI: 10.1186/s12889-016-3692-7
Elisabeth Rataj grew up in Saxony, Germany, where she obtained a Master of Public Health at the University of Dresden. There she also worked at the Centre for Evidence-Based Health Care. She is currently working as Advisor at the Department of Education in the Autonomous Region in Muslim Mindanao, Philippines. Elisabeth’s main research interest is Health Promotion in the Global South. More particularly the areas of Environmental Health and Quality Health Care Infrastructure.