A water crisis: How climate change affects our health

In his 12 years on earth, Philtino Ties has only ever known drought. Rain is rare in his home in the Karoo, a semidesert in South Africa. Dams, rivers and boreholes have dried up.

Thousands of kilometers away, in the northern Indian state of Bihar, 13-year-old Shivday Kumari regularly witnesses the flash floods that now go hand in hand with monsoon season.

Global heating plays a major role in both the drought in the Karoo and flooding in Bihar. And those weather events have an impact on Philtino and Shivday's health. And that of millions more.

"We are transforming all of our natural systems. And those transformations are affecting all the core conditions for human health and well-being," says Samuel Myers, a medical doctor and director of the Boston-based Planetary Health Alliance, which seeks to address global environmental change and its impact on health.

The World Health Organization (WHO) predicts some 250,000 additional climate-related deaths annually between 2030 and 2050 from malnutrition, malaria and heat stress, among other things.

Climate change impacts our health and bodies in many ways.

High temperatures can induce heat stroke, chronic fatigue and cognitive decline.

Individuals suffer trauma and mental health issues resulting from forced migration and climate disasters.

At the same time, burning fossil fuels releases harmful air pollutants, while rising temperatures prolong pollen seasons — both of which can worsen allergies and decrease lung function.

Extreme temperatures and air pollution can also lead to heart attack, stroke and cardiovascular failure.

If flooding contaminates freshwater supplies, diarrhea and diseases like cholera can easily spread.

Water scarcity, however, can also result in such illnesses as it forces people to rely on dirty water for drinking and hygiene. And not having enough to drink causes dehydration, which can lead to kidney problems.

Dehydration is linked to joint pain and can trigger or worsen arthritis too.

Joint and muscle pain, as well as headache, fever and vomiting, are also symptoms of mosquito-borne dengue fever, which the WHO says has increased 30-fold in the past 50 years. As cooler regions warm, disease-carrying animals like ticks and mosquitos are expanding their range.

When an essential resource makes you sick

Flooding and drought are perhaps two of the most contrasting impacts of climate breakdown and both affect the supply of clean water, which is essential for our health.

Some 2.2 billion people are already living without access to safe drinking water, while 3 billion do not have basic handwashing facilities.

In 2017 more than 1,300 children under 5 died each day from diarrhea linked to inadequate water, sanitation and hygiene, according to UNICEF, the UN agency responsible for humanitarian aid for children. And the coronavirus pandemic has further highlighted the problems that come with a lack of clean water. Frequent handwashing is one of the most effective ways to slow transmission of COVID-19, yet billions of people are unable to follow that advice.

The situation will only worsen if we don't limit global warming.

Shivday's village of Babhnaha is sandwiched between the rivers Koshi and Kamla in the Darbhanga district of the north Indian state of Bihar.

During the monsoon season, which runs from June to September, floodwaters now regularly submerge roads around the village, turning it into an island.

Rains used to be steady and the onset of flooding gradual. As the river filled, water seeped slowly across the land. Now heavy rains fall in just a few days, causing flash flooding. In the first three weeks of June this year, Bihar recorded almost double the usual average rainfall for that period.

This type of scenario I think in a couple of years will become more severe," says Banku Bihari Sarkar, emergency officer at UNICEF India.

Shivday lives in a simple building with her mother, aunt and cousin. She and her family rely on money from her father and uncle, who work in the city. They can no longer depend on their potato and wheat crops, which are often destroyed by floods.

Some 84% of people in the Darbhanga district live from the land. When the rains occur, many go undernourished, making them more vulnerable to infection.

Children are hit particularly hard. India's 2015-16 National Family Health Survey found that in rural Bihar only 7.4% of children aged 6 to 23 months received an "adequate" diet, and 49.3% of children under 5 years old were stunted — meaning chronic undernutrition has left them short for their age.

Left to right: Shivday's aunt, Chandra Kala Devi, cousin, Laxmi Kumari, Shivday Kumari and Shivday's mother, Vuchani Devi. The family stand in front of their home in Babhnaha village, Darbhanga.

Waterlogged fields in Darbhanga in August 2020. Heavy rains wash away crops. Even after floods start to recede, surviving crops can rot in stagnant water.

Shivday holds the family's ration card. When floodwaters submerge the fields the family often loses an entire year's crops, forcing them to rely on rations from the government.

Floodwaters also regularly contaminate drinking water supplies. Figures from the local Primary Healthcare Centre (PHC) near Babhnaha village show diarrhea cases almost double in the months following the monsoon.

Drinking dirty water has made Shivday sick too.

There are no doctors or nurses in Babhnaha village, but there is a medical center run by community health worker Munni Devi.

This year, like many in the recent past, floodwaters have cut off access to the center, making it hard for Devi to treat monsoon-related illnesses.

"The children are suffering from coughs, colds and diarrhea. Most of them are weak and vulnerable," Devi says.

Devi has to treat patients in the street or at their homes with what little medicine she has, as she can't get to the supplies in her clinic.

Though she deals with each day as it comes, she knows that things are changing.

"Every year the flood situation seems to be getting worse... We wonder how much worse it will be in the future."

Philtino lives on the 396-hectare (978-acre) Mardeck farm near Victoria West, a town in the central Karoo region of South Africa's Northern Cape.

The Karoo is bigger than Germany and means "land of thirst" in the old Khoisan language. In the past, the South African summer brought rains to the region and the land bloomed. Parts of the Karoo have now been dry for more than five years.

Some there have access to as little as 5 liters of water a day for hygiene, cooking and drinking. The minimum required for survival is 7.5 to 15 liters, according to the WHO. Germans consume on average more than 100 liters a day.

The farm, where Philtino lives with his grandfather, mother and two brothers, no longer produces enough to support them, so their father lives and works in another town and sends money home.

Back when it used to rain, Philtino's grandfather grew maize, onions and alfalfa and kept 280 livestock. Now they have just 48 sheep.

The farm's boreholes have dried up and the family is dependent on water deliveries from NGOs and the municipality. Sometimes, there is no option but to collect water from a nearby river. That comes at a cost.

The only thing that makes me sick is the water from the river," says Philtino. "That gives us stomach problems even if we boil it."

Left to right: Belano Zane Mauers, farm worker Ndoyisile Ngongo, Philtino Ties, Hermanus Kay, Ryan Kay and Ellie van Roy stand on a dry field on which they used to plant onions, maize and alfalfa. In the background is their homestead.

Philtino Ties fetches river water to give to the remaining farm animals.

It's the same story across the Karoo. Fields are parched, almost nothing grows and there's very little food for livestock.

Living in poverty with little to no prospect of work, some locals now pick food from landfills. Others have turned to eating dogs and cats, says Corene Conradie, a coordinator at Gift of the Givers, a South African disaster relief NGO.

"These are pets they are starting to eat due to hunger and due to having nowhere else to turn to for food."

Reducing emissions and adapting to reality

The WHO predicts that heat exposure alone will cause 38,000 additional deaths each year among the elderly between 2030 and 2050. But mitigating emissions by, for instance, switching to renewable energy will have a positive impact on health and death tolls, according to a recent study by independent international research alliance, Climate Impact Lab.

Even so, many more deaths will occur in poorer countries that lack important infrastructure such as good healthcare or money to invest in adapting. Though they are least responsible for historical emissions, these nations are bearing the brunt of climate change.

The study also highlighted the importance of adaptation in countries and regions already experiencing the consequences of global heating. In the Karoo and Bihar, such measures, though small, are underway.

Many families in Victoria West rely on water and food deliveries from South African NGO Gift of the Givers.

But the organization also drills boreholes, installs rainwater harvesting and purification systems and encourages adaptations like community gardening and more efficient irrigation on farms to work with what little water there is.

"What would happen if the rains don't come? We need to stand on our feet and make a plan to adjust our lifestyles, especially in these small communities," says Corene Conradie of Gift of the Givers.

In Bihar, UNICEF is working with local authorities and volunteer-run Village Disaster Management Committees (VDMCs) to help communities deal with flooding.

VDMC member Dilip Kumar was involved in the construction of drainage channels to ensure stagnant water flows out of the village quickly, thereby helping stop the spread of mosquito-borne disease. But that's not all they are doing.

Looking to the future

As children and young people around the world continue to campaign for more action on climate change, their futures remain uncertain. According to medical journal The Lancet's recent report "A Future for the World's Children," global warming, environmental degradation and inequality are affecting children's health and ability to "survive and thrive."

It adds that the wealthy countries threatening "the future of all children through excessive carbon emissions," should do more to tackle climate change to ensure their future health.

But what do Shivday and Philtino wish for the future?

Credits

Authors: Jennifer Collins, Inga Sieg

Editing: Anja Kimmig, Tamsin Walker

Copy editing: Ruby Russell

Reporting and images India: Catherine Davison

Reporting and images South Africa: Henner Frankenfeld

Video editing: Friederike Rohrmann

Design: Angela Dehio, Olof Pock

Illustration: Anna Wills, Nora-Charlotte Tomm, Peter Schwendke

Development: Olga Urusova

Excutive editor: Vanessa Fischer

Thank you to Gift of the Givers, South Africa, and to Bihar SEWA Samiti and UNICEF, India

A water crisis: How climate change affects our health

Clear Water

Rain

Water

Bodymap

When an essential resource makes you sick

Babhnaha

Shivday's life

India Imagegallery

Floodwaters

Shivdays Interview

Floodwaters in India

Street Checkup in India

West Victoria

Philitinos life

Africa Imagegallery

Across the Karoo

Phumla Seane, a nurse

Interview with Phumla Seane, a nurse

Reducing emissions and adapting to reality

Foodaid in Africa

UNICEF in Bihar

Dilip, India

Looking to the future

Flood in India

Looking for the rain

Philitino, an interview

Credits

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