SK Nazmul Huda, Labin Rahman and John Richards :
Since the beginning of the industrial revolution two centuries ago, mankind has added enough greenhouse gases to trigger major climate changes. Temperature on earth is rising by 0.5 to 10 C every 30 years. The sea level is rising by 4cm every 10 years. Scientists predict that an increase below 20 C is manageable. However, unless drastic reductions in use of fossil fuels begin now, the planet earth will cross this threshold before the end of the century. If drastic reductions are not taken, the consequences are uncertain – but virtually all predicted outcomes are bad.
One outcome facing us in Bangladesh is the impact on our coastal area due to rising sea level and the prospect of more frequent cyclones. On National Safe Motherhood day, we typically discuss adequate maternal and child care services, the value of breastfeeding, and other public health issues. We suggest this is a good occasion to discuss the link between climate change and pregnancy outcomes in coastal districts of Bangladesh.
Gabura Patakhali, a union at Shyamnagar, Satkhira illustrates climate-induced effects on safe motherhood. It was a green community where 20 000 people were living peacefully. They had adequate drinking water and courtyard gardens. They undertook vegetable, fruit and cereal farming, raised poultry and dairy cows. Now, large areas of the community are submerged due to rising sea level. Many who could afford to do so have migrated to other places. Many have taken shelter at the homes of friends and relations. Many families are taking shelter where they can, on the embankments.
Water for drinking and household activities now comes from 50km away. Local farms have been devastated: no courtyard gardens, no vegetables, no fruits, no eggs, no milk, no chickens, no trees to provide shade. As life became more difficult, village doctors were among those who left. Since road communication is seriously disrupted, government and NGO health workers are seen less often now. Family planning services, oral salines, and other essential health services are not as accessible as before.
When migrating families take shelter with friends or relations, their adolescent girls become a major burden on their parents. Their schooling may stop, and many are subjected to early marriage. As family planning services have been interrupted, many early-married girls experience early pregnancy, a threat to safe motherhood.
Lack of vegetables and fruits leads to micronutrient deficiency, a second risk factor for adverse pregnancy outcomes. Climate-induced changes in agriculture system force many to lose traditional work or to change occupation and face aggravated poverty.
Resulting malnutrition during pregnancy is linked with low birth weight babies and other pregnancy complications, a third link between climate change and threat to safe motherhood. Lack of access to safe water may lead to hygiene problems, diarrhea, chronic infections and ill health. Pregnant women and children are the members of a family most sensitive to these problems.
Climate change may expose pregnant women to more extreme temperatures. If core body temperature rises significantly, it affects the fetus, which cannot cope with such changes.
The point of all this is, how to overcome the challenges? There are no easy answers. In the case of Gabura Patakhali, local citizens need to address the issues together with governmental agencies, field staff, NGOs and local institutions. The health department should ensure that safe motherhood services are available and accessed by the community – despite difficulties in provision. In the long run, the citizens in Gabura Patakhali are relying on the world’s citizens to take seriously their commitments to “defossilize” the world economy.
(Sk Nazmul Huda PhD is the Country Project Manager, Fistula Care Plus Project of EngenderHealth, Bangladesh, Labin Rahman is a Research Fellow in a Safe Motherhood Study Project of Simon Fraser University, BC, Canada, John Richards PhD is a Professor of Public Policy department at Simon Fraser University, Vancouver, Canada and a former Member of Parliament, Saskatchewan Canada. )
