Is Southeast Asia’s Health Care Workforce Ready For Climate Change?

Across the region, it’s never been more critical to cultivate a resilient health care workforce capable of addressing climate-induced public health issues.

TANGERANG, April 26 – Health care workers are at the frontline of the climate battle.

As populations, particularly in Asia, confront the brutal realities of a heating planet, having suitably trained, motivated and well-equipped health care workers is essential.

But there is a danger that vital resourcing is currently inadequate, and that the health of people, particularly vulnerable and marginalised populations, will suffer as a result.

Increasingly intense and frequent extreme weather events have heightened Southeast Asia’s vulnerability to disasters and climate change. They have contributed to rising deaths, exacerbated health risks, widened health inequities, and strained health care systems.

Countries including the Philippines, one of the region’s most disaster-prone nations, and Indonesia, whose capital Jakarta, is the fastest-sinking mega city in the world,  face significant challenges.

Extreme weather has heightened the likelihood of disasters such as the floods and landslides last month in West Sumatra and Demak-Kudus which affected more than 71,000 people and forced more than 15,000 children from their homes. 

Beyond such extreme weather events, the persisting rates of air pollutionheat-related deaths, rising rates in malnutrition due to food insecurity, escalating water scarcity and poor hygiene conditions, alongside the spread of infectious diseases is concerning. 

Women, children and the elderly are disproportionately victim to some of these challenges – with heat-related deaths impacting women and elderly, and malnutrition hitting young children the hardest. Rising rates of mental health issues, particularly among youth in the region, further compound these challenges.

Addressing these urgent climate-health threats requires a health care workforce capable of identifying, responding to, and managing emergencies. The workforce will also need to be able to deal with the evolving health risks and shifting disease patterns posed by climate change.

While dedicated health care workforce toil tirelessly to provide essential health care across the world, particularly during climate-induced emergencies, systemic gaps and resource limitations often hamper their ability to effectively address climate impacts on public health. 

Currently, a majority of the health care workforce, particularly across the Global South, operate with limited infrastructure for emergency response and disease surveillance, and with some awareness of climate-related health risks.

Challenges around inadequate training and resources, fragmented workforce deployment and coordination mechanisms and insufficient health interventions tailored to climate vulnerabilities persist.

These challenges are particularly acute across rural and remote areas already experiencing health inequities. This calls for targeted investments in health care workforce training and capacity building to cultivate a climate-resilient health care workforce to strengthen the overall response and readiness of health care systems.

The World Health Organization’s (WHO) “Operational framework for building climate-resilient and low-carbon health systems” serves as a guiding tool for evaluating and strengthening health systems’ resilience to climate change.

It emphasises the importance of developing a climate-resilient health care workforce and calls for the health care sector to lead efforts to reduce its own greenhouse gas emissions. 

The framework  also focuses on fostering action across sectors to improve awareness-raising and enhancing communication about the health impacts of climate change.

A key element of the framework is for countries to develop Health National Adaptation Plans, embedded within their multi-sectoral National Adaptation Plans (NAPs), which is a broader process established by the United Nations to improve ‘whole-of-economy’ resilience to climate change.  

The recent WHO review found that while all 19 NAPs submitted to the United Nations Framework Convention on Climate Change by December 2020 highlighted health as a priority sector vulnerable to climate change, the extent to which climate-health risks were addressed varied.

Sixteen of these plans included actions for the health workforce, suggesting that the need to strengthen the health workforce in the face of climate change is recognised, at least by this group of predominantly low- and middle-income countries.

The Covid-19 pandemic highlighted the crucial role of health care workers, both in clinical and non-clinical settings, as trusted intermediaries and frontline responders. 

Health care workers fulfil diverse roles: from health promotion and disease prevention, including vaccine delivery, to safeguarding sexual and reproductive health, particularly in rural and remote areas.

And when the pandemic arrived, it impacted every aspect of health care, from increased demand, through supply chain disruption, to health care worker illness and death, particularly across low-and middle-income countries.

These challenges encountered – and lessons learned – during the Covid-19 pandemic offer valuable insights into the complexities of addressing climate change impacts. 

One parallel lies in health care workforce fatigue

The prolonged duration and intensity of the pandemic exacerbated burnout among frontline workers, highlighting the importance of safeguarding their physical and mental health wellbeing. Inadequate physical and mental protection during the pandemic also exposed health care workers to heightened health risks and deaths, underlining the need for robust safety measures. 

The workforce challenges during Covid-19 have also been gendered in nature, with women bearing a disproportionate burden of the crisis’s impacts. 

With more than 70 percent of the global health care workforce being women, health care workers faced unique challenges, including increased exposure to infection due to their higher representation in frontline roles. They are often juggling caregiving responsibilities at home, placing them at greater risk of burnout and mental health strain.

Existing systemic gender-based disparities in voluntary versus paid positions among health teams and in leadership positions within the health care sector have also been exacerbated by the pandemic. 

Women have faced heightened risks of gender-based violence, both within and outside health care settings – adding an additional layer of vulnerability to their experiences.

At a critical time of building back stronger post-Covid-19 and confronting the escalating climate crisis, it is clear, more than ever before, that if governments and health systems prioritise strengthening of climate-resilience of the health care workforce they will be better equipped to effectively navigate and adapt to rapidly shifting health risks posed by climate change. 

The global health crisis stemming from the climate crisis underscores the urgent need for action. Cultivating a resilient health care workforce is paramount to effectively addressing climate-induced public health challenges and mitigating the profound impacts felt by the most vulnerable populations worldwide.

Gabriela Fernando is an assistant professor of public health at Monash University, Indonesia. Angie Bone is a public health physician and an associate professor of practice in planetary health at Monash Sustainable Development Institute. 

Article courtesy of 360info.  

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