Climate And Health Vulnerability & Adaptation Assessment .

Climate and HealthVulnerability & AdaptationAssessment ProfileManaus - BrazilChristovam Barcellos (ICICT/Fiocruz)Diego Xavier Silva (ICICT/Fiocruz)Rita Bacuri (CPqLMD/Fiocruz)

Assessment Objectives To identify the possible links between climatechange - more specifically hydrological regime and water related diseases. To suggest tools for monitoring changes in riverregime and water related diseases. To identify social actors and strategies toimplement adaptation plans. To contribute as a pilot study for the BrazilianClimate and Health Observatory

Why Manaus? The city of Manaus,Brazil, is situated atthe confluence ofNegro, Amazon andPurus rivers thatdetermine the region’shydrology, togetherwith the Amazonforest that surrounds it.Since Manaus is an important regional harbor and the main Amazonianmetropolis, the city tends to act as a shelter for groups evaded from areassubmitted to environmental stress, ethnical struggles or economic crisis.

Why Manaus? The water level of RioNegro has been a strongregulator of city’seconomic and socialdynamics, since itsfoundation. Thepersistence of woodenhouses built on stilts(palafitas) is an exampleof adaptation of the localpopulation to the climaticvariability.

Approach to OrganizationThree steps:Health problem definition/Climate factorsGathering and analysis of secondary dataDiscussion of results with stakeholders

Assessment Methods The first step in our study was tofocus on one health problem. Thischoice may represent a majorchange in the proposed guide.Because of the city geographicalcharacteristics and the presentconcern of local authorities andgeneral public, we selected wateras a key climate issue to beaddressed. Local researchers andauthorities have participated ofthis decision.

Assessment MethodsQuantitative approach The second step was to collect andgather routine data for the selectedindicators (at Fiocruz, Rio de Janeiro).This activity produced a preliminaryreport that was distributed among allparticipants (stakeholders). We haveused time series to demonstrate theseasonality and long term variabilityof precipitation and river water level,and to link them to the incidence ofwater related diseases. GIS was alsoused to identify vulnerable populationgroups.

Assessment MethodsQuantitative approach Environmental data: Land use, altimetry, floodableareas, river water level. Weather and climate: Temperature, precipitation,seasonal and long term forecasts; Socioeconomic data: Census information (households,sanitation, migration, education, income); Health data: Health service provision, mortality andmorbidity (hospitalization and disease notification.

Health outcomes Malaria incidence and hospitalizationDengue incidence and hospitalizationLeptospirosis incidenceHepatitis A incidence and hospitalizationInfant mortality by diarrhoea

Assessment MethodsQualitative approach The final activity was aworkshop during whichthe preliminary reportwas discussed by thegroup. The reportbrought evidences onthe relationship betweenriver water regime andthe transmission ofselected diseases butavoided to pose anexplanation about thecausal link betweenwater regime anddiseases.The explanation of the dynamics ofdisease transmission was suggested bythe workshop participants.

Malaria incidence

Leptospirosis in incidence and river waterlevel

Major Findings Changes in the river water level are assimilatedby the inhabitants, if these variations occurwithin a range that does not compromise theoperation of transportation systems, sanitation,water and food supply. Major changes, such as prolonged droughts aswell as floodings, may cause the collapse ofthese systems. Both extreme climate events occurred in cityduring 2009, leading to a perception that climatechanges are already affecting the city.

Extreme events in ManausRiver water level

Utility of Assessment & MeetingDecision Needs All used data (socioeconomic, epidemiological andclimate) are available for public use for free. It can beemployed in a CC monitoring system. Stakeholders were especially satisfied with the analysisof health, environment, climate and socioeconomicindicators. They were familiar with the problemspresented and felt comfortable to comment and interpretthe statistical results. The final report was built on reliable information and itreflects the views of stakeholders on the current healthproblems and climate scenarios. The study participantsdeclared that the final assessment report will be useful todiscuss adaptation strategies and to seek financialsources for its implementation.

Major Challenges It would be useful to include primary data and insights from fieldwork.Due to the limited budget and time it was not possible to incorporateadditional data. Stakeholders are concerned with the possibility of materialize plansand benefits to the society. The assessment should point out projectopportunities and financial sources. The opinion of stakeholders varies substantially according to theirposition in the institutional framework (governmental or nongovernmental, sector, political party and so on). The guidance should suggest methodologies of quantitative (graphs,maps, indicators, etc.) and qualitative research (structured or semistructured interviews, focus group etc.). The stakeholder opinionconvergence in some aspects was difficultly achieved or evenimpossible. A methodology for dealing with different points of viewwould be welcome.

Vulnerability or vulnerabilities?the different origins and vulnerabilitiesof deprived social groups, such as: Urbanized indigenous people Migrants from the eastern Amazon Migrants from other regions of thecountry traditional riverside inhabitants(ribeirinhos)

“Invasions” along the urban fringe- Recent migrants from the easternAmazon- Poor sanitation and housingconditions- Malaria hotspots

Houses on stilts along the riverside- Traditional Amazonian population- Subject to river changes and watertransmitted diseases- More adapted to environmentalchanges

Adaptation strategies for differentvulnerabilities

Adaptation strategies for differentvulnerabilities – Creek (Igarapés)

Thank youChristovam Barcellos (ICICT/Fiocruz)Diego Xavier Silva (ICICT/Fiocruz)Rita Bacuri (CPqLMD/Fiocruz)Yara,Queen of theAmazonian rivers

indicators (at Fiocruz, Rio de Janeiro). This activity produced a preliminary report that was distributed among all participants (stakeholders). We have used time series to demonstrate the seasonality and long term variability of precipitation and river water level, and to link them to the incidence of water related diseases. GIS was also