Southern Africa is in the eye of the climate change storm. In the next 80 years it’s likely to experience an increase in temperature that exceeds the global average. But little is known about whether vulnerable groups in the region are equipped to deal with these changes and the resulting health problems.
One of the ways they can be assisted, in South Africa at least, is through the work of environmental health practitioners. There are 3 833 practitioners registered with the Health Professions Council of South Africa across the country. They operate at the interface between government and communities, dealing with environmental safety and community health in local government districts.
Environmental health practitioners work in the areas of water quality, food control, waste management, health surveillance of premises, surveillance and prevention of communicable diseases, vector control (methods to limit or eradicate disease pathogens transmitted via mammals, birds, insects or other arthropods) and environmental pollution control. They spend time in communities doing environmental monitoring, disease surveillance (for example during rabies outbreaks) as well as awareness and educational campaigns.
In 2011, the Conference of the Parties (COP)-17 meeting hosted in South Africa highlighted the importance of involving environmental health and health care practitioners in helping communities increase their capacity to respond to the impact of climate change. Local legislation echoes this. But in reality, this isn’t happening.
Our study looked at the role that environmental health practitioners play in helping communities adapt to climate change. The participants acknowledged that climate change poses a serious threat to public health. But they said there was no clarity on what their role should be in preventing adverse risks from a changing climate.
From these findings we concluded that implementing climate change adaptation plans, and considering appropriate climate services, could become part of environmental health practitioners’ work. Practitioners should receive formal training on climate change.
The health practitioners we spoke to identified a number of areas in which they could help communities guard their health in the face of a changing climate. These included encouraging tree planting and vegetable gardening, improving storm water drainage systems, strengthening climate and health research programmes and developing community early warning systems.
Two-thirds of the 48 respondents said their role in this work should be supportive, rather than leading. And 42% believed that climate change adaptation action was best dealt with at a global level. This suggests that the practitioners may not yet have identified or clarified their role in climate change adaptation among local communities, where the effects are felt most.
This may be because when it comes to climate change there’s a lack of information on community level policy, regulations and standards, budgetary matters, research, training and education.
Some municipalities did have climate change, health strategies and policies in place. These included the City of Cape Town and eThekwini (Durban) municipalities. But human capacity and financial constraints were identified as challenges to educating and encouraging practitioners to advocate for climate change health and adaptation practices.
What needs to be done
There needs to be a debate about the role that environmental health practitioners can play to help communities manage climate threats. Resources have to be made available to support these efforts.
There are examples of where this has happened successfully. The city of Rustenburg in the North West province, in partnership with the South African Medical Research Council, is in the process of developing a Heat and Health Plan for its citizens.
The effort was prompted by Rustenburg being declared as a vulnerable location in 2016 after about 40 people died during a single heatwave. The climate and health adaptation measures, which were suggested by stakeholders during a consultative workshop in Rustenburg, echo those mentioned in our study.
The establishment of an iDEWS (infectious Diseases Early Warning System) Bureau to predict malaria, diarrhoea and pneumonia in Limpopo province is another success story.
As climate change takes hold, environmental health practitioners may have an important role to play in ensuring that the environments – especially built environments – in which people live are fit to promote health, safety and well-being. This should be a national priority to ensure that their role is clarified.