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Article Excerpt
Small island states are likely the countries most vulnerable to climate variability and long-term climate change. Climate models suggest that small island states will experience warmer temperatures and changes in rainfall, soil moisture budgets, prevailing winds (speed and direction), and patterns of wave action. El Nino events likely will strengthen short-term and interannual climate variations. In addition, global mean sea level is projected to increase by 0.09-0.88 m by 2100, with variable effects on regional and local sea level. To better understand the potential human health consequences of these projected changes, a series of workshops and a conference organized by the World Health Organization, in partnership with the World Meteorological Organization and the United Nations Environment Programme, addressed the following issues: the current distribution and burden of climate-sensitive diseases in small island states, the potential future health impacts of climate variability and change, the interventions currently used to reduce the burden of climate-sensitive diseases, additional interventions that are needed to adapt to current and future health impacts, and the health implications of climate variability and change in other sectors. Information on these issues is synthesized and key recommendations are identified for improving the capacity of the health sector to anticipate and prepare for climate variability and change in small island states. Key words: adaptation, climate change, climate variability, human health, small island states, vulnerability. Environ Health Perspect 114:1957-1963 (2006). doi: 10.1289/ehp.8429 available via http://dx.doi.org/ [Online 11 July 2006]
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Former President Leo Falcam of the Federated States of Micronesia stated, "for Pacific Island States, climate change and its associated effects are our main security concern" (Falcam 2001). The same could be said for many small island states.
There is no standard definition of a small island state (Schmidt 2005). The Small Island Developing States Network defines them as small islands and low-lying coastal countries that share similar sustainable development challenges (Small Island Developing States Network 2003); this review includes 37 of the 51 small island developing states and territories. Islands such as the U.S. Virgin Islands and Netherlands Antilles were excluded because they are parts of other countries, and countries such as Belize were excluded because they are not islands. The discussion in this article also applies, to varying degrees, to island territories of larger nations, vulnerable coastal locations, and isolated islands in archipelagic nations such as Indonesia and the Philippines.
Small island states share many features that constrain their ability to adapt to current climate variability and future climate change, including their small or very small physical size, remoteness from major land masses, limited natural resources (often with unique animal and plant life), vulnerability to natural disasters and extreme weather events, economies sensitive to external shocks, populations with high growth rates and densities, poorly developed infrastructure, and limited financial and human resources (Nurse et al. 2001). Some islands have significant emigration and "brain drain." Small island states also display wide diversity: the islands differ in geologic type, size, elevation, soil composition, drainage characteristics, and natural resources. Some of the larger islands have significant elevation, whereas others are low-lying small coral atolls with limited or no land for evacuation in times of natural disaster. Natural resources range from scarce to abundant. Some islands have abundant surface water, whereas others are completely dependent on groundwater; water requirements are just as diverse. Social, cultural, and economic settings also vary. Some islands have large commercial or industrial centers, and others have extensive agriculture. Infrastructure, including health infrastructure, is sometimes poorly developed. Human communities range from large densely populated cities to small villages and dispersed rural populations.
The diversity of the small island states in demographic, health, economic, environment, and climate indicators is shown in Tables 1 and 2. As shown in Table 1, populations range from 2,000 in Niue to > 11 million in Cuba, with the percentage living in urban areas ranging from 13% in Papua New Guinea to 100% in Nauru. Particularly in Asia and the Pacific, many small island states have young populations, with a significant fraction of the population younger than 15 years. Most small island states have relatively healthy life expectancies (HALEs) in the range of 50-60 years (compared with HALEs of 70 years or more in most developed countries), with approximately 7-8 years of healthy life lost in males and 9-10 years in females compared with males and females in developed countries. As shown by the probability of dying before reaching 5 years of age, most of these years of life lost are in the young. Annual growth rates during 1992-2002 ranged from negative in several small island states (in most cases, due to emigration) to > 3%. Growth rates were not associated with gross domestic product (GDP) per capita; 3% or higher growth rates were experienced in Comoros with a GDP per capita of US$278 and in Bahrain with a GDP per capita of $12,012.
Table 2 shows the diversity of small island states in environment and climate indicators. Small island states account for 35.5 million megatons in Singapore. Energy consumption per capita has a similar broad range.
The diversity of small island states will affect both the climate change impacts they experience and their ability to adapt to these impacts. Of course, it will not be possible to adapt to some impacts, such as an island becoming uninhabitable because of sea-level rise. Current and projected climate change--related effects also will be experienced by coastal mainland areas.
To better understand the vulnerability of small island states to current climate variability and to build capacity to cope with climate change through adaptation planning, we present information in this article that is synthesized from presentations and discussions at three workshops [Samoa (July 2000), Barbados (May 2002), and the Maldives (December 2003)] and a conference (after the Barbados workshop) organized by the World Health Organization, in partnership with the World Meteorological Organization and the United Nations Environment Programme [Aron et al. 2003; World Health Organization (WHO) 2000, 2003]. Key recommendations are identified for improving the capacity of the health sector to anticipate and prepare for climate variability and change.
Climate Variability and Change in Small Island States
Past climatic trends. Temperatures have been increasing by as much as 0.1[degrees]C per decade in regions where small island states are located (Nurse et al. 2001). Increases in surface air temperatures have been greater than global rates of warming in areas such as the Pacific Ocean and the Caribbean Sea. Based on data from 34 stations in the Pacific from about 160[degrees] east and mostly south of the equator, surface air temperatures increased by 0.3-0.8[degrees]C during the 20th century (Nurse et al. 2001)....
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