At its best, the 2016 Paris climate agreement is a fledgling roadmap to fundamentally changing the way humans interact with their environment; at its worst, it’s the grandest of empty gestures.
Whichever the case, global recognition of the climate crisis is certainly a step in the right direction, providing the basis for more ambitious future commitments. However, for communities already experiencing the often catastrophic consequences of a warming Earth, large-scale action and incremental progress offers little in the way of relief — their priority, simply put, is survival.
Small island developing states are quite literally on the frontlines of climate change, facing effects such as rising sea levels, climbing temperatures, and extreme weather events disproportionate to the rest of the world. Though scattered across the Caribbean, Pacific, Indian, and Atlantic oceans, they share similar environmental and economic conditions.
In general, SIDS are isolated, exposed, and have limited resources. When natural disasters such as cyclones, storm surges, landslides, and floods wreak havoc on SIDS, which experts agree is happening with increasing frequency — their geography complicates and slows the recovery process.
“On small islands, GIS technology can be tailored to provide context-specific insights on the interactions between natural disasters, relief efforts, and the public health response.”
—Post-disaster, when small island governments mobilize to repair damaged infrastructure and distribute relief supplies, images of leveled houses and relief food trucks dominate the immediate news coverage, while health concerns — which can plague communities for months, sometimes even years, after — don’t really factor into the public consciousness. Less visible but no less deadly, waterborne and other infectious diseases thrive when water, sanitation, and health delivery infrastructure is damaged, leaving small islands especially vulnerable post-disaster.
The case of Haiti is a particularly alarming example. In October 2010, 10 months after a catastrophic earthquake, a cholera outbreak was confirmed on the island. The public health crisis, which the country is still struggling with, has been one of the worst in recent history — killing nearly 10,000 people and infecting more than 820,000.
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Described by the World Health Organization as “a disease of inequity,” the tools exist to prevent cholera-related death, including a safe, inexpensive, and highly effective vaccine. Still, the disease claims an estimated average of 120,000 lives per year, mostly in the world’s most underserved areas. If the tools to prevent deaths from cholera exist, then the problem must lie with how we leverage them.
The Nigeria Centre for Disease Control, known as NCDC, and eHealth Africa, public health experts in digital solutions to improve health outcomes, partnered on an initiative to address this problem. Their work provides an illustrative blueprint on how computational and technological advancement, when harnessed correctly, can help protect against cholera and similar infectious diseases.
Geographic information systems allow scientists to capture, store, and analyze data on different aspects of a geographical point. In response to the 2018 cholera outbreak in Nigeria, eHA’s geographic information system and data analytics team worked with the NCDC’s disease surveillance team and cholera technical working group to conduct a hotspot mapping of cholera, using historical outbreak data. The analysis of these datasets, which employed the scan statistics approach, helped to identify specific trends, significant cholera hotspots, and relative risk across the country.
These insights were then used by the NCDC National Incident Coordination Centre to strategically plan the response and allocate resources to support affected communities. Data-informed decisions, such as where response teams should be deployed and what quantity of oral cholera vaccines were required per local government area, improved the effectiveness of the reactive vaccination campaigns and risk communication strategies.
This work provides a model for how other governments could adopt geospatial technology and develop early warning systems that inform disease outbreak detection and response strategies. Of course, the conditions in SIDS differ from Nigeria — they are much smaller, less populated, and surrounded by water. That said, the challenges posed by unreliable internet, power, or transportation infrastructure in Nigeria’s most remote areas can resemble those on islands rendered especially inaccessible by the wreckage and destruction of a natural disaster.
The technology used in the eHA and NCDC project can be used to improve infectious disease prediction, detection, and response in all environments, and for underserved and hard-to-reach communities, these insights can be particularly transformative. As small island governments face increasing rates of extreme weather incidents, geospatial data analysis provides an invaluable tool to address the associated public health threats.
On small islands, GIS technology can be tailored to provide context-specific insights on the interactions between natural disasters, relief efforts, and the public health response. For example, the combination of disease, infrastructure, and damage data can identify weak points in current water and sanitation infrastructure that need to be strengthened, and point to where backup infrastructure systems need to be developed.
The inclusion of data on historical damage to transport systems can help plan for alternative delivery routes, ensuring commodities such as vaccines or clean water get to at-risk communities that are hard to reach post-disaster.
Though long-term, large-scale changes in human behavior are fundamental to curbing climate change, this does not absolve the global community of an obligation to act swiftly and protect those battling its immediate and severe impact.
Integrating technology into traditional problem-solving enables us to be proactive, rather than reactive, in these efforts. Governments that invest in initiatives such as the NCDC and eHA cholera outbreak detection and response project can leverage data to make more informed decisions about emergency preparedness; response, program, and policy development; as well as resource allocation.
In disaster-prone and resource-limited areas such as SIDS, this has the potential to tremendously improve health outcomes. It’s important to remember that, just like traditional resources, the benefits of life-saving technology tend to be unevenly distributed. The challenges facing the global community, be they related to climate change, health, education, or a myriad of other problems, must be approached collaboratively. Only through cooperation, partnership, and active knowledge sharing can we ensure our solutions don’t overlook the most vulnerable and underserved among us.
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