It’s time for urgent action to solve the climate-health crisis

It has been more than a decade since Kenya witnessed such a devastating calamity. It is not possible to watch the news without experiencing heartbreak at the wreckage caused by the ongoing floods. The 2007 post-election violence was the largest ever-witnessed man-made disaster in the life of post-independence Kenya. As a nation, we stared into an abyss as countrymen took weapons upon each other, leaving a trail of destruction that we are yet to fully recover from. However, the past week has been ridden with tidal wave after tidal wave of heart-
wrenching news as the full-blown effects of the El-Nino continue their march across the country, sweeping along everything in its wake. 

The death toll stands at more than 200 lives lost to the menace that is here to rubberstamp its reputation; water is a powerful enemy to have

From the flooding rivulets, now swollen into chaotic rapids within our city and without, making away with human life while leaving destruction in their wake; to the overflowing underground disasters, steadily submerging stately homes and estates, swallowing up those who had the audacity to unwittingly settle in on their pathway; to the monsters breaking through the decades-old dams that have always held strong, thundering downstream like the apocalypse; all we are left with is a body count. If we were wondering what the impact of climate change is going to look like when it comes to health, we are just getting started. Our most immediate concerns include dealing with the physical injuries sustained by those affected, such as the Mai Mahiu victims who were literally buried under the debris occasioned by the waters thundering downstream from the broken dam. 

Broken bones and soft tissue injuries are expected for those lucky to survive. Exposed to the elements of the weather, the extreme cold will quickly claim more victims due to hypothermia (abnormally low body temperatures), with the very young

and the very old being the most vulnerable. With the destruction of infrastructure, the immersion of live electrical wires in the water poses a real threat of electrocution to those caught up in the rising waters. Death is occasioned by drowning and suffocation for those buried in the mud.

Last week, the national police service cautioned that the National Museum’s live exhibits may have found their way to our streets in Nairobi; a statement that was quickly refuted by the custodians of the snakes. However, in dry, snake-prone areas, the rate of snake bites drastically goes up in the rainy season as the snake habitats are flooded, forcing them out to seek warmer, drier areas in the comfort of our homes.

The overflowing rivers and inland fresh water bodies are encroaching homes and bringing with them the water body inhabitants such as hippos and crocodiles; creating a whole new frontier of human-wildlife conflict right at the doorstep. We can only expect more injuries and loss of life.

With the lack of appropriate health and other critical emergency response structures in place, we are facing an even more difficult next phase; infection, starvation and malnutrition, coupled with mental health disorders. The current situation is one where we are smoking a cigarette next to the oil spill. 

The past five years, we have had sporadic cholera outbreaks that are almost becoming endemic. With our inadequate sewerage infrastructure in the city, most especially in the informal settlements, sweeping away of pit latrines in the flooding villages, the ducks are

already lined up in a row for the worst imaginable cholera outbreak ever! And we all know that when it rains, it pours; therefore, expect its other relatives like shigellosis and typhoid to be right behind.

Do not let the cold fool you, the mosquitoes are all out in a breeding party and they only need 10 days to perform a mass invasion. The malaria season will be upon us in no time. In areas prone to Dengue fever and Chikungunya virus, we shall not be spared another round of outbreaks.

With farmers’ crop having been swept to sea following the fake fertiliser teaser, I hope we have tightened our belts for the famine and hunger that is doing press-ups. Again, our little ones and the elderly remain at highest risk of severe malnutrition and outright starvation.

The impact of displacement, loss of lives, homes, property and economic livelihoods is real to hundreds of thousands of people in the country right now. The level of trauma being experienced is at an all-time high. The lasting mental health impact is going to be debilitating, with post-traumatic stress disorder, anxiety disorder and depression being top of the list. These are not conditions that can be wished away.

What is astounding is the callous manner in which the government has handled this crisis. For a country that was proud to host the first-ever Africa Climate Summit, we wonder what the pomp was all about. The weatherman has been consistent in all his predictions about the weather expectations. We started from rubbishing the pronouncements, to ghosting the disaster management funds and finally, to wishing away the striking health workers’ demands at a time when we desperately need the emergency services efficiently running.

Does Kenya has the capacity for a proper, well-coordinated emergency response? Yes, we do. We have seen this first hand during past dark events like the Westgate terror attack. We had the security forces, the emergency medical units and the humanitarian response, all in place, ensuring the best possible outcome in the circumstances.

What is glaringly clear is that economic discrimination is deeply entrenched in our ruling class. Where are the safe havens for those who are displaced? Where are the tents, thermal blankets, food rations, clean water dispensers and emergency medical kits in the affected areas? Where are the dozens of excavators on site, making every last ditch effort to reach those who are trapped?

This is the time for the government to put aside its pride and bring the doctors’ strike to an immediate end. The government must admit that it tried to pull the rug under the most vulnerable segment of health workers for selfish reasons and it was called out for this. It is time to put the populace first and get the health workers back in the hospitals because the real disaster is still doing press-ups and is on the way. This is the real impact of climate on health!

We should be expecting to see a stock-piling of cholera and typhoid vaccines; anti- snake venom redistribution; facility stocking of supplies to combat diarrhoeal, malaria and other waterborne disease outbreak; we expect the dusting up of our hospital isolations units; reassembling of our mental health support response teams; and capacity-building for health workers in preparation for the deluge. We need to see leadership!

Dr Bosire is an obstetrician/ gynaecologist