Identification of Priority Actions to Identification of Priority Actions to Adapt to Climate Change in the Adapt to Climate Change in the

Health Sector Health Sector –– The GambiaThe Gambia

Bernard Edward GomezBernard Edward GomezDepartment of Water ResourcesDepartment of Water Resources

Banjul Banjul The GambiaThe Gambia

Tel: (220) 422 4122 / 771 9570Tel: (220) 422 4122 / 771 9570Email: <be63gomez@yahoo.co.uk>Email: <be63gomez@yahoo.co.uk>

OverviewOverview

Climate scenarios & status of health sectorClimate scenarios & status of health sector

Adverse impacts of cc on health Adverse impacts of cc on health -- MalariaMalaria

Identification of priority activities & Identification of priority activities & devtdevt of of health project profileshealth project profiles

Strengths of NAPA methodologyStrengths of NAPA methodology

Lessons, gaps & next stepsLessons, gaps & next steps

Climate scenarios Climate scenarios -- temperaturetemperature

Model projections of mean monthly temperature of The Gambia to 2100

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JAN FEB MAR APR MAY JUN JUL AOG SEPT OCT NOV DEC

O C

1951-1990 CCCM GFDL30 HCGG HCGS GFDLTRAN

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Climate scenarios Climate scenarios -- rainfallrainfall

JAN

FEB M

AR APR M

AY JUN JU

L AUG SE

P OCT NO

V DEC

1951-1990HCGG

HCGSGFDL30

GFDL01CCCM0.00

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100.00

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300.00

350.00

400.00

mm

Model projections of monthly rainfall in The Gambia up to 2100

Which way Which way –– The Gambia?The Gambia?

Observed rainfallObserved rainfall TemperatureTemperature

Current health statusCurrent health status

Population size: 1,384,145 (2003 census)Population size: 1,384,145 (2003 census)Annual growth rate: 3.5%Annual growth rate: 3.5%Urban Population: 38%Urban Population: 38%Life expectancy: 58 yrsLife expectancy: 58 yrsTotal fertility rate: 5.1 Total fertility rate: 5.1 Crude birth rate (per 1,000 population): 46Crude birth rate (per 1,000 population): 46Crude death rate (per 1,000 population): 23Crude death rate (per 1,000 population): 23Infant mortality rate (per 1,000 live births): 61 Infant mortality rate (per 1,000 live births): 61 Under 5 mortality rate (per 1,000): 75 Under 5 mortality rate (per 1,000): 75 Population access to safe water: 62%Population access to safe water: 62%

Current Health status cont…Current Health status cont…

Primary Health Care (PHC) Strategy (1979)Primary Health Care (PHC) Strategy (1979)National Health Policy (1994)National Health Policy (1994)Main Elements of the Policy:Main Elements of the Policy:

–– Safe motherhoodSafe motherhood–– Family planningFamily planning–– Child survivalChild survival–– Proper nutritionProper nutrition–– Control of common endemic diseasesControl of common endemic diseases–– Health promotionHealth promotion

Adverse effects of cc on health Adverse effects of cc on health -- MalariaMalaria

Malaria is an infection caused by a parasite and carried Malaria is an infection caused by a parasite and carried from person to person by mosquitoesfrom person to person by mosquitoes

Endemic in The Gambia with marked seasonal variation, Endemic in The Gambia with marked seasonal variation, highest during rainy season (June to October)highest during rainy season (June to October)

Leading cause of death in The Gambia, disrupts socioLeading cause of death in The Gambia, disrupts socio--economic activities and fuels povertyeconomic activities and fuels poverty

Weaker environmental constraints for spread of waterWeaker environmental constraints for spread of water--based and insect vectorbased and insect vector--borne infections borne infections

Identification of Priorities Identification of Priorities –– NAPA NAPA Desk review of existing literatureDesk review of existing literatureValidation in the 7 Local Gov. Authorities (LGA)Validation in the 7 Local Gov. Authorities (LGA)PRA PRA

–– Priority thematic areas (04) per LGAPriority thematic areas (04) per LGA–– Nature of the vulnerabilityNature of the vulnerability–– Range of affected populationsRange of affected populations–– Types of physical impactsTypes of physical impacts–– Scope of economic risksScope of economic risks–– Urgency of the threatUrgency of the threat–– How does the current climate monitoring/prediction system enhancHow does the current climate monitoring/prediction system enhance e

understanding of the stresses caused by the climate system understanding of the stresses caused by the climate system –– Differentiated impact of climate change on men and womenDifferentiated impact of climate change on men and women–– Adaptation Options: Ranking /Location /Stakeholders /Actors /PolAdaptation Options: Ranking /Location /Stakeholders /Actors /Policy icy

/Technology /Project/Technology /Project–– Criteria for prioritisation of adaptation and coping strategiesCriteria for prioritisation of adaptation and coping strategies–– Prioritized criteria for selecting adaptation and coping strategPrioritized criteria for selecting adaptation and coping strategiesies

Identification … Identification … contdcontd

National stakeholder rankingNational stakeholder ranking–– Use of MCA tool (selection of criteria & scoring of proposed Use of MCA tool (selection of criteria & scoring of proposed

adaptation options against criteria) adaptation options against criteria)

Ranking as per national policyRanking as per national policyReconciliation of stakeholder Reconciliation of stakeholder vsvs policy policy Selection of actions for interventionSelection of actions for interventionProject profile development Project profile development ((Environmental sanitation, Environmental sanitation, screening programmes, provision of drugs & supplies, public screening programmes, provision of drugs & supplies, public awareness creation, training of disease surveillance personnel)awareness creation, training of disease surveillance personnel)

5588Public transportPublic transport

1199Clean Clean technologytechnology

Reducing Reducing respiratory respiratory diseases/ailmentdiseases/ailment

5577Public Public awareness awareness creationcreation

Reducing tempReducing temp--related disabilityrelated disability

101033Improved water Improved water managementmanagement

551111Vaccination Vaccination programmesprogrammes

1166Environment Environment sanitationsanitation

Controlling Controlling spread of waterspread of water--based diseasesbased diseases

Cutting down Cutting down disease burden disease burden related to ccrelated to cc

Policy Policy rankingranking

Stakeholder Stakeholder rankingranking

Adaptation Adaptation OptionsOptions

SubSub--objectivesobjectives

General General ObjectiveObjective

Strengths of NAPA MethodologyStrengths of NAPA MethodologyStakeholder participation in identification of Stakeholder participation in identification of problems and solutionsproblems and solutionsAwareness creation (stakeholders, policy)Awareness creation (stakeholders, policy)Entry point for streamlining cc into Entry point for streamlining cc into natnat. policy. policyFlexibilityFlexibility

LessonsLessons: : Dynamism of adaptation to cc Dynamism of adaptation to cc Difficulty in Difficulty in prioritisingprioritising across thematic areasacross thematic areasNeed for combination of actions to achieve desired objective Need for combination of actions to achieve desired objective Subjectivity of opinions by stakeholdersSubjectivity of opinions by stakeholders

Gaps, next stepsGaps, next steps

Data gaps:Data gaps:–– sociosocio--economic economic –– ClimateClimate–– Other stresses (extreme events, indirect effects, etc.)Other stresses (extreme events, indirect effects, etc.)

Next steps:Next steps:–– Hurdles in project profile Hurdles in project profile devtdevt (absence of Good Practices, (absence of Good Practices,

etc.)etc.)–– Implementation bottlenecks (institutional framework)Implementation bottlenecks (institutional framework)