One of the most important, but lesser discussed dimensions of climate change, is the impact it has on the physical and mental health of vulnerable communities. In India, those living in the ecologically fragile zones such as the coasts and the mountains are the most vulnerable.

Last year the Himalayan states, particularly Himachal Pradesh, Uttarakhand and Sikkim witnessed unprecedented natural disasters. One can imagine the anxiety levels of the residents who witnessed roads washing away, large scale landslides and collapsing of buildings. This reporter witnessed the traumatised people spending sleepless nights as reports of ongoing disasters poured in from across Himachal Pradesh. The loss of livelihood had a multiplier impact on their anxiety levels.

The World Health Organization (WHO) had stated in October last year that, “Climate change presents a fundamental threat to human health. It affects the physical environment as well as all aspects of both natural and human systems – including social and economic conditions and the functioning of health systems.

“It is therefore a threat multiplier, undermining and potentially reversing decades of health progress. As climatic conditions change, more frequent and intensifying weather and climate events are observed, including storms, extreme heat, floods, droughts and wildfires.

“These weather and climate hazards affect health both directly and indirectly, increasing the risk of deaths, non-communicable diseases, the emergence and spread of infectious diseases, and health emergencies.”

It added, “Climate change is also having an impact on our health workforce and infrastructure, reducing capacity to provide universal health coverage (UHC). More fundamentally, climate shocks and growing stresses such as changing temperature and precipitation patterns, drought, floods and rising sea levels degrade the environmental and social determinants of physical and mental health.

“All aspects of health are affected by climate change, from clean air, water and soil to food systems and livelihoods. Further delay in tackling climate change will increase health risks, undermine decades of improvements in global health, and contravene our collective commitments to ensure the human right to health for all.

“Research shows that 3.6 billion people already live in areas highly susceptible to climate change. Between 2030 and 2050, climate change is expected to cause approximately 250 000 additional deaths per year, from undernutrition, malaria, diarrhoea and heat stress alone.

“The direct damage costs to health (excluding costs in health-determining sectors such as agriculture and water and sanitation) is estimated to be between US$ 2–4 billion per year by 2030.

“Areas with weak health infrastructure – mostly in developing countries – will be the least able to cope without assistance to prepare and respond.”

Last week, an interesting exercise was undertaken in Dehradun to discuss the impact of climate change on physical and mental health of the people in Uttarakhand. Several experts and health professionals dealt with these aspects at length in the event organised by Social Development for Communities (SDC) Foundation.

Dr. Mahesh Bhatt, a surgeon and writer said there was an immediate need to bring climate justice to the table, when talking about climate change. “I might be using two cars, air-conditioning and 10 light bulbs in my house and be safe. However, my cousin in a remote village in Uttarakhand might witness his fields being washed away from a cloudburst, which happened due to climate change, in which I too have played a part,” Dr. Bhatt said

Dr. P. S. Negi, a former scientist at Wadia Institute of Himalayan Geology further elaborated on how everything is interconnected. He cited the example of how particulate matter emitted from fires and fossil fuels are increasing the temperatures and becoming a cause for receding snowlines and glaciers. “Climate change affects everything – ecology, economy, health, and wellbeing. Entire species of medicinal plants in the Higher Himalayas are at risk,” Dr. Negi said.

Adding to his views Dr. Mayank Badola, the Chief Medical Officer (CMO) at the Lal Bahadur Shastri National Academy of Administration (LBSNAA) at Mussoorie, called for more efficient surveillance systems and detection systems for diseases, especially those that are vector borne. “Those living in the mountain areas and coastal regions are most susceptible to climate change. Thus, there is as much a need for mitigation as adapting measures,” Dr. Badola pointed out.

He claimed that the Uttarakhand government is working on bettering its healthcare in the face of climate change by capacity building, information education communication (IEC) robustness, along with making healthcare facilities less polluting.

It was pointed out that climate change is also having an impact on the patients of gynaecologists. This aspect was highlighted by Dr. Meghna Aswal who shared her experiences. She said that she has seen a direct connection between rising atmospheric temperatures and preterm labour, and heat stress, in pregnant women, as well as low birth weight and foetal distress in newborns.

“Even as Covid was taking its toll, we actually saw a decrease in asthma patients due to low air pollution levels. Scientific evidence also shows a connection between air pollution and neurodevelopmental and neurodegenerative disorders,” Dr. said.

Pollution is said to be aiding and abetting multiple health disorders and ailments. This was an aspect that was brought to light by another medical expert Dr. S. D. Joshi. He shared how he had once seen a post mortem report of a young male with black lungs. The man was not a smoker but was employed in the transport sector.

“Micro plastics, black carbon and so many other forms of pollution are causing a surge in diseases such as strokes, heart attacks, diabetes, thyroid dysfunction and so on,” Dr. Joshi said.

Of late there have been reports of apple belts shifting in both Himachal Pradesh and even Uttarakhand. At the same time there have been reports of some flora varieties becoming extinct.

This aspect was again brought to light by Dr. Pradeep Mehta of United Nations Development Programme (UNDP) who pointed at various varieties of Rajma (kidney beans) going extinct. He added that the decline in crop diversity is having an impact on the nutrition and health of the people.

“Our culture of crop diversity and ‘barah anaj’ (12 grains) is fast dying, which is impacting our nutrition intake. Studies show that the number of climate migrants has far overtaken the number of war migrants which is a cause for extreme worry,” he said.

Climate change’s impact on health is marked by multiple complexities. Alongside modern day development, society’s needs cannot be ignored. But experts say that the focus needs to be on ‘impact based development’ instead of ‘need based development’.

This aspect was explained by Dr. Nidhi Singh of CEDAR, an organisation working on climate change adaptation. “It is also crucial that we bring discussions on gender equality, disability and social inclusion (GEDSI) to the table. After all, it is women, children and the disabled who bear the brunt of any catastrophe,” Dr. Singh said.

Pointing out another dimension of the phenomenon, IEC officer Anil Sati drew attention towards the increase in vector-borne diseases in not only the plains and valleys of Uttarakhand but also the higher reaches of the hills. “Dengue lasts for months now and people in the far-up Chamoli district were affected by it. Somewhere and somehow, we are all responsible for climate change and need to change our habits and lifestyles,” Sati said.

Social worker Rakesh Bijalwan who works in the field of migration and reverse migration questioned mindless consumption and the pattern of chaotic urbanisation. “Yes, we all are looking forward to changing our diesel and petrol cars to electric vehicles (EVs) but have we stopped to think about the pollution caused from these car batteries which is far more than those from hybrid or internal combustion models,” Bijalwan said. He stressed upon the need for ‘mindful consumption’ and better public transport.

Anoop Nautiyal and Prerna Raturi of SDC Foundation while underlining the need for more such deliberations called upon those present to take this crucial issue to their networks and forums so that strategies can be developed for both mitigation and adaptation to climate change.

The WHO communication referred to earlier also pointed out that the Intergovernmental Panel on Climate Change's (IPCC) Sixth Assessment Report (AR6) concluded that climate risks are appearing faster and will become more severe sooner than previously expected, and it will be harder to adapt with increased global heating.

“It further reveals that 3.6 billion people already live in areas highly susceptible to climate change. Despite contributing minimally to global emissions, low-income countries and small island developing states (SIDS) endure the harshest health impacts. In vulnerable regions, the death rate from extreme weather events in the last decade was 15 times higher than in less vulnerable ones.

“Climate change is impacting health in a myriad of ways, including by leading to death and illness from increasingly frequent extreme weather events, such as heat waves, storms and floods, the disruption of food systems, increases in zoonoses and food-, water- and vector-borne diseases, and mental health issues. Furthermore, climate change is undermining many of the social determinants for good health, such as livelihoods, equality and access to health care and social support structures.

“These climate-sensitive health risks are disproportionately felt by the most vulnerable and disadvantaged, including women, children, ethnic minorities, poor communities, migrants or displaced persons, older populations, and those with underlying health conditions,” the WHO stated.

Speaking about issues observed at a micro level in the neighbouring state of Himachal Pradesh, Akshay Jasrotia who works with pastoral communities, said there was a need to holistically understand the changes. He underlined the need to understand the concerns and viewpoint of the communities at large who are more anxious as they try to adapt to the fast changing scenarios.

Highlighting the most important issue of water scarcity Jasrotia said, “while we often discuss the per capita availability of water for humans, we tend to ignore that there are an equal number of domestic animals residing in the villages who also need water to quench their thirst.

“We need to design our policies looking at different aspects. Right now also there are people from pastoral communities across the state complaining about scarcity of drinking water for their herds. This is the scenario in Himachal Pradesh that is a water surplus state.” Jasrotia added that the planning needs to be decentralised to address the concerns of the people.

It needs to be pointed out that the state was devoid of snow and rain through the large part of the month of January. This led to some anxious moments for not only the pastoral communities but for the agriculturists and horticulturists as well.

Jasrotia also highlighted the need to bridge the gap between the haves and have nots when it comes to resources like water. He pointed out that the failure to adapt to changes often leads to panic. Another aspect that he highlighted was the tendency to impose remedial measures on communities already at the receiving end.

Some interesting revelations came to light during the camps for migratory shepherds that were recently organised in different districts of the state by Himachal Ghumantu Pashupalak Mahasabha (HGPM) of which Jasrotia is the state advisor. The camps were organised with the help of the field staff of different government departments.

A report prepared on the camps that has been submitted to the authorities has called for certain important interventions. It stated: “During plantation drives, the local residents and right holders are being consulted, however, the migratory sheep breeders are not consulted as a result of which at many places, the entry points to the grazing area, water bodies are being cut off which leads to problems for the pastoralists when they arrive during winters for migration.

“Any patch of forest closed for plantation should have an opening period mentioned and must be timely opened for grazing. Most of the time, they remain closed for more than the time mentioned in the particular project which also causes weed infestation.”

The report has called for lantana eradication activity in the winter pastures for reclamation of grazing area. At the same time it was stated that the native bushes, grasses and fodder trees were also eliminated along with lantana, which causes ecological imbalance. The need for intensive seeding of grasses for optimum forage and fodder production has also been underlined. It has been suggested that the lantana eradication activity be linked with Rural Development & Panchayati Raj Department.

While calling for making the forest permit regime real-time and aligned with the Forest Rights Act 2006, the HGPM has drawn attention to another important issue. It stated in its report that, “The water bodies being developed by the FD (Forest Department) in different projects should be designed in an animal friendly way so that they can drink water easily.

“The water supply schemes aligned through the forest grazing areas where there is a water scarcity, a suitable outlet at some places may be given for the flock of migratory shepherds upon their request on seasonal basis (during winters).”

The organisation has sought that the conflicts of the sheep breeders or migratory communities over the seasonal use of common land, should be dealt with on priority, and resolved as per the revenue settlement with the local population.

There have been repeated calls at all levels for reducing emissions of greenhouse gases through better transport, food and energy use. It has been underlined that such measures result in health gains as pollution declines.

Himachal Pradesh has been making efforts in this direction. Recently, Chief Minister Sukhvinder Singh Sukhu said that the impacts of global warming are now clearly visible and there is a need to take preempted steps to curb the problem. He said that his government is committed to transform Himachal Pradesh into a Green Energy state by March 31, 2026, and various measures have already been implemented. This includes Rajiv Gandhi Self-Employment Startup Yojna, providing a 50 percent subsidy on the purchase of e-taxis, e-buses, and e-trucks.

In his speech on the 54th Statehood Day function in Dharampur in Mandi on January 25, Sukhu said, “E-vehicles are being promoted in a big way in Himachal and the state government has imposed a ban on the purchase of petrol and diesel vehicles in all government departments from January 1, 2024.”

The CM claimed the promotion of e-vehicles reflects the government's dedication to sustainable transportation, reducing carbon emissions and positioning Himachal Pradesh as a leader in green energy for a cleaner and healthier future. He added that the government aims to establish six green corridors by March this year, ensuring convenient e-charging stations for tourists and locals.

In February, 13 charging stations will be operational, with plans to set up a total of 108 stations at identified petrol pumps within the next two months, the CM said. He added that the Kiratpur to Keylong Green Corridor was already operational, featuring five e-charging stations while three stations have been set up from Shimla to Bilaspur.

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RAJEEV KHANNA