Climate Change Is Making Malawi Sick

Climate change is now coming into sharp focus in Malawi not only in the context of environmental degradation or agricultural loss, but also regarding the low-income communities’ public health stress. As the climate shocks increase, they combine with the structural vulnerabilities, which have been building over time, and this puts pressure on health systems that are already stretched to full capacity. Even though, Malawi generates less than 0.02 percent of the world greenhouse gas emissions, the country still registers a higher climate related public health issues. Climate change is not only an environmental issue, but also a health and governance crisis which needs a long-term policy focus.

Health is not a priority in global climate debates, where it is discussed as a co-benefit of adaptation and not as a goal. But in Malawi, illness, malnutrition, displacement, and system breakdown are the measures of the impact of climate change. This fact questions the existing frameworks of policies that do not integrate climate action and health planning, and it also indicates the vulnerability of governments structures that react to crisis only when it is too late.

Climate Vulnerability

The Malawi’s economic and social setup has a profound background to its exposure to climate-related health risks. Climate variability has a direct impact on the household well-being since approximately 80 percent of the Malawi population depends on rain-fed agriculture as a source of income and food security. Even the slight changes in the timing or intensity of rainfall can cause food shortages, decrease income, and cause nutritional stress.

Malawi’s health system is also long term understaffed, under equipped and under infrastructured and therefore cannot respond to sudden demand spikes. Climate shocks do not introduce new weaknesses in case of occurrence but bring out and intensify the weaknesses. This brings about the meaning of determining the climate vulnerability as a structural phenomenon rather than the environmental factors in relation to the process of policy making.

Floods, Water Systems and Cholera Outbreaks.

Extreme rainfall and flooding have turned out to be among the major contributors to the development of health crises among the population in Malawi. Floods are frequent contaminants of water resources, sanitation facilities are destroyed, and populations are displaced, which creates ideal conditions to spread waterborne diseases. The introduction of pathogens into the drinking water sources by heavy rains is easy in the rural areas where people still use wells.

In Malawi, the most common health issue is a Cholera outbreak. For instance, in 2022, the outbreak began in Machinga district in the wake of tropical storm Ana and Cyclone Gombe that have resulted in flooding and displacement of a low-immunity population with no access to safe water, sanitation, and hygiene.

The twenty-nine districts in Malawi (overall case fatality rate (CFR) 3.3) with active transmission still reported 36943 cases between 3 March 2022 and 3 February 2023, constituting 1210 deaths. The January (17078) figure of cases was 143 per cent higher than December (7017 cases). As of 3 February, Mangochi district which borders Lake Malawi had the highest number of cases with 6974 cases and 114 deaths (CFR 1.6%).

Another problem that poses a risk to the delivery of healthcare is flooding. They obstruct the roads, delay the ambulance services, and destroy or make the health facilities ineffective. The networks of distribution of vital medicines, vaccines, and diagnostic devices are broken, and medical professionals find it difficult to access the target population. The upheavals are not only in emergency response but also in routine services like immunization programs, antenatal services and chronic illness management. Each episode of floods is therefore linked with both the short- and long-term impact on the people in terms of their health.

Nutritional Health, Drought, and Food Insecurity

When a flood strikes, the damage and diseases are quite clear: people are cut, water-borne diseases are transmitted, and lives are lost. Drought, however, halls the same affliction after a longer, less melodramatic curtain. Although the direct risks of flood water are obvious, the crisis of a long dry period that is building up gradually can be as catastrophic as the direct one, or even more so.

The long dry seasons reduce the crop harvests, raise food costs and leave the families with less to consume. This translates to low subsistence farmers and low-income households consuming less food and fewer diverse diets. When food is insufficient, children are deprived of the nutrients they require to develop and adults particularly the pregnant women are at a greater risk of malnutrition.

Malawi already must deal with strikingly elevated levels of chronic undernutrition. Approximately 30 to 40 percent of children below five years of age are stunted, which is a grim sign that they are not receiving sufficient nutrients. This is aggravated by climate shocks, be it floods or droughts, which reduce food availability. Malnutrition causes the weakening of the immune systems and infection can easily establish itself and the body is difficult to resist. Practically, drought becomes an epidemic that goes silent, depleting health even before a famine is proclaimed.

The existing policies on climate are likely to consider agriculture, nutrition, and health as silos. But food security is not only an economic or humanitarian challenge, it is a determinant of health. Plans of adaptation which disregard nutrition and health only cover symptoms but not the cause. In order to really safeguard the people of Malawi, policies should interlace climate resilience, food production, and health outcomes into one and unified policy.

Climate Change and Disease Transmitting Vectors

Climate change also affects the transmission dynamics vector-borne diseases such as Malaria. Malawi is a state with a high prevalence of malaria and changes in the temperature and rainfall patterns affect the breeding of the parasites, the growth of the same as well as the seasons of the mosquitoes and the parasites. An early spring could be extended due to the rise in temperature and unpredictable rains offer fresh breeding areas.

Although there is a progress in malaria control in Malawi in terms of bed net distribution, indoor residual spraying, and improved diagnostics, the issue of climate variability complicates the process of implementing the given measures. The presence of longer transmission seasons increases the costs, and weather patterns are not predictable; hence, the process of planning becomes more difficult. It requires more funds and flexibility to keep the momentum, thereby putting pressure on already stretched budgets of the people in terms of health.

Climate Stress and Mental Health Social Aspect

The mental health impact of climate change is one of the issues that are not given much interest in Malawi. The chronic stress and anxiety together with psychological trauma are the result of frequent exposure to floods, crop failures, and displacement. Loss of harvests, rebuilding houses lead to long-term emotional stress which affects social cohesion and productivity.

Regardless of these facts, mental health has not received the health and climate policy focus. Services are few and psychosocial support is seldom mentioned in climate adaptation models. In relation to the policy, the failure to manage the mental health issues reduces the ability of the communities to recover, adapt, and plan on the long-term basis.

Weaknesses in Health Systems, Governance, and Policy

Malawi has been striving to have the climate change elements integrated in the public health planning. The foreign partners and the Ministry of Health have improved in disease monitoring, emergency preparedness and using climate information to make health decisions. This has been eased by community health workers in making sure that early warning is translated to local action that attests the significance of decentralization.

These efforts are however constrained by structural and institutional factors. Health facilities are not normally built in such a manner that would survive during severe weather conditions. Early warning systems do not have consistency with automatic financing or quick response systems. General climate shocks make it challenging to scale up social protection programs and households are left to pay the health risks on their own.

Climate finance mechanisms continue to push health system resilience to the periphery at the international level. The adaptation funding is more likely to be interested in infrastructure, energy or agriculture as compared to health sector which is as a second matter. It is reflective of greater governance failure in which the result of community health does not feature among the concerns of climate decision-making.

Conclusion

Deforestation, laxity, and ad hoc economic planning are some of the factors leading to the environmental degradation. Climate change may be international, but its repercussions are defined by the capability of the national governance. The effective and comprehensive climate policy should be answerable at the foreign and the domestic stages.

The experience of Malawi proves that climate change is no longer a remote environmental issue, but a direct present situational crisis in health and governance of the people. The outbreak of diseases caused by floods, malnutrition caused by droughts, the proliferation of diseases transmitted by vectors, and the continuous mental health strain can prove that climate shock takes advantage of structural weaknesses and fragmentation of policies. These are not inevitable consequences of nature, but the creation of the governing structures, which do not include climate action as a component of health planning.

A change in both international and domestic policy agenda is also needed in reframing climate change as a national health problem. Health system resilience, food security, water and sanitation and disease prevention should be at the center of climate finance and adaptation strategies as opposed to being considered as sideshows. Malawi has a public health toll that points to the importance of climate justice and responsible governance given that the country has contributed little to the global emissions. Climate action will not succeed without making health the core of climate policy, as it will continue to deal with symptoms and leave the drivers of vulnerability alone.