Is Southeast Asia's healthcare workforce ready for climate change?

Tangerang (Indonesia): Across the region, it’s never been more critical to cultivate a resilient healthcare workforce capable of addressing climate-induced public health issues.

Healthcare workers are at the frontline of the climate battle.

As populations, particularly in Asia, confront the brutal realities of a heating planet, having suitably trained, motivated and well-equipped healthcare workers is essential.

But there is a danger that vital resourcing is currently inadequate, and that the health of people, particularly vulnerable and marginalised populations, will suffer as a result.

Increasingly intense and frequent extreme weather events have heightened Southeast Asia’s vulnerability to disasters and climate change. They have contributed to rising deaths, exacerbated health risks, widened health inequities, and strained healthcare systems.

Countries including the Philippines, one of the region's most disaster-prone nations, and Indonesia, whose capital Jakarta, is the fastest-sinking mega city in the world, face significant challenges.

Extreme weather has heightened the likelihood of disasters such as the floods and landslides last month in West Sumatra and Demak-Kudus which affected more than 71,000 people and forced more than 15,000 children from their homes.

Beyond such extreme weather events, the persisting rates of air pollution, heat-related deaths, rising rates in malnutrition due to food insecurity, escalating water scarcity and poor hygiene conditions, alongside the spread of infectious diseases is concerning.

Women, children and the elderly are disproportionately victim to some of these challenges – with heat-related deaths impacting women and elderly, and malnutrition hitting young children the hardest. Rising rates of mental health issues, particularly among youth in the region, further compound these challenges.

Addressing these urgent climate-health threats requires a healthcare workforce capable of identifying, responding to, and managing emergencies. The workforce will also need to be able to deal with the evolving health risks and shifting disease patterns posed by climate change.

A lack of resources and other systemic problems While dedicated healthcare workforce toil tirelessly to provide essential healthcare across the world, particularly during climate-induced emergencies, systemic gaps and resource limitations often hamper their ability to effectively address climate impacts on public health.

Currently, a majority of the healthcare workforce, particularly across the Global South, operate with limited infrastructure for emergency response and disease surveillance, and with some awareness of climate-related health risks.

Challenges around inadequate training and resources, fragmented workforce deployment and coordination mechanisms and insufficient health interventions tailored to climate vulnerabilities persist.

These challenges are particularly acute across rural and remote areas already experiencing health inequities. This calls for targeted investments in healthcare workforce training and capacity building to cultivate a climate-resilient healthcare workforce to strengthen the overall response and readiness of healthcare systems.

Frameworks in place, but not implemented consistently The World Health Organisation (WHO)’s “Operational framework for building climate-resilient and low-carbon health systems” serves as a guiding tool for evaluating and strengthening health systems' resilience to climate change.

It emphasises the importance of developing a climate-resilient healthcare workforce and calls for the healthcare sector to lead efforts to reduce its own greenhouse gas emissions.

The framework also focuses on fostering action across sectors to improve awareness-raising and enhancing communication about the health impacts of climate change.

A key element of the framework is for countries to develop Health National Adaptation Plans, embedded within their multi-sectoral National Adaptation Plans (NAPs), which is a broader process established by the United Nations to improve ‘whole-of-economy’ resilience to climate change.

The recent WHO review found that while all 19 NAPs submitted to the United Nations Framework Convention on Climate Change by December 2020 highlighted health as a priority sector vulnerable to climate change, the extent to which climate-health risks were addressed varied.

Sixteen of these plans included actions for the health workforce, suggesting that the need to strengthen the health workforce in the face of climate change is recognised, at least by this group of predominantly low and middle income countries.

Building on lessons from COVID-19 The COVID-19 pandemic highlighted the crucial role of healthcare workers, both in clinical and non-clinical settings, as trusted intermediaries and frontline responders.

Healthcare workers fulfil diverse roles: from health promotion and disease prevention, including vaccine delivery, to safeguarding sexual and reproductive health, particularly in rural and remote areas. And when the pandemic arrived, it impacted every aspect of healthcare, from increased demand, through supply chain disruption, to healthcare worker illness and death, particularly across low-and middle-income countries.

These challenges encountered – and lessons learned – during the COVID-19 pandemic offer valuable insights into the complexities of addressing climate change impacts.

One parallel lies in healthcare workforce fatigue The prolonged duration and intensity of the pandemic exacerbated burnout among frontline workers, highlighting the importance of safeguarding their physical and mental health wellbeing. Inadequate physical and mental protection during the pandemic also exposed healthcare workers to heightened health risks and deaths, underlining the need for robust safety measures.

The workforce challenges during COVID-19 have also been gendered in nature, with women bearing a disproportionate burden of the crisis's impacts.

With more than 70 per cent of the global healthcare workforce being women, healthcare workers faced unique challenges, including increased exposure to infection due to their higher representation in frontline roles.

They are often juggling caregiving responsibilities at home, placing them at greater risk of burnout and mental health strain.

Existing systemic gender-based disparities in voluntary versus paid positions among health teams and in leadership positions within the healthcare sector have also been exacerbated by the pandemic.

Women have faced heightened risks of gender-based violence, both within and outside healthcare settings – adding an additional layer of vulnerability to their experiences.

At a critical time of building back stronger post-COVID-19 and confronting the escalating climate crisis, it is clear, more than ever before, that if governments and health systems prioritise strengthening of climate-resilience of the healthcare workforce they will be better equipped to effectively navigate and adapt to rapidly shifting health risks posed by climate change.

The global health crisis stemming from the climate crisis underscores the urgent need for action. Cultivating a resilient healthcare workforce is paramount to effectively addressing climate-induced public health challenges and mitigating the profound impacts felt by the most vulnerable populations worldwide. (360info.org)