Desastres naturais e saúde: uma análise da situação do Brasil Natural disasters and health: an analysis of the situation in Brazil (meteorological; hydrological; climatological; geophysical/ geological)
Drought is often a hidden risk with the potential to become a silent public health disaster. It is difficult to define precisely when it starts or when it is over, and although it is a climatological event, its impacts depend on other human activities, and are intensified by social vulnerability. In Brazil, half of all natural disaster events are drought related, and they cause half of the impacts in number of affected persons. One large affected area is the semiarid region of Brazil’s Northeast, which has historically been affected by drought. Many health and well-being indicators in this region are worse than the rest of the country, based on an analysis of 5565 municipalities using available census data for 1991, 2000 and 2010, which allowed separating the 1133 municipalities affected by drought in order to compare them with the rest of the country. Although great progress has been made in reducing social and economic vulnerability, climate change and the expected changes in the semiarid region in the next few decades call for a review of current programs, particularly in public health, and the planning of new interventions with local communities. This study reviews the literature, analyzes available data and identifies possible actions and actors. The aim is to ensure there will be sufficient and sustainable local adaptive capacity and resilience, for a population already living within the limits of environmental vulnerability.
IntroductionBrazil has a large semiarid region, which covers part of 9 states, over 20% of the 5565 municipalities in the country and at 22.5 million persons, 12% of the country’s population. This region experiences recurrent and extended droughts and is characterized by low economic development, scarcity of natural resources including water, and difficult agricultural and livestock production. Local governments and communities need easily obtainable tools to aid their decision making process in managing risks associated with drought.MethodsTo inform decision-making at the level of municipalities, we investigated factors contributing to the health risks of drought. We used education and poverty indicators to measure vulnerability, number of drought damage evaluations and historical drought occurrences as indicators of hazard, and access to water as an indicator of exposure, to derive a drought disaster risk index.ResultsIndicators such as access to piped water, illiteracy and poverty show marked differences in most states and, in nearly all states, the living conditions of communities in the semiarid region are worse than in the rest of each state. There are municipalities at high drought disaster risk in every state and there are a larger number of municipalities at higher risks from the center to the north of the semiarid region.ConclusionsUnderstanding local hazards, exposures and vulnerabilities provides the means to understand local communities’ risks and develop interventions to reduce them. In addition, communities in these regions need to be empowered to add their traditional knowledge to scientific tools, and to identify the actions most relevant to their needs and realities.
Introduction:The objective of this study was to understand and assess the perception of communities, organized civil society, health professionals, and decision-makers of several governmental institutions, regarding vulnerabilities and health impacts in drought prone municipalities of Brazil.Methods:This study was carried out through a qualitative investigation in eight municipalities in the Brazilian Semiarid region. Data collection was done through semi-structure and structure interviews, and discussion with local actors, which included communities groups, health professionals, governmental managers and organized civil society.ResultsThe results point to the local actors’ concerns and to the fragility of the health sector in the planning of integrated actions directed towards risks and impacts associated with drought conditions on human health.Discussion:The lack of a specific knowledge contributes to making invisible the process that determines the impacts of drought on health, leading to an acceptance of drought in those municipalities, reducing the capacity of the health system to respond to droughts.Keywords:drought, vulnerability, risks, health, perception, Brazilian Semiarid, resilience
The aim of building climate resilient and environmentally sustainable health care facilities is: (a) to enhance their capacity to protect and improve the health of their target communities in an unstable and changing climate; and (b) to empower them to optimize the use of resources and minimize the release of pollutants and waste into the environment. Such health care facilities contribute to high quality of care and accessibility of services and, by helping reduce facility costs, also ensure better affordability. They are an important component of universal health coverage. Action is needed in at least four areas which are fundamental requirements for providing safe and quality care: having adequate numbers of skilled human resources, with decent working conditions, empowered and informed to respond to these environmental challenges; sustainable and safe management of water, sanitation and health care waste; sustainable energy services; and appropriate infrastructure and technologies, including all the operations that allow for the efficient functioning of a health care facility. Importantly, this work contributes to promoting actions to ensure that health care facilities are constantly and increasingly strengthened and continue to be efficient and responsive to improve health and contribute to reducing inequities and vulnerability within their local settings. To this end, we propose a framework to respond to these challenges.
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