Effects of environmental degradation on human health along with future consequences.
Introduction:
Environmental degradation and its impact on human health have been a serious global issue for the last few decades. Environmental degradation is both anthropogenic as well as non-anthropogenic. The two main reasons include the Industrial Revolution and a population explosion. There are mainly three main types of environmental degradation which are land/soil degradation, water degradation, and air degradation. WHO estimates anthropogenic factors contribute to a significant percentage of all environmental degradation in recent years with environment-related deaths contributing almost 23 % of global deaths (Prüss-Üstün et al., 2006).
Relationship between environmental degradation and human health:
Human beings rely on the environment heavily for various resources as well as ecosystem-related services such as clean air, water, and food. There is an intricate relationship between human beings and the environment. A multitude of health-related problems occur due to environmental degradation because of disruption in essential services. Environmental degradation has immediate, short term and long-term effects on human health. Immediate effects are generally caused by air pollution affecting the respiratory and cardiovascular systems.
Current effects of environmental degradation on the human health:
Air pollution: Air pollution is a major environmental hazard and is attributed to in 2012, ambient air pollution was responsible for 3.7 million deaths, representing 6.7 % of the total deaths with About 88% of these deaths occurring in low and middle-income countries. (WHO, 2014). Increasing levels of air pollution, driven by factors like industrial emissions, vehicular exhaust, burning fossil fuel, and deforestation with an increase in greenhouse gases including carbon monoxide, carbon dioxide, sulfur dioxide, nitrogen oxides, and hydrocarbons have been linked to respiratory, cardiovascular, and neurological disorders. Inhalation of particulate matter and toxic gases can result in respiratory infections, asthma, lung cancer, and chronic illnesses. Recently studies in China, Italy, and the United States have shown an association between air pollution and the transmission of COVID-19 (Zhang et al., 2020).
Contaminated water and waterborne diseases; water scarcity
Environmental degradation often results in water contamination by various means including industrial waste, agriculture runoff, and poor and improper/ unhealthy sanitation practices. In 2022, at least 1.7 billion people used a drinking water source contaminated with feces globally. Consuming contaminated water may result in individuals suffering from various waterborne diseases such as diarrhea, cholera, typhoid, and polio which are estimated to cause approximately 505 000 diarrhoeal deaths each year (Shayo et al., 2023). Depletion of freshwater resources and high salinity of water pose significant problems, especially for women and children in low-income countries.
Loss of biodiversity and emerging zoonotic diseases:
Degradation of the existing habitat and increasing human encroachment activities in the wildlife, transmission of zoonotic diseases is facilitated. biodiversity loss appears to increase the risk of human exposure to both new and established zoonotic pathogens. Multiple human-mediated environmental changes and activities have been found to be key drivers of zoonotic disease emergence, promoting the conditions in which zoonoses can emerge e.g. Ebola virus, SARS, and most recently Covid-19 pandemic (Keesing & Ostfeld, 2021).
Food security and malnutrition:
Environmental degradation causes disruption in the agricultural system heralding in decreasing yield of crops, food shortages, and resultant escalation of food prices. This contributes to malnutrition, both overnutrition and undernutrition having long-term impacts on human health. In recent years, in developing countries, the rapid growth of food production has also a concern for having a negative impact on the environment due to the overuse of various fertilizers, pesticides, and insecticides (Subramaniam & Masron, 2021).
Future consequences of environmental degradation on Human Health
Climate change and extreme weather events:
Environmental degradation results in worsening climate change with a resultant increase in the frequency and intensity of extreme weather events such as hurricanes, floods, droughts, and heat waves. These results in disruptions to food and water security, worsening air quality, the rise of vector-borne diseases, exacerbations of chronic disease, mental health stressors, and worker injury risks. It is estimated to cause almost 60,000 deaths per annum globally (Leal Filho et al., 2022).
Environmental toxins and chronic diseases, cancers:
Continued environmental degradation makes human beings prone to continuous exposure to harmful substances such as heavy metals, pesticides, and persistent organic pollutants. According to the Global Alliance on Health and Pollution, exposure to toxic air, water, soil, and chemical pollution is the largest environmental cause of premature death, with an estimated 8.3 million deaths globally in 2017. Although much is known about the substances that result in environmental hazards impacting human health, many challenges exist due to various factors. Overt dependence on substances and energy sources associated with toxins, difficulty in assessing the actual environmental impact, and vested interests of stakeholders are the prime factors. Neurodegenerative disorders including Parkinson’s disease and amyotrophic lateral sclerosis have been linked to various toxins including rotenone and permethrin used as insecticides. Studies in low-income countries have demonstrated an increase in infectious diseases attributed to environmental pollutants and the resultant poor immune status of people (Sarah et al., 2022). According to an analysis published by the International Agency for Research on Cancer (IARC), 120 chemicals have been identified as “known” carcinogens; another 81 have been identified as “probable” carcinogens; and another 299 as “possibly” carcinogenic. Well-known carcinogens are asbestos, nickel, cadmium, radon, vinyl chloride, benzidine, and benzene. Besides, an association between endocrine and reproductive disorders with environmental toxins has also been noted (Cohen & Jefferies, 2019).
Mental health impacts:
Escalation in environmental degradation has been associated with varying degrees of mental health issues in humans. Climate change, deforestation, and pollution have a negative impact on mental health as demonstrated in various studies. It is generally noted that individuals of low socioeconomic status or indigenous populations are in psychosocial distress (Wigand et al., 2022).
Displacement, migration, socioeconomic and health impacts:
Although migration can be an adaptive strategy to climate changes, migration due to environmental changes is complex and its impact differs variably on a multitude of factors having direct or indirect effects. The migrating or host communities may be subjected to the long-term effects of migration in geomorphological and population health contexts (Schwerdtle et al., 2018).
Multidimensional and disproportionate impact on vulnerable populations:
Climate changes and environmental degradation have resulted in explicit inequalities among the vulnerable and marginalized population compared to the affluent in exacerbating all health consequences. Limited economic and technological resources imply increased impacts on this population to cope with the risks of climate change (Khine & Langkulsen, 2023). Environmental degradation has a significant effect in difficulty in addressing the poverty issues in the impoverished society and results in difficulty in achieving the desired goals.
Socio-economic impact
Environmental degradation can have significant socioeconomic impacts. When the environment is degraded, not only agriculture, and farming but also other sectors including tourism are affected resulting in economic loss. Depletion of natural resources can disrupt the supply chain and increase prices of goods and services. In the long run, this results in a significant burden on healthcare expenditure which further continues the vicious cycle.
Mitigating the Effect of environmental degradation on human Health:
Climate change and environmental degradation have profound impacts on human health and need to be properly addressed in a multifaceted approach. Adopting a One Health approach, enhancing cross-sector, transboundary communication, as well as collaboration among multiple stakeholders is prudent in minimizing the risks related to environmental degradation. The severity of the health risks depends on the ability of the existing public health system to adequately intervene based on the local resources.
To mitigate the existing and future consequences of environmental degradation, it is imperative to have early preparedness, develop climate resilient infrastructure and sustainable practices, use renewable sources of energy, reduce emissions of short-lived climate pollutants, address pollution issues as well as public education, reinforcing controlling strategies, reforestation, crop rotation as well as reducing exposure to harmful pollutants. Besides, it is essential to address environmental health disparities and risks.
Conclusion:
Government Laws and policies should be developed and strictly implemented prioritizing both the environment and human health. International cooperation among different countries and partners is essential to achieve desired goals and its sustainability. A strong environmental education (EE) system with the responsiveness of humans towards nature for sustainability and environmental security is the need of time.
References:
Cohen, L., & Jefferies, A. (2019). Environmental exposures and cancer: Using the precautionary principle. Ecancermedicalscience, 13, ed91. https://doi.org/10.3332/ecancer.2019.ed91
Keesing, F., & Ostfeld, R. S. (2021). Impacts of biodiversity and biodiversity loss on zoonotic diseases. Proceedings of the National Academy of Sciences, 118(17), e2023540118. https://doi.org/10.1073/pnas.2023540118
Khine, M. M., & Langkulsen, U. (2023). The Implications of Climate Change on Health among Vulnerable Populations in South Africa: A Systematic Review. International Journal of Environmental Research and Public Health, 20(4), 3425. https://doi.org/10.3390/ijerph20043425
Leal Filho, W., Balasubramanian, M., Purcell, W., & Paz, S. (2022). Handling the health impacts of extreme climate events. Environmental Sciences Europe, 34(1), 45. https://doi.org/10.1186/s12302-022-00621-3
Prüss-Üstün, A., Corvalán, C., & World Health Organization. (2006). Preventing disease through healthy environments: Towards an estimate of the environmental burden of disease. World Health Organization.
Sarah, R. H., Shariful Islam, M., Zamiur Rahaman, M., Afrin, S., Rahman, M., & Saif-Ur-Rahman, K. M. (2022). Pivotal role of environmental toxicants on developing infectious diseases in LMICs: A protocol for a systematic review and meta-analysis. BMJ Open, 12(7), e058927. https://doi.org/10.1136/bmjopen-2021-058927
Schwerdtle, P., Bowen, K., & McMichael, C. (2018). The health impacts of climate-related migration. BMC Medicine, 16(1), 1. https://doi.org/10.1186/s12916-017-0981-7
Shayo, G. M., Elimbinzi, E., Shao, G. N., & Fabian, C. (2023). Severity of waterborne diseases in developing countries and the effectiveness of ceramic filters for improving water quality. Bulletin of the National Research Centre, 47(1), 113. https://doi.org/10.1186/s42269-023-01088-9
Subramaniam, Y., & Masron, T. A. (2021). Food security and environmental degradation: Evidence from developing countries. GeoJournal, 86(3), 1141–1153. https://doi.org/10.1007/s10708-019-10119-w
Wigand, M. E., Timmermann, C., Scherp, A., Becker, T., & Steger, F. (2022). Climate Change, Pollution, Deforestation, and Mental Health: Research Trends, Gaps, and Ethical Considerations. GeoHealth, 6(11), e2022GH000632. https://doi.org/10.1029/2022GH000632
Zhang, Z., Xue, T., & Jin, X. (2020). Effects of meteorological conditions and air pollution on COVID-19 transmission: Evidence from 219 Chinese cities. The Science of the Total Environment, 741, 140244. https://doi.org/10.1016/j.scitotenv.2020.140244
HEALTH SECTOR IN NEPAL AND ITS CHALLENGES
As in many developing nations, health care in Nepal is provided jointly by the government and the private sector. The private sector is mostly profit oriented and is barely providing health care to the privileged group. The public health institutions are however the only hope for the remaining larger population. The services at these institutions are either not within reach of the majority of the population or simply lack the adequate man power, technology and infrastructure to provide the care for the needy.
According to the World Health Organization report on 2000 of the assessment of the world’s health systems, Nepal ranked 150th out of the 191 member states. The report also highlighted the important fact that Nepal was one the countries which was having the least fair financing of the health system. This had been attributed to the inequitable distribution of the health care to the general population with failure in the implementation of the running health programmes.
The Alma-Ata declaration of 1978 to which Nepal abided to, affirmed health as a fundamental human right and that the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. Nepal has been adopting the primary health care (PHC) with essential PHC services for the last two decades. Various goals and targets were set for ‘Achieving Health For All by the Year 2000’; some of the goals include at least 5% of gross national product should be spent on health; at least 90% of children should have a weight for age that corresponds to the reference values; safe water should be available in the home or within 15 minutes’ walking distance, and adequate sanitary facilities should be available in the home or immediate vicinity; people should have access to trained personnel for attending pregnancy and childbirth; and child care should be available up to at least one year of age.
Nepal had developed and adopted a national health policy in 1991. A 20 year (1997- 2017) Second Long Term Health Plan (SLTHP) is also being implemented which mainly aims at improving the health status of the underprivileged, the most vulnerable groups, women and children, the rural population, and the marginalized. This was promulgated to deliver essential health care in equitable distribution to the community with their full participation by means of technically competent and socially responsible health personnel. Different national health programmes were devised to curtail the existing health problems; however these programmes achieved relatively few successes when considering benefit to the aimed population. The reason for failure of these national health programmes can be attributed to be multifactorial. The most noteworthy factors that can be attributed to this are the lackadaisical approach by government officials and bureaucrats, non-scientific allocation of resources and uncoordinated implementation. The health ministry bewildered by its internal as well as external chaos also fails to enforce regulations that they themselves have created or are supposed to implement in the public interest. The availability of the resources at time s has not been justifiably utilized with waste of the medicines or facilities as expired or unusable state. By proper channels and coordination of the various levels of this chain of health system, this could be avoided and thus those facilities be utilized by the needy people. The Jajarkot incidence which took a heavy toll of life by a mere diarrhea or an outbreak of measles can exemplify how efficient and expedite management is of the government and health system to tackle any disasters. As a further setback, the existing allocations for the health sector have been curtailed off in the name for the various general development programmes which would barely exist.
A note must also be made to the volatile political scenario of the country which poses a great impact to the health sector. The monopoly and biased appointments have created havoc as seen in the recent shutdown of major hospitals with the brunt of the impact going to the marginalized society who cannot afford the expense of aristocratic private hospitals. Lack of security at working place, no proper incentive to the workers has led to massive brain drain in the medical field thus adding to the ongoing health related crisis. It should however be commented that the disarray in health sector doesn’t lie on the government alone but a major role also does play from the community as well as the medical fraternity itself. The various bandhs and inhumanly attitude of a part of the community has further dragged the health sector to dismay. The implementation of various essential health services and provision of emergency services to the needy have been affected immensely resulting in increase of the already high morbidities and mortalities.
The integrity of the medical fraternity itself is also in a mess and can also be questioned. In recent times, an inharmonious difference among the fraternity has also been an inculcating process to the disgrace of the medical community in general. Politicization and segmentalization of the institution has been a root for the dividend of the medical professionals. Be it the medical council’s election or any appointment of the members of the medical association, we have witnessed how much the system have been supervened by these processes. This has led to the deterioration of the already crippled health system thus warranting a drastic change to revert it. Over impulsive propagation of the hierarchy has also led to mistrust and bitter relations among the medical workers. Besides, the various incidences depict the widespread corruption, bribery, moonlighting and other illegal practices being practiced and encouraged by the health professionals themselves. The evil of commission, nepotisms has rooted so deeply that it deems very much imperative to wipe it from the bottom lest it corrodes the entire society.
Recently it has been advocated that health insurance system be implemented to the large population. In a country where approximately 30 % of the population is living under the poverty line, although virtually it may appear beneficial to the poorest people, it however doesn’t seem quite practicable and realistic at the present context of the economic instability of the country. A more rational approach would be the proper training of the health workers, proper implementation and distribution of the available resources and education of the community from the grass-root level, to achieve the expected goals.
A sound vision from the policy makers with proper implementation of the programmes, an attitude of humanity above self from the medical professionals and a thorough commitment from the community will definitely be a boon to the health care system thus making a healthier Nepal.
Prasun's Words 