Stakeholder (SH) Engagement Stakeholder (SH) Engagement and Links to Decision-Making: and Links to Decision-Making:

Adaptation to Climate Adaptation to Climate Change / Variability Impacting Change / Variability Impacting on Dengue Fever in Caribbean on Dengue Fever in Caribbean

CountriesCountries

Sam RawlinsSam Rawlins

Project SIS 06Project SIS 06

• The University of the West Indies (UWI), Climate Unit, Mona, Kingston, Jamaica.

• The Caribbean Epidemiology Centre (CAREC), Port of Spain, Trinidad and Tobago.

• UWI Dept of Pathology, Trinidad.

• 21 Caribbean Countries anti-DF programs.

IntroductionIntroduction

• Dengue Fever (DF) is endemic in virtually all Caribbean Countries.

• There has been a significant increase of prevalence and severity in the last two decades.

• There has been greater occurrences in El Nino and El Nino+1 years, suggesting a Climate Change (CC) correlation.

Map of the Caribbean countriesMap of the Caribbean countries

Dengue in the Caribbean: In light of the temperature trend (previous diagram), the increase in dengue since 1992 could be due to increasing temperatures - See black circles

El Nino

El Nino + 1

Fig. 1 REPORTED CASES OF DENGUE FEVER BY ENSO AND NEUTRAL YEARS (1980-2002)

0

1000

2000

3000

4000

5000

6000

7000

8000

9000

YEAR

Neautral Year ENSO Year

Decisions which may be influenced Decisions which may be influenced by this projectby this project

• Reduction of Dengue fever cases (occurrence), related to CC/V

• Thro’ the reduction of mosquito vectors (Aedes aegypti)

• Thro’ the reduction of potential habitats increased thro’ appropriate climate conditions

• Thro’ Environmental Sanitation (ES)

Decision-Makers Include:-Decision-Makers Include:-

• Public Health authorities (Ministries of Health) in our 21 Member countries

• Focal Points in public health – Vector Control Staff, Epidemiologists, Educators

• Local Govt. staff who facilitate anti-DF action

• Contd.

Decision-Makers contd.Decision-Makers contd.

• Communities who are at risk for DF and who must implement anti-DF action

• Families who are at risk and must participate in anti-vector action

• Individuals who are at risk and must be part of the solution

• The scientific community who must be sensitized for positive influence.

Research is Relevant as followsResearch is Relevant as follows

• To confirm a link between CC/V and DF vector production and DF Cases

• Predict which CC conditions are most appropriate for DF transmission

• Inform what ES actions are necessary to prevent increase in vectors and DF cases

• Provide results useful for public education programs for mitigation and adaptation.

Stakeholders engaged in the Stakeholders engaged in the ProjectProject

• Ministries of Health: Participation in Epid. and CC data collection

• Scientific community will evaluate the evidence.

• Communities in the Caribbean are the at-risk group for the DF

• From these, information is required on:-

Stakeholders information on CCStakeholders information on CC

• Understanding of the concept of CC

• Perception of how CC affects us

• Sources of info on CC

• Self-reported action on DF prevention

• Willingness to act further on DF prevention if CC link could be demonstrated

• Actual proof of current action (inspection).

Reported Causes of CC in Trinidad Reported Causes of CC in Trinidad communitiescommunities

• Criteria % Comm. Sch

• Greenhouse Gases 4.8 5.2

• Holes in the Ozone Layer 23.8 5.2

• Burning Vegetation 14.3 0

• Automobile Exhaust Fumes 4.8 10.5

• All of the Above 47.6 57.9 Don’t know 4.8 15.8

How Climate Change Affects Two How Climate Change Affects Two Trinidad CommunitiesTrinidad Communities

• Criteria (%) Comm. Sch.,

• Health 37.5 7.1

• Water Resources 12.5 0

• Agriculture 12.5 14.3

• Biodiversity 4.2 7.1

• Coastal degradation etc. 4.2 14.3

• All Equally 29.2 50

Health Factors affected by CC/CV Health Factors affected by CC/CV in Trinidad Communitiesin Trinidad Communities

• Criteria %Comm. % Sch.• Food-Borne Dis. 14.3 5.5• Water-Borne Dis. 14.3 11.1• Vector-Borne Dis. 14.3 11.1• Respiratory Dis. 0 11.1• Heat Stresses 9.5 16.7• All Equally 47.6 38.9• None 0 5.5

Benefits (B) and Costs (C) of Benefits (B) and Costs (C) of Researchers working with Researchers working with

StakeholdersStakeholders• Bringing a Global concept Local (B)

• Empowering the local scientific – climate and epidemiologic – community (B)

• Brining a new practical tool to Public Health (B)

• Spending time and other resources on the project (C)

Benefits (B) and Costs (C) to the Benefits (B) and Costs (C) to the StakeholderStakeholder

• Accessing modern technology tools for DF prevention (B)

• Possibility of applying this tool to other areas of health (B)

• Possible application of CC tools to other areas e.g. Water res., Biodiversity, Agric., Coastal Degradation (B)

• Scarce resources now being utilized without a clear assurance of outcome (C)

Appropriate Role of SHs in Appropriate Role of SHs in assessing CC vulnerabilityassessing CC vulnerability

• Data collection for research (MoHs; Cl.Gp)

• Appropriate response to prediction info e.g. ES improvement at risk times (MoHs Comm.)

• Health education and promotion (MoH)

• Participation of Scientific Research Gp. on interpretation of Disease & CC info.

Assessment Design and Assessment Design and Implementation for better serviceImplementation for better service

• In a manner that is clear (to the layman) & convincing of CC & vulnerability

• If Stakeholders can be comfortable enough with the concepts to accept this as their own project, if

• The benefits (adaptation) can be clearly discernible and demonstrated.

Information Sources on CC in 2 Information Sources on CC in 2 Communities in TrinidadCommunities in Trinidad

• Sources % Comm. % Stud• Peers 0 6.7• Family 5 0• News/Journals 30 13.3• Elec. Media 20 6.7• All Above 40 26.7• None 5 26.7• Personal Obs. 0 20

Attitudes and Practices of 2 Attitudes and Practices of 2 populations on CC regarding DF populations on CC regarding DF

and its preventionand its prevention• Criteria % Comm. %Students

• Do Nothing 0 5.3

• Organize an E.S.

• Campaign 68.2 63.2

• Leave to PH 31.8 15.8

• Don’t Know 0 15.8

Willingness to Participate in Vector Willingness to Participate in Vector Control Action re CCControl Action re CC

• Criteria % Comm. % Students

• Yes 100 94.1

• No 0 5.9

Current Personal Involvement in Current Personal Involvement in VC activities, related to CCVC activities, related to CC

• Criteria % Comm. % Students

• Yes 80 31.3

• No 20 62.5

• Don’t Know 0 6.3

ConclusionConclusion

• There is a need for appropriate info to show to our SHs, the link of VBDs & CC; only 11 – 14% now are aware.

• Such health Promotion for the younger sector is very important.

• Results of this study could stimulate all SHs into action.