Keywords

FormalPara Key Points

  • The climate emergency exacerbates the risk of epidemics, diseases, and health emergencies in the Philippines.

  • If nothing is done, then millions of lives will be at risk from the direct impact of disasters and the health effects that arise as communities cope and recover.

  • Policymakers must advocate for sustainable and climate-protective practices to avoid the negative effect of human activities on the environment. They must also advocate for measures that protect and support communities during disaster events.

FormalPara Summary for Policymakers

The problem of the occurrence of regular environmental disasters (e.g., cyclones, floods, droughts, landslides) and the subsequent health concerns (e.g., epidemics, fatalities) that accompany it is as direct result of climate change impacts and the Filipino people remain the most vulnerable to these.

  • In general, climate-related health impacts can be categorized as either direct or indirect. Direct impacts include that of heat stress, which can directly cause cardiovascular and respiratory problems and even deaths. Indirect health impacts include ecological mediations, vector-borne diseases, marine-borne diseases, and air pollution (Lu 2016). Examples are in the case of increased exposure to extreme thermal conditions where a direct effect is an increase in heat- and cold-related deaths and illnesses, while a direct effect is an increased incidence of transmission of infectious diseases. The occurrence of extreme weather events has a direct health impact through the increase in the frequency and severity of injuries, deaths, and psychosocial disorders. The Philippines is fourth among countries that are most exposed to multiple hazards due to natural disasters. The risk exposure to disaster covers 22.3% of the total area and 36.4% of the population of the country. According to the Institute for International Law of Peace and Armed Conflict—IFHV (2018) World Risk Report, the Philippines is ranked third in the highest disaster risk, with Vanuatu being first and Tonga second. They also report that the country lacks coping and adaptive mechanisms to mitigate the impact of climate change. There have been several natural disasters that plagued the Philippines. In terms of fatalities and health emergencies, storm, flood, and earthquakes caused lives and damaged properties. Ground shaking was more frequent than tsunami in the country. Viral infectious diseases caused more deaths than bacterial and parasitic infectious diseases.

  • There are observed health implications due to the effect of climate change. Dengue fever cases in the Philippines have been noted to be associated with temperature increase in the last decade (Perez 2009). As the temperature rises, so do the cases of dengue across the country. Among the top five natural disasters causing massive number of health emergencies and fatalities, earthquake caused the most number of deaths, while storm adversely affected the most number of people. Flooding was the most devastating economically. In the Philippines, the top natural disasters that have occurred from 1900 to 2011 were storms and earthquakes; however, storms occurred more frequently and caused more harm to people among the two disasters. These damages not only translate to losses within the health dimension but include the economic dimension as well. The damages of climate-change-related disasters (e.g., storms, floods) are further aggravated by the lack of economic resources. In terms of vulnerability based on the economic risk to gross domestic product (GDP), the Philippines ranked tenth place. The country is estimated to have 50.3% of total area at risk, 81.3% of population in areas at risk, and 85.2% of GDP in areas at risk.

The most common communicable diseases arising from disasters and emergencies include diarrhea, acute respiratory infection, measles, and malaria (WHO 2006). Communities and populations who have survived through disasters are forced to seek temporary shelter until it is safe to return to their original homes. However, makeshift shelters are not equipped with proper sanitation faculties to accommodate the families displaced, increasing the risk of communicable diseases post-disaster. The most common communicable diseases arising from disasters and emergencies include diarrhea, acute respiratory infection, measles, and malaria.

  • Even after the occurrence of a natural disaster, the threat to health from communicable diseases remains and even worsens. In reality following natural disasters, the disaster effects on size, health status, and living conditions of the displaced populations increase the risk of outbreak development (Toole 1997 as cited in WHO 2006). In general, the overall risk for development of communicable disease outbreaks is lower than perceived. However, the risk of transmission of certain endemic and epidemic-prone diseases can increase following natural disasters

Invest in research and development for projecting the impacts of climate change to health, and its relationship to epidemics and health emergencies.

To address this, policymakers at the national level must encourage sustainable practices nationwide to reduce the effects of climate change and support the local government in identifying vulnerable communities and provide ways to prevent and mitigate the risks identified.

  • Conduct risk and vulnerability assessments of all communities to identify those at significant risk for the health-related effects of climate change.

  • Advocate for the construction of well-equipped facilities that can serve as temporary safe shelters for communities displaced by environmental disasters among other mitigation and prevention interventions for specific disasters.

  • Provide pathways that allow affected communities’ access to government resources for the rapid rehabilitation and protection of vulnerable communities.

To address this, policymakers at the local level must work with the national government to identify vulnerable communities within their jurisdiction and initiate protective and preventive measures.

  • Local policymakers should work side by side with communities to increase their awareness on the risks present and ways to address this such as through training workshops and capability building sessions.

  • Local policymakers should push for the creation and empowerment of a disaster risk reduction unit to carry out preventive measures and disaster responses.

  • Local policymakers should work with the national government to ensure that business, institutions, and individual citizens registered under their area comply with sustainable and climate-protective practices.

1 Introduction

Climate change is considered the biggest global health threat of the twenty-first century claiming approximately thousands of lives yearly and will continue to affect the lives of people through disasters brought about climate change, climate-sensitive diseases, and other health conditions that are exacerbated by climate change (PAHO, n.d.). It is projected that climate change will lead to an unacceptable and catastrophic risk to the human health directly and indirectly (Watts et al. 2015).

Climate change has direct and indirect impact on health. The direct impacts include the changing climate, particularly heat waves, droughts, heavy storms, floods, and sea level rise (PAHO n.d.; Watts et al. 2015). The indirect impacts of climate change include the vector-borne and airway diseases, food and water insecurity, undernutrition, forced displacement, and mental health illnesses, which result from the modifications brought about climate change to the environment (PAHO n.d; Watts et al. 2015). The detrimental effects of climate change to the social and environmental determinants of health, specifically air, water, food, and shelter, were estimated to cost an additional 250,000 fatalities annually by 2030 to 2050 due to malnutrition, malaria, diarrhea, and heat stress, and a direct cost of approximately USD $2–4 billion per year by 2030 for health (WHO 2021). Environmental factors that are harmful to health, particularly air pollution, extreme weather events, forced displacement, food insecurity, pressures on mental health, and diseases, were responsible for almost 13 million fatalities globally, which represented almost 22% of global fatalities and 26% of fatalities for children below 5 years old in 2012 (Prüss-Üstün et al. 2016).

Climate change aggravates natural disasters. Studies showed that global climate change accounted for the increasing magnitude and frequency of natural disasters. Kahn (2005) noted that the frequency and severity of natural disaster can be caused, augmented, and amplified by climate change. The Economics of Climate Adaptation (ECA) (2009) also showed that climate change is directly associated with the intensity of natural hazards.

The increasing surface temperature globally increases the risk for more frequent droughts and increased intensity of powerful storms through the increased heat in the atmosphere, warmer ocean surface temperature, and rising sea levels, which increases wind speeds in tropical storms (US Geological Survey n.d.). The devastating effects of natural disasters include changes in the physical landscape, socio-physical, biochemical, and increasing the exposure and vulnerability of the community to environmental stressors, which increases the vulnerability of the impacted communities and displaced individuals to the negative economic and health impact of natural disasters.

Climate change negatively impacts the environment by decreasing the sea ice and water resources, and increasing permafrost thawing, heat waves, and precipitation. In Asia, it is projected that fatalities related to flood- and drought-related diseases will increase, freshwater availability will be reduced by 2050, and coastal lines will be at risk due to increased flooding (US Geological Survey n.d.). Tropical-cyclone-related hazards and heavy precipitation were found to increase with increasing and worsening climate change in Japan and East Asia (Mori et al. 2021). Cappelli et al. (2021) analyzed natural disasters between 1992 and 2018 in 149 countries and determined the connection between climate-change-induced disasters, inequality, and vulnerability. Inequality to access and availability of technologies, infrastructure, and preventive measures was found to be inversely proportional with extreme climatic events, showing that countries with higher levels of inequalities, including gender differences in vulnerability, reported increasing frequency of extreme climatic events (Cappelli et al. 2021).

Asia is considered as one of the regions considered the most prone to natural disasters or one-third of disasters that occurred globally due to its geographic location and diverse topography (Jha et al. 2018). Asian countries, particularly the Philippines, Bangladesh, Cambodia, India, Pakistan, and Viet Nam, are the most vulnerable and susceptible to natural disasters (Jha et al. 2018). It was estimated that natural disasters costed Asia approximately 350,000 fatalities, almost USD $500 billion in total damages, and more than billion affected lives (Jha et al. 2018).

A recipient of some of the worst natural disasters arising from climate change, the Philippines suffered almost 75% of the world’s natural disasters that happened in the years 1970–1977 and occurred in Asia and the Pacific Region, including other Pacific Island countries. Located along the typhoon belt in the Pacific, the Philippines is highly prone to hydrometeorological events, which is 80% of the country’s natural disasters, and experiences an average of 20 typhoons annually (Jha et al. 2018). The country experienced changes in paths of typhoon and increasing intensity, and frequency of hot days and warm nights. It is expected that the average precipitation deviation will increase by 8 mm per month and could be associated with an additional disaster in the country every 3 years (Thomas 2013, as cited by Jha et al. 2018). Also, the Philippines is located in the middle of the most active earthquake zones in the world, The Pacific Ring of Fire, which makes the country more vulnerable to frequent volcanic eruptions and earthquakes.

Climate-related disasters are the manifestations of global warming. The impact of climate change and disasters is detrimental especially to developing regions with high levels of poverty, and poor and inadequate health infrastructure and healthcare system that is unable to adopt, prepare, and respond to health risks posed by climate change. Building resilience against climate change and climate-sensitive natural disasters in the Philippines requires understanding on how these threats impacted public health in the country.

This study aims to present the frequency and severity of natural disasters in the Philippines and the attendant epidemics after a type of natural disaster brought about by climate change using information from previously published studies related to this topic.

The study tries to answer the following questions:

  1. 1.

    What are the determinants affecting the frequency and magnitude of disasters brought about by climate change in the Philippines?

  2. 2.

    What are the critical health consequences of a disaster and its associated environmental risk factors?

  3. 3.

    What are the prevalent diseases observed in the affected communities as an aftermath of a disaster?

  4. 4.

    What are the recurring epidemics afflicting the Philippines in the past years?

2 Methodology

The study looked into trends of natural disasters related to climate change in the Philippines. Data also included profiling of types of diseases, health and safety emergencies in the aftermath of natural disasters. Both local and international data were looked into. The data used in this study were gathered from the records of Emergency Events Database (EM-DAT) of the Office of U.S. Foreign Disaster Assistance/Centre for Research on the Epidemiology of Disasters (OFDA/CRED) International Disasters Database, the World Economic Forum’s Global Risks Report World Risk Index, Independent Evaluation Group (IEG) of the World Bank, United Nations International Strategy for Disaster Reduction Secretariat (UNISDR), and the National Disaster Risk Reduction and Management Council (NDRRMC) formerly known as National Disaster Coordinating Council (NDCC). Then discursive and analytic methods were employed in building the thematic arguments and frameworks in the study on the relations of natural disasters, climate change, and health/ wellbeing.

3 Results and Discussion

Highly vulnerable to hydrometeorological disasters, particularly floods, landslides, and typhoons, the Philippines is included by the International Red Cross and Crescent Societies as one of the disaster-prone countries in the world. Philippines is an archipelago that is susceptible to tsunamis and typhoons (Esteban and Fabian, 2004). Situated in the typhoon belt of the North Pacific Basin, the Philippines is at increased risk to typhoons and El Nino phenomenon (Co, 2010).

3.1 Climate Change, Natural Disasters, and Epidemics

Climate is a long-term change in the average weather patterns that define the Earth’s local, regional, and global climates. These changes accompany various observed effects to the planet (NASA, 2019). In relation to the occurrence of natural disasters, changes in the global climate worsen climate hazards and increase the risk of extreme weather conditions (Oxfam International). With increasing global surface temperatures, more droughts are produced, and water vapor is evaporated that augments the development of powerful storms. Furthermore, rising sea levels in high areas not usually reached by sea are then subjected to erosive effects of the waves and currents.

Both Global Climate Risk Index reports in 2015 (Kreft et al., 2015) and 2019 (Institute for Economics and Peace, 2019) listed the Philippines as the number one most affected country by climate change. The country has had ten of its deadliest typhoons from 1947 to 2014 although five of these have only occurred in 2006 (The Climate Reality Project, 2016). This may possibly be attributed to the worsening climate conditions over the past years. Damages brought about by typhoon cause displacement of populations that contribute to increasing cases of communicable diseases, most notable are those brought about by disrupted sources of clean water (Watson et al. 2007).

Apart from typhoons, droughts or El Niño have been occurring as a result of climate change and these have had grave health consequences. Changes in temperature are seen to be positively correlated to increase in dengue and malaria cases. The 2015 El Niño in the Philippines saw a 60 percent (60%) increase in the number of dengue cases (USAID, 2017). The Philippines Atmospheric, Geophysical, and Astronomical Services Administration (PAGASA, n.d.) expects a projected 1°C increase in 2020 and a 2°C increase in 2050. Given these projected increases, a possible worsening of climate-sensitive health conditions can be expected.

In general, Climate-related health impacts can be categorized as either direct or indirect. Direct impacts include that of heat stress, which can directly cause cardiovascular and respiratory problems and even deaths. Indirect health impacts include ecological mediations, vector-borne diseases, marine-borne diseases, and air pollution (Lu 2016). Climate and natural disaster-related health conditions will be discussed in the succeeding sections. The table below summarizes the possible climate-related health impacts.

3.2 Disaster Statistics: Philippine Setting

The Philippines is fourth among countries that are most exposed to multiple hazards due to natural disasters. The risk exposure to disaster covers 22.3% of the total area and 36.4% of the population of the country. See Table 4.2.

Table 4.1 Summary of climate-related health impacts
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Table 4.2 Countries most exposed to multiple hazards
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According to the Institute for International Law of Peace and Armed Conflict—IFHV (2018) World Risk Report, the Philippines is ranked third in the highest disaster risk, with Vanuatu being first and Tonga second. The report attributes these high disaster risk indices to the countries’ very high exposure to occurrences of cyclones and earthquakes. The calculation for the World Risk Index is based on four components: (1) exposure to earthquakes, cyclones, floods, droughts, and sea level rise; (2) susceptibility depending on infrastructure, food supply, and economic framework conditions; (3) coping capabilities depending on governance, health care, social and material security; and (4) adaptive capacities related to coming natural events, climate change, and other challenges (Bündnis Entwicklung Hilft 2018). The top 10 countries with the highest World Risk Index are presented in the table below.

Highly susceptible and prone to natural disasters, the Philippines has been identified as one of the top countries at risk for natural disasters worldwide. According to the Modeled Number of People Present in Hazard Zones by the United Nations International Strategy for Disaster Reduction Secretariat (UNISDR) (2009), the Philippines ranked 2nd out of 89 countries at risk of cyclone, 2nd out of 153 for risk of earthquake, 4th out of 162 for risk of landslide, 5th out of 265 for risk of tsunami, 8th out of 162 for risk of flood, and 33rd out of 184 for risk of drought.

There have been several natural disasters that plagued the Philippines. Table 4.5 summarizes the natural disasters that have occurred in the Philippines from 1900 to 2019. In terms of fatalities and health emergencies, storm, flood and earthquakes caused lives and damaged properties. Ground shaking was more frequent than tsunami in the country. Viral infectious diseases caused more deaths than bacterial and parasitic infectious diseases.

3.3 Epidemics as Type of Natural Disaster

There are three common categories of disasters: (1) biological, (2) geophysical, and (3) hydrometeorological. Biological encompasses epidemics and vector-borne diseases, manifesting as bacterial (e.g., cholera and meningococcal), viral (e.g., acute, acute diarrheal syndrome, acute respiratory syndrome (SARS), dengue/dengue hemorrhagic fever, and influenza), and parasitic infectious diseases. Meanwhile, geophysical disasters pertain to earthquakes, tsunamis, and volcanic eruptions as a result of geological forces. Lastly, hydrometeorological disasters cover floods, tidal waves, storms, typhoons, landslides, avalanches, droughts, forest fires, and instances of extreme rainfall brought about by extreme temperatures and climatic conditions.

In relation to dengue being the number one cause of death in the biological category of disasters, dengue fever cases in the Philippines have been noted to be associated with temperature increase in the last decade (Perez 2009). Perez (2009) observed an increasing trend of cases as temperature increases across the country between 1992 and 2005. In fact, the most number of cases (35,600 cases) and the highest temperature (0.9 Celsius increase) were reported in 1998 (Perez 2009).

Among the top five natural disasters causing massive number of health emergencies and fatalities, earthquake caused the most number of deaths, while storm adversely affected the most number of people affected. Flooding was the most devastating economically. The top natural disasters that have frequently occurred from 1900 to 2011 in the Philippines include earthquake, flood, and storm.

In terms of vulnerability based on the economic risk to gross domestic product (GDP), the Philippines ranked tenth place. The country is estimated to have 50.3% of total area at risk, 81.3% of population in areas at risk, and 85.2% of GDP in areas at risk.

3.4 Types of Communicable Diseases in Disasters and Emergencies

The presence of a large number of dead bodies is commonly expected to result in higher chances for an outbreak to occur (de Ville de Goyet, 2004). In reality following natural disasters, the disaster effects on size, health status, and living conditions of the displaced populations increase the risk of outbreak development (Toole 1997 as cited in WHO 2006).

In general, the overall risk for development of communicable disease outbreaks is lower than perceived. However, the risk of transmission of certain endemic- and epidemic-prone diseases can increase following natural disasters (WHO 2006).

Natural disasters may result in infectious diseases during outbreaks due to population displacement and environmental stressors that exacerbate vulnerability of the impacted communities to various diseases. Infectious diseases include diarrheal diseases, acute respiratory infections, malaria, leptospirosis, measles, dengue fever, viral hepatitis, typhoid fever, meningitis, tetanus, and cutaneous mucormycosis (Isidore et al. 2012). See Table 4.3.

Table 4.3 List of the common diseases in affected communities after a natural disaster
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3.5 Outbreak of Diseases by Type of Disaster

Immediate adverse health effects occur after natural disasters. Some of these immediate health effects are presented in Table 4.4. Malnutrition, respiratory and gastrointestinal illnesses are found to be associated with drought. Trauma-related injuries and fatalities, including crush injuries, are the immediate health effects for earthquakes. Burn injuries, respiratory illness, and fatalities occur mostly for fires. Drowning, diarrheal diseases, respiratory infections, and bites are health effects of floods. Disease outbreaks after flooding and in a large-scale population displacement are more commonly reported compared to earthquake, volcanic eruptions, and tsunamis, and small-scale population displacement (Watson et al., 2009). Hyperthermic illness, respiratory problems, and permanent disabilities resulting from stroke are the immediate health effects of heat waves. Water-borne and vector-borne diseases and trauma-related injuries are commonly reported for hydrometeorological disasters, specifically hurricanes, typhoons, and cyclones. Crush injuries, fractures, and soft-tissue injuries are the immediate health effects for tornadoes. Respiratory illnesses, burn injuries, and infections are some of the immediate health effects of volcanic eruptions. Frostbite, cardiovascular and respiratory illnesses, and food- and water-borne diseases are the immediate health effects of winter storms.

Table 4.4 Immediate health effects of natural disaster
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Table 4.5 SPEED data on communicable diseases post-typhoon Yolanda (2013), Pablo (2012), and Habagat (2012)
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In the documented list of epidemic occurrences (from 2000 to 2019), dengue accounted for the highest fatality count, with 737 recorded deaths and 123,939 reported cases. These findings underscore the significance of addressing the health risks in the country, more particularly in the developing disaster management and public health strategies.

Among the natural disasters, flooding emerged as the predominant catalyst for the onset of epidemic outbreaks. Meanwhile, at the global level, it was found that the common epidemics that arise as an aftermath of various disasters include, but are not limited to, cholera, diarrhea, hepatitis A and E, measles, meningitis, tetanus, leptospirosis, acute respiratory syndrome, coccidiomycosis, and malaria.

3.6 International Data on Epidemics

Bacterial infectious diseases accounted the greatest number of fatalities, followed by parasitic and viral infectious diseases. Although Africa reported the greatest mean number of events related to bacterial infectious diseases, Asia recorded the most number of people killed per event. Generally, Asia had the highest mean number of fatalities in all three groups of epidemics.

3.7 Cases of Natural Disasters and Epidemics in the Philippines

Cases of disease epidemics were noted in the occurrence of natural disasters in the Philippines. Typhoons account for most of the natural disaster occurrences in the country. In 2011, the Health Emergency Management Bureau (HEMB) created the Surveillance for Post Extreme Emergencies and Disasters (SPEED), which is a real-time syndromic surveillance system that allows the early detection and monitoring of post-disaster disease trends (Salazar et al. 2016). In this surveillance system, 21 syndromes are provided which are divided into three groups of conditions: communicable diseases, non-communicable diseases, and injuries.

Salazar et al. (2016) made a study on post-disaster health impact of natural hazards in the Philippines in 2013 through an analysis of the 2013 SPEED data. In the study, a total of 4,645 SPEED reports are seen with 3,425 for typhoons, 609 for earthquakes, and 611 for floods. The 2013 SPEED data was divided into two groups to compare the syndrome rates per 10,000 individuals within 2 months and after 2 months post-disaster.

Within 2 months, communicable diseases had the highest number of syndrome rates for flood (N = 551), earthquake (N = 582), and typhoon (N = 1,614). For flood (N = 551), the syndrome rates are the following: communicable diseases are 18.8 (14.2–23.5); injuries are 1.7 (0.9–2.5); and non-communicable diseases are 0.7 (0.5–1.0) within 2 months. For earthquake (N = 582), the syndrome rates are the following: communicable diseases are 54.9 (36.5); injuries are 6; and non-communicable diseases are 9.2 (5.2–13.1) within 2 months. For typhoon (N = 1,614), the syndrome rates are the following: communicable diseases are 84.5 (69.45–99.4); injuries are 10.9 (8.3–13.5); and non-communicable diseases are 10.3 (8.4–12.2) within 2 months (Salazar et al. 2016).

After 2 months post-disaster, communicable diseases still had the greatest number of syndrome rates for flood (N = 60), earthquake (N = 27), and typhoon (N = 1,811). For flood (N = 60), the syndrome rates are the following: communicable diseases are 14.5 (12.4–16.7); injuries are 0.4 (0.1–0.6); and non-communicable diseases are 0.2 (0.1–0.2). For earthquake (N = 27), the syndrome rates are the following: communicable diseases are 14.7 (11.3–18.2); injuries are 1.2 (0.6–1.7); and non-communicable diseases are 1.5 (0.7–2.3). For typhoon (N = 1,811), the syndrome rates are the following: communicable diseases are 14.2 (12.5–15.8); injuries are 1.4 (1.1–1.7); and non-communicable diseases are 2.3 (1.9–2.6) (Salazar et al. 2016).

Typhoons account for most of the syndrome reports. Floods and communicable diseases also account for a large number of syndrome reports in the SPEED data. This is consistent with current literature regarding communicable diseases being a result of disruption of living conditions or displacement of populations during natural disasters (de Ville de Goyet 2004; Murthy and Christian 2010; Kouadio et al. 2012). Respiratory infection was seen to account for the highest consultation rates. In children under 5 years old, acute respiratory infection, open wounds, high blood pressure, skin disease, acute watery diarrhea, and fever account for the highest consultation rates, most of which are from under the communicable syndrome group (Salazar et al. 2016).

Communicable diseases appear to be the more prevalent conditions during occurrences of typhoon. SPEED data on post-disaster consultations for Typhoon Yolanda (2013), Bopha/Pablo (2012), and Southwest Monsoon Floods/Habagat (2012) resulted to increased number of Hepatitis A/E, Leptospirosis, Measles, Meningitis, Dengue, and Tetanus cases (Quiambao 2016). The table below summarizes the number of communicable disease cases on post-disaster periods. See Table 4.5 and Figure 4.1.

Fig. 4.1
A bar graph compares the data from communicable diseases post-typhoon Yolanda, Pablo, and Habagat. The diseases compared are Hepatitis leptospirosis, meningitis, dengue, and tetanus. Dengue has the highest data.

SPEED data on communicable diseases post-typhoon Yolanda (2013), Pablo (2012), and Habagat (2012)

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In this present decade, the Philippines saw the onslaught of Super Typhoon Yolanda in 2013 which resulted in massive losses in life, infrastructure, and resources. The Center for Research on the Epidemiology of Disasters Database (2019) reports a total of 7,354 deaths and 16,106,870 people affected at the end of the typhoon’s visit. In health infrastructure alone, damage amounted to 19.2 million US Dollars (Health Emergency Management Bureau 2014). Total damages are estimated to amount to 14 billion US Dollars (Calamur 2013). Additionally, there was a total of 340,000 consultations reported through the SPEED system in the affected areas of the typhoon, and 58 percent (58%) of these consultations were for watery diarrhea, 13 percent (13%) for suspected measles, nine percent (9%) for hemorrhagic fever, six percent (6%) for acute bloody diarrhea, and five percent (5%) for leptospirosis; alerts for typhoid fever, dengue, rabies, and suspected meningococcemia were also noted in the disaster report (WHO 2014).

Typhoon Haiyan/Yolanda has been the subject of in-depth studies on post-disaster health impacts in the Philippines covering not only the direct physical effects brought about by the disaster but also the effects on the current management of people living with particular conditions as well as the mental health of the survivors and responders. During the typhoon, target client medications such as that of for Pulmonary Tuberculosis (PTB) were made unavailable resulting to a 6–8-week period where people with PTB left without continuous medication intake (Lew et al, 2015). These would mean possible development of antibacterial resistance in some clients and progression to a different category of treatment under the National TB Control Program.

Mental health is also affected during the course of natural disasters. In a study by Hugelius et al. (2017), assessing the health among survivors and responders to the Typhoon, 42 percent (42%) of the respondents noted that they have suffered mental health problems related to the typhoon at a particular point in time while 12 percent (12%) reported persistent mental health problems. Contributing factors to the occurrence of mental health problems were the damage and displacement from homes as well as losses of loved ones during the disaster.

The El Nino phenomenon has also caused droughts and in turn causing malnutrition, especially among children. This was reiterated in the study of Rojas et al in 2014 where they showed the link between drought with food insecurity and malnutrition cases. From 2000 to 2019, the Philippines saw four incidences of drought; there were no noted cases of deaths, however, a recorded estimate total of 197,687 people were affected with food shortage, among others (CRED, 2019). According to the National Nutrition Survey of the Food and Nutrition Research Institute (FNRI), there has been a noted increase in the cases of malnutrition in the country particularly in children from 30.3 percent (30.3%) to 33.4 percent (33.4%) in the 2013 report (Bermejo 2017). Hunger is seen to be more prevalent in areas where fishing and farming are the main sources of food and income (Felizco & Zapanta 2016). Malnutrition due to shortage in food also aggravates the increased risk to communicable diseases especially in areas with poor living and sanitary conditions. Food shortages can be attributed to either: (1) food stock destruction due to damage of crops or (2) disruption of food distribution systems. Malnutrition follows and exacerbates the occurrence/spread of diseases. The spread of diseases is also enhanced by lack of water supply and sanitation conditions. For instance, in Haiti, an outbreak of cholera was reported after the earthquake affecting 112,330 people, and eventually causing 2,478 deaths. The massive number of cases of cholera reported were attributed to unsanitary conditions (WHO 2010).

Likewise, the increasing risk of outbreaks of diseases and epidemics in the aftermath of natural disasters can be accounted by several factors such as mass population movement from the zone of danger or overcrowding in evacuation centers; inadequacies of health services and sanitary facilities; shortages of safe food, safe water, and food supplies. Disruption of surveillance and disease prevention services are also primary factors for spread or exacerbation of communicable diseases such as that of disruption in tuberculosis direct observed short-term treatments and the expanded program on immunization.

4 Conclusion

Communicable diseases remained the most commonly reported health conditions during post-disaster periods. The most common communicable diseases brought about by climate-related disasters are diarrhea, acute respiratory infection, measles, and malaria, which are aggravated by malnutrition. Internationally, the major epidemics occurring after a type of natural disasters are cholera, diarrhea, hepatitis A and E, measles, meningitis, tetanus, diarrhea, leptospirosis, acute respiratory syndrome, coccidiomycosis, and malaria. Population displacement, disruption in way of living and livelihood, and the inadequate health services contribute to the health burden during disasters.

There is a need for policymakers to actively investigate and address the vulnerability of communities against environmental disasters brought about by climate change, such as floods, cyclones, and droughts. Beyond pushing for disaster risk reduction interventions, policymakers should also shine light upon the actions needed to reduce and prevent further climate change. Studies should be done to look into sustainable practices such as renewable energy resources and recycling. Investments should be directed toward renewable energy and resources, while local government units should shift to the development of green cities.