\n<\/p>\n
In November in Solomon Islands, the former Tongan health minister Dr Saia Ma\u2019u Piukala stood outside the main hospital in Honiara and \u201cwatched seawater lapping at its outer walls\u201d.<\/p>\n
\u201cThe facility is now under threat, with plans under way to relocate it to higher ground \u2013 a massive and costly undertaking,\u201d Saia, a surgeon and now the World Health Organization\u2019s regional director for the western Pacific, tells the Guardian.<\/p>\n
\u201cIt should never have come to this.\u201d<\/p>\n
The impact on patients and health services is just one part of a growing health burden driven by sea-level rise, including water contamination, infectious disease, food insecurity, displacement and worsening mental health.<\/p>\n
In 2024, at the inaugural UN general assembly meeting on sea-level rise, representatives of small island developing states and low-lying countries described the issue as a global crisis threatening 1 billion people worldwide, urging governments globally to act to protect their health and lives.<\/p>\n
\u201cWe contributed almost nothing to this global scourge but it is our land that is being consumed by the sea,\u201d Samoa\u2019s then prime minister, Afioga Fiam\u0113 Naomi Mata\u02bbafa, told the meeting.<\/p>\n
The result is a Lancet Commission on sea-level rise health and justice, co-chaired by the leading climate negotiator Christiana Figueres and enlisting almost two dozen health and environment experts as commissioners \u2013 Saia among them.<\/p>\n
<\/span>Dr Saia Ma\u2019u Piukala visits the National Referral hospital in Honiara, Solomon Islands.<\/span> Photograph: Ruel Serrano\/WHO<\/p>\n One of the most difficult questions the commission will grapple with is this: who should be responsible for paying when cities like Honiara are forced to rebuild critical infrastructure due to the impacts of some of the most polluting corporations and countries?<\/p>\n In 14 Pacific island countries, Saia says, 62% of health infrastructure lies within 500 metres of the coast.<\/p>\n \u201cThe consequences of inaction are now too severe to ignore,\u201d he says. \u201cThe evidence of climate\u2011related health harm is overwhelming and irrefutable.<\/p>\n \u201cAs both a doctor and a former health minister, I firmly believe that health is ultimately a political choice.\u201d<\/p>\n One of the most immediate health consequences is unsafe water, as saltwater seeps into underground freshwater sources and contaminates drinking supplies.<\/p>\n Flooding can overwhelm sanitation systems, pushing sewage and pollutants into water sources and increasing the risk of waterborne diseases such as cholera and leptospirosis.<\/p>\n Human migrations and displacements caused by sea-level rise also lead to overcrowding and poor conditions, fuelling the spread of infectious disease.<\/p>\n Salinated water may lead to increases in blood pressure, with higher salt intake linked to hypertension and damage to the heart, brain, kidneys and blood vessels.<\/p>\n And when salinated water destroys crops, populations become malnourished, with many losing their livelihoods as farmland becomes unviable.<\/p>\n A co-chair of the commission, Prof Kathryn Bowen, said sea-level rise would be a core component of the health chapter of the seventh report of the Intergovernmental Panel on Climate Change, the UN body that assesses the science related to climate change.<\/p>\n \u201cOne of the core human needs is fresh water,\u201d she says. \u201cWe\u2019re starting to see that this salinity and contamination is linked to worse cardiovascular, renal and pregnancy related health outcomes, and we know that the combination of sea water intrusion and agricultural practices has also been linked to heavy metal sources being found in groundwater.\u201d<\/p>\n In some countries, women and girls are largely responsible for collecting water for cooking and sanitation, and are forced to travel further when local supplies are polluted. Longer journeys increase their exposure to sexual violence, as well as exploitation and waterborne disease.<\/p>\n Sea-level rise also makes weather events more dangerous, as storm surges and flooding reach further inland. Crowded emergency shelters can expose women and girls to sexual violence and poor sanitation, leading some to avoid shelters altogether.<\/p>\n <\/span>Seawater flooding a village in Kiribati.<\/span> Photograph: Jonas Gratzer\/LightRocket\/Getty Images<\/p>\n Pregnant women and young children are particularly vulnerable to diseases from drinking-water contamination, and disrupted healthcare access is linked to poor pregnancy outcomes and child health risks.<\/p>\n The director general of India\u2019s Centre for Science and Environment, Sunita Narain, said: \u201cIt is clear that women are disproportionately hit \u2026 The increased frequency and intensity of these weather events puts pressure on livelihoods and this means that the men are the first to migrate in search of work.<\/p>\n \u201cThis then puts additional pressure on women to cope and indeed survive.\u201d<\/p>\n Even when relocation in response to the threat of sea-level rise is planned, Bowen says, deliberate and permanent relocation ahead of disaster has profound impacts, with education, housing and other critical services also needing to move.<\/p>\n Saia has seen the health impacts of this relocation first-hand. \u201cIn the Pacific, health is inseparable from identity,\u201d he says. \u201cSea\u2011level rise does not just take land; it erodes culture, traditions and people\u2019s sense of belonging.<\/p>\n \u201cIn low\u2011lying atoll countries such as Kiribati, Nauru, the Marshall Islands and Tuvalu, families are being pushed off ancestral land as erosion worsens and flooding becomes routine. This disrupts food systems, community practices and social cohesion.<\/p>\n \u201cProtecting health means safeguarding both physical facilities and the deep connections to place that sustain wellbeing.\u201d<\/p>\n The commission will focus its work on areas where sanitation systems are compromised, waterborne and vector-borne diseases are accelerating and health services are strained.<\/p>\n By the end of 2027, it will present recommendations designed for adoption by governments, institutions and civil society.<\/p>\n \u201cThis commission is obviously going to be fairly dire in many of its findings,\u201d Bowen says. \u201cBut we have to balance that with the fact that we know how to get ourselves out of this, that we\u2019ve got so many ingredients to propose a strong set of solutions.<\/p>\n \u201cOne of the principals of the Commission\u2019s work is imagination, and as part of that we need to find ways to promote empathy and connection and move away from the individualistic ways of life we are all being pushed towards, particularly through political structures.<\/p>\n \u201cBut quite fundamentally, we need to be urgently reducing our emissions. We can\u2019t adapt our way out of this.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" In November in Solomon Islands, the former Tongan health minister Dr Saia Ma\u2019u Piukala stood outside the main hospital in Honiara and \u201cwatched seawater lapping at its outer walls\u201d. \u201cThe facility is now under threat, with plans under way to relocate it to higher ground \u2013 a massive and costly undertaking,\u201d Saia, a surgeon and<\/p>\n","protected":false},"author":1,"featured_media":48032,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[51],"tags":[37,8013,1040,313,24143],"class_list":{"0":"post-48031","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-health","9":"tag-impacts","10":"tag-pay","11":"tag-rise","12":"tag-sealevel"},"_links":{"self":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/48031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=48031"}],"version-history":[{"count":0,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/posts\/48031\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=\/wp\/v2\/media\/48032"}],"wp:attachment":[{"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=48031"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=48031"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/naijaglobalnews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=48031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}What are the health impacts of sea-level rise?<\/h2>\n
What are the gender inequality impacts?<\/h2>\n
What impacts does relocation have?<\/h2>\n
How will the Lancet Commission work?<\/h2>\n