Middlesex University Research Repository An open access repository of Middlesex University research http://eprints.mdx.ac.uk Kabir, Russell (2014) The impacts of cyclones Sidr and Aila on the health of the coastal people of Bangladesh. PhD thesis, Middlesex University. [Thesis] Final accepted version (with author’s formatting) This version is available at: https://eprints.mdx.ac.uk/18382/ Copyright: Middlesex University Research Repository makes the University’s research available electronically. Copyright and moral rights to this work are retained by the author and/or other copyright owners unless otherwise stated. The work is supplied on the understanding that any use for commercial gain is strictly forbidden. A copy may be downloaded for personal, non-commercial, research or study without prior permission and without charge. 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See also repository copyright: re-use policy: http://eprints.mdx.ac.uk/policies.html#copy The impacts of cyclones Sidr and Aila on the health of the coastal people of Bangladesh Thesis Submitted to Middlesex University in partial fulfillment of the award of Doctor of Philosophy By Russell Kabir M00337597 MIDDLESEX UNIVERSITY, LONDON, UK NOVEMBER 2014 Dedication To My parents Professor M.Kabir and Anjuman Ara Kabir & wife Urmi & my little princess Manha II DECLARATION OF ORIGINALITY I declare that this thesis contents of original work undertaken solely by myself at Middlesex University between 2010 and 2014: where work by other authors is referred to, it has been properly referenced. Part of my research has been presented in conferences as well as published in journals and I have given a fuller list of information. I hereby declare that any Internet sources published or unpublished works from which I have quoted or drawn references have been reference fully in the text and in the contents list. Name: Russell Kabir Signature: Date: Name of Supervisors Dr. Hafiz T.A.Khan (Director of Studies) Dr. Emma Ball Professor Kay Caldwell III ACKNOWLEDGEMENT I have worked with so many people while researching, writing and modifying this thesis for the last four years that this could list many more names, but to keep it concise, I would like to acknowledge the following people who have helped above and beyond the call of duty. First and foremost, I would like to thank my Director of Studies, Dr. Hafiz T. A. Khan. I expressed my heartiest gratitude for his generous guidance from the early days to end of my study. I am also grateful for his close supervision, continuous support, potential introductions and constant encouragement for the preparation of the thesis, writing and presentation papers in different scientific conferences and publication of papers in different international journals. Moreover, his timely help, encouragement and support enabled me to complete my research on time. I express my heartiest honour to Dr. Emma Ball, my second supervisor, for her valuable support, comments, encouragement, suggestions, feedbacks, review and helpful discussions. My sincere thanks to Professor Kay Caldwell, my third supervisor for encouraging me to explore the new ways of doing research over the last three years and assisted me to get more resources from various sources. My gratitude goes to Md. Twyeafur Rahman of University of Strathclyde, Glasgow, Dr. Md. Shahjahan of Daffodil University, Bangladesh, Dr. Md. Mobarak Hossain Khan of University of Bielefeld, Germany and Miss Sonia Frowde of Glyndŵr University, London for their valuable comments, suggestions and helpful discussions. IV Thank you to all interviewees from Baliatali and Barabari villages who gave their time, welcomed us in their homes and provided this thesis with so many inspiring stories and insightful perspectives on this topic. I also gratefully acknowledge the participation of members of Non-Governmental Organizations of Amtali and Koyra sub -districts. Special thanks to Hridoy and Faisal for their valuable support during the field study. I would like to thank my family, my friends and all those who accompanied me on this PhD journey for the last three years. I would especially like to thank my father Professor M. Kabir, mother Anjuman Ara, brother Rashed Kabir, and sister in law Nimmi Kabir, mother –in-law Nurunnahar and my late father in law Abdul Wahed. Last but not least, I would heartily like to thank my wife Dr. Nahida Ferdous and my daughter Manhneera Kabir. Both have been extremely patient and supportive when I was mentally distracted during the years of my studies. V ABSTRACT Global climate change is now a reality and this change is mainly happening due to global warming. The world has begun to witness the consequences of climate change with the increased frequency of extreme natural events like cyclones, tsunamis, hurricanes and floods. Populations affected by these extreme natural events are left helpless, miserable and in limitless agony. Due to its geographical location, topography, high population density, poverty and lower adaptive competence Bangladesh is considered to be highly vulnerable to natural disasters in the world. Climate changes have triggered an increase in the incidences of natural disasters (like cyclones) over the coastal region of Bangladesh. The coastal part of the country is the most vulnerable and the southwestern part of the coastal area is identified as environmentally handicapped by climate change. Climate change is openly threatening the very existence of people’s lives and livelhoods in Bangladesh. In recent times Bangladesh was hit by two consecutive cyclones Sidr in 2007 and Aila in 2009. The effects of climate change on the environment interacts with the health and population in Bangladesh at numerous complex levels. There are direct health effects through various vector and waterborne diseases, but arguably more important indirect effects as well. So far, little is known about climate change and its impact on human health in Bangladesh. This study was devised following the recent super cyclone Sidr that hit Bangladesh in November 2007 and cyclone Aila that hit in May 2009. The study aims to assess the impact of climate change on health of the coastal population of Bangladesh. This study was conducted in the cyclone Sidr affected area Amtali Upazila of Barguna District and in the cyclone Aila affected area Koyra Upazila of Khulna district. A questionnaire survey was used to collect primary VI data from households of the affected populations. Focus groups with health service providers of the affected areas was also employed. A mixed method approach was used in this research. Quantitative data was analysed using descriptive statistics, frequency distribution, chi-square, correlation analysis and logistic regression analysis. Thematic analysis was used to analyse qualitative data. This research concludes that climate change largely affects human health in Bangladesh. Natural disasters due to climate change are affecting the general and mental health of the population of the affected areas. Prevalence of diarrhoea, skin diseases, hepatitis (jaundice) and other infectious diseases has increased after the cyclones. The risk of injury and death also increased during the time of natural disaster. According to the health service providers’, climate change affected the mental status of people. On the other hand, the focus group discussion revealed that women, children and older adults are the most vulnerable group and are facing serious health concerns due to climate change. A majority of the health professionals, service providers and local community of coastal areas of Bangladesh are aware of the health impacts of climate change but their knowledge regarding health protection measures is limited. It is hoped that the findings of this research will have enormous policy implications. Key words: Climate change, Sidr, Aila, Natural disaster, Human health, Coastal areas, Health effects, Bangladesh VII ABBREVIATIONS ADB Asian Development Bank AIDS Acquired Immune Deficiency Syndrome BBS Bangladesh Bureau of Statistics BCAS Bangladesh Centre for Advanced Studies BMD Bangladesh Meterological Department BUET Bangladesh University of Engineering and Technology CCC Climate Change Cell CCVI Climate Change Vulnerability Index CDC Centre for Disease Control and Prevention CEGIS Centre for Enviornment and Geographic Information Services CFC Chlorofluorocarbon CI Confidence Interval CO2 Carbon Dioxide CRI Climate Risk Index CRED Centre for Research on the Epidemiology of Disasters DALY Disability Adjusted Life Year DF Degree of Freedom DH Department of Health DGHS