Vulnerability and Adaptation to Climate Change-Induced Malaria and Cholera in the Lake Victoria Region (AF91) P.Z. Yanda, R.Y.M. Kangalawe, R.J. Sigalla Institute of Resource Assessment, University of Dar es Salaam Tanzania

4 Outline Introduction Methodology Factors Contributing to Vulnerability and Adaptation to Malaria –Demographic and wealth characteristics –Vulnerability to Malaria by Sex and Age Groups –Landscape Characteristics –Water availability and incidences of malaria –Knowledge, Perceptions and Practices of Malaria Factors Contributing to Vulnerability and Adaptation to Cholera. –Accessibility and availability of sanitation facilities –Knowledge, attitude and practice of Cholera –Trend in Incidences/outbreaks of Cholera –How they address the problem (adaptation)

Introduction This study is part of the East Africa Project AF91, which looks at the impacts, vulnerability and adaptations to climate change-induced malaria and cholera in the Lake Victoria Region. Malaria is endemic to the region and has been creeping upwards from lowlands to highlands. Cholera is also common in the region particularly in areas around the lakeshore.

6 Introduction - cont. Malaria and cholera epidemics have occurred to varying degrees in the East African region in the last decades. As a consequence health authorities have had a problem in deciding which factors are most important and which policy interventions to institute. This study examines the relationships between socio-economic characteristics and vulnerability and adaptation to malaria and cholera in the Lake Victoria region, Tanzania (so as to inform decisions).

Methodology Collection and analysis of secondary data Participatory discussions and stakeholder workshop Household interviews Field observations. Data analysis using SPSS

Factors Contributing to Vulnerability to Malaria Demographic and wealth characteristics –Causes and factors that influence severity of malaria and how the disease can be controlled or treated commonly perceived by the community –Most people reported to vulnerable irrespective of variations in demographic and wealth characteristics

Factors Contributing to Vulnerability to Malaria - cont. Vulnerability to malaria by sex and age groups –Women, children and the elderly are more vulnerable to malaria mainly because they sleep much earlier in the evening – hence more vulnerable to mosquito bites –Women and children are vulnerable to mosquito bites while weeding bean fields. –Men spend much time away from home and appear to be less exposed to mosquito bites, and consequently less vulnerable to malaria.

Factors Contributing to Vulnerability to Malaria - cont. Landscape Characteristics –No clear correlation between locations of the homesteads on the landscape & presence of stagnant water and proportion of household members hospitalised due to malaria. –Occurrence of malaria in the area may be associated with multiple factors other than the terrain features, e.g. climate variability

Factors Contributing to Vulnerability to Malaria - cont. Water availability and incidences of malaria –More severe incidences/outbreaks of malaria occur during the rainy season, usually between September and April, and the period just after the end of the rainy season. –Particularly serious in years following prolonged dry seasons. –This is the period when water is most available for the mosquitoes to breed. –During this season mosquitoes find suitable breeding ground in potholes, in bean fields where the microclimate is dump and humid and in cut banana stems that retain water.

Knowledge, Perceptions and Practices of Malaria (Local Adaptation) Increasing use of health facilities –Use of modern medicine Increasing use of bed nets –But many households are unable to buy mosquito nets sufficient for all household member –Attributed to large household sizes and the low incomes of the households. Therefore many people are still subject to mosquito bite and hence vulnerable to getting malaria. –Treatment of bednets with insecticides to kill mosquitoes

Knowledge, Perceptions and Practices of Malaria (Local Adaptation – cont.) Many people use traditional measures (local herbs) to cure malaria. This appears to be a crucial adaptation strategy particularly given the high poverty level in the area Clearing of vegetation around homesteads Destruction of cut banana stems so that they do not harbour water and provide breeding grounds for mosquitoes

Factors Contributing to Vulnerability and Adaptation to Cholera Accessibility and availability of sanitation facilities –In seasons with above average rainfall many toilets get flooded and many also collapsing because of the sandiness of the soils –Not using toilets, –Poor disposal of other wastes e.g. residues from fruits Knowledge, attitude and practice of Cholera –All the people are knowledge about cholera –Practice - as advised by health officers (cleanliness, boiling drinking water, etc) –No traditional cure for cholera – perceived as a new disease

Factors Contributing to Vulnerability and Adaptation to Cholera - cont. Trends on incidences/outbreaks of Cholera –Analysis of data going on Community does not have adequate adaptation mechanisms to cholera Need for a rigorous community health education

Conclusion More severe incidences/outbreaks of malaria during the rainy season and just after the end of the rainy season Women and children are more vulnerable to mosquito bite, hence more vulnerable to malaria than men. Poverty influence adaptation to malaria Although only a few households reported to have had encountered cholera during the last outbreaks, many people are vulnerable to the diseases particularly because of drinking untreated water. The community does not have adequate adaptation mechanisms to both malaria and cholera. Further analysis needed for both malaria and cholera data.

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