Peter Yeboah, Executive Director, Christian Health Association of Ghana, offers his perspective on faith-based approaches to global health
Dr. Tonny Tumwesigye, Executive Director, Uganda Protestant Medical Bureau, gives his remarks on faith-based approaches to global health.
As a child growing up in Nepal’s mountainous Upper Mustang region, Ghana Gurung understood that his survival depended on the mountains and his community. Today, as senior conservation program director at World Wildlife Fund-Nepal, he works to protect the endangered and elusive snow leopard by improving local communities’ livelihoods and the mountains’ ecosystem.
“Survival of the snow leopard is…important for our own survival,” Gurung says in a podcast of his remarks at a recent panel discussion, “Securing the Third Pole: Science, Conservation, and Community Resilience in Asia’s High Mountains,” at the Wilson Center. He didn’t always believe this. As he herded his families’ goats, Gurung knew that in the harsh mountain climate, livestock is livelihood. When a snow leopard attacked and ate his goats, he was angry: “A loss of one animal is a loss of your economy, cash in the bank,” he says. But through his Buddhist faith and his ecological education, he came to see the important role played by snow leopards; as an umbrella species, the leopards are a top predator and indicate the overall health of the ecosystem.
Climate change also threatens the snow leopard and its habitat, says Gurung. The tall grasses of his youth are now degraded, as are the habitats that support wild blue sheep, the snow leopards’ primary prey. “It’s not only wildlife and ecosystem that suffers; it’s people [that] suffer a lot,” says Gurung. To adapt to the changing climate, people are resettling alongside riverbeds that are vulnerable to flooding. And more catastrophically, water from melting glaciers could potentially impact billions of people downstream. Just a few months ago, one day of rain flooded 300,000 households.
Climate change knows no political borders, and neither do snow leopards. They can travels more than 2,000 kilometers between countries, said Gurung. Twelve countries have joined together to create the Global Snow Leopard and Ecosystem Protection Program, a global forum that brings together “countries that don’t normally sit side-by-side to talk too much in political terms,” says Gurung. But the snow leopard—acting as an “ambassador”—brings them together, he says.
“You can call it adaptation, or you can call it mere survival strategies,” Gurung says of community-based efforts to protect snow leopards. For example, citizen scientists from local Sherpa communities set up camera traps, collect scat for DNA analysis, and help put radio collars on the the cats. “It’s not all about ecology of conservation for snow leopards, it’s about community,” he says. “The community holds the key to the survival of the species.”
Climate change poses an undeniable threat to small island states, but many islanders do not even know what climate change is, says Camari Koto, an indigenous Fijian academic and educator at the University of the South Pacific and member of the Resilience Academy, in our latest podcast. “They know it’s happening, they are unconsciously [taking] adaptive responses,” and certainly feel the brunt of its effects, she says. “But they don’t see climate change as an immediate threat.”
As Fiji presides over the 23rd UN Climate Change Conference of Parties (COP-23), perspectives in the South Pacific are beginning to shift. The first island nation to host the conference, Fiji is showcasing its leadership on climate change issues for both the global community and Fijians themselves, Koto says.
“Our government was able to engage right [at] the grassroots level in creating awareness” within Fijian communities, says Koto, an advocate for building sustainable livelihoods and community resilience. It is especially important for the younger generation to be sensitized to climate risks “to start thinking about the threats that we have now,” she says, “and about ways in which they can help to make things better.” We must “prompt them to think about ways forward.”
“It’s the community working together, collaborating, and valuing their relationship” to one another that is at the core of livelihood resilience, says Koto. Community is “the platform of our forefathers.”
“Innovation happens when there are pioneers that stick with it,” says Monica Kerrigan, vice president of innovations at Jhpiego in a podcast from the Wilson Center’s Maternal Health Initiative. At a recent panel discussion on “Reaching the Farthest Behind: Facility-Level Innovations in Maternal Health,” Kerrigan shone a light on some of the challenges facing innovators trying to change the way we care for mothers and their children.
According to Kerrigan, one of the key components of delivering truly innovative solutions is partnership. “We need to use our partnerships to bend the curve,” Kerrigan says. “We at Jhpiego are good at things; other people are better at other things.” Effective partners harness one another’s comparative advantages to plan for scalability and adaptability. “When we think about scaling up,” she says, “we have to think about it now, in the design process.”
Even as these developments are being rolled out, Kerrigan warns against “falling in love with the solution”—investing time, energy, and money into just one idea. Instead, she urges innovators to “fall in love with the problem” first. After years of work in maternal health innovations, Kerrigan admits that one of her biggest challenges is learning to more effectively use data to change plans.
Innovations are not always shiny and new products; they may be restructured business models or processes. For example, the Low Dose High Frequency model, developed by Jhpiego, incorporates “targeted spurts of training that would allow people to learn faster, better, more affordably, and sustainably,” she says, preventing the loss of productivity often caused by removing healthcare personnel from their positions to train in classrooms.
“[Change] is part of prototyping and adapting, and willingness to look at what you are doing well and continue to do it,” says Kerrigan. “Let’s deliver on our promises to mothers and newborns.”
Maps help us to grasp complex ideas, such as patterns of risk and vulnerability, but the stories they tell can have significant implications. “It’s very difficult to validate that what you’re capturing in the maps is representative of real-world phenomenon,” says Joshua Busby in this week’s “Backdraft” episode, describing his efforts to map climate and security hotspots in Africa and Asia. “You have to be modest in what you think the maps can tell policymakers, but also realize there is some seductive power in the way maps simplify complex reality.”
The maps produced by Busby’s Climate Change and African Political Stability and Complex Emergencies and Political Stability projects are designed to help planners, donors, and national governments “shore up resilience on the ground.”
“The real question that we have to ask and answer all the time is, ‘Do the maps have any basis in reality? Are they useful?’ ” says Busby, associate professor from the LBJ School at the University of Texas, Austin.
When Busby and his team traveled to East Africa, they found that some of the challenges associated with chronic water scarcity were missing from their work, so they incorporated new indicators and updated the maps to more accurately represent the current situation. Without this “groundtruthing,” the maps could be misinterpreted and used to support interventions and other policy actions that could produce negative results, such as conflict.
Building Consensus on Climate Action
With proper groundtruthing, maps can be useful tools for reaching new audiences—and for reaching across the aisle. To build political consensus on climate change in the United States, Busby suggests focusing on related challenges, like water’s connection to security. “Because of its centrality to human wellbeing, [water] creates a reservoir of political goodwill that goes across political ideologies, and that’s why we’ve had great success in the U.S. government in creating a groundswell of sustained support for water and sanitation projects.”
However, a focus on water is not a silver bullet, especially if that focus is primarily on providing infrastructure, or “taps and toilets,” without supporting the governance mechanisms needed to manage resources sustainably. “What’s been lost in this wider discussion are concerns about water and security and the institutions both at the national and international [level] that can shore up the ability of countries to manage water resources on their own,” says Busby.
Donors should support efforts to build the capacity of countries to sustainably manage their water resources, particularly resources that are shared with other countries. As climate change increases both floods and droughts, poorly managed water resources could spur political instability both within and between countries.
“How do we present things in a responsible way?” asks Dr. Doris Chou of the World Health Organization (WHO) during a Wilson Center panel discussion on “Maternal and Women’s Health, Two Years In: Measuring Progress Towards Meeting the SDGs.” “My job is to make sure things don’t get misinterpreted,” says Chou.
WHO’s Ending Preventable Maternal Mortality (EPMM) strategy, which was published in 2015, informed the Sustainable Development Goals’ (SDGs) indicator index for maternal health. Chou explains that the EPMM’s themes “speak to empowering women and girls, ensuring country engagement and leadership, and…improving metrics and measurement.”
To ensure accuracy, we need to use have clear shared definitions of maternal health terminology. “What do we mean by maternal death?” Chou asks. “There is a definition, but the interpretation of that definition, we found in the MDG monitoring, varied widely.” Miscommunication and misunderstanding between English and Spanish definitions of the term led to “three years of political discussion—on one word,” she explains.
Accuracy also requires seeking input from the most important people: the women and adolescents who are at the center of the data. “Can we make sure that everybody who needs to be at the table is at the table to think this through? For instance…when we talk about measuring essential adolescent services, what is essential? ‘Essential’ to you and me might be very different than ‘essential’ to the adolescent that we are trying to reach,” says Chou.
“We have to take stock of the old, while we are moving forward and trying to look really far in the future so that we can really always make sure that things are harmonized,” Chou explains, but sometimes it is necessary to stop and understand why we are doing what we are doing.
“We are really in a fantastic time that we can really think about this and make a change,” says Chou. “Everyone, everywhere, has something to do.”
In this podcast postscript, Simon Nicholson goes into detail about the array of climate engineering technologies being researched.
When the Paris Agreement set an ambitious goal of limiting the global temperature rise to 1.5 degrees Celsius above pre-industrial levels, the negotiators put climate engineering on the table, says Simon Nicholson, professor at American University in this week’s episode of Backdraft. Once the purview of science fiction, a majority of the models run by the Intergovernmental Panel on Climate Change (IPCC) required large-scale use of climate engineering technologies to keep additional warming below 2 degrees.
“Nobody who was arguing for that 1.5 degree target at Paris was thinking in their heads we should start shooting sulfate particles into the atmosphere,” says Nicholson. They were looking at the science and recognizing that without aggressive action a lot of people will suffer. But, says Nicholson, it’s not clear that the target is attainable through traditional mitigation alone. “The entire conversation is in some ways an unintended consequence of not doing enough. Very few people want to talk about doing climate engineering. The reason you get a growing number of scientists and policymakers [discussing climate engineering], is because the situation is getting pretty desperate.”
There are two types of climate engineering technologies – solar radiation management and carbon dioxide removal. While carbon dioxide removal tends to be slow-acting and expensive, solar radiation management is fast-acting and seemingly cheap. “One thing to really pay attention to is that each of the technologies has its own risk profile,” says Nicholson, the co-founder of the Forum for Climate Engineering Assessment. “We have to parse them out and discuss them one by one.”
Both technologies have significant environmental, political and social, and existential implications. For example, bio-energy with carbon capture and storage (BECCS), a carbon dioxide removal technology used in the IPCC modeling, would require an immense industrial infrastructure to capture carbon and move it to storage. There would be massive changes in land use, which could generate political and social conflicts. Determining who gets a voice in the decision-making process will be extremely complicated and could increase the vulnerability of already vulnerable communities, says Nicholson.
While faster-acting and less expensive than carbon removal technologies like BECCS, solar radiation management technologies, like stratospheric aerosol injection, could have devastating environmental consequences. “Even if we get it right, there is potential for downsides,” says Nicholson.
“The biggest problem is the social and political transformation that’s needed so that long-term human beings and the way that we live are compatible with ecological realities,” says Nicholson. “Solar radiation is not a fix… And yet, one could imagine politicians and other actors try to sell it as a fix.”
Currently, there is no formal governance system overseeing climate engineering, and Nicholson suggests that this may be an even bigger hurdle than even the environmental impacts. A successful climate intervention would require at least a couple hundred years to achieve a significant decrease in temperature, and stopping an intervention prematurely could lead to a spike in warming. “How do you build a system of governance that lasts across multiple centuries?” he asks. “It might not be the technological challenges that sink something like stratospheric aerosol injection; it may be that the political conversation is just too tough. We just can’t find a way to put together a governance arrangement that’s robust enough that the world community buys it.”
“Although negotiators didn’t intend for this to be the case, now we’re kind of locked into a conversation where climate engineering is on the table,” says Nicholson. “If these [technologies] do start to come onto the table, then they can’t be used as cover for inaction. And that is perhaps the biggest political challenge in this space.”
“Water scarcity is a nightmare scenario that is all too real and all but inevitable in Pakistan,” says Michael Kugelman, deputy director of the Wilson Center’s Asia Program, in this week’s podcast.
Pakistan faces the intersecting challenges of population growth, inefficient infrastructure and policies, deep societal inequality, and climate change, leading to a situation where the country is “voraciously consuming water even as water tables are plummeting precipitously,” says Kugelman. Not only are water problems exacerbating internal tensions, they’re complicating relations with fellow riparian and upstream rival, India.
The degree of Pakistan’s dilemma is profound. A 2015 International Monetary Fund report found that Pakistan’s water consumption is the fourth highest in the world and its water intensity rate (the amount of water needed for every unit of GDP) is also among the highest. Groundwater reserves, the “last resort of water security,” says Kugelman, is a “safety net that is fraying.” He cites a NASA study that found the Indus Basin aquifer, shared between India and Pakistan, is the second most overdrawn in the world.
High levels of consumption are driven by the “robust demand of a rapidly growing population, which now numbers close to 200 million people,” says Kugelman. The annual growth rate is around 1.8 percent, and is projected to stay above 1 percent until at least 2030.
Poor infrastructure and policy also contribute to the dilemma. “Pakistan is unfortunately rather notorious for its leaky, dilapidated pipes, canals, and dams,” says Kugelman, which in turn supply a huge agricultural sector that guzzles water at an enormous rate. The government subsidizes water-intensive crops, like sugar, while encouraging inefficient irrigation methods, like flood irrigation. Overall, agriculture may account for 90 percent of Pakistan’s water usage, says Kugelman.
In “feudal-like conditions” of deep inequality, tenants struggle to access water on land controlled by elites, who face little scrutiny in how they use it. “It’s been said that land ownership is as a proxy for water rights,” says Kugelman. “If you don’t own land, your right to water is highly tenuous.”
While these factors drive up demand, climate change is imperiling supply. The glaciers of the Western Himalayas, the headwaters of the Indus River and its tributaries, have been melting rapidly. “The government in Pakistan has claimed that glacial melt on Pakistan’s mountains has increased by nearly 25 percent in recent years,” says Kugelman. “The once mighty Indus River has slowed to essentially a trickle in parts of the southern province of Sindh.”
Many in Pakistan, including anti-India terror groups, see these problems and accuse India of hoarding water and depleting rivers that flow across the border. Some believe the only solution is to “liberate” the disputed border areas of Jammu and Kashmir.
But Kugelman says there is no evidence to support this accusation and that India is “more of a convenient scapegoat than a genuine explanation.” India has mostly built “run of the river” dams that do not store appreciable amounts of water and thus do not keep water from flowing across the border, he says. The Indus Waters Treaty also gives Pakistan the rights to the three largest rivers of the basin, amounting to 80 percent of flows, says Kugelman. “The broader reality is that there has actually been a fair level of cooperation between these two enemies in managing transboundary water resources in the Indus Basin.”
Climate change and rapid population growth are changing conditions significantly and there have been calls on both sides for the treaty to be renegotiated, but Kugelman believes there is not enough trust between the two for a renegotiation to be productive at the moment. “It is 100 percent wrong to claim that water is a soft issue, that the two sides can use water as a confidence building measure,” he asserts.
Resolution of Pakistan’s water problems will require mainly domestic changes, but in the public eye are more connected with cross-border, nationalist contentions, a dynamic that only entrenches problems. “You cannot separate transboundary water management from the ugly, complex, political disputes in India-Pakistan relations,” he says. “There is really nothing apolitical about transboundary water management on the Indian Subcontinent.”
Michael Kugelman spoke at the Wilson Center on May 9, 2017.
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