Climate Change and Health Adaptation Strategy in Lao PDR

By
Dr Tayphasavanh Fengthong
Director of Environmental Health Division
Dr Sivixay Thammalangsy
Director of Administrative Division
Climate Change and Health
Adaptation Strategy in Lao PDR
The South East Asia Regional Workshop “ The Impact of Climate
Change and Health”, 16-18 June 2009, Shangri-La Hotel,
Jakarta,Indonesia

Outlines
Country description
Relationship between climate change and health
Impacts of Climate change on different
sectors in Lao PDR
Impacts of Climate change on Health in Lao
PDR
What we have done so far?
The way forward

Thailand
Cambodia
Vietnam
China
Myanmar
Country description
Lao PDR is a land-linked country,
and shares border with China, Vietnam,
Cambodia, Thailand and Myanmar.
Total area : 236,800 km2
Population: 5.62 mill Density : 24 p/sqkm
17 provinces including Vientiane Capital
Capita income USD 500 /c/y
Total fertility rate: 4.9%,
Crude birth rates: 41% Crude death rates: 16%,

Adult literacy rate: (F: 50%; M:74%)
Population growth rate: 2.5% per year
Life expectancy: 61 years (F: 63; M: 59)
Population leaving in rural area: 72.8%
47 ethnic groups, covering
120 ethnic sub-groups and languages
11,000+ small villages and mostly
with poor road access
Agriculture = 80% of jobs, mostly
subsistence farming in remote areas
Country description

Relationship between climate
change and health

Eyes (cataracts, etc.)
Skin damage/cancer
Land cover
(forest, etc)
Direct
impacts
Thermal stress: death, disease events, injury
Storms, cyclones, floods, fires
Sea-level rise: physical hazards, displacement
Biodiversity
changes, &
ecosystem
disruption
Changes in host species,
vectors (mosquitoes, etc.)
Infectious
disease risks
Food yields:
nutrition
and health
Human
predation
Stratospheric
ozone depletion
Poverty, slum, hygiene; physical hazards;
infectious disease risks (mobility, density)
e.g. pollination
Avian ‘flu,
Nipah virus,
BSE, etc.
Land use
Water–sheds,
systems Food-production
systems
Urbanisation;
human settlements
Global Climate and Environmental Changes
pathways, health risks
Climate
change
Immune suppression

Regional
Weather
Changes:
Heat waves
Extreme
weather
Temperature
Precipitation
Health effects
Temperature
related
illnesses and
deaths
Extreme
weather events
related health
effects
Air pollution
related health
effects
Water and food
born diseases
Vector and
rodent borne
diseases
Malnutrition
Mental health
Microbiological
economics
Microbiological
Contamination
pathways
Transmission
dynamics
Agro-ecosystem
hydrology
Socio-economics
demographics
ClimateClimate
change
ModulatingModulating
influences
Climate change and Health
Impacts
Direct
impact
Indirect
impact

Impacts of Climate change
On different sectors in Lao PDR

Vulnerability = (Magnitude, Exposure, Adaptive Capacity)
Why Lao PDR so vulnerable?
- High dependence on NR
- Low adaptive capacity as LDC
A most recent study on climate change mapping for Southeast
Asia, sponsored by the Economy and Environment Program for
Southeast Asia (EEPSEA), ranked Lao PDR as a most
vulnerable country.

Note: i) Unit = 1,000 tons; ii) CO2-eq = CO2 equivalent; iii) Conversion factors, 1
ton of CH4 = 21 tons of CO2-eq, 1 ton of N2O = 310 tons of CO2-eq.
GHG in1990
CO2 CH4 N2O Total CO2-eq
Energy 414.90 22.70 0.12 928.80
Agriculture 0.00 271.27 0.00 5,696.67
LULUCF 16,628.67 29.50 0.20 17,310.17
Waste 0.00 11.43 0.00 240.03
Total 17,043.57 334.90 0.32 24,175.67

Agriculture sector
GHG in 1990

Land and Forestry changes
Trend of forests in Lao PDR
Released GHG in 1990

Energy sector
Energy consumption
Energy consumption by sector
Trends of energy consumption

Waste management sector
• In 1990, CH4 released from landfill
site and wastewater treatments equal
to 11.20 and 0.23 tons with CO2eq = 2.4
mil tons (1% of National GHG
released).
• There were only landfill sites in 5 big
urban cities: Vientiane, Luangprabang,
Thakek, Savannakhet and Pakse.
• In 2002, Cities in Vientiane Capital discharged yearly wastewater from
industries = 8.22 mil m3.
Industrial Wastewater
1.4%
2.5%
5.6%
90.5%
textile industry
beverage industry
pulp & paper industry
meat processing industry

Annual Mean Temperature Trend in Major Cities for 1971 -2007
24
25
26
27
28
29
1970 1975 1980 1985 1990 1995 2000 2005 2010
Year
Temperature(Celsius)
Pakse
Savannakhet
Vientiane Capital
Vientiane Province
Luangprabang
Xayaboury
Temperature
increased

Annual Mean-MaximumPrecipitation Trend in Major Cities from
1971 - 2007 (mmin 24 hours)
10
20
30
40
50
60
70
1970 1975 1980 1985 1990 1995 2000 2005 2010
Year
Precipitations(mm)
Pakse
Savannakhet
Vientiane Capital
Vientiane Province
Luangprabang
Xayaboury

Flooding on July 2008 in Lao
PDR, more than 200,000 people
and 75,000 ha affected
Impact of climate change

ແຫຼ ່ ງຂໍ ້ ມູ ນ: ກົ ມແຜນການ, ກະຊວງກະສິ ກໍ າ ແລະ ປ່ າໄມ້ ປີ 2005

Impacts of Climate change
On Health in Lao PDR

Health situations
Considerable progress has been achieved over the past
ten years in improving the health system in the Lao PDR
which are Maternal, infant and under five infant mortality
rates (MMR, IMR and U5MR, respectively) have dropped
significantly
MMR
IMR
U5MR
1995 2000 2005
656
104
170
530 405
82 70
106 98

Child and maternal malnutrition
The malnutrition rate in children under five in
Lao PDR is very high compared to other
countries in South East Asia and Asia in
general.
Almost two in every five children under age
five in Lao PDR are moderately and severely
underweight (37.9 percent)
Stunting: 41.2% Wasting: 7.4%

1377
4
3968
3
9176
21
17638
63
3414
10
5495
13
6349
6
6853
17
4185
22
0
2000
4000
6000
8000
10000
12000
14000
16000
18000
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Cases and deaths of DF, DHF and DSS by year from 200-2008 in Lao
PDR
cases deaths

12440
520
2941
15
2042
3
1572
7
1761
10
2018
0
1886
2
2931
6
7444
7
0
2000
4000
6000
8000
10000
12000
14000
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cases and deaths of severe diarrhea by year from 2000-2008 in Lao
PDR
cases deaths
Source:Epidemiology Division, Center for Laboratory and Epidemiology
Department of Hygiene andd Prevention, Ministry of Health

Comparison of severe diarrhea from 2005-
Œ2007
In 2005
2018 cases
02 deaths
In 2006
1886 cases
No death
In 2007
2931 cases
06 deaths
Source: Epidemiology Division, Center for Laboratory and Epidemiology

343
3
1361
20
1237
0
1278
0
1846
7
1576
1
1868
0
1429
1
1736
0
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cases and deaths of typhoid by year from 2000-2008 in Lao PDR
cases deaths

Comparison of typhoid from -2005 Œ- 2007
In 2005
1576 cases
01 death
In 2006
1868 cases
No death
In 2007
1429 cases
01 death
Source: Epidemiology Division, Center for Laboratory and Epidemiology

799
4
899
0
959
1
790
1
878
0
1108
0
942
0
1103
0
1732
1
0
200
400
600
800
1000
1200
1400
1600
1800
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cases ad deaths of dysentery by year from 2000-2008 in Lao PDR
cases deaths

296
8
239
1
615
0
300
3
334
0
1108
0
345
0
436
2
763
0
0
200
400
600
800
1000
1200
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cases and deaths of food poisoning by year from 2000-2008in Lao PDR
cases deaths

394
3
366
2
451
0
382
2
391
3
488
0
453
0
644
0
966
0
0
100
200
300
400
500
600
700
800
900
1000
Number
2000 2001 2002 2003 2004 2005 2006 2007 2008
Year
Cases and deaths of hepatitis by year from 2000-2008 in Lao PDR
cases deaths

0 0 4 0
37
0
75
0
100
0
0
10
20
30
40
50
60
70
80
90
100
Number
< 1 1 to 5 6 to 10 11 to 15 > 15
Age group
Cases and deaths of hepatitis outbreak by age group in Vientiane Province,
2008, Lao PDR
Cases Deaths
83
0
53
0
42
0
30
0
4
0 1 0
0
10
20
30
40
50
60
70
80
90
Number
Viengkham KeoOudom Phonhong Thoulakhom Hinheub Vanvieng
District
Cases and deaths of hepatitis outbreak by district in Vientiane Province,
2008, Lao PDR
Case Death

Regional
Weather
Changes:
Heat waves
Extreme
weather
Temperature
Precipitation
Health effects
Mental health
Health effects
Temperature
related
illnesses and
deaths
Extreme
weather events
related health
effects
Air pollution
related health
effects
Water and food
born diseases
Vector and
rodent borne
diseases
Malnutrition
Mental health
Microbiological
Contamination
pathways
Transmission
dynamics
Agro-ecosystem
hydrology
Socio-economics
demographics
ClimateClimate
change
ModulatingModulating
influences
Evaluation of
adaptation
Health specific
adaptation
measuresResearch
needs
Driving
forces
• Population
dynamics
• Unsustainable
Economic
development
Natural
causes
GHG
emissions
Adaptive
capacity
Mitigative
capacity
Mitigation
measures

1.First National Communication on Climat Change-FNC
(completed)
2.Technology need Assessment for Mitigating Greenhouse
Gases (completed)
3.Public Awareness on Climate Change (completed)
4.National Adaptation Programmes of Action-NAPA (On
going)
5.National Capacity Self Assessment (NCSA) (On going)
6.Clean Development Mechanism –CDM (on going)
7.Second National Communication on Climat Change-SNC)
(Start implementation)
Projects underProjects under UNFCCCUNFCCC

88. Draft Policy/Strategy and National. Draft Policy/Strategy and National
Environment and Health Action PlanEnvironment and Health Action Plan--
NEHAPNEHAP
1.1. TWG onTWG on Air QualityAir Quality
2.2. TWG on Water, Hygiene and SanitationTWG on Water, Hygiene and Sanitation
3.3. TWG on Solid and Hazardous WasteTWG on Solid and Hazardous Waste
4.4. TWG on Toxic Chemical and Hazardous SubstancesTWG on Toxic Chemical and Hazardous Substances
5.5. TWG on Climate Change, Ozone Depletion and Ecosystem ChangeTWG on Climate Change, Ozone Depletion and Ecosystem Change
6.6. TWG On Preparedness And Response In Environment Health EmergenciesTWG On Preparedness And Response In Environment Health Emergencies..
Draft National Strategy and Action Plan on Climate
Change
Draft Strategy on Climate Change and Health Adaptation

Plan Implementation
NSCCC Chair
NSCCC Secretariat
(DOE)
MPI
Vice Chair
WREA
Standing Vice Chair
MAF
Vice Chair
Climate Change Office
8 TWGs
Min. of Agriculture & Forest
Min. of Energy & Mines
Min. of Public Works & Transport
Water Resources Environment Authority
Min. of Planning & Investment
Land Administration Authority
Min. of Health
Min. of Finance
Universities
Private sectors
International Organizations
TA
Vice Minister of Health
DOHP
EHD NEW HEC MC LEC
CD FDDPIDC

1. Finalize Draft Strategy on Climate Change and
Health Adaptation:
– Educate and aware public and policy makers about
climate change and health impacts including co-
benefits with concerned sectors
– Enhance risk communication and management
– Improve disaster public health preparedness,
planning and emergency response.
– Undertaking vulnerability studies of existing water
supply and sanitation systems and ensuring that new
systems are built to reduce vulnerability
– Strengthen food safety program
The Way Forward

– Enhance surveillance system
– Conduct a study on health impact of climate change
– Encourage active participation of concerned agencies to
mitigate climate change and Work in partnership with
other agencies.
– Thermal stress management
– Strengthen health care services at different levels
2. Disseminate and Implement Policy/Strategy andPolicy/Strategy and
National Environment andNational Environment and ntHealth ActionHealth Action
PlanPlan--NEHAPNEHAP
3. Disseminate National Nutrition Policy/Strategy and
Finalize and Implement Nutrition Action Plan
The Way Forward

Climate Change and Health Adaptation Strategy in Lao PDR

Climate Change and Health Adaptation Strategy in Lao PDR

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