Will climate change cause more complex effects on sexual and reproductive health?
The Zika viral epidemic represents a perfect storm of climate change, disease, sexuality and reproductive health. In 2009, I was deeply interested in the effects of climate change worldwide. I work for a regional organisation and I was studying trends which I thought would impact women’s health and rights.
Disasters – both natural and climate change induced were one of these trends. Three key events stood out in my memory; the 2004 Indian Ocean tsunami, the 2008 Cyclone Nargis in Myanmar and the 2010 Pakistan floods. These incidents affected the partners we work with on the ground, and many had rushed in to deliver aid. A number of partners talked about the need of access to comprehensive sexual and reproductive health services, occurrences of sexual violence, and of course the need for camps to be set up in a manner that suited the needs and realities of women. One of the activists in my circle told me that after the tsunami, women who had tubal ligation in Tamil Nadu, had fought for and won the right to reverse tubal ligation, because they had lost their children in the tsunami. I was often on the lookout for such interesting angles to sexual and reproductive issues during the times of disaster.
In 2009, I read an Oxfam briefing paper which posited that the greatest impact of climate change will be on people’s health. This seemed to reiterate all the experiences I had with partners. This paper also talked about a particular health challenge – the increase in water-borne, insect-borne, vector-borne diseases due to increases in temperature and rain, and the inability of health and municipal services to be able to plan and manage these changes.
In Malaysia, we have seen year-on-year drastic increases of dengue, and it helped me connect this issue with the larger, little explored connection with climate change. Even in my country, health personnel often attribute it to different things such as; newer, pesticide-resistant mosquitoes and lack of civic consciousness of citizens. However, this was an interesting angle, and of course I could also pick up on the regional stories of dengue and Chikungunya in the Philippines, Indonesia and India.
Naturally, when the first stories of Zika surfaced, these three connections came foremost to my mind.
The first stories revealed that the virus was first reported in May in Brazil, there was an increase in the births of babies with microcephaly – around 3700 to 4000 between October and now. Many were aghast because this spike of babies with microcephaly puts stress on health services, families and communities – and even on educational services. Since the Zika virus manifests itself in indiscernible ways, women may not know that they have contracted the virus, if pregnant – until they deliver. A week ago, I was sitting on a panel in an international conference – when the astonishing news broke that the solution El Salvador presented was that women must avoid pregnancy till 2018 due to the potentially dangerous Zika virus.
Just yesterday, the first case of the sexual transmission of Zika has been recorded in Texas. But in 2013 itself, the possibility of sexual transmission of Zika had been published in medical journals by looking at the case study of an infected person in Tahiti. Some attribute the fast spread of Zika due to dual transmission modes.
It is equally interesting to consider that the largest outbreak is occurring in a region, which has highly restrictive abortion laws and access to contraceptives including condoms is limited due to socio-religious norms.
Many years ago, I wrote a proposal which posited this hypothesis: an undue burden will be placed on women who live in countries which face climate change and have fundamentalist policies (influenced by religion, and do not recognise sexual and reproductive rights) because they will be denied access to essential services. This viral epidemic is one such example.
A comprehensive approach is needed to combat diseases such as these.
One, access to dual-protection methods (pregnancy prevention and safe sex) is essential.
Two, access to comprehensive maternal health services: ante-natal scans to enable early detection, access to pregnancy termination (as a choice), and safe delivery and neo-natal care (as a choice).
Three, understanding that as time goes by, climate change will only cause more complex effects on sexual and reproductive health, and in order to cater for this we need policy, programme and paradigm change, which enables individuals and couples to be able to make decisions about their bodies and lives.
In the longer run, in order to create more resilient societies, which can cope with the multifarious effects of climate change, it would be essential to recognise the rights and agency of individuals and couples. We must further ensure that community systems are built with this perspective in mind. To stop this now, we have to start this now.