Minister of Health, Dr. Austin Demby, on Thursday 4th April 2024, officially launched Sierra Leone’s first ever Climate-Health Unit at the Atlantic Hotel in Freetown. The launch reinforces the Ministry of Health’s determination to adapt and mitigate the adverse effects of climate change on health.
The impacts of climate change are already being felt in Sierra Leone with far reaching consequences. Unusual rainfall patterns, rising sea level and heat waves are driving these changes. In Freetown, a city nestled between the Atlantic Ocean and the mountain range with natural landscape, the problem is further aggravated by an alarming deforestation driven mainly by acute housing challenge and poor urban planning.
In 2017, part of a hill collapsed bringing with it huge earth and boulders on the densely populated community of Mortomeh. Over 1000 people lost their lives with thousands left homeless. It was the worst climate related disaster the country has suffered in recent memory. Unusual rainfall was blamed for the catastrophe, a grim reminder of the worsening global climate crisis.
But the global climate crisis has far more reaching social and economic implications than the immediate disasters that may occur. Climate change has a devastating impact on human health and well-being. The World Health Organization (WHO) estimates that between 2030 and 2050, climate change will cause an additional deaths of roughly 250,000 per year from diseases like malaria, diarrhoea and heat stress. These climate related challenges will cost the health sector, including others like agriculture and water and sanitation, which are dependent on health, an estimated US$2-4 billion per year by 2030.
It is in recognition of this critical nexus between climate change and health that at COP28 last year, health was well spotlighted with an inaugural and historical Health Day, which gave African health experts the opportunity to demand for adequate infrastructure and training of the continent’s health workforce. But, it was also a chance for smaller nations like Sierra Leone to make bold commitments to go green for health and to raise awareness about the need for Africa to deal with the attendant health implications of the global climate crisis.
In fulfilment of that bold declaration at COP28 in Dubai, the Minister of Health on Thursday 4th April this year, inaugurated Sierra Leone’s first climate health unit and also launched the climate vulnerability assessment report. The new unit will help the health sector withstand and respond to climate health risks. Prior to the launch of this unit, last year President Julius Maada Bio also launched Sierra Leone’s National Public Health Agency, an institution charged with the responsibility to prevent, prepare for, and respond to potential public health emergencies. NPHA is that agency that is looking out for the public by putting out feelers to see what is going on in communities, and be able to detect and mount a robust response. So what value can these institutions add to the climate response and how is the ministry preparing for the attendant health implications of climate change?
In this interview, the Minister of Health, Dr. Austin Demby, speaks exclusively to Abdul Brima about the complex intersections between climate change and health and what the health sector is doing to mitigate and adapt.
Question:
Over the years we have seen how Sierra Leone has been able to respond to public health emergencies. You look at Ebola and the lessons learnt from that impacted our response to Covid-19. How have those lessons prepared us to respond to any future climate related health disasters?
Well I think the Ebola experience taught us a lot of lesions as to how we should be prepared and how to effectively respond. As you rightly said, it was lesions learnt from Ebola that allowed us to mount a very robust response to Covid-19 and that was why we had very small numbers of infection and small numbers of death in our country.
For us as you do these things, it is important to have a systems approach to it. So, not just wait for one crisis and you assemble teams together and mount a response and at the end of the crises you drop your guard down and wait for the next one. So, what we have now is for Sierra Leone to build on all these past experiences and create an institutional home for our ability to prepare for and effectively respond. So that is why we have established the National Public Health Agency here. So our interest is not just on climate and health but all emergencies. And I think what we want to do is to be able to prepare for them. For example, we know the consequences of climate change. We are going to have an increase in rainfall. We are going to have devastating consequences of that rainfall. We are going to have rodents and vectors expand their range as a result of that. And so what you want is an agency that is looking out for the public that is able to put out fillers to see what is going on in the community and be able to detect it early and mount a response. So from a climate standpoint, the NPHA is going to be critically important to help us prevent, prepare for, and adequately respond to health emergencies.
Question:
From a policy standpoint, what premium do you think that the government is attaching to climate and health?
Well, we were in Dubai for CORP28 and in Dubai, we made this incredible commitment that as a nation, we will go green for health. What that means is that even though we have very minimal contribution to greenhouse gases, we still rely on diesel-powered generators to run some of our hospitals when the main power fails. What that means is that we are not just churning out toxic hydrocarbons on the one hand, but we are also just really expending tremendous amounts of resources and in some cases close to 20% of our resources buying fuel to run these generators. What we are trying to do in Sierra Leone is to completely move away from that and go completely green by looking for renewable energy sources here and ensure that all of our sixteen hundred (1600) facilities go green.
As we work towards 2030, we are going to improve the number of facilities from 1600 to about 2000 and so we are saying that with all of these new facilities, we are going to be very conscious of our energy needs. We are going to be conscious of our climate and ensure that we are looking at renewable energy sources as we move forward. Similarly, we are looking at all of the ambulances that we have. Most of the ambulances are stationary, they are waiting several hours before they are called out, and when they are called, they need to rush to these places and be responsive quickly.
They require fuel and one of the limitations here is the ability to fuel these ambulances. So what we are looking at now is hybrid ambulances that have solar panels attached so that they would be charging while waiting for the calls. When the calls come, the ambulances will have a minimum amount of carbon immediate fuel and at the same time rely on solar energy to be able to power them.
We are also looking at solar power motorcycle ambulances for remote locations so that in these remote sites, they will be able to take patients to the main roads and be able to link them up with the main ambulance system. Finally, we are going for LED lights sources that will dramatically reduce the power consumption within the Ministry of Health. For us, that is our contribution to limiting greenhouse gases, on the one hand, but it has the incredible effect of bringing efficiency in quality of care to the people of Sierra Leone. So we are going green and we are going green deliberately.
Question:
For you, what is that one thing that keeps you motivated and wanting to do more in the climate and health space?
Well, the climate situation will not go away if we don’t do something about it. So in a country like Sierra Leone, we have a lot of the assets that are available to us. We have sunlight, we have an abundance of water. What we want is to be able to have a system that has clear redundancy built in, such that if you are in an area that gets flooded and you get cut off, you are able to utilise other amenities that are available to you if you cannot cross the river on one side.
We want to have a situation where all of the schools are clued into ensuring that we are growing trees, we are maintaining our environment and we are securing our coastal waters. We want to build this into the fabric of our nation especially in the health sector.
We want our hospital facilities to be green, to have trees. Trees are not only good for protecting against the hazards of the sunlight, but they produce so much oxygen that is nearly therapeutic. So, we are doing a lot of these climate related activities in so many other sectors; but I think health is a discrete area and we want to lead by what we do every day.
Finally, how do you think that countries in Africa can really prepare for and respond to eventual climate disasters?
This is one of the times in our lives that you really see the world order changes right under our noises. This is the time for Africa. We have an incredible amount of sunlight here. Even our deserts could be converted to major energy sources for the continent.
We have a very, very youthful and dynamic population. They are going to be here for the next 60 to 70 years. They will have to be actively involved in preparing the Africa they want and the Africa they need. So I’m very bullish, very enthusiastic and very energized because we have the people, we have the resources, we have the energy, we have the drive, we have the leadership that is pointing us in the right direction and I think we should all watch out for this space. This is the era for Africa and we have to take advantage of it.
Here is a video highlight of the Minister’s interview.