A population's technological vulnerability necessarily reflects its economic
conditions and cultural values. However, it refers particularly to the extent
and quality of those of its technologies that would, intentionally or unintentionally,
affect the health impacts of climate change. Some technologies affect basic
community vulnerability; other technologies affect the capacity to prevent or
treat specific injuries and diseases. The former category includes such things
as: urban design (influencing the heat island effect); types of air-conditioning
(domestic evaporative coolers in New Delhi, India, largely accounted for an
outbreak of dengue in 1997); capacity and integrity of sewer systems (in various
rapidly-expanding developing country cities, systems are seriously overloaded
and would be unable to cope with an increase in precipitation intensity); wholesale
and retail food storage and safety inspection facilities (could be a source
of summer food poisoning outbreaks in warmer climate); housing design (control
of infectious disease vectors); and coastal barriers commensurate with projected
sea level rise and storm surges. The latter category includes such things as:
public education systems (especially via popular media); vaccination programmes;
health-care system capacity, accessibility and organisation; disaster response
capacity; and food reserves and food distribution system. Current barriers to
the implementation of public health "technologies" are listed in
Table 14.3.
| Table 14.3 Current barriers to the
implementation of public health strategies and application of preventive
technologies |
| Barrier |
Manifestation |
Example |
| Low income |
Some people unable to purchase the means to improve health - either directly
from health care provider or via other means |
During cholera epidemic in Brazil, very poor had difficulties in purchasing
filtering devices or rain collecting devices |
| Institutional decentralisation |
Political-administrative decentralisation of the health systems and disease
control programmes |
Local governments are not prepared to take responsibility for health services,
such as malaria control, sanitation, infrastructure building, etc |
| Lack of funding from central government |
Sometimes linked to regional or global economic crises; often linked to
high levels of military spending or to debt repayment programmes from World
Bank and IMF |
Susceptibility of populations in Tajikistan, Somalia and northern Kenya
to mosquito-borne infectious diseases, in wake of political crises, military
action and lack of centrally-provided funds |
| Lack of technological capacity |
Lack of investment in new/up to-date equipment, trained personnel, transport,
etc. |
Lack of refrigerators/cold chain for vaccines, etc.No meteorological radar
for weather early warning systemsLack of aeroplanes for the control of forest
fires |
| Poor communication between institutions |
Inefficient use of limited resources |
Poor inter-institutional co-ordination between disaster relief and public
health agencies |
| Lack of understanding of the underlying issues |
Lack of education and understanding on the links between environment,
ecology and human health |
Ignorance in some traditional communities about the vector-borne basis
of certain infectious diseases.Low appreciation of the physiological stressfulness
of prolonged thermal extremes. |
| Poor policy decisions |
Indiscriminate use of pesticides and anti-malarial drugs |
Rise of resistant mosquitoes and parasite, leading to increased disease
transmission |
| Discrimination |
Vulnerable populations (e.g., poor, illiterate, powerless) may not be
seen as a priority by the politicians and decision makers |
Refugee or ethnic minority populations often do not receive equal access
to health services |