Life expectancy is generally considered as a key indicator of the general state of health of the nation. In terms of life expectancy at birth, Moldova is now in a slightly better situation than in the pre-transition era. At the same time, life expectancy is shorter in rural areas than in urban areas (68.2 years and 71.2 years respectively). This is related to a number of factors, including lower levels of access to health care, poor water quality, poverty and cultural factors in rural areas. While the general health of the Moldovan population tended to improve over the past decade, comparative statistics show that the situation in most transition countries has better improved than in Moldova. .
Possible impacts of climate change on health in Moldova
It is clear that climate change and extreme weather phenomena have a direct impact on health. However, it can also affect forestry, agriculture and economy, which would cause problems related to food security and poor sanitary conditions that may lead, in turn, to serious medium and long-term effects on health .
The drought effects on health could, for example, cause a decrease in food production and lead to nutritional problems among the population, making them more vulnerable to diseases.
In an UNICEF survey, conducted in Moldova, local leaders anticipated that the greatest impact of the 2007 drought will be the effect on health. In fact, eight out of ten respondents (and 91% of medical personnel interviewed) consider that it has already made its effect.
However, drought long-term effects can be devastating. Increased competition for arable land can possibly lead to migration to cities and abroad, as well as conflicts along with diminishing resources.
The assessment of risks and opportunities of climate change impacts on health
According to vulnerability assessment regarding risks / opportunities of climate change on health, the most vulnerable regions of Moldova that will be affected by possible climate change will be Chisinau, southern and partly central regions, which, based on expert judgments, the largest number of high-probability risks related to climate change was identified.
It is considered that in Moldova, six of the identified risks should have high priority:
- Increasing number of deaths caused by heat waves;
- Increasing number of diseases caused by air pollution;
- High risk of allergies;
- High risk of drought and water shortage;
- Increasing cases of food- and waterborne diseases.
In this case, there is an opportunity associated with climate impacts on health: reducing mortality due to the cold in winter. However, within these regions, the analysis must be based on the fact that climate change does not affect equally different groups of people: some groups are obviously more vulnerable than others. For example, infrastructure for health care services, is far less accessible in rural areas and the rural population has a larger number of people who are not registered with a family doctor (62% of the total number of people not registered) and a much larger share of people without mandatory health insurance (27.3% of the rural population compared to 19.9% of urban population). Moreover, every third person who does not hold a medical insurance policy is part of the five poorest. Secondly, the rural population (about 60% of the total) is more dependent to decentralized supply of water than the urban population and the decline in water quality will affect the rural population (one of the most vulnerable groups to intestinal diseases are children).
In short, actions to improve adaptation to climate change in the health sector in Moldova could include:
- • The transposition of previous procedures, debated in conferences, into a structured national assessment of climate change medical risk and bringing them to the attention of policy makers;
- discussion and development of adaptation strategies to be used by the health sector to identify health risks associated with climate in the country;
- selecting a governing body that will coordinate the preparation of climate change on public health issues and the reaction to it;
- definition of roles and responsibilities; reviewing and strengthening existing disease surveillance systems in order to include climate-related health consequences, such as the morbidity and mortality associated with the heat;
- identification, monitoring and supervision of risk groups and vulnerable population;
- develop treatment protocols for medical problems caused by climate; health professionals and public awareness;
- training and guiding public health professionals and offering consultation to the population on the measures to be taken during extreme weather phenomena such as heat waves, floods and droughts;
- creating a monitoring and evaluation mechanism to assess the effectiveness of training and necessary measures; examining the cost (and volume) of CO2 emissions and energy used for air conditioning and support the population in alternative cooling methods;
- maintaining international and regional cooperation.