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Stakeholder (SH) Engagement and Links to DecisionMaking: Adaptation to Climate Change / Variability Impacting on Dengue Fever in Caribbean Countries Sam Rawlins Project SIS 06 • The University of the West Indies (UWI), Climate Unit, Mona, Kingston, Jamaica. • The Caribbean Epidemiology Centre (CAREC), Port of Spain, Trinidad and Tobago. • UWI Dept of Pathology, Trinidad. • 21 Caribbean Countries anti-DF programs. Introduction • Dengue Fever (DF) is endemic in virtually all Caribbean Countries. • There has been a significant increase of prevalence and severity in the last two decades. • There has been greater occurrences in El Nino and El Nino+1 years, suggesting a Climate Change (CC) correlation. Map of the Caribbean countries Dengue in the Caribbean: In light of the temperature trend (previous diagram), the increase in dengue since 1992 could be due to increasing temperatures - See black circles El Nino El Nino + 1 Decisions which may be influenced by this project • Reduction of Dengue fever cases (occurrence), related to CC/V • Thro’ the reduction of mosquito vectors (Aedes aegypti) • Thro’ the reduction of potential habitats increased thro’ appropriate climate conditions • Thro’ Environmental Sanitation (ES) Decision-Makers Include:• Public Health authorities (Ministries of Health) in our 21 Member countries • Focal Points in public health – Vector Control Staff, Epidemiologists, Educators • Local Govt. staff who facilitate anti-DF action • Contd. Decision-Makers contd. • Communities who are at risk for DF and who must implement anti-DF action • Families who are at risk and must participate in anti-vector action • Individuals who are at risk and must be part of the solution • The scientific community who must be sensitized for positive influence. Research is Relevant as follows • To confirm a link between CC/V and DF vector production and DF Cases • Predict which CC conditions are most appropriate for DF transmission • Inform what ES actions are necessary to prevent increase in vectors and DF cases • Provide results useful for public education programs for mitigation and adaptation. Stakeholders engaged in the Project • Ministries of Health: Participation in Epid. and CC data collection • Scientific community will evaluate the evidence. • Communities in the Caribbean are the atrisk group for the DF • From these, information is required on:- Stakeholders information on CC • • • • • Understanding of the concept of CC Perception of how CC affects us Sources of info on CC Self-reported action on DF prevention Willingness to act further on DF prevention if CC link could be demonstrated • Actual proof of current action (inspection). Reported Causes of CC in Trinidad communities • • • • • • Criteria % Greenhouse Gases Holes in the Ozone Layer Burning Vegetation Automobile Exhaust Fumes All of the Above Don’t know Comm. Sch 4.8 5.2 23.8 5.2 14.3 0 4.8 10.5 47.6 57.9 4.8 15.8 How Climate Change Affects Two Trinidad Communities • • • • • • • Criteria (%) Comm. Sch., Health 37.5 7.1 Water Resources 12.5 0 Agriculture 12.5 14.3 Biodiversity 4.2 7.1 Coastal degradation etc. 4.2 14.3 All Equally 29.2 50 Health Factors affected by CC/CV in Trinidad Communities • • • • • • • • Criteria Food-Borne Dis. Water-Borne Dis. Vector-Borne Dis. Respiratory Dis. Heat Stresses All Equally None %Comm. 14.3 14.3 14.3 0 9.5 47.6 0 % Sch. 5.5 11.1 11.1 11.1 16.7 38.9 5.5 Benefits (B) and Costs (C) of Researchers working with Stakeholders • Bringing a Global concept Local (B) • Empowering the local scientific – climate and epidemiologic – community (B) • Brining a new practical tool to Public Health (B) • Spending time and other resources on the project (C) Benefits (B) and Costs (C) to the Stakeholder • Accessing modern technology tools for DF prevention (B) • Possibility of applying this tool to other areas of health (B) • Possible application of CC tools to other areas e.g. Water res., Biodiversity, Agric., Coastal Degradation (B) • Scarce resources now being utilized without a clear assurance of outcome (C) Appropriate Role of SHs in assessing CC vulnerability • Data collection for research (MoHs; Cl.Gp) • Appropriate response to prediction info e.g. ES improvement at risk times (MoHs Comm.) • Health education and promotion (MoH) • Participation of Scientific Research Gp. on interpretation of Disease & CC info. Assessment Design and Implementation for better service • In a manner that is clear (to the layman) & convincing of CC & vulnerability • If Stakeholders can be comfortable enough with the concepts to accept this as their own project, if • The benefits (adaptation) can be clearly discernible and demonstrated. Information Sources on CC in 2 Communities in Trinidad • • • • • • • • Sources % Comm. % Stud Peers 0 Family 5 News/Journals 30 Elec. Media 20 All Above 40 26.7 None 5 Personal Obs. 0 6.7 0 13.3 6.7 26.7 20 Attitudes and Practices of 2 populations on CC regarding DF and its prevention • • • • • • Criteria Do Nothing Organize an E.S. Campaign Leave to PH Don’t Know % Comm. %Students 0 5.3 68.2 31.8 0 63.2 15.8 15.8 Willingness to Participate in Vector Control Action re CC • Criteria • Yes • No % Comm. % Students 100 94.1 0 5.9 Current Personal Involvement in VC activities, related to CC • Criteria % Comm. % Students • Yes • No • Don’t Know 80 20 0 31.3 62.5 6.3 Conclusion • There is a need for appropriate info to show to our SHs, the link of VBDs & CC; only 11 – 14% now are aware. • Such health Promotion for the younger sector is very important. • Results of this study could stimulate all SHs into action.