Project SIS 06

1. Stakeholder (SH) Engagement and Links to Decision-Making: Adaptation to Climate Change / Variability Impacting on Dengue Fever in Caribbean CountriesSam Rawlins

2. 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.

3. 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.

4. Map of the Caribbean countries

5. 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

7. 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)

8. 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.

9. 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.

10. 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.

11. 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 at-risk group for the DF • From these, information is required on:-

12. 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).

13. Reported Causes of CC in Trinidad communities • Criteria % Comm. Sch • Greenhouse Gases 4.8 5.2 • Holes in the Ozone Layer 23.8 5.2 • Burning Vegetation 14.3 0 • Automobile Exhaust Fumes 4.8 10.5 • All of the Above 47.6 57.9 Don’t know 4.8 15.8

14. 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

15. Health Factors affected by CC/CV in Trinidad Communities • Criteria%Comm. % Sch. • Food-Borne Dis. 14.3 5.5 • Water-Borne Dis. 14.3 11.1 • Vector-Borne Dis. 14.3 11.1 • Respiratory Dis. 0 11.1 • Heat Stresses 9.5 16.7 • All Equally 47.6 38.9 • None 0 5.5

16. 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)

17. 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)

18. 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.

19. 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.

20. Information Sources on CC in 2 Communities in Trinidad • Sources% Comm. % Stud • Peers 0 6.7 • Family 5 0 • News/Journals 30 13.3 • Elec. Media 20 6.7 • All Above 40 26.7 • None 5 26.7 • Personal Obs. 0 20

21. Attitudes and Practices of 2 populations on CC regarding DF and its prevention • Criteria % Comm. %Students • Do Nothing 0 5.3 • Organize an E.S. • Campaign 68.2 63.2 • Leave to PH 31.8 15.8 • Don’t Know 0 15.8

22. Willingness to Participate in Vector Control Action re CC • Criteria% Comm. % Students • Yes 100 94.1 • No 0 5.9

23. Current Personal Involvement in VC activities, related to CC • Criteria% Comm. % Students • Yes 80 31.3 • No 20 62.5 • Don’t Know 0 6.3

24. 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.