Enhancing Public Health and Climate Resiliency

Armed with knowledge from training conducted by USAID, a community health officer provides medical help to people affected by floods in Sikkim. (Photograph courtesy Krithika Murali)

For Sonamkit Lepcha, the community health officer at the Lingdong sub health center-health and wellness center in North Sikkim, it was like any other day in October 2023. As she stepped out to meet with the community, the Teesta river overflowed and submerged vast areas of villages and towns in North Sikkim. A combination of excess rainfall and a Glacial Lake Outburst Flood event at South Lhonak Lake in North Sikkim triggered the debris flow and flood.

There was no power for days and the paths to the community health center were completely waterlogged. Lepcha and her team soon established a relief camp at Bring Bong, an outpost accessible only through the hardest-hit area, Chungthang Dam. Armed with knowledge from training conducted by the U.S. Agency for International Development (USAID), Lepcha provided crucial antenatal and postnatal care and handled emergency cases.

Through similar interventions, USAID is bolstering the resilience of community and primary health care systems. “This journey began in 2017, when USAID was requested to support the state of Jharkhand for the then newly-launched Ayushman Bharat program. Today, USAID stands as a key partner of the government of India in 12 states,” says Dr. Anuradha Jain, USAID senior advisor for health system strengthening. “Our mission is to revolutionize and reimagine primary health care, making it equitable, inclusive, comprehensive, responsive and client-centered and ultimately improving the health outcomes for India’s population.”

The natural calamity faced by Sikkim vividly underscores how climate change impacts public health outcomes. In 2023, USAID successfully collaborated with the government of India’s National Program on Climate Change and Human Health across 13 states. “This collaboration aims to provide technical assistance for the establishment of green and climate-resilient health care facilities, while enhancing the resilience and client-centered approach of the primary health care system,” says Dr. Neeraj Agrawal, chief of party for USAID’s NISHTHA project, its flagship health system strengthening initiative.

Climate-health intervention

USAID is working closely with the National Program on Climate Change and Human Health. They support the development of State Action Plans for Climate Change and Human Health. Additionally, they are creating models for green and climate-resilient health care facilities and strengthening climate-informed surveillance systems. Furthermore, they are creating awareness through concerted social behavior change communication and community engagement. Finally, they are developing information, education and communication content for different stakeholders on climate-related impacts on health.

Specifically, USAID is supporting 10,792 facilities for surveillance of heat-related illnesses across 297 districts and 90 sentinel sites for surveillance of air pollution-related illnesses in 13 states. Through the NISHTHA project, USAID has trained more than 4,700 public health workers to manage heat-related illnesses, air-pollution-related illnesses and green measures.

Strengthening oxygen ecosystems

During COVID-19, USAID worked on strengthening the oxygen ecosystem in six states in India. One example is the oxygen plant in Odisha, a disaster-prone area where climate-resilient infrastructure was built to protect the oxygen plant from climatic effects. “The implementation of cyclone-resistant concretized structures for 28 oxygen plants in Odisha, especially in the vulnerable coastal districts of Balasore, Bhadrak, Ganjam, Jagatsinghpur, Kendrapada, Khordha and Puri, not only ensured the continuous production of medical oxygen during adverse weather conditions but also contributed to future-proofing the oxygen supply chain,” says, Dr. Jayendra Kasar who led the oxygen strategy for the project. As a result of on-site medical grade oxygen production, there is a significant reduction in the need for transportation of medical oxygen leading to cost savings and environmental sustainability by lowering the carbon footprint associated with transportation of oxygen cylinders and liquid medical oxygen.

Advocating for disaster resilience

The recent flash floods in Sikkim underscored the importance and need for disaster-ready primary health care systems. As part of the International Disaster Risk Reduction Day, USAID helped raise awareness within the health workforce and communities for preparation and prompt action during disasters. The activities included emergency response drills, disaster planning, shelter mapping and awareness sessions for health care staff on identifying and managing heat-related illnesses and preparedness plans for emergency cooling.

USAID also identified the need and advocated with the state government for disaster-resilient structures to house the medical-grade oxygen plants. At the state level, multiple stakeholders were involved in setting up these oxygen plants including infrastructure development, plant procurement, installation, operationalization and maintenance. As part of this extensive technical assistance activity, the USAID-supported state teams worked diligently to bring all stakeholders together and coordinate effectively for the timely operationalization of the plants.

Paromita Pain is an associate professor of Global Media Studies at the University of Nevada, Reno.