The BMJ Appeal 2023-24: Why the climate crisis is also a crisis for women’s health
BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2930 (Published 13 December 2023) Cite this as: BMJ 2023;383:p2930
The climate emergency is deepening. From the deadly drought in the Horn of Africa to flooding in South Asia, extreme weather events caused by climate change are increasing in frequency and severity at an alarming rate. And women disproportionately bear the brunt of the climate crisis, with disastrous consequences for their health.
Devastatingly, women and children are 14 times as likely as men to die during disasters such as floods, which are worsening with climate change.1 One study analysing disasters in 141 countries found that gender differences in mortality were directly linked to women’s economic and social rights.2 For example, boys were given preferential treatment during rescue efforts and, in the aftermath of disasters, women and girls were more likely to experience food shortages and to have fewer economic resources.
The countries most affected by the climate crisis and its related health consequences are concentrated in Africa, Asia, and Latin America: an estimated 98% of the 400 000 deaths attributable to climate change in 2010 occurred in global south countries.3 Climate change is intrinsically linked to poverty, causing the most harm to the world’s poorest people. It’s also intrinsically linked to gender—both because women make up most of the world’s poor people and because gender norms and their social and economic status make women more vulnerable to the effects of the climate crisis.
Data from the World Bank show that women in the global south are more likely than men to be dependent on agriculture for their food and income.4 Yet floods and droughts cause devastation to crops and farmland, as we saw earlier this year when the longest lasting cyclone ever recorded, tropical cyclone Freddy, hit Mozambique, Zimbabwe, and Malawi, sweeping away homes and affecting more than 500 000 people.
Women’s health needs don’t stop in a crisis
Around 80% of people displaced by the climate crisis worldwide are women.5 They resort to living in camps or temporary accommodation, often exposed to freezing winters or sweltering summers. Diseases spread quickly because of the overcrowded conditions and from living without access to water or sanitation.
This also limits the ability to manage periods safely and hygienically, which can lead to ill health. Women are usually the primary caregivers for children and older people, so they’re placed under heightened stress when climate disasters rob them of their home, source of income, or food security. Time and time again women’s mental and physical health suffer because of climate change.
ActionAid colleagues have seen how health infrastructure is often damaged in the wake of heatwaves, flooding, and wildfires, at a time when the demand for care usually increases. In areas where displaced families settle, the high concentration of people often means that healthcare needs can’t be met—not only services to treat injury or infection but also sexual reproductive care and maternal healthcare needs. Pregnancy doesn’t stop in a crisis. During Uganda’s drought, for example, health facility managers reported that water shortages meant that mothers seeking maternal health services had to fetch water before they could be examined or have procedures.6
The threat of sexual violence increases during extreme weather events, posing another danger to women. Periods of drought in Uganda, for example, were found to coincide with rising rates of domestic violence and sexual abuse, which the United Nations Population Fund attributed to reduced productive activities and family conflict over financial difficulties.6 Women and girls are also at increased risk of sexual violence in drought conditions because they must walk longer distances to collect water, firewood, and food.
Parents struggling to provide for their children can feel as though they have no choice but to consider early marriage for their daughters,7 often resulting in early pregnancy that carries its own severe health risks. Those who are displaced from their homes during extreme weather are vulnerable to rape and trafficking.8
Women’s role in disaster response
A meagre 0.01% of global funding is spent on initiatives aimed at both climate change and gender, the United Nations has reported.9 This makes tackling the disproportionate effects of the climate crisis on women extremely challenging. It’s widely understood that climate change disaster support must be tailored to the specific needs of the people most affected, but women’s voices must be central to determining those needs. Maternal healthcare and provisions for menstruation are often forgotten in the wake of extreme weather events, even though these are as much necessities as food and water.
It’s also clear that the role of women in disaster response extends beyond articulating what resources women need to survive. Research shows that women’s community level leadership improves the humanitarian response to disasters, ensuring that it’s more inclusive and builds resilience for future emergencies.10 Women contribute skills and local expertise that lead to better health, safety, and wellbeing outcomes for all. ActionAid is already witnessing the positive effects of women playing a crucial role in disaster response and preparedness, partnering with women in Nepal and Cambodia who are leading disaster committees in their communities.
The United Nations’ COP28 climate change conference, taking place this past week, included the fresh political idea of a “health day.” The return of the World Health Organization’s health pavilion also offered an opportunity for climate experts at the conference to engage with health issues and for health experts to join discussions on climate action. During the conference ActionAid shone a light on the chronic underspending on women’s needs in climate change disasters, including health; called for more climate finance to reduce the risks women and girls face; and advocated for more women’s leadership and localisation in disaster preparedness and response so that women’s and girls’ needs are never sidelined.
Above all else, health discussions must take place through a gendered lens, recognising that climate change is a feminist issue. Tackling gender inequality is non-negotiable if we hope to survive and build resilience to the climate related disasters to come.
The BMJ’s 2023 annual appeal supports ActionAid’s work with women and girls in over 45 countries to help achieve social justice and gender equality and to eradicate poverty. Shifting the power and working directly with women and girls, including in humanitarian emergencies, means that women’s specific health needs are less likely to be overlooked, putting them in a better position to build the future they deserve.
Please donate to help women and girls live full, safe, and healthy lives, regardless of where they’re born.
You can donate now at https://actionaid.org.uk/changelives/bmj-annual-appeal-2023-24
Footnotes
Competing interests: None declared.
Provenance and peer review: Commissioned, not externally peer reviewed.