The health effects of drought and our role in planning
Dr Ayman Shenouda
Last week’s blog on GP-led strategies to reach out to drought-affected farmers has started some good discussion around the role of GPs and our broader public health role.
What we are seeing is a significant drought particularly in the worst-affected parts of NSW where the current dry conditions have spread to most inland parts of the state.
The recent media focus is a good thing to keep some philanthropic and government dollars flowing, but we really need a better preventative strategy to protect our farmers and our food resources from these extremes.
What we are seeing is reactive policy which only demonstrates the ineffectiveness of our national drought management policies.
While short-term drought-related health shocks can be more obvious, it is those longer term, more indirect health implications that are harder to measure and monitor.
In helping our communities prepare for drought, GPs should have a leading public health role in developing drought-related public health vulnerability assessments.
This involves working with the community and key partners to ensure coordinated preparedness and response efforts. Staying engaged through non-drought periods is essential.
Here are some key steps that we could consider in undertaking drought planning and vulnerability assessments in our own communities.
Identify vulnerable populations
It is clear that drought severity and the vulnerability of particular populations requires a more targeted and planned response.
While the health effects of drought can be severe, the health disparities in diverse rural communities can make public health planning a challenge.
This is why GPs need to have an active role in identifying those priority groups within our community.
Most rural practices sustain themselves by being attentive to key changes within their communities and know how to work within constrained resources.
We need to allocate a greater proportion of total health resources to drought impact mitigation and prevention.
A key part of this is enabling planning and establishing a leadership role for GPs in decisions to develop appropriate models of health care for these at-risk groups.
It is important to note that there is also a doctor drought in some regions too.
The distribution of GPs to underserved areas requires similar planning together with ensuring the adequacy of health infrastructure for longer-term service viability.
Make disease projections
We need more data around this but generally, populations face an increased risk of illness in the year they are exposed to drought.
A formal role for GPs in addressing the data gaps to build more evidence around the causal links between health and the environment is needed to inform future policy nationally.
More research dollars and faster research into what works at the local level to help us better understand the risks and health status of populations.
This requires a sustained research effort and is part of a broader investment strategy and structured support towards disease prevention.
Planning for specific health effects
Droughts have many consequences for health. Social impacts are quite obvious as drought contributes to debt burden and the psychological impacts run deep.
Generally, we will see more air and water-borne diseases and infections, with effects on air quality including related respiratory illness.
The worsening of chronic illnesses and mental health conditions through social impacts and compromised food and nutrition.
The more immediate impacts of heat include increased risk of dehydration and heat stress.
A community capacity-building program for drought response should be prioritised to both assess drought impacts and explore actions in response from a health perspective.
We have a good understanding of what the health vulnerabilities are for our own communities in times of drought. Allocation of funds towards drought mitigation in relation to health is needed.
Establish intervention strategies
Inadequate social impact indicators make this task harder but we need to think about building resilience to drought.
In building resilience, implementing critical programs to protect the most vulnerable health populations in specific locations is important.
Building the evidence base for population-level interventions will also help close the gap between research and practice.
A national program to support communities to undertake drought-related public health vulnerability assessments is a good way to make this happen.
GPs should have a leading role in supporting proactive mitigation and health planning measures in managing drought risk and health impacts for their communities.
Dr Ayman Shenouda