Global Climate Change, Population Displacement, and Public Health: The Next Wave of Migration 3030418898, 9783030418892

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Lawrence A. Palinkas

Global Climate Change, Population Displacement, and Public Health The Next Wave of Migration

Global Climate Change, Population Displacement, and Public Health

Lawrence A. Palinkas

Global Climate Change, Population Displacement, and Public Health The Next Wave of Migration

Lawrence A. Palinkas Suzanne Dworak-Peck School of Social Work University of Southern California Los Angeles, CA, USA

ISBN 978-3-030-41889-2    ISBN 978-3-030-41890-8 (eBook) https://doi.org/10.1007/978-3-030-41890-8 © Springer Nature Switzerland AG 2020 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

To my children and grandchildren, partners in the struggle to give hope to future generations.

Preface

The history of the United States usually acknowledges four major waves of migration. This timeline ignores the fact that the first immigrants to the North American continent arrived from Asia. The first wave occurred during the seventeenth century when colonists arrived from England and northern Europe beginning in 1609, and slaves arrived from Africa beginning in 1619. This wave lasted into the eighteenth century, peaking shortly before the American Revolution. The second wave lasted about 50 years, through the mid-nineteenth century, and brought mostly Irish and Germans to the United States. The third wave began in the late nineteenth century and lasted about 40 years, bringing in millions of immigrants from southern and eastern Europe and Asia. The fourth wave began after US immigration law abolished quotas based on nationalities in 1965 and continued into the first decade of the twenty-first century. It has been the largest immigration wave in US history. The majority of immigrants in this wave came from Latin America and Asia. At the present time, the United States is experiencing a new wave of migration. Like previous waves, many immigrants in this most recent wave have been motivated to come to America by a desire to flee extreme poverty and violence. Many have come officially in their status as refugees from war-torn nations such as Syria. Others have arrived without legal status but nevertheless seeking asylum from nations such as El Salvador, Nicaragua, and Guatemala. Despite differences in language and culture, these new migrants share in common a perceived need to relocate that has been initiated or accelerated by profound changes in the physical environment resulting from climate change. Unlike previous waves of immigrants, this next wave has not been met with open arms, as the federal government has enacted policies and procedures designed to prevent this wave from entering the country. In this respect, the United States is not alone. Similar efforts have been initiated by and within the European Union, Australia, and throughout South and Southeast Asia to restrict the flow of migrants arriving from countries like Bangladesh that are also experiencing climate-related environmental changes. However, based on projections released by the Intergovernmental Panel on Climate Change (IPCC), this next wave will only continue to grow in size and intensity in coming years. With increased efforts to restrict vii

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the flow of international migration, much of this next wave of displaced migrants will occur within national borders. Similar to the great migration from the “Dust Bowl” of the American Great Plains in the 1930s, changes in the physical environment are expected to result in large numbers of Americans relocating to places of the country less susceptible to hurricanes, floods, fires, droughts, rising temperatures, and sea level rise. Unfortunately, those places are becoming much harder to find. This book is not intended to make a case that climate change is happening or that it is caused by human activity. That case has already been well documented. Rather, its intention is to examine how climate change and its resulting impacts on the physical environment has already and is likely to be directly or indirectly related to both voluntary and forced migration of millions of people around the world. Directly, this migration has been precipitated by rising sea levels or prolonged drought that has made the land simply uninhabitable. Indirectly, migration has been precipitated by civil conflicts or extreme poverty, which are consequences of change in the physical environment. In either instance, these changes have resulted in profound changes in health and well-being. These changes are the focus of this book. In the past decade, several different labels have been applied to this next wave of migrants. Often referred to as climate refugees or environmental refugees, the term refugee has often been objected to by governments and scholars on the grounds that these migrants do not meet the definition of refugee as established by the 1951 Geneva Convention, that the term itself is derogatory and discriminatory, and that not all climate-related displacement is forced. In response to these arguments, although the term has been recently used to describe climate-related displacement that is forced, planned, and involves entire communities, I have elected to refer to these individuals as “climigrants” which ignores the distinction between forced and voluntary migrants, but rather focuses on the circumstances they have in common which have less to do with their experiences prior to migration and more to do with their experiences during and after relocation elsewhere. For me, the issue of climigration is a personal as well as professional one. A long-time resident of Southern California, I have experienced firsthand the challenges of being a particular form of climigrant, one who must evacuate in the face of an oncoming wildfire. In 2003, the home we had lived in for 10 years in the quiet neighborhood of Scripps Ranch in San Diego burned to the ground in the infamous Cedar Fire. Fortunately, we had moved from the home 1 year prior to that, but we showed up to help the residents sift through the ashes, looking for valuable mementos of their past. Since then, we have twice been forced to evacuate from our current home in the face of threatening wildfires. Our evacuations were temporary, lasting no more than a few days each, but the experience made us appreciate the profound sense of loss that comes to anyone who has lost everything and nowhere to go. Although this book represents the work of researchers from several different disciplines within and outside the academy, I wish to acknowledge in particular my colleagues engaged in the Social Work Grand Challenge to Create Social Responses to Changing Environments, whose invaluable advice and support helped to shape the ideas contained within this book. Among others, this distinguished group of

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scholars includes the following: Susan Kemp, Marleen Wong, Vivien Villaverde, Lisa Reyes Mason, Russell Vergara, Samantha Teixeira, and Shanondora Billiot. I am also thankful to Janet Kim, publishing editor at Springer, and anonymous reviewers for valuable comments and guidance. Los Angeles, CA, USA  Lawrence A. Palinkas

Abbreviations

ABM ACLED ADB ALE ANTHC AOD ASCAD ASEAN BETO CBITS CDC CETA CFIR COPD CPPR CRED CSIRO DRRM EBT EJF EMDR ENSO EPA EPIS

Australian Bureau of Meteorology Armed Conflict and Location Event Data Asian Development Bank Additional living expenses Alaska Native Tribal Health Consortium Adjusted odds ratio Arab Center for the Studies of Arid Zones and Dry Lands Association of Southeast Asian Nations Bioenergy Technologies Office Cognitive-Behavioral Intervention for Trauma in Schools US Centers for Disease Control Common elements treatment approach Consolidated Framework for Implementation Research Chronic obstructive pulmonary disease Community Partnered Participatory Research Centre for Research on the Epidemiology of Disasters Commonwealth Scientific and Industrial Research Organisation Disaster Risk Reduction and Management Evidence-based treatment Environmental Justice Foundation Eye Movement Desensitization and Reprocessing El Niño-Southern Oscillation US Environmental Protection Agency Exploration, Preparation, Implementation and Sustainment Framework EU European Union EWE Extreme weather event FAO Food and Agriculture Organization (United Nations) FEMA Federal Emergency Management Agency FEWS NET Famine Early Warning System Network FIT Families in Transition xi

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GAD GAO GCM IASC IAWG ICARDA ICS IDA IDP IFRC IOM IPCC ISF LHW MASA MDD MDG MED MFG NCD NCTSN NDMA NET OCHA OR ORR PERLC PERRC PFA PICTS PM PM+ PMTO PST PTSD RCT RE-AIM SciTS SDG SFP SIC SIDS SLR SOLAR

Abbreviations

Generalized anxiety disorder US Government Accountability Office Global Compact for Safe, Orderly and Regular Migration Inter-Agency Standing Committee (World Health Organization) Immediate Action Workgroup International Center for Agricultural Research in the Dry Areas Incident Command System Individual development accounts Internally displaced persons International Federation of Red Cross and Red Crescent Societies International Organization for Migration Intergovernmental Panel on Climate Change Interactive Systems Framework Lay health worker Ministry of Agriculture and Food Security, Mozambique Major depressive disorder Millennium Development Goals Microenterprise development Multiple Family Group Noncommunicable diseases National Child Traumatic Stress Network National Disaster Management Agencies Narrative Exposure Therapy Office for Coordination of Humanitarian Affairs (United Nations) Odds ratio US Office of Refugee Resettlement Preparedness and Emergency Response Learning Centers Preparedness and Emergency Response Research Centers Psychological First Aid Pacific Island Countries and Territories Particulate matter Problem Management Plus Parent Management Training—Oregon Problem-Solving Treatment Post-traumatic stress disorder Randomized controlled trial Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework Science of Team Science Sustainable Development Goals Strengthening Families Program Stages of Implementation Completion Scale Small Island Developing States Sea level rise Skills fOr Life Adjustment and Resilience

Abbreviations

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TDI TF-CBT TST TTIM U5MR UNDRR UNESA UNESC UNESCAP

Translation, Dissemination, and Implementation Initiative Trauma-Focused Cognitive-Behavioral Therapy Trauma Systems Therapy Teacher Training Implementation Model Under-five [years of age] mortality rate United Nations Office of Disaster Risk Reduction United Nations Department of Economic and Social Affairs United Nations Economic and Social Council United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific United Nations Framework Convention on Climate Change United Nations High Commissioner for Refugees United Nations Office for the Coordination of Humanitarian Affairs US Army Corps of Engineers US Global Change Research Program US Agency for International Development Vanuatu Climate Change and Disaster Risk Reduction Policy World Food Program (United Nations) World Health Organization World Health Organization Africa Region World Health Organization Southeast Asia Region World Health Organization Western Pacific Region

UNFCCC UNHCR UNOCHA USACE USGCRP USAID VCCDRRP WFP WHO WHO AR WHO SEA WHO WPR

Contents

1 Introduction����������������������������������������������������������������������������������������������    1 1.1 The Wet and the Dry ������������������������������������������������������������������������    1 1.2 The History of Climate Change and Population Displacement��������    2 1.3 The Present Day��������������������������������������������������������������������������������    3 1.4 Aims of the Book������������������������������������������������������������������������������    8 1.5 Organization of the Book������������������������������������������������������������������    9 References��������������������������������������������������������������������������������������������������   10 Part I Acute Climate-Related Events 2 Hurricane Katrina and New Orleans����������������������������������������������������   17 2.1 The Narrative������������������������������������������������������������������������������������   17 2.1.1 The Event������������������������������������������������������������������������������   17 2.1.2 The Displacement ����������������������������������������������������������������   17 2.2 Hurricane Katrina������������������������������������������������������������������������������   18 2.3 Patterns of Displacement������������������������������������������������������������������   19 2.3.1 Numbers of Climigrants��������������������������������������������������������   19 2.3.2 Displacement-Related Decisions������������������������������������������   20 2.4 Characteristics of the Displaced��������������������������������������������������������   23 2.5 Impacts of Displacement������������������������������������������������������������������   25 2.5.1 Impacts on the Displaced������������������������������������������������������   25 2.5.2 Impacts on Community of Origin ����������������������������������������   27 2.5.3 Impacts on Host Communities����������������������������������������������   28 2.6 Lessons Learned��������������������������������������������������������������������������������   28 References��������������������������������������������������������������������������������������������������   29 3 Hurricane Maria and Puerto Rico ��������������������������������������������������������   35 3.1 The Narrative������������������������������������������������������������������������������������   35 3.1.1 The Event������������������������������������������������������������������������������   35 3.1.2 The Displacement ����������������������������������������������������������������   36

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3.2 Hurricane Maria��������������������������������������������������������������������������������   36 3.2.1 The Damage��������������������������������������������������������������������������   36 3.2.2 The Deaths����������������������������������������������������������������������������   37 3.3 Patterns of Displacement������������������������������������������������������������������   38 3.3.1 Numbers of Climigrants��������������������������������������������������������   38 3.3.2 Displacement-Related Decisions������������������������������������������   39 3.4 Impacts of Displacement������������������������������������������������������������������   44 3.4.1 Impacts on the Displaced������������������������������������������������������   44 3.4.2 Impacts on Community of Origin ����������������������������������������   45 3.4.3 Impacts on Host Communities����������������������������������������������   46 3.5 Lessons Learned��������������������������������������������������������������������������������   47 3.5.1 Post-Maria Climigration and Puerto Rico’s Historic Pattern of Circular Migration����������������������������������   47 3.5.2 The Disparity of Climigration����������������������������������������������   48 3.5.3 Maria as a Template for Subsequent Disasters ��������������������   48 References��������������������������������������������������������������������������������������������������   50 4 The California Wildfires��������������������������������������������������������������������������   53 4.1 The Narrative������������������������������������������������������������������������������������   53 4.1.1 The Event������������������������������������������������������������������������������   53 4.1.2 The Displacement ����������������������������������������������������������������   54 4.2 The Wildfires������������������������������������������������������������������������������������   54 4.3 Patterns of Displacement������������������������������������������������������������������   55 4.3.1 Numbers of Climigrants��������������������������������������������������������   55 4.3.2 Displacement-Related Decisions������������������������������������������   57 4.4 Impacts of Displacement������������������������������������������������������������������   60 4.4.1 Impacts on the Displaced������������������������������������������������������   60 4.4.2 Impacts on Community of Origin ����������������������������������������   61 4.4.3 Impacts on Host Communities����������������������������������������������   62 4.5 Lessons Learned��������������������������������������������������������������������������������   63 4.5.1 Disparities in Risk and Resilience����������������������������������������   63 4.5.2 Wildfire Evacuees as Climigrants ����������������������������������������   63 References��������������������������������������������������������������������������������������������������   64 Part II Long-Term Climate-Related Events 5 Fleeing Drought: The Great Migration to Europe��������������������������������   71 5.1 The Narrative������������������������������������������������������������������������������������   71 5.1.1 The Event������������������������������������������������������������������������������   71 5.1.2 The Displacement ����������������������������������������������������������������   71 5.2 The Great Migration ������������������������������������������������������������������������   72 5.2.1 Syria��������������������������������������������������������������������������������������   73 5.2.2 Sub-Saharan Africa ��������������������������������������������������������������   73 5.3 Patterns of Displacement������������������������������������������������������������������   77 5.3.1 Numbers of Climigrants��������������������������������������������������������   77 5.3.2 Displacement-Related Decisions������������������������������������������   78 5.3.3 Return Migration������������������������������������������������������������������   82

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5.4 Impacts of Displacement������������������������������������������������������������������   82 5.4.1 Impacts on the Displaced������������������������������������������������������   82 5.4.2 Impacts on Community of Origin ����������������������������������������   85 5.4.3 Impacts on Host Communities����������������������������������������������   86 5.5 Lessons Learned��������������������������������������������������������������������������������   88 5.5.1 The Great Migration as a Template for Other Climigrations due to Drought ����������������������������������������������   88 5.5.2 Drought and Disparity����������������������������������������������������������   90 5.5.3 Designation of Climigrants as Refugees������������������������������   91 References��������������������������������������������������������������������������������������������������   91 6 Fleeing Flooding: Asia and the Pacific ��������������������������������������������������   99 6.1 The Narrative������������������������������������������������������������������������������������   99 6.1.1 The Event������������������������������������������������������������������������������   99 6.1.2 The Displacement ����������������������������������������������������������������   99 6.2 Flooding and Sea Level Rise������������������������������������������������������������  100 6.2.1 Bangladesh����������������������������������������������������������������������������  101 6.2.2 Small Island Developing States (SIDS) in the Pacific����������  102 6.2.3 North Korea��������������������������������������������������������������������������  103 6.3 Patterns of Displacement������������������������������������������������������������������  103 6.3.1 Numbers of Climigrants��������������������������������������������������������  103 6.3.2 Displacement-Related Decisions������������������������������������������  106 6.4 Patterns of Relocation ����������������������������������������������������������������������  112 6.4.1 Forced and Voluntary Relocation������������������������������������������  112 6.4.2 Internal Relocation����������������������������������������������������������������  113 6.4.3 External Relocation��������������������������������������������������������������  114 6.5 Impacts of Displacement������������������������������������������������������������������  116 6.5.1 Impacts on the Displaced������������������������������������������������������  116 6.5.2 Impacts on Community of Origin ����������������������������������������  118 6.5.3 Impacts on Host Communities����������������������������������������������  119 6.6 Lessons Learned��������������������������������������������������������������������������������  119 References��������������������������������������������������������������������������������������������������  120 7 Fleeing Coastal Erosion: Kivalina and Isle de Jean Charles ��������������  127 7.1 The Narrative������������������������������������������������������������������������������������  127 7.1.1 The Event������������������������������������������������������������������������������  127 7.1.2 The Displacement ����������������������������������������������������������������  127 7.2 Coastal Erosion ��������������������������������������������������������������������������������  128 7.2.1 Alaska ����������������������������������������������������������������������������������  128 7.2.2 Gulf of Mexico����������������������������������������������������������������������  129 7.3 Patterns of Displacement������������������������������������������������������������������  130 7.3.1 Numbers of Climigrants��������������������������������������������������������  130 7.3.2 Displacement-Related Decisions������������������������������������������  132 7.4 Impacts of Displacement������������������������������������������������������������������  135 7.4.1 Impacts on the Displaced������������������������������������������������������  135 7.4.2 Impacts on Community of Origin ����������������������������������������  136 7.4.3 Impacts on Host Communities����������������������������������������������  138

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7.5 Lessons Learned��������������������������������������������������������������������������������  139 7.5.1 Models for Other Coastal Communities ������������������������������  139 7.5.2 Federal Responses to Coastal Erosion����������������������������������  140 7.5.3 Disparities in Displacement��������������������������������������������������  140 7.5.4 Cohesion vs. Dispersion�������������������������������������������������������  141 7.5.5 Continuity vs. Change����������������������������������������������������������  141 References��������������������������������������������������������������������������������������������������  142 Part III Responses to Climigration 8 Policy Responses to Climigration ����������������������������������������������������������  149 8.1 Introduction��������������������������������������������������������������������������������������  149 8.2 The Three-Tier Model for Responding to Climigration ������������������  149 8.3 General Principles of Climigration Policies ������������������������������������  150 8.3.1 Types of Policies ������������������������������������������������������������������  150 8.3.2 Climigration as Adaptation ��������������������������������������������������  151 8.4 Policies That Mitigate Need for Climigration����������������������������������  152 8.4.1 Disaster Risk Reduction��������������������������������������������������������  152 8.4.2 Mitigation of Health Impacts of Climate Change����������������  154 8.5 Policies That Facilitate and Regulate Climigration��������������������������  155 8.6 Policies That Mitigate the Health Impacts of Climigration��������������  158 8.6.1 Access to Services����������������������������������������������������������������  158 8.6.2 Protection of Migrant Workers����������������������������������������������  159 8.7 Challenges in Developing Climigration Policies������������������������������  159 8.7.1 General Issues ����������������������������������������������������������������������  159 8.7.2 International Policies������������������������������������������������������������  160 8.7.3 National Policies ������������������������������������������������������������������  162 8.7.4 Policies to Address Inequality of Climate Change Risk and Impacts�����������������������������������������������������  163 8.8 Summary ������������������������������������������������������������������������������������������  163 References��������������������������������������������������������������������������������������������������  166 9 Practice Responses to Climigration��������������������������������������������������������  171 9.1 Introduction��������������������������������������������������������������������������������������  171 9.2 The Three-Tier Model and Climigration Resettlement Practice������������������������������������������������������������������������  172 9.2.1 Tier I. Addressing Socioenvironmental Impacts������������������  172 9.2.2 Tier II. Addressing Community Impacts������������������������������  178 9.2.3 Tier III. Addressing Individual Impacts��������������������������������  182 9.3 Implementation and Sustainability of Evidence-Based Services��������������������������������������������������������������  190 9.4 Summary ������������������������������������������������������������������������������������������  192 References��������������������������������������������������������������������������������������������������  194

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10 The Future of Climigration��������������������������������������������������������������������  203 10.1 The Current and Future State of Climigration��������������������������������  203 10.2 Unresolved Issues ��������������������������������������������������������������������������  204 10.2.1 What to Call People Displaced by Climate Change ��������  204 10.2.2 Climigration as Adaptation ����������������������������������������������  206 10.2.3 Climigration as a Public Health Threat����������������������������  207 10.3 Response to the Climigration Crisis ����������������������������������������������  208 10.3.1 Efforts to Prevent Population Displacement ��������������������  209 10.3.2 Efforts to Manage Population Displacement��������������������  210 10.3.3 Efforts to Mitigate the Consequences of Population Displacement��������������������������������������������������������������������  210 10.3.4 The Role of Partnerships in These Efforts������������������������  211 10.4 Summary ����������������������������������������������������������������������������������������  212 References��������������������������������������������������������������������������������������������������  213 Appendix A ������������������������������������������������������������������������������������������������������  217 Appendix B ������������������������������������������������������������������������������������������������������  223 Index������������������������������������������������������������������������������������������������������������������  227

Chapter 1

Introduction

1.1  The Wet and the Dry On September 21, 2017, the day after Hurricane Maria swept across Puerto Rico, Yolimar Garayalde Figueroa stepped outside her home. At once, she saw that everything had changed. “It felt like we were back in my grandparents’ time,” she recalls. “Everything was destroyed…. There was absolutely no phone reception, no TV, no wifi. If you wanted to know about a person, you had to go directly to them.” During the storm, a tree fell on the family home, cracking the ceiling above Figueroa’s bed. The rain and wind, which peaked at 250 km (155 miles) per hour, blew in the home’s windows. Water flooded the structure, destroying many of the family’s possessions. Soon Figueroa would discover the storm had destroyed much of the rest of her island as well. That included its power grid, meaning no one had electricity. For many—including Figueroa and her family—water no longer flowed from the kitchen tap. “We went eight months without electricity and six without water,” she notes. Before the storm, Figueroa attended the University of Puerto Rico. But she soon found it impractical to return that fall. The hurricane had destroyed one of the family’s two cars. Now they all had to share just one. With no power or wifi, studying would be impossible. Plus, she adds, “I knew I had to work even more hours than I already did to help my family get back on track.” Then an opportunity arose. The University of Central Florida offered the teen a spot at its campus in Orlando. Figueroa’s parents encouraged her to go for it. “They told me I needed to stay focused on my studies.” So, Figueroa packed her bags, got on a plane, and joined thousands of storm-ravaged Puerto Ricans who left this US territory for the mainland (Zielinski 2018). In the crisis I was not able to grow anything and most of my extended family went to the refugee camps in Kenya. I stayed back in Jamaame because my family was small, and we © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_1

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2

1 Introduction thought we could manage … [but] we [then] ran out of money and didn’t know what to do. We then decided to go to Kismayo, and we went into an IDP camp in Kismayo where we found some temporary and random support. I managed to trace some of my distant relatives in Kismayo, and through them I traced my nephew who was in Kenya. We also left the camp and found some relatives we could stay with. My nephew sent us US$100 every month for 7 months. During this time I was going back and forth from Jamaame to make sure that my farm was ready for the next season. When we had the first harvest the whole family returned to Jamaame. Some of my extended family are now back but many are still in there (Maxwell et al. 2015: 14).

1.2  T  he History of Climate Change and Population Displacement Human history is filled with numerous instances of large-scale migration for reasons related to changes in climate. The migration of protohumans from forests to savanna was precipitated by changes in climate (Uno et al. 2016). Later, tropical Africa began to experience mega-droughts approximately 135,000 years ago, driving humans to coastal settings and eventually to other continents (Cohen et  al. 2007). The wobble of Earth’s axis, with a period of about 20,000  years, and the corresponding changes in climate are known to have caused massive shifts in vegetation in tropical and subtropical regions. Such shifts opened up green corridors between Africa, the Sinai and the Arabian Peninsula, enabling some Homo sapiens to leave Northeastern Africa and embark onto their grand journey into Asia, Europe, Australia, and eventually the Americas. About every 20,000 years, warmer and wetter Northern Hemisphere tropical summers have accelerated migration and exchange between Africa and Eurasia (Timmermann and Friedrich 2016): Archaeological evidence suggests that human settlement patterns have responded repeatedly to changes in the climate. There is evidence that the emergence of the first large, urban societies was driven by a combination of climatic and environmental desiccation. The complex societies of Egypt and Mesopotamia, for example, emerged as people migrated away from desiccating rangelands and into riverine areas. The resulting need to organize densely packed populations in order to manage scarce resources in restricted areas has been identified as one of the main driving forces behind the development of the first civilizations. (IOM 2008: 21)

Another period of notable climate-related migration was the Little Ice Age, a period lasting from the early fourteenth century through the mid-nineteenth century. During this period, alpine glaciers advanced far below their previous limits, obliterating farms and villages throughout Western Europe. Frequent cold winters and cool, wet summers led to crop failures and famines over much of Northern and Central Europe. In the seventeenth century, the North Atlantic cod fisheries declined as ocean temperatures fell. Climatic variability predominately affected harvests and the quality of agricultural products, leading to price increases, increased poverty and food insecurity, civil unrest, and wars between major powers like England and Spain (Fagan 2000). These pressures, in turn, motivated millions of Europeans to

1.3  The Present Day

3

move to other parts of Europe and the Americas. Glaser et  al. (2017) describe a cascade of events that led to outmigration from southwest Germany to North America during the nineteenth century. Their models show that temperature and precipitation explained 24% of the total variation in grain harvests and 22% of potato yields. These yields, in turn, accounted for 29% of the total variation in cereal prices and cereal prices for 38% of the numbers of residents who left the region. A similar set of migration pressures occurred in North America between 1250 and 1500, where the Native American cultures of the Upper Mississippi Valley and the western prairies began a general decline as drier conditions set in, accompanied by a transfer from agriculture to hunting. Many Native American communities like the Anasazi simply vanished over time due to prolonged drought, disease, and tribal conflicts (Polyak and Asmerom 2001). A third illustration of climigration occurred in the United States in the 1930s when poor land management, overcultivation of fields, and prolonged drought turned the western Great Plains into the Dust Bowl, an infamous prolonged dust storm that made life in the heartland unbearable. This environmental disaster forced up to 2.5 million people to leave the region and move to parts of the country that were also experiencing water and resource shortages. Many of these migrants moved to California, where they experienced hostility, discrimination, and violence. Echoing the experience of modern-day migrants from Central America seeking asylum at the southern border of the United States, many of the migrating “Okies” were blocked from entering the state by law enforcement officials who were called on to guard the California border (Gregory 1989). In each of these instances, climate-related displacement is a twin story of necessity and opportunity. Migration theories have often referred to push and pull factors that precipitate migration (Lee 1966; Hammar et al. 1997). Push factors are based on perceptions of disadvantage, loss, and necessity, while pull factors are based on advantage, gain, and opportunity. In the case of climate-related migration or “climigration,” the changing environment creates pressure to migrate for survival in areas rendered uninhabitable. Climate and climatic variability have long pushed humans to migrate to new lands and territories (Hugo 1996; Diamond 2005; Linden 2006; Fagan 2008; McLeman 2011; Glaser et al. 2017). However, they may also create opportunities for improvement in quality of life in areas that were habitable in comparison. Both reasons for migration necessitated changes of one form or another, i.e., biological-physiological adaptations to new environments (arid, polar, altitude) and/or cultural-development of technology (tools, shelter, economy).

1.3  The Present Day The degradation of the physical environment is one of the most significant problems facing the world today. Human impacts on the environment include increased atmospheric carbon dioxide, air and water pollution, soil contamination and destabilization, and technological disasters such as oil spills and chemical contamination of

4

1 Introduction

drinking water. Drawing on published results of leading modeling groups around the world, the fifth report of the Intergovernmental Panel on Climate Change (IPCC 2013) forecasts an increase in world average temperature by 2100 within the range of 1.5 to 5.8° C. Sea levels during this period are projected to increase in the range of 0.26 to 0.98 m, thereby inundating low-lying areas and Small Island Developing States (SIDS) such as Tuvalu, Fiji, the Solomon Islands, the Marshall Islands, the Maldives, and some of the Lesser Antilles (IPCC 2013). Extreme precipitation events over most of the mid-latitude land masses and wet tropical regions will very likely become increasingly intense and frequent by the end of this century as global mean surface temperature increases (IPCC 2013). For instance, Bangladesh has had 70 climate-related natural disasters in the past 10 years. Conversely, mean levels of precipitation will likely decrease in many mid-latitude and subtropical dry regions, leading to drought conditions, increased risk of wildfires, and rising water insecurity (IPCC 2013). A significant decline in ocean pH levels during this period may lead to a dramatic reduction in marine life as a food source (IPCC 2019). One of the most pronounced impacts of global climate change is the massive displacement of populations (IPCC 2013; EJF 2009). The global population of forcibly displaced people grew substantially from 34 million in 1997 to 66 million in 2016 (UNHCR 2017). In 2016, there were three times as many people displaced by sudden-onset disasters, most of which was climate or weather-related, as were displaced by conflict; two thirds of the estimated 24.2 million people displaced that year were in East Asia and the Pacific (UNESCAP 2017). Most of the displacement was temporary and internal. However, with the projected number of displaced persons ranging from 20  million to 200  million by 2050 (Myers 2002), a massive humanitarian catastrophe appears to be unfolding even now (Atapattu 2018). Climigrants are people forced to migrate because of acute and extreme weather events or long-term changes to their local environment that compromise their well-­ being or livelihood, such as increased droughts, desertification, sea level rise, and the disruption of seasonal weather patterns such as monsoons (Myers 1993). The IPCC (2007) has estimated that there may be 150 million such displaced persons by 2050, due primarily to coastal flooding, shoreline erosion, and agricultural degradation. The Environmental Justice Foundation (EJF 2009) claimed that 500 million to 600 million people—nearly 10% of the world’s population—are at risk of displacement from climate change. Around 26 million have already migrated elsewhere, a figure that the EJF predicts could grow to 150 million by 2050. Low and middle-­ income countries like Bangladesh, Papua New Guinea, Somalia, and Chad are especially vulnerable to large movements of people because of climate change (EJF 2009). Other estimates have varied widely, ranging between 25  million and one billion by 2050, with 200 million as the most frequently cited estimate (Myers 2005). The United States will not only see increasing numbers of transnational climigrants but will increasingly be faced with internal displacement as people move from arid, hot, and fire-prone areas to those with more moderate climates. Domestically and globally, already vulnerable and marginalized groups are most likely to be involuntarily displaced (Warner et al. 2009). Whether internal or transnational, these population shifts will have significant implications for US cities and

1.3  The Present Day

5

regions, from strains on infrastructure capacities and economic resources to social challenges associated with changing community demographics (IPCC 2014). Climigration occurs in response to two broad categories of climate-related changes in the environment. The first category is comprised of acute, extreme weather events (EWEs) like hurricanes, floods, and wildfires. By 2015, more than 375 million people per year were projected to be affected by climate-related disasters, over 50% more than those affected in an average year during the previous decade (Schuemer-Cross and Taylor 2009). By 2050, 200 million people per year could need international humanitarian aid as a result of climate-related disasters and the socioeconomic impact of climate change (IFRC 2019). To provide but a few examples, in 2005, one million people living in the coast of the Gulf of Mexico were displaced by Hurricane Katrina (Plyer 2016). In 2013, 4.1 million people living in the Philippines were displaced by Typhoon Haiyan (UNHCR 2014). In 2017, more than 200,000 people living in Puerto Rico fled to Florida due to Hurricane Maria (Sesin 2017). In 2018, an estimated 100,000 people were displaced by wildfires in California (Rizzo 2018). There are three forms of climigration in response to such acute events. The first form is temporary and short-term as evacuees are able to return once the immediate threat has passed. The second form is also temporary, but longer-term as evacuees must reside elsewhere while homes and infrastructure are being rebuilt. The third form is permanent as evacuees either voluntarily reside elsewhere, preferably somewhere that is less vulnerable to such events, or are forced to do so because of an inability to rebuild due to limited resources or permanent changes in the environment. In high-income countries, the displacement is often temporary as victims seek to rebuild and return to devastated communities. In low- and middle-income countries, the opportunities to do so are constrained by a lack of resources, as in the following: ‘We went home [after the cyclone had passed] and saw that there was nothing left. There wasn’t a single house that you could live in. Only the houses built around trees, somehow their structure was still there, but they were unlivable. All the mud houses, clay houses were completely gone.’  - Ataur Rahman, describing his village after Cyclone Aila struck Bangladesh. (EJF 2009)

In addition to the lack of shelter, climigrants are motivated to move elsewhere for economic reasons. According to the World Bank’s Building Resilience report (2013), economic losses from natural disasters rose from $50 billion each year in the 1980s to just under $200 billion each year in the first decade of the twenty-first century. Total reported losses from disasters are estimated at $3.8 trillion in this period with 74% caused by extreme weather alone (Munich 2013). “Since 1980, the U.S. has sustained 241 weather and climate disasters where the overall damage costs reached or exceeded $1 billion (including adjustments based on the Consumer Price Index, as of January 2019). The cumulative cost for these 241 events exceeds $1.6 trillion” (Smith 2019). While much of the economic costs are reflected in damage to infrastructure that must be rebuilt, it also reflects higher levels of unemployment and lost income as businesses take time to rebuild or simply move away.

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1 Introduction

Another reason for moving away in the aftermath of an acute climate-related event is the health of disaster victims. Such events disrupt physical, social, and communication infrastructures; diminish coping resources and social supports; drain or deplete household assets; and pose temporary and long-term threats to physical and mental health and safety (Caruana 2010; Moser and Satterthwaite 2010; Wells et al. 2013). They exacerbate existing physical and mental health problems and create new problems that interfere with help-seeking and evacuation (Neriq et al. 2009; North and Pfefferbaum 2013). The tendency for people to move will be associated particularly with the existence (or perception or expectation) of an increased frequency of serious and extreme weather disasters, (McMichael et al. 2012). Some of this movement will occur within a country (internal displacement), and some will occur from one country to another (external displacement). The second category of climate-related changes in environment that precipitate climigration is long-term events that occur over a period of years or decades if not longer. These include prolonged drought, rising temperatures, and coastal erosion due to sea level rise. These events tend to slowly displace people or contribute to preemptive migration or planned relocation of whole communities (UNESCAP 2017). At present, such forms of climigration are occurring in five major parts of the globe (Benko 2017). The first hot spot has been the Middle East in general and Syria in particular. Although largely viewed as a civil conflict affecting millions of people, the origins of the conflict have been linked to a 3-year drought in the eastern part of the country, beginning in 2007 in which 1.5 million people fled to cities in Western Syria from rural areas due to water scarcity, crop failures, and livestock deaths (Levy et al. 2017). Soaring food prices contributed to social and economic tensions and the subsequent civil conflict. The return of drought conditions in 2011 affected between two and three million people, with one million driven into food insecurity (Gleick 2014). The Lake Chad region of Africa constitutes the second hot spot for climigration. A vital resource for Cameroon, Chad, Niger, and Nigeria, the lake has shrunk by more than 90% since 1963. It represents an ecological disaster that has been linked to the Boko Haram insurgency crisis in the region, along with the displacement of 3.5 million people, many of whom have migrated to Europe. China is the third hot spot for climigration. In the western part of the country, deserts have expanded by 21,000 square miles since 1975, crowding out cropland and producing devastating sandstorms (Rogers and Wang 2006; Sun et al. 2017). In response, the Chinese government has resettled hundreds of thousands of “ecological migrants”—many of them ethnic minorities—from across affected areas (Wong 2016). The Philippines is the fourth hot spot. Warming oceans have already made and will continue to make typhoons and tropical storms more intense and destructive. Since 2013, nearly 15 million people have been displaced by typhoons. In 2013, Typhoon Haiyan killed more than 7000 people and displaced 4.1  million people (UNHCR 2014).

1.3  The Present Day

7

The fifth hot spot is the Amazon Basin. Glacial melting in the Andes has led to a reduction in reserves of fresh water to the east (IOM 2008). Prolonged drought has contributed to an increase in tensions between locals and mining and agribusiness operations. This resource conflict will drive more migrants to the Amazon Basin where they will be engaged in illegal mining and coca cultivation and involvement in criminal gangs (IPCC 2014). Climigration in response to this category of environmental change typically is permanent, although as illustrated in the narrative presented at the beginning of the chapter, it can be temporary as displaced residents wait years before returning to countries and communities of origin. Residents fleeing from rising sea levels are motivated to leave because their homes become uninhabitable. Both sea level rise and droughts also have severe economic impacts as loss of terrestrial and inland water ecosystems and associated biodiversity adversely affect economic activity (IPCC 2014), loss of livelihoods and income due to insufficient access to drinking and irrigation water, and loss of marine and coastal ecosystems, biodiversity, and the ecosystem will affect goods, functions, and services they provide for coastal livelihoods, especially for fishing communities (IPCC 2019). Climigration is also sensitive to increases in temperature. A study by Missirian and Schlenker (2017) found that between 2000 and 2014, weather variations in 103 source countries translated into an average of 251,000 asylum applications to the European Union per year. They also found that deviations from a moderate optimum temperature of 20° C increased asylum applications in a nonlinear fashion, suggesting an accelerated increase under continued future warming. This category of climate-related environmental changes also is associated with numerous health impacts that may serve to precipitate climigration. Between 1995 and 2015, 2.3 billion people were affected by floods, 1.1 billion by drought, 660 million by storms, 94 million by extreme temperatures, and eight million by wildfires and landslides (CRED 2016). During that same period, 242,000 people were killed by storms, 164,000 people by extreme temperatures, 157,000 people by flooding, 22,000 people by droughts, and 20,000 people by wildfires and landslides (CRED 2016). In 2017 alone, 85  million people were affected by floods, 73  million by drought, 33 million by storms; eight million by extreme temperatures; and 400,000 by wildfires and landslides. That same year witnessed 3331 deaths due to floods, 2510, due to storms, 2312 due to landslides, 359 due to extreme temperatures, and 165 due to wildfires (CRED 2018). Climate change is also referred to as a health “risk multiplier”, as it can indirectly trigger or amplify preexisting health risks (McMichael 2017). The World Health Organization (WHO) estimates that between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year, from malnutrition, malaria, diarrhea, and heat stress (WHO 2018). Most of these deaths are expected to occur among the poorest populations in low- and middle-income countries, where vulnerability is highest (WHO 2015). Among the health impacts of climate change are the following:

8

1 Introduction

• Increased heat-related morbidity and mortality in adults, associated with rising ambient temperatures (Basu 2009). • Increased risk of diarrheal disease and cholera due to increased ambient temperatures and heavy precipitation and drought events (Zhang et al. 2012) • Increased risk of vector-borne diseases, including malaria, dengue fever, West Nile virus, chikungunya, Lyme disease, Rocky Mountain spotted fever, plague, hantavirus pulmonary syndrome, and Chagas disease due to increased temperatures and precipitation (Banu et al. 2014; Adehoot et al. 2015) • Impaired physical development (stunting) related to undernutrition associated with drought (Hagos et al. 2014) and flooding (Rodriguez-Llanes et al. 2016) • Increased asthma prevalence and severity due to rise in air pollutants, including ozone and elevated pollen counts (Kim et al. 2014) • Increased adverse birth outcomes, including preterm birth, associated with rising ambient temperatures (Basu et al. 2010; Kent et al. 2014) Increased risk for these disorders may be an incentive to climigrate, especially if they are linked to shortages of food and water (McMichael et al. 2012). Children are especially vulnerable to adverse climate-related health impacts associated with these long-term events due to their immature physiology and metabolism; incomplete development; higher exposure to air, food, and water per unit body weight; and dependence on affected caregivers (Sheffield and Landrigan 2011). In fact, it is estimated that 88% of existing global burden of disease attributable to climate change occurs in children under 5 years of age (Zhang et al. 2007). Children in world’s poorest countries are most affected by climate change (Haines et al. 2006). Historical studies have also linked civil conflicts and long-term changes in climate. Periods of prolonged drought in Egypt and Mesoamerica and the Little Ice Age in Europe have been linked to wars between communities, tribes, regions, and nation states due to competition for limited resources (Hsiang et  al. 2011; Levy et al. 2017). A study conducted by Hsiang et al. (2013) found that each standard deviation of greater rainfall or warmer temperatures increased intergroup conflict by 14% and in some regions by 50%.

1.4  Aims of the Book In recent years, there have been a number of books written about climate refugees (Goodell 2017; Wennersten and Robbins 2017; Hirsch 2017; Behrmann and Kent 2018). Many of them like The Water Will Come by Jeff Goodell (2017) represent accounts written by journalists describing the toll of climate change. Others like Climate Refugees: Beyond the Legal Impasse?, edited by Simon Behrman and Avidan Kent (2018), are academic treatises on the legal ramifications of climate-­ related migration. Their aim is to address the question of whether climigrants are migrants or refugees and should be granted the same legal status as refugees of civil

1.5  Organization of the Book

9

conflicts like Syria and Afghanistan. In contrast to much of this work, this book takes the perspective of the physical and mental health-related causes and consequences of climate change-related migration. It also seeks to place climate-related migration in broader context of cultural change and human evolution by viewing migration as a means of adapting to environmental change and considering the biological and cultural changes associated with migration. Although other books on climate migration have included a focus on the need for policies to address the growing problem, in this book, policy and practice are considered from the perspective on mitigating both the need to migrate (i.e., pre-migration), as well as the adverse health impacts of migration (i.e., post-migration). The aim of this book is to examine the causes and consequences of population displacement related to climate change in the recent past, the present, and the near future. It focuses on two forms of population displacement, one that occurs in the aftermath of a natural disaster such as a hurricane or typhoon or massive wildfires and one that occurs in response to a longer-term change in environment such as prolonged droughts, persistent flooding, or gradual rise in sea levels. Each of these two forms of displacement is illustrated by three case studies. In the first instance, the displacements from New Orleans and other parts of the Gulf Coast that occurred in the aftermath of Hurricane Katrina, from Puerto Rico in the aftermath of Hurricane Maria, and from California in the aftermath of the wildfires of 2017 and 2018 are used to illustrate the reasons for displacement, impacts on the health and well-being of displaced individuals and families, and impacts on the communities of origin and host communities. In the second instance, the mass migration in recent years from sub-Saharan Africa and the Middle East due to drought, from the Asia-Pacific Rim due to sea level rise and flooding, and from small Alaskan Native and Native American villages in the United States due to coastal erosion are used to illustrate similar impacts over a longer period of time. These case examples highlight the scale of population displacement and its impacts worldwide and argue for the implementation of specific policies and practices designed to manage the migration process, moderate the need for displacement, and mitigate the adverse social and health consequences of such displacement.

1.5  Organization of the Book The remaining chapters of this book are organized into three parts. The first part includes three chapters that provide case illustrations of displacement resulting from natural disasters. A chapter each is devoted to displacement of residents from New Orleans after Hurricane Katrina in 2005, residents of Puerto Rico after Hurricane Maria in 2017, and residents throughout California after the devastating wildfires in 2017 and 2018. The second part includes three chapters that provide illustrations of displacement resulting from long-term changes in environment due to climate change. A chapter each is devoted to displacement of populations from the Middle East and sub-Saharan Africa to Europe due to prolonged drought, from

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1 Introduction Climate-related environmental changes

Impacts of environmental changes Tier I

Socioenvironmental

Acute

Climigration patterns Duration

Tier I Policy

Short-term

Habitability/economic

Hurricanes Floods Wildfires

Climigration response

Practice Long-term

Tier II Tier II

Permanent

Policy

Social/civil conflict

Long-term Droughts Temperatures Sea level rise Coastal erosion

Degree of choice

Tier III

Physical/mental Health

Practice

Voluntary

Tier III

Forced

economic

Policy

Practice

Fig. 1.1  Conceptual framework of drivers of and responses to climigration

South Asia and the Pacific due to prolonged flooding and sea level rise, and from coastal communities in the United States due to coastal erosion. The third part includes two chapters focused on policy and practice responses to climate-related displacement and a concluding chapter that describes potential strategies for preventing, managing, and mitigating climate-related population displacement and its effects through the development and maintenance of partnerships involving academics, policy makers, service providers, communities, and climigrants themselves. Parts 1 and 2 of this book are structured to address three components of a conceptual framework of climigration that is illustrated in Fig. 1.1: the two types of climate-related environmental changes (acute and long-term), the impacts of these environmental changes organized into three tiers (socioenvironmental, social, and individual), and the patterns of migration resulting from these impacts, classified in terms of duration (temporary versus permanent) and degree of choice (voluntary versus forced). Part 3 is structured along the lines of policy and practice responses to these patterns of migration, organized into three tiers that correspond to the three tiers of impacts.

References Adehoot S, Pacheco SE, Council on Environmental Health (2015) Climate change and children’s health. Pediatrics 136(5):e1468–e1484. https://doi.org/10.1542/peds.2015-3233 Atapattu S (2018) A new category of refugees? In: Behrmann S, Kent A (eds) Climate refugees’: beyond the legal impasse? Routledge, New York, pp 34–51

References

11

Banu S, Hu W, Guo Y et al (2014) Projecting the impact of climate change on dengue transmission in Dhaka, Bangladesh. Environ Int 63:137–142 Basu R (2009) High ambient temperatures and mortality: a review of epidemiologic studies from 2001 to 2008. Environ Health 8:40. http://ehjournal.biomedcentral.com/ articles/10.1186/1476-069X-8-40 Basu R, Malig B, Ostro B (2010) High ambient temperature and the risk of pre-term delivery. Am J Epidemiol 172(10):1108–1117. https://doi.org/10.1093/aje/kwq170 Behrmann S, Kent A (eds) (2018) ‘Climate refugees’: beyond the legal impasse? Routledge, New York Benko J (2017) Hot zones. The New York Times Magazine, pp. 56–57 Caruana C (2010) Picking up the pieces: family functioning in the aftermath of natural disaster. Fam Matters 84:79–88 Centre for Research on the Epidemiology of Disasters (CRED) (2016) What is the human cost of weather-related disasters (1995-2015)? CRED Crunch, Brussels. http://cred.be/HCWRD. Accessed 24 Oct 2019 Centre for Research on the Epidemiology of Disasters (CRED) (2018) Natural disasters 2017. CRED, Brussels. CRED. 2018 EM-DAT file dated 02/07/2018. https://cred.be/sites/default/ files/adsr_2017.pdf. Accessed 24 Oct 2019 Cohen AS, Stone JR, Beuning KR et al (2007) Ecological consequences of early Pleistocene megadroughts in tropical Africa. Proc Natl Acad Sci 104(42):16422–16426 Diamond J (2005) Collapse: how societies choose to fail or succeed. Viking, New York Environmental Justice Foundation (EJF) (2009) No place like home: where next for climate refugees. Environmental Justice Foundation, London. https://ejfoundation.org/reports/no-placelike-home-where-next-for-climate-refugees. Accessed 21 May 2016 Fagan B (2000) The lattice ice age: how climate made history 1400–1850. Norton, New York Fagan B (2008) The Great Warming: climate change and the rise and fall of civilizations. Bloomsbury Press, New York Glaser R, Himmelsbach I, Bosmeier A (2017) Climate of migration? How climate triggered migration from southwest Germany to North America during the 19th century. Clim Past 13:1573–1592 Gleick PH (2014) Water, drought, climate change, and conflict in Syria. Weather Clim Soc 6:331–340 Goodell B (2017) The water will come: rising seas, sinking cities, and the remaking of the civilized world. Little and Brown, New York Gregory J (1989) American exodus: the dust bowl migration and Okie culture in California. Oxford University Press, New York Hagos S, Kunde T, Mariam DH et al (2014) Climate change, crop production, and child undernutrition in Ethiopia: a longitudinal panel study. BMC Public Health 14:884. http://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-14-884 Haines A, Kovats RS, Campbell-Lendrum D et al (2006) Climate change and human health: impacts, vulnerabilities, and public health. Public Health 120:585–596 Hammar T, Brochmann G, Tams K et al (1997) International migration, immobility and development, multidisciplinary perspectives. Berg, Oxford Hirsch RE (2017) Climate migrants: on the move in a warming world. Twenty-First Century Books, Minneapolis, MN Hsiang SM, Meng KC, Cane MA (2011) Civil conflicts are associated with the global climate. Nature 476:438–440 Hsiang SM, Burke M, Miguel E (2013) Quantifying the influence of climate on human conflict. Science 341(6151):1235367 Hugo G (1996) Environmental concerns and international migration. Int Migr Rev 30:105–131. https://doi.org/10.2307/2547462

12

1 Introduction

Intergovernmental Panel on Climate Change (IPCC) (2007) Climate change 2007: impact, adaptations and vulnerability. In: Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2013) Climate change 2013: the physical science basis. In: Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2014) Impacts, adaptations and vulnerability. 2 vols. In: Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2019) Summary for policymakers. In: Pörtner HO, Roberts DC, Masson-Delmotte V et al (eds) IPCC Special report on the ocean and cryosphere in a changing climate. https://www.ipcc.ch/srocc/home/. Accessed 1 Oct 2019 International Federation of Red Cross and Red Crescent Societies (IFRC) (2019) The cost of doing nothing: the humanitarian price of climate change and how it can be avoided. https://media.ifrc. org/ifrc/wp-content/uploads/sites/5/2019/09/2019-IFRC-CODN-EN.pdf. Accessed 7 Oct 2019 International Organization for Migration (IOM) (2008) Migration and climate change. IOM Migration Research Series No. 31. IOM, Geneva Kent ST, McCLure LA, Zaitchik BF et al (2014) Heat waves and health outcomes in Alabama (USA): the importance of heat wave definition. Environ Health Perspect 122(2):151–158. https://doi.org/10.1289/ehp.1307262 Kim BJ, Lee SY, Kim HB et al (2014) Environmental changes, microbiota, and allergic diseases. Allergy Asthma Immunol Res 6(5):389–400. https://doi.org/10.4168/aair.2014.6.5.389 Lee ES (1966) A theory of migration. Demography 3:47–57 Levy BS, Sidel VW, Patz J (2017) Climate change and collective violence. Annu Rev Public Health 38:241–257. https://doi.org/10.1146/annurev-publichealth-031816-044232 Linden E (2006) The winds of change: climate, weather, and the destruction of civilizations. Simon and Schuster, New York Maxwell D, Majid N, Adan G et al (2015) Facing famine: Somali experiences in the famine of 2011. Feinstein International Center, Tufts University, Somerville, MA McLeman RA (2011) Climate change, migration, and critical international security considerations. International Organization for Migration, Geneva. http://www.unescogym.org/ wp-content/uploads/2015/11/Climate-change-migration-and-critical-international-securityconsiderations.pdf. Accessed 12 Jun 2019 McMichael A (2017) Climate change and the health of nations: famines, fevers and the fate of populations. Oxford University Press, New York McMichael T, Montgomery H, Costello A (2012) Health risks, present and future, from global climate change. BMJ 344:e1359. https://doi.org/10.1136/bmj.e1359 Missirian A, Schlenker W (2017) Asylum applications respond to temperature fluctuations. Science 358:1610–1614 Moser C, Satterthwaite D (2010) Toward pro-poor adaptation to climate change in the urban centers of low- and middle-income countries. In: Mearns R, Norton A (eds) Social dimensions of climate change: equity and vulnerability in a warming world. The World Bank, Washington, DC, pp 231–238 Munich RE (2013) Evaluating the economics of climate risks and opportunities in the insurance sector: progress and insights from the LSE “Munich Re Programme.” http://www.lse.ac.uk/ CATS/Assets/Documents/14-0964-Munich-Brochure-interactive-FINAL.pdf. Accessed 22 May 2016 Myers N (1993) Population, environment and development. Environ Conserv 20(3):205–216 Myers N (2002) Environmental refugees: a growing phenomenon of the 21st century. Phil Trans R Soc Lond B 357:609–613. https://doi.org/10.1098/rstb.2001.0953 Myers N (2005) Environmental refugees: an emergent security issue. 13th Economic Forum, Prague, pp 23–27

References

13

Neriq Y, Galea S, Norris FH (eds) (2009) Mental health and disasters. Cambridge University Press, New York North CS, Pfefferbaum B (2013) Mental health response to community disasters: a systematic review. JAMA 310(5):507–518. https://doi.org/10.1001/jama.2013.107799 Plyer A (2016) Facts for features: Katrina impact. The Data Center. https://www.datacenterresearch.org/data-resources/katrina/facts-for-impact/. Accessed 7 Oct 2019 Polyak V, Asmerom Y (2001) Late Holocene climate and cultural changes in the southwestern United States. Science 294(5540):148–151 Rizzo CA (2018) Uncontrolled California wildfires force more than 100,000 people to evacuate. Travel & Leisure. https://www.travelandleisure.com/travel-news/california-wildfires. Accessed 23 Mar 2019 Rodriguez-Llanes JM, Ranjan-Dash S, Mukhopadhyay A et al (2016) Flood-exposure is associated with higher prevalence of child undernutrition in rural Eastern India. Int J Environ Res Public Health 13(2):210. https://doi.org/10.3390/ijerph13020210 Rogers S, Wang M (2006) Environmental resettlement and social dis/re-articulation in Inner Mongolia, China. Popul Environ 28(1):41–68 Schuemer-Cross T, Taylor BH (2009) The right to survive: the humanitarian challenge for the 21st century. Oxfam International, Oxford Sesin C (2017) Over 200,000 Puerto Ricans have arrived in Florida since Hurricane Maria. NBC News, 30 Nov. https://www.nbcnews.com/news/latino/over-200-000-puerto-ricans-havearrived-florida-hurricane-maria-n825111. Accessed 24 Apr 2019 Sheffield PE, Landrigan PJ (2011) Global climate change and children’s health: threats and strategies for prevention. Environ Health Perspect 119:291–298 Smith AB (2019) 2018’s billion dollar disasters in context. NOAA Climate.gov. https://www.climate.gov/news-features/blogs/beyond-data/2018s-billion-dollar-disasters-context. Accessed 7 Oct 2019 Sun Y, Xu C, Zhang H et  al (2017) Migration in response to climate change and its impact in China. Int J Clim Change Strat Manage 9(3):352–373. https://doi.org/10.1108/ IJCCSM-05-2016-0061 Timmermann A, Friedrich T (2016) Late Pleistocene climate drivers of early human migration. Nature 538(7623):92–95. https://doi.org/10.1038/nature19365 United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2017) Migration and climate change in Asia and the Pacific https://www. unescap.org/sites/default/files/GCMPREP_5E.PDF. Accessed 12 Apr 2019 United Nations High Commissioner for Refugees (UNHCR) (2014) 1-year on from Typhoon Haiyan. Thousands of people still rebuilding lives, 7 Nov United Nations High Commissioner for Refugees (UNHCR) (2017) Global trends. Forced displacement in 2016. The UN Refugee Agency, Geneva Uno KT, Polissar PJ, Jackson KE et al (2016) Neogene biomarker record of vegetation change in eastern Africa. Proc Natl Acad Sci 113(23):16422–16426. https://doi.org/10.1073/ pnas.1521267113 Warner K, Ehrhart C, de Sherbinin A et  al (2009) In search of shelter: mapping the effects of climate change on human migration and displacement. http://www.ciesin.columbia.edu/documents/clim-migr-report-june09_media.pdf. Accessed 7 Oct 2019 Wells KB, Springgate BF, Lizaola E et al (2013) Community engagement in disaster preparedness and recovery: a tale of two cities—Los Angeles and New Orleans. Psychiatr Clin North Am 36(3):451–466 Wennersten JR, Robbins D (2017) Rising tides: climate refugees in the twenty-first century. Indiana University Press, Bloomington, IN Wong E (2016) Resettling China’s ‘ecological migrants’. New York Times, 25 Oct. https://www. nytimes.com/interactive/2016/10/25/world/asia/china-climate-change-resettlement.html. Accessed 18 Dec 2018

14

1 Introduction

World Bank (2013) Building resilience: Integrating climate and disaster risk into development. Lessons from World Bank Group experience. The World Bank, Washington, DC World Health Organization (WHO) (2015) Human health and climate change in Pacific island countries. https://iris.wpro.who.int/bitstream/handle/10665.1/12399/9789290617303_eng.pdf. Accessed 2 Oct 2019 World Health Organization (WHO) (2018) Climate change and health. https://www.who.int/newsroom/fact-sheets/detail/climate-change-and-health. Accessed 7 Oct 2019 Zhang Y, Bi P, Hiller JE (2007) Climate change and disability-adjusted life years. J Environ Health 70:32–36 Zhang Y, Bi P, Hiller JE (2012) Projected burden of disease for Salmonella infection due to increased temperature in Australian temperate and subtropical regions. Environ Int 44:26–30. https://doi.org/10.1016/j.envint.2012.01.007 Zielinski S (2018) Climate change sends people on the move. Science News for Students, 20 Sept. https://www.sciencenewsforstudents.org/article/climate-change-sets-people-move. Accessed 24 Apr 2019

Part I

Acute Climate-Related Events

Chapter 2

Hurricane Katrina and New Orleans

2.1  The Narrative 2.1.1  The Event At about 9 a.m. the people inside heard a rumbling sound. It was the water, coming from the storm surge. Within 20 min, the rooms of the nursing home were flooded to the ceiling. Those 20 min were horrific. “People were screaming like somebody was murdering them,” said Gene Alonzo, a retired fisherman who was at the home to be with his brother, a resident, during the storm. The able-bodied frantically tried to put the residents onto mattresses and float them out the windows. When the windows filled with water, they chopped a hole in the roof and tried pull people through, still on their mattresses. Many of the residents were in wheelchairs. Some couldn’t get out of bed at all. Others were in too much shock to move. Trishka Stevens hadn’t walked in 5 years when the surge broke through the air conditioning ducts and filled her room. Holding the sides of her bed, she used her strength to tip her head above the water. Steve Snyder, a 29-year-old oil worker, had just been flooded out of his own house nearby and was driving by on a boat when he heard the screams from inside the building and from the roof, where survivors were clinging to life. Snyder broke the window in Steven’s room and pulled her out. “I thought the man was my angel,” Stevens said later (Brinkley 2006: 220).

2.1.2  The Displacement After being evacuated from New Orleans by the federal government, Daniel and his family stayed for about 2 months at a shelter in Baton Rouge. They felt fortunate because, unlike many families, the three of them were able to stay together as they were transported out of the city and then relocated to a temporary disaster shelter. © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_2

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Soon after their arrival in Baton Rouge, they received their one-time $2000 assistance check from FEMA.  These were emergency funds, meant to help evacuee households purchase basic necessities and, if necessary, secure transport to a different place. The Taylor family used some of those initial funds to travel by bus to New York City. This was just a temporary diversion and was not intended as a permanent move. Then they used their remaining funds to get the family, again by bus, back to Baton Rouge and the shelter. Then they left again for Los Angeles, where Daniel’s older brother, Caston, was living… The Taylor family stayed in California for about 2  months, moving between Caston’s apartment and a shelter in a rundown long-term motel. They felt “stuck” and decided to leave. Deirdre, who was unable to find a job, was worried that if she stayed in California, she would have to collect welfare, something she had done before and hoped to never do again. Also, the neighborhood where she was staying was, according to Daniel, “a very poor area” where there was “mostly drugs and stuff like that,” so they “had to move out of there” (Fothergill and Peek 2015: 44–45).

2.2  Hurricane Katrina One of the most devastating hurricanes in US history, Katrina developed into a hurricane over the Bahamas on August 23, 2005, making landfall in Florida for a brief period of time before emerging and becoming a Category 5 hurricane in the Gulf of Mexico 3 days later. By the time it had made a second landfall over southeast Louisiana and Mississippi on August 29, Katrina had weakened to a Category 3 hurricane. The levee system that protected the City of New Orleans and surrounding areas from the waters of Lake Pontchartrain and Lake Borgne was completely overwhelmed by 10 inches of rain and Katrina’s storm surge and breached in more than 50 locations. By August 30, 80% of the city, as well as large tracts of neighboring parishes, became flooded, and the floodwaters lingered for weeks (Knabb et al. 2005). Despite an order from New Orleans Mayor Ray Nagin for a mandatory evacuation of the city the previous day, tens of thousands of residents remained in the city. Municipal police and fire services and local agencies were unable to respond to the increasingly desperate situation. With no relief in sight and in the absence of any organized effort to restore order, some neighborhoods were looted. Many people had to be rescued from rooftops by helicopter in the flooded Lower Ninth Ward (Hopper 2010). An estimated 30,000 people sought shelter at the New Orleans Superdome, and an additional 25,000 had gathered at the Convention Center (Scott 2015). With poor sanitation, limited supplies of food and clean water, and high temperatures and humidity, life in these facilities quickly became unbearable. Eventually, National Guard troops arrived to assist local law enforcement in restoring order and deliver supplies of food and water. Soon afterward, construction crews began the task of rebuilding the breached levees.

2.3  Patterns of Displacement

19

Ultimately, the storm contributed to 1836 deaths and caused more than $160 billion in damage. Katrina also left a profound impact on the transportation infrastructure of the region as well as on the dominant tourism and oil and gas industries. Thousands of jobs were lost as were millions of dollars in tax revenues as many sectors of the regional economy took months and years to fully recover from the storm (Knabb et al. 2005).

2.3  Patterns of Displacement 2.3.1  Numbers of Climigrants About 70% of the approximately 452,000 residents in the city of New Orleans in 2005 evacuated prior to Katrina’s arrival (Elliott and Pais 2006). In all, an estimated 1.5 million people living along the Gulf Coast were displaced as a result of the hurricane (Fothergill and Peek 2015). This displacement was distinguished by four characteristics: duration, geographic dispersion, number of relocations, and disparities in patterns of displacement. For most evacuees, displacement was a temporary phenomenon. As many as 273,000 people were housed in temporary evacuation shelters during and shortly after the hurricane and either returned to their homes or other locations in New Orleans or migrated elsewhere in Louisiana and beyond. However, hundreds of thousands of other people would remain without a home for many months to follow. In the year after the hurricane, just under one-half (47%) of pre-Hurricane Katrina adults from New Orleans remained displaced (Sastry and Gregory 2014: 754). As many as 140,000 residents never returned to New Orleans (Robertson 2011). The disaster resulted in a diaspora, with evacuees scattered throughout the country (Ericson et al. 2005). Houston, Texas, received an estimated 250,000 refugees, more than anywhere else in the country (Bliss 2015). Approximately 150,000 of these climigrants remained in Houston 1  year later; the rest eventually resettled to other locations in Texas as well as to other states (Sastry and Gregory 2014). Initially, information from US Postal Service change-of-address records in the initial months after the hurricane (e.g., Tizon and Smith 2005), reports from the Federal Emergency Management Agency (FEMA), and news sources (e.g., Nigg et al. 2006) was used to monitor the number of destinations of New Orleans residents displaced by Katrina. A study by Nigg et  al. (2006) found that by the end of September 2005, evacuees were registered in every state, although three-quarters were within 250 miles of New Orleans. One year later, Texas had become the leading location of displaced residents, with almost 40% of those who were living away from the metropolitan area (18% of the total). About one-quarter of those who had relocated away from the New Orleans metropolitan area (12% of the total) lived someplace else in Louisiana. Southern states other than Louisiana and Texas accounted for another 25% of the displaced population (12% of the total), with the

20

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leading locations being Georgia (3.4% of the total), Alabama (1.8%), Mississippi (1.7%), and Florida (1.7%). Other locations of former New Orleans residents displaced by Katrina included California (1.1% of the total), New York (0.5%), and Ohio (0.4%) (Sastry and Gregory 2014). In addition to variations in duration and geographic dispersion, population displacement from areas impacted by Katrina was characterized by the instability of relocation. Some families moved more than three times in a search for stability (Weber and Peek 2012). A survey of school-aged children in Grades 4 through 12 attending school in Orleans, Plaquemines, St. Bernard, and St. John the Baptist parishes conducted in 2005 through 2006 indicated that the number of different places students lived since the hurricane ranged from 1 to 10 with a mean of 3. Less than half of the participants (40.1%) had returned to their homes. The following year, in 2006 through 2007, the number of places students lived since the hurricane had increased slightly to an average of 3.05, and 44.3% had returned to their homes (Osofsky et al. 2009). The fourth characteristic of the displacement was the disparities in patterns of displacement. Residents from poorer and predominately black areas of the city were more likely to have been displaced to more distant locations, with the main destinations outside the New Orleans metropolitan area being Houston, Baton Rouge, Dallas, and Atlanta (Tizon and Smith 2005). Whites and higher-income evacuees, on the other hand, were more likely to have been displaced to nearby locations, with the New Orleans metropolitan area being the primary destination (Frey et al. 2007). Young adults (aged 25–39) were also more likely to move further away from New Orleans, and adults born outside Louisiana were more likely to have moved out of the state after Katrina (Sastry and Gregory 2014).

2.3.2  Displacement-Related Decisions 2.3.2.1  Whether to Move Related to these three patterns of displacement were three sets of decisions that displaced individuals were required to make: (1) whether to move; (2) where to move; and (3) whether to return. According to Fussell (2015: 1237): Race, class, age, gender, family statuses, and social network composition significantly differentiated the evacuation timing of Gulf Coast residents (Elliott and Pais 2006; Fussell 2006; Groen and Polivka 2010; Haney et al. 2010; Thiede and Brown 2013). For example, a Gallup survey of adult evacuees registered with the Red Cross conducted 1-month after Hurricane Katrina found that 70% of New Orleanians had evacuated before the storm, 25% evacuated during or after the storm, and 5% never evacuated. It also showed that 21% reported they lacked finances or a car that would have allowed them to evacuate (Elliott and Pais 2006). Low-income residents and men were more likely to have evacuated during or after the Hurricane, while African Americans were the majority of the small group who never evacuated. Consistent with the vulnerability approach, those with more resources— geographically diverse social networks, higher incomes, more education, and access to transportation—evacuated before the storm hit, and those with the fewest resources sheltered in place or in shelters of last resort.

2.3  Patterns of Displacement

21

Differences in the perception of the hurricane as dangerous and deadly and response to the event were also important in understanding the decision whether to stay or move. A Gallup survey of Katrina evacuees registered with the Red Cross found that 49% of New Orleanians who did not evacuate said they did not think that the hurricane would be as bad as it was (Elliott and Pais 2006). Another survey of Katrina evacuees in Houston area shelters found that half had not heard an evacuation order or had heard an order that lacked clear instructions. Others failed to evacuate prior to the storm because they lacked transportation (34%), underestimated how bad the storm would be (28%), or were physically unable or caring for someone physically unable to leave (12%) (Brodie et al. 2006). 2.3.2.2  Where to Move As to where to move, many of the evacuees chose a destination in order to be with family or friends. In some instance, evacuees were loaded onto buses bound for Memphis or Salt Lake City and were unaware of the destination only after having arrived there (Bliss 2015). In contrast, Hurricane Katrina evacuees in Atlanta were more likely to have chosen their destination rather than being sent there by authorities (Ellison 2006). Among those who had a choice, the decision as to where to relocate was influenced by several factors including age, sex, marital status, number of children, employment, occupation, and previous migration experience (Greenwood 1985; Long 1992), social networks (Stark and Bloom 1985), and contextual factors (Sastry and Gregory 2014). The decision where to move was also influenced by predisaster patterns of out-­ migration from the impacted region. Between 1970 and 2005, the city’s population declined from 594,000 to 455,000 inhabitants (Census Bureau 2005). Climigrants fleeing the devastation caused by Katrina moved along established migration routes to destinations and networks of friends and contacts in those cities (Sastry and Gregory 2014). However, perhaps the most important characteristic of the decision where to move was the disparities in such decisions. According to Sastry and Gregory (2014), high rates of poverty and disadvantage among the pre-Hurricane Katrina population of New Orleans were likely to have affected evacuation destinations and displacement locations. “The choice of where to evacuate and resettle may have been constrained among poor families because of their limited resources” (Sastry and Gregory 2014: 757). 2.3.2.3  Whether to Return The third displacement-related decision concerned whether or not to return to New Orleans. This decision was based primarily on the ability to return. This ability was based, first and foremost, on the extent of damage to homes and neighborhoods and

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the presence of water and debris that impeded movement. According to Fussell (2015: 1232): Residents’ returns were impeded by storm debris on the roadways, lack of utility services and floodwater, which reached the rooftops of single story houses in some neighborhoods. The “dewatering” of the below-sea-level city took six weeks and was prolonged when Hurricane Rita added rain to the floodwaters on September 25 (Kates et  al. 2006). Widespread housing damage prevented residents’ returns: 71.5 percent of the 188,251 housing units in Orleans were damaged, with 55.9 percent having major or severe damage (US Department of Homeland Security 2006).

In addition to the physical obstacles, displaced residents of New Orleans also encountered numerous bureaucratic obstacles. Residents were allowed to return home only if their neighborhood had been declared by government officials to be suitable for occupancy. This decision was based on the amount of flood and wind damage and the amount of time it took to remove debris and restore utilities. The decision was also based on highly politicized planning decisions about allocation of funding for rebuilding (Fussell 2015). The decision of whether and when to return was also determined by socioeconomic status and social vulnerability. One year after Katrina, less than half of the black people evacuated from New Orleans had returned, compared to 67% of nonblack people (Bliss 2015). Those neighborhoods with the greatest population losses were those that had more African American and low-income households; had more multiunit residences, rental units, and subsidized housing; had experienced more housing damage; and had received less Federal Emergency Management Agency assistance (Kamel 2012; Wang et  al. 2014; Fussell 2015). Entire neighborhoods were still abandoned, and tens of thousands of people remained displaced and homeless 5 years after Katrina. As noted earlier, the decision whether and when to return was associated, in part, with the extent of damage caused by the storm in different neighborhoods in New Orleans. However, that damage also varied by race/ethnicity and socioeconomic status. The first neighborhoods to reopen were also least damaged with higher property values and greater concentrations of upper middle-class residents; the last to reopen were the low-lying neighborhoods with lower property values and greater concentrations of low-income residents (Fussell 2015). Socially advantaged residents were also more likely to have homeowner’s insurance and receive payments relatively quickly and reliably in order to rebuild. In contrast, their socially disadvantaged counterparts often had to wait years to receive limited funds from disaster relief programs before rebuilding (Fussell 2015). Residents of rental properties and subsidized housing were especially impacted by disparities in the decision whether and when to return. Groups that were more likely to rent rather than own their homes prior to Katrina were less likely to return. This included African Americans and households with below-poverty level incomes. New Orleans experienced a severe reduction in livable rental properties after Katrina, making it difficult if not impossible for socially vulnerable displaced residents to find adequate rental housing and return (Fussell 2015). In addition, the city’s four major public housing complexes were destroyed or condemned (Wennersten and Robbins 2017).

2.4  Characteristics of the Displaced

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The disparity in the ability to return to New Orleans and elsewhere was certainly not unique to Katrina survivors: Disasters tend to disproportionately damage rental and low-income housing, which also tend to be rebuilt more slowly, if at all, while owner-occupied housing is typically repaired and rebuilt quickly (Bolin and Stanford 1998; Comerio 1998; Fothergill and Peek 2004; Fothergill et al. 1999; Zhang and Peacock 2010; Peacock et al. 2014). This “homeowner bias” in post-disaster housing recovery is attributed to the more efficient delivery of insurance payments and federal disaster assistance to homeowners. (Fussell 2015: 1235)

One of the consequences of this disparity in housing ownership is a shift in the demographic characteristics of climigrant communities of origin as socioeconomically advantaged groups, specifically non-Hispanic whites and older adults, are less likely to migrate permanently and socioeconomically disadvantaged groups, such as racial minorities and female-headed, low-income households that live in neighborhoods or communities that are geographically vulnerable to flooding and storm damage and possess limited resources to prevent such damage or rebuild afterward, are more likely to do so (Campanella 2006; Logan 2006; Finch et al. 2010; Fothergill and Peek 2004; Peacock et  al. 2014; Fussell 2015). Extreme weather events can permanently alter the distribution of these two groups in a community. In addition to disparities in the availability of housing, the decision to return to New Orleans and other communities affected by Katrina was influenced by disparities in access to schools and social services. Parents of young children, who felt host communities like Houston were safer and had better schools, and the elderly, who believed New Orleans lacked social services, were less likely to return to New Orleans after Katrina (Dart 2015). Clinics and public health centers were shut down by the disaster. Hospital capacity was reduced by 80% initially, and about 75% of the safety net clinics closed in New Orleans. An estimated 4400 physicians were displaced, and many health-care workers were laid off. Three years later, hospitals continued to operate at limited capacity, and community-based providers remained strained. Although efforts such as the federal Primary Care Access and Stabilization Grant improved some aspects of primary care, access challenges remained, particularly in behavioral health and specialty care (Springgate et al. 2009). Disparities in post-Katrina employment opportunities were another factor contributing to the decision to return. For many low-income residents of color, there was little economic incentive to return to New Orleans. Many low-wage occupations formerly held by black residents were taken by Hispanic immigrants willing to work for even lower wages. A 2011 Loyola University study found that 52% of working-age black men in New Orleans did not have jobs, compared to 9.5% of blacks living in Texas (Dart 2015).

2.4  Characteristics of the Displaced As with most individuals living in the areas impacted by the hurricane, displaced individuals experienced high rates of mental and behavioral health problems. A study of 1043 residents of the areas affected by Hurricane Katrina found that 49.1%

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of New Orleans residents had a 30-day prevalence of any DSM-IV anxiety-mood disorder and 30.3% had PTSD (Galea et al. 2007). The 30-day prevalence in other areas in Alabama, Louisiana, and Mississippi affected by the hurricane was 26.4% for any anxiety-mood disorder and 12.5% for PTSD. The extent of stressor exposure was more strongly related to the outcomes in the New Orleans metropolitan area subsample than the remainder of the sample residing in Alabama, Louisiana, and Mississippi affected by Katrina, perhaps due to differences in vulnerability and resources. A study by Schumacher et al. (2010) reported a significant increase in interpersonal violence post-Katrina. One year after the hurricane, Kessler et  al. (2008) found that the prevalence increased significantly in a representative sample of 815 pre-hurricane residents for PTSD (20.9 vs. 14.9% at baseline), serious mental illness (14.0 vs. 10.9%), suicidal ideation (6.4 vs. 2.8%), and suicide plans (2.5 vs. 1.0%). These increases were contrary to results reported by other disaster studies, where post-disaster mental disorder typically decreases with time. In another study conducted 1  year after the hurricane, Sastry and VanLandringham (2009) found a total of 39% of respondents in a sample of 144 New Orleans residents had a DSM-IV anxiety or mood disorder in the past 30 days. Symptoms of posttraumatic stress remained high 43–54 months later, especially among those who experienced hurricane-related trauma and had poor mental health and low SES before the hurricane (Paxson et al. 2012). Studies also found disparities in these mental and behavioral health problems. Blacks had higher rates of severe mental illness than did whites or others 1 year after the hurricane (Sastry and VanLandringham 2009). Rhodes et al. (2010) found that nearly half (47.7%) of marginalized community members of New Orleans (mainly low-income, African American women) showed probable signs of PTSD after Hurricane Katrina. In contrast, only 5% of a sample of 82 Vietnamese Americans met all PTSD criteria (Norris et  al. 2009). Nevertheless, “severity of exposure to the floodwaters, property loss, and subjective trauma were independently related to PTSD symptoms. Symptoms were highest among participants who were low in acculturation or who had high Katrina exposure in combination with prolonged stays in transition camps during emigration” (Norris et al. 2009: 91). Children living in the region were especially vulnerable to these mental and behavioral health problems, with as many as 60% of New Orleans schoolchildren screening positive for PTSD symptoms (Jaycox et  al. 2010). More than 50% of 1077 children reported significant mental health distress 2  years after Katrina (Abramson et al. 2008). A study by Osofsky et al. (2009) found that half of the children surveyed in the first year (2005 through 2006) met the cutoff for referral for mental health services; in the second year (2006 through 2007), 41% still met the cutoff for referral. Investigators also found that children experienced increased trauma symptoms if they were currently separated from a parent or caregiver, if they had lived in a shelter, or if they were living in a trailer instead of their house (Osofsky et al. 2009: 218). In addition, “many children experienced personal losses including destruction of their home or neighborhood, death of family members or friends during or shortly after the storm, having their personal belongings such as toys or

2.5  Impacts of Displacement

25

clothes destroyed, and loss of family finances because of parental unemployment” (Osofsky et al. 2009: 212). A study by Fothergill and Peek (2015) also found that many of the children affected by Hurricane Katrina had also been exposed to poverty, violence, failing schools, housing instability, and other stresses in their daily lives and were among those most likely to be forced to relocate since their neighborhoods and communities were susceptible to flooding.

2.5  Impacts of Displacement 2.5.1  Impacts on the Displaced Given that displacement was also tied to exposure to the damage caused by the hurricane, evacuees who were unable to return to New Orleans may have also been more likely to be at increased risk for these problems. Perhaps the most notable impact of displacement was on the mental and behavioral health of a population already made vulnerable by exposure to the hurricane itself. A population-based post-Katrina study of New Orleans conducted by Sastry and VanLandringham (2009) found probable mental illness was six times more likely among respondents whose homes were unlivable compared to those with livable homes. Another study conducted by Abramson et al. (2008) found living outside of one’s pre-Katrina community was associated with poorer mental health in a sample of residents of emergency housing or housing tracts in Louisiana and Mississippi with major damage from Hurricane Katrina. In another study, Katrina-related PTSD was found in 38% of relocated survivors compared to 10% in demographically matched controls (Tucker et al. 2012). More than 50% of Katrina evacuees living in Louisville KY had PTSD 1 year after hurricane (LaJoie et al. 2010). More than one-fourth of a sample of evacuees living in Dallas met the criteria for major depressive disorder (MDD). About one-third of the individuals received a referral to mental health services for meeting symptom criteria for MDD and PTSD (King et  al. 2016). Permanently relocated low-income residents, predominately African American single mothers, exhibited significantly higher levels than returned residents of psychological distress and perceived stress, and unstably housed residents exhibited significantly higher levels of perceived stress (Fussell and Lowe 2014). Having to evacuate before, during, or after a disaster enhances risk for psychological distress (Najarian et al. 2001; Kiliç et al. 2006). A systematic review of studies of postdisaster displacement documented significant increases in psychological symptoms of distress, depression, and posttraumatic stress among disaster victims who had relocated, compared to those who returned to their predisaster communities (UscherPines 2009). According to Fussell and Lowe (2014: 138): Displacement often disrupts the social support systems that mediate the mental health impacts of primary disaster stressors (e.g. Le et al. 2013). Further, displacement alters regular routines associated with homes, jobs, physical activity, participation in social organiza-

26

2  Hurricane Katrina and New Orleans tions, and healthcare access (Abramson et  al. 2010). It may also introduce additional stressors when housing conditions are crowded or evacuees feel socially isolated, in danger, or that they are victims of discrimination (Riad and Norris 1996; Weems et al. 2007). These all suggest that displaced residents are likely to experience more secondary stressors than those who have returned to their homes or communities, and that displacement experiences may be associated with different levels of resource loss (Lock et al. 2012).

The authors also pointed to four specific characteristics of displacement that were found to be associated with rates of post-disaster mental health in research conducted in the aftermath of Katrina: 1) the geographic distance of a person from their predisaster community; 2) the type of housing to which residents relocated; 3) the number of moves; and 4) length of time in interim housing (Fussell and Lowe 2014). Many of those who were displaced by Katrina also experienced a decline in perceived quality of life. The federal government’s capacity to assist those whose homes were damaged or destroyed was quickly overwhelmed by the sheer number of Gulf Coast residents in need of shelter: For thousands of those evacuees, living conditions in Houston were not good. According to a 2006 survey by the city of Houston, about a quarter of former New Orleans residents who were displaced to Houston (including those displaced by Rita, which hit the Gulf less than a month after Katrina) were staked out in FEMA-funded apartments in high-crime, high-­ poverty neighborhoods on the city’s southwest side. (Bliss 2015)

Displacement also resulted in increased feelings of social isolation. While many displaced residents migrated to places close by family and friends who were living in other parts of the state or country, others were cut off from the sources and the material and emotional social support disaster victims often rely upon (Ibañez et al. 2004; Wadsworth et al. 2009). For many of these survivors, moving to an unfamiliar city meant limited opportunities for mobilizing support (Kaniasty and Norris 1993; Norris et al. 2005), and empathy and support from the larger host community diminished over time. Another stressor experienced by many displaced Katrina survivors was reduced access to care. A population-based assessment of the health-care access of 610 residents of FEMA trailer parks in Mississippi 2 years after Katrina found a worsening of chronic condition, mental illness, and barriers to health-care access since displacement (Shebab et  al. 2008). Sixty-two percent reported their health status as being fair or poor after displacement, compared to 32% in the time period before displacement. Fifty-seven percent met criteria for major depressive disorder, and 72% report symptoms of depression since displacement. Since displacement, 24% of respondents reported suicidal ideation, and 5% reported personal suicide attempts. “We estimated suicide attempts and suicide rates to be 1,314 per 100,000 per year and 43.8 per 100,000 per year, respectively, in this population” (Shebab et  al. 2008: w422). Finally, many displaced residents living in Houston and elsewhere experienced discrimination. Native Houstonians became less empathetic and more dissatisfied with the perceived encroachment on their community and overreliance on their goodwill and services by their less fortunate neighbors who had arrived from New

2.5  Impacts of Displacement

27

Orleans. “Twelve months after the disaster, at a meeting in a church in an affluent part of Houston, hundreds of white residents demanded the mayor send the ‘Katrina illegal immigrants’ back to Louisiana” (Dart 2015). Concern about the stigma of a displaced resident being referred to as a “Katrina refugee” led to calls to stop using the term (Pesca 2005). Each of these experiences is likely to have contributed to the mental and behavioral health problems experienced by those displaced by Katrina. A study of 708 adults living in the 23 southernmost counties of Mississippi found that after adjustment for individual- and county-level sociodemographic characteristics and county-­level hurricane exposure, joint exposure to both displacement and low social cohesion was associated with substantially higher odds of depression (Le et  al. 2013). Associations were much weaker for exposure to low social cohesion or only to displacement. The study concluded the following: Displaced persons may experience higher risk for depression than the nondisplaced because in addition to the trauma of the event itself, they may experience a host of additional stressors that unfold and persist afterward (Porter and Haslam 2005; Uscher-Pines 2009). In addition to material and administrative hardships such as decreased access to medical and social services, worse living conditions, repair or replacement of damaged possessions, application processes for governmental aid, and difficulty finding employment, the loss of social networks, social supports, and normal routines can add to the psychological burden of displacement. (Le et al. 2013: 1729–1730)

However, not all of the experiences of displacement were negative. Many of the displaced residents from New Orleans found an improved quality of life and more opportunities in other locations throughout the United States: Hurricane Katrina was a blessing to me. I thank God that everything happened. And not just saying that because none of my family is dead or we have another house. Just to get out of New Orleans … Because when you live in something, you only see what you see … God, you gave me an opportunity to get out of a place that was below sea level. It’s hard to get a job there, the poverty rate there. You allowed me to get out of there and to get into a place where there’s more opportunities. And anybody who is out of New Orleans is in a place that has more opportunities than New Orleans. (Bosick 2015: 249)

2.5.2  Impacts on Community of Origin The most notable impact of displacement post-Katrina was a decline in the population of the region. For instance, the population of New Orleans declined from 484,674 in 2000 to 344,000 in the year after Katrina (Nossiter 2006). By 2014, the city’s population had risen to 384,320. Despite the increase in diversity due to an influx of Hispanics seeking employment opportunities in the rebuilding of the city and the return of Vietnamese American residents, about 100,000 of the African Americans who were displaced by the hurricane never returned, compared to only 9000 whites (Bliss 2015). In the predominantly black Lower Ninth Ward, only 30% of pre-Katrina residents had returned by 2013. “But out of all groups, it seems to be

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children who were the least likely to return to New Orleans. From 2000 to 2010, the Data Center reports, the number of children under the age of 18 living in New Orleans decreased by 56,193, or 43 percent” (Bliss 2015).

2.5.3  Impacts on Host Communities Given the housing, financial, and health-care needs of the displaced, host communities experienced a strain on existing resources available to meet these needs. In Texas, “housing was scarce and often unaffordable for evacuees. Schools, transit systems, and Medicaid programs were overwhelmed” (Bliss 2015). In turn, limited resources and misperceptions of the new arrivals led to increased levels of social tension and community conflict. As noted earlier, many of the overwhelmingly poor and black evacuees sent to Houston were housed in FEMA-funded apartments in poor and crime-ridden neighborhoods. Claims that the influx of evacuees was linked to a supposed crime wave only added to the growing hostility of long-time residents toward the newcomers (Hopkins 2011; Holywell 2015). Although subsequent investigation found the purported association between the arrival of the evacuees and a crime wave to be false, the negative attitude toward the newcomers persisted. A citywide survey conducted in 2010 revealed that 58% of Houstonians felt that the overall impact of the evacuees on the city had been negative (Bliss 2015).

2.6  Lessons Learned Our examination of Hurricane Katrina and its aftermath reveals four important lessons tied to population displacement and climate-related extreme weather events. The first lesson is that there are different patterns of displacement that are linked to different types of decisions required of survivors of extreme weather events. In the case of Hurricane Katrina, displacement for some meant short-term evacuation from the city until civil authorities had given the authorization to return to intact or slightly damaged homes. For others, it meant longer-term absence from New Orleans until homes could be rebuilt or alternative housing could be found. For still others, the departure was permanent as many former residents found a better quality of life elsewhere or were too poor and lacking in resources to return. These patterns of displacement were also influenced by three sets of decisions, those related to whether to leave the city, those related to where to go, and those related to whether to return. The decision of whether to leave was influenced by the ability to do so (i.e., availability of transportation) as well as the perceived risk associated with the extreme weather event. The decision where to go was driven for some by evacuation authorities and for others by social ties, often family and friends who had left New Orleans in the years prior to Katrina. The decision to return was driven by the attrac-

References

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tion of better employment or educational opportunities elsewhere, connections to social support elsewhere, and the availability of housing, employment, and services upon return to New Orleans. The second lesson to be learned from Hurricane Katrina is that the displaced were saddled with two burdens, one associated with the degree of exposure to the extreme weather event and one associated with the displacement experience itself. Many of those who were displaced from New Orleans during and after the hurricane bore witness to the death and destruction caused by the hurricane. The traumatic experience resulted in a dramatic increase in posttraumatic stress, psychiatric disorders, substance use, and domestic violence. Separation from family and friends, housing insecurity, reduced access to care, and experience of discrimination for being a “Katrina refugee” only added to the stress, prolonging traumatic symptoms or generating new symptoms of psychological distress. The third lesson is that both patterns of displacement and its effects on the displaced were not shared equally. More affluent, white residents were able to recover from the disaster and return to New Orleans than less affluent, black residents. The decision to stay or to go, to return home or to remain at a host community, is directly tied to wealth. In any natural disaster, wealthier residents will initially be more likely to possess the resources necessary to leave. Later, they will be more likely to return and rebuild. In other words, they will be the first to leave and the first to return in the aftermath of an acute extreme weather event like Katrina. The final lesson is that the burdens of displacement are not experienced by the displaced alone; they are also experienced by those that remain in the affected community and those that receive the displaced into their own communities. Hurricane Katrina left New Orleans a smaller, older, less ethnically diverse community. Many residents who remained or returned saw family and friends who were important sources of comfort and support permanently settle in other parts of the state or country. While many host cities welcomed displaced residents of the Gulf Coast in the days, weeks, and months after Katrina, in some communities, most notably Houston where over 250,000 were relocated, the strain on existing services and resources resulted in a backlash against the displaced and a struggle to meet the needs of all residents. In subsequent chapters, we will see these lessons reinforced by the experience of others who have been displaced by other extreme weather events such as fires and floods and by long-term changes in climate such as droughts and coastal erosion.

References Abramson D, Stehling-Ariza T, Garfield R et al (2008) Prevalence and predictors of mental health distress post-Katrina: findings from the Gulf Coast Child and Family Health Study. Disaster Med Public Health Prep 2(2):77–86 Abramson DM, Park YS, Stehling-Ariza T et  al (2010) Children as bellweathers of recovery: dysfunctional systems and the effects of parents, households, and neighborhoods on serious

30

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emotional disturbance in children after Hurricane Katrina. Disaster Med Public Health Prep 4(Suppl 1):S17–S27. https://doi.org/10.1001/dmp.2010.7 Bliss L (2015) 10 years later: There’s so much we don’t know about where Katrina survivors ended up. Citylab, 25 Aug. https://www.citylab.com/equity/2015/08/10-years-later %2D%2Dtheresstill-a-lot-we-dont-know-about-where-katrina-survivors-ended-up/401216/. Accessed 15 Apr 2019 Bolin R, Stanford L (1998) The Northridge earthquake: vulnerability and disasters. Routledge, New York Bosick SJ (2015) Pushed out on my own: the impact of Hurricane Katrina in the lives of low-­ income emerging adults. Sociol Perspect 58(2):243–263 Brinkley D (2006) The great deluge: Hurricane Katrina, New Orleans, and the Mississippi Gulf Coast. William Morrow, New York Brodie M, Weltzien E, Altman D et al (2006) Experiences of hurricane Katrina evacuees in Houston shelters: implications for future planning. Am J Public Health 96:1402–1408 Campanella R (2006) Geographies of New Orleans: urban fabrics before the storm. University of Louisiana Press, Lafayette, LA U.S.  Census Bureau (2005) American factfinder, 7 Sept. http://www.factfinder2.census.gov. libproxy2.usc.edu. Accessed 18 Apr 2019 Comerio MC (1998) Disaster hits home: new policy for urban housing recovery. University of California Press, Berkeley, CA Dart T (2015) ‘New Orleans West’: Houston is home for many evacuees 10 years after Katrina. The Guardian (UK), 25 Aug. https://www.theguardian.com/us-news/2015/aug/25/new-orleanswest-houston-hurricane-katrina. Accessed 15 Apr 2019 Elliott JR, Pais J (2006) Race, class, and Hurricane Katrina: social differences in human responses to disaster. Soc Sci Res 35:295–321 Ellison D (2006) Katrina’s aftermath: a tale of two cities. Houston Chronicle, 19 Sept. http:// www.chron.com/news/houston-texas/article/Moving-on-proves-easier-for-evacuees-inAtlanta-1649800.php. Accessed 15 Apr 2019 Ericson M, Tse A, Wilgoren J (2005) Katrina’s diaspora. New York Times, 5 Oct. https://archive. nytimes.com/www.nytimes.com/imagepages/2005/10/02/national/nationalspecial/20051002di aspora_graphic.html?module=inline. Accessed 12 Jan 2019 Finch C, Emrich CT, Cutter SL (2010) Disaster disparities and differential recovery in New Orleans. Popul Environ 31(4):179–202 Fothergill A, Peek LA (2004) Poverty and disasters in the United States: a review of recent sociological findings. Nat Hazards 32:89–110 Fothergill A, Peek LA (2015) Children of Katrina. University of Texas Press, Austin, TX Fothergill A, Maestas EGM, Darlington JD (1999) Race, ethnicity, and disasters in the United States: a review of the literature. Disasters 23:156–173 Frey WH, Singer A, Park D (2007) Resettling New Orleans: the first full picture from the census (Metropolitan Policy Program Report). The Brookings Institution, Washington, DC Fussell E (2006) Leaving New Orleans: social stratification, networks, and hurricane evacuation. In Understanding Katrina: perspectives from the social sciences. http://undersstandingkatrina. ssrc.org/Fussell/. Accessed 14 Apr 2019 Fussell E (2015) The long-term recovery of New Orleans’ population after Hurricane Katrina. Am Behav Sci 59(10):1231–1245 Fussell E, Lowe SR (2014) The impact of housing displacement on the mental health of low-­ income parents after Hurricane Katrina. Soc Sci Med 113:137–144 Galea S, Brewin CR, Gruber M et al (2007) Exposure to hurricane-related stressors and mental illness after Hurricane Katrina. Arch Gen Psychiatry 64:1427–1434 Greenwood MJ (1985) Human migration: theory, models, and empirical studies. J Regional Sci:25521–25544 Groen JA, Polivka AE (2010) Going home after Hurricane Katrina: determinants of return migration and changes in affected areas. Demography 47:821–844

References

31

Holywell R (2015) No, Katrina evacuees didn’t cause a Houston crime wave. Rice University Kinder Institute for Urban Research, August 25, 2015. https://kinder.rice.edu/2015/08/25/no-­ katrina-­evacuees-didnt-cause-a-houston-crime-wave. Accessed 13 Apr 2019 Haney TJ, Elliott JR, Fussell E (2010) Families and hurricane response: risk, roles, resources, race and religion. In: Brunsma D, Overfelt D, Picou JS (eds) The sociology of Katrina: perspectives on a modern catastrophe, 2nd edn. Rowman & Littlefield, Landham, MD, pp 77–102 Hopkins DJ (2011) Flooded communities: explaining local reactions to the post-Katrina migrants. Pol Res Q 20:1–17 Hopper J (2010) Katrina at five: the lower ninth ward. ABC News, Aug. 26, 2010. https://abcnews. go.com/WN/katrina-lower-ninth-ward/story?id=11488921. Accessed 13 Apr 2019 Ibañez GE, Buck CA, Khatchikian N et al (2004) Qualitative analysis of coping strategies among Mexican disaster survivors. Anxiety Stress Coping 17:69–85 Jaycox LH, Cohen JA, Mannarino AP et  al (2010) Children’s mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies. J Trauma Stress 23:223–231 Kamel N (2012) Marginalisation, federal assistance and repopulation patterns in the New Orleans metropolitan area following Hurricane Katrina. Urban Stud 49:3211–3231 Kaniasty K, Norris FH (1993) A test of the social support deterioration model in the context of natural disaster. J Pers Soc Psychol 64:395–408 Kates RW, Colten CE, Laska S et  al (2006) Reconstruction of New Orleans after Hurricane Katrina: a research perspective. Proc Natl Acad Sci 103:14653–14660 Kessler RC, Galea S, Gruber MJ et al (2008) Trends in mental illness and suicidality after Hurricane Katrina. Mol Psychiatry 13:374–384 Kiliç C, Aydin I, Taskintuna N et  al (2006) Predictors of psychological distress of the 1999 earthquake in Turkey: effects of relocation after the disaster. Acta Psychiatr Scand 114:194–202 King RV, Polatin PB, Hogan D et  al (2016) Needs assessment of Hurricane Katrina evacuees residing temporarily in Dallas. Community Ment Health J 52(1):18–24 Knabb RD, Rhome JR, Brown DP (2005) Tropical cyclone report Hurricane Katrina. National Hurricane Center. https://www.nhc.noaa.gov/data/tcr/AL122005_Katrina.pdf. Accessed 18 Apr 2019 LaJoie AS, Sprang G, McKinney WP (2010) Long-term effects of Hurricane Katrina on the psychological well-being of evacuees. Disasters 34:1031–1044 Le F, Tracy M, Norris FH et al (2013) Displacement, county social cohesion, and depression after a large-scale traumatic event. Soc Psychiatry Psychiatr Epidemiol 48:1729–1741 Lock S, Rubin GJ, Murray V et al (2012) Secondary stressors and extreme events and disasters: a systematic review of primary research from 2010-2011. PLoS Curr 29:4 Logan JR (2006) The impact of Katrina: race and class in storm-damaged neighborhoods. http:// wps.ablongman.com/wps/media/objects/12936/13246811/pdf/Report_2.pdf. Accessed 15 Apr 2019 Long L (1992) Changing residence: comparative perspectives on its relationship to age, sex, and marital status. Popul Stud 46:141–158 Najarian L, Goenjian A, Pelcovitz D et al (2001) The effect of relocation after a natural disaster. J Trauma Stress 14:511–526 Nigg JM, Barnshaw J, Torres MR (2006) Hurricane Katrina and the flooding of New Orleans: emergent issues in sheltering and temporary housing. Ann Am Acad Pol Soc Sci 604:113–128 Norris FH, Baker CK, Murphy AD et al (2005) Social support mobilization and deterioration after Mexico's 1999 flood: effects of context, gender and time. Am J Community Psychol 36:15–28 Norris FH, VanLandingham MJ, Vu L (2009) PTSD in Vietnamese Americans following Hurricane Katrina: prevalence, patterns and predictors. J Trauma Stress 22:91–101 Nossiter A (2006) New Orleans population is reduced nearly 60%. New York Times, 7 Oct. https:// www.nytimes.com/2006/10/07/us/07population.html. Accessed 2 Feb 2017 Osofsky HJ, Osofsky JD, Kronenberg M et al (2009) Posttraumatic stress symptoms in children after Hurricane Katrina: predicting the need for mental health services. Am J Orthopsychiatry 79:212–220

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Paxson C, Fussell E, Rhodes MJ et al (2012) Five years later: recovery from post-traumatic stress and psychological distress among low-income mothers affected by Hurricane Katrina. Soc Sci Med 74:150–157 Peacock WG, Van Zandt S, Zhang Y et al (2014) Inequities in long-term housing recovery after disasters. J Am Plann Assoc 80:356–371 Pesca M (2005) Are Katrina's victims ‘refugees’ or ‘evacuees?’ NPR reporters notebook, 5 Sept. https://www.npr.org/templates/story/story.php?storyId=4833613. Accessed 15 Apr 2019 Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294:602–612 Rhodes J, Cha C, Paxson C et al (2010) The impact of hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry 80(2):237–247 Riad JK, Norris FH (1996) The influence of relocation on the environmental, social, and psychological stress experienced by disaster victims. Environ Behav 28(2):163–182 Robertson C (2011) Smaller New Orleans after Katrina, census shows. New York Times, 3 Feb. https://www.nytimes.com/2011/02/04/us/04census.html. Accessed 15 Apr 2019 Sastry N, Gregory J (2014) The location of displaced New Orleans residents in the year after Hurricane Katrina. Demography 51:753–775 Sastry N, VanLandringham M (2009) One year later: mental illness prevalence and disparities among New Orleans residents displaced by Hurricane Katrina. Am J Public Health 99(suppl 3):S725–S731 Schumacher JA, Coffey SF, Norris FH et  al (2010) Intimate partner violence and Hurricane Katrina: predictors and associated mental health outcomes. Violence Vict 25:588.603 Scott N (2015) Refuge of last resort: five days inside the superdome for Hurricane Katrina. USA Today, 24 Aug. https://ftw.usatoday.com/2015/08/refuge-of-last-resort-five-days-inside-thesuperdome-for-hurricane-katrina. Accessed 15 Apr 2019 Shebab N, Anastario MP, Lawry L (2008) Access to care among displaced Mississippi residents in FEMA travel trailer parks two years after Katrina. Health Aff 27:w416–w429 Springgate BF, Allen C, Jones C et  al (2009) A rapid community participatory assessment of healthcare access in post-Katrina New Orleans. Am J Prev Med 27:S237–S243 Stark O, Bloom DE (1985) The new economics of labor migration. Am Econ Rev 75:173–178 Thiede BC, Brown DL (2013) Hurricane Katrina: who stayed and why? Pop Res Policy Rev 32:803–824 Tizon TA, Smith D (2005) Evacuees of Hurricane Katrina resettle along a racial divide. Los Angeles Times, 12 Dec. http://articles.latimes.com/2005/dec/12/nation/na-migration12. Accessed 19 Apr 2019 Tucker P, Pfefferbaum B, Jeon-Slaughter H et al (2012) Emotional stress and heart rate variability measures associated with cardiovascular risk in relocated Katrina survivors. Psychosom Med 74:160–168 U.S. Department of Homeland Security (2006) Current housing unit damage estimates: Hurricanes Katrina, Rita, and Wilma. www.huduser.org/publications/pdf/GulfCoast_Hsngdmgest.pdf. Accessed 15 Apr 2019 Uscher-Pines L (2009) Health effects of relocation following disaster: a systematic review of the literature. Disasters 33:1–22 Wadsworth ME, DeCarlo Santiago C, Einhorn L (2009) Coping with displacement from Hurricane Katrina: predictors of one-year post-traumatic stress and depression symptom trajectories. Anxiety Stress Coping 22:413–432 Wang F, Tang Q, Wang L (2014) Post-Katrina population loss and uneven recovery in New Orleans, 2000–2010. Geogr Rev 104:310–327 Weber L, Peek L (eds) (2012) Displaced: life in the Katrina diaspora. University of Texas Press, Austin, TX

References

33

Weems CF, Watts SE, Marsee MA et al (2007) The psychosocial impact of Hurricane Katrina: contextual differences in psychological symptoms, social support, and discrimination. Behav Res Ther 45(10):2295–2306 Wennersten JR, Robbins D (2017) Rising tides: climate refugees in the twenty-first century. Indiana University Press, Bloomington, IN Zhang Y, Peacock WG (2010) Planning for housing recovery? Lessons learned from Hurricane Andrew. J Am Plann Assoc 76:5–24

Chapter 3

Hurricane Maria and Puerto Rico

3.1  The Narrative 3.1.1  The Event I can’t watch the US news. I physically can’t—I have no way to—but even as the Internet is slowly returning to work this week, I couldn’t bring myself to. Puerto Rico is living through a catastrophe, and the federal government is not exactly showing compassion. Maria has laid bare an old and enduring chasm between the San Juan metro area and everyone else. They call us la isla, as if we don’t also live on the same island as they do. So when San Juan quickly recovered, as all provisions and supplies were funneled to its ports—while the governor called meetings of all the town mayors, making the only leaders helping western Puerto Rico waste the day traveling for hours to San Juan—the image sent by the Puerto Rican central government to everyone else is that since San Juan is ok, all of Puerto Rico is ok. But we are not ok. There are still over 150 people from rural towns unaccounted for. Almost everyone is without power, even if the water plants are slowly coming online (powered by diesel generators). As we are able to be more mobile, we hear more stories. One of my dearest friends spent 18 h of the storm floating on an air mattress inside of her living room in 5 ft of water, before being rescued by good Samaritans on kayaks. My husband’s secretary lost everything as the river and ocean united to flood her home. She found fish in her house. My building’s janitor described how the flood waters converted his home into a blender, moving furniture from one room to another. “But I’m not throwing anything away, I’m just drying it out,” he says. “Because I don’t know what FEMA is going to give us” (Mazak 2017).

© Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_3

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3.1.2  The Displacement Fernando De la Vega and his family landed in Miami, but they were lucky to even find an open flight off the island, he said. Vega, who had been without power in Guaynabo since Hurricane Irma, was concerned for the health and well-being of his two daughters; one has special needs and the other is pregnant. Until conditions improve, they’ll likely stay in Miami. “Ultimately, something clicked in my head and I said ‘We need to get out of here, at least temporarily,’” he said. Enid Olivieri, also from Guaynabo, booked one flight that was canceled and wasn’t able to communicate with her sister in Virginia over the phone to book another. Eventually, she was able to leave with her aunt, uncle, and mother on a relief flight for the elderly and people with medical needs to Fort Lauderdale before heading to Virginia. “It’s very difficult to uproot yourself and come here, but we see no choice,” she said. Olivieri, who has apnea, uses a machine at night to help her breathe. When she lost power, she and her husband moved around a lot, staying in hotels and with relatives who had electricity so she could sleep at night. But it wasn’t a permanent fix. “My husband told me, ‘You have to leave. You call your sister, and you have to leave.’ So I left,” she said. Olivieri’s husband will fly to the states in a couple of weeks (Dobrin 2017).

3.2  Hurricane Maria 3.2.1  The Damage Classified as a Category 5 hurricane at its peak, Hurricane Maria is regarded as the worst natural disaster on record to affect the islands located in the northeastern Caribbean, most notably Dominica and Puerto Rico. It is also considered to be one of the deadliest Atlantic hurricanes on record. Maria became a tropical storm on September 16, 2017, and reached Category 5 strength on September 18 just before making landfall on Dominica. By the time it struck Puerto Rico on September 20, it had weakened slightly to Category 4, causing widespread flooding and structural damage across the island. Some communities were almost completely destroyed with few structures escaping significant damage. The combined destructive power of storm surge and wave action from Maria produced extensive damage to buildings, homes, and roads along the northwest, east, and southeast coast of Puerto Rico and the south coast of Vieques. The La Plata River flooded the town of Toa Baja, where hundreds of families needed to be rescued from their rooftops (Pasch et al. 2019). The hurricane also destroyed the island’s power grid, leaving all 3.4 million residents without electricity. All of Puerto Rico was declared a Federal Disaster Zone shortly after the hurricane. One week after the hurricane, 95% of the island

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was without power, less than half the population had tap water, and 95% of the island had no cell phone service (Pasch et al. 2019). One month after the hurricane, 88% of the island still had no power, 29% lacked tap water, and 40% of the island had no cell service. All hospitals were open, but most were on backup generators that provide limited power. About half of sewage treatment plants on the island were still not functioning. FEMA reported 60,000 homes had damaged roofs that required repair. Only 392 miles of Puerto Rico’s 5073 miles of road were open. Some towns continued to be isolated, and helicopters were used to deliver relief supplies including food and water. Three months after the hurricane, 1.5 million people or 45% of Puerto Ricans still had no power; 14% had no tap water; and over 90% cell service was restored. By the end of January 2018, electricity had been restored to about 65% of the island (Pasch et al. 2019). The NOAA estimate of damage in Puerto Rico and the US Virgin Islands due to Maria was 90 billion dollars, making Maria the third costliest hurricane in the US history, behind Katrina (2005) and Harvey (2017) (Pasch et al. 2019).

3.2.2  The Deaths Although the number of deaths that could be directly attributed to the storm became a subject to controversy and wide variation due to differences in quality of data and methodology employed, Hurricane Maria was also potentially one of the deadliest hurricanes in US history. An initial estimate provided by the government of Puerto Rico placed the number of excess deaths at 64 (Santos-Lozada and Howard 2018). However, subsequent analyses reported substantially higher disaster-related mortality. Using preliminary death counts through October 2017, Santos-Lozada and Howard (2017) estimated the number of excess deaths related to the hurricane to be 1085. They subsequently revised the estimate upward to 1139 excess deaths (95% CI: 1006 to 1272) by using death counts from vital statistics records through December 2017 (Santos-Lozada and Howard 2018). Using mortality data from the Puerto Rico Vital Statistics System, Santos-Burgoa et al. (2018) conducted a time series analysis and estimated 1191 excess deaths (95% CI: 836 to 1544) and 2975 excess deaths (95% CI: 2658 to 3290) under a preferred displacement scenario from September 2017 to February 2018. Residents of municipalities with the lowest socioeconomic development and men aged 65 years or older were at greatest risk for mortality (Santos-Burgoa et al. 2018). Another study of a stratified random sample of 3299 residents estimated a mortality rate of 14.3 deaths per 1000 persons from September 20 to December 31, 2017, yielding a total of 4645 excess deaths (95% CI: 793 to 8498) or a 62% increase in mortality rate compared to the same period in 2016 (Kishore et  al. 2018). One-third of the deaths were attributed to delayed or interrupted health care. Using time series forecasting with monthly mortality data in Puerto Rico from January 2010 and September 2017, Verma et  al. (2018) estimated the number of excess deaths in the 102 days following Maria to be 4970 (95% CI: 1117 to 8822).

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3.3  Patterns of Displacement 3.3.1  Numbers of Climigrants In the 10 weeks following the hurricane, more than 200,000 Puerto Ricans relocated to Florida, with most of the new arrivals settling in and around Miami and Orlando (Sesin 2017). Using data from the American Community Survey, investigators at the Center for Puerto Rican Studies at Hunter College in New York estimated a loss of up to 212,607 persons, or 6% of the Puerto Rican population on the island would migrate to the mainland in the year after Hurricane Maria and that by 2019, one in seven residents may have relocated to the mainland (Melendez and Hinojosa 2017). By 2019, they estimated a departure of 470,335 or 14% of the population or roughly the same number of people as the island lost during the prior decade of economic stagnation. Their projections indicated that Florida would be the state most likely to be affected by the exodus—with an estimated annual flow of between 40,000 and 82,000 people. However, this assessment was based on the assumption that there will be no significant return migration (Melendez and Hinojosa 2017). Subsequent research conducted by the Pew Research Center based on US Census data found that the migration from Puerto Rico was closer to 130,000 or 3.9% of the population (Figs. 3.1 and 3.2). Using data supplied by FEMA, a subsequent report issued by the Center identified 40,013 household members and 19,271 households, who changed their mailing address since they first registered with FEMA and relocated to the US mainland as a result of Hurricane Maria (Hinojosa et al. 2018). Florida received 45% of FEMA evacuees, followed by New York (9%), Massachusetts (8%), and Pennsylvania (7%). Using data from Facebook, Alexander et al. (2019) found evidence to indicate a 17% increase in the number of Puerto Rican migrants on the mainland between October 2017 and January 2018. States with the biggest increases were Florida, New York, and Pennsylvania, and there were disproportionately larger increases in the 15–30 age groups and for men compared to women. However, they also found evidence of subsequent return migration to Puerto Rico over the period January 2018 to March 2018. Using data harvested from a sample of nearly 500,000 smartphones in partnership with a major US cell phone carrier, a New  York-based company called Teralytics estimated that between the months of August 2017 and February 2018, nearly 6% of the Puerto Rican population left the island and was still living in the mainland. Another 6% left between September and October 2017 but returned to the island by February 2018 (Echenique and Melgar 2018). “Most of those who left the island moved to Florida (43 percent), followed by New York (9 percent), Texas (7 percent) and Pennsylvania (6 percent). Within Florida, the areas that received the largest amount of Puerto Ricans were Orlando (22 percent in Orange County), Osceola County (15 percent), and Miami (100% in Miami-Dade County)” (Echenique and Melgar 2018) (Table 3.1).

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Fig. 3.1  Puerto Rico’s population growth rate 2009–2018. Reprinted from “Puerto Rico’s population declined sharply after Hurricane’s Maria and Irma.” Pew Research Center, Washington, DC (July 26, 2019) https://www.pewresearch.org/fact-tank/2019/07/26/puerto-rico-population-2018/

It is also important to note that not all of the climigration occurred from the island to the mainland. In a stratified random sample of 3299 households across Puerto Rico in early 2018, Kishore et al. (2018) found that of those who left because of the hurricane, the majority (52%) moved elsewhere within Puerto Rico. They further noted that the median age of those who left and did not return, or were missing, was 25 years, as compared with a median age of 50 among those staying or dying in the household (Fig. 3.3) (Kishore et al. 2018: 165).

3.3.2  Displacement-Related Decisions The damage to housing and infrastructure was perhaps the most immediate reason for moving elsewhere. An estimated 10,000 people were in shelters across the island because their homes were destroyed by Hurricane Maria. In one community, 60% of the population was left homeless by the hurricane (Allen et al. 2017). Eventually, more than 1.1  million Puerto Ricans registered for FEMA help after Hurricane

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Fig. 3.2  Net migration from previous year 2009–2018, Puerto Rico. Reprinted from “Puerto Rico’s population declined sharply after Hurricane’s Maria and Irma.” Pew Research Center, Washington, DC (July 26, 2019) https://www.pewresearch.org/fact-tank/2019/07/26/ puerto-rico-population-2018/

Maria. However, two out of five applicants were deemed ineligible, often because they were renters or lacked documents to prove ownership of residences (Hernandez 2018b). Destruction of the island’s infrastructure resulted in shortages of food and water and limited access to health care for residents with injuries due to the hurricane or with chronic diseases in need of treatment. According to a report prepared by the Henry J. Kaiser Family Foundation: Over eight in ten (83 percent) say they were affected by the hurricane in at least one of the following ways: they were without grid power for four or more months, they had employment losses, their home was destroyed or majorly damaged, their vehicle was damaged, they drank water from a natural source, they or a family member have a new or worsened health condition, or they have received mental health services as a result of the storm. In

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Table 3.1  Top ten counties receiving Puerto Rican population

County Orange Osceola Miami-Dade Hillsborough Polk Broward Bronx Seminole Hampden Philadelphia

State Florida Florida Florida Florida Florida Florida New York Florida Massachusetts Pennsylvania

Total 34,858 22,610 15,233 13,091 12,262 10,580 7455 7430 5767 5357

Reproduced from Echenique M, Melgar L (2018) Mapping Puerto Rico’s hurricane migration with mobile phone data. Citylab and Univision, with permission from Citylab. Retrieved from https://www.citylab.com/environment/2018/05/watchpuerto-ricos-hurricane-migration-viamobile-phone-data/559889/ addition, half say they had trouble getting enough water to drink (50 percent) and 70 ­percent say the lack of electricity caused them to have trouble storing and preparing fresh foods. (DiJulio et al. 2018: 1) Percent of Persons Who Remained or of Persons Who Left

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Remained in 2017 Left in 2017

25

20

15

10

5

0

0-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

>80

Age Group (yr)

Fig. 3.3  Age distribution of persons who left households in 2017, as compared with those who remained. (Adapted from Kishore N, Marques D, Mahmud A, et al. (2018) Mortality in Puerto Rico after Hurricane Maria. The New England Journal of Medicine 379(2):162–170. Copyright 2018 by Massachusetts Medical Society, with permission from Massachusetts Medical Society

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In addition, a quarter of Puerto Rican residents reported their life was still somewhat or very disrupted a year after the storm. More than half believed rebuilding the island was not a priority of the federal government, and half stated the federal response was worse than the response in Texas and Florida after Hurricanes Harvey and Maria. Most concerning was the fear expressed by the vast majority of respondents that another hurricane will hit the island and cause similar or worse damage. In the longer term, residents have been leaving Puerto Rico since the hurricane for economic reasons. Along with the damage to housing, the hurricane resulted in heavy damage to the island’s economy. Estimates of the economic impact of the hurricane ranged from $43 billion to $139 billion (Ortiz 2018). In addition, 8000 small businesses had not reopened in the year following the hurricane. Another study indicated 40% of the residents had lost their job or were earning less money a year after Maria (Ortiz 2018). The hurricane contributed to an already bleak economic situation. At the time the hurricane occurred, the commonwealth was experiencing a debt crisis, owing creditors over $70 billion. In 2016, the Congress enacted a law to help Puerto Rico restructure a portion of its debt and establish a federal control board to oversee the island’s finances. In August 2018, the Financial Oversight and Management Board for Puerto Rico reported the commonwealth had $74 billion in bond debt and $49 billion in unfunded pension liabilities as of May 2017 (Kobre and Kim 2018). The island’s debt load amounts to $12,000 per capita, with its debt representing more than three-quarters of its annual gross national product, which would make it one of the most indebted countries in the world (Decambre 2017). Several reports published after the hurricane pointed to actual and potential loss of jobs. The unemployment rates in Puerto Rico increased slightly after Maria from 10.6% in September to 11.0% in December 2017. However, 1 year after the hurricane, the unemployment rate had dropped to 8.4% (Bureau of Labor Statistics 2018). Using an econometric model of the costs of cyclones over the past 60 years and applying it to the pre-storm conditions in Puerto Rico, researchers from the Climate Impact Lab found that Maria could lower Puerto Rican incomes by 21% over the next 15 years—a cumulative $180 billion in lost economic output (Melendez and Hinojosa 2017). Loss of income is especially problematic given that nearly half of the island’s population lives in poverty and household income is about $18,000 a year. That amounts to less than half that of Mississippi, the poorest state in the United States (Hernandez 2018a). The scarcity of jobs, along with low wages and a rising cost of living, has caused young, working-age Puerto Ricans to head for the mainland (Hernandez 2018a). Limited employment opportunities and loss of income also are linked to the challenges in obtaining health care. According to a report issued in 2017 by the Kaiser Family Foundation, 49% of individuals and families in Puerto Rico had Medicaid as their health-care insurance, and another 6% were uninsured (Kaiser Family Foundation 2017). The stress of living with few resources, lack of infrastructure, and disrupted employment is also likely to have contributed to the decision to leave the island. Puerto Rico was already struggling with an increase in mental illness amid a 10-year

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recession that brought soaring unemployment, poverty, and family separation caused by emigration. Maria is believed to have exacerbated the problem (Dickerson 2017). Many Puerto Ricans reported intense feelings of anxiety and depression for the first time in their lives. One study reported a 16% increase in the suicide rate from 2016 and a 26% increase in the number of suicides over the same period after Maria (Ramphal 2018). A cross-sectional survey of 74 households in the low-­ income community of Punta Santiago conducted 6 months after the storm found that 54.1% of study participants scored in the clinically significant range for major depression, 48.6% for generalized anxiety disorder, and 41.9% for PTSD (Ferré et  al. 2018). At 6  months, power was restored to only 10% of households; 10% reported having insufficient food for the next 3 days; about half (52.9%) believed their homes to be unsafe for habitation; 60.8% lost all personal belongings; the community experienced a 20% drop in employment and a decrease in mean income by 37% among those who continued working; and a worsening of symptoms was reported among those living with a chronic illness. Another study by Scaramutti et al. (2019) found rates of PTSD to be higher among displaced Puerto Rican residents living in Florida than those living in Puerto Rico (OR, 2.94; 95% CI, 1.67–5.26). Among participants in both Florida and Puerto Rico, those living in urban areas were more likely than those in rural/suburban areas to meet criteria for PTSD and generalized anxiety disorder. Individuals who left Puerto Rico may have been those who suffered the greatest personal and property losses during and after the storm (Scaramutti et al. 2019). Limited government assistance may also have contributed to the decision to leave the island. As noted above, the commonwealth government was already saddled with a large debt and few financial resources, thus limiting their ability to provide long-term relief to residents affected by the hurricane. A study conducted by Willison et al. (2019) found that the federal response was faster and more generous across measures of money and staffing to victims of Hurricanes Harvey and Irma in Texas and Florida, compared with the response to victims of Hurricane Maria in Puerto Rico. The authors noted that “Maria caused more damage in Puerto Rico than Irma in Florida or Harvey in Texas in terms of loss of electricity and housing destruction, with overall damage estimates comparable to Harvey and greater than estimates for Irma” (Willison et al. 2019: 2). However, Within the first 9 days after the hurricanes hit, both Harvey and Irma survivors had already received nearly US$100 million in FEMA dollars awarded to individuals and families, whereas Maria survivors had only received slightly over US$6 million in recovery aid. Within the first 2 months post-landfall, Harvey and Irma survivors each received nearly US$ 2 billion (Harvey $1.28 billion and Irma US$899 million). Maria funds did not hit US$1 billion until 4 months after landfall. (Willison et al. 2019: 2)

Further, within 9 days of landfall, there were 30,000 federal employees (FEMA and National Guard) posted in Texas, 16,200 posted in Florida, and 10,000 posted in Puerto Rico. FEMA delivered less food, water, tarps, and helicopters to Puerto Rico and took longer to deliver it than was the case during their response in Texas and Florida (Willison et al. 2019).

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The weak federal response to the disaster may also have contributed to secondary displacement among Puerto Rican climigrants who arrived on the mainland: Osceola County was a Federal Emergency Management Agency-funded relocation site and a natural destination for Puerto Ricans looking to join family members or reside in an established Puerto Rican diaspora. The unpredictability of FEMA funding and shared housing with extended family, however, led many to be displaced again within months of their arrival. (Hamm-Rodriguez and Morales 2018: 2)

3.4  Impacts of Displacement 3.4.1  Impacts on the Displaced One effect of the climigration experience has been a reduction in quality of life as climigrants have been forced to come to terms with the increased cost of living on the mainland and challenges in finding suitable employment and housing: While the social situation of some families improved significantly after moving to the United States, others found that their once-comfortable and relatively privileged life in Puerto Rico could not be replicated in Central Florida. Difficulty adapting to life in Florida was a reality for many displaced Puerto Rican families. However, the economic crisis and slow recovery on the island prevent many from returning even when that is their preference. (Hamm-Rodriguez and Morales 2018: 10)

Finding suitable housing upon arrival to the mainland also proved to be especially problematic. Many Puerto Ricans who relocated to the US mainland following the storm received 6-month FEMA vouchers to pay for apartments or hotels (Scaramutti et al. 2019). However, the demand for housing among displaced families far outweighed the supply, and it was impossible to assist all families in need (Hamm-­ Rodriguez and Morales 2018). High rents and restrictions such as limitations on the number of individuals living in a unit, credit requirements, and substantial deposits prevented families from securing housing and contributed to longer-term residential, social, and emotional instability (Hamm-Rodriguez and Morales 2018). For those able to find temporary housing in hotels, limited physical space, no access to kitchens, and emotionally volatile situations caused by the many displaced families, who were often dealing with severe trauma and high levels of stress, being housed in the same hotels, made life miserable (Hamm-Rodriguez and Morales 2018). Along with the experience of traumatic events such as evictions and difficulty finding employment, these stressors were responsible for displaced families moving elsewhere in search of some sense of stability (Hamm-Rodriguez and Morales 2018). Differences in wealth and access to resources also produced disparities in the climigration experience of Puerto Ricans who relocated to the mainland. Climigrants from Puerto Rico arrived on the mainland in two waves. The first wave, which occurred during or shortly after the hurricane struck the island, had the financial means to leave the island on their own. In contrast, the second wave of climigrants was often only able to migrate with government assistance. Having previously lived

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in poverty on the island, many of these second wave climigrants were unable to find employment after they arrived (Hamm-Rodriguez and Morales 2018). The disparities between the two groups were especially noted in differences in academic performance in Florida schools: School administrators and teachers mentioned having difficulties supporting students that relocated during the second migration wave—who tended to be from families living in poverty and who they sometimes perceived as presenting behavioral challenges and showing large academic gaps. In contrast, students from more economically stable families— many of whom attended private schools in Puerto Rico and came with the first migration wave—were often praised for their intelligence and for being good students. This finding reflects inequities in educational quality on the island that are replicated and compounded through displacement and transition to school systems with significantly different curriculum, standards, assessments, rules, and discipline procedures. (Hamm-Rodriguez and Morales 2018: 8–9)

The impact of climigration was also particularly noticeable among school-aged youth. In their study of displaced Puerto Rican K-12 students in Florida after Maria, Hamm-Rodriguez and Morales (2018) cited reports of teachers that the ongoing trauma experienced by many students after the hurricane was mainly the result of difficult life situations during the transition to living in Florida, such as housing and income instability or the death of a close family member. “In some cases, teachers felt that these experiences increased student resistance to or the inability to feel attached to new schools and living environments” (p. 6).

3.4.2  Impacts on Community of Origin As noted earlier, the hurricane resulted in some profound demographic shifts of the population of Puerto Rico and of Puerto Ricans living on the mainland. Overall, the population of the island decreased from 3.8  million in 2004 to 3.2  million after Hurricane Maria in 2018 (Fig. 3.4). “The municipios with the largest populations also experienced some of the fastest rates of decline. San Juan (population 321,000), Bayamón (170,000), Carolina (148,000) and Ponce (133,000) all had decreases of 4% or more. Las Marías had the island’s largest decrease, with a decline of more than 5%” (Flores and Krogstad 2019). The migration also resulted in an increase in the proportion of younger and older residents. “Overall, 81% of the island’s population was ages 18 and older in 2018, up from 75% in 2008. The share who were 65 and older increased from 14% in 2008 to 21% in 2018” (Flores and Krogstad 2019). Related to the depopulation of the island, the climigration of younger residents seeking employment opportunities is likely to mitigate the prospects of economic recovery. According to Melendez and Hinojosa (2017), Hurricane Maria accelerated the propensity to migrate to the mainland to a point where the depopulation of Puerto Rico can be considered as one of the most significant hurdles for future economic recovery.

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Fig. 3.4  Population estimates 1950–2018, Puerto Rico. Reprinted from “Puerto Rico’s population declined sharply after Hurricane’s Maria and Irma.” Pew Research Center, Washington, DC (July 26, 2019) https://www.pewresearch.org/fact-tank/2019/07/26/puerto-rico-population-2018/

3.4.3  Impacts on Host Communities Displacement from Puerto Rico also placed a substantial burden on available resources in host communities on the mainland, especially in Florida. According to Florida’s Department of Education, a total of 11,554 students from Puerto Rico enrolled in Florida public school districts, a 12% increase since December 5, 2017, when a total of 10,324 students were enrolled. Relative to other states, Florida’s school districts were the most impacted of incoming school-aged children from Puerto Rico as a result of the exodus after Hurricane Maria (Hinojosa et al. 2018). In absolute terms, the largest increase in enrollment occurred in Miami-Dade and Broward County school districts. By December 2017, more than 10,300 students from Puerto Rico had enrolled in Florida school districts, representing a 5% increase in the total kindergarten through 12th grade enrollment in the state since 2015. The vast majority of those students arrived in districts in Central Florida (Meléndez et al. 2017). Since the hurricane, more than 22,000 students from the island have enrolled in stateside schools (Hernandez 2018a). These demographic shifts have significantly affected the schools in receiving communities—which have seen an influx in Puerto Rican students needing enrollment assistance, language support, counseling, and other services. In Osceola County in central Florida, most of the Puerto Rican students displaced from Hurricane Maria qualified for services under the Families in Transition (FIT) program through the McKinney-Vento Homeless Assistance Act. These students received uniforms, transportation, free breakfast and lunch, and other services. Further,

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The district made several accommodations to ensure that students could enroll in school as soon as possible, including registering students in schools and programs without documentation of school history or services previously received; providing extended time frames to submit required paperwork; waiving requirements for physicals and vaccine records and later facilitating their completion; and supporting temporary guardianship efforts for students who arrived without parents. (Hamm-Rodriguez and Morales 2018: 5)

To address the mental health needs of students and their families, the school district hired additional social workers and guidance counselors. Social workers also visited the hotels where displaced families were housed to ensure that those who needed counseling received it. As a result of these efforts, student mental health referrals doubled from the amount of the previous academic year (Hamm-Rodriguez and Morales 2018). In addition to the impact on school systems, climigration from Puerto Rico to Florida and elsewhere severely impacted the delivery of health and social services. Nonprofit organizations responded to this impact by mobilizing community support and secured private funding sources to help meet the basic needs of the climigrants who arrived in Central Florida (Hamm-Rodriguez and Morales 2018). Community organizations also struggled to address long-term needs of families who planned to remain in host communities. In Connecticut, one study documented the impact of displaced Puerto Rican climigrants on an existing health center: Many recently displaced Puerto Ricans who came to New Haven after Hurricane Maria sought care at FHCHC. The organization quickly realized that normal workflows would not suffice to address the resulting increased demand. All patients were new to the clinic, most had significant social determinants of health needs, many required complex care coordination and management, and nearly everyone had some degree of mental health need. Scheduling this demographically unique population in the normal new patient registration process quickly overwhelmed the normal system of care. (Paek et al. 2018: xi)

3.5  Lessons Learned 3.5.1  P  ost-Maria Climigration and Puerto Rico’s Historic Pattern of Circular Migration While Maria is only one of a number of hurricanes since Katrina to have resulted in widespread damage and loss of life along with climigration, it offers some insight into the impacts of climate change on historical patterns of migration around the world, on the one hand, and the linkage between climigration and income disparities and economic vulnerability on the other. Puerto Ricans have moved back and forth between the island and the mainland for more than a century after they received US citizenship in 1917. This pattern of circular migration is a fundamental part of the Puerto Rican experience. However, migration from the island increased dramatically in size and speed in the past decade, threatening to change Puerto Rico’s economic and social future (Hernandez 2018a). During this period, net migration from

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Puerto Rico to the mainland amounted to approximately half a million, approximately 10% of the island’s population. This movement was largely driven by economic stagnation, high unemployment, and the impact of the fiscal crisis on economic recovery (Melendez and Hinojosa 2017). With Maria, however, the pattern of migration has undergone some profound changes. Damaged infrastructure and reduced economic opportunities as businesses leave the island have increased incentives to leave and reduced incentives to return. However, despite predictions that by the end of 2018, 200,000 more residents will have left the US territory for good (Hernandez 2018a), the exact number of climigrants who permanently relocated to Florida and elsewhere remains unknown.

3.5.2  The Disparity of Climigration As noted in Chap. 2, those most economically vulnerable were more likely to leave New Orleans after Katrina and less likely to return. After Maria, the association between socioeconomic status and climigration was more complicated. Like Maria, wealthier residents living in San Juan experienced less damage and quicker recovery, were more likely to have been in the first wave of climigrants from the island, and were more likely to return to the island. However, better-educated younger people were more likely to move away, seeking higher-paying jobs on the mainland. Possessing fewer resources and options to leave, less educated residents were also more likely to remain and not migrate, even temporarily. Consequently, the storm simultaneously increased income disparities on the island as those on either end of the socioeconomic spectrum were more likely to remain or return and those in the middle more likely to leave. In this respect, both the pattern of climigration and its impact on the community of origin were different from that experienced by New Orleans after Katrina. Puerto Rico also provides an illustration of the disparities in disaster response. As noted in Sect. 3.3.2, investigations of the amount of money, staff, and resources devoted to Puerto Rico after Maria were significantly less than that devoted to parts of Texas and Florida devastated by Hurricanes Harvey and Irma. Funding for disaster relief became a political wedge issue between the federal and territorial governments and contributed to a belief throughout the island of isolation, abandonment, and discrimination.

3.5.3  Maria as a Template for Subsequent Disasters Since Maria, the United States has been impacted by other disasters that have produced even more dramatic consequences. In September 2018, storm surges and prolonged and intense rainfall created by Hurricane Florence resulted in an estimated $24 billion in property damage and economic losses and 51 deaths in North and

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South Carolina (Stewart and Berg 2019). In October of that year, Hurricane Michael caused widespread devastation across the Florida Panhandle and farther inland across Georgia, the Carolinas and Virginia resulting in $25 billion in property damage and economic losses. There were at least 45 fatalities blamed on the storm in the United States (Beven et al. 2019). Like Maria, these hurricanes affected parts of the United States that are vulnerable to the increase in the number of hurricanes with greater power. They demonstrate how destruction of housing and infrastructure can lead to internal migration that is largely temporary due to ties to the land. More than one million people in the path of Hurricane Florence were ordered to evacuate prior to the hurricane’s arrival, and more than 26,000 sought shelter after the hurricane’s departure (Bredemeier 2018). Tens of thousands of residents were displaced due to Hurricane Michael (Harris 2018). Unlike Maria, these hurricanes occurred in parts of the United States that have greater economic resources and political clout that enables communities to rebuild and temporary migrants to return. It is expected that relatively few residents of the regions affected by these hurricanes anticipated not returning as soon as possible, and those unable to do so had the fewest resources to enable them to return and rebuild. In many respects, climigration after Hurricane Maria bears closer resemblance to the climigration experience from New Orleans and the Gulf Coast after Hurricane Katrina. Both events were associated with severe damage over a large area, a large number of deaths attributed to the disaster, increased symptoms of PTSD and other mental and behavioral health problems, the occurrence of both temporary and permanent displacement, and increased burdens on host communities. However, unlike Katrina, the climigration experience subsequent to Hurricane Maria also revealed the importance of cultural differences between many of the climigrants and their host communities. Hamm-Rodriguez and Morales (2018) note that Puerto Rican climigrants expected that schools on the mainland would accommodate to if not protect and maintain their language and culture. “Educational practices in U.S. schools that require linguistically and culturally diverse students to assimilate come in direct conflict with these expectations” (Hamm-Rodriguez and Morales 2018). Beyond the failure of schools to accommodate to the cultural expectations of many Puerto Rican climigrant families, however, the inability to plan for relocation and possible relocation to areas of the country with fewer family members and smaller proportions of Puerto Rican residents increased the risk of a cultural alienation of and by the climigrants. This was undoubtedly less of an issue for climigrants who relocated to communities in Florida and New  York with large Puerto Rican immigrant populations. The extent to which such cultural alienation occurred, however, remains to be determined. In the next chapter, we shift from water to fire, with equally devastating consequences.

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References Alexander M, Polimis K, Zagheni E (2019) The impact of Hurricane Maria on out-migration from Puerto Rico: evidence from Facebook data. SocArXiv Papers, 28 Jan. http://paa2019.populationassociation.org/uploads/190568. Accessed 28 Jan 2019 Allen G, Penaloza M, National Public Radio (2017) Desperation in Puerto Rican town where 60 percent are now homeless. National Public Radio, 25 Sept. https://www.npr. org/2017/09/25/553532405/in-puerto-rican-town-situation-turns-dire-at-packed-shelter. Accessed 26 Sept 2017 Beven JL II, Berg R, Hagen A (2019) National Hurricane Center Tropical Cyclone Report: Hurricane Michael 7–11, October 2018. https://www.nhc.noaa.gov/data/tcr/AL142018_ Michael.pdf. Accessed 12 Aug 2019 Bredemeier M (2018) North Carolina Governor warns of risk to life from remnants of Hurricane Florence. VOA News, 16 Sept 2018. https://www.voanews.com/usa/north-carolina-governorwarns-risk-life-remnants-hurricane-florence. Accessed 12 Aug 2019 Bureau of Labor Statistics (2018) Puerto Rico economy at a glance. 2018. https://www.bls.gov/ eag/eag.pr.htm. Accessed 28 Jan 2019 Decambre M (2017) Puerto Rico has more than $70 billion in debt because of this. Marketwatch, 7 Oct. https://www.marketwatch.com/story/why-does-puerto-rico-have-more-than-70-billionin-debt-2017-10-04. Accessed 30 Jan 2019 Dickerson C (2017) After hurricane, signs of a mental health crisis in Puerto Rico. New  York Times, 13 Nov. https://www.nytimes.com/2017/11/13/us/puerto-rico-hurricane-maria-mentalhealth.html. Accessed 12 Jan 2018 DiJulio B, Muñana C, Brodie M (2018) Views and experiences of Puerto Ricans one year after Hurricane Maria: the Washington Post/Kaiser Family Foundation survey of Puerto Rico residents. Henry J.  Kaiser Family Foundation, Washington, DC. http://files.kff.org/attachment/ Report-Views-and-Experiences-of-Puerto-Ricans-One-Year-After-Hurricane-Maria. Accessed 26 Aug 2019 Dobrin I (2017) ‘Get us out of here’: amid broken infrastructure, Puerto Ricans flee to Florida. NPR, 13 Oct. https://www.npr.org/2017/10/13/557108484/-get-us-out-of-here-amid-brokeninfrastructure-puerto-ricans-flee-to-florida. Accessed 30 Oct 2019. ©2017 National Public Radio, Inc. Excerpt from NPR News report titled “‘Get Us Out of Here’: Amid Broken Infrastructure, Puerto Ricans Flee To Florida” by Isabel Dorbin was originally published on npr.org on October 13, 2017, and is used with the permission of NPR. Any unauthorized duplication is strictly prohibited Echenique M, Melgar L (2018) Mapping Puerto Rico’s hurricane migration with mobile phone data. Citylab, 11 May. https://www.citylab.com/environment/2018/05/watch-puerto-ricos-hurricane-migration-via-mobile-phone-data/559889/. Accessed 29 Jan 2019 Ferré IM, Negron S, Shultz JM et al (2018) Hurricane Maria’s impact on Punta Santiago, Puerto Rico: community needs and mental health assessment six months postimpact. Disaster Med Public Health Prep 208:103 Flores A, Krogstad JM (2019) Puerto Rico’s population declined sharply after Hurricane’s Maria and Irma. Pew Research Center Factank, 26 Jul. https://www.pewresearch.org/facttank/2019/07/26/puerto-rico-population-2018/. Accessed 11 Nov 2019 Hamm-Rodriguez M, Morales AS (2018) The effects of displacement on Puerto Rican K-12 students in Florida after Hurricane Maria. Natural Hazards Center, Boulder, CO. https://hazards. colorado.edu/quick-response-report/the-effects-of-displacement-on-puerto-rican-k-12-students-in-florida-after-hurricane-maria. Accessed 18 Jan 2019 Harris A (2018) ‘Baby, I don’t got a home’: Hurricane Michael’s homeless seek shelter. Miami Herald, 21 Oct. https://www.miamiherald.com/news/weather/hurricane/article220336875. html. Accessed 25 Mar 2020 Hernandez AR (2018a) Exodus from Puerto Rico grows as island struggles to rebound from Hurricane Maria. The Washington Post, 6 Mar. https://www.washingtonpost.com/national/exodus-

References

51

from-puerto-rico-grows-as-island-struggles-to-rebound-from-hurricane-maria/2018/03/06/ b2fcb996-16c3-11e8-92c9-376b4fe57ff7_story.html?utm_term=.1b6b6fda7a76. Accessed 12 Nov 2018 Hernandez AR (2018b) Thousands of Puerto Ricans displaced by Hurricane Maria could be forced out of their temporary homes. Independent, 12 Aug. https://www.independent.co.uk/ news/world/americas/hurricane-maria-puerto-rico-fema-displaced-families-temporary-housing-a8488266.html. Accessed 12 Nov 2018 Hinojosa J, Roman N, Melendez E (2018) Puerto Rican post-Maria relocation by states. Research Brief. Center for Puerto Rican Studies, Hunter College CUNY, New  York. https://centropr. hunter.cuny.edu/research/data-center/research-briefs/puerto-rican-post-maria-relocationstates. Accessed 22 Feb 2019 Kaiser Family Foundation (2017) Puerto Rico: fast facts. Menlo Park, CA, Oct 2. https://www.kff. org/disparities-policy/fact-sheet/Puerto-rico-fast-facts/. Accessed 23 Feb 2019 Kishore N, Marques D, Mahmud A et al (2018) Mortality in Puerto Rico after Hurricane Maria. N Engl J Med 279:162–170 Kobre and Kim, LLC (2018) The Financial Oversight & Management Board for Puerto Rico: final investigative report. https://assets.documentcloud.org/documents/4777926/FOMB-FinalInvestigative-Report-Kobre-amp-Kim.pdf. Accessed 28 May 2019 Mazak C (2017) ‘We are not okay’: a first-hand account of Hurricane Maria. Ecowatch, 23 Oct. https://www.ecowatch.com/hurricane-maria-firsthand-2500191361.html. Accessed 23 Feb 2019 Melendez E, Hinojosa J (2017) Estimates of post-Hurricane Maria exodus from Puerto Rico. Research Brief. Center for Puerto Rican Studies, Hunter College, CUNY, New York. https:// centropr.hunter.cuny.edu/sites/default/files/RB2017-01-POST-MARIA%20EXODUS_ V3.pdf. Accessed 22 Feb 2019 Meléndez E, Hinojosa J, Roman N (2017) Post-Hurricane Maria exodus from Puerto Rico and school enrollment in Florida. Research Brief. Center for Puerto Rican Studies, Hunter College, CUNY, New  York. https://centropr.hunter.cuny.edu/research/data-center/research-briefs/post-­ hurricane-­maria-exodus-puerto-rico-and-school-enrollment. Accessed 22 Feb 2019 Ortiz J (2018) Hurricane Maria’s economic impact on Puerto Rico: at least $43 billion, possibly as high as $159 billion. USA Today, 4 Dec. https://www.usatoday.com/story/news/2018/12/04/ hurricane-maria-economic-impact-puerto-rico/2209231002/. Accessed 23 Feb 2019 Paek H, Niess M, Padilla B et al (2018) A community health center blueprint for responding to the needs of the displaced after a natural disaster: the Hurricane Maria experience. J Health Care Poor Underserv 29(2):x–xvi. https://doi.org/10.1353/hpu.2018.0040 Pasch RJ, Penny AB, Berg R (2019) National Hurricane Center Tropical Cyclone report: Hurricane Maria 16-30 September 2017. https://www.nhc.noaa.gov/data/tcr/AL152017_Maria.pdf. Accessed 12 Aug 2019 Ramphal L (2018) Medical and psychosocial needs of the Puerto Rican people after Hurricane Maria. Proc Baylor U Med Ctr 31:294–296 Santos AR, Howard JT (2017) Estimates of excess deaths in Puerto Rico following Hurricane Maria. SocArxiv 1–8. https://osf.io/preprints/socarxiv/s7dmu/ Santos-Burgoa C, Suarez E, Goldman-Hawes A et  al (2018) Differential and persistent risk of excess mortality from Hurricane Maria in Puerto Rico: a time series analysis. Lancet Planet Health 2(11):e478–e488 Santos-Lozada AR, Howard JT (2018) Use of death counts from vital statistics to calculate excess deaths in Puerto Rico following Hurricane Maria. JAMA 320:1491–1492 Scaramutti C, Salas-Wright CP, Vos SR et al (2019) The mental health impact of Hurricane Maria on Puerto Ricans in Puerto Rico and Florida. Disaster Med Public Health Prep 30:1–4. https:// doi.org/10.1017/dmp.2018.151 Sesin C (2017) Over 200,000 Puerto Ricans have arrived in Florida since Hurricane Maria. NBC News, 30, Nov. https://www.nbcnews.com/news/latino/over-200-000-puerto-ricans-havearrived-florida-hurricane-maria-n825111. Accessed 22 Feb 2019

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Stewart SR, Berg R (2019) National Hurricane Center Tropical Cyclone Report: Hurricane Florence 31 August–17 September 2017. https://www.nhc.noaa.gov/data/tcr/AL062018_Florence.pdf. Accessed 12 Aug 2019 Verma AA, Murray J, Mamdani MM (2018) Mortality in Puerto Rico after Hurricane Maria. N Engl J Med 379:19 Willison CE, Singer PM, Creary MS et al (2019) Quantifying inequities in US federal response to hurricane disaster in Texas, Florida compared with Puerto Rico. BMC Glob Health 4(1):e001191. https://doi.org/10.1136/bmjgh-2018-001191

Chapter 4

The California Wildfires

4.1  The Narrative 4.1.1  The Event The sign that greets visitors to this town in the Sierra Nevada foothills proudly states: “May you find Paradise to be all its name implies.” But after a fast-moving wildfire ravaged this community of 27,000 people, forcing thousands to flee by car and on foot, Paradise has become something else entirely. It has joined the growing list of California towns and cities devastated by one of the worst fire seasons on record. Officials said at least nine people died and more than 6700 homes and commercial buildings were lost—making it the most destructive fire to property in state history. On Friday, a day after the Camp Fire broke out, this formerly thriving community sat under a dark canopy of ash and smoke. Homes and businesses had been reduced to piles of twisted metal. Tall pine trees and utility poles smoldered. According to the California Teachers Assn., at least five of the nine schools in Paradise were destroyed, including Paradise Elementary School. Cars abandoned by fleeing motorists who found themselves unable to escape lay crumpled in the roadways, their tires melted. It forced more than 50,000 people in Paradise and surrounding towns to evacuate. Many of them spilled onto a four-lane road called Skyway—the main evacuation route out of Paradise—that quickly became jammed. Residents described sitting in traffic as flames on both sides of the road reached for their cars (St. John et al. 2018).

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4.1.2  The Displacement Shelly Lanning, her husband, and two children are staying with her mother in Ukiah, an hour from where her home burned down the morning of Oct. 9. She’s not sure where she’s going to live next. Lanning, 46, ran a day-care center and her husband a catering company out of their home in Santa Rosa’s Coffey Park neighborhood. Fire destroyed the entire community, including the apartment building down the street from Lanning’s home, where her 23-year-old son lived. Lanning would like to find a new place that will fit her whole family, including their Labrador retriever mix Jax. But she can’t. “We’ve been looking everywhere,” Lanning said. “If there’s anything available, they’re gone in seconds.” Lanning is one of thousands of residents who have lost their homes in a region that has faced some of the worst effects of the state’s housing affordability crisis. A limited housing supply fueled by the San Francisco Bay Area’s booming job growth and decades of slow construction has forced home values and rents to near record highs (Dillon 2017).

4.2  The Wildfires Climate change-related wildfires have become a global phenomenon. Some parts of the world have been especially affected, including western Canada and Australia (Gillette et al. 2004; Millman 2013). However, the most attention in recent years has been focused on the western United States in general and the state of California in particular (Abatzoglou and Williams 2016). Large forest fires have become more frequent in the western United States since the 1980s (Westerling et  al. 2006; Dennison et al. 2014). As with hurricanes, the frequency and size of wildfires in the southwest states are expected to increase (Garfin et al. 2014). “Climate models predict up to a 74% increase in area burned in California and a possible doubling of wildfire emissions by the end of the century (Hurteau et  al. 2014)” (Hutchinson et al. 2018). There have been hundreds of notable fires that have created widespread damage and loss of property and life in the past two decades. In 2003, wildfires in Southern California consumed more than 750,000 acres and destroyed 3640 homes, 33 commercial properties, and 1141 other structures (Kunzli et al. 2006). In October 2007, a series of 30 wildfires in Southern California burned 972,147 acres, destroyed more than 1500 homes, and resulted in at least 14 deaths. In October 2017, the Tubbs Fire in Northern California burned more than 38,000 acres in Napa, Sonoma, and Lake counties, destroyed more than 5% of the housing stock of the city of Santa Rosa, and resulted in 22 deaths (Nelson et  al. 2017). Later that year, the Thomas Fire burned almost 282,000 acres in Santa Barbara and Ventura counties in Southern California, destroyed 1063 structures, and resulted in 23 deaths, mostly due to mudslides in burned areas (Livingston and Panzar 2017).

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With each succeeding year, wildfires in California have become more frequent, more widespread, more destructive, and more expensive to contain. The worst year ever for fires in California has been 2018. That year, there were more than 8000 fires that killed more than 100 people and destroyed more than 17,000 homes and 700 businesses (Serna 2019). In early November, the Camp Fire burned more than 153,000 acres in Northern California, causing 88 deaths and destroying more than 18,000 structures. The town of Paradise was almost completely destroyed. This marked the most destructive and deadliest wildfire on record in California and the deadliest wildfire in the United States since the Cloquet Fire in 1918 killed 453 people in Minnesota. In Southern California, the Woolsey Fire destroyed more than 1500 structures and caused at least three fatalities in and around Malibu (Smith 2019). According to the National Climate Assessment report (USGCRP 2018), human-­ caused climate change in the form of prolonged drought and increased temperatures led to a 650% increase in burned area in western US mid-elevation conifer forests between 1970 and 2003. Between 1984 and 2008, wildfire and bark beetle outbreaks caused by warmer temperatures during the winter months caused extensive tree death across 20% of forests in Arizona and New Mexico. Wildfires in Southern California, those driven by fall Santa Ana winds and those that coincide with the hot and dry weather of June through September, are expected to increase with climate change, with a projected increase in overall burn areas of 64% and 77%, respectively, by 2040–2060 relative to 1981–2000 (Adelaine et al. 2017). Numerous fire models project a doubling of burned area in the southern Rockies and up to a 74% increase in burned area in California (USGCRP 2018). However, this increase cannot be attributed to climate change alone. Unusual accumulations of combustible material and debris that create the potential for more intensive and extensive wildfires have been attributed, in part, to fire suppression policies that have been in effect for several years: Wildfire can threaten people and homes, particularly as building expands in fire-prone areas. Wildfires around Los Angeles from 1990 to 2009 caused $3.1 billion in damages (unadjusted for inflation). Respiratory illnesses and life disruptions from the Station Fire north of Los Angeles in 2009 cost an estimated $84 per person per day (in 2009 dollars). In addition, wildfires degraded drinking water upstream of Albuquerque with sediment, acidity, and nitrates and in Fort Collins, Colorado, with sediment and precursors of cancer-­ causing trihalomethane, necessitating a multi-month switch to alternative municipal water supplies. (Gutman 2018)

4.3  Patterns of Displacement 4.3.1  Numbers of Climigrants There are no studies to date that have documented the number of individuals who have been dislocated by wildfires in California, either in the short term or permanently. What little information there is available from newspaper accounts usually

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Table 4.1  Major wildfires burning in California on October 29, 2019 Name Kincade Saddle Ridge Tick Getty

Acres burned 75,415 8799

No of days as of 10/29/19 6 19

Percent contained 15 97

Number of people evacuated 200,000 100,000

4615 650

5 1

86 5

40,000 10,000

Sources: various—Los Angeles Times (2019), NBC News (2019), CBS News (2019a), Gerber et al. (2019), and CBS News (2019b)

provides rough estimates based on the number of people estimated to have lived in areas that underwent mandatory evacuation orders or who lived in housing destroyed by fires. For instance, the Camp Fire in Butte County displaced as many as 50,000 people (Phillips 2018). Over 50,000 people were displaced by the Woolsey and Hill fires in Southern California during the same period (Rizzo 2018). Altogether, an unprecedented 21,000 homes across Northern California were lost in 14 months to fire (Parvini and Simani 2018). The Thomas Fire, which burned in Ventura County in 2017, resulted in the evacuation of an estimated 50,000 people, while the Creek Fire in northern Los Angeles resulted in the evacuation of between 100,000 and 150,000 people. During the month of October 2019, four major fires resulted in the evacuation of over 350,000 people (Table 4.1). California is certainly not the only place where wildfires have resulted in massive evacuations. The Fort McMurray Wildfire, which occurred in Alberta Canada on May 3 2016, forced the entire population of 88,000 to evacuate and destroyed 10% of all homes (Brown et al. 2019). The Black Saturday bushfires in the Australian state of Victoria in February 2009 were among Australia’s all-time worst bushfire disasters, resulting in 173 deaths, more than 2000 homes destroyed, and 7500 people displaced (Verghis 2019). There were three forms of displacement associated with each of these wildfires. The first form was temporary evacuations. This displacement lasted usually until the fires had been successfully contained and residents were allowed to return to their homes that were undamaged and/or suitable for habitation. The number of residents in this category can be identified by the estimates of residents in fire-damaged areas who were ordered to evacuate or who voluntarily did so. The second form of displacement lasted for longer periods of time until damaged or destroyed housing could be repaired or rebuilt. The number of residents in this category is unknown but could be identified through enumeration of number of homes destroyed and insurance claims filed. The third category of displaced residents includes those who were unwilling or unable to rebuild their homes and businesses or who preferred to move to areas that were less vulnerable to wildfires. The number of residents in this category is unknown and can only be estimated indirectly by census data.

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4.3.2  Displacement-Related Decisions A primary reason for permanent displacement is tied to concerns associated with living in wildfire-prone areas. As noted in Sect. 4.2, drier conditions combined with rising temperatures are predicted to generate conditions that will result in increased wildfire events and more acres burned per fire. The impact of wildfires in California has been increasing and expected to continue into the future, potentially motivating residents to move out of state to places that are less prone to wildfires and more affordable. 4.3.2.1  Demographic Factors Along with other kinds of disasters, victims of wildfires may be motivated to move by sociodemographic characteristics, including female gender, age, and low socioeconomic status, although a study of victims of Colorado’s Fourmile Fire found little evidence to support this. The study conducted by Nawretzki et al. (2014) did find significantly higher levels of risk perception in those who moved compared with those who did not. 4.3.2.2  Economic Impacts Along with the perception of vulnerability to wildfires, permanently displaced residents are likely to have experienced periods where they were forced into temporary housing or shelter and confronted with the costs of rebuilding destroyed or damaged homes and paying higher premiums on fire insurance. In the past, residents of wildfire-­prone areas have relied on insurance to rebuild and return to devastated communities. This practice was supported by municipal governments that would fast-track permits and waive fees, as was the case in Santa Rosa after the Tubbs Fire (Levine and Waddell 2018). In 11 California fires from 1970 to 2009, builders reconstructed 94% of the burned homes within 25 years (Levine and Waddell 2018). However, more homeowners could find it hard to rebuild as insurers reassess the risk of a new future of fire and decide to stop issuing fire insurance in high-risk areas. In Redding, California, insurance companies hiked rates or canceled policies altogether after the Carr Fire burned 1079 homes in the summer of 2018. “Among the unforeseen costs of remaining are obtaining permitting, hiring contractors and meeting new fire-safety codes. Insurance policies only cover the cost of rebuilding a burned-down home; they don’t cover upgrades to meet relatively new fire ordinances, like the use of non-combustible roofs and other materials” (Levine and Waddell 2018). Those most likely to move from areas devastated by wildfires or prone to risk of wildfires are older residents who lack the resources to rebuild with or without the help of insurance. Many of the evacuees of the Camp Fire were older people who lost everything and had little wherewithal to rebuild (Levine 2018).

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The longer-term question displaced Californians will need to answer is whether or not to rebuild. Between 2006 and 2016, more than one million people moved out of California, largely because of the high costs of housing. Increases in fire insurance premiums and updating of building codes to make housing better able to withstand fires will further increase the costs of housing and financial capacity to rebuild (Passey 2018). Older adults who counted on the value of their homes to cover their retirement may be encouraged to go to a less expensive market where that home equity will go a lot further (Passey 2018). Wildfires also result in significant damage to the economy of affected communities by destroying local businesses and infrastructure such as schools and medical facilities. This results in few opportunities for employment and restricted access to goods and services. CoreLogic®, a leading global property information, analytics, and data-enabled solutions provider, estimated total losses from the Camp Fire in Northern California to be between $11 billion and $13 billion and losses from the Woolsey Fire in Southern California to be an additional $4 billion to $6 billion (CoreLogic 2018). Estimates include damage to residential and commercial properties and additional living expenses (ALE), and the estimated losses include fire, smoke, demand surge, and debris removal. However, they do not appear to include health-care costs. 4.3.2.3  Health Impacts As with other forms of climate change, wildfires pose significant risks to health and well-being, which could motivate people to move elsewhere. In general, the number of people who will experience adverse health effects from wildfires is increasing (Smith et al. 2014). The number of persons who are vulnerable is also expanding because more people live near fire-prone areas (Radeloff et  al. 2005). Wildfire smoke exposures have been associated with premature death and increased inpatient hospitalizations and emergency department presentations (Johnston et al. 2012; Liu et al. 2015; Reid et al. 2016; Hutchinson et al. 2018). Other pathways that link wildfires to adverse health include exposure to the flames and radiant heat resulting in burns; soil contaminated by the chemical products of burning vegetation; suspended dust dispersed through the air; and water contamination, caused by particulate matter deposition on water or leachates from the land directly affected by fire (Finlay et al. 2012). Among the greatest health impacts associated with wildfires is the consequence of the release of large amounts of particulate matter (PM) and other toxic substances into the air, including carbon dioxide, carbon monoxide, and methane. Each year, emissions of fine PM from wildfires in the United States range between 118,000 and 986,000 metric tons and carbon dioxide emissions between 24 and 134 million tons (Hutchinson et al. 2018). Wildfires also release polycyclic aromatic hydrocarbons, aldehydes, and volatile organic compounds. Each of these emissions is associated with adverse health effects, including an increase in daily mortality. A study of the effects of bushfires between 1997 and 2004 found a 5% increase in non-accidental

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mortality (OR 1.05 (95%CI: 1.00–1.10) on days of high air pollution from bushfire smoke (Finlay et al. 2012). Several studies have documented the increase in the number and prevalence of respiratory illnesses associated with wildfires. A study of Medi-Cal beneficiaries living in San Diego County during the 2007 wildfires found a significant increase in respiratory diagnoses (34% increase in emergency department presentations), especially asthma (a 112% increase) and acute bronchitis (72% increase) (Hutchinson et al. 2018). Other studies have reported an association with wildfires and chronic obstructive pulmonary disease (COPD) (Reid et  al. 2016). Medical surveillance from San Diego County revealed significant increases in hospital emergency room visits for asthma, respiratory problems, and eye irritation during the 2003 fire period (Viswanathan et al. 2006). Children appear to be the most vulnerable to increased respiratory illnesses, partially related to their smaller airway size. In their study, Hutchinson et al. (2018) found a 236% increase in asthma, 267% increase in emergency department presentations, and 131% increase in inpatient hospitalizations, and outpatient visits respectively suggest a particularly high association among young children (0–4 years). In another study, exposure to fire smoke smell for more than 6 days was associated with more than fourfold higher rates of eye symptoms, approximately threefold increased rates of dry cough and sneezing and more than twofold higher rates of cold, sore throat, wet cough, medication use, physician visits, and missed school due to symptoms (Kunzli et al. 2006). Those with pre-existing cardiopulmonary conditions and smokers are also at risk for smoke-related respiratory illness (Brook et al. 2012). An 8-year study of air pollution levels, including those from bushfires, and hospital admissions showed that a 10  μg/m3 increase in bushfire PM10 was associated with a 1.24% increase in all respiratory admissions, a 3.80% increase in COPD admission, and a 5.02% increase in adult asthma admissions (Morgan et al. 2010). A study of Sydney air pollution between 1997 and 2004 also found that cardiovascular mortality rates increased by 10% on days with high levels of bushfire smoke (Johnson et al. 2011). 4.3.2.4  Mental Health Impacts Another consequence of exposure to wildfires has been elevated rates of traumatic stress and other mental disorders. Marshall et al. (2007) reported that 24% of those who applied for disaster assistance after a wildfire in California in 2003 showed symptoms of PTSD and 33% had symptoms of major depression at a 3-month follow-­up. Property damage and physical injury during the fires were significantly associated with psychopathology. Women and persons with bipolar disorder were especially vulnerable to these impacts. A cross-sectional case control study (Papanikolaou et al. 2011) of those affected by the Greek wildfires of 2007 reported increased symptoms of somatization, depression, anxiety, hostility, and paranoia in wildfire victims compared with controls. Another study of 30 adults 6 weeks post exposure to wildfires showed increased levels of posttraumatic stress, depression, and anxiety symptoms (Jones et al. 2003).

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Several studies of victims of bushfires in Australia have also documented significant psychological impacts associated with exposure to such events and long afterward. In one such study, McFarlane et al. (1997) found that 42% of the population exposed to wildfires was classified as potential psychiatric cases, more than double that seen in the nonexposed population 12 months after the fires. A series of studies conducted after the 2009 Black Saturday bushfires in Victoria reported a dose-­ response relationship between community impacts and rates of PTSD, depression, severe psychological distress, and heavy drinking (Bryant et  al. 2014). Younger children are at especially high risk of symptoms of PTSD and depression subsequent to a wildfire (McFarlane 1987; McDermott and Palmer 2002; McFarlane and Van Hooff 2009; Yelland et al. 2010). In adolescents and young adults, increased tobacco and anxiolytic use has been observed after wildfire exposure (Parslow and Jorm 2006). In addition to the exposure to trauma and loss of property, wildfires may also contribute to adverse mental health outcomes for residents who move to the foothills/mountains due to attractive vistas and landscapes and feel a sense of loss when landscapes are devastated (Nawretzki et al. 2014). Perhaps the most notable mental health consequence, however, is the pervasive sense of anxiety among residents in fire-prone areas who either have had to evacuate in the past or are likely to evacuate in the future as fires grow in both frequency and intensity (Arango and Fuller 2019; Gutierrez et al. 2019). Purchase of emergency generators and collection of valuable papers, photographs, and keepsakes has become more commonplace in anticipation of having to flee at a moment’s notice. While symptoms of anxiety are not likely to require extensive clinical intervention, they could potentially benefit for less intensive interventions such as those to be discussed in Chap. 9.

4.4  Impacts of Displacement 4.4.1  Impacts on the Displaced Individuals who have been displaced by wildfires appear to be especially vulnerable to these aforementioned impacts. A survey of 161 households displaced by wildfires in Southern California in 2007 found that 29% reported a health-care need since evacuation, primarily a need for prescription medications, and 28% of participants did not receive care that met their perceived need (Jenkins et al. 2009). Low socioeconomic status is another risk factor for adverse health impacts. Increased adverse health events were apparent, even at mildly degraded Air  Quality  Index levels, among Medi-Cal beneficiaries in San Diego County after the 2007 wildfires (Hutchinson et al. 2018). Wildfire-related health-care utilization appeared to persist beyond the initial high-exposure period among Medi-Cal beneficiaries in San Diego County after the 2007 wildfires (Hutchinson et al. 2018).

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As noted in Sect. 4.3.2.3, several studies have documented significant mental health impacts of people who were exposed to wildfires. Many of these people were forced to evacuate, thus making it difficult to distinguish between residents who were and were not displaced. Nevertheless, studies limited to residents who were displaced have documented significant mental health impacts as well. A study of 754 residents with pre-existing mental health conditions living in evacuation zones during the 2007 San Diego County fires found that evacuation had a profound impact on stress, mood, and confusion about knowing when and whether to evacuate (Tally et al. 2013). A qualitative study of survivors of wildfires in the Northwest Territories of Canada in 2014 pointed to an association between experiences of evacuation and isolation as well as feelings of fear, stress, and uncertainty and acute and long-term negative impacts for their mental and emotional well-being (Dodd et al. 2018). A study of 3070 Grade 7–12 students who were displaced by the Fort McMurray Wildfire in Northern Alberta, Canada, in 2016 found that 37% met criteria for probable PTSD; 31% met criteria for probable depression; 27% met criteria for probable anxiety; and 15% met criteria for probable alcohol and substance use disorder. Overall, 46% of student met criteria for one or more of these disorders (Brown et al. 2019). Furthermore, students whose homes were destroyed by the fire reported significantly higher levels of probable disorders and symptoms of distress than students whose homes were not destroyed. A study of Fort McMurray adults who were evacuated found significant associations between the 1-month prevalence rate for generalized anxiety disorder symptomatology and witnessing of homes being destroyed by the wildfire, living in a different home after the wildfire, receiving limited governmental or family support, and receiving counseling after the wildfire (Agyapong et  al. 2018). Data from 379 adults collected 3  months after the evacuation found that 62.5% of respondents to a self-report questionnaire had provisional PTSD and 29.1% who completed a diagnostic interview met criteria for PTSD, 25.5% for depression, and 43.6% for insomnia (Belleville et al. 2019).

4.4.2  Impacts on Community of Origin Perhaps the most obvious impact of wildfire displacement is a decline in population in communities of origin. For instance, the town of Paradise, California, devastated by the Camp Fire is believed to have lost 90% of its pre-fire population (Lam 2019). In contrast, the population of Fort McMurray, Alberta, declined only 11% between 2016 and 2018 (Thurton 2019). One of the impacts of displacement on communities of origin has been a change in their demographic characteristics. Without the resources to rebuild, many older and low-income residents of communities affected by wildfires have been forced to move. In Napa County, areas of wine country that were devastated by wildfire now have some of the lowest poverty rates in the United States. A potential explanation for that decline is that homes lost to an earlier fire forced the poorest residents to leave the Napa area entirely (Parvini and Simani 2018). As with the residents of

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New Orleans after Katrina, more affluent neighborhoods remained intact, while lower-income residents were forced to flee. Another impact of wildfires at the community level associated with displacement was increased levels of community conflict. Although wildfires have also been reported to bring community members together (Carroll et al. 2011), they may also perpetuate social conflicts within a community, especially between those who lost their homes and property and those who did not (Carroll et  al. 2006). Increased conflict also adversely impacted mental health as communal coping has been found to buffer mental health outcomes in wildfire victims who evacuated (Afifi et al. 2012). For temporarily displaced residents who chose to return to impacted communities, conflicts are likely to occur over the desire and the ability to rebuild. “The increasing frequency of massive wildfires has caused some officials to consider the wisdom of building in the so-called urban-wildland interface. However, the local nature of zoning regulations suggests that large-scale change will not occur anytime soon” (Parvini and Simani 2018). According to a 2014 study by the Nature Conservancy, builders in California were on track to add 645,000 new homes in highly fire-prone areas by 2050 (Levine 2018). In contrast, efforts to expand the supply of affordable housing in response to wildfire damage have been consistently opposed by local residents. For instance, a plan to implement rent control in Santa Rosa to control rising housing costs approved by the City Council after the Tubbs Fire was overturned by voters in a special election. In Santa Rosa, efforts of city officials to increase the supply of affordable housing have run counter to a traditional reluctance of local residents to approve the construction of new homes out of a fear of unmanaged growth. Consequently, “the region will probably face tension over how much new home building it should accept, including whether it should rebuild at all in areas at risk of wildfire devastation” (Dillon 2017).

4.4.3  Impacts on Host Communities In contrast to studies of the impacts of people displaced by hurricanes like Katrina and Maria, there have been no known studies conducted to date on similar impacts of displaced victims of wildfires on the communities to which they relocated. However, anecdotal evidence reported in the aftermath of the Camp Fire in Northern California suggest that host communities like Chico and Oroville have been impacted by the influx of evacuees from Paradise. Chico’s population grew by 19,000 in the aftermath of the Camp Fire, and the number of new residents remains somewhere between 10,000 and 19,000. There have been reports of enhanced levels of stress; concerns about increases in crime, congestion, lack of housing, and homelessness; and a recall effort against the mayor for failing to manage the influx of climigrants (Bizjak 2019).

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4.5  Lessons Learned 4.5.1  Disparities in Risk and Resilience Although wildfires are often described as indiscriminate, striking any community in their path and affecting both rich and poor, the reality is that there are wide variations in risk and resilience to such events. As Squires (2018) observed, “socioeconomic differences between fire sites like Woolsey and Camp illustrate the stark disparity between those affected.” Many of the celebrities living in the affluent community of Malibu are expected to rebuild their multimillion dollar homes after the Woolsey Fire, while many former Paradise residents who lost their homes in the Camp Fire simply may not be able to afford rebuilding costs (Squires 2018). In addition, Butte County established six shelter sites for more than 52,000 people displaced by the Camp Fire. An outbreak of norovirus at four shelter sites affected as many as 145 evacuees (Clift 2018). According to Squires (2018), “Heading into winter, the situation has all the makings of long-term displacement: a socially vulnerable population with nominal means and no place to go.”

4.5.2  Wildfire Evacuees as Climigrants As with the hurricane events described in the past two chapters, evacuees of wildfires in California and elsewhere are expected to exhibit mental health problems associated with exposure to the event itself and the process of relocation. These problems will vary by age, gender, socioeconomic status, pre-event mental health status, and degree of exposure to death and destruction. Displacement is also likely to contribute to an increase in feelings of social isolation and reduced feelings of social support as networks of family and friends are disrupted by such events (Bryant et  al. 2017). Likewise, host communities will experience a strain on resources as evacuees arrive seeking services and educational and employment opportunities. Such resource strain is likely to generate tensions between established residents and evacuees, as it did in Houston and other cities after Hurricane Katrina. These impacts bear many similarities to those forced to move by hurricanes and, as we shall see in later chapters, by floods, droughts, and coastal erosion. Yet, wildfire evacuees are not typically viewed as environmental migrants or climate refugees, primarily because most tend to return to communities of origin and rebuild lost or damaged homes and property. Although they were in a sense forced to migrate by oncoming flames or an evacuation order, most evacuees have every intension of returning. As this chapter illustrates, however, not everyone can return. Those who cannot afford to rebuild or prefer to live somewhere less prone to wildfires become permanently displaced and certainly meet the criteria for being a climigrant. Nevertheless, even those who evacuate for a short time and then return to

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undamaged homes after an all clear announcement is issued by public authorities, or those who must live elsewhere until rebuilding is completed, are still impacted by the experience of dislocation. Those impacts are financial, but also psychological and social. They, too, meet the criteria of a climigrant as a person who is dislocated as a result of a climate-induced change in the environment. Wildfire in California and elsewhere is usually viewed in the context of long-­ term drought. The prospect of continual drought in fire-prone areas resulting from climate change means that both wildfires and displacement will be a fact of life for vulnerable individuals and communities for some time. However, as we shall see in the next chapter, drought brings other hazards to health and well-being, such as poverty, undernutrition, and civil conflict, that will also result in different forms of displacement.

References Abatzoglou JT, Williams AP (2016) Impact of anthropogenic climate change on wildfire across western US forests. Proc Natl Acad Sci 113:11770–11775 Adelaine SA, Sato M, Jin Y et al (2017) An assessment of climate change impacts on Los Angeles (California USA) hospitals, wildfires highest priority. Prehosp Disaster Med 32:556–562 Afifi WA, Felix ED, Afifi TD (2012) The impact of uncertainty and communal coping on mental health following natural disasters. Anxiety Stress Coping 25 (3):329–347 Agyapong VIO, Hrabok M, Juhas M et al (2018) Prevalence rates and predictors of generalized anxiety disorder symptoms in residents of Fort McMurray six months after a wildfire. Front Psych 9:345. https://doi.org/10.3389/fpsyt.2018.00345 Arango T, Fuller T (2019) Life in fire-scarred California is being always ready to run. New York Times, 26 Oct. https://www.nytimes.com/2019/10/25/us/california-fires-evacuations.html. Accessed 26 Oct 2019 Belleville G, Ouelet MC, Morin CM (2019) Post-traumatic stress among evacuees from the 2016 Forst McMurray Wildfires: exploration of psychological and sleep symptoms three months after the evacuation. Int J Environ Res Public Health 16(9):E1604. https://doi.org/10.3390/ ijerph1609160 Bizjak T (2019) Chico’s post Camp Fire world: car crashes, frayed nerves and bare-knuckle politics. Sacramento Bee, 23 May. https://www.sacbee.com/news/california/article230015334. html. Accessed 14 Oct 2019 Brook RD, Rajagopalan S, Pope CA 3rd et al (2012) Particulate matter air pollution and cardiovascular disease: an update to the scientific statement from the American Heart Association. Circulation 121:2331–2378 Brown MRG, Agyapong V, Greenshaw AJ et al (2019) Significant PTSD and other mental health effects present 18 months after the Fort McMurray Wildfire: findings from 3,070 Grades 7-12 students. Front Psych 10:623. https://doi.org/10.3389/fpsyt.2019.0623 Bryant RA, Gallagher HC, Lisa Gibbs L et al (2017) Mental health and social networks after disaster. Am J Psychiatry 174 (3):277–285 Bryant R, Waters E, Gibbs L et al (2014) Psychological outcomes following the Victorian Black Saturday bushfires. Aust NZ J Psychiatry 48(7):634–643 Carroll MS, Higgins LL, Cohn PJ et al (2006) Community wildfire events as a source of social conflict. Rural Sociol 71(2):261–280 Carroll MS, Paveglio T, Jakes PJ et al (2011) Nontribal community recovery from wildfire five years later: the case of the Roseo-Chediski fire. Soc Nat Resour 24(7):672–687

References

65

CBS News (2019a) Tens of thousands ordered to evacuate after wildfire explodes in Southern California. CBS News, 11 Oct. https://www.cbsnews.com/news/fires-in-california-saddleridgewildfire-explodes-prompting-mandatory-evacuations-amid-power-outages-2019-10-11/. Accessed 29 Oct 2019 CBS News (2019b) Residents near California wildfire urged to be ready to “go at a moment’s notice”—live updates. CBS News, 29 Oct. https://www.cbsnews.com/live-news/fire-in-california-latest-getty-kincade-sonoma-tick-fires-evacuations-today-live-updates-2019-10-29/. Accessed 29 Oct 2019 Clift T (2018) More than 140 Camp Fire evacuees at shelters have had norovirus, some ‘acutely ill’. Sacramento Bee, 15 Nov. https://www.sacbee.com/latest-news/article221739265.html. Accessed 25 Apr 2019 CoreLogic (2018) The Camp and Woolsey Wildfires in California cause devastating losses between $15 billion and $19 billion according to CoreLogic. 27 Nov. https://www.corelogic.com/news/ the-camp-and-woolsey-wildfires-in-california-cause-devastating-losses-between-15-billionand-19-billion-according-to-corelogic.aspx?WT.mc_id=crlg_181126_hC1gk. Accessed 13 Oct 2019 Dennison PE, Brewer SC, Arnold JD et  al (2014) Large wildfire trends in the western United States, 1984-2011. Geophys Res Lett 41:2928–2933 Dillon L (2017) Thousands displaced by Northern California’s wildfires now face the region’s housing shortage. Los Angeles Times, 19 Oct. https://www.latimes.com/politics/la-mesanta-rosa-fires-housing-shortage-20171019-story.html. Accessed 24 Apr 2019 Dodd W, Scott P, Howard C et  al (2018) Lived experience of a record wildfire season in the Northwest Territories, Canada. Can J Public Health 109(3):327–337. https://doi.org/10.17269/ s41997-018-0070-5 Finlay SE, Moffat A, Gazzard R et al (2012) Health impacts of wildfires. PLoS Curr 4:e4f959951cce2c. https://doi.org/10.1371/4f959951cce2c Garfin G, Franco G, Blanco H et al (2014) Southwest. In: Melillo JM, Richmond TC, Yohe GW (eds) Climate change impacts in the United States: the third national climate assessment. US Global Change Research Program, Washington, DC, pp 462–486 Gerber M, Fry H, Cosgrove J (2019) Tick fire: residents tally losses as firefighters battle flames and high winds. Los Angeles Times, 25 Oct. https://www.latimes.com/california/story/2019-10-25/ tick-fire-jumps-14-freeway-friday. Accessed 29 Oct 2019 Gillette NP, Weaver AJ, Zwiers FW et al (2004) Detecting the effect of climate change on Canadian forest fires. Geophys Res Lett 31:L18211. https://doi.org/10.1029/2004GL020876 Gutierrez M, Chabria A, Newberry L, et al (2019) Kincade fire stokes anxiety and a frightening sense of déjà vu among weary residents. Los Angeles Times, 28 Oct. https://www.latimes. com/california/story/2019-10-28/la-me-northern-california-residents-experience-anxiety-andworry. Accessed 28 Oct 2019 Gutman R (2018) The three most chilling conclusions from the climate report. The Atlantic, 26 Nov. https://www.theatlantic.com/science/archive/2018/11/most-chilling-parts-2018-climateassessment/576598/. Accessed 16 Apr 2019 Hurteau MD, Westerling AL, Wiedinmyer C et al (2014) Projected effects of climate and development on California wildfire emissions through 2100. Environ Sci Technol 48:2298–2304. https://doi.org/10.1021/es4050133 Hutchinson JA, Vargo J, Milet M et al (2018) The San Diego 2007 wildfires and Medi-Cal emergency department presentations, inpatient hospitalizations, and outpatient visits: an observational study of smoke exposure periods and a bidirectional case-crossover analysis. PLoS Med 17(7):e1002601 Jenkins JL, Hsu EB, Sauer LM et al (2009) Prevalence of unmet health care needs and description of health care-seeking behavior among displaced people after the 2007 California wildfires. Disaster Med Public Health Prep 3(2 Suppl):S24–S28. https://doi.org/10.1097/ DMP.0b013e31819f1afc

66

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Johnson F, Hanighan I, Henderson S et al (2011) Extreme air pollution events from bushfires and dust storms and their association with mortality in Sydney, Australia 1994–2007. Environ Res 111(6):811–816. https://doi.org/10.1016/j.envres.2011.05.007 Johnston FH, Henderson SB, Chen Y et al (2012) Estimated global mortality attributable to smoke from landscape fires. Environ Health Perspect 120:695–701 Jones RT, Ribbe DP, Cunningham P et al (2003) Psychosocial correlates of wildfire disaster: post disaster adult reactions. Fire Technol 39(2):103–117 Kunzli N, Avol E, Wu J et al (2006) Health effects of the 2003 Southern California wildfires on children. Am J Respir Crit Care Med 174:1221–1228 Lam K (2019) Northern California town of Paradise lost 90% of its population after Camp fire, data shows. USA Today, 11 Jul. https://www.usatoday.com/story/news/nation/2019/07/11/paradisecalifornia-population-camp-fire-california-wildfire-fund/1710525001/. Accessed 14 Oct 2019 Levine AS (2018) After a wildfire, rebuilding life can be hardest for the oldest. New York Times, 25 Nov. https://www.nytimes.com/2018/11/25/us/california-wildfire-senior-shelter.html. Accessed 23 Jan 2019 Levine S, Waddell K (2018) Californians usually rebuild after a fire. That could change. Axios, 15 Nov. https://www.axios.com/moving-back-to-the-fire-zone-1542315977-3e8998beaab0-4d19-b00d-daa997a127c4.html. Accessed 23 Jan 2019 Liu JC, Pereira G, Uhl SA et al (2015) A systematic review of the physical health impacts from non-occupational exposure to wildfire smoke. Environ Res 136:120–132 Livingston M, Panzar J (2017) Thomas fire becomes the largest wildfire on record in California. Los Angeles Times, 22 Dec. https://www.latimes.com/local/lanow/la-me-thomas-fire-size20171222-20171222-htmlstory.html. Accessed 24 Jan 2019 Los Angeles Times (2019) California wildfires map. Los Angeles Times, 29 Oct. https://www. latimes.com/wildfires-map/. Accessed 29 Oct 2019 Marshall GN, Schell TL, Elliott MN et al (2007) Psychiatric disorders among adults seeking emergency disaster assistance after a wildland-urban interface fire. Psychiatr Serv 58:509–514 McDermott BM, Palmer LJ (2002) Postdisaster emotional distress, depression and event-related variables: findings across child and adolescent developmental stages. Aust N Z J Psychiatry 36(6):754–761 McFarlane AC (1987) Posttraumatic phenomena in a longitudinal study of children following a natural disaster. J Am Acad Child Adolesc Psychiatry 26(5):764–769 McFarlane ACM, Van Hooff MBH (2009) Impact of childhood exposure to a natural disaster on adult mental health: 20-year longitudinal follow-up study. Br J Psychiatry 195(2):142–148 McFarlane AC, Clayer JR, Bookless CL (1997) Psychiatric morbidity following a natural disaster: an Australian bushfire. Soc Psychiatry Psychiatr Epidemiol 32(5):261–268 Millman O (2013) Climate Council finds ‘clear link’ between bush fires and climate change. The Guardian (UK), 24 Oct. https://www.theguardian.com/world/2013/oct/25/climate-councilclear-link-bushfires. Accessed 24 Jan 2019 Morgan G, Sheppeard V, Khalaj B et al (2010) Effects of bushfire smoke on daily mortality and hospital admissions in Sydney, Australia. Epidemiology 21(1):47–55 Nawretzki RJ, Brenkert-Smith H, Hunter LM et al (2014) Wildfire-migration dynamics: lessons from Colorado’s Fourmile Canyon fire. Soc Nat Resour 27(2):215–225 NBC News (2019) Northern California wildfires force nearly 200,000 people to evacuate. NBC News, 28 Oct. https://www.nbcnews.com/news/us-news/180-000-under-evacuation-twomajor-wildfires-flank-california-n1072551. Accessed 29 Oct 2019 Nelson LJ, Kohli S, St. John P, et al (2017) Death toll from Northern California fires jumps to at least 24; 5,700 structures destroyed. Los Angeles Times, 13 Oct. https://www.latimes.com/ local/lanow/la-me-ln-fires-20171013-story.html. Accessed 24 Jan 2019 Papanikolaou V, Adamis D, Melton RC et  al (2011) Psychological distress following wildfires disaster in a rural part of Greece. A case control population based study. Int J Emerg Ment Health 13(1):11–26

References

67

Parslow RA, Jorm AF (2006) Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults. Addiction 101(7):1044–1050 Parvini S, Simani E (2018) As California wildfires displace low-income residents in wine country, tech industry continues to bolster Bay Area wealth. Los Angeles Times, 5 Dec. https://www. latimes.com/local/lanow/la-me-ln-california-income-poverty-census-20181205-story.html. Accessed 23 Jan 2019 Passey J (2018) California wildfire victims face new challenges finding housing. Marketwatch, 8 Dec. https://www.marketwatch.com/story/california-wildfire-victims-will-face-unique-challenges-finding-new-housing-2018-11-16. Accessed 25 Jan 2019 Phillips AM (2018) 50,000 displaced by Northern California fire. Where will they go? Los Angeles Times, 25 Nov. https://www.latimes.com/local/california/la-me-california-fires-woolsey-hillcamp-50-000-displaced-by-paradise-fire-where-1543163215-htmlstory.html. Accessed 23 Jan 2019 Radeloff VC, Hammer RB, Stewart SI et al (2005) The wildland–urban interface in the United States. Ecol Appl 15:799–805 Reid CE, Brauer M, Johnston FH et al (2016) Critical review of health impacts of wildfire smoke exposure. Environ Health Perspect 124:1334–1343 Rizzo CA (2018) Uncontrolled California wildfires force more than 100,000 people to evacuate. Travel & Leisure, 9 Nov. https://www.travelandleisure.com/travel-news/california-wildfires. Accessed 23 Jan 2019 Serna J (2019) 2018 was California’s worst year of fire ever, federal report confirms. Los Angeles Times, 9 Mar. https://www.latimes.com/local/lanow/la-me-ln-california-fires-record-report20190309-story.html. Accessed 18 Mar 2019 Smith A (2019) 2018’s billion dollar disasters in context. Climate.gov, 7 Feb. https://www.climate.gov/news-features/blogs/beyond-data/2018s-billion-dollar-disasters-context. Accessed 7 Oct 2019 Smith K, Woodward A, Campell-Lendrum D et al (2014) Human health—impacts adaptation and co-benefits. In: Field CB, Barros VR, Dokken KJ et al (eds) Climate change 2014: impacts, adaptation, and vulnerability. Working Group II contribution to the IPCC Fifth Assessment Report. Cambridge University Press, New York, pp 709–754 Squires L (2018) California wildfires: mapping social vulnerability. Direct Relief, 24 Nov. https:// www.directrelief.org/2018/11/california-wildfires-mapping-social-vulnerability/. Accessed 22 Jan 2019 St. John P, Sahagun L, Castillo A et al (2018) Paradise fire becomes one of California’s worst: 6,700 structures lost; at least nine dead. Los Angeles Times, 9 Nov. https://www.latimes.com/ local/lanow/la-me-camp-fire-20181109-story.html. Accessed 8 Nov 2019 Tally S, Levack A, Sarkin AJ et  al (2013) The impact of the San Diego wildfires on a general mental health population residing in evacuations areas. Adm Policy Ment Health 40:348–354 Thurton D (2019) Fort McMurray population down nearly 11 per cent since wildfire, census shows. CBC News, 15 Jan. https://www.cbc.ca/news/canada/edmonton/fort-mcmurray-censuspopulation-1.4978907. Accessed 12 Oct 2019 USGCRP (2018) Impacts, risks, and adaptation in the United States: Fourth National Climate Assessment, Volume II.  Reidmiller DR,  Avery CW, Easterling DR et  al (eds). U.S.  Global Change Research Program, Washington, DC. doi: 10.7930/NCA4.2018 Verghis S (2019) Black Saturday: the bushfire disaster that shook Australia. BBC News, 7 Feb. https://www.bbc.com/news/world-australia-47038202. Accessed 14 Oct 2019 Viswanathan S, Eris L, Diunugala N et al (2006) An analysis of effects of San Diego wildfire on ambient air quality. J Air Waste Manag Assoc 56:56–67 Westerling AL, Hildago HG, Cayan DR et al (2006) Warming and earlier spring increase western U.S. forest wildfire activity. Science 313:940–943 Yelland C, Robinson P, Lock C et  al (2010) Bushfire impact on youth. J Trauma Stress 23(2):274–277

Part II

Long-Term Climate-Related Events

Chapter 5

Fleeing Drought: The Great Migration to Europe

5.1  The Narrative 5.1.1  The Event Life is far from easy here. Fisherman Samuel Ngargoto, 35, looks to God for help. “Not only are the fish smaller, but there are also fewer of them,” he says. “And as the lake transforms into a marsh, the hogfish, a rare and valuable fish that fetches a high price at the market, is becoming harder to find. We aren’t able to compensate for this loss with other species, like carp and catfish, which have succeeded in adapting to the changes in the lake but aren’t worth much. God needs to send us a miracle because there’s too much suffering involved in living on this lake” (Collectif Argos 2010: 96).

5.1.2  The Displacement “I travelled to Libya by car through the desert for 15 days; then we reached Libya. We tried to find out how to get a job, and then we got a job, but the country is not safe and does not have a government. It just has militias and rebels. Sometimes when they see you on the street, especially when you are Black, then they stop you and check your pockets, and take all that you have got, and they tell you, ‘We don’t want to see you again in these places.’ Sometimes, when you go to work, after you did your work, they just tell you that ‘We don’t have money for it.’ If you talk, they just kill you for no reason. And also, they call Black people slaves” (Hansen 2018).

© Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_5

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5.2  The Great Migration Throughout history, Europe has been a destination for countless refugees and migrants fleeing war, natural disaster, or poverty or seeking new opportunities and a better quality of life. For centuries, many immigrants arrived from parts of the world that had been controlled by European colonial powers such as England, France, Spain, Germany, Italy, and the Netherlands. This pattern of migration increased substantially in the twentieth century, especially after World War II, as living standards throughout Europe in general and Western Europe in particular began to improve. Beginning in 2013, a new wave of immigrants arrived in Europe from North Africa or the Middle East. The number of arrivals peaked in 2015 when 1,011,712 immigrants landed on European soil after crossing the Mediterranean Sea from North Africa, most notably Libya, while 34,887 immigrants traveled by land from Turkey to Bulgaria and Greece (IOM 2015). The largest numbers of migrants were refugees fleeing the civil conflict in Syria. For most of these migrants, travel to Europe has been dangerous and illegal. The flow of migrants gave rise to a lucrative trade in human trafficking throughout North Africa as migrants were placed onto overcrowded vessels or smuggled by land at the Spanish Enclaves of Ceuta and Melilla. In 2015, over 900 migrants were believed to have drowned crossing the Mediterranean. However, there were 3149 other deaths of migrants that year according to the IOM (2019a, b). Between 2014 and September 2019, there were 18,871 deaths overall, most occurring in the Eastern Mediterranean (Table 5.1). Since 2015, migrants have continued to arrive from these two primary routes, but in smaller numbers each year as European nations have made concerted efforts to prevent them: In early 2016, the European Union (EU) reached an agreement with Turkey aimed at stopping the massive influx of refugees and migrants into the Union. Under the deal, the EU and Turkey agreed that all new migrants crossing from Turkey to the Greek islands after 20 March 2016 would be returned to Turkey if they were not applying or not eligible for asylum, or were asylum seekers whose application was considered inadmissible in the EU. (Ben Farhat et al. 2018: 1)

The arrangement also included legal channels of resettlement of Syrian refugees to the EU.  Many others seeking asylum have been placed in detention centers in Table 5.1  Numbers of Deaths of Migrants from Africa and Middle East by Route Year 2014 2015 2016 2017 2018 2019

Central Mediterranean 3165 3149 4581 2853 1314 658

Eastern Mediterranean 59 803 434 62 174 58

Western Mediterranean 59 102 128 234 811 237

Adapted from Europe—mixed migration flows to Europe monthly overview, by International Organization on Migration, 2019. https://displacement.iom.int/reports/europe-%E2%80%94mixed-migration-flows-europe-monthly-overview-june-2019

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Greece, living in difficult conditions as they await resettlement or deportation (Ben Farhat et al. 2018).

5.2.1  Syria Much of the attention devoted to the great migration to Europe in the past decade has focused on the plight of refugees from Syria. However, climate change is likely to have contributed to the development of the civil war in Syria, which began in 2011 (Gleick 2014; Levy et al. 2017). From 2006 through 2009, a severe drought transformed approximately 60% of the land area into desert, and approximately 80% of cattle died (Levy et  al. 2017). The return of drought conditions in 2011 affected between two and three million people, with one million driven into food insecurity (Gleick 2014). As many as 1.5 million people abandoned their farms and moved to cities, which were already burdened with more than one million Iraqi refugees. Most of the climigrants were unable to find employment and were not well received by either the government or the host communities (Trigo et al. 2010). Soaring food prices also contributed to social and economic tensions and the subsequent civil conflict. “Unlike the ‘Arab Spring’ in Egypt and Tunisia, the Syrian uprising took place among the most impoverished and in marginalized neighborhoods with high concentrations of rural migrants” (EJF 2017: 35): Globally, Syria is one of the countries most vulnerable to water scarcity (Levy 2008) and most economically affected by drought (Erian et al. 2010) The country suffered a number of droughts in the 20th century (ICARDA 2010), with evidence showing an increasing tendency in annual and seasonal droughts over time (ASCAD 2010). Climate change has contributed to altered precipitation patterns (ICARDA 2010), increased temperatures (ICARDA 2010), and an increased number of sandstorms (The Watchers 2016). Some 185,180 km2 of Syrian land is thought vulnerable to droughts: 63.65% has high or medium vulnerability to drought (ASCAD 2011). EJF 2017: 33

5.2.2  Sub-Saharan Africa Mixed in with refugees from civil conflicts like Syria and Afghanistan have been a substantial number of climigrants from West Africa (Nigeria, Cameroon, Chad) and the Horn of Africa (Somalia, South Sudan, Ethiopia, Eretria), fleeing the effects of climate change on the environment. The decline in agricultural productivity resulting from reductions in rainfall and increasing temperatures throughout Africa is likely to be the primary reason for displacement and migration. Agriculture accounts for an average of one-third of the annual GDP of most African countries and employs approximately three-quarters of the labor force (Mohamoud et  al. 2014). Crop yields are expected to decline by as much as 50% in some of the poorest African countries as early as 2020 as a result of climate change and climate variability (FAO 2009). Such a decline is expected to increase the number of Africans living in poverty, which, combined with increasing population pressure, will accelerate land degradation throughout

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Fig. 5.1  Map of the Sahel Region of Africa (Reproduced from Ibrahim 2019)

the continent. Since about 1950, about 65% of all agricultural land in Africa, more than a quarter of the continent, has experienced soil degradation (FAO 2009). Accelerating desertification and deforestation is also a primary cause of environmentally induced displacement in many areas in Africa. Africa is the driest of the world continents with 43% of its landmass being categorized as dry lands, 74% of which is already seriously or moderately degraded. Deforestation has also displaced many  peasant farmers and added to social tensions, conflict, and poverty. Furthermore, direct effects from extreme weather events or sea level rise have put lowland situated, highly populated areas at risk, especially in parts of Egypt and West Africa (Mohamoud et al. 2014). 5.2.2.1  West Africa Stretching across Africa from the Atlantic to the Indian Ocean is a region known as the Sahel (Fig. 5.1). Comprised of 10 different countries, totaling 300 million people, the Sahel is one of the most environmentally degraded regions in the world with temperature increases projected to be 1.5 times higher than the global average (UN News 2018). It is regularly hit by droughts and floods, which have enormous consequences on people’s ability to earn a living and feed their families. However, in recent years, acute rainfall deficits in several regions of the Sahel and worsening insecurity have escalated humanitarian needs. The Sahel belt, which extends from Cameroon and Mauritania in the west to South  Sudan and Eretria in the east, is expected to experience a 10% decrease in annual rainfall by 2050 (IPCC 2007), leading to an increase in desertification of arable land and currently impacting the lives of over 67 million people living in the region (Mohamoud et al. 2014). At the present time, one in ten residents in the region is food insecure of which 10.8 million individuals are reaching emergency levels (OCHA 2018), and an estimated 4.7 million children under the age of 5 years suffer from acute malnutrition

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(OCHA 2018). Around 2.5 million pastoralists and agropastoralists were at risk of serious livelihood crisis in 2018 due to severe deficits in available food and water for livestock. Mauritania and parts of Burkina Faso, Chad, Senegal, and Mali are the worst affected in the Sahel. Armed attacks in border regions with Burkina Faso and Niger, banditry, and intercommunity conflict have increased in Mali’s central regions (OCHA 2018). The Lake Chad Basin is located in the western part of the Sahel and includes the countries of Nigeria, Cameroon, Niger, and Chad. In recent years, violence generated by non-state armed groups such as Boko Haram has been the main driver of displacement within and outside the region. However, communal clashes and the conflicts throughout the region have been exacerbated by climate changes that have resulted in prolonged droughts and disruption of the region’s agricultural economy and led to a major humanitarian crisis (IOM 2019a: 1). “Parts of Chad and Niger have been hit by drought that has affected Sahel countries following poor rains in the 2017 season, leading to an early onset of the lean season. In areas worst hit by violence, almost 500,000 children are severely acutely malnourished and 5.8 million people are struggling with high levels of food insecurity” (OCHA 2018: 3). Migration within and across the borders of these four countries and beyond has long been a common practice in the Lake Chad region. The region has traditionally been the center of a thriving trade in agricultural produce, fish, and other goods and commodities. Cross-border movements were commonly undertaken for economic and educational purposes, to find grazing land or a spouse and to visit or settle with family or communities of the same ethnic group (IOM 2019a, b). These cross-­ border movements have extended beyond the region to North Africa. For instance, there is a long tradition of migration through Niger into North Africa (Brachet 2018) much of which was traditionally been used as a common household strategy to diffuse economic risk such as those that occur during frequent periods of drought (Charrière and Frésia 2008; Kirwin and Anderson 2018). In recent years, however, the region has experienced massive displacement due to an ongoing insurgency and its impact on the fragile political and economic structures of countries in the subregion (WHO AR 2018): From June 2011 through June 2018, ACLED (Armed Conflict and Location Event Data) identified 3,346 incidents in which 43,261 people were killed (Matfess 2018). Alongside the deadly attacks, local populations live in volatile and insecure conditions, fleeing homes to look for safer places in their own or neighboring areas, state capitals, different parts of their countries and to other countries. 17.2 million people are living in the affected areas, and almost 4.5 million persons (IDPs, refugees, asylum seekers and returnees) are displaced across Nigeria, Niger, Cameroon and Chad, resulting in a major displacement crisis in the region. (IOM 2019a: 9)

One of the countries contributing to the influx of climigrants from sub-Saharan Africa is Nigeria. While armed conflict with Boko Haram has received the most attention, communal conflict precipitated by climate change has also been on the rise. Seminomadic cattle herders in Northern Nigeria have started moving their herds into densely populated farming areas to the south, seeking grasslands that have not already been degraded by climate change. At the same time, farmers have expanded their fields, often into the herders’ traditional grazing routes, leading to an

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escalation of violence as traditional forms of mediation of disputes between the two groups have broken down (Mahr 2019). 5.2.2.2  East Africa As is the case in West Africa, prolonged drought and reduced agricultural productivity have contributed to rising levels of civil conflict and population displacement. This is especially true in Sudan and Somalia. “Sudan is among the first nations that the United Nations officially identified as experiencing climate change–induced state failure, war, forced migration, and famine” (Shultz et al. 2019: 119). Rising temperatures, reduced rainfall, and prolonged droughts will severely impact the pastoral and nomadic groups residing in the semiarid areas of Sudan and further increase the already high risk of economic, political, security, and public health concerns (Worldwatch Institute 2009; Elasha et al. 2005; Singh et al. 2011). “The worst impacts of the repeated droughts have been felt most on the central and northern states of northern Kordofan, northern and western Darfur, and the Red Sea and White Nile states (Giannini et  al. 2008; Scheffran et  al. 2014)” (Shultz et  al. 2019: 119). South Sudan is experiencing drought conditions. “Since 1980, decreasing rainfall has been accompanied by rapid increases in temperature by more than 1°C. This warming, which is two and a half times greater than the global warming, is making ‘normal’ years effectively drier” (Government of Netherlands 2019). “Up to 95 percent of people in South Sudan, or more than 11 million people, depend on climate sensitive sectors, including agriculture, forestry resources and fisheries for their livelihoods” (Stalon and Chowdhary 2017). Drier weather spells are also likely to lead to increased deforestation and resource-based conflicts between the pastoralists and farmers over access to grazing land. Somalia has also experienced significant climate-related environmental changes. “The ability of around 70% of Somalis to meet their basic needs depends heavily on a regular climate pattern. However, over the past decade climate change-related desertification has expanded in Somalia, making the local population even more vulnerable” (Kuele and Miola 2018). The 2015–2016 El Niño phenomenon worsened an already widespread drought in Puntland and Somaliland with a devastating impact on communities and their livelihoods, increasing food insecurity, cash shortages, out-migration, and death of livestock and affecting other areas of the country, specifically in Jubaland in the south. Somaliland and Puntland experienced below average rains for up to four seasons, spanning 2 years, and affected nearly 1.4 million people (OCHA 2016). Two years later, below average rains during the “Gu” (April–June 2019) and “Deyr” (October–December 2018) rainy seasons caused worsening drought in many parts of the country, resulting in harvest levels up to 70% below average in some parts. An estimated 5.4 million people were expected to be food insecure by July 2019, with 2.2 million needing immediate emergency assistance. The most recent drought came just as the country was beginning to

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recover from the 2016–2017 drought that led to the displacement of over a million people inside Somalia (UNHCR 2019a). As in the case of South Sudan, climate change has contributed to armed conflict in Somalia. According to Kuele and Miola (2018), it does so by exacerbating tensions between clans; boosting the ranks and role of terrorist groups, including al-­ Shabaab; and increasing migration: First, climate change sharpens disputes over already-scarce resources between warlords. While al-Shabaab has conquered large pieces of the country’s territory, clan elders still wield considerable power, dominating the political system. In this sense, the severe droughts cause disruptions to water access, high rates of malnutrition, disease outbreaks and food insecurity. This leads to tension and even open disputes between clans. In a country facing such challenges, resources like food and water are not only a basic need, but also a source of power. Second, the relationship between the proliferation of illegal armed groups and the severe droughts in Somalia is evident in the case of al-Shabaab. The group has been successful in attracting young people who are affected by famine and food insecurity and who face no job prospects. Those youth end up joining al-Shabaab in a bid to survive, finding no other option than to get involved with the extremist group.

5.3  Patterns of Displacement 5.3.1  Numbers of Climigrants As of September 2019, more than 13 million Syrians have been displaced from their homes as a result of the civil conflict. About 5.6 million displaced Syrians live in neighboring countries in the Middle East and North Africa, including Turkey (3.6 million), Lebanon (924,161), Jordan (657,445) and Iraq (228,573), and Egypt (130,371) (UNHCR 2019a). About one million displaced Syrians have requested asylum to Europe since the conflict began. Germany, with more than 300,000 applications, and Sweden, with 100,000, are the EU’s top receiving countries (Migration Policy Centre 2016). Another six million Syrians have been displaced within the country (Connor 2018). Most of the displaced residents fleeing drought-affected areas in West Africa have traveled to Libya seeking transportation to Italy or other places in southern Europe. “Over 600 000 African migrants have arrived in Italy through the perilous Central Mediterranean route since 2014, and nearly 120,000 arrived in 2017 alone” (IOM 2019b). According to the Pew Research Center (Connor 2018), since 2010, eight of the top ten countries with the fastest-growing international migration rates were in sub-Saharan Africa. However, the majority of migrants will be displaced residents that relocate elsewhere in Africa. By 2050, there will be 86 million internal migrants in sub-Saharan Africa from environmental change alone, representing up to 4% of the region’s total population (Rigaud et al. 2018). For instance, although West Africans are heading to Europe in growing numbers, there is ten times more

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migration within West Africa than migration to Europe (Charrière and Frésia 2008). Nigeria is experiencing the largest displacement in West Africa, with more than two million persons internally displaced in the North East across six states. The highest numbers of displaced households reside in host communities located in Borno, Adamawa, and Yobe states (IOM 2019a). Both forms of climigration could reach historically unprecedented levels. In East Africa, the volatile political situation and food insecurity have led to large internal displacement and movements across borders. Overall, there were 4.4 million refugees and asylum seekers and an additional three million internally displaced across the East Africa region in July 2017 (OCHA 2017). Half of the South Sudan population has been affected, and a third (up to four million) has been displaced by conflict. Many have fled to neighboring Uganda, making it the largest refugee-hosting country in Africa (UNHCR 2018). In 2016, at least one million Somalis were internally displaced. Around 300,000 Somali refugees were living in the Dadaab refugee complex, the world’s largest refugee camp, located in neighboring Kenya. However, The Kenyan government announced their intention to close the compound, placing the future of its current residents in doubt (Kuele and Miola 2018). Between November 2016 and June 2017, there were an estimated 739,000 drought displacements in Somalia. More than 480,000 of the displaced, or 65%, were under the age of 18  years. Moreover, people under 5  years old represented more than one-quarter (195,000) of all those displaced (UNHCR 2017). Drought also forced more than 49,000 people to flee their homes in 2019. People who are already displaced because of conflict and violence are also affected by the drought (UNHCR 2019a).

5.3.2  Displacement-Related Decisions In each of these settings, long-term changes in the environment related to climate change are a direct cause of climigration in only a small percentage of cases. For the most part, climate change has contributed to other factors that serve as more immediate inducements to change. The great migration to Europe and elsewhere has been the result of profound changes in the economic and political environment, which, in turn, have been influenced by changes in the physical environment due to climate change. In the next few sections, we examine these economic and political changes. 5.3.2.1  Economic Impacts As noted in Sect. 5.2.1, prolonged drought across the Sahel region has resulted in diminished productivity of the predominately agricultural economy and increased levels of food insecurity. Research on potential impacts of drought has consistently pointed to economic loss as a motivation for relocation (Barreau et  al. 2017). In addition, many climigrants from Africa have also been motivated by economic

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opportunities in Europe. A study conducted by Kirwin and Anderson (2018) found that West Africans who would migrate if given the means and opportunity were far more likely to cite economic benefits as their primary motivation (better jobs and pay and the opportunity to send money home) than to mention gaining personal freedoms, furthering their education, or escaping insecurity. Intimately connected to economic considerations is food security. According to the IPCC (2014), temperature increases of 2 °C or more above late twentieth-­century levels are expected to negatively impact yields of wheat, rice, and maize in tropical and temperate regions. Rural areas in particular are expected to experience major impacts on water availability and supply, food security, infrastructure, and agricultural incomes, including shifts in production areas of food and nonfood crops across the world. Residents of drought-affected areas, therefore, will be motivated to move to areas better suited to growing crops and less impacted by food insecurity. 5.3.2.2  Civil Conflict The civil conflicts occurring in Syria, South Sudan, Somalia, Nigeria, Chad, and elsewhere in Western and Eastern Africa are major contributors to the massive displacement of people throughout Africa and the Middle East. “Increasing evidence indicates that climate change is causally associated with collective violence, generally in combination with other factors” (Levy et al. 2017: 241). In its initial stages, the chain of causality begins prolonged drought, which, in turn, leads to reduced agricultural productivity, which leads to increases in food prices, followed by food riots (Levy et al. 2017). The crises in Africa and the Middle East are certainly not the first time that changing temperatures have contributed to armed conflict. Zhang et  al. (2007a) argued that climate change was the major underlying cause of armed conflict and other major humanitarian crises in the preindustrial era in the northern hemisphere as decreasing temperatures led sequentially to lower agricultural production, price inflation, war, famine, and population decline. In Europe between 1560 and 1660, lower temperatures were the underlying cause of ecological, socioeconomic, and demographic catastrophes. Likewise, in Eastern China over the past 1000  years, military conflict was significantly associated with periods of lower temperatures, when there was lower agricultural production (Zhang et al. 2007b). In more recent years, studies have linked an increased risk of civil conflict with warmer temperature times. Hsiang et al. (2011), for instance, found the likelihood of new civil conflicts increased from 3% to 6% during years of the El Nino Southern Oscillation (ENSO) and contributed to the development of 21% of civil conflicts worldwide since 1950. Burke and colleagues found a significant association between warmer temperatures and civil war in sub-Saharan Africa between 1981 and 2002 and projected a 54% increase in armed conflict in Africa by 2030. O’Loughlin et al. (2012) found that substantially warmer temperatures in East Africa between 1990 and 2009 significantly increased the risk of violence. A meta-analysis conducted by Hsiang and Burke (2014) found strong linkages between climate anomalies and

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conflict and social instability. In most of the studies reviewed by the authors, high temperature and high or low precipitation extremes were associated with both conflict and sociopolitical instability around the globe. Nevertheless, climate change is not the sole cause of collective violence. “Other major causes of collective violence include socioeconomic and political instability, disputes over political power and land ownership, poverty and socioeconomic disparities, high unemployment, authoritarian governments, violation of human rights and other manifestations of social justice, and ethnic hatred” (Levy et  al. 2017: 251). However, “climate change has the potential to affect how people interact in communities and with each other. Shrinking natural resources and threats to territories have the potential to force migrations and create direct competition for limited resources” (Trombley et al. 2017: 48). 5.3.2.3  Physical Health Impacts The impact of prolonged drought on food security and nutrition with implications for morbidity and mortality has been well documented throughout East Africa, especially among children, where drought has been directly linked to malnutrition, linear growth, and stunting (Kinyoki et al. 2015; Bahru et al. 2019; Cooper et al. 2019). However, a recent systematic review found that while there are high levels of all types of child undernutrition in drought-affected populations in low-income settings, the extent to which these levels are attributable to drought has not been clearly quantified and may be context specific (Belesova et al. 2019). Moreover, it is unclear to what extent the impacts of drought on the health of children influence the decision to migrate. A study by Mason et al. (2012) found that the average under-5 years mortality rate (U5MR) and global acute malnutrition rate in the Horn of Africa were similar overall between displaced and local residents. Drought can also negatively impact the availability and quality of drinking water, which, in turn, can lead to water-related disease and the exacerbation of heat stress. Reduced water levels can increase contaminant concentrations in groundwater and surface water when stream flows are reduced and wells are over-pumped, resulting in stagnation of groundwater (Yusa et al. 2015). In other parts of the world, including North America and Europe, prolonged drought has been linked to an increased risk from mosquito-borne infections, such as West Nile virus (Yusa et al. 2015). The dry, dusty conditions and dust storms that occur with prolonged drought can also adversely impact health. Such conditions can also positively affect the growth and dissemination of coccidioidomycosis (valley fever). Droughts can also lead to an increase in airborne fine particulate matter, allergen, and dust concentrations, which can exacerbate respiratory diseases (e.g., asthma, allergies, dust pneumonia, bronchitis) in drought-prone areas (Yusa et al. 2015).

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5.3.2.4  Mental Health Impacts Droughts also bring with them severe mental health consequences. Poverty can increase during a drought because of closures of business, job losses, and incurred debts (Barreau et al. 2017). Unemployment, food affordability, and infrastructure costs such as well drilling might lead to adverse outcomes such as depression and anxiety and possibly suicide: While individuals will react to financial hardship in different ways, there is evidence that stress and social isolation may occur, as well as the possibility of increased workloads, decreased time and resources, and disruption of children’s education so that they can help at home or with the family business (Alston 2012; Carnie et al. 2011; Hossain et al. 2008; Babugura 2008; Tonna et al. 2014). These stressful situations cause uncertainty about the future, increasing anxiety (Alston 2012; Carnie et al. 2011). Shame and humiliation over financial struggles may also contribute to social isolation and depressive symptoms (Anderson 2009). Additionally, there is evidence that these types of situations allow stress and tension to permeate the household, sometimes resulting in domestic abuse (Alston 2012; Anderson 2009; Carnie et al. 2011; Dean and Stain 2007). These economic-related pathways overlap and interact in such a way that they may also result in depression, anxiety, and suicide. (Vins et al. 2015: 13,257)

Drought-prone areas are vulnerable to chronically lower socioeconomic status and educational attainment than are other areas and, consequently, to higher levels of distress and learned helplessness (Coelho et  al. 2004). Economic pressures also undermine social capital that is associated with mental health and well-being (De Silva et  al. 2005; Sartorius 2007; Whitley and McKenzie 2005). For those who remain employed, the loss of work capacity and income due to increasing heat exposure while working (Kjellstrom 2009) is also likely to cause mental health problems for many millions of people (Berry et al. 2010). In addition to economic losses, droughts can affect mental health for other reasons. These include a diminishment in community cohesion, the loss of community identity, threats to a sense of continuity and sense of belonging as people are forced to move in and out of communities because of environmental stressors, and an undermining of cultural integrity if people have to leave their homelands (Clayton et al. 2017). Australia is another setting where prolonged drought has created severe economic and mental health impacts that have precipitated climigration. Studies of rural residents impacted by drought in Australia have reported more suicides (Albrecht et al. 2007; Berry et al. 2010, 2011; Hanigan et al. 2012; Nicholls et al. 2006) and increased distress (O’Brien et al. 2014; Stain et al. 2011) in rural areas, with the most severe impacts potentially affecting older farmers (Polain et al. 2011). A study by Hanigan et al. (2018) found drought duration was associated with higher distress in younger rural women, but not older rural women or men. This pattern did not vary between farmers and non-farmers. Drought was associated with increased distress, but this differed between subgroups. Exposure to drought also moderates the association between measures of food insecurity and psychological distress, generally increasing the distress level (Friel et  al. 2014). Migration away from

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drought-prone area, often in search of better employment opportunities, is a related outcome (Vins et al. 2015). Several physical health consequences of climate change are also risk factors for mental health outcomes. For instance, food insecurity and undernutrition have been independently linked to increased psychological distress, mental illness, and compromised child development (Friel et al. 2014; Muldoon et al. 2013; Vozoris and Tarasuk 2003). Although individuals who do migrate may be more likely to do so for reasons of poor mental and behavioral health, such problems are tied more to economic and political rather than direct environmental change. A review conducted by Vins et al. (2015) found several pathways for drought affecting mental health. The researchers found support for pathways linking mental health outcomes to economic effects and migration but not to environmental degradation.

5.3.3  Return Migration One of the characteristics of displacement in West Africa has been the circular nature of migration. Migrants seeking refuge in Europe are usually denied asylum, necessitating travel back to communities and countries of origin. For internally displaced persons or persons displaced in adjacent countries, the dynamics of migration are complex: characterized by multiple displacements, pendular movements (such as those returning to areas of origin to check on their assets/livelihoods, to carry out agricultural activities, etc.), forced returns, as well as the returns of refugees according to the Tripartite agreement signed in March 2017 between the governments Cameroon and Nigeria, and UNHCR. The agreement calls for safe, dignified, informed and voluntary returns from Cameroon to Nigeria. In addition, the absence of identity documents and strong ethnic and family links that span across borders and do not necessarily identify with a specific country, make the categorization of displacement challenging (IOM 2019a: 12).

5.4  Impacts of Displacement 5.4.1  Impacts on the Displaced 5.4.1.1  Access to Services One of the most significant aspects of displacement, especially for those who lack legal status as refugees, is limited access to health and social services. IDPs and asylum seekers living in detention center receive limited physical and mental health care that often fails to meet the most basic standards (IOM 2019b). Access to quality health care for legal refugees can also be a challenge:

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Syrian refugees registered with the UNHCR in Jordan were able to access primary, secondary, and some tertiary healthcare free of charge at Ministry of Health facilities before late 2014 and out-of-pocket payments were not required for many services. Due to the burgeoning refugee population and high cost of care, current refugees are required to pay out-of-­ pocket at the same rate as uninsured Jordanians. Although this is still highly subsidized, the costs of both accessing and providing uninterrupted care for chronic health conditions can be considerable and may be a barrier to care, especially given recent declines in humanitarian assistance. (Doocy et al. 2016: 2)

5.4.1.2  Mental Health Several studies have documented the stress experienced by Syrian refugees who have migrated to Europe and neighboring countries in the Middle East. They include cultural integration issues, the loss of family and community support, discrimination and adverse political climate, loneliness and boredom, prohibition to work, and disruption of education for children (Kirmayer et al. 2011; Miller and Rasmussen 2010; Sijbrandij et al. 2017). For Syrians who have been able to travel to Europe, prolonged delays in being granted asylum, extended stays in relocation centers in Greece, multiple dislocations, and the lack of recognition of academic degrees and other qualifications have also increased levels of stress (Sijbrandij et  al. 2017). These stressors place refugees at considerable risk of developing symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), and related somatic health symptoms (de Jong et al. 2003; Fazel et al. 2005; Hassan et al. 2016; Steel et al. 2009; Ben Farhat et al. 2018; Poole et al. 2018). Epidemiological studies indicate that the age-standardized point prevalence of PTSD and major depression in conflict-affected populations is estimated to be 12.9% and 7.6%, respectively (Charlson et al. 2016). Studies of Syrian refugees have documented perhaps the most dramatic mental health effects of both the conflict and the subsequent displacement (Alpak et  al. 2015). A cross-sectional survey of 728 Syrian refugees in Greece during the winter of 2016–2017 found that between 31 and 77.5% reported having experienced at least 1 violent event in Syria, 24.8–57.5% during the journey to Greece, and 5–8% in their Greek settlement. Over 75% of respondents age 15 years and older screened positive for anxiety disorder (Ben Farhat et al. 2018). Another study by Poole et al. (2018) detected major depressive disorder (MDD) in 44% (95% CI: 37–50) of participants. Significant risk factors for MDD in this group of refugees included female gender (adjusted odds ratio [AOR]: 3.23, p = 0.019), each additional child (AOR: 1.61, p = 0.006), and increased time in the asylum process in Greece (AOR: 1.15, p = 0.043), while ever being married was associated with reduced odds of MDD (AOR: 0.23, p = 0.042). A study of Syrian refugee children in Turkey found that nearly half showed clinically significant levels of anxiety and withdrawal (Cartwright et al. 2015). Exposure to pre-migration traumatic events and post-migration stressors can have a prolonged negative effect a decade or more after migration (Fazel and Betancourt 2018).

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Many climigrants who attempted to travel to Europe after the agreement between the EU and Turkey in 2016 were placed in “detention camps” on Greek islands. There, they would spend months or years under the constant fear of being returned to Turkey. Syrians were generally granted refugee status in Greece, and those who arrived before the agreement were allowed to relocate to other European countries. Afghans had some chances of being granted asylum in Greece, but most migrants from Africa were refused asylum (Eleftherakos et al. 2018). A qualitative study of Syrian, Afghan, and Congolese migrants in two refugee camps on Lesbos Island in Greece found evidence of institutional abuse, continuous traumatic stress, and limited provision of mental health services (Eleftherakos et al. 2018). A meta-analysis of studies published between 1959 and 2002 of predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons found that postdisplacement conditions moderated mental health outcomes with worse outcomes observed for refugees living in institutional accommodations (i.e., camps), experiencing restricted economic opportunity, displaced internally within their own country, repatriated to a country they had previously fled, or whose initiating conflict was unresolved. Refugees who were older, more educated, and female and who had higher predisplacement socioeconomic status and rural residence also had worse outcomes (Porter and Haslam 2005). However, refugees were not the only migrants arriving with mental health problems. Migrants from drought-stricken communities with depressed economies lose access to community resources, services, and support systems (Hart et  al. 2011; Nicholls et al. 2006; Dean and Stain 2007; Zamani et al. 2006; Albrecht et al. 2007). “Altered family and community structures coupled with social and geographic isolation can also be issues for those who emigrate and those left behind, and may lead to symptoms of anxiety and depression” (Vins et al. 2015: 13,259). For both refugees and voluntary migrants, climigration and displacement may lead to the disruption of social ties between migrants and those remaining in communities of origin. These ties provide social and material resources that buffer mental health stressors related to both prolonged and acute climate events. However, maintaining social ties with those remaining in communities of origin often comes with a cost to climigrants. “Some migrants, including those from poor regions or communities with no formal safety net, may face considerable burden to provide financial and emotional resources to family members who remain in countries of origin” (Torres and Casey 2017: 1). Apart from the loss of valuable social supports, migration in any form necessitates an evaluation of individual and cultural identity. Challenges to traditional beliefs and practices in migrants unprepared for displacement can have significant impacts on mental health. “Migration to a host country where culture, language, and lifestyle may be vastly different may also contribute to psychosocial malaise as displaced migrants can face stressors associated with xenophobia and racism from people in their new host country” (Hayes et al. 2018: 7). The poor reception given by host communities is a common occurrence among migrating populations (McLeman 2006; Doherty and Clayton 2011; Shukla 2013), resulting in significant social marginalization (Torres and Casey 2017).

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Mental health problems are also relevant for social integration in host communities. For example, a study of refugees living in Switzerland by Schick et al. (2016) found associations between lack of social integration and decreased health-related quality of life, functional impairment, and severity of symptoms of depression, anxiety, and PTSD. Finally, the migration experience of both refugees from civil conflicts and voluntary climigrants fleeing poverty is characterized by the experience of loss. “Indeed, the departure is a pivotal moment in the process, one that involves a multitude of profound and psychologically staggering losses. Material losses include home, lands, crops, tools, machinery, vehicles, and importantly, many sentimental personal possessions” (Shultz et al. 2019: 118). 5.4.1.3  Physical Health Climigrants face various physical health risks. Long and overcrowded travel in the back of container trucks poses serious health risks to migrants, with reported cases of migrant deaths due to suffocation (IOM 2013). In addition, refugees and migrants routinely travel through deserts in order to enter various countries through unofficial borders. “These unregulated routes are extremely dangerous because of the nature of the journey and the lack of access to health services, water, food and shelter along the way. Between January and June 2016, the IOM recorded 471 deaths and disappearances in Africa, many due to exposure, hunger or dehydration in the Sahara Desert (IOM 2016)” (WHO AR 2018). Travel through major transportation hubs places them at increased risk for infectious and parasitic diseases (WHO 2018). Migrants displaced by climate change may also experience acculturation stress and increased rates of physical illnesses, which secondarily would be associated with psychological distress (Padhy et al. 2015). In addition to health risks, climigrants face numerous challenges in obtaining needed health services during their migration (WHO 2018).

5.4.2  Impacts on Community of Origin As with climigration in response to acute events, climigration in response to long-­ term changes in environment will inevitably lead to declines in the population of communities of origin, which, in turn, might lead to adverse outcomes such as depression and anxiety and possibly suicide (Barreau et al. 2017). The disruption of social ties with climigrants will also have potentially adverse consequences for family members who remain in places of origin (Torres and Casey 2017). Altered family and community structures coupled with social and geographic isolation can also be issues for those left behind as well as for those who climigrate, leading to symptoms of anxiety and depression. Likewise, there will be two groups of residents of communities of origin who stay behind: those that do not need to leave because of available resources and those unable to leave due to lack of resources or poor health.

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5.4.3  Impacts on Host Communities Perhaps the most notable impact of the great migration to Europe has been the strain on existing social resources. Despite their reputations as being generous social welfare states, many European countries have reported numerous challenges to delivering services, including a lack of translators, adequate staffing of clinics, a reluctance of migrants to use services even when needed due to stigma, lack of transportation, and dissonance with cultural expectations of health care. Immigrants who have not been granted asylum are especially vulnerable to the lack of access of services (Sijbrandij et al. 2017). Climigrants from low-income countries in Africa present an added level of cultural complexity with potentially different family, religious, and social values that shape the process of adjustment to living in high-income countries in Europe (Fazel and Betancourt 2018). Newly arrived climigrants also bring with them a variety of health problems in need to care. These include communicable diseases such as respiratory, gastrointestinal, and dermatologic infections (Pavli and Maltezou 2017). The growing displacement of older populations from middle-income countries like Syria also brings a higher burden of chronic health conditions such as diabetes and cardiovascular disease which pose new challenges for humanitarian agencies and host country governments (Doocy et al. 2016). These climigrants face numerous barriers to access to health care, including legal, communication, cultural, and bureaucratic challenges. Further, the lack of integration regarding health-care delivery across Europe due to policy differences between health-care systems and social services makes delivery of quality care and continuity of care to this population extremely problematic (Pavli and Maltezou 2017). Climigration from areas affected by drought can also have significant health impacts on host communities. Although these has been little evidence of climigrants traveling to Europe bringing with them infectious and parasitic diseases in large numbers (WHO AR 2018), studies of past drought-related migrations have documented increased rates of such diseases in host communities in other parts of Africa. For instance, reports of a drought-induced migration of pastoralists in West Africa in the 1970s noted exacerbation of cholera in settlement communities given the conditions of the relief camps such as poor sanitation, poor water supplies, and poor nutrition (Prothero 1994). Poor sanitation systems, unsafe drinking water, inadequate health services, diarrheal disease, malnutrition, typhoid, hepatitis, meningococcal meningitis, and cutaneous leishmaniasis have been reported in migrant camps in Sudan (Ahmed 1990). Resistance to acceptance of climigrants from the Middle East and Africa has gained traction with the rise of populist and nationalist movements throughout Europe. This has led to the rise of far-right political parties seeking to restrict immigration of refugees and climigrants, particularly from predominately Muslim countries, out of concern for political security, cultural identity, and xenophobia (Nielson 2018). The rise of populism was supported by widespread concerns related to terrorism and health and the provision of generous social welfare benefits to

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noncitizens (Human Rights Watch 2019; Landmann et  al. 2019). Efforts by the European Union to distribute the influx of climigrants during the Great Migration met with opposition from several countries, as illustrated by the erection of fences along the border separating Serbia and Hungary (Sandford 2017) and Norway and Russia, enactment of policies in Hungary designed to discourage prolonged stays and applications for asylum and facilitate movement through the country to other destinations (Goździak 2019), and a poll from the Pew Research Center in 2016 showing 82% of Hungarians believed refugees were a “burden on our country because they take our jobs and social benefits.” The poll also found that 76% believed refugees would increase the likelihood of terrorism in their country (Wike et al. 2016). One of the most notorious examples of government restrictions of climigrant travel throughout Europe was the “Calais Jungle,” established outside of the French port city of Calais by climigrants seeking transit to the United Kingdom. The camp existed from January 2015 to October 2016, when it was cleared of residents and dismantled on orders of the French government. During that time, several thousand climigrants lived in the camp while seeking to transportation through the Chunnel connecting France with the UK. In addition, several European nations have enacted laws designed to protect cultural hegemony and restrict cultural practices deemed to discourage integration with mainstream societies. These include the adoption of a law in Denmark requiring Muslim women to shake hands with men during citizenship ceremonies, a practice forbidden in many Muslim societies (Sorensen 2018), and the adoption of laws throughout Europe outlawing the wearing of “ideologically or religiously characterized that cover the whole or large parts of the hair” (i.e., headscarves) (Weaver 2018; Stone 2019) and use of “burkinis” on French beaches (Dearden 2016). Such legislation has only added to the sense of alienation experienced by many climigrants. Several acts of violence against climigrants have also been reported (Nielsen 2018; Tondo and Giuffrida 2018). Of course, not all climigrants are attempting to resettle in Europe. Migration across borders is occurring throughout Africa and the Middle East. For instance, “more than 850,000 refugees are hosted in Ethiopia in 25 camps across five regional states, mainly from Eritrea, Somalia and South Sudan. Many of the border regions receiving refugees face the challenges of poor infrastructure, high levels of poverty, adverse environmental conditions, low capacity and poor development indicators” (WHO AR 2018: 15). “An estimated 14 percent of the population in Johannesburg is foreign-born, mainly from Mozambique, Nigeria and Zimbabwe. Informal housing in cities is the most frequent accommodation for poor and marginalized populations. Refugees and migrants in Johannesburg usually live in same-sex hostels, as they are the cheaper form of accommodation in town. Many companies use these as cheap housing for migrant workers” (WHO AR 2018: 16): Every year, hundreds of migrants of different nationalities are sent to Bamako from Europe or other West African countries. They may also arrive at border posts of Kidal and Nioro after expulsion from Algeria and Mauritania. Most deportees are traumatised by their ordeal and Malian authorities have limited capacity to provide them with the necessary

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5  Fleeing Drought: The Great Migration to Europe a­ ssistance…. Migrants often suffer from injuries caused by transport or are ill or exhausted because of long periods in the desert. AME provides first aid and financial support to ensure continuation of treatment to forced returnees. In 2009, AME partnered with Médicins du Monde to provide mental health support to forced returnees and set up a referral system to the Malian health system. (WHO AR 2018: 19)

Perhaps the country most impacted by climigration has been Uganda, which has the largest refugee population in Africa and is the third largest refugee-hosting nation in the world. “In 2017, Uganda hosted 1.7  million international migrants, of which 1.3  million were refugees and asylum seekers, primarily from DRC and South Sudan” (WHO AR 2018: 21). Continuing political instability and armed conflict make it unlikely these refugees will be able to return to their home countries in the near future.

5.5  Lessons Learned 5.5.1  T  he Great Migration as a Template for Other Climigrations due to Drought The effects of prolonged drought on population displacement are by no means limited to Africa. A very similar scenario is taking place along the US border with Mexico. Hundreds of thousands of migrants from Central America, especially Guatemala, El Salvador, and Honduras, have sought asylum in the United States in response to debilitating levels of poverty and threats of violence. However, increasing variability in climate in the region has led to an increase in both extreme weather events and flood and periods of prolonged droughts (Leutert 2018). Both of these types of events have had substantial impacts on the region’s agricultural economy, which employs one in four workers in Honduras, one in ten in El Salvador, and one in three in Guatemala. In 2018, the World Bank reported that climate change could lead to at least 1.4 million people to flee their homes in Mexico and Central America and migrate during the next three decades (Rigaud et al. 2018). Coffee cultivators in the region are at particular risk for disruption because the crop is highly sensitive to weather variations. “Reduced yields of coffee and subsistence crops like corn and beans could significantly increase food insecurity and malnutrition. By some predictions, the amount of land suitable for growing coffee in Central America could drop by more than 40 percent by 2050” (Semple 2019: 13). As in Africa and the Middle East, migration is more likely to be motivated by communal violence and poverty than specifically by climate change. Nevertheless, in 2016, the United Nations’ World Food Program (WFP) estimated that the devastating El Niño event that began in 2015 was one of the worst on record and its impact continues to be felt in the Dry Corridor (Fig. 5.2), compounding the damage from 2 consecutive years of drought. As a result, some 3.5 million people are in need of humanitarian assistance with 1.6  million moderately or severely food

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Fig. 5.2  Map of the Dry Corridor of Central America. Source: Food and Agriculture Organization of the United Nations, 2016, T.  Diaz and D.  Burgeon, Dry corridor Central America situation report, http://www.fao.org/3/a-br092e.pdf. Reproduced with permission

insecure in the hard-hit countries of El Salvador, Guatemala, and Honduras (FAO 2016). The WFP concluded that the El Niño drought conditions that started in 2014 caused a significant increase in irregular migration to the United States. A study conducted by the WFP (2017) found the most frequently cited reason for migration was “no food.” More recently, the Food and Agriculture Organization reported that erratic weather patterns in the Central American Dry Corridor could leave 1.4 million people in urgent need of food assistance (FAO 2019). Drought conditions have also contributed to a reduction in agricultural productivity and increased poverty in southern Africa. Mozambique has been subjected to prolonged drought, especially in the southern part of the country. According to UNICEF, drought affected 2.1 million people in 2017, mostly in the southern and central provinces of Mozambique. Two years of consecutive drought triggered by the El Niño phenomenon led to severe food and nutrition insecurity (FEWS NET 2019; OCHA 2019). Mozambique is also vulnerable to extreme weather events and sea level rise. Mozambique’s coastal cities are among the most vulnerable in Africa to climate change. “By the 2040’s, Mozambique’s coast could lose up to 4,850 km2 of land and almost 1 million people could be forced to migrate inland” (USAID 2019). In 2017,

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Mozambique experienced a number of overlapping hazards and concurrent crises, including flooding, outbreaks of cholera, a tropical cyclone, and political and security instability resulting in pockets of population displacement throughout the country. Cyclone Dineo affected 550,000 people in Inhambane province; 21,543 people were displaced by conflict, and 3616 cases of cholera were reported (OCHA 2019). On March 14, 2019, Tropical Cyclone Idai struck the southeast coast of Mozambique. The UN High Commissioner for Refugees reported that 1.85 million people needed assistance. Approximately 146,000 people were internally displaced (UNHCR 2019b). The cyclone and subsequent flooding damaged 100,000 homes, destroyed one million acres of crops, and demolished $1 billion worth of infrastructure (Reid 2019). Just over a month later, in April, Cyclone Kenneth hit northern Mozambique with sustained winds of up to 140 miles per hour, affecting another 300,000 people (Yarnell and Cone 2019): Current estimates from the Ministry of Agriculture and Food Security (MASA) indicate over a million metric tons of crops were lost including corn, rice, groundnuts, beans, and vegetables were destroyed nationwide as a result of the poor rainfall in the southern semiarid areas and three Tropical Cyclones, Desmond, Idai, and Kenneth. MASA estimates nearly 800,000 MT loss in national maize grain production, representing a reduction of more than 30 percent as compared to the last two years’ average... The tropical cyclone damaged fishing boats and equipment for fishing as well as infrastructure, a key livelihood for thousands of households along the coast... The 2018/19 crop production will be significantly below last year’s production and the 5-year average. (FEWS NET 2019: 2)

Historically, Mozambicans adapted to the fluctuation in agricultural productivity by temporarily migrating to South Africa, seeking employment in the mines and elsewhere (De Vietter 2007). Reports of a marked increase in the number of “labor migrants” flooding across the border into South Africa have generated hostility due to claims that migrants are taking jobs away from South African citizens (Campbell 2006). However, the exact number of labor or permanent migrants from Mozambique living in South Africa cannot be determined because the vast majority of these migrants are undocumented.

5.5.2  Drought and Disparity As with the climate change-related events reviewed in previous chapters, communities exposed to long-term changes such as drought experience disparities in exposure, impact, and capacity for migration. Whether living in a low- and middle-income country like Chad experiencing decades of drought conditions or in a rural region in a high-income country like the United States or Australia, exposure to and impacts associated with these long-term changes vary by socioeconomic status. Individuals with fewer resources are more exposed to these changes by virtue of where they live and their capacity for adapting to these changes. Consequently, they are more likely to experience diminished employment opportunities and financial resources, adverse mental and physical health impacts, and political persecution and violence and civil

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conflict. Individuals with limited resources are also more likely to be exposed to violence and exploitation during migration and undocumented legal status and threat of deportation subsequent to migration. Climigrants with fewer resources are also more likely to experience difficulty integrating into the host society.

5.5.3  Designation of Climigrants as Refugees The second major lesson to be learned from the great migration to Europe and elsewhere is that climigrants are identified or labeled based on the secondary impacts of climate change. In this chapter, we focused on three specific impacts: economic, political, and health (mental and physical). Climigrants fleeing the political impacts, usually manifested in the form of civil conflicts, are labeled refugees with all the rights accorded by international law. Climigrants fleeing economic and health impacts are labeled voluntary migrants with no universally recognized right to migration and relocation. The climigrant may have a very different migration experience depending on whether she or he is labeled as voluntary or involuntary. The designation of being voluntary or involuntary is likely to influence the willingness of the host community to accept the climigrant and provide them access to services. In Europe, those who are labeled as voluntary have generally not been granted asylum and are either forced to return to their countries of origin or remain with no legal status and under constant threat of deportation. However, both groups of climigrants also share many similarities. Both groups have been “forced” to leave their places of origin, even if the reasons differ. Both groups have been vulnerable to exploitation and human trafficking due to limited financial resources. Both have experienced traumatic events such as physical violence, drowning, sexual assaults, and other forms of criminal victimization. Both have experienced uncertainty, stress, and social isolation. Increasingly, both have experienced the hostility of host communities and unwillingness to accept them regardless of legal status. Both groups are in need of the same kinds of assistance from national and international organizations and host communities. Given the similarities between voluntary and involuntary migrants and between climigrants fleeing acute events tied to extreme weather and long-term events like droughts, thought must be given as to whether the response to climate-related displacement should be the same for all climigrants or tailored to meet specific needs of subgroups of climigrants.

References Ahmed H (1990) Effects of drought and desertification on health and social life in the Sudan. World Health Forum 11(4):424 Albrecht G, Sartore GM, Connor L et al (2007) Solastalgia: the distress caused by environmental change. Aust Psychiatry 15:S95–S98

92

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Alpak G, Unal A, Bulbul F et al (2015) Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study. Int J Psychiatry Clin Pract 19(1):45–50 Alston M (2012) Rural male suicide in Australia. Soc Sci Med 74:515–522 Anderson D (2009) Enduring drought then coping with climate change: lived experience and local resolve in rural mental health. Rural Soc 19:340–352 Arab Center for the Studies of Arid Zones and Dry Lands (ACSAD) (2011) Drought vulnerability in the Arab region. Case study-drought in Syria. Ten years of scarce water (2000–2010). http:// www.unisdr.org/files/23905_droughtsyriasmall.pdf. Accessed 3 October 2019 Arab Center for the Studies of Arid Zones and Dry Lands (ASCAD) (2010) Drought analysis in Syrian Al Jazeera Region by using Standardized Precipitation Index (SPI). Arab J Arid Environ 3. http://www.acsad.org/images/pdf/by2at/mqalat/2010030109.pdf. Accessed 3 October 2019 Babugura AA (2008) Vulnerability of children and youth in drought disasters: a case study of Botswana. Child Youth Environ 18:126–157 Bahru BA, Bosch C, Birner R et al (2019) Drought and child undernutrition in Ethiopia: a longitudinal path analysis. PLoS One 14(6):e0217821. https://doi.org/10.1371/journal.pone.0217821 Barreau T, Conway D, Haught K et al (2017) Physical, mental and financial impacts from drought in two California counties, 2015. Am J Public Health 107(5):783–790. https://doi.org/10.2105/ AJPH.2017.303695 Belesova K, Agabiirwe CN, Zou M et al (2019) Drought exposure as a risk factor for child undernutrition in low- and middle-income countries: a systematic review and assessment of empirical evidence. Environ Int 131:104973. https://doi.org/10.1016/j.envint.2019.104973 Ben Farhat J, Blanchet K, Bjertrup PJ et al (2018) Syrian refugees in Greece: experience with violence, mental health status, and access to information during the journey and while in Greece. BMC Med 16:40. https://doi.org/10.1186/s12916-018-1028-4 Berry HL, Bowen K, Kjellstrom T (2010) Climate change and mental health: a causal pathways framework. Int J Public Health 55:123–132 Berry HL, Hogan A, Owen J et  al (2011) Climate change and farmers’ mental health: risks and responses. Asia Pac J Public Health 23(2 Suppl):119S–132S. https://doi. org/10.1177/1010539510392556 Brachet J (2018) Manufacturing smugglers: from irregular to clandestine mobility in the Sahara. Ann Am Acad Pol Soc Sci 676(1):16–35 Campbell EK (2006) Reflections on illegal immigration in Botswana and South Africa. Afr Popul Stud 21(2):23–44 Carnie TL, Berry HL, Blinkhorn SA et al (2011) In their own words: young people’s mental health in drought-affected rural and remote NSW. Aust J Rural Health 19:244–248 Cartwright K, El-Khani A, Subryan A et  al (2015) Establishing the feasibility of assessing the mental health of children displaced by the Syrian conflict. Global Mental Health 2: e8 Charlson FJ, Flaxman A, Ferrari AJ et al (2016) Post-traumatic stress disorder and major depression in conflict-affected populations: an epidemiological model and predictor analysis. Glob Mental Health (Camb) 3:e4. https://doi.org/10.1017/gmh.2015.26 Charrière F, Frésia M (2008) West Africa as a migration and protection area, UN High Commissioner for Refugees (UNHCR). www.refworld.org/docid/4a277db82.html. Accessed 25 Aug 2019 Clayton S, Manning C, Hodge C (2017) Beyond storms and droughts: the psychological impacts of climate change. American Psychological Association and ecoAmerica, Washington, DC. Coelho A, Adair J, Mocellin J (2004) Psychological responses to drought in Northeast Brazil. Int J Psychol 38:95–103 Connor P (2018) Most displaced Syrians are in the Middle East, and about a million are in Europe. Pew Research Center, 29 Jan. https://www.pewresearch.org/fact-tank/2018/01/29/where-displaced-syrians-have-resettled/. Accessed 25 Aug 2019 Cooper MW, Brown ME, Hochrainer-Stigler S et al (2019) Mapping the effects of drought in child stunting. Proc Natl Acad Sci 116(35):17219–17224. https://doi.org/10.1073/pnas.1905228116 Collectif Argos (2010) Climate refugees. MIT Press, Cambridge, MA.

References

93

de Jong JT, Komproe IH, Van Ommeren M (2003) Common mental disorders in postconflict settings. Lancet 361(9375):2128–2130 De Silva MJ, McKenzie K, Harpham T et al (2005) Social capital and mental illness: a systematic review. J Epidemiol Community Health 59:619–627 De Vietter F (2007) Migration and development in Mozambique: poverty, inequality and survival. Dev South Africa 27:137–153 Dean J, Stain HJ (2007) The impact of drought on the emotional well-being of children and adolescents in rural and remote New South Wales. J Rural Health 23:356–364 Dearden L (2016) Burkini ban: why is France arresting Muslim women for wearing full-body swimwear and why are people so angry? Independent, 24 Aug, https://www.independent. co.uk/news/world/europe/burkini-ban-why-is-france-arresting-muslim-women-for-wearingfull-body-swimwear-and-why-are-people-a7207971.html. Accessed 14 Sept 2019 Doherty TJ, Clayton S (2011) The psychological impacts of global climate change. Am Psychol 66:265–276 Doocy S, Lyles E, Akhu-Zaheya L et al (2016) Health service utilization among Syrian refugees with chronic health conditions. PLoS One 11(4):e0150088. https://doi.org/10.1371/journal. pone.0150088 Elasha BO, Elhassan NG, Ahmed H, et al (2005) Sustainable livelihood approach for assessing community resilience to climate change: case studies from Sudan. Assessments of Impacts and Adaptations to Climate Change Working Paper No. 17. http://www.start.org/Projects/AIACC_ Project/working_papers/Working%20Papers/AIACC_WP_No017.pdf. Accessed 3 Oct 2019 Eleftherakos C, van den Boogaard W, Barry D, et  al (2018) “I prefer dying fast than dying slowly”, how institutional abuse worsens the mental health of stranded Syrian, Afghan and Congolese migrants on Lesbos Island following the implementation of the EU-Turkey deal. Confl Health 12:38. Environmental Justice Foundation (EJF) (2017) Beyond borders: our changing climate—its role in conflict and displacement. Environmental Justice Foundation, London. https://ejfoundation. org/resources/downloads/BeyondBorders-2.pdf. Accessed 30 Sept 2019 Erian W, Katlan B, Babah O (2010) Drought vulnerability in the Arab region. Special case study: Syria. ISDR. http://www.preventionweb.net/english/hyogo/gar/2011/en/bgdocs/Erian_ Katlan_&_Babah_2010.pdf. Accessed 3 Oct 2019 Famine Early Warning System Network (FEWS NET) (2019) Mozambique food security outlook June 2019 to January 2020. 30 Jun. https://fews.net/sites/default/files/documents/reports/ MOZAMBIQUE_Food_Security_Outlook_June%202019_Final.pdf. Accessed 12 Sept 2019 Fazel M, Betancourt TS (2018) Preventive mental health interventions for refugee children and adolescents in high income settings. Lancet Child Adolesc Health 2:121–132 Fazel M, Wheeler J, Danesh J (2005) Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet 365(9647):1309–1314. https://doi. org/10.1016/S0140-6736(05)61027-6 Food and Agriculture Organization (FAO) (2009) The special challenge for sub-Saharan Africa. http://www.fao.org/fileadmin/templates/wsfs/docs/Issues_papers/HLEF2050_Africa.pdf. Accessed 6 Jun 2019 Food and Agriculture Organization (FAO) (2016) Dry corridor Central America situation report. http://www.fao.org/3/a-br092e.pdf. Accessed 15 Oct 2019 Food and Agriculture Organization (FAO) (2019) Erratic weather patterns in the Central American dry corridor leave 1.4 million people in urgent needs of food assistance. http://www.fao.org/ emergencies/fao-in-action/stories/stories-detail/en/c/1192519/. Accessed 15 Oct 2019 Friel S, Berry H, Dinh H et  al (2014) The  impact of drought on the association between food securiy and mental health in a nationally representative Austalian sample.  BMC Public Health 14:1102. doi: 10.1186/1471-2458-14-1102 Giannini A, Biasutti M, Verstraete MM (2008) A climate model-based review of drought in the Sahel: desertification, the re-greening and climate change. Global Planet Change 64(3-4):119–128

94

5  Fleeing Drought: The Great Migration to Europe

Gleick PH (2014) Water, drought, climate change, and conflict in Syria. Weather Clim Soc 6:331–340 Government of Netherlands, Ministry of Foreign Affairs (2019) Climate change profile: South Sudan. https://reliefweb.int/report/south-sudan/climate-change-profile-south-sudan. Accessed 23 Sept 2019 Goździak E (2019) Using fear of the “other,” Orbán reshapes migration policy in a Hungary built on cultural diversity. Migration Policy Institute, 10 Oct. https://www.migrationpolicy.org/article/orban-reshapes-migration-policy-hungary. Accessed 17 Oct 2019 Hanigan IC, Butler CD, Kokic PN et al (2012) Suicide and drought in New South Wales, Australia, 1970–2007. Proc Natl Acad Sci 109:13950–13955 Hanigan IC, Schirmer J, Niyonsenga T (2018) Drought and distress in southeastern Australia. Ecohealth 15(3):642–655. https://doi.org/10.1007/s10393-018-1339-0 Hansen KM (2018) Voices from the jungle: stories from the Calais refugee camp. https://www. plutobooks.com/blog/voices-from-the-jungle/. Accessed 19 Sept 2019 Hart CR, Berry HL, Tonna AM (2011) Improving the mental health of rural New South Wales communities facing drought and other adversities. Aust J Rural Health 19:231–238 Hassan G, Ventevogel P, Jefee-Bahloul H et al (2016) Mental health and psychological wellbeing of Syrians affected by armed conflict. Epidemiol Psychiatr Sci 25(2):129–141. https://doi. org/10.1017/S2045796016000044 Hayes K, Blashki G, Wiseman J et al (2018) Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst 12:28. https://doi.org/10.1186/s13033-018-0210-6 Hossain D, Eley R, Coutts J et al (2008) Mental health of farmers in southern Queensland: issues and support. Aust J Rural Health 16:343–348 Hsiang SM, Burke M (2014) Climate, conflict, and social stability: what does the evidence say? Clim. Change 123:39–55 Hsiang SM, Meng KC, Cane MA (2011) Civil conflicts are associated with the global climate. Nature 476:438–440 Human Rights Watch (2019) European Union: events of 2018. https://www.hrw.org/worldreport/2019/country-chapters/european-union. Accessed 17 Oct 2019 Ibrahim HO (2019) The Sahel: a land of opportunity. United Nations Sustainable Development Goals Advocates, 10 Jun. https://www.unsdgadvocates.org/news/sahel-opportunity. Accessed 31 Oct 2019. Intergovernmental Panel on Climate Change (IPCC) (2007) Climate change 2007: impact, adaptations and vulnerability. In: Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2014) Impacts, adaptations and vulnerability. 2 vols. In: Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York International Center for Agricultural Research in the Dry Areas (ICARDA) (2010) Climate and drought atlas for parts of the Near East. A baseline dataset for planning adaptation strategies to climate change. http://geoagro.icarda.org/downloads/publications/reports/EMed_%20_ Final%20Report_Final_v2_maps.pdf. Accessed 3 Oct 2019 International Organization for Migration (IOM) (2013) Health vulnerabilities study of mixed migration flows from the East and Horn of Africa and the Great Lakes region to Southern Africa. https://publications.iom.int/system/files/pdf/migration_health_study_finalweb.pdf. Accessed 3 Sept 2019 International Organization for Migration (IOM) (2015) Compilation of available data and information 2015. https://www.iom.int/sites/default/files/situation_reports/file/Mixed-FlowsMediterranean-and-Beyond-Compilation-Overview-2015.pdf. Accessed 5 Sept 2019 International Organization for Migration (IOM) (2016) Niger deaths add to growing toll of migrant fatalities within Africa. 17 Jun. https://www.iom.int/news/niger-deaths-add-growing-tollmigrant-fatalities-within-africa. Accessed 18 Sept 2019

References

95

International Organization for Migration (IOM) (2019a) Within and beyond borders: tracking displacement in the Lake Chad region. Displacement tracking matrix. https://www.iom.int/sites/ default/files/dtm/lake_chad_basin_dtm_201903.pdf. Accessed 27 Sept 2019 International Organization for Migration (IOM) (2019b) Europe—mixed migration flows to Europe monthly overview (June 2019). https://displacement.iom.int/reports/europe-%E2%80%94mixed-migration-flows-europe-monthly-overview-june-2019. Accessed 23 Aug 2019 Kinyoki DK, Berkley JA, Moloney GM et al (2015) Predictors of the risk of malnutrition among children under the age of 5 years in Somalia. Public Health Nutr 18(17):3125–3133. https://doi. org/10.1017/S1368980015001913 Kirmayer LJ, Narasiah L, Munoz M et al (2011) Common mental health problems in immigrants and refugees: general approach in primary care. CMAJ 183(12):E959–E967. https://doi. org/10.1503/cmaj.090292 Kirwin M, Anderson J (2018) Identifying the factors driving West African migration. West African Papers 17. OECD, Paris. https://doi.org/10.1787/eb3b2806-en Kjellstrom T (2009) Climate change, direct heat exposure, health and well-being in low and middle income countries. Glob Health Action 2:1–3 Kuele G, Miola AC (2018) Climate change is feeding armed conflict in Somalia. ISS Today, 6 Apr. https://issafrica.org/iss-today/climate-change-is-feeding-armed-conflict-in-somalia. Accessed 12 Sept 2019 Landmann H, Gaschler R, Rohmann A (2019) What is threatening about refugees? Identifying different types of threat and their association with emotional responses and attitudes towards refugee migration. Euro J Soc Psychol. https://doi.org/10.1002/ejsp.2593 Leutert S (2018) How climate change is affecting rural Honduras and pushing people north. Washington Post, 6 Nov. https://www.washingtonpost.com/news/global-opinions/ wp/2018/11/06/how-climate-change-is-affecting-rural-honduras-and-pushing-peoplenorth/?arc404=true. Accessed 12 Jan 2019 Levy M (2008) Assessment of select climate change impacts on U.S. national security. Center for International Earth Science Information Network (CIESIN) Working Paper. http://www.ciesin.columbia.edu/documents/Climate_Security_CIESIN_July_2008_v1_0.ed.pdf. Accessed 3 Oct 2019 Levy BS, Sidel VW, Patz J (2017) Climate change and collective violence. Annu Rev Public Health 38:241–257. https://doi.org/10.1146/annurev-publichealth-031816-044232 Mahr K (2019) Guns, religion and climate change intensify Nigeria’s bloody farmer-herder clashes. Los Angeles Times, 21 Feb. https://www.latimes.com/world/africa/la-fg-nigeriafarmer-herder-violence-20190221-story.html. Accessed 15 Aug 2019 Mason JB, White JM, Heron L (2012) Child acute malnutrition and mortality in populations affected by displacement in the Horn of Africa, 1997-2009. Int J Environ Res Public Health 9(3):791–806. https://doi.org/10.3390/ijerph9030791 Matfess H (2018) Boko Haram’s deadly persistence (1 January 2011–31 August 2018). ACLED, 13 Sept. https://www.acleddata.com/2018/09/13/boko-harams-deadly-persistence-1-january2011-31-august-2018/. Accessed 21 Aug 2019 McLeman R (2006) Migration out of 1930s rural eastern Oklahoma: insights for climate change research. Great Plains Quart 26:27–40 Migration Policy Centre (2016) The Syrian refugee crisis and its repercussions for the EU. http:// syrianrefugees.eu/. Accessed 28 Aug 2019 Miller KE, Rasmussen A (2010) War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med 70(1):7–16 Mohamoud A, Kaloga A, Kreft S (2014) Climate change, development, and migration: an African diaspora perspective. Germanwatch e.V, Bonn. www.germanwatch.org/en/8456. Accessed 8 Sept 2019

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Muldoon KA, Duff PK, Fielden S et al (2013) Food insecurity is associated with psychiatric morbidity in a nationally representative study of mental illness among food insecure Canadians. Soc Psychiatry Psychiatr Epidemiol 48(5):795–803 UN News (2018) Building climate resilience and peace, go hand in hand for Africa’s Sahel – UN forum. 13 Nov. https://news.un.org/en/story/2018/11/1025671. Accessed 27 Sept 2019 Nicholls N, Butler CD, Hanigan I (2006) Inter-annual rainfall variations and suicide in New South Wales, Australia, 1964–2001. Int J Biometeorol 50:139–143 Nielson N (2018) Xenophobia on the rise in Germany, study finds. eurobserver, 9 Nov. https:// euobserver.com/migration/143336. Accessed 27 Sep 2019. O’Brien LV, Berry HL, Coleman C (2014) Drought as a mental health exposure. Environ Res 131:181–187 O’Loughlin J, Witmer FD, Linke AM et  al (2012) Climate variability and conflict risk in East Africa, 1990–2009. Proc Natl Acad Sci 109:18344–18349 Office for Coordination of Humanitarian Affairs (OCHA) (2016) 2017 Somalia humanitarian needs overview. 28 Nov. https://www.humanitarianresponse.info/en/operations/somalia/ document/2017-somalia-humanitarian-needs-overview. Accessed 23 Aug 2019 Office for Coordination of Humanitarian Affairs (OCHA) (2017) Revised requirements and response priorities September 2017 Lake Chad Basin emergency. https://reliefweb.int/sites/ reliefweb.int/files/resources/LCB_Revised%20HNRO_Sept%202017-EN.pdf. Accessed 23 Aug 2019 Office for Coordination of Humanitarian Affairs (OCHA) (2018) Sahel: overview of humanitarian needs and requirements. https://reliefweb.int/sites/reliefweb.int/files/resources/Sahel%20 HNRO%202018.pdf. Accessed 27 Sep 2019 Office for Coordination of Humanitarian Affairs (OCHA) (2019) Mozambique: Cyclones Idai and Kenneth. United Nations Office for Coordination of Humanitarian Affairs. https://www. unocha.org/southern-and-eastern-africa-rosea/mozambique. Accessed 5 Sept 2019 Padhy SK, Sarkar S, Panigrahi M et al (2015) Mental health effects of climate change. Indian J Occup Environ Med 19:3–7 Pavli A, Maltezou H (2017) Health problems of newly arrived migrants and refugees in Europe. J Travel Med 24(4). https://doi.org/10.1093/jtm/tax016 Polain JD, Berry HL, Hoskin JO (2011) Rapid change, climate adversity and the next ‘big dry’: old farmers’ mental health. Aust J Rural Health 19(5):239–243 Poole DN, Hedt-Gauthier B, Liao S et al (2018) Major depressive disorder prevalence and risk factors among Syrian asylum seekers in Greece. BMC Public Health 18:908. https://doi. org/10.1186/s12889-018-5822-x Porter M, Haslam N (2005) Predisplacement and postdisplacement factors associated with mental health of refugees and internally displaced persons: a meta-analysis. JAMA 294(5):602–612 Prothero R (1994) Forced movements of population and health hazards in tropical Africa. Int J Epidemiol 23(4):657–664 Reid K (2019) 2019 Cyclone Idai. World Vision. 26 Apr. https://www.worldvision.org/disasterrelief-news-stories/2019-cyclone-idai-facts. Accessed 30 Sept 2019 Rigaud K, Kanta A, Jones B et al (2018) Groundswell: preparing for internal climate migration. The World Bank, Washington, DC Sandford A (2017) Hungary completes new anti-migrant border fence with Serbia. Euronews 28 Apr. https://www.euronews.com/2017/04/28/hungary-completes-new-anti-migrant-borderfence-with-serbia. Accessed 27 Sept 2019 Sartorius N (2007) Stigma and mental health. Lancet 270:810–811 Scheffran J, Ide T, Schilling J (2014) Violent climate or climate of violence? Concepts and relations with focus on Kenya and Sudan. Int J Hum Rights 18(3):369–390 Schick M, Zumwald A, Knöpfli B et  al (2016) Challenging future, challenging past: the relationship of social integration and psychological impairment in traumatized refugees. Eur J Psychotraumatol 7:28057

References

97

Semple K (2019) Central American farmers head to the U.S., fleeing climate change. New York Times, 13 Apr. https://www.nytimes.com/2019/04/13/world/americas/coffee-climate-change-­ migration.html. Accessed 14 Oct 2019 Shukla J (2013) Extreme weather events and mental health: tackling the psychosocial challenge. ISRN Publ Health:1–7 Shultz JM, Rechkemmer A, Rai A et al (2019) Public health and mental health implications of environmentally induced forced migration. Disaster Med Public Health Prep 13(2):116–122. https://doi.org/10.1017/dmp.2018.27 Sijbrandij M, Acarturk C, Bird M et  al (2017) Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries. Eur J Psychotraumatol 8:1388102. https://doi.org/10.1080/2000819 8.2017.1388102 Singh S, Muchtaq U, Holm-Hansen C et al (2011) The importance of climate change to health. Lancet 378(9785):29–30 Sorensen MS (2018) Denmark, with an eye on Muslims, requires new citizens to shake hands. New York Times, 20 Dec. https://www.nytimes.com/2018/12/20/world/europe/denmark-muslims-handshake-law.html. Accessed 27 Sep 2019 Stalon JL, Chowdhary B (2017) Confronting climate change in South Sudan. UNDP Our Perspectives, 29 June. https://www.undp.org/content/undp/en/home/blog/2017/6/29/ Confronting-climate-change-in-South-Sudan.html. Accessed 27 Sept 2019 Stain HJ, Kelly B, Carr, VJ et al (2011) The psychological impact of chronic environmental adversity: responding to prolonged drought. Soc Sci Med 73(11):1593–1599 Steel Z, Chey T, Silove D et al (2009) Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. JAMA 302(5):537–549. https://doi.org/10.1001/ jama.2009.1132 Stone J (2019) French senate votes to ban mothers who wear headscarves from accompanying children on school trips. Independent, 17 May. https://www.independent.co.uk/news/world/ europe/france-burqa-ban-niqab-school-senate-vote-islam-children-republicans-a8918741. html. Accessed 27 Sept 2019 The Watchers (2016) Significant increase in frequency and intensity of sandstorms in the Middle East over the past 15 years. 17 Jun. https://watchers.news/2016/06/17/significant-increase-infrequency-and-intensity-of-sandstorms-in-the-middle-east-over-the-past-15-years/. Accessed 4 Sept 2019 Tondo L, Giuffrida A (2018) Warning of ‘dangerous acceleration’ in attacks on immigrants in Italy. The Guardian (UK), 3 Aug. https://www.theguardian.com/global/2018/aug/03/warningof-dangerous-acceleration-in-attacks-on-immigrants-in-italy. Accessed 27 Sept 2019 Tonna A, Kelly B, Crockett J et al (2014) Improving the mental health of drought-affected communities: an Australian model. Rural Soc 19:296–305 Torres JM, Casey JA (2017) The centrality of social ties to climate migration and mental health. BMC Public Health 17(1):600. https://doi.org/10.1186/s12889-017-4508-0 Trigo RM, Gouveia CM, Barriopedro D (2010) The intense 2007–2009 drought in the Fertile Crescent: impacts and associated atmospheric circulation. Agric For Meteorol 150(9):1245–1257 Trombley J, Chalupka S, Anderko L (2017) Climate change and mental health. Am J Nurs 117:44–52. https://doi.org/10.1097/01.NAJ.0000515232.51795.fa U.S. Agency for International Development (USAID) (2019) Mozambique. Climatelinks, https:// www.climatelinks.org/countries/mozambique. Accessed 12 Sept 2019 UN World Food Program (WFP) (2017) Food security and emigration: why people flee and the impact on family members left behind in El Salvador, Guatemala and Honduras. https://docs.wfp.org/api/documents/WFP-0000019629/download/?_ ga=2.205021456.1465601691.1571846116-835557198.1571166292. Accessed 10 Oct 2019

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United Nations High Commissioner for Refugees (UNHCR) (2017) UNHCR Somalia: PRMN Drought displacements to 31 May 2017, 31 May. https://data2.unhcr.org/en/documents/ details/57361. Accessed 23 Aug 2019 United Nations High Commissioner for Refugees (UNHCR) (2018) UNHCR global appeal 2018–2019. http://reporting.unhcr.org/sites/default/files/ga2018/pdf/Global_Appeal_2018_ full_lowres.pdf. Accessed 23 Aug 2019 United Nations High Commissioner for Refugees (UNHCR) (2019a) UNHCR warns of growing climate-related displacement in Somalia. https://www.unhcr.org/en-us/news/ briefing/2019/6/5cf61d304/unhcr-warns-growing-climate-related-displacement-somalia.html. Accessed 23 Aug 2019 United Nations High Commissioner for Refugees (UNHCR) (2019b) UNHCR Factsheet: Cyclone Idai. Jun. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/ files/2019/07/UNHCR_FACTSHEET_MOZ_Idai-JUNE2019_20190710.pdf. Accessed 23 Aug 2019 Vins H, Bell J, Saha S et al (2015) The mental health outcomes of drought: a systematic review and causal process diagram. Int J Environ Res Public Health 12(10):13251–13275. https://doi. org/10.3390/ijerph121013251 Vozoris NT, Tarasuk VS (2003) Household food insufficiency is associated with poorer health. J Nutr 133(1):120–126 Weaver M (2018) Burqa bans, headscarves and veils: a timeline of legislation in the west. The Guardian (UK), 31 May. https://www.theguardian.com/world/2017/mar/14/headscarves-andmuslim-veil-ban-debate-timeline. Accessed 3 Oct 2019 Whitley R, McKenzie K (2005) Social capital and psychiatry: review of the literature. Harv Rev Psychiatry 13:71–84 Wike R, Stokes B, Simmons K (2016) Europeans fear wave of refugees will mean more terrorism, fewer jobs. Pew Research Center Global Attitudes and Trends. 11 July. https://www.pewresearch.org/global/2016/07/11/europeans-fear-wave-of-refugees-will-mean-more-terrorismfewer-jobs/. Accessed 15 Aug 2019 World Health Organization Africa Region (WHO AR) (2018) Health of refugees and migrants. Regional situation analysis, practices, experiences, lessons learned and ways forward. https:// www.who.int/migrants/publications/AFRO-report.pdf?ua=1. Accessed 20 Sept 2019 Worldwatch Institute (2009) State of the world 2009: confronting climate change. Worldwatch Institute, Washington, DC Yarnell M, Cone D (2019) Devastation and displacement: unprecedented cyclones in Mozambique and Zimbabwe a sign of what’s to come? Refugees International, 13 Aug. https://www. refugeesinternational.org/reports/2019/8/12/devastation-and-displacement-unprecedentedcyclones-in-mozambique-and-zimbabwe-a-sign-of-whats-to-come. Accessed 28 Sept 2019 Yusa A, Berry P, Cheng J et al (2015) Climate change, drought, and human health in Canada. Int J Environ Res Public Health 12(7):8359–8412. https://doi.org/10.3390/ijerph120708359 Zamani GH, Gorgievski-Duijvesteijn MJ, Zarafshani K (2006) Coping with drought: towards a multilevel understanding based on conservation of resources theory. Hum Ecol 34:677–692 Zhang DD, Brecke P, Lee HF et al (2007a) Global climate change, war, and population decline in recent human history. Proc Natl Acad Sci 104:19214–19219 Zhang DD, Zhang J, Lee HF et al (2007b) Climate change and war frequency in Eastern China over the last millennium. Hum Ecol 35:403–414

Chapter 6

Fleeing Flooding: Asia and the Pacific

6.1  The Narrative 6.1.1  The Event A slow-motion tidal wave: that’s similar to the description given to us by Helia Vavaï, a slender woman of 46 who directs Tuvalu’s weather observatory, when we visited her a few days earlier. “In 20 years, the temperature here has risen by 0.4°C,” she said. “That’s a huge increase! It leads to periods of drought as well as warming of the ocean’s surface, which contributes to the formation of devastating cyclones and could eventually result in the destruction of coral. But the most serious threat today is a recurrence of abnormally high tides – with disturbing consequences. The first we’ve seen is the appearance of large puddles of saltwater, which are pushed by ebb tides across the coral substratum to the island’s lowest points. In other places, the water still doesn’t rise to the subsurface but it sterilizes the soil underground and prevents cultivation of the island’s two major root crops, taro and pulaka, which play an important role in our diet” … “The second consequence of these abnormal tidal ranges is coastal flooding, resulting from swells generated in the lagoon by west winds,” she said. “These winds have been increasing in intensity and duration during the rainy season. The flooding also contributes to coastal erosion. Have you noticed that there’s only one beach left in Funafuti?” (Collectif Argos 2010: 273)

6.1.2  The Displacement Hamid, age 25, is lean and muscular, though he says he’s much skinnier now than he was a year ago when he decided to leave his village. At great length, in a voice made hoarse by pollution, he tells us of the difficulties of his job as a rickshaw driver. After 10 h of work each day, he washes up with a bucketful of water, eats a © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_6

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meal of spiced rice and chats awhile with his friends from the village, and then collapses on a mat for a dreamless night that barely restores his energy… “When there’s a full moon, I can’t help thinking of the Sundarbans. That’s the best time for fishing in the mangrove forest. I loved that. I still feel it calling me.” As he reminisced, Hamid’s melancholy gaze gained a bit of sharpness, a little more vigor, but his empty look of resignation soon returned. “I had to stop fishing because the tigers were getting more aggressive and attacks were increasing. I was too scared. There was no work outside the mangrove forest, and I wasn’t able to feed my family, so I followed my brother-in-law to Dhaka. I’m not the only one; there are more and more of us here. A year ago, there were 11 of us, and now there are around 50” (Collectif Argos 2010: 63).

6.2  Flooding and Sea Level Rise According to the IPCC (2014), Asia accounts for seven of the world’s ten countries most vulnerable to climate change. Pacific Island Countries and Territories (PICTs) are also identified as being among the most vulnerable to the effects of climate change and the origin of the “first climate change refugees” (Campbell 2014). According to the United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP), climate change is increasing the frequency and intensity of both acute and slow-onset disasters in both regions, primarily relating to the following: • Increased flooding in coastal and urban areas, rivers and glacial lake outburst floods; • Sea-level rise, contributing to more severe storm surges, inundation, saltwater-­ intrusion salinization of freshwater sources and soil, submergence, destruction of coastal ecosystems and ecosystem services, loss of land mass and erosion; • Hydrological changes in major river basins where 1.5  billion people live (especially the Indus, Ganges, Brahmaputra, Mekong, Yellow, Yangtze, Tarim and Amu and Syr Darya rivers) • Shifts in precipitation patterns and temperatures impacting agricultural production; • Increased droughts, resulting in water scarcity and food shortages, exacerbating livelihood stress and increasing malnutrition; • Increased heat-related morbidity and mortality, including workplace heat stress, for both outdoor and indoor workers without air-cooling systems, especially in factories; • Changes in the incidence and geographic distribution of climate-sensitive infectious diseases, including vector- and water-borne diseases; and • Ocean acidification, impacting biodiversity, ecosystem resilience and fish stocks (UNESCAP 2017: 3–4).

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While flooding is often viewed as the primary problem facing Asia and, to a slightly lesser extent, the Pacific, much of the flooding can be tied to sea level rise (SLR), which, in turn, is linked to greater erosion of land and more frequent and extreme weather events (EWEs). Thirty centimeters of SLR will erode as much as 45 m of coastal land in some areas in Asia, while the coasts of China, Japan, and the Korean Peninsula are expected to recede an average of 6 m per year (Wennersten and Robbins 2017). With each cyclone originating in the Bay of Bengal and North Indian Ocean or the western Pacific Ocean, tidal surges break more ground and reach further inland. Countries with coastal low-lying land like China, Vietnam, India, Indonesia, Bangladesh, and Japan are particularly vulnerable to SLR. SLR, floods, and storms are slowly eroding land surrounding the major river deltas of Bangladesh, India, Myanmar, Thailand, Cambodia, and Vietnam (Wennersten and Robbins 2017). Given that some 2.4  billion people live in low-lying coastal zones and flood plains throughout Asia, the human toll of SLR and flooding is expected to be enormous. By 2050, more than a million people living along the Ganges-Brahmaputra-­ Meghna river delta in Bangladesh will be impacted by SLR, and up to seven million people living along the Mekong delta in Vietnam may be forced to leave (Wennersten and Robbins 2017). Densely populated urban areas are believed to be especially vulnerable to sea level rise, cyclones, and flooding in both Asia and the Pacific (Doocy et al. 2013; UNESCAP 2014). A total of 17 of the 25 cities that are most exposed to a 1 m sea level rise worldwide are in Asia and the Pacific (Dasgupta et al. 2007). In East Asia, 12 million people living in 23 cities on the coast and $864 billion in economic assets will be threatened by sea level rise (Wennersten and Robbins 2017). The Organization for Economic Co-operation and Development (OECD) predicted that nine of the top ten cities in the world at greatest risk of flooding in terms of exposed population by 2070 are in Asia (Wennersten and Robbins 2017).

6.2.1  Bangladesh The geographical location and low-lying terrain of Bangladesh make it particularly vulnerable to cyclones and flooding. Located north of the Bay of Bengal and the adjoining North Indian Ocean, Bangladesh has experienced 15 significant cyclones since 1960 (Nahar et  al. 2014). The coastal region is particularly vulnerable to flooding because it lies directly in the path of tropical cyclones and has a wide and shallow continental shelf and a coastline that funnels storm surges inland (Karim and Mimura 2008). However, flooding is linked to other factors besides cyclones. Eighty percent of the country consists of floodplains of the Ganges, Brahmaputra, Meghna, and several other minor rivers (Brouwer et al. 2007). In addition to heavy rainfall during the monsoon season, an enormous amount of water flows through the country from the Himalayas. On average, one-fifth of the country is flooded annually, and approximately one-third of the country is flooded once a decade. In some years, as much as

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70% of the country has been affected for up to 3  months at a time (Mizra 2002; Government of Bangladesh 2010). Historically, annual floods have played an important part of the lives of rural Bangladeshis as they help to fertilize soil for growing rice and other crops (Nahar et al. 2014). However, increased precipitation, melting glaciers in the Himalayas, and construction of hydroelectric dams that trap silt and sediment have exceeded the rural population’s ability to adapt and make use of the floods, resulting in massive loss of land in many low-lying coastal and riverine areas (Oppenheimer et al. 2014; Haque et al. 2019). Related to the risk of both cyclones and flooding in Bangladesh is the gradual warming of the oceans and SLR. Bangladesh is considered to be one of the most vulnerable countries in the world to SLR (IPCC 2007) due to rising temperatures and the subsidence of the Ganges delta (Haque 1997; Karim and Mimura 2008). SLR is expected to result in more intense cyclones (Karim and Mimura 2008) and reduced agricultural productivity and availability of fresh water due to increased salinity of the soil (Darby 2017) and up to 17% of its land mass (IPCC 2007). Reduced flows of freshwater rivers and streams due to drought in the dry season could contribute to further intrusion of saltwater and contamination of fields and groundwater.

6.2.2  Small Island Developing States (SIDS) in the Pacific Along with the large nation states of South, East, and Southeast Asia, smaller nations in the Western Pacific are among the most likely to be affected by climate change (IPCC 2013; Campbell 2014). These nations are often referred to as Small Island Developing States (SIDS) or Pacific Island Countries and Territories (PICTs). These islands are expected to experience a reduction in available supplies of fresh water and agricultural productivity due to drought and more frequent and intense cyclones, causing more frequent and severe flooding and problems associated with SLR (Campbell 2014). Increasing ocean acidification is also likely to impact coral reefs and coastal ecosystems and potentially lead to a reduction in subsistence and commercial harvesting of marine resources (ABM and CSIRO 2011; Campbell 2014). Projected changes in the physical environment are also expected to have significant impacts on human health (e.g., changing disease vectors, heat-related diseases, and waterborne diseases) (Campbell 2014: 3). Much of the media attention focused on climate change in the Pacific has highlighted the risk of certain island nations being submerged due to rising sea levels. These include Vanuatu, Tuvalu, Kiribati, and the Marshall Islands. These and other low-lying islands and atolls are projected to experience the largest relative increase in flood risk due to sea level rise in the coming century (Nichols 2004; Nichols and Tol 2006; IPCC 2013). Such flood risk has already begun to force entire communities to relocate. For instance, communities from the Carteret Islands have already moved to higher ground on the mainland of Papua New Guinea (UNESCAP 2014). In 2005, the United Nations declared the 100 people living on the island of

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Tegua, one of the 274 islands that comprise the Torres Strait Islands, to be the world’s first “climate change refugees” (UNESCAP 2014). Much of the flooding associated with sea level rise in the region comes in the form of abnormally high tides. According to Hirsch (2017: 23): The increase in sea level is making life difficult on island nations such as Kiribati. Rising oceans cause flooding when they combine with extreme high-water events. These include high waves from a storm or seasonal high tides, known as king tides, which usually wash ashore about twice a year. Because of rising seas, king tides and other high-water events are higher than in the past. Floodwater breaches seawalls, submerges roads, and swamps houses.

6.2.3  North Korea North Korea has historically endured years of devastating floods alternative with periods of prolonged drought. However, in recent years, these alternating forms of natural disaster have cycled with greater frequency and intensity. In 1995, a series of floods devastated over 400,000 hectares of fertile land in North Korea. This led to an approximately 30% drop in grain production. A second wave of floods in the next year struck the “breadbasket” regions of North Korea’s arable land, resulting in a loss of 300,000 metric tons of grain. Although the exact numbers have been disputed (Goodkind and West 2001), an estimated one to three million people, as much as 10% of North Korea’s population, are believed to have starved to death from 1995 to 1998 (Crossing Borders 2019a). In 2000 and 2001, North Korea experienced severe droughts that ruined the soil and irrigation systems. In 2015, nearly seven out of ten North Koreans were affected by natural disasters, including droughts and floods (Guha-Sapir et al. 2016).

6.3  Patterns of Displacement 6.3.1  Numbers of Climigrants Although 60% of the global population resides in Asia, 80% of people worldwide displaced by natural disasters between 2008 and 2013 were from Asia; in 2013 that number jumped to 87% (Wennersten and Robbins 2017). Two groups of people are likely to relocate as a result of SLR and flooding in Asia and the Pacific. The first group includes individuals with sufficient financial and social resources that afford them the means and opportunity to relocate. However, those same resources enable them to remain and rebuild if they choose to do so. The second group of people includes individuals lacking sufficient resources to rebuild or relocate. Relative to the first group, the second group is typically lacking in social and economic resources, placing them at greater risk of exposure to and impacts of SLR and flooding. This includes women, children, older people, people with disabilities,

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indigenous groups, and stateless people with limited access to assistance because of their legal status as noncitizens (UNESCAP 2017: 4). However, while having more reason to relocate, this group also is less likely to have the financial and social resources necessary for relocation. 6.3.1.1  Bangladesh Despite these environmental threats, the exact number of people likely to be displaced in Bangladesh is not entirely clear. The Asian Development Bank (ADB) estimated that 130 million people live on the coast at approximately 1.5 m above sea level, where floods and storms are intensified by poor drainage and infrastructure and high levels of poverty (ADB 2017). “This situation is made worse by trends suggesting that people are increasingly moving towards coastal and urban areas, rather than away from them. Migrants moving to these areas tend to have less knowledge of disaster risks in new areas, leading them to take up residence in more hazardous locations than long-term residents” (UNESCAP 2017: 4). Consequently, more than 30 million Bangladeshis are liable to “lose everything” because of climate change over the next 30–50 years (Vidal 2012). In the Ganges-Brahmaputra-­ Meghna delta alone, more than three million people may become displaced (Wennersten and Robbins 2017). Perhaps the greatest motivation for displacement, however, is tied to economic circumstances of exposed residents both before and after experiencing extreme weather events: Poverty rates in coastal districts of Bangladesh are significantly above the national average. The majority of coastal district residents are low-income agricultural workers, many of whom are landless and relatively asset-poor. Thus, when they are struck by disaster, they have insufficient resources to protect themselves, to adequately rebuild their lives after the event, or to access the medical services that they urgently require. (Nahar et al. 2014: 2)

Residents of coastal or low-lying riverine areas may therefore be displaced, either because of damage or destruction of homes or because damage to crops depletes already limited resources (IPCC 2014; McMichael et  al. 2012; Schwerdtle et  al. 2018; Haque et al. 2019; Arsenault et al. 2015; Islam et al. 2010). In 2017, eight million people were affected by floods, 103,855 houses were destroyed, 633,792 houses were partially damaged, and 4636 schools and several hundred thousand acres of farmland had been flooded (Vidal 2018). However, the extent to which changes in the physical environment are resulting in population displacement at the present time has been the subject of intense debate. Claims made by the government of 30 million climate migrants have been widely disputed inside and outside Bangladesh (Darby 2017). Further, while increased salinity had led to a decline in agricultural production in coastal areas, it has also created new opportunities for shrimp farming (Darby 2017). Climate change may be viewed as a factor that contributes to existing patterns of migration from rural to urban areas for economic reasons. For instance, a study by Brouwer

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et al. (2007) found that about a quarter of 700 floodplain residents living along the Meghna River reported having relatives that moved to Dhaka or abroad in the past 15 years, seeking employment or other economic opportunities. Only 2% of survey respondents said that the main reason for moving is directly related to the flood problems experienced in the area. Thus, while climate change may contribute to migration in Bangladesh, it is not the primary driver. 6.3.1.2  Small Island Developing States (SIDS) in the Western Pacific Flooding and high winds from tropical cyclones have also contributed to displacement in the region. About 4000 residents of Tuvalu and 3300 residents of Vanuatu were displaced by Cyclone Pam in 2015 (Wennersten and Robbins 2017). However, Pam was only one of the four major disasters to hit Vanuatu that year, the others being an underwater earthquake, tsunami, and volcanic explosion. The combination of events led to an estimated destruction of about 75% of the crops, depletion of emergency food supplies, and damage or destruction of 90% of the physical structures on the island (Shultz et al. 2019). As in the case of Bangladesh, the high cost of adapting to SLR and flooding has been viewed as a potential driver for migration within or from SIDS in the Pacific (Biermann and Boas 2010; Gemenne 2011; Nichols et  al. 2011; Speelman et  al. 2017). A cheaper alternative to the construction of protective barriers and other infrastructure, migration from these countries is a form of adaptation to these environmental changes in two respects. First, climigrants seek to relocate to areas less impacted by SLR, either on the same island or region or another part of the globe. Second, climigrants assist their communities of origin in adapting to the environmental changes through remittances to home-island families (Speelman et al. 2017). As in the case of Bangladesh, however, the extent to which migration is the result of climate change is subject to debate. While some scholars (Locke 2009; Shen and Gemenne 2011) have pointed to climate change as a driver of migration in Tuvalu, others (e.g., Mortreaux and Barnett 2009) have found that migrants do not consider climate change as a factor, now or in the future (Speelman et  al. 2017). Recent migration from Tuvalu and elsewhere has been driven primarily by economic considerations and not climate change (Mortreaux and Barnett 2009; Farbotko and Lazrus 2012). A study by Speelman and colleagues found similar attitudes among residents living in the Maldives, a cluster of islands in the Indian Ocean: Respondents are worried about the impacts climate change and sea-level rise will have on their islands. Most respondents think that both sea-level rise and climate change will significantly impact their island and that these impacts will affect their life significantly in the future. However, most respondents find that sea-level rise and climate change do not affect their daily life currently, nor do they feel that current environmental problems make life more difficult. (Speelman et al. 2017: 442)

Another migration driver in the region has been overpopulation and its related problems. “For example, the population of Kiribati is projected to increase by roughly 50% to over 160,000 by 2050 (Campbell and Bedford 2013)”, resulting in

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the displacement of some residents to settle on marginal land prone to flooding (Donner and Webber 2014). Even without further sea level rise, “international migration from low-lying atoll regions may occur in the future due to population pressure alone (Donner 2015)” (Speelman et al. 2017: 434). 6.3.1.3  North Korea During this same period, somewhere between 100,000 to 300,000 North Korean defectors made their way out of the country seeking refuge and resources. The majority of these climigrants escaped through China, where an estimated 200,000 remain today in fear of deportation back to North Korea and subsequent punishment. After another extreme flood event in the North, over 2800 North Korean defectors were accepted in South Korea in 2008 and over 2900 in 2009. Although this represents only a fraction of the total population of the refugees who escaped from North Korea during this period, it is most likely that even more North Koreans sought refuge in China following the natural disasters in 2007 (Crossing Borders 2019b). 6.3.1.4  Philippines As with the rest of the western Pacific, the Philippines has been subjected to more frequent and severe cyclones in recent years. In 2013, Typhoon Haiyan resulted in an estimated 6300 deaths and 4.1 million people displaced (UNHCR 2014). One year later, 20,000 people remained displaced (UNHCR 2014). One and a half years after the typhoon, less than 18% of the population felt that life had returned to normal, and only 32% of households were able to meet their basic needs, compared to 83% before the typhoon (Sherwood et al. 2015). The following year, the evacuations in the Philippines prompted by typhoons Rammasun and Hagupit in 2014 are considered to be the greatest displacement event in the world history (Wennersten and Robbins 2017).

6.3.2  Displacement-Related Decisions There are several factors that have and potentially will motivate residents of Asia and the Pacific to move. Based on an analysis provided by Campbell (2014), the UNESCAP identified three forms of security that may be jeopardized by climate change in the Pacific: land, livelihood, and habitat. Land security may be threatened by coastal or river plain flooding or erosion. “In such cases, the physical sites for settlement may be rendered marginal or, in the worst cases, incapable of supporting habitation” (UNESCAP 2014: 14). “Second, although localities may remain safe and secure in terms of shelter, they become less able to support the cash based and

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subsistence livelihoods of their inhabitants. Among other things, food security and opportunities for employment would be threatened” (UNESCAP 2014: 11). Third, habitat security may be threatened even if settlement locations may be physically secure and livelihoods sustainable, due to changing disease vectors, the loss of water supply quantity or quality, and increased incidence of exposure to and intensity of extreme events (UNESCAP 2014). As noted above land security is being threatened throughout Asia and the Pacific as a result of coastal erosion. Nevertheless, the UNESCAP report notes that uncertainty remains about how much land, if any, will be lost from atolls (or how much will become submerged) and when, if it does eventuate, the degradation will occur, how many people are likely to experience the negative impacts of climate change and how many of those affected will become migrants (UNESCAP 2014). 6.3.2.1  Economic Impacts Perhaps the most significant impacts of climate change that lead to migration are economic. Much of the economic impacts are tied to a reduction in agricultural production in rural areas. For instance, nearly 88% of the world’s rice supply is produced in the low-lying deltas in South and Southeast Asia that are especially vulnerable to sea level rise (Wennersten and Robbins 2017). Paradoxically, Asia’s rice economy is also being impacted by the absence of water. “Water scarcity harms more than twenty-three million hectares of rice in South and Southeast Asia. Droughts are expected to recur more often and extend further into irrigated lands” (Wennersten and Robbins 2017: 202). Whether there is too much or little water for long periods of time, the changing climate is likely to result in successive crop failures that will result in financial collapse of the agricultural economy and increased debt, further weakening the capacity of rural residents to adapt to climate change by either diversifying or moving. Another economic impact is damage to housing and infrastructure. Adapting to SLR through infrastructure projects like building sea walls and barriers is costly, especially for low-lying developing countries like Bangladesh and Vietnam that can least afford this option (Wennersten and Robbins 2017: 190). In Bangladesh, Brower and colleagues (2007) estimated average flood damage costs to be almost US$200 per household per year, amounting to approximately 20% of average household income. As economic losses from climate change mount, rural residents living in poverty will become even more exposed to economic loss. In a survey of 672 people living in a floodplain in Bangladesh, Brouwer et al. (2007) found that households with lower income and less access to productive assets face higher exposure to risk of flooding. Income inequality also plays a role in determining sources of collective vulnerability, as disparities in income and asset distribution at the community level tend to be associated with risk exposure levels.

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6.3.2.2  Health Impacts A second potential motivation for climigration is the health impacts of climate change. Faced with cyclones, floods, and SLR, Bangladeshis have several reasons for relocating. For instance, cyclonic winds and storm surges are often responsible for substantial injury and death. From 1877 to 1995, 16 tropical cyclones with death tolls greater than 5000 occurred in Bangladesh (Doocy et  al. 2013). Bangladesh accounts for 80–90% of all global cyclone-related losses in terms of lives and property globally (Chowdhury 2002). The country also has the highest natural disaster mortality rate in the world (Brouwer et al. 2007). Residents of Bangladesh are also at increased risk of morbidity due to climate-­ related changes in the environment. This includes an elevated prevalence of diarrhea, cholera, and other intestinal disorders that increase significantly during and after floods due to a shortage of clean drinking water (Brouwer et  al. 2007). Several studies have also found significant positive associations between the incidence of leading infectious, waterborne, and vector-borne disease and increases in temperature, humidity, rainfall, and the incidence of EWEs (Hashizime et al. 2007; Hasib and Chathoth 2016; Kabir et al. 2014; Mani and Wang 2014; Haque et al. 2019). A list of the highest priority climate-sensitive health risks of individual Pacific island nations is provided in Table 6.1. As with Asia, water insecurity is a major concern in the context of climate change in the Pacific, particularly with respect to altered rainfall patterns and more severe extreme weather events such as droughts and floods (Cashman et al. 2010; McMichael and Lindgren 2011): Rapidly growing demand, land-use change leading to deforestation, urbanization and tourism are already placing significant strain on the limited freshwater reserves in small island environments (IPCC 2014). The atoll countries (Kiribati, the Marshall Islands, Nauru, Tuvalu and Tokelau) are particularly susceptible to water insecurity from climate change, being dependent on rainwater and, in some cases, freshwater aquifers. (WHO 2015: 31)

Climate change in Asia and the Pacific will have both direct and indirect effects on food security. The most direct effect, particularly in the smaller atoll countries in the Pacific, will be further reduction of already declining agricultural output per capita (ADB 2012). A common problem for children in many Pacific island countries, malnutrition is linked with communicable disease risk and has profound implications for child health and development (Lovell 2011). Food security will also be threatened by foodborne pathogens such as ciguatera, a toxidrome, caused by consumption of contaminated reef fish. Ciguatera is found throughout the Pacific and has been linked to warmer sea surface temperatures and El Niño-Southern Oscillation (ENSO) cycles (Hales et al. 1999; Llewellyn 2010), becoming more commonplace over the past few decades (Skinner et  al. 2011). “Pacific island countries have among the highest rates of ciguatera in the world” (WHO 2015: 31–32). Another health-related consequence of climate change is the physical trauma associated with extreme weather events like cyclones. In the 30-year period between 1977 and 2009, 290,000 were injured by cyclones, excluding an estimated 28,000

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Climate-sensitive health risk Direct effects Health impacts of extreme weather eventsa Heat-related illnessb Indirect effects Water security and safety (including waterborne diseases)c Food security and safety (including malnutrition and foodborne diseases)d Vector-borne diseasese Zoonosesf Respiratory illnessg Disorders of the eyes, ears, skin, and other body systemsh Diffuse effects Disorders of mental/psychosocial healthi,j Noncommunicable diseases (NCDs)i,k Health systems problemsi,l Population pressuresm

Country Cook Marshall Islands Fiji Kiribati Islands

Table 6.1  Highest priority climate-sensitive health risks in Pacific island countries

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Table 6.1 (continued) a While this was typically taken to mean traumatic injuries and deaths, it may also be assumed to include the psychosocial impacts of extreme events b Including occupational exposure to hotter working conditions c This category encompasses waterborne infections causing diarrheal illness, as well as typhoid fever, and also includes problems such as sea level rise-induced salinization of potable water supplies d Including food insecurity, foodborne diseases causing diarrheal illness and ciguatera (“fish poisoning”) e Including, but not limited to, dengue fever and malaria; noting that these two diseases occur in some, but not all, Pacific island countries (e.g., malaria is currently limited to Solomon Islands and Vanuatu) f The primary zoonosis of concern in most Pacific island countries is leptospirosis g Including infections, obstructive airways disease (e.g., asthma), and the pulmonary effects of heat and air pollution h This category includes a range of health problems, from skin infections and cataracts to sexually transmitted infections that were of concern in various Pacific island countries in the context of climate change i A number of climate-sensitive health risks may be considered to cut across categories—for example, there may be direct mental health consequences of extreme weather events; NCDs may be affected indirectly through disruption of food supplies or more diffusely through sociopolitical strategies related to climate change, industry, and trade; health systems problems may be directly affected by extreme weather events as well as via the broader impact of climate change on development j Includes the unspecified detrimental effects of social disruption, e.g., loss of life, land, or livelihoods due to climate change-related phenomena; this category may include, inter alia, depression, anxiety, and posttraumatic stress disorder k While NCDs is a non-specific term, in this context it primarily refers to circulatory diseases (e.g., cardiovascular disease, cerebrovascular disease, hypertension, etc.) as well as endocrine disorders such as diabetes; in some Pacific island countries, this was also taken to include cancers and mental health disorders l Including compromised access to health services, damage to health infrastructure, and additional strain on scarce resources (e.g., for climate-sensitive disease surveillance) m Includes the possibility of climate change-induced resettlement and the effect of climate change-induced sea level rise in exacerbating overcrowding

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to 114,000 unrecorded injuries (Doocy et al. 2013). Mortality and injury rates were disproportionately concentrated in less developed nations of Southeast Asia and the Western Pacific. Storm surges and floods are the primary causes of death in cyclones (Noji 2000). Cyclone mortality risk is particularly high in lower-income countries, with lacerations, wounds, contusions, blunt trauma, animal/insect bites, and motor vehicle injuries among the most frequent types of injuries reported (Doocy et al. 2013). Not all residents living in affected areas are equally exposed to risk of death and injuries, which may contribute to disparities in displacement. Studies of deaths after a cyclone hit Bangladesh in 1991 reported higher rates among females (71/1000) compared to males (15/1000) and both children and older adults compared to young and middle-aged adults (Rahman and Bennish 1993; Bern et al. 1993; Chowdury et al. 1993; Nahar et al. 2014). Other risk factors for mortality included residence type, not reaching shelter, and geographic location (Doocy et al. 2013). Climate change is also likely to be an important multiplier of existing health problems experienced by the population. “It is important to note that the health status of Pacific island communities is generally poor, with average life expectancies 10 years or more below those of developed countries (Taylor et al. 2004), and rates of obesity and noncommunicable diseases (NCDs) among the highest in the world (WHO 2011)” (WHO 2015: 23). For instance, the potential for SLR-induced salinization of potable water sources has substantial implications for increasing or exacerbating hypertension, a risk factor for cardiovascular disease, diabetes, and maternal and child health during pregnancy (Khan et al. 2011). Cholera and other infectious diseases are another consequence of climate change that could potentially motivate migration. In one study, almost half of Bangladeshi participants (46%) reported suffering each year from diarrhea during the rainy season. Ninety-nine percent sought medical treatment for this (Brouwer et al. 2007). 6.3.2.3  Mental Health Impacts In addition to impacts on physical health, people throughout parts of Asia and the Pacific already or likely to be impacted by climate change may be motivated to move by the experience of the mental health consequences of exposure to changes in the physical environment. A small study conducted in the Solomon Islands reported widespread effects of sea level rise on individuals and their families, causing fear and worry on a personal and community level (Asugeni et al. 2015). Studies of survivors of a super cyclone that hit Orissa in India in 1999 reported 5- and 12-month post-event prevalence of PTSD of 44.3% and 30.6%, respectively (Kar et al. 2004, 2007). Comparisons of the prevalence of anxiety and depression prior to and 5-month post-disaster showed increases from 8.5% to 57.5% and from 9.1% to 52.7%, respectively (Kar et al. 2004). A study of 111 women in a Bangladeshi village who survived cyclone Mora in 2017 found that 65% experienced depressive symptoms, 36% were physically injured, 28% had to be absent from work with consequent income loss, and 17% experienced death of a family member. Younger

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age, being an income earner, disaster-related physical injury, and post-disaster work absenteeism were identified as risk factors associated with depressive symptoms (Mamun et al. 2019). Nahar et al. (2014) have observed that women in particular have difficulty coping with climate disasters due to limited access to critical services and facilities during and after the disaster, household responsibilities, sexual harassment, and the consequence of widowhood: Recent studies focusing on Pacific island nations have indicated the need to prioritize mental health services to be able to confront the effects of trauma exposure and psychological distress associated with increasing frequency and severity of climate change–related natural disasters (Butler et al. 2014; McIver et al. 2016). These studies also specifically highlighted the vulnerabilities of South Pacific SIDS nations to disaster-associated and environmentally induced forced migration. (Shultz et al. 2019: 5)

6.3.2.4  Other Impacts To date, there has been no evidence of an association between climate change and civil conflict in Asia and the Pacific as there has been in Africa and the Middle East. However, the UNESCAP report concluded: “Although climate change is not likely to be the cause of conflict or cross-border movement, it is a threat multiplier, contributing to factors that destabilize already volatile situations” (UNESCAP 2017: 8).

6.4  Patterns of Relocation 6.4.1  Forced and Voluntary Relocation In Chapter 1, it was noted that climigration comes in different forms. One distinction is based on whether the climate-related changes that motivate migration are acute as in EWEs or long-term as in temperature increases, SLR, and prolonged droughts. Another distinction is based on whether the moves are temporary and short term, temporary but longer term, or permanent. The literature on climate-­ related population displacement in Asia and the Pacific tends to focus on the distinction between voluntary and forced migration (Campbell 2014; UNESCAP 2014). Voluntary climigration is the movement by individuals seeking work or other economic opportunities. While economic factors may serve to motivate other kinds of immigrants, these factors are often linked to gradual changes in the environment that may limit existing opportunities. A drought lasting a few years may be sufficient for a farmer to move elsewhere to seek gainful employment, only to return to one’s home community once the drought has come to an end. As others may prefer to remain because of the cost of migrating or the availability of other options to make a living, the decision to move is regarded as a choice of staying or going, even if that choice is shaped or constrained by characteristics of the physical environment. As most job and other economic opportunities in Asia and the Pacific are to

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be found in urban settings, voluntary migration is often characterized as a rural to urban phenomenon. Voluntary migration is also characterized in terms of the willingness of the migrant to retain some forms of social and emotional ties with the community of origin, usually reflected by remittances sent to family members who stay behind (Campbell 2014; UNESCAP 2014). “While the evidence is mixed, declining agricultural yields as a result of drought, rising temperatures and excessive and variable rainfall prompt people to consider migration as a way of diversifying livelihoods. Migration also assists communities to recover from disasters and adapt to climate change through remittance transfers and development of skills and networks” (UNESCAP 2017: 2). Forced migration, on the other hand, is typically characterized as the movement of entire communities seeking land, livelihood, and food security. Loss of these forms of security is associated with longer-term and more severe forms of climate-­ related changes in the environment, including soil erosion, sea level rise and inundation, soil salinization and lack of freshwater supplies, and rising temperatures. In these circumstances, options are few and the choice is often limited to when and where to migrate. Unlike the rural to urban pattern of the voluntary climigrant, entire communities that are forced to migrate often seek similar settings (i.e., rural to rural) to maintain a sense of social, cultural, and economic continuity. Rather than maintain social and emotional ties to one’s community of origin, however, forced migration is characterized as abandonment.

6.4.2  Internal Relocation It is anticipated that most of the displacement that occurs as a result of climate change in Asia and the Pacific will be internal, i.e., within countries, territories, or islands. Most of this internal displacement will be from rural areas affected by sea level rise, floods, or drought to urban areas. A study in Bangladesh found that weather variability, floods, excessive rainfall, droughts, salinity intrusion, and tropical cyclones that impacted on agriculture- and aquaculture-based livelihoods contributed to internal and international migration. Nearly 60% of respondents migrated internally as an adaptation response (IOM 2016). “Climate refugees, mostly rural farmers and fishermen, are moving into the slums of the country’s two largest cities, Dhaka and Chittagong. As conditions deteriorate, the capacity of these areas to absorb more people is nearing an end” (Glennon 2017). Dhaka and other large cities are already home to a growing number of environmental refugees (Vidal 2018). In fact, it is estimated that as much as 70% of the slum dwellers of Dhaka moved there after experiencing environmental difficulties in the countryside (McPherson 2015). Temporary and short-term migration from rural to urban areas in Bangladesh has long been used as a way to earn money. However, with the damage to housing and infrastructure and destruction of agricultural capacity caused by constant flooding, soil erosion and salinization, long-term droughts, and acute extreme weather events, it is becoming harder for those residents to move back to their communities of

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origin. “Climate change is forcing people to move to Dhaka and stay there” (Wennersten and Robbins 2017: 193). While urban migration might relieve the pressures caused by climate change in rural areas, it generates other pressures that threaten both the physical environment and quality of life for urban residents: There are numerous problems associated with urban growth in many Pacific island countries. These problems include access to land by migrants, a lack of employment and limited opportunities for subsistence livelihoods, and the growth of squatter settlements, which have limited access to infrastructure and are often located on exposed sites, such as low-­lying or steep land. Urban areas in the region tend to be neglected in terms of disaster risk reduction (Bryant-Tokalau and Campbell 2014) and squatter settlements are often at the greatest risk. Climate change-related rural to urban migration may serve as a catalyst for increasing the demand for international migration access for countries affected by climate change. (UNESCAP 2014: 19)

6.4.3  External Relocation On a somewhat smaller scale relative to internal migration, climigrants may seek refuge in other countries. Although most of the population displacement resulting from extreme weather events throughout Asia and the Pacific is internal, climigration to other countries has been known to occur. In the 2016 IOM study cited earlier, 14% of the Bangladeshis surveyed indicated international migration was a viable adaptation response, primarily toward India and the Middle East. In contrast, a survey of residents of Tuvalu found that only 5% cited environmental reasons as a reason to migrate internationally (Milan et al. 2016). In the Philippines, declining rice production linked to climate variations in certain areas has been shown to be associated with increased international migration, especially among women (Bordey et al. 2013). However, international migration is particularly significant for low-lying SIDS facing the prospect of entire territories being submerged by sea level rise. Much of this migration will be to other Pacific nations with higher elevation, such as Fiji and Vanuatu. Leading the way has been Kiribati, which purchased 20 square kilometers of land in Fiji for potential population relocation. Climigrants are also likely to travel to where labor market opportunities are or are perceived to be, including the Middle East, Europe, and East and Southeast Asia. According to the UNESCAP report (2017), international migration to these destinations, especially by women from climate-affected countries like Bangladesh and Philippines seeking employment abroad, has tripled since 1990. However, the ability to relocate to an international destination is constrained by several factors, including affordability, access, social networks, host community receptivity, and employment opportunities (IPCC 2014; UNESCAP 2017). The financial requirements of international migration in particular constitute a barrier to access for those who are the poorest and most vulnerable to climate change (IPCC 2014). In the 2016 IOM study, for instance, most of the climigrants traveling to

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other countries from Bangladesh are from middle- to upper-income households. Lacking comparable financial resources, climigrants from poorer and lower middle-­ income households are often forced to take out high-interest and risky loans to finance their relocation outside the country. In Asia and the Pacific, “cross-border movement is expected to happen gradually, mostly through existing channels, rather than in a mass influx of irregular migrants. However, reduced options for affordable, safe and regular migration increase the motivation to use irregular and dangerous migration channels” (UNESCAP 2017: 5). For those lacking existing safe and legal migration pathways, the alternative is to migrate without authorization and hope for the best: Just as Syria has the image of the washed-up toddler boy, Asia has its own poster child for climate change – hundreds of them, stranded on boats, banished from their destinations and consigned to life on the perilous seas, often referred to in the media as ‘boat people.’ Oftentimes, boats of hundreds or thousands of refugees are at sea for months, unable to find port. Many have been abandoned by the ship crews without food or water, still more have capsized. It is an exceedingly dangerous journey, but the refugees who have been forced to leave Myanmar and Bangladesh have nowhere else to go. (Wennersten and Robbins 2017: 191)

Neighboring India has placed armed guards on the border with Bangladesh to keep out poor migrants with few work skills. “Climate refugees from Bangladesh, a predominately Muslim country, are not welcome in the neighboring countries of India and Myanmar. India is building its version of a border wall, a barbed-wire fence; violence in Myanmar in December 2016 drove an estimated 65,000 Rohinga, an ethnic Muslim minority, into Bangladesh” (Glennon 2017). Australia placed many of the boat people fleeing from South and Southeast Asia into immigration detention centers located throughout the country and neighboring islands in the Pacific. For North Korean refugees escaping famine and political repression, the primary migration pathway is through China, where migrants are subjected to human trafficking and extortion and where detection by government authorities can result in forced repatriation, imprisonment, and even death (Chang et al. 2008). Pressure to migrate illegally to international destinations also carries with it an increased risk of involvement in human trafficking. In the Philippines, following Typhoon Haiyan in 2013, increased rates of trafficking were recorded in highly affected areas. Traffickers targeted internally displaced persons, women-headed households, and children who had lost their parents in the disaster. Similar trends were recorded in Bangladesh following Cyclone Sidr in 2007 and Cyclone Aila in 2009. Smuggling of drought-affected migrants from Cambodia to Thailand has also been reported (IOM 2016). Smugglers target poorer households with promises of assistance in traveling abroad at little or no cost, only to charge exorbitant fees and hazardous journeys and a prospect of long-term debt and servitude (IOM 2017). The UN Economic and Social Council report suggested that one potential implication of entire nations being submerged is the potential loss of statehood (UNESCAP 2017). In such circumstances, one option for wholesale displacement of entire communities or countries is through the purchase of land in less-impacted areas. As noted earlier, the government of Kiribati purchased land in Fiji that can be

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used to cultivate food if Kiribati’s land becomes infertile from saltwater erosion in the short term but also to resettle the Kiribati population in the long term as climate change continues to threaten land and habitability security (Elsmoor and Rosen 2016). However, relocating an entire nation across national borders poses a number of social, cultural, and legal challenges. Communities seeking to relocate in their entirety to another country may have a difficult time if new laws conflict with traditional cultural practices; if suitable land is rare and/or exceedingly expensive; and if host community support is likely to be limited (Campbell 2014). As the UNESCAP report (2014) notes, livelihood security under these circumstances is likely to be no greater than in the community of origin. The question remains regarding to which international destinations climate change-related migrants from the Asia and Pacific islands will be able to go. With respect to the Pacific, “while many observers state that other Pacific island destinations would be the best options in terms of environmental and cultural similarities, it is likely that most of these islands will be facing their own climate change-­initiated demographic pressures” (UNESCAP 2014: 20). The same is true in Asia as climigrants from Bangladesh seek refuge in neighboring countries that are themselves being impacted by climate change. As most migrants who move to other countries will tend to move to urban areas, opportunities to obtain livelihood security are likely to be limited and contested by internally displaced climigrants from rural areas. From this perspective, planned relocation is extremely problematic. “It involves rupturing the essential person-land connection at the place of origin and requiring a destination community to make land available for the community being resettled” (UNESCAP 2014: 21). Furthermore, island nations like Papua New Guinea, Solomon Islands, Vanuatu, Tuvalu, Kiribati, and Nauru have very limited opportunities for international migration access (Campbell 2014). In the absence of more opportunities to move outside the region, climigrants are likely to move to places where climate-related environmental changes have already occurred or are likely to occur (UNESCAP 2017).

6.5  Impacts of Displacement 6.5.1  Impacts on the Displaced Although poor health resulting from climate-related changes in the environment may inspire some to migrate, the adverse effects of climigration in Asia and the Pacific have also been well documented: Displacement which is related to weather events… has been found to be associated with a higher incidence of illness, loss of household possessions, lower income and savings, reduced access to healthcare services and other basic necessities (e.g., food, water sanitation, education and shelter), disruption of social networks and marginalization among the displaced (Alam et  al. 2017; Arsenault et  al. 2015; Hutton and Haque 2004; Islam and

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Hasan 2016; Islam and Shamsuddoha 2017; McMichael et  al. 2012; Schwerdtle et  al. 2018). (Haque et al. 2019: 10)

In Bangladesh, for example, cyclone survivors who moved to urban slum areas have been found to be living without clean water supplies and sanitation, education, and basic health services (Uddin and Mazur 2015). The financial stress associated with climigration also increases the risk of mental health problems experienced by climigrants. Although voluntary migrants, as noted in Sect. 6.4.1, may relocate for the express purpose of seeking employment and economic opportunities that are unavailable and/or otherwise degraded by climate change in communities of origin, they may also find themselves encountering financial pressures at their places of destination as they face unemployment, underemployment, or low-paying jobs: Struggling to make ends meet, they may find themselves under pressure to provide those who remain at “home” with remittances. McLeod (2010) highlighted that receiving families in host communities in New Zealand often face an additional financial burden and other social costs when relatives join them from the Pacific islands. Following tropical cyclones in Pacific island countries, expatriate communities in New Zealand have been found to suffer considerably in providing their kinfolk with assistance, and cases of borrowing from loan sharks to support their relatives have been reported. (UNESCAP 2014: 22–23)

Perhaps the most dramatic instance of the mental health consequences of forced migration is among North Korean refugees fleeing starvation and political persecution. These refugees experience poor mental health (Chung and Seo 2007; Kim et al. 2011; Min 2008), unemployment (Bidet 2009; Kim and Jang 2007; Lankov 2006), discrimination (Kim and Jang 2007; Kim 2010; Um et al. 2015), and social exclusion (Kim 2010; Park et al. 2009; Suh 2002) in South Korea, in addition to trauma experienced before entering the new society (Jeon et al. 2005). In the case of depressive disorders, the prevalence among North Korean refugees has been reported to be twice the rate of their South Korean counterparts (Kim et al. 2011). However, climigration may also provide mental health benefits. A study of Tongan migrants to New Zealand, for instance, found evidence of significantly improved mental health relative to those who remained in Tonga (Stillman et al. 2009). Climigrants are also less likely to have access to and utilize accessible health-­ care services. In Bangladesh, a survey of 1200 households conducted by Haque et al. (2019) found that caregivers displaced for climate-related reasons were significantly less likely to seek care or to use provider-prescribed care to manage children’s illnesses and half as likely as those of non-displaced parents to have their children treated by a trained provider: The reduced access to healthcare of the displaced may reflect that households in displacement-­prone areas (and local healthcare providers) are often forced to move to more geographically remote locations which are away from the local market and local healthcare and other facilities. Following relocation, the displaced may also lose benefits which can result from familiarity with a local healthcare provider, such as options to visit without prior appointment, flexible payment options and home visits from the provider, and this may adversely affect their healthcare seeking behavior. (Haque et al. 2019: 17)

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International migration is also likely to impact and be impacted by the legal status of climigrants. In recent years, there have been some high-profile court cases filed by immigrants from Pacific Islands seeking permanent residence in New Zealand by claiming refugee status. In one such case, Ioane Teitiota, a native of Kiribati, failed in his efforts to seek permanent residence status and was subsequently deported because the court found that he and his family did not meet the technical definition for “refugee” as defined in the 1951 Convention Relating to the Status of Refugees (Dastgheib 2015). In contrast, the New Zealand government approved petitions of the Alesana family from Tuvalu to remain in New Zealand as permanent residents on the grounds that family members were already present in the country and ready to sponsor new migrants (Noack 2014).

6.5.2  Impacts on Community of Origin Despite the loss of population, climigration may produce certain benefits, the most obvious being the transmission of remittances from climigrants to relatives in communities of origin: Remittances diversify household incomes and can therefore aid in meeting basic needs when natural resource-based livelihoods are less productive, such as seasonally, during ENSO-related events, over the long-term due to climate trends or due to natural disasters (Barnett and Webber 2010). For example, remittances to Samoan households increase significantly following cyclones (Paulson 1993). Remittances can increase development opportunities in homeland Pacific island economies by increasing access to education and health services, improving assets (such as housing) and enabling investment (ADB 2012). (UNESCAP 2014: 23)

A second potential benefit of temporary climigration is the transfer of skills, knowledge, and technology to communities of origin. “The periodic or permanent return of migrants can move new social capital into homeland communities by increasing the transfer of ideas, innovations, knowledge, information and skills” (UNESCAP 2014: 24). A third potential benefit of climigration to communities of origin is reduced pressure on limited resources. “Migration can act as a ‘pressure release valve’, reducing demands on resources in sending regions, particularly where these may be compromised by both environmental degradation and increasing population pressure (Barnett and Webber 2010; Barnett and Chamberlain 2010)” (UNESCAP 2014: 24). Nevertheless, the decline in population due to climigration is likely to produce more harm than good. Cyclones have been shown to threaten the viability of island communities with the out-migration of economically productive residents, especially males, and the skills they take with them (Barnett 2012). The potential benefits that accrue from remittances sent by these migrants to their home communities may be outweighed by the loss of occupational skills, manpower, and sources of social support.

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6.5.3  Impacts on Host Communities While temporary climigration may produce some benefits for individual communities of origin, larger-scale population shifts are expected to have significant implications for the Asia-Pacific region, straining infrastructure capacities and economic resources and creating new social challenges associated with changing community demographics (IPCC 2014). For instance: where international migration opportunities are limited, internal migration to urban areas can increase pressure on resources. This is the situation in South Tarawa, Kiribati, where the usable land area is 12  km2 and the total population is 50,182 people, with a population growth rate of 4.4 percent (2010 census). Only 22 percent of South Tarawa residents identify themselves as being from South Tarawa (statistics are from Office Te Beretitenti, 2012). The increased population has put significant pressure on freshwater resources and sanitation systems. (Storey and Hunter 2010) (UNESCAP 2014: 24)

Another consequence of forced climigration for both climigrants and their hosts is an increased potential for social conflict and civil unrest. For instance, Campbell (2014) asserts that moving to nearby locations that are outside the individuals’ or communities’ customary lands or moving greater distances away from the local area to lands that belong to other customary groups “have costs, but these increase with physical and social (particularly from a customary perspective) distance from the origin, and these costs are likely to be even higher when whole communities are required to relocate… Relocating to land belonging to a different kinship group (whether within one’s own country or even in another PICT) is often fraught with longstanding tensions” (Campbell 2014: 17). Thus, “for relocatees, to be forced from one’s land is likely to be highly traumatic, but the giving up of land to relocatees by destination communities may be equally difficult (Campbell 2010). Proximate relocation outside one’s customary land, or relocation to other PICTs, is likely to be fraught with problems over land tenure, which can continue for generations” (Campbell 2014: 15).

6.6  Lessons Learned The evidence to date in Asia and the Pacific is consistent with that obtained in other parts of the world where climigration is taking place, with respect to the impacts of displacement for environmental reasons. These impacts include economic insecurity, impaired physical and mental health and access to health care, and social isolation and discrimination. Internal displacement, especially from rural to urban areas, contributes to overcrowding and overextension of capacity to house and deliver services to new as well as existing residents. For the time being, external migration in this region is likely to be limited as nations enhance border security or erect legal barriers to keep out climigrants, while LMICs like Bangladesh and SIDS like Kiribati and Vanuatu seek leverage against HICS like New Zealand, Australia, and

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the United States for reparations for damage due to human-caused changes and a relief valve for overpopulation and lack of economic opportunity. The experience of climate change and migration in Asia and the Pacific also illustrate disparities in exposure to climate-related changes in environment and their social, economic, and health impacts. These disparities are the result of geography and poverty. Residents of low-lying coastal areas and river deltas of South, Southeast, and East Asia and island atolls of the Pacific are more likely to experience extreme weather events and less likely to recover from them because they lack the social and economic resources to do so. As Brower et al. observe, “poorer people tend to be more (often) exposed to environmental risk than wealthy people. The latter are furthermore able to take protective measures or are able to avoid certain environmental (health) risks” (Brouwer et al. 2007: 315). However, not everyone is willing or able to migrate. Many residents of Kiribati express skepticism as to the need to prepare for climate change (Ives 2016). Furthermore, climate change is not widely viewed in the region as the primary motivation for migration. “In most cases, climate migrants are not easy to distinguish from economic migrants: they arrive looking for work” (Darby 2017). Finally, it is clear that climigration comes at a cost to migrants, to communities of origin and destination, and to national and international efforts to manage displacement. However, the alternative, which is not to migrate, is also costly. Whether it has been to move for brief periods of time from rural to urban areas as in Bangladesh or to move further inland or to neighboring islands as in the Pacific, migration has traditionally played an important role as an adaptive strategy for coping with extreme weather events. However, sea level rise and the resulting increase in frequency and severity of such events have led to a consideration of alternative adaptive strategies, which will require substantial financial resources. Sadly, it is an expense very few potential climigrants can afford to pay.

References Alam GMM, Alam K, Muchtaq S (2017) Climate change perceptions and local adaptation strategies of hazard-prone rural households in Bangladesh. Clim Risk Manag 17(Suppl C):52–63 Arsenault M, Azam M, Ahmad S (2015) Riverbank erosion and migration in Bangladesh’s Char lands. In: Mallick B, Etzold B (eds) Environment, migration and adaptation: evidence and politics of climate change in Bangladesh. AHDPH, Dhaka, pp 41–62 Asian Development Bank (ADB) (2012) Addressing climate change and migration in Asia and the Pacific. Asian Development Bank, Manila. https://www.adb.org/sites/default/files/ publication/29662/addressing-climate-change-migration.pdf. Accessed 18 Apr 2019 Asian Development Bank (ADB) (2017) A region at risk: the human dimensions of climate change in Asia and the Pacific. Asian Development Bank, Manila. https://adb.org/sites/default/files/ publication/325251/region-risk-climate-change.pdf. Accessed 18 Apr 2019 Asugeni J, MacLaren D, Massey PD et  al (2015) Mental health issues from rising sea level in a remote coastal region of the Solomon Islands: current and future. Australas Psychiatry 23:22–25. https://doi.org/10.1177/1039856215609767

References

121

Australian Bureau of Meteorology and Commonwealth Scientific and Industrial Research Organisation (ABM and CSIRO) (2011) Climate change in the Pacific: scientific assessment and new research, vol 1: regional overview. Pacific Climate Change Science Program, Aspen, CO Barnett J (2012) On the risks of engineering mobility to reduce vulnerability to climate change: insights from a small island state. In: Hastrup K, Olwig KF (eds) Climate change and human mobility. Cambridge University Press, New York, pp. 169–189 Barnett J, Chamberlain N (2010) Migration as climate change adaptation: implications for the Pacific. In: Burson B (ed) Climate change and migration: South Pacific perspectives. Institute of Policy Studies, Wellington Barnett J, Webber M (2010)  Accommodating migration to promote adaptation to climate change. The World Bank, Policy Research Working Paper Series 5270. The World Bank, Washington, DC Bern C, Sniezekv J, Mathbor GM et al (1993) Risk factors for mortality in the Bangladesh cyclone of 1991. Bull World Health Organ 71(1):73–78 Bidet E (2009) Social capital and work integration of migrants: the case of North Korean defectors in South Korea. Asian Perspect 33(2):151–179 Biermann F, Boas I (2010) Preparing for a warmer world: towards a global governance system to protect climate refugees. Glob Environ Polit 10(1):60–88 Bordey FH, Launio CC, Quilang EJP, et al (2013) Linking climate change, rice yield and migration: the Philippine Experience. WorldFish—economy and environment programme for South-­East Asia, Manila. https://core.ac.uk/download/pdf/18311266.pdf. Accessed 24 Apr 2019 Brouwer R, Akter S, Brander L et  al (2007) Socioeconomic variability and adaptation to environmental risk: a case study of climate change and flooding in Bangladesh. Risk Anal 27(2):313–326 Bryant-Tokelau J, Campbell J (2014). Coping with floods in urban Fiji: responses and resilience of the poor. In: Sakai M, Jurriëns E, Zhang J, et al (eds) Disaster relief in the Asia Pacific: agency and resilience. Routledge, Oxford, pp. 132–146 Butler CD, Bowles DC, McIver L et  al (2014) Mental health, cognition, and the challenges of climate change. In: Butler CD (ed) Climate change and global health. CAB eBooks, Wallingford, pp 251–259 Campbell J (2010) Climate-induced community relocation in the Pacific: the meaning and importance of land. In: McAdam J (ed) Climate change and displacement: multidisciplinary perspectives. Hart, Oxford, pp 57–79 Campbell J (2014) Climate-change migration in the Pacific. Contemp Pacific 26(1):1–28 Campbell J, Bedford R (2013) Migration and climate change in Oceana. In: Piguet E, Laczko F (eds) People on the move in a changing climate. Global migration issues 2, pp 177–204 Cashman A, Nurse L, John C (2010) Climate change in the Caribbean: the water management implications. J Environ Develop 19(1):42–67 Chang Y, Haggard S, Noland M (2008) Migration experiences of North Korean refugees: survey evidence from China. Working Paper 08-4. Peterson Institute for International Economics, Washington, DC. https://www.piie.com/sites/default/files/publications/wp/wp08-4.pdf. Accessed 16 Oct 2017 Chowdhury KMMH (2002) Cyclone preparedness and management in Bangladesh. Improvement of early warning system and responses in Bangladesh towards total disaster risk management approach. Bangladesh Public Administration Training Center, Dhaka, pp 115–119 Chowdury AM, Bhuyia AU, Chowdhury AY et al (1993) The Bangladesh cyclone of 1991: why so many people died. Disasters 17(4):291–304 Chung S, Seo JY (2007) A study on posttraumatic stress disorder among North Korean defectors and their social adjustment in South Korea. J Loss Trauma 12(4):365–382 Collectif Argos (2010) Climate refugees. MIT Press, Cambridge, MA Crossing Borders (2019a) The North Korean famine. https://www.crossingbordersnk.org/thenorth-korean-famine. Accessed 18 Jun 2019

122

6  Fleeing Flooding: Asia and the Pacific

Crossing Borders (2019b) North Korean refugees. https://www.crossingbordersnk.org/northkorean-refugees. Accessed 18 Jun 2019 Darby M (2017) What will become of Bangladesh’s climate migrants? Climate Home News, 14 Aug. https://www.climatechangenews.com/2017/08/14/will-become-bangladeshs-climatemigrants/. Accessed 23 Apr 2019 Dasgupta S, LaPlante B, Meisner C et  al (2007) The impact of sea level rise on developing countries: a comparative analysis. World Bank Policy Research Working Paper 4136. World Bank, Washington, DC Dastgheib S (2015) Kiribati climate change refugee told he must leave New Zealand. The Guardian (UK), 22 Sept. https://www.theguardian.com/environment/2015/sep/22/kiribati-climatechange-refugee-told-he-must-leave-new-zealand. Accessed 12 Jun 2019 Donner SD (2015) The legacy of migration in response to climate stress: learning for the Gilbertese resettlement in the Solomon Islands. Nat Res Forum 39(3-4):191–201. https://doi.org/10.1007/ s11625-014-0242-z Donner SD, Webber S (2014) Obstacles to climate change adaptation decisions: a case study of sea-level rise and coastal protection measures in Kiribati. Sustain Sci 9(3):331–345. https://doi. org/10.1007/s11625-014-0242-z Doocy S, Dick A, Daniels A et al (2013) The human impact of tropical cyclones: a historical review of events 1980-2009 and systematic literature review. PLoS Curr 5. pii: ecurrents.dis.266435 4a5571512063ed29d25ffbce74. https://doi.org/10.1371/currents.dis.2664354a5571512063ed2 9d29d25ffbce74 Elsmoor J, Rosen Z (2016) Kiribati’s land purchase in Fiji: does it make sense? Devpolicyblog, 11 Jan. https://www.devpolicy.org/kitibatis-land-purchase-in-fiji-does-it-make-sense-20160111/. Accessed 12 Jun 2019 Farbotko C, Lazrus H (2012) The first climate refugees? Contesting global narratives of climate change in Tuvalu. Glob Environ Chang 22(2):382–390. https://doi.org/10.1016/j. gloenvcha.2011.11.014 Gemenne F (2011) Climate-induced population displacements in a 4°C world. Philos Trans R Soc Lond A Math Phys Eng Sci 369(1934):182–195. https://doi.org/10.1098/rsta.2010.0287 Glennon R (2017) The unfolding tragedy of climate change in Bangladesh. Scientific American Guest Blog, 21 Apr. https://blogs.scientificamerican.com/guest-blog/the-unfolding-tragedy-ofclimate-change-in-bangladesh/. Accessed 11 Jun 2019 Goodkind D, West L (2001) The North Korean famine and its demographic impact. Popul Dev Rev 27(2):219–238 Government of Bangladesh (2010) National plan for disaster management, 2010–2015. Disaster Management Bureau, Disaster Management & Relief Division, Dhaka Guha-Sapir D, Hoyois P, Below R (2016) Annual disaster statistical review 2015: the numbers and trends. Centre for Research on the Epidemiology of Disasters, Brussels. http://www.cred.be/ sites/default/files/ADSR_2015.pdf. Accessed 12 Oct 2019 Hales S, Weinstein P, Woodward A (1999). Ciguatera (fish poisoning), El Niño, and Pacific sea surface temperatures. Ecosystem Health 5(1):20–55 Haque CE (1997) Atmospheric hazards preparedness in Bangladesh: a study of warning, adjustment and recovery from the April 1991 cyclone. Nat Hazards 16:181–202 Haque MR, Parr N, Muhidin S (2019) Parents’ healthcare-seeking behavior for their children among the climate-related displaced population of rural Bangladesh. Soc Sci Med 226:9–20 Hashizime M, Armstrong B, Hajat S et  al (2007) Association between climate variability and hospital visits for non-cholera diarrhea in Bangladesh: effects and vulnerable groups. Int J Epidemiol 36:1030–1037. https://doi.org/10.1093/ije/dym148 Hasib E, Chathoth P (2016) Health impact of climate change in Bangladesh: a summary. Curr Urban Stud 4:1–8. https://doi.org/10.4236/cus.2016.41001 Hirsch R (2017) Climate migrants: on the move in a warming world. Twenty-First Century Books, Minneapolis, MN

References

123

Hutton D, Haque CE (2004) Human vulnerability, dislocation and resettlement: adaptation processes of river-bank erosion-induced displaces in Bangladesh. Disasters 28(1):41–62 Intergovernmental Panel on Climate Change (IPCC) (2007) Climate change 2007: impact, adaptations and vulnerability. In: Contribution of Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2013) Climate change 2013: the physical science basis. In: Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Intergovernmental Panel on Climate Change (IPCC) (2014) Impacts, adaptations and vulnerability. 2 vols. In: Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York International Organization for Migration (IOM) (2016) Assessing the climate change environmental degradation and migration nexus in South Asia. https://publications.iom.int/system/files/pdf/ environmental_degradation_nexus_in_south_asia.pdf. Accessed 12 Jun 2019 International Organization for Migration (IOM) (2017) Community study on the needs of returned migrants following the Andaman Sea crisis (Dhaka, 2017). http://publications.iom.int/fr/system/files/pdf/community_study_andaman_sea_crisis.pdf. Accessed 12 Jun 2019 Islam MR, Hasan M (2016) Climate-induced human displacement: a case study of Cyclone Aila in the south-west coastal region of Bangladesh. Nat Hazards 8(2):1051–1071 Islam MR, Shamsuddoha M (2017) Socioeconomic consequences of climate-induced human displacement and migration in Bangladesh. Int Sociol 32(3):277–298 Islam SN, Singh S, Shaheed H et al (2010) Settlement relocations in the char-lands of Padma river basin in Ganges delta, Bangladesh. Front Earth Sci China 4(4):393–402 Ives M (2016) Remote Pacific nation, threatened by rising seas. New York Times, 3 Jul. https:// www.nytimes.com/2016/07/03/world/asia/climate-change-kiribati.html. Accessed 14 Apr 2019 Jeon WT, Hong CH, Lee CH et al (2005) Correlation between traumatic events and posttraumatic stress disorder among North Korean defectors in South Korea. J Trauma Stress 18(2):147–154 Kabir R, Khan HTA, Ball E et al (2014) Climate change and public health situations in coastal areas of Bangladesh. Int J Soc Sci Stud 2(2):109–116 Kar N, Jagadisha PS, Murali N et al (2004) Mental health consequences of the trauma of super-­ cyclone 1999 in Orissa. Indian J Psychiatry 46(3):228–237 Kar N, Mohaapatra PK, Nayak KC et  al (2007) Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: exploring cross-cultural validity and vulnerability factors. BMC Psychiatry 7(1):1–9 Karim MF, Mimura N (2008) Impacts of climate change and sea-level rise on cyclonic storm surge floods in Bangladesh. Glob Environ Chang 18:490–500 Kim SY (2010) Tackling the social exclusion of the North Korean refugees in South Korea. Korea Observer 41(1):93–129 Kim JU, Jang DJ (2007) Aliens among brothers? The status and perception of North Korean refugees in South Korea. Asian Perspect 31(2):5–22 Kim HH, Lee YJ, Kim HK et al (2011) Prevalence and correlates of psychiatric symptoms in North Korean defectors. Psychiatr Investig 8(3):179–185 Khan AE, Ireson A, Kovats S et al (2011) Drinking water salinity and maternal health in coastal Bangladesh: implications of climate change. Environ Health Perspect 119(9):1328–1332 Lankov A (2006) Bitter taste of paradise: North Korean refugees in South Korea. J East Asian Stud 6(1):105–137 Llewellyn LE (2010) Revisiting the association between sea surface temperature and the epidemiology of fish poisoning in the South Pacific: reassessing the link between ciguatera and climate change. Toxicon 56(5):691–697 Locke JT (2009) Climate change induced migration in the Pacific Region: sudden crisis and long term developments. Geogr J 175(3):171–180. https://doi.org/10.1111/j.1475-4959.2008.00317.x

124

6  Fleeing Flooding: Asia and the Pacific

Lovell SA (2011) Health governance and the impact of climate change on Pacific small island developing states. Int Hum Dimen Program (IHDP) Update (1):50–55 Mamun MA, Huq N, Papia ZF et al (2019) Prevalence of depression among Bangladeshi village women subsequent to a natural disaster: a pilot study. Psychiatry Res 276:124–128 Mani M, Wang L (2014) Climate change and health impacts: how vulnerable is Bangladesh and what needs to be done? World Bank, Washington, DC McIver L, Kim R, Woodward A et al (2016) Health impacts of climate change in Pacific island countries: a regional assessment of vulnerabilities and adaptation priorities. Environ Health Perspect 124:1707–1714 McLeod D (2010) Potential impacts of climate change migration on Pacific families living in New Zealand. In: Burson B et al (eds) Climate change and migration: South Pacific perspectives New Zealand. Institute of Policy Studies, Wellington McMichael AJ, Lindgren E (2011) Climate change: present and future risks to health and necessary responses. J Intern Med 270(5):401–413. https://doi.org/10.1111/j.1365-2796.2011.02415.x McMichael C, Barnett J, McMichael AJ (2012) An ill wind? Climate change, migration and health. Environ Health Perspect 120(5):646–654 McPherson P (2015) Dhaka: the city where climate refugees are already a reality. The Guardian (UK), 1 Dec. https://www.theguardian.com/cities/2015/dec/01/dhaka-city-climate-refugeesreality. Accessed 12 Aug 2019 Milan A, Oakes R, Campbell J (2016) Tuvalu: climate change and migration  – Relationships between household vulnerability, human mobility and climate change. United Nations University, Bonn. http://collections.unu.edu/eserv/UNU:5856/Online_No_18_Tuvalu_ Report_161207_Pdf. Accessed 18 Aug 2019 Min SK (2008) Divided countries, divided mind 1: psycho-social issues in adaptation problems of North Korean defectors. Psychiatr Investig 5(1):1–13 Mizra MMQ (2002) Global warming and changes in the probability of occurrence of floods in Bangladesh and implications. Glob Environ Chang 12:127–138 Mortreaux C, Barnett J (2009) Climate change, migration and adaptation in Funafuti, Tuvalu. Glob Environ Change 19(1):105–112. https://doi.org/10.1016/j.gloenvcha.2008.09.006 Nahar N, Blomstedt Y, Wu B et  al (2014) Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh. BMC Public Health 14:708 Nichols RJ (2004) Coastal flooding and wetland loss in the 21st century: changes under the SRES climate and socio-economic scenarios. Glob Environ Chang 14(1):69–86 Nichols RJ, Tol RSJ (2006) Impacts and responses to sea level rise: a global analysis of the SRES scenarios over the twenty-first century. Philos Trans R Soc Lond A Math Phys Eng Sci 364(1841):1073-1095 Nichols RJ, Marinova N, Lowe JA et  al (2011) Sea level rise and its possible impacts given a “beyond 4oC world” in the twenty-first century. Philos Trans R Soc Lond A Math Phys Eng Sci 369(1934):161–181 Noack R (2014) Has the era of the ‘climate change refugee’ begun? Washington Post, 7 Aug. https://www.washingtonpost.com/news/worldviews/wp/2014/08/07/has-the-era-of-theclimate-change-refugee-begun/. Accessed 6 Jan 2019 Noji E (2000) Public health issues in disasters. Crit Care Med 33:S29–S33. 56–58 Oppenheimer M, Campos M, Warren R et al (2014) Emergent risks and key vulnerabilities. In: Climate Change 2014: impacts, adaptations, and vulnerability Working Group II Contribution to the IPCC 5th Assessment Report. Cambridge University Press, New York, pp 1039–1099 Park K, Cho Y, Yoon IJ (2009) Social inclusion and length of stay as determinants of health among North Korean refugees in South Korea. Int J Public Health 54(3):175–182 Paulson DD (1993) Hurricane hazard in western Samoa. Geogr Rev 83(1):43–53 Rahman MO, Bennish M (1993) Health related response to natural disasters: the case of the Bangladesh cyclone of 1991. Soc Sci Med 36(7):903–914 Schwerdtle P, Bowen K, McMichael C (2018) The health impacts of climate-related migration. BMC Med 16(1):1. https://doi.org/10.1186/s12916-017-0981-7

References

125

Shen S, Gemenne F (2011) Contrasted views on environmental change and migration: the case of Tuvaluan migration to New Zealand. Int Migr 49:e224–e242. https://doi. org/10.1111/j.1468-2435.2010.00635x Sherwood A, Bradley M, Rossi L et  al (2015) Resolving post-disaster displacement: insights from the Philippines after Typhoon Haiyan (Yolanda). Brookings Institution, Washington, DC. https://www.brookings.edu/wp-content/uploads/2016/06/Resolving-PostDisasterDisplacementInsights-from-the-Philippines-after Typhoon-Haiyan-June-2015.pdf. Accessed 23 Mar 2019 Shultz JM, Rechkemmer A, Rai A et al (2019) Public health and mental health implications of environmentally induced forced migration. Disaster Med Public Health Prep 13(2):116–122. https://doi.org/10.1017/dmp.2018.27 Skinner MP, Brewer TD, Johnstone R et al (2011) Ciguatera dish poisoning in the Pacific islands (1998 to 2008). PLoS Negl Trop Dis 5 (12):e1416 Speelman LH, Nicholls RJ, Dyke J (2017) Contemporary migration intentions in the Maldives: the role of environmental and other factors. Sustain Sci 12:433–451 Stillman S, McKenzie D, Gibson J (2009) Migration and mental health: evidence from a natural experiment. J Health Econ 28:677–687 Storey D, Hunter S (2010) Kiribati: an environmental ‘perfect storm’. Australian Geographer 41 (2):167–181 Suh JJ (2002) North Korean defectors: their adaptation and resettlement. E Asian Rev 14(3):67–86 Taylor R (2004) Contemporary patterns of Pacific island mortality. Int J Epidemiol 34 (1):207–214 Uddin J, Mazur RE (2015) Socioeconomic factors differentiating healthcare utilization of cyclone survivors in rural Bangladesh: a case study of cyclone Sidr. Health Policy Plan 30(6):782–790 Um MY, Chi I, Kim HJ et  al (2015) Correlates of depressive symptoms among North Korean refugees adapting to South Korean society: the moderating role of perceived discrimination. Soc Sci Med 131:107–113 United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2014) Climate change and migration issues in the Pacific. https://www. ilo.org/dyn/migpractice/docs/261/Pacific.pdf. Accessed 12 Apr 2019 United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2017) Migration and climate change in Asia and the Pacific. https://www. unescap.org/sites/default/files/GCMPREP_5E.PDF. Accessed 12 Apr 2019 United Nations High Commissioner for Refugees (UNHCR) (2014) 1-year on from Typhoon Haiyan, Thousands of people still rebuilding lives. 7 Nov. http://unhcr.org/uk/news/ briefing/2014/11/545c9cda6/1-year-typhoon-haiyan-thousands-people-still-rebuilding-lives. html. Accessed 22 Mar 2019 Vidal J (2012) Bangladesh has seen the enemy that is climate change. Climate Central. https:// www.climatecentral.org/news/we-have-seen-the-enemy-bangladeshs-war-against-climatechange. Accessed 22 Mar 2019 Vidal J (2018) ‘Boats pass over where our land was’: Bangladesh’s climate refugees—photo essay. The Guardian (UK), 4 Jan. https://www.theguardian.com/global-development/2018/jan/04/ bangladesh-climate-refugees-john-vidal-photo-essay. Accessed 12 Apr 2019 Wennersten JR, Robbins D (2017) Rising tides: climate refugees in the twenty-first century. Indiana University Press, Bloomington, IN World Health Organization (WHO) (2011) Noncommunicable diseases country profiles. World Health Organization, Geneva. https://www.who.int/nmh/publications/ncd_profiles_report.pdf. Accessed 22 Jun 2019 World Health Organization (WHO) (2015) Human health and climate change in Pacific island countries. https://iris.wpro.who.int/bitstream/handle/10665.1/12399/9789290617303_eng.pdf. Accessed 22 Jun 2019

Chapter 7

Fleeing Coastal Erosion: Kivalina and Isle de Jean Charles

7.1  The Narrative 7.1.1  The Event For our Island people, it is more than simply a place to live. It is the epicenter of our Tribe and traditions. It is where our ancestors survived after being displaced by Indian Removal Act-era policies and where we cultivated what has become a unique part of Louisiana culture. Today, the land that has sustained us for generations is vanishing before our eyes. Our tribal lands are plagued by a host of environmental problems—coastal erosion and saltwater intrusion, caused by canals dredged through our surrounding marshland by oil and gas companies; land sinking due to a lack of soil renewal or “crevasse,” because of the construction of levees that separated us from the river; and rising seas. These environmental changes have led to increasing flood risk and changes in our life ways. For example, our Island needed a levee, but the small levee that protects our Island during high tide has also led our bayou to become stagnant, killing the ecosystem we once had. The need for reliable access to jobs and services up the bayou have forced many of our people to nearby areas, including Pointe-aux-Chenes, Bourg, Montegut, Chauvin, along Bayou Grand Caillou, and Houma. For over 15  years, we have been planning a Tribal Resettlement in order to bring our people back together, rejuvenate our ways of life, and secure a future for our Tribe (Isle de Jean Charles 2019).

7.1.2  The Displacement On the other side of the United States, a small village of approximately 350 people on the Ninglick River on the western edge of Alaska faces similar troubles ahead. In Newtok, rising seas and melting permafrost caused by climate change have meant © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_7

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the Ninglick is gradually eroding the land. “They see the river bearing down on them. They all accept it, they all know they have to leave,” said Joel Neimeyer, the co-chair of the Denali Commission, a federal agency tasked with coordinating government assistance for coastal resilience in Alaska. “The river is coming at 70 feet a year. You can just take out a tape measure and measure it” (Bagri 2017).

7.2  Coastal Erosion Over the past decade, several studies, including the Fourth IPCC Report ( 2013) and the National Climate Change Assessment (USGCRP 2018), have pointed to the accelerated rate of coastal erosion around the United States due to sea level rise. Especially vulnerable is the US Atlantic coast and the coastline along the Gulf of Mexico. King tides and “sunny day” flooding have become common occurrences in communities like Miami Beach, Florida, and Charleston, South Carolina. At 4.5 mm per year, Norfolk, Virginia, has the highest rate of sea level rise on the US East Coast and has been ranked 10th among the world’s port cities whose assets are at risk from rising seas by the Organisation for Economic Co-operation and Development (Kramer 2016). According to the US Army Corps of Engineers, the only US city in greater danger than Norfolk is New Orleans. Rising sea level is a problem for the entire low-lying region situated at the mouth of the Chesapeake Bay. Known as Hampton Roads, the region comprises seven major municipalities, ten smaller ones, and two million inhabitants. The sea level in Norfolk has risen 46 cm in the past 100 years, faster than the global average (Kramer 2016). Along with Norfolk, cities along the Eastern Seaboard like Baltimore, Charleston, and Miami have experienced a significant increase in sunny day flooding in the past decade (Morrison 2018). From 2011 to 2015, sea level rose an inch per year in some locales from North Carolina to Florida (Valle-Levinson et al. 2017). The cost of sea level rise and coastal erosion is likely to be immense. Throughout the United States, there are an estimated 49.4 million housing units in counties with coastal borders, and property values within one-eighth of a mile from the coast are worth at least $1.4 trillion. Flooding from rising sea levels and storms is likely to destroy, or make unsuitable for use, billions of dollars of property by the middle of the twenty-first century, with the Atlantic and Gulf coasts facing greater-than-­ average risk compared to other regions of the country (USGCRP 2018).

7.2.1  Alaska One of the parts of the United States where climigration is already underway is Alaska. For residents in many if not most communities, climigration may take the form of relocation of individuals or families. For residents in coastal communities, climigration will take the form of relocation of entire communities. In 2018, at least

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17 predominately Native American or Alaska Native were in the process of climate-­ related relocations (Stein 2018). Many of these communities reside in remote, isolated locations in Alaska where travel to and from the outside world occurs by air (small airfields), land (snowmobiles in the winter), and sea (boats during the summer months). The changes in climate contributing to coastal erosion are a manifestation of warming temperatures throughout the state. The average temperature across Alaska has increased by approximately 3° F over the past 60 years, more than twice the warming seen in the rest of the United States. Temperatures in the winter have increased by an average of 6° F and have led to an earlier breakup of river ice in the spring. By the middle of this century, average annual temperatures in Alaska are projected to increase an additional 2–4°  F (EPA 2017; Chapin et  al. 2014). This increase in temperature is likely to lead to an increase in the rate of coastal erosion in Alaska through two mechanisms. First, coastal communities located in western Alaska depend on Arctic sea ice to protect them from the storms that originate in the Bering and Chukchi Seas and cause hurricane-strength damage on the coast due to wave action and storm surges (Shulski and Wendler 2007). A delay in freezing of the Arctic seas prevents the nearshore pack ice from forming and exposes many coastal communities to the flooding and erosion caused by storms that originate in the Bering and Chukchi Sea and occur primarily between August and early December (Shulski and Wendler 2007). Second, climate change leads to more permafrost thaw and disruptions to freeze-thaw cycles, potentially causing damage to transportation infrastructure, including highways, railroads, and airstrips (EPA 2017; U.S. Arctic Research Commission Permafrost Task Force 2003).

7.2.2  Gulf of Mexico Coastal erosion due to climate change is also occurring in other parts of the United States, most notably in the Gulf of Mexico. From 2005 to 2008, a series of hurricanes batter the coast of Louisiana and neighboring states. In Louisiana alone, approximately one-fourth of the state’s wetlands are believed to have disappeared for good. “Louisiana is experiencing the most severe wetland loss and barrier island erosion in North America. Rates of land loss exceed 100 square kilometers per year in the Mississippi River delta and chenier plains. Rapid sea level rise induced by delta-plain subsidence and a deficit of terrigenous wetland sediment are the primary factors driving the rapid deterioration of the Louisiana coastal zone” (Penland and Ramsey 1990: 323). One community impacted by this erosion is Isle de Jean Charles, Louisiana, home to 99 members of the Biloxi-Chitimacha-Choctaw band of Native Americans. The community is connected to the mainland by a four-mile stretch of road that lies inches above sea level and immediately drops off into open water on either side. “Even on a calm day, salt water laps over the road’s tenuous boundaries and splashes the concrete” (Stein 2018). The physical erosion of this lifeline to the outside world

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is the product of sea level rise and the dredging done by oil and gas companies to lay pipelines and canals, which has allowed saltwater to intrude and kill the freshwater vegetation that held the land together. Since 1955, the community has lost 98% of its land (Stein 2018). Many homes are raised on stilts to avoid damage from floodwaters. When the road out of the community is flooded, access to vital resources like hospitals is restricted (Stein 2018). Once a thriving fishing community, many residents of Isle de Jean Charles commute off-island for work (Baurick 2017). Other residents have moved away due to frequent flooding and storm damage or for health reasons.

7.3  Patterns of Displacement 7.3.1  Numbers of Climigrants With increasing coastal erosion, estimates of outmigration from vulnerable communities with and without adaptation range from two million to 2.5 million from Miami and south Florida; from 373,000 to 500,000 from New Orleans; and from 15,808 to 50,804 in New York-New Jersey (Hauer 2017). Hauer et al. (2016) estimated a sea level rise SLR of 0.9 m would likely threaten the habitability of 4.2 million people in the United States; a SLR of 1.8 m would place 13.1 million people at risk for climigration. Climate change impacts are expected to drive climigration from coastal locations, but exactly how much displacement will occur remains uncertain. As demonstrated by the migration of affected individuals in the wake of Hurricane Katrina, impacts from storms can disperse climigrants from coastal areas to all 50 states, with economic and social costs felt across the country. Sea level rise might reshape the US population distribution. However, an assessment of the extent of displacement due to coastal erosion is quite difficult because there are no common reporting systems (Gutman 2018). One of the Alaska Native communities already severely impacted by this climate-­ related erosion is the Inupiat village of Kivalina, located on a barrier reef of 27 acres approximately 80 miles north of the Arctic Circle. In 1992, Kivalina residents voted to relocate their entire community, primarily because of the steady erosion of the land surrounding their community. The decision was later supported by a US Government Accountability Office study (GAO 2003) and an Army Corps of Engineers study (USACE 2006): The erosion impacts infrastructure that is essential for the viability of the community in its current location. These include the only means of access to the community, the summer barge landing and the community’s airstrip, the community’s sole water source, and the stability of the community’s sewage containment area (ANTHC 2011; USACE 2006). According to the USACE 2006 report, the entire community will be lost to erosion by 2026 without erosion protection. (Bronen 2013: 16)

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However, the community has yet to relocate despite continuing and widespread damage to the community’s infrastructure and severely diminished availability of land. A major reason for the delay in relocation has been the relative absence of support from federal and state government agencies. “Government officials tasked with ensuring public safety lack the power to fully assess, mitigate, and address the problem. This has left Kivalina in what is termed here as an ‘administrative orbit,’ with residents made to work their way through a patchwork of various government programs and procedures that are time-consuming and often insufficient” (Shearer 2012: 174). Consequently, the community lacks the funds to relocate, although in 2016–2017 the Alaska Legislature appropriated $50.5 million for the construction of a new school at a proposed relocation site for the community (Oliver 2018). Another obstacle to relocation is the dependence on the existing infrastructure available in communities of origin. “Historically, communities could move away from areas affected by erosion because they did not depend on built infrastructure. However, the construction of public facilities such as power plants, schools, health clinics, and airports tie communities to the land and limits their ability to move (USACE 2009)” (Bronen 2013: 5). Another community severely impacted by coastal erosion is the Yup’ik village of Newtok, where approximately 400 residents live in an area surrounded by flat marshlands along the Ninglick River near the Bering Sea in western Alaska. Like Kivalina, Newtok is experiencing accelerated rates of erosion due to wave action and thermal degradation of the permafrost-rich riverbank (Cox 2007). For Newtok, however, this erosion has been exacerbated by the occurrence of six extreme weather events between 1989 and 2006 (Bronen 2013). As a result, the entire village has taken on a warped appearance. Homes slump, telephone poles tilt at odd angles, and boardwalks are sinking in the mire. In 2005, rising storm waters completely surrounded the village for several days, submerging boardwalks, destroying fuel storage facilities, shutting down utilities, spreading sewage-laced floodwater throughout the community, and displacing people from their homes. “Experts predict that the old village will be washed away by 2019 if not sooner” (Hirsch 2017: 15). Unlike Kivalina, Newtok has identified a relocation site, accepted by state and federal government agencies, by using existing funding streams available to communities. However the relocation process has been proceeding slowly with no clear timeline for when community members will be able to relocate (Bronen 2013). The US Army Corps of Engineers estimated the cost of relocating Newtok at $80 million to $130 million (Hirsch 2017). In 2018, the village received $15 million as part of a new federal spending bill to assist with relocation efforts. However, local residents are less concerned about the monetary cost of relocating than they are about the cost to future generations of failing to relocate (DeMarban 2018). In collaboration with the Louisiana Office of Community Development, Disaster Recovery Unit, the community of Isle de Jean Charles submitted an application for funding available through the Natural Disaster Resilience Competition, established during the Obama administration in 2014, to relocate the entire community. The Isle de Jean Charles Resettlement Project was awarded $48.3 million (Davenport and Robertson 2016). A 515-acre parcel of land located north of the island in rural

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Terrebonne Parish was identified as a potential site for relocation. This site can accommodate both current residents of Isle de Jean Charles along with former residents who have relocated to other parts of Terrebonne and neighboring parishes. However, after having resettled elsewhere, the exact number of former residents who ultimately will move to this proposed site remains unknown. Moreover, some of the older residents who had hoped to relocate shortly after the grant was awarded in 2016 continue to live in Isle de Jean Charles and have lost interest in moving (Baurick 2017). Further, although the proposed relocation site is located several miles inland, flooding and storms will still have an impact over the next century as the high rate of coastal land loss brings the shoreline closer to the new community (Baurick 2017).

7.3.2  Displacement-Related Decisions 7.3.2.1  Change in Physical Environment As attested by the above examples, climigration of individuals, families, and entire communities will be motivated, in part, by the persistent flooding and coastal erosion of certain parts of the country. As Zanolli (2016) observes, Terrebonne Parish has experienced a hurricane and/or severe flooding every 2 or 3 years since 1998, leading to major population shifts within the parish. Since 2010, 20% or more of the residents of some bayou communities have relocated to towns north of the town of Houma. However, coastal erosion in this area is not due solely to sea level rise or storms. In Louisiana, for example, canals dredged by oil and gas companies drilling in the areas and levees built along the Mississippi River are impeding the deposit of sediment that would otherwise replenish coastal land (Zanolli 2016). 7.3.2.2  Economic Impacts However, while the energy sector of local and regional economies may contribute to the pace of climate change impacts to the physical environment, these impacts are likely to have negative consequences for other sectors, most notably subsistence production in smaller, Native communities. In Alaska, for example: as temperatures warm, moose are moving north. Caribou and salmon are disappearing from their normal ranges and seeking new territories. Across the tundra, certain species of berries and other plants are disappearing, replaced by shrubs and trees. These changes put a profound strain on the indigenous peoples of the Arctic, many of whom move between seasonal camps and rely on hunting, fishing and foraging for food. (Hirsch 2017: 12)

Although large and small communities alike are projected to experience significant damage to housing and infrastructure, small communities will be especially vulnerable. For instance, children living in Isle de Jean Charles often miss school when flooding blocks their school bus (Davenport and Robertson 2016). Residents of

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Lafitte, Louisiana, which saw a 21% decline in its population between 2000 and 2010, have lived off the water for generations—trapping and skinning muskrats and other marsh dwellers, fishing, crabbing, oystering, building and repairing boats, and ferrying workers and supplies to offshore rigs. However, SLR and coastal erosion will also impact large cities like Miami and New Orleans and communities along the Eastern seaboard. 7.3.2.3  Health Impacts Another important motivation for relocation will increasingly be tied to the health impacts of climate change and coastal erosion. Isle de Jean Charles has reportedly been plagued with mold and mildew problems for several years, and many of the islands have health problems as a result (Zanolli 2016). Although it has yet to be linked to any decision of residents in communities like Kivalina and Newtok to relocate: increasing temperatures have enabled new diseases to expand in Alaska – such as Vibrio parahaemolyticus and gastroenteritis in Prince William Sound oysters. Epidemiologists have noticed increases in the number and extent of existing diseases such as botulism (e.g., Shishmaref), paralytic shellfish poisoning, giardiasis; Trichinella from walrus; and anisakiasis from anadromous and marine fishes. Also noted in a geographic expansion of diseases such as Giardia (as beavers expand their territories) and increases in bacterial skin infections from a variety of sources… Projections indicate a greater number of diseases including Echinococcus multilocularis (parasitic tape worm disease), and a greater incidence of skin infections. In addition, there is considerable concern about the emergence of new or existing vector-borne diseases as temperatures become warm enough to support ticks, different species of mosquitoes, etc. (e.g., West Nile virus, Lyme disease, tularemia) and the emergence of new viral diseases transmissible to humans from rodents due to expanding populations and latitudinal shifts in distribution (e.g., ‘roboviruses’ in white footed deer mice and voles). (Callaway 2018: 5)

In addition to the emergence of new infectious diseases, the depletion of fish and game linked to climate change could have potentially adverse health impacts. Alaska Native peoples depend economically, nutritionally, and culturally on subsistence harvesting of fish and game. These resources are vulnerable to climate change and their loss would affect food availability and human health (Chapin et al. 2014). Along with the decrease in availability of nutritious subsistence food, climate change has the potential to impact traditional strategies for combatting fluctuating subsistence resources like harvesting multiple species and exchanging subsistence items with other communities: Some preferred marine mammals such as walrus and seal populations are already in sharp decline with the retreating arctic ice cap, caribou have already suffered a 50% decline throughout the arctic, and parasitic organisms such as Ichthyophonus (associated with warmer waters) are starting to infest salmon stocks. Thus, climate change presents a new, more encompassing threat, in that multiple subsistence resource categories may be at risk at the same time, although from different climate drivers. These impacts limit the opportunity within a community to ramp up the harvest of alternative species. (Callaway 2018: 2–3)

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The health of native communities is also threatened by loss of clean water, saltwater intrusion, and sewage contamination from thawing permafrost, as well as by the northward expansion of diseases. Warming also increases exposure to toxic chemicals, such as mercury and organic pesticides, that have been transported to Arctic regions or are stored in landfills and are released when the soil begins to thaw (Chapin et al. 2014). There will also be increasing exposure to pesticides used to control mosquitoes carrying West Nile virus that have extended their territory throughout the state as a result of increased temperatures (Callaway 2018). Such contamination has already occurring in the village of Newtok. Between 1994 and 2004, 29% of Newtok infants were hospitalized with lower respiratory tract infections because of high levels of community contamination and lack of potable water for drinking and hygiene/sanitation practices (ASCG 2008). Increased salinization of soil due to coastal flooding has also affected the availability of potable water (Cox 2007). Climate change also creates the potential for an increase in accidental injuries due to traveling farther out to sea on thinning ice in search of depleted stocks of fish and marine mammals, increased possibility of injury and death from exposure to more intense or more frequent storms, and greater injuries from increased icy road conditions (Callaway 2018). To date, however, there has been no evidence of a significant increase of accidental injuries associated with coastal erosion in any part of the United States apart from some anecdotal evidence. Increased erosion of the nation’s coastline is also likely to impact both availability of and demand for health services. In Isle de Jean Charles, for instance, Davenport and Robertson (2016) cited the example of a woman with lupus who is afraid of what will happen if she is sick and cannot reach a doctor when the only road out of the community is flooded. In Alaska, increases in extreme events such as flooding and storms, damage to waste and sewage facilities, introduction of new infectious diseases, and clinical issues resulting from community and individual response to adverse sociocultural and economic circumstances are likely to place greater demands on existing health-care and emergency response systems, especially during major events (Callaway 2018). Perhaps the greatest health impact associated with climate change in coastal communities is stress, anxiety, and uncertainty related to storm damage and coastal erosion. According to Callaway (2018: 7): At numerous gatherings, people throughout the state, but especially rural Alaskans, express concern and depression about present changes and projected future changes in Alaska’s climate and the resulting impacts on culture, subsistence, traditional knowledge and ways of knowing, fish, and wildlife. In addition, continuing losses in community infrastructures, community relocation and dislocation, and changed winter recreational activities all have the potential to impact the rural Alaskan way of life. All of these changes portend drastic outcomes for mental health, community wellness, family integrity, and potential increase in alcoholism, drug use, and other destructive coping behaviors.

As noted earlier, there has also been considerable stress and anxiety related to uncertainty and delays in relocation in communities impacted by coastal erosion.

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Although the health impacts of both the climate change impacts on the physical environment have yet to be conducted, the experience of similar Native American and Alaskan Native communities in Alaska in the aftermath of the Exxon Valdez oil spill in 1989 provides an illustration of potential impacts on health and social welfare. The oil spill, which occurred in 1989, was an acute event like a hurricane, but did not result in any loss of human life. Rather, its primary manifestation was a short-term destruction of the local ecosystem that provided the basis for local commercial fishing and subsistence activities, as well as long-term degradation of the physical environment. Most notably, the event represented the death of a way of life, at least in the short term. Several studies reported increased rates of posttraumatic stress symptoms in individual communities in the aftermath of the Exxon Valdez oil spill (Donald et al. 1990; Picou et al. 1997; Picou and Gill 1996). The Oiled Mayors Study found that exposure to the oil spill and subsequent cleanup in general and loss of subsistence resources and activities in particular was significantly associated with the post-spill prevalence of generalized anxiety disorder (GAD), PTSD, and depressive symptoms (Palinkas et al. 1992, 1993a, b, 2004; Russell et al. 1996); a significant increase in alcohol and drug abuse and associated problems in the community and among family and friends (Palinkas et al. 1993a; Russell et al. 1996); a significant decline in perceived health status and an increase in both self-report and physician-verified post-spill physical health symptoms, including heart disease, high blood pressure, diabetes, thyroid problems, cancer, asthma, ulcers, bronchitis, chronic coughs, and skin rashes (Impact Assessment 1990; Palinkas et al. 1993a); reports of domestic and interpersonal violence within the family (McLees-Palinkas 1994); and several child outcomes such as a decline in children’s relations with other children in community, an increase in sleep disturbances, and a decline in academic performance (McLees-Palinkas 1994). Individuals who reported loss of important economic, cultural, and social resources experienced significantly higher levels of psychological symptoms and prevalence of psychiatric disorders. In the Oiled Mayors Study, 54.8% of Alaska Natives and 45.2% of non-Natives reported a decline in subsistence activities compared to the same period a year before the spill (Palinkas et al. 2004). In both groups, a decline in subsistence activities was significantly associated with a significantly higher rate of PTSD.

7.4  Impacts of Displacement 7.4.1  Impacts on the Displaced Since there has been no relocation of an entire community due to coastal erosion to date, the likely impacts on displaced residents remain unknown. Some have relied on anecdotal evidence to argue that these residents will experience adverse mental

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and behavioral health consequences with relocation. Stein (2018), for instance, asserts that: “relocation will always be traumatic. Even if there is government support and the promise of a shiny new town, coming to grips with the dissolution of your home comes with existential pain.” Using the relocation of the community of King Island as a precedent, Callaway (2018: 4) points to post-relocation problems from increased drinking, domestic violence, and other social problems: “Uprooting your entire life is traumatic and brings with it tremendous stresses.” Another potential consequence of community relocation is increased social isolation of residents. This may be less of an issue when communities move altogether or individual residents move to communities to be near extended family. However, anything that might jeopardize community relations is a potential source of anxiety and uncertainty (Martin 2018). Social ties are critical to cultural continuity and individual well-being (Palinkas 1987) and are reinforced by collective production and distribution of subsistence harvests. While geographic dispersal of extended kind groups limits the opportunities for these subsistence activities, opportunities are also limited by loss of subsistence resources due to climate change. Native populations are thus faced with a dilemma of either moving as individuals or remaining in their communities; both choices risk loss of subsistence activities and cultural identity. The only solution is to move as a community to a place where these activities can continue.

7.4.2  Impacts on Community of Origin Conflict may also arise within the climigrants of relocated communities. For instance, a lack of consensus on where to relocate has shown itself to be a potential flashpoint for conflict within impacted communities. In Isle de Jean Charles, for instance, some residents have expressed a desire to relocate in the most northern corner of the parish, while others have expressed a preference to staying near their old homes, jobs, and families (Stein 2018). The lack of trust of impacted communities in the willingness and ability of government agencies to assist them has been noted in Isle de Jean Charles, LA. Stein (2018) quoted one resident who asserted “We learned a long time ago not to trust when they come with paper and pen.” Mistrust of the government’s intent and doubt that it will follow through on its commitments to the community persists. The lack of trust extends to the oil and gas companies that contributed to the coastal erosion as well as to government agencies tasked with relocating the community. However, like many other coastal communities in Louisiana, residents of Isle de Jean Charles residents rely on the oil and gas industry for employment despite the fact that this same industry has contributed to land erosion by dredging innumerable canals in the area (Zanolli 2016). The same lack of trust and frustration in working with government agencies has been evident in Alaska Native village efforts to relocate. In 2000, Kivalina voted to pursue relocation to Kiniktuuraq, a site a mile southeast of the village on the

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Chukchi Sea coastline that had long been used by residents as a camping ground during hunting trips. However, an evaluation of the site by the Army Corps of Engineers concluded that it was “vulnerable to erosion and must be armored using armor rock and riprap” (USACE 2006: 77). This frustrated Kivalina residents because it conflicted with their traditional knowledge of the area. “Indigenous knowledge … is often treated as anecdotal and non-scientific (Bielawski 1996) and thus ineligible for meeting NEPA requirements, as well as FEMA flood plain insurance” (Shearer 2012: 179): With low populations and high construction costs in rural Alaska, Alaska Native village mitigation plans are often not seen as cost-effective (GAO 2009). Eligibility for FEMA’s two disaster recovery program and also the Hazard Mitigation Grant Program is generally limited to areas that have been declared federal disasters. Since many of the villages are facing gradual erosion problems and have not received a declared disaster designation, they do not qualify for these programs (GAO 2009). (Shearer 2012: 179)

In Kivalina, villagers perceive the government as unreliable, eroding their trust in government agencies and procedures (Shearer 2012). At a meeting of the Immediate Action Workgroup in Fairbanks in 2007, Stanley Tom, tribal administrator for the Newtok Traditional Council, summed up the challenges Newtok faces “No agency has authority to lead relocation efforts: No funding specifically for relocation; Patchwork funding from agencies and grants” and noted that ‘Getting funding takes time that we don’t have. We can’t keep up with the erosion’ (IAWG 2007)” (Bronen 2013: 13). Loss of cultural identity is another potential impact of community relocation. As noted above, residents of coastal communities have experienced reduced opportunities to engage in traditional subsistence activities with relocation. In Isle de Jean Charles, for instance, Native American residents have fished and hunted in the area since the nineteenth century (O’Dowd 2017). Loss of culture has been a major concern of these residents as well as non-Native residents of other Louisiana coastal communities threatened with the possibility of forced climigration (Davenport and Robertson 2016; Sack and Schwartz 2018). In Alaska, shifts and dislocations of subsistence species have the potential to interrupt traditional sharing practices and compromise subsistence contributions to diet. Changes in subsistence harvests, in turn, have drastic impacts on social networks, which in turn can have substantial impacts to emotional and physical health (Callaway 2018): Proposals to relocate communities to larger, more secure villages have been rejected by numerous communities (including Newtok, Shishmaref, and Kivalina). The reasons expressed for the rejection of these alternatives center on loss of ready access to well-­ known subsistence resources, loss of history and a sense of an intact community and fear of loss of support from extended kin (social networks) integral to survival. (Callaway 2018: 5)

In both Alaska and the Gulf Coast, displaced residents will also be engaged in efforts to seek compensation for relocation through litigation. Residents of Kivalina and Isle de Jean Charles have already experienced being caught in the middle in lawsuits between local and state governments and tribal entities and oil and gas companies. For instance:

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In 2013, the South Louisiana Flood Protection Authority  – East filed suit against thirty-­ seven oil and gas companies in what the New York Times called ‘the most ambitious environmental lawsuit ever.’ The lawsuit argued that the fossil fuel companies were supposed to fill in the canals after they were finished using them and that they broke their permits by not doing so and now need to take responsibility for the damages. But the lawsuit faced fierce opposition by local and state politicians who are interested in protecting the oil and gas industry, a major source of economic activity. (Wennersten and Robbins 2017: 88)

Ultimately, a state judge ruled against the flood authority’s lawsuit. At the same time, the councils of Plaquemines Parish and Jefferson Parish also filed several lawsuits against the oil and gas industry for damages to wetlands. In turn, the industry donated heavily to the campaigns of the others running for council positions in the 2014 elections. The effort succeeded because many of the original council members who filed the original motion to begin lawsuits were no longer in office, and the new council members voted to drop the lawsuits (Wennersten and Robbins 2017). In 2008, the village of Kivalina filed a legal claim against 24 oil, electricity, and coal companies for their greenhouse gas emissions, exacerbating global warming and the erosion of Kivalina’s coastline and seeking damages equivalent to village relocation. The case was dismissed and appealed to the US district court, which dismissed it again on the grounds that the greenhouse gas emissions needed to be regulated by the Congress, not the courts. A final appeal to the Supreme Court was unsuccessful after the Court refused to hear it in 2013 (Wennersten and Robbins 2017). Participation in litigation in the aftermath of the Exxon Valdez oil spill was also significantly associated with symptoms of depression and PTSD (Arata et al. 2000). Picou et al. (2004) found that the litigant status and litigation stress were significant predictors of intrusive stress three and one half years after the oil spill.

7.4.3  Impacts on Host Communities As was the case with communities that hosted displaced residents of New Orleans in the aftermath of Hurricane Katrina, communities that host residents displaced by coastal erosion are likely to experience increased demand on available goods and services, including housing, education, jobs, and health and social services. Hauer (2017) estimated that a mean sea level rise of 1.8 m could result in a net migration of 818,938 climigrants to Austin, Texas; 461,411 climigrants to Orlando, Florida; and 320,937 climigrants to Atlanta, Georgia. In addition to separation of residents from traditional sources of support, relocation from small rural communities may lead to increased conflict between relocated residents and residents of host communities. As Callaway (2018: 4) notes, “Households moving into new communities may not receive the respect and political influence that they enjoyed in their home community, and most importantly social networks rarely transfer intact and the underlying support that households and families enjoyed in their home communities may be fractured or may cease to function altogether.”

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There has also been conflict between communities over relocation efforts. In Louisiana, for instance, Chiefs of the Biloxi-Chitimacha-Choctaw and the United Houma Nation debated who would be allowed to live there beyond the islanders themselves and whether some islanders could resettle elsewhere. A buffer area between the new community and its surrounding neighborhood has been suggested as a way of reducing the tension between the two groups (Davenport and Robertson 2016).

7.5  Lessons Learned While relocation of entire communities due to climate-related coastal erosion has yet to occur, the examples of small communities like Kivalina and Isle de Jean Charles offer some valuable lessons for other communities that will face similar pressure to relocate. We conclude this chapter with a discussion of how small Alaska Native and American Indian communities can serve as a model for other communities, the role of the federal government in the process of relocation, the fundamental role of disparities in erosion impacts and relocation experiences, the consequences of relocating as an entire community or as dispersed individuals and families, and the priority given to maintaining social and cultural continuity versus embracing and preparing for change.

7.5.1  Models for Other Coastal Communities Although it is unlikely that large urban areas like Miami, Norfolk, or New Orleans will see wholesale climigration and relocation in the near future, in the next 50 years, there may be efforts to relocate entire neighborhoods in larger cities and entire smaller communities. The chief motivation for such relocation is likely to be reduced habitability and potentially reduced employment opportunities. As coastal erosion reduces the amount of habitable space, residents will have no choice but to look elsewhere for places to live. Construction of seawalls and other barriers will have limited effect. Coastal erosion will also produce erosion of infrastructure that will have economic consequences, eroding access to goods and services and precipitating relocation of businesses in search of more supportive infrastructure, taking jobs with them. Relocation is also likely to add to feelings of stress and anxiety of potential climigrants as they become involved in litigation that seeks to provide compensation for damages to property and expenses incurred for relocation and social conflict between segments of the community that are more impacted by erosion and segments that are less impacted and face increasing uncertainty about their future if they choose to stay or choose to leave.

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7.5.2  Federal Responses to Coastal Erosion The impending relocation of small Native American communities also provides some insight into the potential for government assistance and support for relocation. Until recently, federal agencies have been unwilling to invest in rebuilding communities impacted by coastal erosion or to pay for relocation of entire communities. Coastal erosion due to global warming has not been viewed the same way by FEMA as a hurricane or tornado. The Stafford Act prohibits use of federal funds to relocate entire communities; consequently, billions of dollars are spent on rebuilding in areas devastated by natural disasters, but relatively little is being spent once it has been determined that rebuilding is no longer possible (FEMA 2019). Among the issues that federal agencies must face in the decision to relocate has been the cost of relocation. Stein (2018) notes with respect to Isle de Jean Charles: The location of the soon-to-be town is also largely a question of economics. Small, rural towns all over the U.S. are dying for a myriad of reasons other than environmental inundation. The project planners want to keep residents as close as possible to their former lives, but they also have to avoid spending $48 million to save a town from environmental hazards only to have it fold because of economic ones.

The availability of employment and services in a newly constructed community is another source of concern. The residents of Isle de Jean Charles, for instance, must decide whether there are sufficient jobs available near the new townsite and whether such jobs match their skills and career experience. As Stein (2018) observes, “many Isle de Jean Charles residents make a living fishing, which limits how far away from the water they can move. Too far north and you’ll keep the town dry but create an unemployment crisis” (Stein 2018). Relocating residents must also consider the availability and proximity of grocery stores, schools, and health-care facilities to service the community. A third concern is the cost of preserving the cultural integrity of the community: The population of Isle de Jean Charles is aging and dwindling, and if new people aren’t attracted to join the community once it relocates to the new site, it could cease to exist. On the other hand, the influx of new residents with no historical ties to the displaced residents could result in the emergence of new traditions and identity and disappearance of the old traditions and identity, thereby defeating the original purpose of relocation. (Stein 2018)

7.5.3  Disparities in Displacement Small Native American communities like Kivalina and Isle de Jean Charles are also relatively poor with few options but to remain until the land is no longer habitable or to move to even less desirable locations for the sake of remaining intact as social groups. Several authors have noted that poor residents and communities have fewer options than affluent communities or residents when confronted by increased coastal erosion. With fewer resources and political clout needed to remain, they will

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be forced either to relocate or to remain and continue to suffer damage to property and diminishing resources. The poor living in low-income neighborhoods will experience coastal erosion sooner, with greater impact to habitable living space than their more affluent neighbors (Goodell 2017). The affluent will also have more options as to when and where to relocate than the poor. As Goodell (2017: 280) asserts: Wealthy people will take care of themselves, either by moving their homes or elevating them or building seawalls or simply writing off the house as it crumbles into the sea, but for the vast majority of people who live on coastlines, it’s going to be a tough day when they wake up and realize that their state or federal government doesn’t have the money or the political will to rescue them.

For residents forced to relocate, migration will further deplete economic resources and add to migration-related stress and anxiety.

7.5.4  Cohesion vs. Dispersion Another consideration in climigration due to coastal erosion is the decision whether to relocate entire communities or to provide assistance to individual residents to relocate to other communities. The latter strategy may be financially more cost-­ effective as state and federal agencies would not have to pay for the cost of acquiring new land and construction of housing and infrastructure to support a relocated community. On the other hand, relocation of individual residents may possibly create a burden on existing services and infrastructure for host communities. It may also result in reduced levels of social support for these residents as existing networks of families, friends, and neighbors become fragmented with relocation of individual members to different communities or parts of the country.

7.5.5  Continuity vs. Change Finally, communities considering relocation and the government agencies that can assist them must consider the choice between engaging in efforts to retain traditional social and cultural systems and preparing communities for social and cultural change. This choice is linked to the decision to relocate as an entire community for the purpose of maintaining some form of social identity and cohesion as members of a distinct community or relocating as individuals or families as the perceived need arises. While residents of a community impacted by coastal erosion may experience the same motivating circumstances such as reduced habitability, the decision of when and where to move may be motivated by different considerations. For instance, older residents may seek to relocate as an entire community to areas where they can continue to engage in the traditional subsistence economy and regain a

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sense of cultural continuity across generations, as in the case of Isle de Jean Charles, while younger, better educated residents may wish to relocate as individuals to seek opportunities for better-paying jobs in the market economy in larger urban areas. As noted throughout this chapter, many residents of traditional Native American communities seek relocation for the purpose of maintaining a way of life that is rapidly disappearing due to coastal erosion as well as exposure to the outside world. Younger residents, on the other hand, express a greater willingness to adopt new values and lifestyles, which can be found outside the community. Both the pace of relocation and the choice of location may be linked to generation with older residents being among the last to relocate with a preference to climigrate as an entire community to rural locations and younger residents being among the first to relocate with a preference to climigrate as individuals or families to urban locations. Differences in climigration preferences, in turn, may exacerbate tension and conflict between generations and accelerate the disappearance of traditional ways of life in favor of those associated with the larger society. Population displacement related to climate-related coastal erosion and other changes in the physical environment must therefore be understood in the context of time as well as space. The factors that motivate people to climigrate are not just environmental but also social and cultural. For some, the decision of when and where to move will be motivated by a desire to hold on to the past, while for others, it will be motivated by a desire to embrace the future.

References Alaska Native Tribal Health Consortium (ANTHC) (2011) Climate change in Kivalina, Alaska. Alaska Native Tribal Health Consortium Center for Climate and Health, Anchorage, AK Arata CM, Picou JS, Jonson GD et al (2000) Coping with technological disaster: an application of the Conservation of Resources model to the Exxon Valdez oil spill. J Trauma Stress 13:23–39 ASCG (2008) Village of Newtok, local hazards mitigation plan. ASCG Inc. of Alaska Bechtol Planning and Development, Newtok Bagri NT (2017) The US is relocating and entire town because of climate change. And this is just the beginning. Quartz, 5 Jun. https://qz.com/994459/the-us-is-relocating-an-entire-townbecause-of-climate-change-and-this-is-just-the-beginning/. Accessed 16 Sept 2019 Baurick T (2017) Here’s where residents of sinking Isle de Jean Charles will relocate. Times-­ Picayune, 19 Dec. https://www.nola.com/environment/index.ssf/2017/12/site_chosen_for_ relocating_isl.html. Accessed 9 Aug 2019 Bielawski E (1996) Inuit indigenous knowledge and science in the Arctic. In: Nader L (ed) Naked science: anthropological inquiry into boundaries, power, and knowledge. Routledge, New York, pp 216–227 Bronen R (2013) Climate-induced displacement of Alaska Native communities. Brookings—LSE Project on Internal Displacement. The Brookings Institution, Washington, DC. https://www. brookings.edu/wp-content/uploads/2016/06/30-climate-alaska-bronen-paper.pdf. Accessed 4 Apr 2019 Callaway D (2018) The long term threats from climate change to rural Alaskan communities. Alaska Park Sci 12(2):1–8. https://www.nps.gov/articles/aps-v12-is-c15.htm. Accessed 9 Aug 2018

References

143

Chapin FS III, Trainor SF, Cochran P et al (2014) Ch 22: Alaska. In: Melillo JM, Richmond TC, Yohe GW (eds) Climate change impacts in the United States. U.S. Global Change Research Program, Washington, DC, pp 514–536 Cox S (2007) An overview of erosion, flooding, and relocation efforts in the native village of Newtok. Alaska Department of Commerce, Community and Economic Development, Anchorage, AK Davenport C, Robertson C (2016) Resettling the first American ‘climate refugees’. New  York Times, 2 May. https://www.nytimes.com/2016/05/03/us/resettling-the-first-american-climaterefugees.html. Accessed 9 Aug 2018 DeMarban A (2018) $15 million from feds a ‘dream come true’ as Alaska village plans relocation. Anchorage Daily News, 27 Mar. https://www.adn.com/alaska-news/ruralalaska/2018/03/26/15-million-in-spending-bill-a-dream-come-true-as-alaska-village-plansmove/. Accessed 9 Aug 2019 Donald R, Cook R, Bixby RF et  al (1990) The stress related impact of the Valdez oil spill on the residents of Cordova and Valdez, Alaska: a comparative study conducted by the Valdez Counseling Center. Valdez Counseling Center, Valdez, AK Environmental Protection Agency (EPA) (2017) Climate impacts in Alaska. Snapshot 19 Jan. https://19january2017snapshot.epa.gov/climate-impacts/climate-impacts-alaska_.html. Accessed 8 Aug 2019 Federal Emergency Management Agency (FEMA) (2019) Robert T. Stafford Disaster Relief and Emergency Assistance Act, 12 Jun. https://www.fema.gov/robert-t-stafford-disaster-relief-andemergency-assistance-act-public-law-93-288-amended. Accessed 19 Oct 2019 Goodell B (2017) The water will come: rising seas, sinking cities, and the remaking of the civilized world. Little, Brown, New York General Accounting Office (GAO) (2003) Alaska Native villages: most are affected by flooding and erosion, but few qualify for federal assistance. GAO Report GAO-04-142. General Accounting Office, Washington, DC.  https://www.gao.gov/assets/250/240810.pdf. Accessed 19 Oct 2019 Government Accountability Office (GAO) (2009) Alaska native villages: limited progress has been made on relocating villages threatened by flooding and erosion. GAO Report GAO-09-551. Government Accountability Office, Washington, DC. https://www.gao.gov/new.items/d09551. pdf. Accessed 19 Oct 2019 Gutman R (2018) The three most chilling conclusions from the climate report. The Atlantic, 26 Nov. https://www.theatlantic.com/science/archive/2018/11/most-chilling-parts-2018-climateassessment/576598/. Accessed 16 Apr 2019 Hauer M (2017) Migration induced by sea-level rise could reshape the US population landscape. Nat Clim Change 7:321–325 Hauer M, Evans JM, Mishra DR (2016) Millions projected to be at risk from sea-level rise in the continental United States. Nat Clim Change 6:691–695 Hirsch R (2017) Climate migrants: on the move in a warming world. Twenty-First Century Books, Minneapolis, MN IAWG (2007) Meeting summary. 6 Nov. Alaska SubCabinet on Climate Change, Immediate Action Workgroup, Juneau, AK Impact Assessment (1990) Economic, social, and psychological impact assessment of the Exxon Valdez oil spill. Final report. Prepared for Oiled Mayors Subcommittee, Alaska Conference of Mayors. Impact Assessment, La Jolla, CA Intergovernmental Panel on Climate Change (IPCC) (2013) Climate change 2013: the physical science basis. In: Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York Isle de Jean Charles (2019) The Island. http://www.isledejeancharles.com/. Accessed 1 Nov 2019 Kramer D (2016) Norfolk: a case study in sea level rise. Phys Today:22–25

144

7  Fleeing Coastal Erosion: Kivalina and Isle de Jean Charles

Martin A (2018) An Alaska village is falling into the sea. Washington is looking the other way. PRI’s The World, 22 Oct. https://www.pri.org/stories/2018-10-22/alaskan-village-falling-seawashington-looking-other-way. Accessed 12 Nov 2018 McLees-Palinkas TL (1994) Psychosocial impacts of disasters on families and children: the Exxon-Valdez oil spill. Master’s Thesis. San Diego State University, San Diego, CA Morrison J (2018) Flooding hot spots: why seas are rising faster on the U.S.  East coast. Yale Environment 360. https://yale.edu/features/flooding-hot-spots-why-seas-are-rising-faster-onthe-u.s.-east-coast. Accessed 12 Nov 2018 O’Dowd P (2017) An island in Louisiana’s bayou is vanishing, and its residents are fleeing to higher ground. WBUR Here and Now, 5 Jun. http://www.wbur.org/hereandnow/2017/06/05/ louisiana-isle-de-jean-charles. Accessed 9 Aug 2018 Oliver SG (2018) Funding secured for Kivalina school, access road. Anchorage Daily News, 11 Aug. https://www.adn.com/arctic/2018/08/11/funding-secured-for-kivalina-school-accessroad/. Accessed 12 Jan 2019 Palinkas LA (1987) Points of stress and modes of adjustment in southwest Alaska. Hum Organ 46:292–304 Palinkas LA, Russell J, Downs MA et al (1992) Ethnic differences in stress, coping, and depressive symptoms after the Exxon Valdez oil spill. J Nerv Ment Dis 180:287–295 Palinkas LA, Downs MA, Petterson JS et al (1993a) Social, cultural and psychological impacts of the Exxon Valdez oil spill. Hum Organ 52(1):1–13 Palinkas LA, Petterson JS, Russell J et al (1993b) Community patterns of psychiatric disorders after the Exxon Valdez oil spill. Am J Psychiatry 150:517–1523 Palinkas LA, Petterson JS, Downs MA et al (2004) Ethnic differences in symptoms of posttraumatic stress after the Exxon Valdez oil spill. Prehosp Disaster Med 19:102–112 Penland S, Ramsey KE (1990) Relative sea level rise in Louisiana and Gulf of Mexico: 1908-1988. J Coast Res 6(2):323–342 Picou JS, Gill DA (1996) The Exxon Valdez oil spill and chronic psychological stress. Am Fish Soc Sympos 18:879–893 Picou JS, Gill DA, Cohen MJ (eds) (1997) The Exxon Valdez disaster: readings on a modern social problem. Kendall-Hunt, Dubuque, IA Picou JS, Marshall BK, Gill DA (2004) Disaster, litigation, and the corrosive community. Soc Forces 82:1493–1522 Russell JC, Downs MA, Petterson JS et al (1996) Psychological and social impacts of the Exxon Valdez oil spill and cleanup. Am Fish Soc Sympos 18:867–878 Sack K, Schwartz J (2018) Left to the tides and fighting for time. New York Times, 25 Feb. https:// www.nytimes.com/interactive/2018/02/24/us/jean-lafitte-floodwaters.html. Accessed 25 Feb 2018 Shearer C (2012) The political ecology of climate adaptation assistance: Alaska Natives, displacement, and relocation. J Pol Ecol 19:174–183 Shulski M, Wendler G (2007) The climate of Alaska. University of Alaska Press, Fairbanks Stein MI (2018) How to save a town from rising waters. Citylab, 24 Jan. https://www.citylab. com/environment/2018/01/how-to-save%2D%2Dtown-from-rising-waters/547646/. Accessed 9 Aug 2018 U.S.  Arctic Research Commission Permafrost Task Force (2003) Climate change, permafrost, and impacts on civil infrastructure. Special Report 01-03. U.S Arctic Research Commission, Arlington, VA. https://storage.googleapis.com/arcticgov-static/publications/other/permafrost. pdf. Accessed 8 Aug 2019 U.S.  Army Corps of Engineers (USACE) (2006) Kivalina relocation master plan. U.S.  Army Corps of Engineers, Alaska, Anchorge, AK U.S. Army Corps of Engineers (USACE) (2009) Study findings and technical report. Alaska baseline erosion estimate. U.S. Army Corps of Engineers, Alaska, Anchorage, AK

References

145

U.S.  Global Change Research Program (USGCRP) (2018) In: Reidmiller DR, Avery CW, Easterling DR et al (eds) Impacts, risks, and adaptation in the United States: Fourth National Climate Assessment, vol 2. U.S. Global Change Research Program, Washington, DC Valle-Levinson A, Dutton A, Martin JB (2017) Spatial and temporal variability of sea level rise hot spots over the eastern United States. Geophys Res Lett 44(15):7876–7882 Wennersten JR, Robbins D (2017) Rising tides: climate refugees in the twenty-first century. Indiana University Press, Bloomington, IN Zanolli L (2016) Louisiana’s vanishing island: the climate ‘refugees’ resettling for $52m. The Guardian (UK), 15 Mar. https://www.theguardian.com/environment/2016/mar/15/louisianaisle-de-jean-charles-ilsand-sea-level-resettlement. Accessed 9 Aug 2018

Part III

Responses to Climigration

Chapter 8

Policy Responses to Climigration

8.1  Introduction The experience of climigration to date has illustrated the need for policies at all levels that anticipate the need for displacement and address the needs of both those who are being displaced and those who willingly or not will be expected to host displaced people. However, despite the numerous policies that have been proposed, relatively few have actually been implemented (Ferris 2014). Development of effective and sustainable policies requires research evidence, financial support, allocation of resources, and coordination of different social, economic, and administrative sectors. Above all, it requires public demand for a policy response to climate change displacement and the political will to implement that response. In this chapter, we focus on three types of policies: (1) policies designed to prevent the need for displacement; (2) policies that regulate and manage the process of displacement; and (3) policies that address the health-care needs of climigrants. The operationalization of each of these three types of policies at international, regional, national, and local levels is examined, along with a consideration of the challenges faced in developing and implementing them. We then conclude with a discussion of the lessons learned from this evaluation and recommendations for policy development.

8.2  The Three-Tier Model for Responding to Climigration Based on research conducted in the aftermath of the Exxon Valdez oil spill, Palinkas (2012, 2015) proposed a conceptual model of disaster impacts and response that identifies three levels or tiers of impacts of both natural and technological disasters: impacts that are direct consequences of the destruction of the physical environment (Tier I); interpersonal impacts that are both direct consequences of the Tier I impacts © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_8

149

150 Fig. 8.1  Three-Tier Model of policy-based prevention and mitigation of human impacts of climate change and climigration

8  Policy Responses to Climigration

Tier 1

Tier 2

Tier 3

Socioenvironmental

Social

Individual

Policies that mitigate need for Climigration

Policies that Facilitate and Regulate Climigration

Policies that Mitigate Health Impacts of Climigration

• Disaster Risk Reduction • Mitigation of health effects of climate change

• Access to services • Protection of migrant workers

and mediators of the relationship between the Tier I and individual impacts (Tier II); and intrapersonal or behavioral health impacts that are consequences of both the Tier I and the interpersonal impacts (Tier III). The model can also be applied to identification of appropriate responses to each of these impacts. A policy-based version of this model is illustrated in Fig. 8.1. Tier I impacts include damage to ecosystems and biodiversity, habitability, short-term and long-term economic and cultural impacts, and impacts on services and infrastructure. Tier II impacts include a dispersal of social ties and reduction in the levels of social support, an increase in the levels of social conflict, and an increase in collective uncertainty about the future and long-term consequences of climate change events. Tier III impacts include health effects related to exposure to environmental hazards as well as increases in the incidence of psychiatric disorders, drug and alcohol abuse and dependence, stress-related physical and mental health symptoms, domestic violence, and child behavioral problems. Although this model was designed to account for impacts of acute events such as disasters, it may also apply to longer-term changes in climate.

8.3  General Principles of Climigration Policies 8.3.1  Types of Policies In 2010, the United Nations Framework Convention on Climate Change (UNFCCC) adopted a statement in Cancun that acknowledged the need to address the movement of people as a climate change adaptation measure by undertaking: “14 (f)

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Measures to enhance understanding, coordination and cooperation with regard to climate change induced displacement, migration and planned relocation, where appropriate, at national, regional and international levels” (Ferris et al. 2011: 27). This has led to the development of policies at three levels: international, national/ regional, and local. Policies are also distinguished by type of climigration. As Ferris et al. (2011: 27–28) note, displacement, migration, and assisted planned relocations have their own actors with different agendas: Humanitarian actors have generally focused on forced displacement while development actors have been the leading actors in issues of planned relocations. Those working on migration, such as the International Organization for Migration, have had a foot in both worlds. Most observers think that migration will be the most widely-used adaptation strategy in responding to the effects of climate change.

8.3.2  Climigration as Adaptation Despite the persistence of opinion that climigration represents a failure to adapt (de Sherbinin et al. 2011a), there is a growing consensus that it is a legitimate form of adaptation to climate change, albeit one of last resort (Barnett and Webber 2010; Black et al. 2011; de Sherbinin et al. 2011b). However, in regions that are currently contributing very little to anthropogenic changes in the environment, adaptation may be their only viable option. High-income countries in general and large urban areas within these countries like Miami or New York in particular have more options than low-income countries, neighborhoods, and rural areas, including the option to build sea walls and remain in place. “For example, the Pacific island nation of Kiribati and the city of Miami in Florida are both threatened by sea-level rise. But whereas Kiribati is considering permanent relocation, possibly to Fiji, the people of Miami intend to stay put and are investing hundreds of millions of dollars in shoring up sea walls and drainage systems” (Lopez-Carr and Marter-Kenyon 2015: 266). Another issue relates to the feasibility of planned relocations. The IPCC (2019: 31) noted: “where the community affected is small, or in the aftermath of a disaster, reducing risk by coastal planned relocations is worth considering if safe alternative localities are available.” However, they also point out that planned relocation can be socially, culturally, financially, and politically constrained. With the exception of planned relocation of a dozen or so Alaska Native villages from coastal areas, planned relocation of residents threatened by climate change does not appear to be an option of most climate change adaptation plans in the United States (Melillo et al. 2014).

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8.4  Policies That Mitigate Need for Climigration 8.4.1  Disaster Risk Reduction To address Tier I impacts, policies are needed that reduce the need to climigrate and keep individuals in their communities of origin. Globally, there are several national and international initiatives that are designed to minimize the damage associated with extreme weather events. For instance, the Association of Southeast Asian Nations (ASEAN) Community Vision 2025 prioritizes disaster risk reduction. In the ASEAN Agreement on Disaster Management and Emergency Response, states undertook to reduce disaster losses by jointly responding to disaster emergencies (UNESCAP 2017). At the regional level, governments across the Pacific have been collaborating to strengthen resilience to climate change and improve disaster management through frameworks such as the Framework for Pacific Regionalism and the Framework for Resilient Development in the Pacific (UNESCAP 2017). At the national level, countries have been integrating disaster risk reduction into sustainable development policies and programs. Bangladesh, for instance, developed an effective early warning system to alert coastal rural areas of impending cyclones; built a network of 2100 cyclone shelters, which can accommodate more than a million people; and financed 4000  miles of coastal embankment projects. It is even planting trees on chars in an effort to create islands that are more durable (Glennon 2017). Such programs are intended to reduce the need for climigration because populations typically adapt by accommodating to changes in the environment or preventing the occurrence of such changes. In low- and middle-income countries like Bangladesh, retreat is not an option because of the country’s high population density, future population projections, and shortage of land (Ali 1999). The experience of extreme weather events in recent years has also led to the development of several recommendations for disaster risk reduction policies. After Typhoon Haiyan, for instance, a study conducted by Sherwood et al. (2015) made the following recommendations to the Philippine government and international supporters: 1. Recognize durable solutions to displacement as a multisectoral concern, including both humanitarian and developmental inputs, and extending beyond the housing sector; 2. Redouble investment in the strengthening of evacuation centers, safer construction techniques and other disaster risk reduction programs; 3. Establish an interactive, rights-based monitoring system for relocation plans, policies and projects, linking local and national levels; 4. Develop and implement enhanced, culturally sensitive livelihood strategies for the affected areas, based on IDPs active participation; 5. Address fairness concerns in the implementation of aid; 6. Strengthen community-based approaches to humanitarian aid and recovery; and

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7. Ensure support for durable solutions and Disaster Risk Reduction and Management (DRRM) efforts at all levels integrate gender analyses and respond to the different needs and capacities of women and men, girls and boys (Sherwood et al. 2015: 5–6). One approach to responding to disasters taken by several countries in the past decade has been to integrate risks from climate change into the development planning process. This process is often referred to as climate-resilient development (World Bank 2013a). The World Bank proposed an operational framework outlining five risk management action pillars and risk identification that provides the base for the other actions, beginning with (1) improved identification and understanding of disaster and climate risks through building capacity for assessments and analysis; and extending to (2) avoiding creation of new risks and reduced risks in society through greater disaster and climate risk consideration in policy and practice; (3) improved capacity to manage crises through developing forecasting, early warning, and contingency plans; (4) increased financial resilience of governments, private sector, and households through financial protection strategies; and (5) quicker, more resilient recovery through support for reconstruction planning. Another approach to disaster planning taken by several national disaster management agencies (NDMAs) has been to assess and map risks, develop contingency plans for evacuations (including plans for warnings, evacuation routes and transportation arrangements, temporary shelters, stockpiling supplies, etc.), warn the populations, and carry out evacuations. When feasible, these plans call for return of evacuees to communities of origin or settlement elsewhere when returns are not feasible (Ferris 2014). Planning for evacuations may include maintaining registries of individuals with disabilities that limit mobility, identification of local resources through community engagement, guidance on evacuation of pets and livestock, and disaster risk reduction education (Ferris 2014). One example of a developed national plan targeting displacement in the context of disaster preparedness is the Vanuatu Climate Change and Disaster Risk Reduction Policy (VCCDRPP) (IOM 2018b). The policy contains three noteworthy elements that serve as a template for other national plans. First, it provides for multi-hazard mapping, disaster risk reduction, and climate change adaptation efforts. Its focus is on reducing the triggers that serve as an impetus to displacement. Second, the policy addresses displacement risks in the broader context of mobility and migration in Vanuatu, including traditional and customary land arrangements, development, and rural to urban migration. Third, the policy incorporates lessons learned from previous displacement experiences and places emphasis on displacement with dignity and safeguards for protecting human rights. The policy identifies 12 strategic priority areas for action to ensure displacement, and human mobility considerations are mainstreamed into Vanuatu’s planning at national and local levels, building on existing policy initiatives. These priority areas are divided into four that are the focus of systems-level interventions relate to and eight that are the focus of sectoral-­ level interventions (Fig. 8.2).

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Intervention Type

• Intervention Focus

Systems

• institutions and governance • safeguards and protection • evidence, information and monitoring • capacity-building, training and resources

Sectoral

• safety and security • land, housing, planning and environment • health and well-being • education • infrastructure and connectivity • agriculture, food security and livelihoods • traditional knowledge, culture and documentation • access to justice and public participation

Fig. 8.2  Vanuatu Systems and Sectoral Level Interventions (Adapted from Vanuatu national policy on climate change and disaster-induced displacement, by International Organization on Migration, 2018. https://www.iom.int/sites/default/files/press_release/file/iom-vanuatu-policy-climate-change-disaster-induced-displacement-2018.pdf

8.4.2  Mitigation of Health Impacts of Climate Change Addressing the health impacts is based on a three-pronged strategy: (1) implementation of preventive and curative public health interventions, (2) support for adaptation measures in health-related sectors such as water and disaster management, and (3) a long-term strategy to reduce the human impacts on climate (WHO WPR 2015). The Essential Public Health Package to Enhance Climate Change Adaptation in Developing Countries (WHO 2010), developed by WHO, suggests six focus areas as a minimum requirement for health ministries to manage the health effects of

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climate change: (1) comprehensive assessments of the risks posed by climate variability and change to population health and health systems; (2) integrated environment and health surveillance; (3) delivery of preventive and curative interventions for the effective management of identified climate-sensitive public health concerns; (4) disaster risk management for health addressing extreme weather events; (5) research; and (6) strengthening of human and institutional capacities and intersectoral coordination. The World Health Organization recommends building climate resilience into all aspects of the health system—“leadership and governance, human resources, information resources, essential medical products and technologies, financing and service delivery – in order to be effective and sustainable” (WHO WPR 2015: 128). WHO also identified ten action areas considered to be essential for building climate-­ resilient health-care systems. These action areas can be found in Appendix 2.

8.5  Policies That Facilitate and Regulate Climigration Policies that facilitate and regulate climigration also have the potential to reduce Tier II impacts that relate to the disruption of social relations and the emergence of social tension and civil conflict. In the past decade, there have been several initiatives designed to address the problem of population displacement associated with climate change. Migration was first recognized as an adaptation strategy in 2010 through the Cancun Adaptation Framework, the aim of which is to provide a global guiding framework for climate-related cross-border displacement. To date, efforts to address migration through this framework have not received broad support (UNESCAP 2017). International recognition that displacement is a major impact of disasters and that migrants experience certain types of vulnerability during disasters was further articulated in the Sendai Framework for Disaster Risk Reduction 2015–2030 (UNDRR 2015). In recognition of the sensitivities of states toward climate-related displacement, the Nansen Initiative was created as a non-binding state-led process. Rather than creating new categories of legal protection for displaced people, the Nansen Initiative offered a toolbox of practices to address displacement at various stages (preparedness for displacement, protection during displacement, and durable solutions following displacement) (Nansen Initiative 2015). “It stresses the need for better data collection, enhanced use of humanitarian protection measures and strengthened management of disaster-related displacement in countries of origin” (UNESCAP 2017: 11). In addition, the Nansen Initiative recognizes the links between internal and international migration, recommends planned relocation for people living in disaster-prone areas only when it cannot be avoided, requires measures to protect people from impoverishment risks associated with relocation, and encourages the use of traditional knowledge- and community-based approaches in mapping disaster risks and identifying suitable evacuation and planned relocation options (McAdam 2013; Nansen Initiative 2015).

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Other documents have outlined guidelines on planned relocation that may or may not be related to climate change which include the World Bank Guidelines on Involuntary Resettlement (World Bank 2013b), the United Nations Guiding Principles on Internal Displacement (UNESC 1998), the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa (Kampala Convention) (African Union 2009), the Peninsula Principles on Climate Displacement within States (Displacement Solutions 2013), the Inter-Agency Standing Committee Framework on Durable Solutions for Internally Displaced Persons (IASC 2010), IASC Operational Guidelines on the Protection of Persons in Situations of Disasters (IASC 2011), the UN Food and Agriculture Organization in Emergencies Guidance Note on Supporting Displaced People and Durable Solutions (FAO 2013), and International Labour Organization Guidelines on the Resettlement of Indigenous Populations (Ferris 2014). The Global Compact for Safe, Orderly and Regular Migration (GCM) is considered to be the most comprehensive agreement ever negotiated on international migration and includes climate change and environmental factors (IOM 2018a). National plans for management of climate-related migration reflect a continuum of approaches to date as to the extent to which climate-related displacement is acknowledged and addressed. An analysis report prepared by the International Organization for Migration in 2018 summarized this continuum as follows: • Out of 66 countries and territories reviewed, 53% make reference to climate change and environmental factors in their national migration and displacement frameworks. • Out of 37 countries and territories having submitted national adaptation policies, plans or strategies, 81% refer to human mobility. • Out of 193 countries and territories having submitted INDCs, 20% refer to human mobility. • Out of 143 countries and territories having submitted NCs, 70% refer to human mobility. (IOM 2018a: 3) The migration policies of some countries such as Botswana, Nigeria, and France include sections outlining national objectives and strategies in addressing population movements in the context of environmental change and plans for mitigating the environmental impacts of migration. “Other countries, such as Nepal, Georgia, and Vanuatu, have gone even further and drafted specialized policies focusing on human mobility and environmental factors” (IOM 2018a: 8). Perhaps the most progressive policy is the one adopted by Uganda. “The government maintains an inclusive approach, granting refugees freedom of movement, a plot of land, the right to seek employment and engage in business, and access public services such as education and health on par with nationals” (WHO AR 2018: 22). In some instances, national policies include plans for planned relocation within a country in the event of climate-related changes in the environment. For instance, “the government of the Maldives developed the ‘Safer Islands’ strategy. The ‘Safer Islands’ are designated islands that are relatively large and better protected from

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natural disasters, where communities from smaller, more vulnerable islands can be resettled” (Speelman et al. 2017: 435). Several initiatives reflect a regional approach to climigration policy. For instance, many of the SIDS in the Pacific have historical ties with high-income countries like Australia, New Zealand, the United States, and France that provide them with varying degrees of privileged entry in the event of forced relocation. • Guam and American Samoa are overseas territories of the United States, and French Polynesia and New Caledonia and are overseas territories of France, allowing free movement of people and citizenship; • The Cook Islands, Niue and Tokelau are part of the Realm of New Zealand and have constitutional ties allowing for rights of entry; • The Pacific Access Category in New Zealand has billets for permanent residence for people from Fiji, Kiribati, Tonga and Tuvalu; • The United States Compact of Free Association agreements with the Federated States of Micronesia, the Marshall Islands and Palau allow all citizens of those countries to live and work in the United States indefinitely; • The Recognized Seasonal Employment scheme in New Zealand and the Seasonal Worker Programme in Australia are open to citizens of selected Pacific islands (UNESCAP 2017: 13). The development of migration policies in the Pacific region is also characterized by attempts to provide different options for climigration within traditional social and cultural contexts. For instance, the Recognized Seasonal Employment scheme in New Zealand and the Seasonal Worker Program in Australia are being increasingly promoted as one potential climate change adaption option (UNESCAP 2017). The recognition that the predominant reasons for migration are to maximize economic opportunities and access to services and to strengthen kinship ties—rather than climate change or environmental pressures per se (see Barnett and Webber 2010; Barnett and Chamberlain 2010)— has important implications for policy that supports climigration as an adaptive strategy. “First, in order to maximize development opportunities, any planned, gradual climate change-related migration should build upon how and why Pacific people historically have migrated. For example, increasing voluntary labour mobility options would enable Pacific islanders to meet their own needs in accordance with their values (Barnett and O’Neil 2012)” (UNESCAP 2014: 25). Farbotko and Lazrus (2012) argued that any consideration of climate change-related migration in Tuvalu must consider how people ordinarily move between national borders while maintaining their culture and sense of community: “For Tuvaluans, migration is…a collectively negotiated means of participation in transnational networks, a way to meet family obligations and desires” (Farbotko and Lazrus 2012: 387). One particular policy that is drawing interest throughout the interest is the “Migration with Dignity” Policy developed and implemented by the government of Kiribati. The policy is part of Kiribati’s long-term relocation strategy and is comprised of two parts:

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The first part of this policy is to create opportunities for those who wish to migrate abroad now and in the near future. The goal is to forge expatriate communities in various receiving countries, such as Australia and New Zealand, so that they may support other migrants in the longer term, and also to enhance the opportunity for remittances to be sent back. With costs largely subsidised by the government, the second part of this policy is to improve the levels of educational and vocational qualifications that can be obtained in Kiribati, so that they match those that are available in the places where residents may migrate to. It is hoped that this training and upskilling will provide opportunities to migrate abroad ‘with dignity’ and build on existing cross-border labour arrangements. (McNamara 2015: 62)

8.6  P  olicies That Mitigate the Health Impacts of Climigration Addressing the individual needs of climigrants also requires policies that attempt to prevent adverse health effects associated with climigration as well as the adverse health effects of climate change itself. Such policies are designed to mitigate the health impacts of displacement, including the assurance that climigrants will have access to quality health care and that migrant workers who may volunteer to move elsewhere to send remittances to family in communities of origin or seek economic opportunities elsewhere may do so without fear of exploitation. These policies address Tier III impacts.

8.6.1  Access to Services For policies developed by some countries, governments also take into consideration the associations between health, climate change, environmental factors, and migration. In some respects, they acknowledge that health may precipitate climigration; in other respects they acknowledge the health risks associated with climigration. “For example, references are made to the interaction between communicable diseases via or due to environmental degradation and climate change and their influence on migration patterns. The impacts the migration process can have on the mental and physical health of individuals are also sometimes mentioned” (IOM 2018a: 12). For the most part, the focus of these policies is on insuring access to health care during and subsequent to climigration. There are numerous obstacles to accessibility to and appropriate utilization of health services by migrants, especially those lacking legal status as refugees. These include a lack of familiarity with enrollment processes and entry points, financial and structural barriers to receiving care, and discouraging or discriminatory treatment by staff. “Migrant-sensitive health systems and programs aim to consciously and systematically incorporate the needs of migrants into all aspects of health services’ financing, policy, planning,

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implementation, and evaluation through a broad range of measures, from single-site interventions to comprehensive national policies” (WHO 2018: 13–14). National legal and policy frameworks of several nations in Africa include nondiscrimination provisions, providing a base for refugees and migrants to assert their rights to access health services that are available to citizens of their countries of residence. “Regionally, the Khartoum process, a platform for political cooperation amongst the countries along the migration route between the Horn of Africa and Europe, launched the Addressing Mixed Migration Flows on East Africa project to set up safe and rights-respectful centers for migrants, strengthening the response capacity of national authorities in addressing the needs of migrants in Eastern Africa” (WHO 2018: 13).

8.6.2  Protection of Migrant Workers One group of migrants that are addressed by regional and global policies is migrant workers who seek employment overseas. As many of these workers come from countries in Southeast Asia, several policies prioritizing the protection of migrant workers have been implemented by the Association of Southeast Asian Nations (ASEAN). This includes the ASEAN Community Vision 2025, the ASEAN Trade Union Council Inter-Union Cooperation Agreement, the ASEAN Declaration on the Protection and Promotion of the Rights of Migrant Workers, and the ASEAN Labour Ministers’ Work Programme (UNESCAP 2017). Although these policies do not make specific references to climate change, they offer important protections to migrants who seek work overseas that may be motivated by reduced opportunities for employment and need to send remittances to family members in countries of origin. These protections also help to protect these workers from threats to health and well-being associated with migration.

8.7  Challenges in Developing Climigration Policies 8.7.1  General Issues Regardless of the scope and scale of a policy, there are several issues that constitute challenges to development and implementation of climigration policies. One such issue is the determination of the environmental conditions that would trigger a policy response. As summarized by Ferris (2014: 7): “Who determines when an area is uninhabitable? On what basis? And how is a determination made on an area that is uninhabitable because of climate change – rather than for example, normal climatic variation or the intersections of natural hazards and human interaction such as deforestation?”

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A second issue pertains to the status of climigrants. Climate change is likely to be an accelerator of other trends, but there are always other drivers of climigration (Ferris 2014; Foresight 2011). That being the case, to what extent are policies developed that pertain specifically to climigrants? For instance, would the programs that are available to survivors of civil conflicts like those in Syria or Somalia who possess legal status as refugees be available to climigrants from Central America because the events leading to the decision to migrate are also linked to the experience of prolonged drought? In the same context, if climate change is a national security issue because of the likely consequence of accelerating the risk of armed conflict, then forced migration due to climate change must also be taken into account as a cause as well as a consequence of climate-related civil conflicts. “Forced migration can by triggered by environmental conflicts, but forced migration due to the scarcity of food or extreme weather events can also in itself trigger conflicts” (EJF 2017: 6). Another issue that creates a potential obstacle to policy development and implementation is the tension between advocating for adaptation and for mitigation. Some advocates for mitigation assert that adaptation efforts diminish efforts to mitigate the causes of climate change and represent a tacit acknowledgement that climate change is inevitable and thus not worth the effort to contain or limit: There is also an undercurrent of resistance to considering issues of planned relocations now out of a concern that doing so would take pressure off national and international actors to implement mitigation measures which would make it possible for people to remain in their homes and communities. It is too early to talk about relocations, this argument goes, as people have a basic right to remain where they are and the international community should be going full-out to mitigate the effects of climate change. The climate change community seems to be moving towards emphasizing the importance of both adaptation and mitigation measures, arguing that these are not mutually exclusive options. (Ferris 2014: 6)

A fourth challenge to policy development is dealing with the consequences of planned migration for both climigrants and host communities or countries. Planned large-scale relocation in anticipation of climate impacts comes with many risks, including landlessness, unemployment, homelessness, social marginalization, reduced access to common-property resources, food insecurity, increased morbidity, and community disarticulation (Cernea 1997). In the Pacific, the most significant risks include a “loss of identity, culture, family ties and community for communities leaving homelands, and conflict and governance issues arising where resettlement is in others’ customary land (Boege 2011; Campbell 2010)” (UNESCAP 2014: 24).

8.7.2  International Policies 8.7.2.1  Legal Definition of Refugee Internally displaced persons are protected and assisted in accordance with the Guiding Principles on Internal Displacement (OCHA 2004). “In contrast, under current international law, there is no special treatment to be accorded to those

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displaced when they relocate outside national borders. They are not refugees under the 1951 Refugee Convention, but rather are considered by receiving governments as economic migrants” (Ferris et  al. 2011: 28). At the present time, the international legal definition of the term “refugee” excludes those who move as a consequence of natural disasters (such as drought, floods, or earthquakes), environmental factors, or famine. They are excluded even though they may need international protection and assistance because their home country cannot or will not provide these things. The lack of any legal status of climigrants who cross international borders has led to calls for an agreed-upon criteria for what constitutes climate-induced migration that reflect a rights-based approach and give clarity to the legal status of people who migrate for climate-related reasons. “There is a need to clarify the obligations of States to persons displaced by climate change within new legal definitions and these must be developed without delay” (EJF 2017: 41). The lack of an accepted definition of a climigrant as a climate refugee or environmental refugee means that their displacement, for the most part, does not trigger any access to government financial grants, food aid, tools, shelter, schools, or clinics (IOM 2008). Advocates for climigrants often use these terms to convey added urgency to the issue: They argue that, in the most literal sense of the words, such people need to “seek refuge” from the impacts of climate change. Any other terminology, they maintain, would downplay the seriousness of these people’s situation. Moreover, the word “refugee” resonates with the general public who can sympathize with the implied sense of duress. It also carries fewer negative connotations than “migrant”, which tends to imply a voluntary move towards a more attractive lifestyle. (IOM 2008: 36)

However, many communities at risk for displacement resent the association between their present circumstances and refugee status. For instance, Farbotko and Lazrus point to research documenting psychological or political resistance to climate change-related migration. “This is related to the Pacific islands resistance to be seen as “climate refugees” which many Pacific islanders feel would threaten the Pacific identity which is linked to land and community (McAdam and Loughry 2009; McNamara and Gibson 2009; Barnett and O’Neil 2012)” (Farbotko and Lazarus 2012: 387). In Chap. 2, we noted a reluctance to refer evacuees from New Orleans after Hurricane Katrina as refugee because of the stigma associated with the term in host communities. Moreover, “there is considerable resistance among the international community to any expansion of the definition of a ‘refugee’. Developed countries fear that accepting the term refugee would compel them to offer the same protections as political refugees; a precedent that no country has yet been willing to set” (IOM 2008: 14): How then should we categorize these people? The International Organization for Migration (IOM) proposes the following definition, “Environmental migrants are persons or groups of persons, who, for compelling reasons of sudden or progressive changes in the environment that adversely affect their lives or living conditions, are obliged to leave their habitual homes, or chose to do so, either temporarily or permanently, and who move either within their country or abroad. (IOM 2008: 15)

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8.7.3  National Policies One of the primary challenges to the development and implementation of policies designed to manage climate-related displacement is the lack of understanding of the climigration phenomenon and its broader social, economic, and political impacts. Siders et al. (2019) have argued, for instance, that displacement or “retreat” “has been seen largely as a last resort, a failure to adapt, or a one-time emergency action; thus little research has focused on retreat, leaving practitioners with little guidance” (p. 761). Nevertheless, relocation is already occurring. “Government programs have relocated populations out of at-risk areas, moved roads and other infrastructure, imposed setback requirements, banned return to disaster-prone areas, or condemned and demolished buildings considered too risky” (Siders et  al. 2019: 761). Unfortunately, these efforts rarely consider the long-term social, economic, cultural, or psychological consequences on those being displaced or the communities or settings to which the climigrants are resettled. In the United States, the Stafford Act, and its amendments, requires that funding be spent on repairing and rebuilding of the original location of the disaster (Bronen 2011). “For communities that are no longer habitable in their current location or located entirely within floodplains, this mean that they are unable to receive government funding to repair and rebuild damaged infrastructure due to state and federal government regulations which prevent government expenditures on infrastructures build within flood plains” (Bronen 2013: 19). Given this restriction, there is no comprehensive governance framework that provides any guidance or assistance to communities seeking to relocate due to long-term environmental events such as coastal erosion. In Alaska: the 2009 GAO report recognized that no government agency has the authority to relocate communities, no governmental organization exists that can address the strategic planning needs of relocation, and no funding is specifically designated for relocation (GAO 2009: 24–27). Even with their survival in imminent danger, none of the villages identified in the 2009 GAO report has yet been able to relocate, owing to governance issues that must first be overcome. (Bronen 2013: 19)

The Federal Emergency Management Agency “can support community relocation only once disaster strikes, and only in response to a handful of hazards, including drought and hurricanes, but not the severe erosion that threatens Arctic settlements” (Lopez-Carr and Marter-Kenyon 2015: 266–267). To develop national policies that can effectively manage climigration, consideration must be given to efforts to prevent the need for climigration on the one hand and to plan for their inevitability on the other hand. As Siders et al. (2019) conclude in their assessment of the need for strategic and managed retreat from climate-­ related changes in the environment: The challenge is to prepare for long-term retreat by limiting developing in at-risk areas, identifying timelines and tipping points for retreat, and analyzing path dependencies  – things that need to happen now to enable retreat in the future. This will require long-term plans with thresholds that trigger specific responses, accompanied by a monitoring program to evaluate conditions and modify plans over time. (p. 763)

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8.7.4  P  olicies to Address Inequality of Climate Change Risk and Impacts The final challenge to addressing climigration in policy development and implementation concerns is the need to prevent and manage displacement in a way that reduces the inequality of climate change impacts that precipitate displacement and the consequences of displacement: The impacts of climate change are expected to be both regressive and heterogeneous, and, thus, contribute to higher inequality. In Brazil, for example, climate change is expected to affect poorer regions more than richer ones; poorer municipalities are expected to suffer a decline of up to 40% in agricultural output by 2040, while richer ones may actually benefit (Assunção and Chein Feres 2009). A study from Ahmed et al. (2009) of 16 countries also suggests that while rural areas are expected to have the greatest numbers of poor, poor populations in urban areas are expected to suffer proportionally more under projected extreme dry events due to their vulnerability to food price increases. An estimated 16% increase in poverty is expected in urban areas compared to a 12% increase amongst rural populations. This introduces an added concern given the rapid pace of urbanization in the developing world. (World Bank 2013a: 9)

The issue of inequality also pertains to the allocation of responsibility for climate change. Several climate change mitigation advocates have argued that according to the principle of “polluters pay,” those countries that caused anthropogenic climate change should provide technical assistance and financial resources to low- and middle-­income countries that need to adapt to the impacts of climate change. In addition, many of these countries had been exploited by colonizing countries for centuries before gaining independence. “In any case, for the sake of justice and fairness, financial support through a global climate finance mechanism and bilateral aid of industrialized and rapidly industrializing countries for Pacific island countries struggling with climate change are urgently needed” (WHO WPR 2015: 133).

8.8  Summary Drawing from this review of existing policies relevant to climigration and the challenges involved in developing and implementing such policies, future policy development and implementation should be based on an agreed-upon set of principles. Several authors have offered recommendations for developing displacement policies related to climate change. For instance, de Sherbinin et al. (2011a: 457) provided seven specific recommendations: • Establishing legal frameworks for climate change resettlement to protect welfare and human rights of affected populations [useful principles are articulated in (Ferris et al. 2011; Oliver-Smith 2009; Cernea 2000)]; • Involvement of affected communities, in both source and destination areas, in assessments and decisions regarding resettlement locations, compensation, and

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development programs [e.g., hurricane affected Mayan populations in Santiago Atitlan, Guatemala, designed their resettlement in culturally appropriate ways (Cantero 2011)]; In cases where resettlement is deemed the best option, the process needs to be fair and equitable for the community, with every effort made to improve livelihoods [e.g., Egyptian Nubians resettled owing to construction of the Aswan High Dam benefited from irrigation works (Scudder 2005)]; Interdisciplinary training for resettlement professionals that includes economics, anthropology, public health, and case studies; Baseline environmental, health, and social impact assessments to establish benchmarks for evaluating resettlement performance through monitoring and evaluation programs [e.g., Nam Theun 2 hydropower station in Laos (Guerrier et al. 2011)]; Research to adapt existing knowledge on resettlement to the special case of climate-­related resettlement, with particular reference to disaster-related resettlement and learning from incipient climate-related resettlement (de Sherbinin et al. 2011b; Bronen 2008; Rogers and Wang 2006; Displacement Solutions 2008); and Establishment of financial mechanisms for capacity building and anticipatory planning in developing countries exposed most to climate risks, with joint funding by donors (e.g., the Green Climate Fund) and the exposed countries themselves, since many M&A projects will not generate revenues that could offset costs.

With respect to the first recommendation, establishment of legal frameworks must “include the protection of the human rights of the populations being displaced and the restoration of their livelihoods” (Ferris et al. 2011: 21). Another suggestion has been to provide temporary protected status, such as provided to Salvadorians and Haitians and Hondurans in the United States after devastating earthquakes in 2001 and 2010, respectively, and legislative measures taken by some EU countries, as well as temporary work visas, may assist those affected by natural disasters (de Sherbinin et al. 2011a). With respect to the second recommendation, “the value that a community places on resettlement compared with other options such as sea-wall construction, temporary emergency evacuation and disaster relief need to be assessed so that appropriate policies can be chosen” (Lopez-Carr and Marter-Kenyon 2015: 266). Embedded in the fifth recommendation is the need to consider the social determinants of health. With respect to development of health policies for people who have been displaced by climate-related changes in the environment, the WHO recommends the following: (1) deploying targeted health services designed for refugees and migrants; (2) investing in improving access to water, sanitation, and appropriate shelter and nutrition; (3) ensuring disease surveillance and rapid response mechanism to deal with outbreaks; and (4) promoting cross-border interventions and foster interactions between partners involved in the provision of health services in different countries to ensure continuation of care for mobile populations (WHO 2018: 29).

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Embedded in the fifth recommendation for conducting research is learning from experience. “Climate-related settlement is already under way in the Mekong River delta of Vietnam, along the Limpopo River of Mozambique, on the coast of Alaska and Louisiana, in the Inner Mongolia Autonomous Region of China, and from the Carteret Islands to Bougainville Island in Papua New Guinea” (de Sherbinin et al. 2011a: 456). Development of policies at all levels should take into consideration the successes and failures of these efforts: Refugee resettlement to third countries offers yet another extensive body of good practice and experience in supporting integration which may be useful to those working on resettlement for other reasons but has been largely ignored in discussions around climate change. These lessons include, for example, the importance of buy-in of both refugees and communities receiving them; sponsorship systems (designation of organizations or individuals to help newcomers find housing, get jobs, enroll children in school, etc.); government support for integration programs (skills training, counseling, job referrals, etc.). (Ferris 2014: 10)

Given the many commonalities between development-related and future climate displacement (Ferris et  al. 2011; Oliver-Smith 2009), much can also be learned from the experience of massive relocation of people due to large-scale infrastructure development projects such as the Three Gorges Dam in China (Cernea 2000, 2008; Scudder 2005). “The multiple similarities between the displacement caused by slow-onset climate change and displacement resulting from infrastructure development projects provide a strategic cognitive advantage for crafting operational approaches and longer term strategies to meet the displacement risk stemming from new challenges of rising sea levels and other effects of climate change” (Ferris et al. 2011: 22). For instance: “The widely cited Impoverishment Risks and Reconstruction model (Cernea 2008) identifies eight basic risks: loss of land, employment, shelter, and access to common resources; economic marginalization; increased morbidity and mortality; food insecurity; and negative cultural and psychological impacts. Resettlement strategies must include economically feasible reconstruction of productive activities [e.g., jobs and education (Cernea 2008)], with sufficient income generation, restoration of livelihoods, and adequate cultural integration with hosts. (de Sherbinin et al. 2011a: 457)

Research supporting the development and implementation of climigration policies should also assess the costs and benefits of displacement. In assessment of costs, for instance, it is important to take into consideration the fact that different groups of climigrants may have a need to relocate, but for different reasons. Ferris identifies three specific groups of climigrants: There are different categories of needs for migration, as outlined by Ferris (2014: 7): • People who need to be relocated from areas prone to sudden-onset natural hazards which are increasing in severity and intensity as a result of climate change (e.g. flood-prone areas, coastal areas); • People who need to be relocated because their livelihoods are threatened by slow-onset effects of climate change (e.g. increasing drought frequency, salinisation of water resulting from sea level rise or unsustainable use of aquifers) and who need to find permanent homes;

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• People who need to be relocated because their country or parts of their country face destruction from the effects of climate change (e.g. small island states facing sea level rise but also riverbank erosion). However, as the previous chapters have repeatedly demonstrated, climigration is also associated with certain costs, including loss of land; loss of jobs; loss of housing; economic and social marginalization; health risks, in terms of increased morbidity and mortality; food insecurity; loss of access to common property resources; and community disarticulation (Ferris et al. 2011: 23). Policies should be implemented to insure that the benefits of climigration must outweigh the costs. Assessment of costs and benefits also applies to the practices for delivering services to climigrants. It is to these practices that we now turn in the next chapter.

References African Union (2009) African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa (Kampala Convention). https://au.int/sites/default/files/ treaties/36846-treaty-0039_-_kampala_convention_african_union_convention_for_the_protection_and_assistance_of_internally_displaced_persons_in_africa_e.pdf. Accessed 3 Oct 2019 Ali A (1999) Climate change impacts and adaptation assessment in Bangladesh. Clim Res 12:109–116 Ahmed SA, Diffenbaugh NS, Hertel TW (2009) Climate volatility deepens poverty vulnerability in developing countries. Environ Res Lett 4 (3):034004 Assunção J, Chein Feres F (2009) Climate change, agricultural productivity and poverty. Working Paper, Department of Economics, Pontifícia Universidade Católica (PUC), Rio de Janeiro. Barnett J, Chamberlain N (2010) Migration as climate change adaptation: implications for the Pacific. In: Burson B (ed) Climate change and migration: South Pacific perspectives. Institute of Policy Studies, Wellington Barnett J, O’Neill S (2012) Islands, resettlement and adaptation. Nat ClimChange 2(1):8–10 Barnett J, Webber M (2010) Accommodating migration to promote adaptation to climate change. The World Bank, Policy Research Working Paper Series 5270. The World Bank, Washington, DC Black R, Bennett SG, Thomas SM et al (2011) Climate change: migration as adaptation. Nature 478(7370):447–449 Boege V (2011) Peacebuilding and state formation in post-conflict Bougainville. Peace Rev 21(1):29–37 Bronen R (2008) Alaskan communities’ rights and resilience. Forced Migr Rev 31:30–32 Bronen R (2011) Climate-induced community relocations: creating an adaptive governance framework based in human rights doctrine. New York Univ Rev Law Soc Change 35(2):356–406 Bronen R (2013) Climate-induced displacement of Alaska Native communities. Brookings—LSE Project on Internal Displacement. The Brookings Institution, Washington, DC. https://www. brookings.edu/wp-content/uploads/2016/06/30-climate-alaska-bronen-paper.pdf. Accessed 4 Apr 2019 Cantero EA (2011) Guatemala: the first Tzutujil city of the twenty-first century. In: Correa E (ed) Preventive resettlement of populations at risk of disaster: experiences from Latin America. World Bank, Washington, DC, pp  85–106. http://www.gfdrr.org/sites/gfdrr/files/publication/ preventive_resettlement_LAC_experiencesDS150.pdf. Accessed 24 Oct 2019

References

167

Campbell J (2010) Climate-induced community relocation in the Pacific: the meaning and importance of land. In: McAdam J (ed) Climate change and displacement: multidisciplinary perspectives, Hart, Oxford UK Cernea M (1997) The risks and reconstruction model for resettling displaced populations. World Development 25(10):1569–1587 Cernea M (2000) Risks, safeguards, and reconstruction: a model for population displacement and resettlement. In: Cernea M, McDowell C (eds) Risks and reconstruction: experiences of resettlers and refugees. World Bank, Washington, DC, pp 11–55 Cernea M (2008) Compensation and benefit sharing: why resettlement policies and practices must be reformed. Water Sci Eng 1(1):89–120. https://doi.org/10.1016/S1674-2370(15)30021-1 de Sherbinin A, Castro M, Gemenne F et al (2011a) Preparing for resettlement associated with climate change. Science 334:456–457 de Sherbinin A, Warner K, Ehrhart C (2011b) Casualties of climate change. Sci Am 304(1):64–71 Displacement Solutions (2008) Bougainville resettlement initiative meeting report. Canberra, Australia, 11 Dec. http://displacementsolutions.org/wp-content/uploads/BG.pdf. Accessed 24 Oct 2019 Displacement Solutions (2013) Peninsula principles on climate displacement within states. http:// displacementsolutions.org/wp-content/uploads/2014/12/Peninsula-Principles.pdf. Accessed 10 Oct 2019 Environmental Justice Foundation (EJF) (2017) Beyond borders: our changing climate—its role in conflict and displacement. Environmental Justice Foundation, London. https://ejfoundation. org/resources/downloads/BeyondBorders-2.pdf. Accessed 30 Sept 2019 Farbotko C, Lazrus H (2012) The first climate refugees? Contesting global narratives of climate change in Tuvalu. Glob Environ Change 22(2):382–390 Ferris E (2014) Planned relocations, disasters and climate change: consolidating good practices and preparing for the future. Background document Sanremo Consultation, 12–14 March. The Brookings Institution, Washington, DC. https://www.brookings.edu/research/planned-relocations-disasters-and-climate-change-consolidating-good-practices-and-preparing-for-thefuture/. Accessed 12 Jul 2019 Ferris E, Cernea M, Petz D (2011) On the front line of climate change and displacement: learning from and with Pacific island countries. The Brookings Institution, Washington DC. https:// www.brookings.edu/wp-content/uploads/2016/06/09_idp_climate_change.pdf. Accessed 6 Sept 2019 Food and Agriculture Organization (FAO) (2013) FAO in emergencies guidance note—supporting displaced people and durable solutions. http://www.fao.org/fileadmin/user_upload/emergencies/docs/Guidance%20Note%20Displacement.pdf. Accessed 8 Oct 2019 Foresight: Migration and Global Environmental Change (2011) Final Project Report. The Government Office for Science, London. https://assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/file/287717/11-1116-migration-and-global-environmental-change.pdf. Accessed 12 Nov 2019 Glennon R (2017) The unfolding tragedy of climate change in Bangladesh. Scientific American Guest Blog, 21 Apr. https://blogs.scientificamerican.com/guest-blog/the-unfolding-tragedy-ofclimate-change-in-bangladesh/. Accessed 12 Aug 2019 Government Accountability Office (GAO) (2009) Alaska native villages: limited progress has been made on relocating villages threatened by flooding and erosion. GAO Report GAO-09-551. Government Accountability Office, Washington, DC. https://www.gao.gov/new.items/d09551. pdf. Accessed 19 Oct 2019 Guerrier G, Paul R, Sananikhom P et al (2011) Strategic success for hydropower in Laos. Science 334(6052):38–38 Inter-Agency Standing Committee (IASC) (2010) IASC framework on durable solutions for internally displaced persons. The Brookings Institution–University of Bern Project on Internal Displacement, Washington, DC. https://www.brookings.edu/research/iasc-framework-ondurable-solutions-for-internally-displaced-persons-2/. Accessed 6 Oct 2019

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Inter-Agency Standing Committee (IASC) (2011) IASC operational guidelines on the protection of persons in situations of disasters. The Brookings Institution—University of Bern Project on Internal Displacement, Washington, DC. https://www.brookings.edu/wp-content/ uploads/2016/06/0106_operational_guidelines_nd.pdf. Accessed 6 Oct 2019 Intergovernmental Panel on Climate Change (IPCC) (2019) Summary for policymakers. In: Pörtner HO, Roberts DC, Masson-Delmotte V et al (eds) IPCC Special report on the ocean and cryosphere in a changing climate. https://www.ipcc.ch/srocc/home/. Accessed 1 Oct 2019 International Organization for Migration (IOM) (2008) Migration and climate change. IOM Migration Research Series No. 31. International Organization for Migration, Geneva International Organization for Migration (IOM) (2018a) Mapping human mobility and climate change in relevant national policies and institutional frameworks. Task Force on displacement Activity I.1. https://unfccc.int/sites/default/files/resource/20180917%20WIM%20TFD%20 I.1%20Output%20final.pdf. Accessed 1 Oct 2019 International Organization for Migration (IOM) (2018b) Vanuatu national policy on climate change and disaster-induced displacement. https://www.iom.int/sites/default/files/press_release/file/ iom-vanuatu-policy-climate-change-disaster-induced-displacement-2018.pdf. Accessed 2 Oct 2019 Lopez-Carr D, Marter-Kenyon J (2015) Manage climate-induced resettlement. Nature 517:265–267 McAdam J (2013) Creating new norms? The Nansen Initiative on disaster-induced cross-border displacement. https://www.brookings.edu/opinions/creating-new-norms-the-nansen-initiativeon-disaster-induced-cross-border-displacement/. Accessed 17 Oct 2019 McAdam J, Loughry M (2009) We aren’t refugees. Inside Story 29 June McNamara KE (2015) Cross-border migration with dignity in Kiribati. Forc Migr Rev 49:62 McNamara KE, Gibson C (2009) “We do not want to leave our land”: Pacific ambassadors at the United Nations resist the category of “climate refugees”. Geoforum 40(3):475–483 Melillo JM, Richmond TC, Yohe GW (eds) (2014) Climate change impacts in the United States: the Third National Climate Assessment. U.S. Global Change Research Program, Washington, DC. https://doi.org/10.7930/J0Z31WJ2 Nansen Initiative (2015) Disaster-induced cross border displacement. https://disasterdisplacement. org/wp-content/uploads/2014/08/EN_Protection_Agenda_Volume_I_-low_res.pdf. Accessed 12 Oct 2019 Oliver-Smith A (2009) Climate change and population displacement: disasters and diasporas in the twenty-first century. In: Crate SA, Nuttall M (eds) Anthropology and climate change. Left Coast Press, Walnut Creek, CA, pp 116–136 Palinkas LA (2012) A conceptual framework for understanding and mitigating the mental health impacts of oil spills: lessons from the Exxon Valdez oil spill. Psychiatry 75(3):203–222 Palinkas LA (2015) Behavioral health and disasters: looking to the future. J Behav Health Serv Res 42:86–95 Rogers S, Wang M (2006) Environmental resettlement and social dis/re-articulation in Inner Mongolia, China. Popul Environ 28(1):41–68 Scudder T (2005) The future of large dams: dealing with social, environmental, institutional and political costs. Earthscan, London Speelman LH, Nicholls RJ, Dyke J (2017) Contemporary migration intentions in the Maldives: the role of environmental and other factors. Sustain Sci 12(3):433–451 Sherwood A, Bradley M, Rossi L, et al (2015) Resolving post-disaster displacement: insights from the Philippines after Typhoon Haiyan (Yolanda). The Brookings Institution, 15 Jun. https://www. brookings.edu/wp-content/uploads/2016/06/Resolving-PostDisaster-DisplacementInsightsfrom-the-Philippines-after Typhoon-Haiyan-June-2015.pdf. Accessed 3 Oct 2019 Siders AR, Hino M, Mach KJ (2019) The case for strategic and managed climate retreat. Science 365(6455):761–763 United Nations Economic and Social Council (UNESC) (1998) Guiding principles on internal displacement. https://documents-dds-ny.un.org/doc/UNDOC/GEN/G98/104/93/PDF/G9810493. pdf?OpenElement. Accessed 6 Oct 2019

References

169

United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2014) Climate change and migration issues in the Pacific. https://www. ilo.org/dyn/migpractice/docs/261/Pacific.pdf. Accessed 12 Apr 2019 United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2017) Migration and climate change in Asia and the Pacific. https://www. unescap.org/sites/default/files/GCMPREP_5E.PDF. Accessed 12 Apr 2019 United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA) (2004) Guiding principles on internal displacement. https://www.unhcr.org/en-us/protection/idps/43ce1cff2/ guiding-principles-internal-displacement.html. Accessed 24 Oct 2019 United Nations Office of Disaster Risk Reduction (UNDRR) (2015) Sendai Framework for disaster risk reduction 2015-2030. https://www.unisdr.org/files/43291_sendaiframeworkfordrren. pdf. Accessed 23 Oct 2019 World Bank (2013a) Building resilience: integrating climate and disaster risk into development. Lessons from World Bank Group experience. The World Bank, Washington, DC. http:// documents.worldbank.org/curated/en/762871468148506173/pdf/826480WP0v10Bu0130B ox37986200OUO090.pdf. Accessed 30 Aug 2019 World Bank (2013b) OP 4 involuntary resettlement. https://policies.worldbank.org/sites/ppf3/ PPFDocuments/090224b0822f89db.pdf. Accessed 23 Oct 2019 World Health Organization (WHO) (2010). Essential public health package to enhance climate change resilience in developing countries  – Meeting Report:1–27. World Health Organization, Geneva. World Health Organization Africa Region (WHO AR) (2018) Health of refugees and migrants. Regional situation analysis, practices, experiences, lessons learned and ways forward. https:// www.who.int/migrants/publications/AFRO-report.pdf?ua=1. Accessed 20 Sept 2019 World Health Organization Western Pacific Region (WHO WPR) (2015) Human health and climate change in Pacific island countries. World Health Organization Western Pacific Region, Manila. https://iris.wpro.who.int/bitstream/handle/10665.1/12399/9789290617303_eng.pdf. Accessed 8 Oct 2019

Chapter 9

Practice Responses to Climigration

9.1  Introduction Whether climigrants are fleeing immediate danger associated with acute weather events, like hurricanes, floods, and fires, or longer-term threats to land, livelihood, and habitability security associated with sea level rise, droughts, and temperature increases, they will require services that address both immediate and long-term needs. In many respects, these services will be similar to those delivered to voluntary and forced (i.e., refugees) migrants who are not necessarily displaced due to climate change. However, the services delivered to climigrants must also take into account the circumstances that precipitate their displacement, i.e., trauma and loss of shelter resulting from an acute weather event or threats to land, livelihood, and habitability resulting from long-term climate-related changes in the environment. In some instances, this will require adaptation of existing programs and practices designed for disaster victims, immigrants, and refugees. In other instances, this will require the design, development, and evaluation of new programs and practices. In either instance, it will require a concerted effort to translate research into practices that can be successfully implemented and sustained. In this chapter, we apply a practice-based version of the three-tiered model introduced in Chap. 8 to lay out a strategy for delivering services to climigrants before and after the displacement occurs based on different categories of climate-related impacts. An illustration of this practice-based version appears in Fig. 9.1. Services delivered prior to migration are designed to prevent the need for displacement or prepare individuals and communities for displacement. Services delivered after resettlement are designed to address the material, social, and mental health needs of climigrants arising from both exposure to climate-related changes in the physical environment and resettlement in a new social environment. We will also examine strategies for implementing and sustaining these services.

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Tier 1

Tier 2

Tier 3

Socioenvironmental

Social

Individual

Sustainable development

Community-based disaster preparedness

Accessible and acceptable health care

Risk communication

Identification of atrisk populations

Preparation for migration and resettlement

Sustainability of host communities

Housing

Employment and financial security

Social skills and conflict management Peer support Social networks and climigration decisionmaking Social integration of climigrants into host communities Building and sustaining social support networks

Mapping of resources Training first responders Delivering schoolbased services Building resilience Evidence-based disaster response Target use of EBPs Task-shifting Stepped and collaborative care Adaptation and advocacy

Fig. 9.1  Three-tier model of prevention and mitigation of human impacts of climate change and climigration

9.2  T  he Three-Tier Model and Climigration Resettlement Practice 9.2.1  Tier I. Addressing Socioenvironmental Impacts Tier I efforts would include services designed to prevent the need for displacement or to assist with relocation and resettlement, either in countries of origin or in other countries less impacted by climate change. These efforts include building communities that are environmentally, socially, and economically sustainable; providing access to health care and education; and providing assistance in locating housing and employment opportunities. 9.2.1.1  Pre-migration Sustainable Development. As noted in Chap. 8, migration is only one of a number of different forms of adaptation to climate change. Adoption of other forms of adaptation may preclude the need to migrate in response to climate-related changes in

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Social Jobs and workforce development Health and well-being Food security Social Acceptability

Economic

Environmental

Economic growth and resilience Affordabilty Energy security Process efficiency Outputs of desired products

Water quality and quantity Soil quality Air quality Greenhouse gas emissions Biodiversity and wildlife

Fig. 9.2  The components of sustainability. (Adapted from Sustainability, by US Department of Energy, Office of Energy Efficiency & Renewable Energy, the Bioenergy Technologies Office, 2019. https://www.energy.gov/eere/bioenergy/sustainability)

the environment. Development of communities that are environmentally, socially, and economically sustainable is one such alternative adaptation strategy (Chi et al. 2019; Dillard et al. 2009; UNDESA 2013). As illustrated in Fig. 9.2, these three forms of sustainability are interrelated: Environmental sustainability seeks to sustain global life-support systems indefinitely (this refers principally to those systems maintaining human life). Source capacities of the global ecosystem provide raw materials – food, water, air, energy; sink capacities assimilate outputs and wastes. These source and sink capacities are large but finite. Sustainability requires that they be maintained rather than run down. (Goodland 1995: 6)

Developing communities that are environmentally sustainable would include infrastructure projects designed to reduce soil erosion and natural resource depletion and increase the availability of food and clean water and energy. One illustration of environmental sustainability efforts to address climate-related environmental changes is found in the Maldives: The small size and extremely low elevation of the coral islands that make up the Maldives place the residents and their livelihoods under threat from climate change, particularly ­sea-­level rise. The highest land point is a mere 2.4 m above sea level, and over 80% of the total land area is less than 1 m above sea level. At present, 42% of the population and 47% of all housing structures are within 100 m of coastline, placing them under severe threat of inundation (Government of Republic of Maldives 2010). Over the last 6 years, more than 90 inhabited islands have been flooded at least once and 37 islands have been flooded regularly or at least once a year. During the 2004 tsunami, many of the islands were completely

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9  Practice Responses to Climigration submerged, illustrating their critical vulnerability. Given the severity of anticipated sealevel rise, population relocation is viewed as inevitable. The government has planned to begin diverting a portion of the country’s annual tourism revenue for the establishment of an investment fund, with a view to purchasing ‘dry land’ to ensure a safe haven for future evacuation. Maldives’ planned evacuations in anticipation of loss of land will inevitably impact sovereignty and national identity. Although Maldives contributes very little to the problem of climate change, the government has pledged to make the country carbon-neutral within a decade. Toward this goal, clean electricity would power not only homes and businesses, but also vehicles. As an added benefit, Maldives would no longer need to import expensive fossil fuels. In addition to relocation and mitigation options, Maldives has focused on reducing vulnerability to sea-level rise through adaptation measures, including undertaking detailed technical and engineering studies to identify coastal protection options; re-forestation to prevent beach erosion; cleaning litter and debris from the coral reefs – a natural barrier against tidal surges; teaching environmental science in school; and imposing rigorous environmental impact assessment on all new resorts. (UNDESA 2010: 7)

Economic sustainability requires that “economic activities be financially feasible, self-renewing, and self-reliant” (Chi et al. 2019: 4). Developing communities that are economically sustainable would include replacement of some economic activities (harvesting of wild marine species, rice production) with activities more resistant to climate change (fish farming, drought-resistant crops), workforce development, and asset building. One well-tested community-based intervention designed to foster individual, family, and community sustainability and resilience is asset building, a social development strategy aimed at reducing economic inequality around the world (Sherraden 2014). The human ability to absorb economic shocks associated with environmental changes depends largely on the household asset base. Environmental disasters often lead to partial or total loss of household assets and reduced potential for income generation, resulting in low coping capacity and further vulnerability (De la Fuente 2007; World Bank 2008). However, despite the increasing attention being given to asset accumulation as a risk mitigation strategy, there are few empirical studies on asset-based strategies for the purpose of climate adaptation (Moser and Satterthwaite 2010). Social sustainability is defined as “a life-enhancing condition within communities, and a process within communities that can achieve that condition” (McKenzie 2004: 12). It refers to the ability of a social system to indefinitely function at a defined level of social well-being. “It occurs when formal and informal processes, systems structures, and relationships facilitate the ability of present and future generations to maintain secure and health communities” (Chi et al. 2019: 4). Developing communities that are socially sustainable would include projects that promote social integration and cohesion and provide accessible and culturally appropriate health care. These projects will simultaneously address Tier II and III needs described below. Addressing the direct health impacts of climate change, however, will require development of health-care systems that are designed to provide primary and specialty care services that are specific to these needs, including facilities, providers, and programs. In low-resource settings that are especially vulnerable to these health impacts, lay health workers (LHWs) are especially needed to shift tasks from more skilled providers and provide community-based services at low cost (WHO 2008).

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Preparation for Migration and Resettlement. Siders et al. (2019) have called for the development of programs for strategic, managed retreat or climigration that is “integrated into the pursuit of broader societal goals (the strategy) and its implementation tailored to context-specific goals (the management)… Decision-making and planning should take place at larger geographic and temporal scales; involve multiple agencies and jurisdictions; address multiple hazards; and be integrated into planning for economic, social and environmental goals” (p. 761). Examples of managed retreat to date include bans on rebuilding (such as in Australia, Germany, Japan, New Zealand, the Philippines, and Sri Lanka), required resettlement to preidentified locations (such as in Colombia, India, and Mozambique), property acquisition (such as in Colombia, Japan, the Netherlands, New Zealand, and the United States), and whole community relocation (such as in Australia, China, Fiji, India, Vietnam, and the United States) (Siders et al. 2019). Programs to manage retreat and assist climigrants with relocation could identify potential sites for relocation, coordinate with agencies that provide resettlement services in host communities, assist in the development of social networks that provide information and resources necessary for resettlement, and assist with transportation to host communities. For climigrants traveling to other countries, services in countries and communities of origin may assist in ensuring that migration is both safe and legal. However, to develop and implement such programs, research is required to address important gaps in our understanding of barriers to relocation and the means to overcome them, to evaluate relocation outcomes, and to project migration rates and destinations due to climate change. Such research will undoubtedly include the formation of research-practice partnerships to develop tools to identify residents who want to climigrate and need assistance and test communication strategies to engage reluctant residents, gathering data on climigration outcomes across multiple metrics and comparing them across contexts and management approaches, and pairing migration projections with risk assessments, economic analyses, and ongoing evolving migration trends (Siders et al. 2019). 9.2.1.2  Post-migration Sustainability of Host Communities. Just as development of sustainable communities is considered to be essential to reducing the need for climigration, sustainable development is important to address the material needs of climigrants’ post-­ migration. The large majority of these climigrants are expected to move to or within urban centers. Urban sustainability requires the integration of four pillars: social development, economic development, environmental management, and urban governance (UNDESA 2013). These four pillars are illustrated in Fig. 9.3. For instance: In general, the integration and coordination of different infrastructures and modes of public transportation save travel time and energy and reduce congestion and carbon emissions; the success of these measures has been reported in cities like Copenhagen, Curitiba, Freiburg and Paris. Other cities, like Bangkok, Lima, Mexico City and Singapore, are also working

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Sustainable Cities Social development •Education and health •Food and nutrition •Green housing and buildings •Water and sanitation •Green public transportation •Green energy access •Recreation areas and community support

Economic development

Environmental management

Urban governance

•Green productive growth •Creation of decent employment •Production and distribution of renewable energy •Technology and innovation (R&D)

•Forest and soil management •Waste and recycling management •Energy efficiency •Water management (including freshwater) •Air quality conservation •Adaptation to and mitigation of climate change

•Palnning and decentralization •Reduction of inequities •Strengthening of civil and political rights •Support of local, national, regional and global links

Fig. 9.3  Pillars for achieving sustainability of cities. (Adapted from World economic and social survey 2013: sustainable development challenges, by United Nations Department of Economic and Social Affairs (UNDESA), Development Policy and Analysis Division, ©2013 United Nations. Used with the permission of the United Nations. https://sustainabledevelopment.un.org/content/ documents/2843WESS2013.pdf) on integrating different forms of public mobility. In many of these cities, the goal is to reduce the transportation time between home, the city and the workplace, so as to reduce energy consumption and ensure that people have more time to be productive and enjoy urban life. (UNDESA 2013: 75)

Housing. One of the most important goals for sustainable host communities is the provision of safe, affordable housing. As illustrated throughout this book, climigrants are often forced to move because their homes are no longer habitable and opportunities for housing nearby are quite limited. Often, climigrants are forced to live in substandard housing in urban slums because of limited financial and economic resources. To reduce slums and squatter settlements, cities like Bangkok and Kuala Lumpur have initiated massive subsidized housing projects (Lim 2012). Provision of adequate housing, however, is of little value unless it is accompanied by available employment opportunities and access to government services (Mitlin and Satterthwaite 2012). Employment and Financial Security. As is the case with refugees in general, climigrants are likely to encounter multiple barriers that prevent them from getting jobs commensurate with their expectations, experience, and qualifications. For internally displaced climigrants, limited employment opportunities, limited education, and lack of specific job skills may be the chief barriers, especially for those moving from rural to urban settings. For international climigrants, these barriers can stem from limited proficiency in the dominant language of the host country,

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difficulty securing acceptance of professional credentials earned in countries of origin by host countries, locally, lack of professional networks, and pressure to take any type of job to quickly become economically self-sufficient (Mathema 2018). For internal and international climigrants who want to start businesses, barriers such as a lack of assets, credit history, and understanding how to run a business in a different setting or country may prevent them from starting businesses of their own (Mathema 2018). Programs in the United States designed to provide employment and financial security include the Refugee Support Services Program, Microenterprise Development Program, and Individual Development Accounts Program, all supported by the US Office of Refugee Resettlement (ORR 2019). The Refugee Support Services Program funding helps refugees and other ORR populations gain economic independence by helping them find and maintain employment, preferably within a year of being enrolled in the program. The Support Services focus on employability assessment, training and job development, vocational training and skills recertification, job placement, and job maintenance. The Refugee Support Services Program also addresses barriers to employment such as social adjustment, English language instruction, interpretation and translation, day care for children, and citizenship and naturalization. The Microenterprise Development (MED) Program helps ORR-served populations gain financial independence by providing loans and training to help them start, sustain, or expand a small business to support themselves and their families. The Individual Development Accounts (IDA) Program helps refugees and other ORR-eligible populations save toward an asset that will help increase financial independence. The program helps refugees understand what assets are, how the US financial system works, and how to manage their money (ORR 2019). There are several programs designed to create employment opportunities and build financial security for refugees throughout the United States that could serve as models for delivery of services to internally and internationally displaced climigrants. For example, Global Talent Idaho aims to further professional integration of skilled immigrants and refugees by providing clients with core classes to prepare them for a career path in the United States, help them build their resume, and have their foreign credentials evaluated (Mathema 2018): For those refugees and immigrants who want to start businesses, the Economic Development Department of the International Institute of St. Louis provides their clients with various business loans that start as low as $500 to as high as $35,000; provide them with technical assistance to teach them the ins and outs of doing business in the United States; and develop their credit score, credit history, and a portfolio. (Mathema 2018: 10–11)

However, the biggest challenges facing programs such as these in lack of funding and part-time or volunteer staff. Health Care. Refugee resettlement programs also typically offer an array of health services designed to meet the needs of refugee populations, including screening for and treatment of communicable and noncommunicable diseases in primary care settings. Given that climigrants lack legal status as refugees, they will require

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services that are affordable, accessible, and acceptable. Affordable services take into consideration the limited income and financial resources and lack of health insurance of most climigrants. Developing affordable services will require efforts to cut costs and expand service eligibility. Accessible services are located in or near geographic areas where climigrants resettle and do not require excessive and expensive means of transportation. Developing accessible services will require expansion of existing health-care facilities or construction of new facilities (Pavli and Maltezou 2017). Acceptable services are those considered to be culturally appropriate in the sense that they meet the expectations of patients and incorporate belief systems as to the cause, course, and cure of illness and disease (Carrillo et al. 1999; Napier et al. 2014). Developing acceptable services will require training of health-care providers in culturally competent service delivery and recruitment and training of lay health workers.

9.2.2  Tier II. Addressing Community Impacts Tier II efforts would address the potential social conflicts arising from climate change itself as well as the population movement of refugees in general, including cultural and ethnic differences and competition for limited resources and employment opportunities: Climate change is expected to impact social relationships between family and community members. In large part, these efforts are expected to be negative. Reduced natural resources may lead to increased competition among community members for food, water, and livelihoods (Gleick 1989). Acute climate events may result in the loss of family dwellings and community meeting places, leading to reduced opportunity for social interaction, and increased social strain. (Clayton et al. 2017) (Torres and Casey 2017: 3)

As demonstrated in Syria, Somalia, and South Sudan, climate change serves as an accelerant of civil conflict, leading to displacement and both internal and international migration. However, “from the moment of arrival, refugees may compete with local citizens for scarce resources such as water, food, housing, and medical services. Their presence increases the demands for education, health services, infrastructure such as water supply, sanitation, and transportation, and also in some cases, for natural resources such as grazing and firewood” (World Bank 2013). Conflict resolution, team-building activities, and efforts to reduce uncertainty among both migrating populations and host communities would be critical to reducing the potential for conflicts resulting from such impacts. Furthermore “policies and programs that aim to maintain ongoing social ties among migrants and their family and community members may be critically important in efforts to enhance population resilience and adaptation to climate change and to improve mental health outcomes” (Torres and Casey 2017: 1).

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9.2.2.1  Pre-migration Community-Based Disaster Preparedness. To prevent such disruption in interpersonal relations, research should focus on activities that can prepare communities to respond collectively and collaboratively to climate-related changes in the environment. There are several existing programs designed to prepare community leaders to respond to any form of community emergency or disaster. These efforts usually include the development of an Incident Command System for disaster response. The Incident Command System (ICS) is a standardized, on-scene, all-hazards incident management approach that (1) allows for the integration of facilities, equipment, personnel, procedures, and communications operating within a common organizational structure; (2) enables a coordinated response among various jurisdictions and functional agencies, both public and private; and (3) establishes common processes for planning and managing resources (Federal Emergency Management Agency (FEMA) 2013). Future research efforts may target the effectiveness of adapting existing ICSs for response to subacute and long-term climate-related environmental changes and integration of local leadership in regional, state, and national disaster response programs. Such research could address the question of whether the level of training community leaders receive is associated with reductions in levels of community uncertainty or whether structured coordination of disaster response is associated with less community level conflict and disruption of social relations (Palinkas 2015). Risk Communication. In addition to adopting Incident Command System procedures, reduction of levels of community uncertainty is especially important and may be accomplished through the use of interventions or practices designed specifically for communicating risk. Risk communications interventions have been shown to have beneficial effects, particularly if they include individual risk assessments or focus on intervention options (Macquire and Pitceathly 2002). There are several programs designed to train disaster responders and community leaders in risk communication, including the Centers for Disease Control’s Crisis and Emergency Risk Communication training program (CDC 2002). However, these programs are primarily designed to address the risks associated with natural disasters. Future research should be focused on adapting these interventions to communicating the risks associated with long-term changes in the environment, as well as determining the effectiveness of these communication programs in reducing social conflict and adverse behavioral health outcomes. Social Skills and Conflict Management. While Incident Command Systems and risk communication training may prepare community leaders for responding to acute weather events, it is not clear whether they adequately prepare them to respond to the social conflicts that often occur after long-term changes such as droughts, higher temperatures, or coastal erosions. Although social skills and conflict management training programs have been developed for health-care providers (Sargeant et al. 2011) and individuals undergoing stressful experiences or at risk for behavioral health problems (Botvin et al. 2008; Webster-Stratton et al. 2001), there has been no research to date to determine whether they could be useful for training

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community leaders who may also experience intense levels of distress or working with communities under stress. Research is recommended to develop and evaluate programs designed to train community leaders in techniques designed to foster social cohesion and manage social conflicts that may help to reduce the level of social conflict and improve access to social support. During a long-term event like a drought or the post-acute phase of a hurricane, similar evidence-based practices may be used to build and sustain social support networks. These include social skills training interventions designed to enable individuals to identify positive sources of support, communicate their needs and acquire needed resources, manage demands from their support networks, and manage potential conflicts with others (Dudley and Cortina 2008). Peer Support. A third area of potential focus pertains to the identification and training of community members who can serve as positive influences during and after a climate-related event. Programs like Psychological First Aid are based on the premise that service delivery is more effective when it involves interaction with peers who share many of the same characteristics or experiences as those who are the target for such services (Allen et al. 2010; Brymer et al. 2006). Future research may target the development and evaluation of peer support programs that could be mobilized during and after a disaster to enable individuals to cope with the behavioral health impacts by making available a form of social support and fostering a sense of community cohesion. Although such programs have been shown to reduce symptoms of depression and other mental health problems (Hardiman and Jaffee 2008; Pfeiffer et al. 2011), the extent to which such programs provide social support during the acute of post-acute phases of an extreme weather event or during a longer-­term event like a drought has yet to be determined. Mobilization of social networks and support may also be facilitated by their engagement in disaster preparedness training and programs, programs designed to mitigate climate change, and programs designed to adapt and rebuild post-disaster in communities of origin (Torres and Casey 2017). For instance, Mathbor (2007) highlights the Cyclone Preparedness Program in Bangladesh as providing ongoing opportunities for interaction and trust-building among local volunteers while also facilitating the exchange of resources (e.g., food shelter) and information (e.g., early warnings regarding environmental risks), thereby increasing preparedness for acute events like cyclones (Adger et al. 2005; Eisenman et al. 2009). Social Networks and Climigration Decision-making. Social ties also play an important role in migration decisions and choice of destinations, given that pre-­ existing social networks are a source of information about the costs and benefits of climigration (Massey et  al. 1993). “For example, scholars have found that the drought-motivated adaptive migration of West African Fulbe herders only occurred because of the long-term development of social networks between migrants and non-migrants through trade and seasonal grazing” (Torres and Casey 2017: 1). Climigrants may also be motivated by a desire to reunify with family or community members. For instance, Mexican residents have been shown to be more likely to migrate after years of drought only if they lived in regions with historically high levels of US migration (Hunter et al. 2013). According to Torres and Casey (2017:

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4), “individuals from these regions likely had strong ties to migrant family or community members, which facilitated the process of migration.” 9.2.2.2  Post-migration Despite the advantages of social networks in facilitating climigration, displacement also comes with a social cost. “Environmentally-motivated migration and displacement may lead to the disruption of existing social ties, with potentially adverse consequences for mobile populations as well as their family members who remain in places of origin” (Torres and Casey 2017: 1). This disruption, in turn, can contribute to severe Tier III mental health impacts: Migration may also adversely impact mental health by disrupting social and community connections. Separation from one’s close family members due to a disaster or conflict may be an acute stressor with both short and long-term impacts on mental health outcomes. Disrupted social ties may contribute to adverse mental health outcomes through mechanisms of social isolation and reduced financial and material (i.e., informational, financial) support (Thoits 2011). Separation from members of one’s origin family or community may also lead to a reduced sense of belonging within a familial, regional, or ethnic network, which may contribute to poorer mental health (Torres et  al. 2016). (Torres and Casey 2017: 5)

Social Integration of Climigrants into Host Communities. To mitigate these impacts, several programs and practices are recommended for building social cohesion and reducing social conflict. “Programs that have a focus on bringing community members together help build trust and relationships among participants” (Mathema 2018: 20). Examples include refugee liaison officers employed by local police departments; pairing students with refugee families to provide basic assistance with tasks such as mentoring children, helping with homework, and performing household chores; providing opportunities for local businesses to learn about refugees and build cultural competency; and using volunteers to assist refugees in learning to navigate the community (Mathema 2018). In the United States, the Office of Refugee Resettlement’s Ethnic Community Self-Help Program provides assistance to refugee community-based organizations and other groups that address community building, facilitate cultural adjustment and integration, and deliver mutually supportive functions such as information exchange, civic participation, resource enhancement, orientation and support to new and established refugees, and public education to the larger community. The premise underlying this program is that the active participation of refugees in resettlement is empowering and plays an important role in the integration of the entire refugee community (ORR 2019). Building and Sustaining Social Support Networks. “Environmentally-motivated migration and displacement may lead to the disruption of existing social ties, with potentially adverse consequences to mobile populations as well as their family members who remain in places of origin” (Torres and Casey 2017: 1). Building or preserving social support networks may also help to address Tier III intrapersonal

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needs. “Social ties have also been linked to population health, through protective mechanisms of resource sharing (i.e., social capital) and emotional support, as well as through stress-inducing mechanisms of social and financial burden (Kawachi and Berkman 2001)” (Torres and Casey 2017: 2). One approach to building and supporting social networks is through evidence-­ based network interventions that use social networks or social network data to generate social influence, accelerate behavior change, improve performance, and/or achieve desirable outcomes among individuals, communities, organizations, or populations (Valente et al. 2015). Valente (2012: 49) describes four types of network interventions: (i) identifying individuals (called “nodes” within the network) who are selected on the basis of some network property; (ii) segmentation, in which the intervention is directed toward groups of people; (iii) induction, in which excitation of the network occurs such that novel interactions between people (links in the network) are activated; and (iv) alteration, interventions that change the network.

Social media and mobile technologies also serve to maintain social ties across great distances and may thus serve as a useful means for facilitating social connection between newly arrived refugees and those in the host societies (Walker et al. 2015). Although refugee populations often have access to such technologies, there is currently no empirical evidence of their effectiveness (Torres and Casey 2017).

9.2.3  Tier III. Addressing Individual Impacts As we have observed in previous chapters, while exposure to climate-related changes in the environment carries with it the risk of mental health problems, those who are displaced by these events are at particular risk. A study of 1615 New York residents affected by Hurricane Sandy, for instance, found that displaced participants were more likely to have posttraumatic stress disorder, depression, anxiety, and increased perceived stress compared with non-displaced participants (Schwartz et al. 2017). For climigrants, exposure to past and ongoing traumatic events such as civil conflicts and human trafficking and the complexities of navigating the post-­ migration environment such as dealing with school, employment, discrimination, and changes of roles within the family are of key importance in understanding the risk and protective factors shaping their mental health (Fazel and Betancourt 2018). Although there is considerable overlap in the mental health impacts of acute and subacute climate-related environmental changes, both the timing and nature of these events as well as the manifestation of specific associations between an event and its mental health consequences suggest the need for a phased approach to service delivery, with each phase building on the services developed and implemented in earlier phases. In each of these phases, service providers would benefit from training and guidance in assessing and assisting people suffering from climate-related mental health problems. Service providers can also play an important role in climate change

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mitigation and developing and implementing evidence-based practices to support mental health. Delivery of effective services in the aftermath of extreme weather events and long-term climate-related environmental changes calls for coordinated preparedness, response, and recovery. These efforts include the mapping of available resources and locations of at-risk populations, development and implementation of effective and sustainable guidelines and interventions for treatment of adverse mental health outcomes and strengthening of individual and community resilience, and training of non-mental health professionals for service delivery. 9.2.3.1  Pre-migration Identification of At-Risk Populations. Mental health impacts of acute weather events may also be addressed by identifying individuals and communities that are most underserved and most susceptible to these impacts (Bourque and Cunsolo Willox 2014). Risk factors for these impacts include female gender, younger age, lower socioeconomic status, less education, minority or ethnic status, psychiatric history, family instability, and inadequate social support (Clayton et al. 2014; Dodgen et al. 2016; Hayes et al. 2018; Trombley et al. 2017; Norris et al. 2002; Rataj et al. 2016). Residents of low- and middle-income countries are especially vulnerable to these outcomes due to their increased exposure to extreme weather events, high levels of poverty, and lack of access to services (Berry et al. 2010; Nahar et al. 2014; Levy et al. 2017; Rataj et al. 2016). One recommendation calls for the use of geographic information systems and related tools to enable communities to more effectively map risk factors and social vulnerabilities, identifying and protecting specific locations and groups (Trombley et al. 2017). Such information could be used to enable mental health providers to proactively address their needs. The context or circumstances in which relocation occurs is also important in assessing individual level of need for services. For instance, a study of older adults in a rural region of central China found that those who were relocated to conserve sensitive ecological areas had higher levels of depressive symptoms than non-­ migrants, but that no differences were observed between migrants who were displaced for infrastructure projects, poverty alleviation, or disaster management (Zeng et al. 2015). Another study of children and young adults found that human-made disaster (e.g., civil conflicts) seemed to show more potential for traumatic symptoms than natural disaster (e.g., Hurricane Katrina) (Myles et al. 2018). Mapping of Resources. Preparedness for extreme weather events should include protocols and procedures for mapping available resources and identifying at-risk populations in need of mental health services in the aftermath of an extreme weather event. The Inter-Agency Standing Committee of the World Health Organization recommended mapping and monitoring psychosocial resources and skills within communities (IASC 2007). Use of resources like the Disaster Psychosocial Assessment and Surveillance Toolkit (Disaster-PAST) can improve disaster preparedness and response and enhance community recovery (Hayes et al. 2018; Ciccone 2012).

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Training of First Responders. Essential to providing an appropriate and sustainable mental health response after natural disasters is the recruitment and training of non-mental health providers who are members of or otherwise knowledgeable about the affected populations (Bourque and Cunsolo Willox 2014; Clayton et al. 2014; Nahar et al. 2014). Mental health teams responding to acute climate-related events must include local people who can be trained as community health workers to deliver less intensive services like Skills fOr Life Adjustment and Resilience (SOLAR) (O’Donnell et  al. 2018), an intervention designed to target individuals experiencing mild to moderate distress and impairment in the aftermath of disaster. Delivering School-Based Services. Clinics are not the only locales for delivering mental health services. “Schools and school staff members are uniquely positioned to help the roughly 100 million children around the world who are exposed to disasters every year” (Lai et al. 2018: 586). School administrators, staff, and teachers may help reduce the psychological impacts of acute weather events such as hurricanes, wildfires, and floods and subacute events such as prolonged droughts and heat waves on children by screening for and recognizing traumatic symptoms, delivering evidence-based interventions designed for use in the classroom (Jaycox 2004), and making appropriate referrals to mental health specialists when indicated. “Trauma-informed” schools may also serve as a location where climigrant children and their families are able to access a range of services, including health-care and linguistic support as well as opening educational opportunities (Fazel and Betancourt 2018). Building Resilience. Service providers may foster individual and community resilience through development and implementation of interventions designed to prevent adverse mental health outcomes (Bourque and Cunsolo Willox 2014; Springgate et al. 2018). Existing interventions such as the Strengthening Families Program (SFP) (Kumpfer et al. 1996), a family skills training program designed to increase resilience and reduce risk factors for behavioral, emotional, academic, and social problems in children 3–16 years old, and Coping with Work and Family Stress (Snow et al. 2002), a workplace preventive intervention designed to teach employees how to deal with stressors at work and at home, may serve as models for the development of interventions that build resilience in families and communities before a disaster strikes. Preventive measures should also be developed for individuals with pre-existing psychiatric conditions who are at risk for serious illness and hospitalization during heat waves (Schmeltz and Gamble 2017). Evidence-Based Disaster Response. While these activities are intended to prevent adverse behavioral health impacts, there exist numerous evidence-based treatments (EBTs) for these impacts once they have occurred. These treatments range from immediate triage and interactions with trained first responders to more intensive evidence-based treatments. An example of the former intervention that has been increasingly used post-disaster is Psychological First Aid (PFA) (Forbes et al. 2011; (Birkhead and Vermeulen 2018). PFA includes eight core actions: • Contact and Engagement: To respond to contacts initiated by survivors or to initiate contacts in a non-intrusive, compassionate, and helpful manner

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• Safety and Comfort: To enhance immediate and ongoing safety and provide physical and emotional comfort • Stabilization (If Needed): To calm and orient emotionally overwhelmed or disoriented survivors • Information Gathering on Current Needs and Concerns: To identify immediate needs and concerns, gather additional information, and tailor Psychological First Aid interventions • Practical Assistance: To offer practical help to survivors in addressing immediate needs and concerns • Connection with Social Supports: To help establish brief or ongoing contacts with primary support persons and other sources of support, including family members, friends, and community helping resources • Information on Coping: To provide information about stress reactions and coping to reduce distress and promote adaptive functioning • Linkage with Collaborative Services: To link survivors with available services needed at the time or in the future (NCTSN 2006) PFA may also be used to address Tier I and Tier II impacts by serving as a form of risk assessment and referral to health services during a disaster and by providing social support and facilitating connections to social support networks (North and Pfefferbaum 2013; Palinkas 2015). The use of different forms of evidence-based or evidence-informed treatments for psychological trauma and distress with different groups of individuals manifesting different levels of symptomatology is also embedded in a number of guidelines for providing effective psychosocial care following extreme weather events and other disasters. For instance, the TENTS guidelines, produced in 2008 by the European Network for Traumatic Stress, are designed to assist in the provision of effective psychosocial care following disasters (European Network for Traumatic Stress 2008). TENTS provides generic advice and is not specific to low-resource settings, but the core principles may still provide useful guidance. “These include consideration of planning, preparation and management; general components of the response (concerning, for example, human rights and cultural issues); and specific components of the response that may be relevant during different phases after the event, from the first week to the period beyond three months” (Nahar et al. 2014: 6). WHO’s Framework for Mental Health and Psychological Support after the Tsunami (WHO SEA 2005) is another protocol, based on the premise that post-­ disaster mental health interventions need to cover both clinical interventions (including medication and psychotherapy) and basic, nonclinical psychological support interventions (such as Psychological First Aid), the latter for the large proportion of disaster-affected populations who do not require and would obtain minimal benefit from intensive evidence-based treatment (Nahar et  al. 2014). The protocol defines four levels of care: (1) community mental health services; (2) mental health care through primary health care; (3) care and support outside the formal health sector; and (4) self and family care. Work performed at the first two levels are led by community mental health teams, with hospital support as necessary, and

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include members from affected communities (and/or community health workers) (Nahar et al. 2014). The next two levels focus on the training of traditional healers, teachers, religious clerics, and other community leaders to provide support, as well as strengthening community networks through activities that facilitate social interaction and mutual support (Nahar et al. 2014). 9.2.3.2  Post-migration Accessible and Acceptable Health Care. Refugee resettlement programs also typically offer an array of health services designed to meet the needs of refugee populations, including screening for and treatment of communicable and noncommunicable diseases in primary care settings. Given that climigrants lack legal status as refugees, they will require services that are affordable, accessible, and acceptable. Affordable services take into consideration the limited income and financial resources and lack of health insurance of most climigrants. Developing affordable services will require efforts to cut costs and expand service eligibility. Accessible services are located in or near geographic areas where climigrants resettle and do not require excessive and expensive means of transportation. Developing accessible services will require expansion of existing health-care facilities or construction of new facilities (Pavli and Maltezou 2017). Acceptable services are those considered to be culturally appropriate in the sense that they meet the expectations of patients and incorporate belief systems as to the cause, course, and cure of illness and disease (Carrillo et al. 1999; Napier et al. 2014). Developing acceptable services will require training of health-care providers in culturally competent service delivery and recruitment and training of lay health workers. Targeted Use of Evidence-Based Practices. While these activities are intended to prevent adverse behavioral health impacts in the aftermath of acute extreme weather events, there exist numerous evidence-based treatments (EBTs) for these impacts once they have occurred that may be delivered to climigrants undergoing displacement who have been traumatized by extreme weather events or the consequences of long-term climate-related changes in environment such as extreme poverty and civil conflicts. Examples of such treatments include Trauma-Focused Cognitive-­ Behavioral Therapy (TF-CBT) (Cohen et al. 2006), a 12-session individual or conjoint intervention that includes both child and parent and is typically delivered in clinics; Cognitive-Behavioral Intervention for Trauma in Schools (CBITS) (Jaycox 2004; Jaycox et al. 2010), a 10-session group and 1–3-session individual intervention designed specifically for use in schools; Eye Movement Desensitization and Reprocessing (EMDR), an 8-session intervention originally designed to alleviate the distress associated with traumatic memories often used to treat PTSD in veterans and victims of natural disasters (Shapiro 1989); and Narrative Exposure Therapy (NET), a 6–10-session intervention that has been used with refugees and asylum seekers resettled in high-income countries (Nosé et al. 2017) and in low-resource settings with lay counselors (Neuner et al. 2008; Robjant and Fazel 2010; Ruf et al. 2010). These interventions have been found to be effective in improving PTSD and

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other symptoms in children experiencing disaster (Cohen et al. 2004; Kataoka et al. 2003; Stein et al. 2003) and civil conflict (Catani et al. 2012). A pre-post Katrina assessment of the School Therapeutic Enhancement Program intervention, which adapted existing evidence-based cognitive-behavioral treatments for depressed and disruptive youth, found that high-need intervention students demonstrated clinically significant lower levels of emotional and behavioral problems, depression, and inattention in comparison to pretreatment levels (Goldman et  al. 2015). Two small RCTs in displaced Syrian refugees in Turkey showed a significant reduction in symptoms of PTSD and depression with exposure to EMDR (Acarturk et al. 2015, 2016). By reducing adverse intrapersonal health outcomes during the post-disaster period, treatments like TF-CBT and CBITS have potential for addressing interpersonal Tier II impacts as well. Studies of refugee families also point to an increased risk of child maltreatment and interpersonal violence, highlighting a need for appropriate interventions (Tappis et al. 2016; Fazel and Betancourt 2018). For instance, Puffer et al. (2017) reported a significant effect on positive parenting practices, caregiver-child interactions, and family functioning in a randomized controlled trial (RCT) of Happy Families, a parenting and family skills intervention for children and their caregivers adapted from the Strengthening Families Program (Kumpfer et al. (1996), with displaced and migrant Myanmarese in a Thai camp. Another RCT with Somali and Pakistani migrants in Norway showed that the Parent Management Training—Oregon (PMTO) (Forgatch and Kjøbli 2016) was effective in enhancing parent practices, with a decrease in harsh discipline and an increase in positive parenting and a decrease in mother-reported child conduct problems (Bjorknes and Manger 2013). Task Shifting and Community/Lay Health Workers. Despite evidence of their effectiveness, interventions such as TF-CBT, EMDR, and NET are usually delivered by highly trained mental health specialists. In both high- and low-resource settings, a shortage of such specialists restricts access to these services to climigrants and other immigrants and refugees. As noted in Chap. 1, most climigrants from low-resource settings migrate to nearby communities or areas within a country that are also low resource in nature. These settings have even fewer trained mental health specialists than are available in high-resource settings (e.g., high-income countries). Even in these settings, the large majority (80–90%) of refugees with symptoms of PTSD or other psychological problems do not visit specialized mental health-care services due to stigma, institutional barriers like the need for referral from a primary care provider, and physical distance to mental health-care services (Sijbrandij et al. 2017). To address these barriers in low-resource settings WHO recommends task shifting as a strategy for delivering less intensive and complex mental health services than the ones described earlier (WHO 2010). “Task-shifting means that a task that is originally performed by a highly-qualified specialist is transferred to a less specialized worker with fewer qualifications. For example, tasks may be shifted to a supervised lay person who is specifically trained to perform a limited task only” (Sijbrandij et al. 2017: 4).

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One approach to treatment of mental health problems among displaced populations by lay providers has been the adoption of a common elements treatment approach (CETA) (Chorpita et al. 2005; Weisz et al. 2012; Murray et al. 2014). Also known as a modular or transdiagnostic approach, CETA trains providers in different treatment elements of standard cognitive-behavioral therapies that can be combined in different ways to treat a range of common mental health symptoms (depression, anxiety, PTSD). The approach has been used in both HICs and LMICs and is viewed as being both sustainable in low-resource settings and more appropriate for treating refugee populations with multiple disorders (Bolton et al. 2014; Murray et al. 2014; Weiss et al. 2015; Murray and Jordans 2016). Randomized clinical trials of use of CETA by lay health providers with Myanmar refugees on the Thailand/Myanmar border (Bolton et al. 2014) and survivors of civil conflict in Iraq (Weiss et al. 2015) and Colombia (Bonilla-Escobar et al. 2018) reported medium to large effect sizes in reductions of depression, anxiety, and posttraumatic stress. In a pre-post treatment study, Murray et al. (2018) trained lay health providers to deliver CETA to youth and families in three Somali refugee camps in Ethiopia. Significant decreases were reported in internalizing and externalizing symptoms, posttraumatic stress, and improvements in well-being. Stepped and Collaborative Care. Another strategy for delivering services to climigrants in both LMICs and HICs is stepped care and collaborative care. European guidelines recommend stepped care and collaborative care as cost-effective alternatives to conventional care for common mental health symptoms. Sijbrandji and colleagues (2017) have recommended a stepped care approach to delivering mental health services to Syrian refugees in Europe. Such an approach would begin by implementing shorter versions of regular CBT and problem-solving treatment (PST) (Gath and Mynors-Wallis 1997) as the first intervention before stepping up to more specialized treatments if needed. Another form of stepped care developed as part of the WHO’s mhGAP is Problem Management Plus (PM+), designed for use in communities affected by adversity (Dawson et al. 2015). PM+ is available as an individual version (Individual PM+) evaluated in Pakistan (Rahman et al. 2016) and Kenya (Bryant et  al. 2017) and as a group version (Group PM+) evaluated in Pakistan (Rahman et al. 2019): These shorter and simpler first-step interventions may be delivered by trained lay-­ counselors. However, as far as we know, stepped care models have not yet been implemented widely within European refugee mental health care. In the Netherlands, a preventive psychosocial task-shifting intervention is currently delivered by peer-refugees in Dutch asylum centers (Kieft et al. 2008), but no studies evaluating the effects of the intervention have been carried out. (Sijbrandij et al. 2017: 5)

As with the treatment of trauma symptoms related to extreme weather events prior to migration, post-migration treatment of symptoms related to disasters and climate-­ related civil conflicts in school-based settings is highly recommended. For instance, teachers, counselors, and other school staff have been trained in CBITS (Jaycox 2004) to address trauma symptoms exhibited by school-aged children exposed to inner city violence, child abuse and neglect, and natural disasters. Such interventions can be employed to provide mental health support to vulnerable refugee

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populations such as unaccompanied minors as well as for families (Tyrer and Fazel 2014; Fazel et al. 2016): For example, a multi-tiered approach was used for a class of refugee children in the USA, called Project SHIFA (Ellis et al. 2013). In this model, broad mental health promotion was offered to all, and those identified at higher risk were placed in school-based early intervention groups. Those with significant distress were given a direct trauma-based treatment under the trauma systems therapy (TST) model with more intense services including home-­ based mental health care, advocacy and case management. (Fazel 2018: 120)

However, the evidence supporting the use of these interventions in both short-term and long-term migration and addressing the psychosocial impacts of other manifestations of climate change is limited, especially in low-resource settings with few trained clinicians and mental health facilities (Hayes et al. 2018). Research is needed to evaluate the effectiveness of existing EBPs in these contexts (Grolnick et  al. 2018; Mitra and Hodes 2019). Given robust evidence of socioeconomic and cultural differences in vulnerability to acute climate-related events, their mental health impacts, and treatment effectiveness, an important cross-cutting dimension in these efforts will be contributions to adapting interventions to ensure they are responsive to both structured inequities and cultural and ethnic differences (Palinkas and Wong 2019). “Although interventions that are effective in high resource-settings have also been shown to be effective in low-resource settings and for migrant populations (Morina et al. 2017), cultural adaptation of the original intervention protocols to the local culture is essential” (Sijbrandij et al. 2017: 3). Adaptation and Advocacy. Responding to the mental health consequences of longer-term changes in the environment such as droughts will require actions rooted in both mitigation and adaptation at all levels—from global to local—and from all sectors and individuals (Hayes et  al. 2018). Several authors have recommended engagement by mental health professionals in advocating for mitigation policies and programs as one response to dealing with subacute and long-lasting climate-­ related events (Bourque and Cunsolo Willox 2014; Clayton et  al. 2014; Dodgen et al. 2016; Doherty and Clayton 2011; Hayes et al. 2018). Adaptation will include implementation of the guidelines, treatment, and preventive interventions described in this section in dealing with acute events. Many of these guidelines and interventions will undoubtedly require forms of adaptation to address the secondary impacts of subacute events such as economic loss, threats to health and well-being, population displacement, environmental degradation and collective violence, as well as the populations most vulnerable to such impacts. For instance, relocating entire communities to geographic areas where sea level rise and frequent extreme weather events are less likely to occur is an adaptation to coastal erosion resulting from sea level rise and more frequent extreme weather events (Hayes et  al. 2018). Public health education of the risks of vector-borne illness is an adaptation to the increasing threats to health and well-being (Hayes et al. 2018). Addressing underlying risk factors for collective violence, such as poverty and socioeconomic disparities, is an adaptation strategy for reducing the mental health consequences associated with such violence (Levy et al. 2017).

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9.3  Implementation and Sustainability of Evidence-Based Services Whether the service is evidence-based and requires adaptation or in development for use with climigrants, delivery of services in all three tiers will require concerted efforts to translate research into practice using principles of implementation science. Implementation research is “the scientific study of methods to promote the systematic uptake of research findings and other evidence-based practices into routine practice, and, hence, to improve the quality and effectiveness of health services” (Eccles and Mittman 2006: 1). Implementation science rests upon four pillars (Palinkas 2019). The first pillar is the generation and application of theories, models, and conceptual frameworks such as Diffusion of Innovation Theory (Rogers 2003); Ottawa Model of Research Use (OMRU, Logan and Graham 1998); Consolidated Framework for Implementation Research (CFIR, Damschroder et  al. 2009); and the Exploration, Preparation, Implementation, and Sustainment (EPIS, Aarons et al. 2011) framework. These are used to identify potential barriers, facilitators, the process, and outcomes of program, practice, and policy implementation. The second pillar of implementation science is the development and application of several strategies for facilitating the implementation of EBPs. Implementation strategies are methods or techniques used to enhance the adoption, implementation, and sustainability of a clinical program, policy, or practice (Proctor et  al. 2013). Their focus may include the systems environment, organization, group, supervision, or individual providers and/or consumers. Examples include learning collaboratives (Institute for Healthcare Improvement 2003), knowledge translation and exchange (Lavis et al. 2003), and cascading dissemination (Chamberlain et al. 2012). The third pillar of implementation science is the assessment of the process and outcomes of implementation efforts. Commonly used measures of implementation outcomes are guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework (RE-AIM, Glasgow et al. 1999) and Proctor et al. (2011) outcomes of acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration, and sustainability. One of the best known of the efforts to develop metrics for accessing implementation process and outcomes is the Stages of Implementation Completion (SIC) scale. The SIC is an 8-stage assessment tool of implementation processes and milestones, with sub-activities within each stage (Chamberlain et al. 2011). The fourth pillar or set of tools of implementation science is characterized by methodological innovation. Examples of such innovation are the design and application of alternatives to the traditional RCT (Brown et al. 2017), use of mixed qualitative-quantitative research methods (Palinkas et  al. 2011), and system science methods such as agent-based modeling (McVay et  al. 2018) and social network analysis (Valente et al. 2015). Efforts to implement evidence-based programs and practices for disaster preparedness have relied on widely used implementation models and frameworks. For

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instance, the Translation, Dissemination, and Implementation (TDI) initiative, funded by the Centers for Disease Control and Prevention, used the Interactive Systems Framework (ISF) (Wandersman et  al. 2008) to determine how selected Preparedness and Emergency Response Research Centers (PERRC) and Preparedness and Emergency Response Learning Center (PERLC) program outputs could be delivered to the practice community, based on their identified needs (Leinhos et al. 2014; Richmond et al. 2014). The ISF served as a guide for designing projects that could best address the research to practice gap at one or more of three ISF systems levels: the prevention synthesis and translation system, the prevention support system, and the prevention delivery system (Qari et  al. 2018). Eisenman et  al. (2018) used Getting to Outcomes (GTO; www.rand.org/gto) to build the capacity of local health departments to translate and implement evidence-based practices in disaster preparedness. Springgate et  al. (2018) are employing a Community Partnered Participatory Research (CPPR) framework to incorporate community priorities, assets, and opportunities for building community resilience in areas of Southern Louisiana at risk for hurricanes and flooding. Health-care worker training, integration of treatments into primary health care, improved supply of medications, and system redesign to overcome both supply and demand barriers to evidence-based care are areas of global mental health in general and mental health services for displaced populations in particular where implementation science can make a significant impact (Collins et  al. 2011; Betancourt and Chambers 2016). For instance, Huang et  al. (2017) used the Teacher Training Implementation Model (TTIM) (Reinke et  al. 2013) and the CFIR and RE-AIM frameworks to implement and evaluate one component of an evidence-based intervention (EBI) for use by Ugandan primary school teachers. It included large group experiential training and small group coaching to introduce and support a range of evidence-based practices (EBPs) to create nurturing and predictable classroom experiences. Using PRISM (Practical, Robust Implementation and Sustainability Model) (Feldstein and Glasgow 2008) for guidance, Ssewamala et al. (2018) are implementing an evidence-based practice, called Multiple Family Group (MFG) (McKay et  al. 2002), aimed at improving child behavioral challenges in schools in Uganda. Murray et al. (2013) used an apprenticeship model of training and supervision of lay counselors to implement an adapted version of TF-CBT in Zambia. Gureje et al. (2015) employed a cascade training strategy to implement task shifting for delivery of mental health services in primary care settings in Nigeria. Implementation of evidence-based interventions will also require certain forms of cultural adaptation to enable fit into the contexts of both communities of origin and host communities. “How, when, and whether existing interventions can be adapted to the cultural sensitivities of specific refugee situations needs to be determine, as adapting interventions is likely to enhance implementation challenges and improve the reach of services available” (Fazel and Betancourt 2018: 128).

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9.4  Summary In this chapter, we introduced a three-tier model of service delivery to climigrants based on three categories of impacts: socio environmental, community, and individual. Addressing socioenvironmental impacts focused on the development of communities that are environmentally, economically, and socially sustainable and providing assistance to climigrants both prior to and subsequent to resettlement. Addressing social impacts focused on fostering social cohesion and support and reducing social conflict. Addressing individual impacts focused on delivery of mental health services. In the course of elucidating the types of services that might be delivered under this three-tier model, three themes became evident. Each theme reveals contrasts in decisions to be made as to when, where, and how services are to be delivered. The first theme pertains to the timing of service delivery. Some of the services described in this chapter (e.g., preparation of climigrants for migration and resettlement, community-­based disaster preparedness, risk communication, social networks and climigration decision-making, identification of at-risk populations, mapping of resources, development and training of first responders, and evidence-based disaster response) are designed for use prior to migration, while others (e.g., programs designed to foster social integration of refugees into the larger community, targeted use of evidence-based practices to treat ongoing symptoms and disorders) have been designed for use after resettlement. However, the majority of programs could conceivably be employed as means to prevent climigration and as means to improve the quality of life of displaced individuals once climigration has occurred. The second theme that pervades this discussion of services for climigrants relates to the decision of where the services are to be delivered. The bulk of services delivered both prior to and subsequent to climigration will be delivered in low-resource settings. In such settings, services must take into consideration the limited resources available for sustainable development, community cohesion and social support, and delivery of evidence-based mental health interventions. Task shifting and stepped care are especially likely to be used to deliver mental health services to internally displaced climigrants, but evidence of their effectiveness in high-income countries suggests it might also be employed in these settings to reduce costs and improve quality of care. Services to international migrants will be tied to legal status as climate refugees and to the pairing of job skills with employment opportunities. While sustainable development is viewed as critical to urban areas in LMICs, it is equally important in HICs as urban centers become host communities for increasing numbers of climigrants. The third theme relates to the decision of whether to adapt existing services offered to other displaced populations or to develop new services. In many instances, existing services can be adapted to meet similar needs of new groups of migrants. For instance, sustainable development can target environmental, social, and economic impacts of climate change that precipitate the decision to migrate. Existing refugee resettlement programs can be adapted to climigrants who may experience

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similar forms of trauma (e.g., civil conflicts, unemployment) as well as unique traumatic experiences (extreme weather events, starvation, inadequate job skills). Existing disaster preparedness and response programs can be tailored to reduce inequality of impacts, promote social cohesion and support, and improve delivery of appropriate and cost-effective services post-disaster. On the other hand, entirely new services and programs may be in order, such as strategic and managed retreat, task shifting in both low- and high-resource settings, and stepped and collaborative care. Careful consideration will be required to determine when and how existing services are to be adapted or new services developed, and when  both new and adapted services will be evaluated for evidence of effectiveness and successfully implemented and sustained. The chapter also highlighted the relationships between climigration and sustainability, social relations, and individual well-being. Sustainable development can be viewed as a strategy to reduce the need for climigration and as a strategy to facilitate successful migration. As revealed in our analysis of Tier II impacts, climigration is also intimately linked to stability and change in social relations. Armed civil conflicts such as those occurring in the Middle East and Africa or tensions between climigrants and residents of host communities as illustrated in Europe during the Great Migration or the city of Houston after Hurricane Katrina demonstrate the range of responses to the competition for scarce resources and the inequality of impacts of climate change. In some circumstances, climigration may act as a relief valve for social pressures in communities of origin as populations competing for scarce resources become smaller and more geographically dispersed. However, it can also contribute to conflict in host communities and countries and lead to a reduction in social support for those who are displaced. The three-tier model also illustrates the linkages between social relations and the other two categories of climate change and climigration impacts. Social conflict and reduced social support reduce the ability to address Tier I impacts and build socially sustainable communities. Conflict and reduced support also exacerbate Tier III impacts and reduce the ability of individuals and service providers to address them. Finally, understanding the scope and scale of mental health impacts associated with climate change in general and climigration in particular is an important first step to developing and implementing services designed to treat or prevent these impacts. The impacts represent consequences of both direct (i.e., heat stress, exposure to extreme weather events) and indirect (i.e., economic loss, threats to health and well-being, displacement and forced migration, collective violence and civil conflict, and alienation from a degraded and potentially uninhabitable environment) consequences of three types of climate-related events: acute, subacute, and long lasting. Some of the mental health impacts and services employed as forms of adaptation to climate change will be specific to each type of event, while other impacts and services will crosscut all three event types. While delivery of services in response to acute and extreme weather events may appear to be of greater priority at the present time, what services are developed and how they are implemented and by whom will have important implications for addressing longer duration events.

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Subacute and long-lasting climate-related events will also require development and implementation of new types of mental health services like planned relocation of communities, public health education, violence prevention, risk communication, personal engagement in environmental conservation, and promotion of positive psychological outcomes associated with climate change.

References Aarons GA, Hurlburt M, Horwitz SM (2011) Advancing a conceptual model of evidence-based practice implementation in public sector services. Adm Policy Ment Health 38:4–23 Acarturk C, Konuk E, Cetinkaya M et al (2015) EMDR for Syrian refugees with posttraumatic stress disorder symptoms: results of a pilot randomized controlled trial. Eur J Psychotraumatol 6:27414. https://doi.org/10.3402/ejpt.v6.27414 Acarturk C, Konuk E, Cetinkaya M et al (2016) The efficacy of eye movement desensitization and reprocessing for post-traumatic stress disorder and depression among Syrian refugees: results of a randomized controlled trial. Psychol Med 46(12):2583–2593. https://doi.org/10.1017/ S0033291716001070 Adger WN, Hughes TP, Folke C et  al (2005) Socio-ecological resilience to coastal disasters. Science 309(5737):357–369 Allen B, Brymer MJ, Steinberg AM et al (2010) Perceptions of psychological first aid among providers responding to Hurricanes Gustav and Ike. J Trauma Stress 23(4):509–513 Berry HL, Bowen K, Kjellstrom T (2010) Climate change and mental health: a causal pathways framework. Int J Public Health 55:123–132. https://doi.org/10.1007/s00038-009-0112-0 Betancourt TS, Chambers DA (2016) Optimizing and era of global mental health implementation science. JAMA Psychiatry 73(2):99–100. https://doi.org/10.1001/jamapsychiatry.2015.2705 Bioenergy Technologies Office (BETO) (2019) Sustainability. US Department of Energy, Office of Energy Efficiency & Renewable Energy. Energy.gov. https://www.energy.gov/eere/bioenergy/ sustainability. Accessed 29 Oct 2019 Birkhead GS, Vermeulen K (2018) Sustainability of psychological first aid training for the disaster response workforce. Am J Public Health 108(S5):S381–S382. https://doi.org/10.2105/ AJPH.2018.304643 Bjorknes R, Manger T (2013) Can parent training alter parent practice and reduce conduct problems in ethnic minority children? A randomized controlled trial. Prev Sci 14:53–63 Bolton P, Lee C, Haroz EE et al (2014) A transdiagnostic community-based mental health treatment for comorbid disorders: development and outcomes of a randomized controlled trial among Burmese refugees in Thailand. PLoS Med 11(11):e1001757. https://doi.org/10.1371/ journal.pmed.1001757 Bonilla-Escobar FJ, Fandino-Losada A, Martinez-Buitrago M et  al (2018) A randomized controlled trial of a transdiagnostic cognitive-behavioral intervention for Afro-descendants’ survivors of systematic violence in Colombia. PLoS One 13(12):e0208483. https://doi.org/10.1371/ journal.pone.0208483 Botvin GJ, Griffin KW, Nichols TD (2008) Preventing youth violence and delinquency through a universal school-based prevention approach. Prev Sci 7(4):403–408 Bourque F, Cunsolo Willox A (2014) Climate change: the next great challenge for public mental health? Int Rev Psychiatry 26:415–422. https://doi.org/10.3109/09540261.2014.925851 Brown CH, Curran G, Palinkas LA et al (2017) An overview of research and evaluation designs for dissemination and implementation. Annu Rev Public Health 38:1–22 Bryant RA, Schafer A, Dawson KS et  al (2017) Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban

References

195

Kenya: a randomised clinical trial. PLoS Med 14(8):e1002371. https://doi.org/10.1371/journal. pmed.1002371 Brymer M, Jacobs A, Layne C et al (2006) Psychological first aid: field operations guide, 2nd edn. National Child Traumatic Stress Network and National Center for PTSD, Los Angeles, CA Carrillo JE, Green AR, Betancourt JR (1999) Cross-cultural primary care: a patient-based approach. Ann Intern Med 130(10):829–834 Catani C, Kohiladevy M, Ruf M et al (2012) Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka. BMC Psychiatry 9:22 Centers for Disease Control and Prevention (CDC) (2002) Crisis and emergency risk communication. http://emergency.cdc.gov/cerc/pdf/CERC-SEPT02.pdf. Accessed 8 Apr 2013 Chamberlain P, Brown, CH, Saldana L (2011) Observational measure of implementation progress in community based settings: The stages of implementation completion (SIC). Implement Sci 6(1): 116 Chamberlain P, Roberts R, Jones H et al (2012) Three collaborative models for scaling up evidence-­ based practices. Adm Policy Ment Health 39(4):278–290 Chi I, Chong AML, Ng TK et al (2019) Social work and sustainable development: an overview. In: Chong A, Chi I (eds) Social work and sustainability in Asia: facing the challenges of global environmental changes. Routledge, London, pp 3–20 Chorpita BF, Daleiden EL, Weisz JR (2005) Identifying and selecting the common elements of evidence-based interventions: a distillation and matching model. Ment Health Serv Res 7:5–20 Ciccone A (2012) Disaster psychosocial assessment and surveillance toolkit (Disaster-Past): methods to enhance disaster preparedness, response and recovery. Louisiana State University Health Sciences Center, New Orleans, LA Clayton S, Manning C, Hodge C (2014) Beyond storms and droughts: the psychological impacts of climate change. American Psychological Association and ecoAmerica, Washington, DC. https://ecoamerica.org/wp-content/uploads/2014/06/eA_Beyond_Storms_and_Droughts_ Psych_Impacts_of_Climate_Change.pdf. Accessed 29 Mar 2020 Clayton S, Manning C, Krygsman K, et  al (2017) Mental health and our changing climate: impacts, implications, and guidance. American Psychological Association and ecoAmerica, Washington, DC. http://ecoamerica.org/wpcontent/uploads/2017/03/ea_apa_mental_health_ report_web.pdf. Accessed 2 May 2019 Cohen JA, Deblinger E, Mannarino AP et al (2004) A multisite, randomized controlled trial for children with sexual abuse-related PTSD symptoms. J Am Acad Child Adolesc Psychiatry 43(4):393–402 Cohen JA, Mannarino AP, Deblinger E (2006) Treating trauma and traumatic grief in children and adolescents. The Guilford Press, New York Collins PY, Patel V, Joestl SS et  al (2011) Grand challenges in global mental health. Nature 475(7354):27–30 Damschroder LJ, Aron DC, Keith RE et  al (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 4:50 Dawson KS, Bryant RA, Harper M et al (2015) Problem Management Plus (PM+): a WHO transdiagnostic psychological intervention for common mental health problems. World Psychiatry 14(3):354–357. https://doi.org/10.1002/wps.20255 De la Fuente A (2007) Climate shocks and their impacts on assets. Occasional paper for UNDP (2007) Fighting climate change: human solidarity in a divided world. Human Development Report 2007/08. Oxford University Press, New York Dillard J, Dujon V, King MC (2009) Introduction. In: Dillard J, Dujon V, King MC (eds) Understanding the social dimension of sustainability. Routledge, New York, pp 1–12 Dodgen D, Donato D, Kelly N et al (2016) Chapter 8. Mental health and well-being. In: Balbus AJ, Gamble JL, Beard CB et al (eds) The impacts of climate change on human health in the United States: a scientific assessment. U.S.  Global Change Research Program, Washington, DC, pp 217–246. https://doi.org/10.7930/J0TX3C9H

196

9  Practice Responses to Climigration

Doherty TJ, Clayton S (2011) The psychological impacts of global climate change. Am Psychol 66:265–276 Dudley NM, Cortina JM (2008) Knowledge and skills that facilitate the personal support dimension of citizenship. J Appl Psychol 93(6):1249–1270 Eccles MP, Mittman BS (2006) Welcome to implementation science. Implement Sci 1(1) Eisenman DP, Glik D, Conzalez L et al (2009) Improving Latino disaster preparedness using social networks. Am J Prev Med 37(6):512–517 Eisenman DP, Adams RM, Lang CM et  al (2018) A program for local health departments to adapt and implement evidence-based emergency preparedness programs. Am J Public Health 108(S5):S396–S398. https://doi.org/10.2105/AJPH.2018.304535 Ellis B, Miller AB, Abdi S, Barrett C, Blood EA, Betancourt TS (2013) Multi-tier mental health program for refugee youth. J Consult Clin Psychol 81:12–140 European Network for Traumatic Stress (2008) TENTS guidelines for psychosocial care following disasters and major incidents. https://www.tentsproject.eu/index.jsp?USMID=93. Accessed 12 May 2019 Fazel M (2018) Psychological and psychosocial interventions for refugee children resettled in high-income countries. Epidemiol Psychiatr Serv 27:117–123 Fazel M, Betancourt TS (2018) Preventive mental health interventions for refugee children and adolescents in high income settings. Lancet Child Adolesc Health 2:121–132 Fazel M, Garcia J, Stein A (2016) The right location? Experiences of refugee adolescents seen by school-based mental health services. Clin Child Psychol Psychiatry 21:368–380 Federal Emergency Management Agency (FEMA) (2013) Incident Command System. http:// www.fema.gov/incident-command-system. Accessed 10 Apr 2013 Feldstein AC, Glasgow RE (2008) A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf 34(4):228–243 Forbes D, Lewis V, Varker T et al (2011) Psychological first aid following trauma: implementation and evaluation framework for high-risk organizations. Psychiatry 74(3):224–239 Forgatch MS, Kjøbli J (2016) Parent Management Training—Oregon Model: adapting intervention with rigorous research. Fam Process 55(3):500–513 Gath DH, Mynors-Wallis LM (1997) Problem-solving treatment in primary care. In: Clark DM, Fairburn CG (eds) Science and practice of cognitive behavior therapy. Oxford University Press, New York, pp 415–431 Glasgow RE, Vogt TM, Boles SM (1999) Evaluating the public health impact of health promotion interventions: the RE-AIM framework. Am J Public Health 89:1322–1327 Gleick PH (1989) The implications of global climatic changes for international security. Clim Change 15(1):309–325 Goldman EE, Bauer D, Newman DL et al (2015) A school-based post-Katrina therapeutic intervention. Adm Policy Ment Health 42:363–372. https://doi.org/10.1007/s10488-014-0576-y Goodland R (1995) The concept of environmental sustainability. Ann Rev Ecol Syst 26:1–24 Government of the Republic of Maldives (2010) National Assessment Report. www.sidsnet.org/ msi_5/docs/nars/AIMS/Maldives-MSI-NAR2010.Pdf. Accessed 8 Sept 2019 Grolnick WS, Schonfeld DJ, Schreiber M et  al (2018) Improving adjustment and resilience in children following a disaster: addressing research challenges. Am Psychol 73:215–229. https:// doi.org/10.1037/amp0000181 Gureje O, Abdulmalik J, Kola L et al (2015) Integrating mental health into primary care in Nigeria: report of a demonstration project using the mental health gap action programme intervention guide. BMC Health Serv Res 15:242 Hardiman ER, Jaffee EM (2008) Outreach and peer-delivered mental health services in New York City following September 11, 2001. Psychiatr Rehabil J 32(2):117–123 Hayes K, Blashki G, Wiseman J et al (2018) Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst 12:28. https://doi.org/10.1186/s13033-018-0210-6

References

197

Huang KY, Nakigudde J, Rhule D et al (2017) Transportability of an evidence-based early childhood intervention in a low-income African country: results of a cluster randomized controlled study. Prev Sci 18(8):964–975. https://doi.org/10.1007/s11121-017-0822-0 Hunter LM, Murray S, Riosmena F (2013) Rainfall patterns and U.S. migration from rural Mexico. Int Migr Rev 47(4):874–909 Institute for Healthcare Improvement (2003) The breakthrough series: IHI’s collaborative model for achieving breakthrough improvement. Institute for Healthcare Improvement, Boston, MA Inter-Agency Standing Committee (IASC) (2007) IASC guidelines on mental health and psychosocial support in emergency settings. IASC, Geneva. https://www.who.int/mental_health/emergencies/guidelines_iasc_mental_health_psychosocial_june_2007.pdf. Accessed 6 May 2019 Jaycox L (2004) Cognitive behavioral intervention for trauma in schools (CBITS). Lopris West, Longmont, CO Jaycox LH, Cohen JA, Mannarino AP et al (2010) Children’s mental health care following Hurricane Katrina: a field trial of trauma-focused psychotherapies. J Trauma Stress 23:223–231. https:// doi.org/10.1002/jts.20518 Kataoka SH, Stein BD, Jaycox LH et al (2003) A school-based mental health program for traumatized Latino immigrant children. J Am Acad Child Adolesc Psychiatry 42(3):311–318 Kawachi I, Berkman LF (2001) Social ties and mental health. J Urban Health 78(3):458–467 Kieft B, Jordans MJ, de Jong JT, Kamperman AM (2008) Paraprofessional counseling within asylum seekers’ groups in the Netherlands: transferring an approach for a non-­ western context to a European setting. Transcult Psychiatry 45(1):105–120. https://doi. org/10.1177/1363461507088000 Kumpfer KL, Molgaard V, Spoth R (1996) The Strengthening Families Program for prevention of delinquency and drug use in special populations. In: Peters RD, McMahon RJ (eds) Childhood disorders, substance abuse, and delinquency: prevention and early intervention approaches. Sage, Newbury Park, CA, pp 241–267 Lai BS, Osborne MC, Lee N et  al (2018) Trauma-informed schools: child disaster exposure, community violence and somatic symptoms. J Affect Disord 238:586–592. https://doi. org/10.1016/j.jad.2018.05.062 Lavis JN, Robertson D, Woodside JM et al (2003) How can research organizations more effectively transfer research knowledge to decision makers? Milbank Q 81(2):221–249 Leinhos M, Qari SH, Williams Johnson M (2014) Preparedness and emergency response and research centers: using a public health systems approach to improve all-hazards preparedness and response. Public Health Rep 129(6 suppl 4):8–18 Levy BS, Sidel VW, Patz J (2017) Climate change and collective violence. Annu Rev Public Health 38:241–257. https://doi.org/10.1146/annurev-publichealth-031816-044232 Lim WSW (2012) Incomplete urbanism: a critical urban strategy for emerging eEconomies. World Scientific, Singapore Logan J, Graham ID (1998) Toward a comprehensive interdisciplinary model of health care research use. Sci Commun 20(2):227–246 Macquire P, Pitceathly C (2002) Key communication skills and how to acquire them. Br Med J 325(7366):697–700 Massey DS, Arango J, Hugo G et  al (1993) Theories of international migration: a review and appraisal. Popul Dev Rev 19(3):431–466 Mathbor GM (2007) Enhancement of community preparedness for natural disasters: the role of social work in building social capital for sustainable disaster relief and management. Int Soc Work 50(3):357–369 Mathema S (2018) What works: innovative approaches to improving refugee integration. Center for American Progress, Washington, DC. https://www.americanprogress.org/issues/immigration/reports/2018/02/28/447283/what-works/. Accessed 23 Jul 2019 McKay MM, Harrison ME, Gonzales J et al (2002) Multiple-family groups for urban children with conduct difficulties and their families. Psychiatr Serv 53(11):1467–1468

198

9  Practice Responses to Climigration

McKenzie S (2004) Social sustainability: towards some definitions. University of South Australia, Hawke Research Institute, Magill, SA McVay VR, Hoffer LD, Combs TB et al (2018) The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach. Implement Sci 13(1):77. https://doi.org/10.1186/s13012-018-0767-0 Mitlin D, Satterthwaite D (2012) Urban poverty in the global south: scale and nature. Routledge, New York Mitra R, Hodes M (2019) Prevention of psychological distress and promotion of resilience amongst unaccompanied refugee minors in resettlement countries. Child Care Health Dev 45:198–215 Morina N, Malek M, Nickerson A et al (2017) Meta-analysis of interventions for posttraumatic stress disorder and depression in adult survivors of mass violence in low- and middle-income countries. Depress Anxiety 34:679–691. https://doi.org/10.1002/da.22618 Moser C, Satterthwaite D (2010) Toward pro-poor adaptation to climate change in the urban centers of low- and middle-income countries. In: Mearns R, Norton A (eds) Social dimensions of climate change: equity and vulnerability in a warming world. The World Bank, Washington, DC, pp 231–238 Murray LK, Jordans MJD (2016) Rethinking the service delivery system for psychological interventions in low and middle income countries. BMC Psychiatry 6:234 Murray LK, Dorsey S, Skavenski S et al (2013) Identification, modification, and implementation of an evidence-based psychotherapy for children in a low-income country: the use of TF-CBT in Zambia. Int J Ment Health Syst 7:24 Murray LK, Dorsey S, Haroz E et  al (2014) A common elements treatment approach for adult mental health problems in low-and middle-income countries. Cogn Behav Pract 21:111–123 Murray LK, Hall BJ, Dorsey S et al (2018) An evaluation of a common elements treatment approach for youth in Somali refugee camps. Glob Mental Health 5:e16. https://doi.org/10.1017/ gmh.2018.7 Myles P, Swenshon S, Haase K et  al (2018) A comparative analysis of psychological trauma experienced by children and young adults in two scenarios: evacuation after a natural disaster vs forced migration to escape armed conflict. Public Health 158:163–175. https://doi. org/10.1016/j.puhe.2018.03.012 Nahar N, Blomstedt Y, Wu B et  al (2014) Increasing the provision of mental health care for vulnerable, disaster-affected people in Bangladesh. BMC Public Health 14:708. https://doi. org/10.1186/1471-2458-14-708 Napier AD, Ancamo C, Butler B et al (2014) Culture and health. Lancet 384(9954):1607–1639. https://doi.org/10.1016/S0140-6736(14)61603-2 National Child Traumatic Stress Network (NCTSN) (2006) Psychological First Aid (PFA) Field Operations Guide, 2nd edn. https://www.nctsn.org/sites/default/files/resources//pfa_field_ operations_guide.pdf. Accessed 2 Feb 2018 Neuner F, Catani C, Ruf M et al (2008) Narrative exposure therapy for treatment of traumatized children and adolescents (KidNET): from neurocognitive theory to field intervention. Child Adolesc Psychiatr Clin N Am 17:641–664 Norris FH, Friedman MJ, Watson PJ et al (2002) 60,000 disaster victims speak: part 1. An empirical review of the empirical literature, 1981-2001. Psychiatry 65:207–239 North CS, Pfefferbaum B (2013) Mental health response to community disasters: a systematic review. JAMA 310(5):517–518 Nosé M, Ballette F, Bighelli I et  al (2017) Psychosocial interventions for post-traumatic stress disorder in refugees and asylum seekers resettled in high-income countries: systematic review and meta-analysis. PLoS One 12(2):e0171030. https://doi.org/10.1371/journal.pone.0171030 O’Donnell ML, Lau W, Fredrickson J, et al (2018) SOLAR: the Skills fOr Life Adjustment and Resilience program: a brief intervention to promote adjustment following disaster. Paper presented at the 34th meeting of the International Society for Traumatic Stress Studies, Washington, DC

References

199

Palinkas LA (2015) Behavioral health and disasters: looking to the future. J Behav Health Serv Res 42(1):86–95 Palinkas LA (2019) Achieving implementation and exchange: the science of delivering evidence-­ based practices to at-risk youth. Policy Press, Bristol Palinkas LA, Wong M (2019) Social sustainability and global climate change: a new challenge for social work. In: Chong A, Chi I (eds) Social work and sustainability in Asia: facing the challenges of global environmental changes. Routledge, London, pp 33–47 Palinkas LA, Aarons GA, Horwitz SM et  al (2011) Mixed method designs in implementation research. Adm Policy Ment Health 38:44–53 Pavli A, Maltezou H (2017) Health problems of newly arrived migrants and refugees in Europe. J Travel Med 24(4). https://doi.org/10.1093/jtm/tax016 Pfeiffer PN, Heisler M, Piette MAM et al (2011) Efficacy of peer support interventions for depression: a meta-analysis. Gen Hosp Psychiatry 33(1):29–36 Proctor E, Silmere H, Raghavan R et al (2011) Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health 38:65–76 Proctor EK, Powell BJ, McMillan C (2013) Implementation strategies: recommendations for specifying and reporting. Implement Sci 8:139 Puffer ES, Annam J, Sims AL et al (2017) The impact of a family skills training intervention among Burmese migrant families in Thailand: a randomized controlled trial. PLoS One 12:e0172611 Qari SH, Leinhos MR, Thomas TN et al (2018) Overview of the translation, dissemination and implementation of public health preparedness and response research and training initiative. Am J Public Health 108(S5):S355–S362. https://doi.org/10.2105/AJPH.2018.304709 Rahman A, Hamdani SU, Awan NR (2016) Effect of a multicomponent behavioral intervention in adults impaired by psychological distress in a conflict-affected area of Pakistan: a randomized controlled trial. JAMA 316(24):2609–2617 Rahman A, Khan MN, Hamdani SU et al (2019) Effectiveness of a brief group psychological intervention for women in a post-conflict setting in Pakistan: a single-blind, cluster, randomized controlled trial. Lancet 393:1733–1744 Rataj E, Kunzweiler K, Garthus-Niegel S (2016) Extreme weather events in developing countries and related injuries and mental health disorders—a systematic review. BMC Public Health 16:1020. https://doi.org/10.1186/s1288-016-3692-7 Reinke WM, Herman KC, Stormont M et al (2013) Illustrating the multiple facets and levels of fidelity of implementation to a teacher classroom management intervention. Adm Policy Ment Health 40(6):494–506. https://doi.org/10.1007/s10488-013-0496-2 Richmond AL, Sobelson RK, Cioffi JP (2014) Preparedness and emergency response learning centers: supporting the workforce for national health security. J Public Health Manag Pract 20(suppl 5):S7–S16 Robjant K, Fazel M (2010) The emerging evidence for narrative exposure therapy: a review. Clin Psychol Rev 30:1030–1039 Rogers EM (2003) Diffusion of innovations, 5th edn. Free Press, New York Ruf M, Schauer M, Neuner F et al (2010) Narrative exposure therapy for 7- to 16-year olds: a randomized controlled trial with traumatized refugee children. J Trauma Stress 23:437–445 Sargeant J, McLeod T, Murray A (2011) An interprofessional approach to teaching communication skills. J Contin Ed Health Professions 31(4):265–267 Schmeltz MT, Gamble JL (2017) Risk characterization of hospitalizations for mental illness and/or behavioral disorders with concurrent heat-related illness. PLoS One 12(10):e0186509. https:// doi.org/10.1371/journal.pone.0186509 Schwartz RM, Gillezeau CN, Lieberman-Cribbin W et al (2017) Longitudinal impact of Hurricane exposure on mental health symptoms. Int J Environ Res Public Health 14(9):E957. https://doi. org/10.3390/ijerph14090957 Shapiro F (1989) Eye movement desensitization: a new treatment for post-traumatic stress disorder. J Behav Ther Exp Psychiatry 20(3):211–217

200

9  Practice Responses to Climigration

Sherraden M (2014) Asset building research and policy: pathways, progress, and potential of a social innovation. In: Cramer R, Shanks TW (eds) The assets perspective: the rise of asset-­ building and its impact on social policy. Palgrave MacMillan, New York, pp 263–284 Siders AR, Hino M, Mach KJ (2019) The case for strategic and managed climate retreat. Science 365(6455):761–763 Sijbrandij M, Acarturk C, Bird M et  al (2017) Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries. Eur J Psychotraumatol 8:1388102. https://doi.org/10.1080/2000819 8.2017.1388102 Snow DL, Swan SG, Wilton L (2002) A workplace coping skills intervention to prevent alcohol abuse. In: Bennett J, Lehman WEK (eds) Preventing workplace substance abuse: beyond drug testing to wellness. American Psychological Association, Washington, DC, pp 57–96 Springgate BF, Arevian AC, Wennerstrom A et  al (2018) Community Resilience Learning Collaborative and Research Network (C-LEARN): study protocol with participatory planning for a randomized comparative effectiveness trial. Int J Environ Res Public Health 7:15. pii: E1683. https://doi.org/10.3390/ijerph15081683 Ssewamala FM, Sensoy Bahar O, McKay MM et  al (2018) Strengthening mental health and research training in Sub-Saharan Africa (SMART Africa): Uganda study protocol. Trials 19(1):423. https://doi.org/10.1186/s13063-018-2751-z Stein BD, Jaycox LH, Kataoka SH et al (2003) A mental health intervention for schoolchildren exposed to violence: a randomized controlled trial. JAMA 290(5):603–611 Tappis H, Freeman J, Glass N et al (2016) Effectiveness of interventions, programs and strategies for gender-based violence prevention in refugee populations: an integrated review. PLoS Curr 8:ecurrents,dis.3a465b66f93276761eb8120eaa5499 Thoits PA (2011) Mechanisms linking social ties and support to physical and mental health. J Health Soc Behav 52(2):145–161 Torres JM, Casey JA (2017) The centrality of social ties to climate migration and mental health. BMC Public Health 17:600. https://doi.org/10.1186/s12889-017-4508-0 Torres JM, Lee A, Gonzalez HM et  al (2016) A longitudinal analysis of cross-border ties and depression for Latino adults. Soc Sci Med 160:111–119 Trombley J, Chalupka S, Anderko L (2017) Climate change and mental health. Am J Nurs 117:44–52. https://doi.org/10.1097/01.NAJ.0000515232.51795.fa Tyrer RA, Fazel M (2014) School and community-based interventions for refugee and asylum seeking children: a systematic review. PLoS One 9(2):e89359 U.S.  Office of Refugee Resettlement (ORR) (2019) Refugees. https://www.acf.hhs.gov/orr/programs/. Accessed 12 Jul 2019 United Nations Department of Economic and Social Affairs (UNDESA) (2010) Trends in sustainable development: Small Island Developing States. United Nations, New York. https://sustainabledevelopment.un.org/content/documents/313Trends_in_Sustainable_Development_SIDS. pdf. Accessed 6 Sept 2019 United Nations Department of Economic and Social Affairs (UNDESA) (2013) World economic and social survey 2013: sustainable development challenges. E/2013/50/Rev 1 ST/ ESA/344. United Nations, New  York. https://sustainabledevelopment.un.org/content/ documents/2843WESS2013.pdf. Accessed 6 Sept 2019 Valente TW (2012) Network interventions. Science 337(6090):49–53 Valente T, Palinkas LA, Czaja S et al (2015) Social network analysis for program implementation (SNAPI). PLoS One 10(6):e0131712. https://doi.org/10.1371/journal.pone.0131712 Walker R, Koh L, Wollersheim D et al (2015) Social connectedness and mobile phone use among refugee women in Australia. Health Soc Care Community 23(3):325–336 Wandersman A, Duffy J, Flaspohler P et al (2008) Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. Am J Community Psychol 41(3-4):171–181. https://doi.org/10.1007/s10464-008-9174-z

References

201

Webster-Stratton C, Reid J, Hammond M (2001) Social skills and problem solving training for children with early-onset conduct problems: who benefits? J Child Psychol Psychiatry 42(7):943–952w Weiss WM, Murray LK, Zangana GAS et al (2015) Community-based mental health treatments for survivors of torture and militant attacks in southern Iraq: a randomized controlled trial. BMC Psychiatry 15(1) Weisz JR, Chorpita BF, Palinkas LA et al (2012) Testing standard and modular designs for psychotherapy with youth depression, anxiety, and conduct problems: a randomized effectiveness trial. Arch Gen Psychiatry 69(3):274–282 World Bank (2008) Poverty data: a supplement to World Development Indicators 2008. The World Bank, Washington, DC World Bank (2013) Building resilience: integrating climate and disaster risk into development. Lessons from World Bank Group experience. The World Bank, Washington DC World Health Organization (WHO) (2008) Tasking shifting: global recommendations and guidelines. World Health Organization, Geneva World Health Organization (WHO) (2010) mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings. World Health Organization, Geneva World Health Organization Regional Office for South-East Asia (WHO SEA) (2005) Framework for mental health and psychosocial support after tsunami. WHO, New Delhi. http://www.searo. who.int/entity/emergencies/documents/sea_earthquake_and_tsunami_framework.pdf?ua=1. Accessed 5 May 2019 Zeng W, Wu Z, Schimmele CM, Li S (2015) Mass relocation and depression among seniors in China. Res Aging 37(7):695–718. https://doi.org/10.1177/0164027514551178

Chapter 10

The Future of Climigration

10.1  The Current and Future State of Climigration Despite substantial research on the topic, it remains unclear whether climigration represents a transient crisis or the “new normal.” In part, this can be attributed to the absence of good data on the number of climigrants today due to confounding with other reasons for migration. For instance, the UNHCR keeps track of numbers of refugees but does not identify anyone as a “climate refugee.” However, apart from a few studies that have surveyed residents in climate-affected communities (e.g., Mortreaux and Barnett 2009; Farbotko and Lazrus 2012; Speelman et  al. 2017), there has been little effort to assess whether planned or potential migration is motivated by climate change specifically or by other factors such as employment opportunities. Moreover, much of this form of climigration is undocumented, and efforts to identify undocumented immigrants have been notoriously unreliable (Capps et al. 2018; Fazel-Zarandi et al. 2018). Another reason why it is difficult to determine whether patterns of current and anticipated climigration represent a new normal is because projections of number of climigrants in the coming years are dependent upon scenarios tied to projects of temperature increases and global efforts to mitigate human-induced causes of climate change (IPCC 2014). As noted in Chap. 1, the numbers of people projected to be displaced by climate change events range from 20 million (Myers 2002) to two billion by the end of the century (Hadlock 2017). However, the exact number of climigrants will depend on a host of factors, including actual levels of reduction of carbon emissions resulting from current and future mitigation efforts, the impact of these efforts on the rate of increase in global temperatures and sea level rise, local and international efforts to prevent the need to migrate from environmentally vulnerable areas impacted by climate change, local and international efforts to facilitate the relocation of climigrants who have no choice but to move, and the sustainability of the current rise of populist and nationalist movements seeking to restrict international migration. © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8_10

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Related to the issue of whether current and projected patterns of climigration represent the new normal is the issue of whether this form of migration should be viewed as an apocalypse or as part of the normal course of human adaptation and evolution. As noted at the beginning of this book, the human species today is the product of a long process of biological and sociocultural evolution in response to climate-related changes in environment. What distinguishes this new form of climigration, however, is the speed at which the environmental changes are occurring as well as the widespread anxiety related to uncertainty of extent of the problem. A report by the American Psychological Association and ecoAmerica (Clayton et al. 2017) proposed that the worsening state of the environment is causing a sense of stress and hopelessness that influences the way people interact with one another and plan for the future. Albrecht (2011) referred to these psychological reactions to climate change as “psychoterratic” syndromes and identified three forms: ‘Ecoanxiety’ refers to the anxiety people face when constantly being surrounded by the wicked and threatening problems associated with a changing climate. ‘Ecoparalysis’ refers to the complex feelings of not being able to take effective action to significantly mitigate climate change risks. ‘Solastalgia’ refers to ‘the distress and isolation caused by the gradual removal of solace from the present state of one’s home environment.’ (Hayes et al. 2018: 7)

Combined with the anxiety and uncertainty has been the growing frustration with unwillingness of government to address the problem (Sengupta 2019; Taylor et al. 2019). Getting back to the question of whether the current and projected patterns of climigration represent a transitory phenomenon or a new normal, the examples of different forms of displacement resulting from different forms of climate-related changes in environment across the globe that were presented in this book offer ample evidence that climigration will indeed be the new normal in the foreseeable future. The overwhelming majority of climigrants will be internal, living in low-­ income countries or low-resource settings of high-income countries, and be disadvantaged socially, economically, and psychologically (IOM 2018). These patterns will persist until the pendulum that is currently swinging toward populism and tribalism swings back to globalization, diversity, and inclusion.

10.2  Unresolved Issues 10.2.1  What to Call People Displaced by Climate Change This book has tackled some of the fundamental issues concerning the nature of climigration processes and outcomes. One of these issues relates to how we should refer to people displaced by climate change. Whether we focus on acute weather events like hurricanes and wildfires or long-term events like sea level rise, coastal flooding, and erosion or drought, it is clear that many climate-related changes are direct and immediate (e.g., evacuation from a fire, home destroyed by a hurricane),

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205 Political

Environmental

macro

Exposure to hazard Ecosystem services, incl. land productivity habitability food/energy/ water security

Discrimination/persecution Governance/freedom Conflict/insecurity Policy incentives Direct coercion

Spatial +/or temporal variability & difference in source & destination

of nce Gradual e u fl tal s e in men r h Sudden T n rive viro of d en ge n Social cha Seeking education

Family/kin obligations

Actual

Personal/household characteristics Age, Sex, Education, Wealth, Marital Status, Preferences, Ethnicity, Religion, Language

micro Migrate

DECISION Demographic Population size/density Population structure Disease prevalence

Perceived

Economic Employment opportunities Income/wages/well-being Producer prices (e.g. Agriculture) Consumer prices

Stay Intervening obstacles and facilitators Political/legal framework Cost of moving Social networks Diasporic links Recruitment agencies Technology

meso

Fig. 10.1 The drivers of climigration. (Adapted from Foresight: Migration and Global Environmental Change Final Project Report by The Government Office for Science, 2011, London, UK. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_ data/file/287717/11-1116-migration-and-global-environmental-change.pdf)

while others are indirect and lasting for much longer periods of time (e.g., unemployment and poverty, civil conflict, mental health problems, illness, and disease). As illustrated in Fig. 10.1, environmental changes influence several different drivers—environmental, social, political, economic, and demographic—which makes it difficult to identify a specific individual or community migrating for a specific reason. Black et al. (2011) suggest that since the impacts of these factors that influence the decision as to whether or not to migrate are so intertwined, it makes little sense to consider them in isolation. Such a conclusion argues for a broader definition of climate-related displacement. The framework also outlined in Fig. 10.1 also argues that these factors influence the decision to move or to stay, framing that decision as a choice, albeit one constrained by several additional factors. Whether forced by dire poverty, civil conflict, the immediate danger of wildfires, or disappearance of land due to sea level rise, or voluntarily seeking temporary employment and opportunities to send remittances to families living in communities of origin, all climigrants seek some form of land, livelihood and habitat security (UNESCAP 2017). The 1951 Geneva Convention defined a refugee as someone who has been forced to flee his or her country because of persecution, war or violence. A refugee has a well-founded fear of persecution for reasons of race, religion, nationality, political opinion or membership in a particular social group. Most likely, they cannot return home or are afraid to do so. War and ethnic, tribal and religious violence are leading causes of refugees fleeing their countries. (UNHCR 2019)

What connects those fleeing their countries because of persecution, war, or violence and those fleeing because of cyclones, flooding, fires, drought, or sea level rise is that they are all seeking safety and security. That search may vary in duration from a few hours as wildfire evacuees are allowed to return to their homes to permanent relocation in a community less impacted by climate-related changes in the environment. It may persist if climigrants are unable to find the safety and security they are

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searching for. Nevertheless, whether international organizations continue to rely on this distinction to provide services and legal status to one group and to deny services or legal status to another group, change is likely to increasingly conflate the distinction between voluntary and forced migration, making the distinction between the two types of migration irrelevant.

10.2.2  Climigration as Adaptation Another issue addressed throughout this book has been whether climigration should be considered a form of adaptation. As noted throughout this book, several scholars and government entities have increasingly referred to climigration as a form of adaptation to environmental changes, in contrast to the typical view of migration as a failure of adaptation (IOM 2008). This is consistent with a critical, social constructivist perspective that seeks to avoid blaming individuals and communities for failing to adapt successfully as indicated by various metrics of health and well-­ being (Singer 1989). From a biological perspective, “adaptation is a property of phenotypic features of organisms relative to selection demands of the environment. Adaptive features are ones having properties of form and function which permit the organism to maintain successfully the synergy between a biological role of that feature and a stated selection force” (Bock 1980: 217). From a social perspective, however, “adaptation is the process by which an individual or group makes certain behavioral or biological adjustments in response to the demands of a social or physical environment. This adaptation may be temporary (proximate adaptation) or it may have long term implications for behavior (ultimate adaptation)” (Palinkas 1989: 235). Human adaptability refers to ecological success as measured by demographic, energetic, or nutritional criteria (Moran 1982). All three of these criteria have implications for human health and wellness at both the individual and the population levels. Adaptation to any environment is determined both by the resources available to the individual or group and the demands placed on an individual or group by the environment. As illustrated numerous times in this book, forced climigration is hardly voluntary, but even voluntary climigration is hardly a choice if there are little or no resources to facilitate the move and if potential host communities are unwilling or unable to assist in resettlement. Thus, the perspective that climigration is a form of adaptation should not be taken to mean that the adaptation is necessarily positive or that the inability to remain in one’s community of origin or to relocate without experiencing social conflict or psychosocial distress is the fault of the climigrant. One way that climigration may enable individuals and communities to adapt to environmental change is through the creation of opportunities to diversify incomes and build resilience. To facilitate this form of adaptation, it will be therefore necessary to make channels for voluntary migration available:

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Within countries, this implies removing arbitrary restrictions on movement, and providing basic infrastructure to enable relocation and settlement in urban areas, ideally sustainably. Internationally, this might include the extension of regional economic communities to cover the free movement of people as well as money and goods. Those at risk of being trapped — the poorest and least mobile  — require additional measures, such as functional early-­ warning systems and tested emergency evacuation plans, to minimize their vulnerability to extreme events. (Black et al. 2011: 448–449)

Disparities in exposure and response to the direct and indirect consequences of climate change also suggest that the decision to migrate must also be framed within a broader geopolitical context. That context is characterized by the disparity between residents of high-income countries that have most contributed to climate change but are least vulnerable to its impacts and residents of low- and middle-income countries that have contributed the least but are most vulnerable to its impacts. The context is also increasingly characterized by opposing forces of globalization, which encourages greater travel and trade across international borders, and populism and nationalism, which encourages greater attention to national identity and security. The discussion of adaptation and disparities also brings into focus the desire to provide choices to climigrants as to whether to remain in communities of origin or to relocate elsewhere. Having more than one option is a laudable goal and is certainly consistent with the principles of the UN SDGs. From an adaptation framework, however, choice is generally not taken into consideration as a response to environmental pressures. Whether the behavioral changes are biologically or culturally induced, they are responses to environmental pressures to change. From a disparity framework, options are not equally distributed in a population. While the struggle to survive may ultimately rest on the choice of the organism, the means of survival may not.

10.2.3  Climigration as a Public Health Threat A third issue we have repeatedly encountered in our examination of climigration has been the debate over whether it should be considered a public health threat or response to a public health threat. Based on the evidence to date, there is little doubt that climate change is a threat to public health. However, with some exceptions such as conflict-related morbidity and mortality and drought-related malnutrition, there is little evidence to date that this public health threat is a primary motivator for climigration. For the most part, climigrants do not migrate out of fear of infectious or respiratory diseases or because they are depressed or anxious. To date, there has been no evidence that heat-related morbidity and mortality has motivated people to move elsewhere. If anything, poor mental or physical health may impede climigration in the same way that healthy people are more likely to migrate in general, thereby accounting for the “healthy migrant effect” (McDonald and Kennedy 2004; Kennedy et al 2015).

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In contrast, there is substantial evidence that displacement itself poses a public health threat. Studies have repeatedly demonstrated that the stress and uncertainty associated with climigration in particular is also associated with increased incidence of mental and behavioral health problems. As illustrated by examples in Asia and Africa, illegal climigration also is associated with threats to safety and well-being due to exploitation by human traffickers, unsafe modes of transportation, and risk of detention and deportation. Although there is little or no evidence that climigrants bring infectious disease with them that poses a danger to host communities, “human mobility can amplify the spread of communicable diseases and the impact of public health events. SARS, H1N1, and H5N1 global epidemics have highlighted this fact” (World Health Organization Africa Region (WHO AR) 2018: 18). Moreover, migrants often do bring with them physical and psychosocial problems in need of treatment or care. These include depression, anxiety, PTSD, substance abuse, interpersonal violence, developmental delays, and noncommunicable disease. Such problems add to pressures of existing service systems to provide care. In addition to the moral argument to provide assistance to those in need regardless of the circumstances that created the need in the first place, there is the economic argument of delivering services before the cost of doing so increases because the need has also increased. Attaching an economic cost to delivering physical and mental health services has become commonplace and helps to inform for research and policy priorities. Likewise, the cost of delivering services to legal refugees has been frequently assessed (Naficy et al. 1998; Bager et al. 2018). However, the costs of treating the social and health problems experienced by climigrants who are not routinely provided care, either because of the nature or duration of the climigration experience, are not routinely assessed, yet are likely to be significant given projected numbers of climigrants and the documented problems they bring with them and experience along the way. Future research must evaluate the cost of failing to provide services, even to temporary evacuees, relative to the social and economic benefits of doing so in a timely manner.

10.3  Response to the Climigration Crisis The examples of population displacement in response to climate-related environmental changes illustrated throughout this book point to three distinct responses to the emerging climigration crisis: (1) efforts to prevent climigration; (2) efforts to manage climigration; and (3) efforts to prevent or mitigate the consequences of climigration. Each of these responses is discussed in turn.

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10.3.1  Efforts to Prevent Population Displacement As discussed in Chap. 9, perhaps the best way of dealing with the next wave of climigration is to prevent it from happening in the first place. Much of the effort to date has been placed on mitigation strategies that focus on the reduction of carbon emissions and the promotion of alternative forms of “clean energy.” Related to this effort is the establishment of sustainability development goals and the emergence of a science of sustainability: The global Sustainable Development Goals (SDGs) provide an evidence-based framework for national, regional and global sustainable development planning and programming over a 15-year period until 2030 (United Nations General Assembly 2015). The framework of 17 goals, 169 targets and 232 indicators builds on the success of other target- and indicator-­ based frameworks such as the Millennium Development Goals (MDGs) (McArthur 2013; McArthur and Rasmussen 2017), and also aims to address the limited progress made on major international agreements. (Tollefson and Gilbert 2012; Allen et al. 2018)

Although none of the SDGs established by the United Nations focuses specifically on climigration, several have implications for insuring the social, economic, and environmental sustainability of communities of origin, host communities, and past, current, and future climigrants (UNESCAP 2017). Sustainability science focuses on the dynamic interactions between nature and society (Clark and Dickson 2003; Jerneck et al. 2011). It is “an emerging field of research dealing with the interactions between natural and social systems, and with how those interactions affect the challenge of sustainability: meeting the needs of present and future generations while substantially reducing poverty and conserving the planet’s life support systems” (Kates 2011: 19449). Sustainability science aims to use the understanding of complex and dynamic interactions between natural and human systems for transforming and developing these sustainably (Clark and Dickson 2003; Jerneck et  al. 2011; Kates et  al. 2001; Komiyama and Takeuchi 2006; Komiyama et al. 2011; Spangenberg 2011; Elliott 2012; Wiek et al. 2012; Yarine et al. 2012). The sustainability of communities of origin of climigrants will rely heavily on existing models and examples of successful sustainable development. Perhaps the most widely recognized model of sustainable development is the “three pillars model” which identifies environmental, economic, and social resources and essential requirements for sustainable development. Other models include the “prism model” that proposes a set of four interlinked forms of capital essential to successful and sustainable development and the “egg of well-being model” that uses the metaphor of an egg to represent the relationships between the different dimensions as concentric ovals with one oval (e.g., the ecosystem) entirely encapsulating the other oval (e.g., people) (Thatcher 2014). There are numerous examples of successful sustainable development, some of which were illustrated in Chap. 9. These examples illustrate the impacts of integrated top-down (i.e., government initiated) and bottom-up (i.e., community and consumer initiated) efforts to develop and implement policies and programs that

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promote sustainable use of energy, water and food, housing, transportation, education, and social and health services (Lachman 1997; Spangenberg 2011; Sachs 2015; Blewitt 2017; World Bank 2013; World Health Organization (WHO) 2019). These examples provide opportunities for communities currently threatened by climate-­related environmental change to reduce the need to climigrate by promoting land, livelihood, and habitat security through sustainable environmental, economic, and social development.

10.3.2  Efforts to Manage Population Displacement Management of population displacement once it has occurred is likely to involve coordinated efforts involving local, regional, national, and international governments and organizations. Local and regional efforts are likely to focus on the delivery of adequate and affordable housing, employment and educational opportunities, and access to services. Many of those efforts were highlighted in Chap. 9. National efforts would scale up the delivery of these services, reduce the number of internally displaced climigrants in “temporary” resettlement camps, and minimize relocation in other areas of a country that are also impacted or are at risk of being impacted by climate-related changes in environment. At the international level, perhaps the most often discussed strategy has called for an amendment to the 1951 Geneva Convention to assign refugee status to individuals whose lives are threatened by climate-related changes in the environment. As noted in Chap. 8, however, there are several obstacles to implementing this strategy. Another is to enforce existing mechanisms such as the Sendai or Cancun frameworks or the Nansen Initiative that would provide funding to assist all climigrants regardless of reasons for displacement. However, climigrants deemed to be voluntary are less likely to be provided assistance under such statutes than climigrants who are deemed to have been forced from communities of origin due to threats to land, livelihood, and habitat security that exceed a specified threshold.

10.3.3  E  fforts to Mitigate the Consequences of Population Displacement In Chap. 9, several policies and practices were proposed to address the health-care and social service needs of climigrants. These practices range from efforts to provide job training and employment opportunities to climigrants in host communities; assist in identifying available and affordable housing; connect climigrants to others from their communities of origin and host communities who can provide social support; screen and identify climigrants in need of physical and mental health services; use evidence-based practices to treat or prevent the occurrence of physical and

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mental health problems; and implement and sustain effective practices and interventions. All of these suggestions, however, are based on certain fundamental assumptions. For instance, none of the proposed programs and practices will produce any demonstrable impact on the lives of climigrants unless they are guaranteed access to them. Access is a matter of the right to use services and the ability to use them without restrictions such as affordability. Even if access to services were to be guaranteed, however, they are unlikely to result in significant improvements in the lives of climigrants unless they are utilized. Effective and efficient utilization will require policies that promote both access to and utilization of health and mental health services that are culturally competent and designed to reduce the stigma of both the problem (e.g., mental illness) and the person presenting with the problem (i.e., the climigrant). Finally, for programs and policies to have any demonstrable impact, they must be successfully implemented and sustained. This requires the use of strategies that are designed to maximize existing resources and capacity and overcome existing barriers to insure routine delivery of services over the long term. Given the climigrant experience both now and in the future, short-term solutions to the problems faced by climigrants are not enough. Sustainment will require a commitment to continued funding and allocation of resources necessary and sufficient to meet the needs of this next wave of migration.

10.3.4  The Role of Partnerships in These Efforts Addressing climigration in the future will require the development and implementation of new forms of research-practice and academic-community partnerships, new sets of partners (including corporate representatives of the energy industry, government officials, physical and biological scientists, and entertainment celebrities), and new forms of collaboration based on principles of equity, respect, diversity, transparency, debate, and compromise. Effective, sustainable research-practice partnerships build upon the existing organizational cultures of research and policy/practice. However, they are not merely an aggregation of these cultures but rather the product of their transformation resulting from the exchange of understandings, values, attitudes, and rules for engagement that occur between researchers, practitioners, community stakeholders, and policy makers. This exchange occurs through a process of debate and compromise. It assumes that there is mutual interest in learning how policy makers and practitioners view research and how researchers view policy and practice. It also requires an ability to communicate using a common language and a willingness to collaborate and compromise (Palinkas and Soydan 2012). Finally, meeting the needs of people at each stage of the climigration process must be founded on the integration of global knowledge with local experience. Although we have usually assigned priority to the former in the belief that it possesses external validity and adheres to standards of scientific rigor, the “local” is vital to adequately respond to current and forthcoming environmental challenges.

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Meeting the health and welfare needs of climigrants will require formation of partnerships between public health researchers and community members and practitioners to generate local knowledge that complements and contributes to the global knowledge generated by researchers and policy makers. Achieving these aims, however, will require the development and application of a new approach to public health research, one that is transdisciplinary, team-based, and translational in character (Gehlert et al. 2017). Not only must researchers from public health and other disciplines learn to work together to capture the complexity of climigration, but it is equally important for researchers to communicate with service providers to ensure that public health discoveries are communicated as quickly as possible and researchers frame their work with a knowledge of community realities. Such communication and collaboration involve the development and maintenance of partnerships between public health researchers, researchers representing other disciplines, and practitioners and policy makers. Transdisciplinary science involves integrating two or more disciplines to produce novel, integrated hybrids of ideas, theories, and methods. A distinguishing feature of transdisciplinary collaboration is the creation of a shared conceptual model or framework for analyzing the problem at hand, which transcends the individual disciplinary perspectives of each team member (Rosenfeld 1992; Fuqua et al. 2004). Team science refers to the approach of conducting research in teams within complex social, organizational, political, and technological milieu that heavily influence how that work occurs (Hall et al. 2018). The Science of Team Science (SciTS) is a cross-disciplinary field of study that aims to build an evidence base and develop translational applications to help maximize the efficiency and effectiveness of team-based research (Hall et al. 2018). Translational science research is the study of the process of research translation, a process of applying ideas, insights, and discoveries generated through basic scientific inquiry to the treatment or prevention of human disease and improvement of individual and social welfare (Palinkas and Soydan 2012). Translational research seeks to understand and facilitate the process of research translation. The aims of translational research are (1) to assess the effectiveness of an intervention or evidence-­based practice in a real-world setting in achieving a specific set of outcomes (effectiveness); (2) to assess and contribute to the distribution of information and intervention materials to a specific social work, public health, or clinical practice audience (dissemination); and (3) to assess and potentially facilitate or promote its adoption, use, and sustainability in such settings (implementation) (Proctor et al. 2009).

10.4  Summary Throughout human history, waves of migration have been bounded by time and space. Humans have long been faced with a decision whether to stay or to go when confronted by a change in the environment. Many human societies elected to remain where they were despite the harshness of the environment. Many have adapted quite

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well from the perspective of demographic, energy, and nutritional criteria. The experience of history offers some measure of optimism that the human experience will adapt to this new environmental challenge. For some, that adaptation may involve efforts to build communities that are environmentally, economically, and socially sustainable. For others, it will involve efforts to relocate to other ecosystems that meet the requirements of land, livelihood, and habitability security. Successful adaptation may be reflected in a reduction of health risks and an improvement in health outcomes. However, it is not merely an ability to respond to changes in the environment that themselves are the product of human activity. It is also the ability to develop a relationship with the environment that involves adjustments by both humans and their environment to meet one another’s needs. Both humans and their environment will continue to influence the decision to stay or to go.

References Albrecht G (2011) Chronic environmental change: emerging ‘psychoterratic’ syndromes. In: Weissbecker I (ed) Climate change and human well-being. Springer, New York, pp 43–56 Allen C, Metternicht G, Wiedmann T (2018) Initial progress in implementing the Sustainable Development Goals (SDGs): a review of evidence from countries. Sustain Sci 13(5):1453–1467 Bager L, Hansen KS, Andersen CJ et al (2018) Does multidisciplinary rehabilitation of tortured refugees represent ‘value-for-money’? A follow-up of a Danish case-study. BMC Health Serv Res 18(1):365. https://doi.org/10.1186/s12913-018-3145-3 Black R, Bennett SG, Thomas SM et al (2011) Climate change: migration as adaptation. Nature 478(7370):447–449 Blewitt J (2017) Understanding sustainable development, 3rd edn. Routledge, New York Bock WJ (1980) The definition and recognition of biological adaptation. Am Zool 20:217–227 Capps R, Gelatt J, Van Hook J et  al (2018) Commentary on “The number of undocumented immigrants in the United States: estimates based on demographic modeling with data from 1990-2016”. PLoS One 13(9):e0204199. https://doi.org/10.1371/journal.pone.0204199 Clark WC, Dickson NM (2003) Sustainability science: the emerging research program. Proc Natl Acad Sci 100(14):8059–8061. https://doi.org/10.1073/pnas.1231333100 Clayton S, Manning C, Hodge C (2017) Beyond storms and droughts: the psychological impacts of climate change. American Psychological Association and ecoAmerica, Washington, DC Elliott JA (2012) An introduction to sustainable development. Routledge perspectives on development. Routledge, New York Farbotko C, Lazrus H (2012) The first climate refugees? Contesting global narratives of climate change in Tuvalu. Glob Environ Chang 22(2):382–390. https://doi.org/10.1016/j. gloenvcha.2011.11.014 Fazel-Zarandi M, Feinstein JS, Kaplan ED (2018) The number of undocumented immigrants in the United States: estimates based on demographic modeling with data from 1990–2016. PLoS One 13(9):e0201193. https://doi.org/10.1371/journal.pone.0201193 Foresight: Migration and Global Environmental Change (2011) Final Project Report. The Government Office for Science, London. https://assets.publishing.service.gov.uk/government/ uploads/system/uploads/attachment_data/file/287717/11-1116-migration-and-global-environmental-change.pdf. Accessed 13 Nov 2019 Fuqua J, Stokols D, Gress J et al (2004) Transdisciplinary collaboration as a basis for enhancing the science and prevention of substance use and “abuse”. Subst Use Misuse 39:1457–1514

214

10  The Future of Climigration

Gehlert S, Hall K, Palinkas LA (2017) Training our next generation scientific work force to address the grand challenges in social work. J Society Soc Work Res 8(1):119–136. https:// doi.org/10.1086/690659 Hadlock L (2017) Rising seas could result in 2 billion refugees by 2100. Phys.org 26, Jun. https:// phys.org/news/2017-06-seas-result-billionrefugees.html. Accessed 30 Sept 2019 Hall KL, Vogel AL, Huang GC et al (2018) The science of team science: a review of the empirical evidence and research gaps on collaboration in science. Am Psychol 73(4):532–548. https:// doi.org/10.1037/amp0000319 Hayes K, Blashki G, Wiseman J et al (2018) Climate change and mental health: risks, impacts and priority actions. Int J Ment Health Syst 12:28. https://doi.org/10.1186/s13033-018-0210-6 Intergovernmental Panel on Climate Change (IPCC) (2014) Impacts, adaptations and vulnerability. 2 vols. In: Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge University Press, New York International Organization for Migration (IOM) (2008) Migration and climate change. IOM Migration Research Series No. 31. International Organization for Migration, Geneva International Organization for Migration (IOM) (2018) Global migration indicators: insights from the global migration data portal. Global Migration Data Analysis Centre (GMDAC), International Organization for Migration, Berlin. https://publications.iom.int/system/files/pdf/ global_migration_indicators_2018.pdf. Accessed 30 Sept 2019 Jerneck A, Olsson L, Ness B et al (2011) Structuring sustainability science. Sustain Sci 6:69–82 Kates RW (2011) What kind of science is sustainability science? Proc Natl Acad Sci 108(49):19449–19450. https://doi.org/10.1073/pnas.1116097108 Kates RW, Clark WC, Corell R et al (2001) Sustainability science. Science 292(5517):641–642 Kennedy S, Kidd MP, McDonald JT et al (2015) The healthy immigrant effect: patterns and evidence from four countries. J Int Migration Integration 16(2):317–332 Komiyama H, Takeuchi K (2006) Sustainability science: building a new discipline. Sustain Sci 1(1):1–6 Komiyama H, Takeuchi K, Shiroyama H et al (eds) (2011) Sustainability science: a multidisciplinary approach. United Nations University Press, Tokyo Lachman BE (1997) Linking sustainable community activities to pollution prevention: a sourcebook. RAND Corporation, Santa Monica, CA McArthur JW (2013) Own the goals: what the millennium development goals have accomplished. Foreign Aff 92:152–162 McArthur JW, Rasmussen K (2017) Change of pace; acceleration and advances during the millennium development goal era. Brookings Institution Global Economy and Development Working Paper 97. https://doi.org/10.2139/ssrn.2941856. Accessed 24 Sept 2019 McDonald JT, Kennedy S (2004) Insights into the ‘healthy immigrant effect’: health status and health service use of immigrants to Canada. Soc Sci Med 59(8):1613–1627 Moran E (1982) Human adaptability: an introduction to ecological anthropology. Westview Press, Boulder, CO Mortreaux C, Barnett J (2009) Climate change, migration and adaptation in Funafuti, Tuvalu. Glob Environ Change 19(1):105–112. https://doi.org/10.1016/j.gloenvcha.2008.09.006 Myers N (2002) Environmental refugees: a growing phenomenon of the 21st century. Phil Trans R Soc Lond B 357:609–613. https://doi.org/10.1098/rstb.2001.0953 Naficy A, Rao MR, Paquet C et al (1998) Treatment and vaccination strategies to control cholera in sub-Saharan refugee settings: a cost-effectiveness analysis. JAMA 279(7):521–525 Palinkas LA (1989) Sociocultural influences on psychosocial adjustment in Antarctica. Med Anthropol 10(4):235–246 Palinkas LA, Soydan H (2012) Translation and implementation of evidence based practice. Oxford University Press, New York Proctor E, Landsverk J, Aarons G et al (2009) Implementation research in mental health services: an emerging science with conceptual, methodological, and training challenges. Adm Policy Ment Health 36(1):24–34. https://doi.org/10.1007/s10488-008-0197-4

References

215

Rosenfeld PL (1992) The potential of transdisciplinary research for sustaining and extending linkages between the health and social sciences. Soc Sci Med 35(11):1343–1357 Sachs J (2015) The age of sustainable development. Columbia University Press, New York Sengupta S (2019) Protesting climate change, young people take to streets in a global strike. New  York Times, 20 Sept. https://www.nytimes.com/2019/09/20/climate/global-climatestrike.html. Accessed 30 Sept 2019 Singer M (1989) The coming of age of critical medical anthropology. Soc Sci Med 28(11):1193–1203 Spangenberg JH (2011) Sustainability science: a review, an analysis and some empirical lessons. Environ Conserv 38(3):275–287 Speelman LH, Nicholls RJ, Dyke J (2017) Contemporary migration intentions in the Maldives: the role of environmental and other factors. Sustain Sci 12:433–451 Taylor M, Watts J, Bartlett J (2019) Climate crisis: 6 million people join latest wave of global protests. The Guardian (UK), 27 Sept. https://www.theguardian.com/environment/2019/ sep/27/climate-crisis-6-million-people-join-latest-wave-of-worldwide-protests. Accessed 30 Sept 2019 Thatcher A (2014) Theoretical definitions and models of sustainable development that apply to human factors and ergonomics. In: Broberg O, Fallentin N, Hasle P et al (eds) 11th International Symposium of Human Factors in Organizational Design and Management and 46th Annual Nordic Ergonomics Society Conference, Copenhagen, August 2014, pp 747–752 Tollefson J, Gilbert N (2012) Rio report card. Nature 486:20 United Nations Economic and Social Council, Economic and Social Commission for Asia and the Pacific (UNESCAP) (2017) Migration and climate change in Asia and the Pacific. https://www. unescap.org/sites/default/files/GCMPREP_5E.PDF. Accessed 12 Apr 2019 United Nations General Assembly (2015) Transforming our world: the 2030 agenda for sustainable development, outcome document of the United Nations summit for the adoption of the post-2015 agenda. RES/A/70/L.1. United Nations, New York United Nations High Commissioner for Refugees (UNHCR) (2019) What is a refugee? https:// www.unrefugees.org/refugee-facts/what-is-a-refugee/. Accessed 24 Sept 2019 Wiek A, Farioli F, Fukushi K, Yarime M (2012) Sustainability science—bridging the gap between science and society. Sustain Sci 7(Suppl):1–4. https://doi.org/10.1007/s11625-011-0154-0 World Bank (2013) Building resilience: integrating climate and disaster risk into development. Lessons from World Bank Group experience. The World Bank, Washington, DC World Health Organization (WHO) (2019) Health, environment, and sustainable development. https://www.who.int/sustainable-development/en/. Accessed 23 Sept 2019 World Health Organization Africa Region (WHO AR) (2018) Health of refugees and migrants. Regional situation analysis, practices, experiences, lessons learned and ways forward. https:// www.who.int/migrants/publications/AFRO-report.pdf?ua=1. Accessed 20 Sept 2019 Yarine M, Trencher G, Mino T (2012) Establishing sustainability science in higher education institutions: towards an integration of academic development, institutionalization, and stakeholder collaborations. Sustain Sci 7(Suppl 1):101–113

Appendix A

Policy recommendations from United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP 2017: 16–20) 67. Member States could consider the following actions: (a) Prioritize the 2030 Agenda, the Sendai Framework, the United Nations Framework Convention on Climate Change, the Paris Agreement, and the United Nations Convention to Combat Desertification and the Convention on Biological Diversity and support developing countries that are highly exposed to climate change and disasters. (b) Implement the Agenda for the Protection of Cross-Border Displaced Persons in the Context of Disasters and Climate Change and the Platform on Disaster Displacement, the United Nations Framework Convention on Climate Change Task Force on Displacement, the Migrants in Countries in Crisis Initiative, and the Addis Ababa Action Agenda, including strengthening dialogue between countries of origin and destination on climate-related migration, strengthening regular migration pathways, expanding visa options, providing temporary protection, addressing seasonal or circular labor migration and permanent migration options, and increasing humanitarian visa quotas and student mobility and family reunification schemes. (c) Ensure that climate change and migration are addressed in forums such as the Bali Process on People Smuggling, Trafficking in Persons and Related Transnational Crime, the Colombo Process, the Abu Dhabi Dialogue, the Asia Dialogue on Forced Migration, the ASEAN Convention Against Trafficking in Persons, Especially Women and Children, and global compacts. (d) Counter human trafficking and other exploitative forms of migration, with attention to post-disaster and climate-vulnerable contexts. (e) Strengthen bilateral and regional labor agreements and private sector partnerships, which integrate safe and regular migration management and decent work goals into shared agendas.

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(f) Strengthen the evidence base upon which to develop context-specific responses, by: (i) Building capacity in all countries to gather disaggregated data on risks, projected impacts, and internal and international migration patterns (ii) Harmonizing data collection methodologies and moving toward integrated regional data collection systems 68. Countries of origin could consider the following actions: (a) Gain accreditation to multilateral funds (such as the Green Climate Fund) and mainstream mobility considerations into projects financed by these funds. (b) Develop durable solutions in line with the Nansen Initiative for internally displaced populations or those at risk of displacement, which: (i) Provide options for well-planned internal relocation that is protection-­ centered and community-driven and addresses multidimensional recovery needs relating to issues including health, education, infrastructure, livelihoods, and security of land tenure (ii) Support return and reintegration of displaced populations following disaster and local integration where people have sought refuge or been evacuated, where appropriate and in consultation with host communities (iii) Strengthen internal migration management and develop durable solutions for people living in informal settlements and stateless people (c) Establish integrated regional frameworks and national, subnational, and local plans to mainstream mobility considerations into disaster risk reduction and adaptation, which: (i) Establish emergency response centers and coordination structures (such as cluster systems and early warning systems, which are frequently monitored) (ii) Promote climate- and disaster-resilient land-use planning, including multi-­ hazard mapping and integrated vulnerability assessments using participatory methods to ensure that multi-hazard data underpins infrastructure, rural, and urban planning (iii) Strengthen disaster-resilient building codes and compliance and climateand disaster-proof critical infrastructure and services (such as water, health, education, energy, biomass, waste management, food, and telecommunications) (d) Equip communities with skills and capacities to adapt to changing environments, including: (i) Mapping and protecting traditional knowledge and cultural heritage, especially of indigenous communities and those who need to relocate away from hazards (ii) Integrating local knowledge of risks and responses into disaster risk reduction and adaptation planning

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(iii) Promoting livelihood diversification and social protection by expanding safe, regular labor migration opportunities, such as new safe and decent labor migration “products” and visa types and insurance schemes, with assistance to vulnerable people (iv) Ensuring that national health systems adapt to climate-related challenges, including pandemic preparedness, implementation of World Health Assembly resolutions 61.17 on the health of migrants and 70.15 on promoting the health of refugees and migrants, and heat health warning systems and new work regulations to avoid heat stress among workers (v) Investing in climate-resilient agriculture, in careful consultation with affected communities (vi) Prioritizing integrated water management, infrastructure, and reservoir development, including diversification of water sources and reuse options (vii) Promoting ecosystem-based approaches, including quantifying the value of ecosystem services and building it into adaptation and risk reduction planning (viii) Enhancing sustainable management of ecosystems, including forests and coral reefs, by preparing inventories, mapping carbon stocks and critical ecosystems, strengthening legal frameworks for environmental protection, and ensuring that equitable benefits are created that do not impact negatively on or displace vulnerable communities (e) Establish protocols with neighboring countries for action in the event of disaster, including protocols to address cross-border displacement. (f) Establish national institutional structures to implement the Warsaw International Mechanism for Loss and Damage Associated with Climate Change Impacts, including insurance mechanisms and risk-pooling solutions. (g) Intensify efforts to achieve the 2030 Agenda with special attention to the Sustainable Development Goals with components related to climate change, disaster, and migration,with a focus on: (i) Reducing migration push factors through poverty reduction, decent job creation, sustainable development, and improved access to basic necessities (water, sanitation, and hygiene for all initiative, health, education, and basic infrastructure) (ii) Promoting women’s leadership (iii) Strengthening the rule of law and access to justice, especially in relation to land, property rights, and gender-responsive land reform (iv) Promoting education, training, and skills recognition systems, to match migrants to appropriate international labor opportunities based on skills levels (v) Maximizing the benefits of safe, well-managed international migration at home, by expanding decent labor migration options, enabling low-cost remittance transfers, increasing financial literacy, leveraging remittances for adaptation and disaster risk reduction, and seeking support from diaspora communities to these ends

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(vi) Recruiting migrant workers under fair recruitment principles, recognizing the dual responsibilities of government and business to adhere to the “employer pays” principle of the Leadership Group for Responsible Recruitment, and that employment conditions should be specified in contracts in advance of departure (vii) Empowering and protecting migrant workers through pre-departure training, orientation, and return assistance, including free, comprehensive, and accurate information regarding rights and conditions of recruitment and employment (viii) Including stateless people and other non-citizens in all national sustainable development planning, disaster risk reduction, and adaptation activities 69. Transit and destination countries could consider the following actions: (a) Increase humanitarian and development assistance to countries of origin to intensify efforts to implement the recommendations above. (b) Increase international cooperation and dialogue on implementation of the Warsaw International Mechanism for Loss and Damage Associated with Climate Change Impacts. (c) Facilitate safe, well-managed, and regular international labor migration channels, in particular for people in countries and communities highly vulnerable to climate change, including by: (i) Expanding circular and seasonal international migration opportunities to new regions and countries to fill genuine short-term labor needs (ii) Implementing the ILO Fair Recruitment Initiative and general principles and operational guidelines for fair recruitment, and the Protocol of 2014 to the Forced Labour Convention, 1930, and its accompanying recommendations (iii) Developing skills recognition and qualification frameworks to facilitate migration to support key sectors (such as the health sector and the aged care sector) (iv) Ensuring that all migrants have access to health services in transit and destination countries, regardless of status and reason for migration, that migrants are included within universal health coverage efforts, and that national health systems are migrant-sensitive (v) Facilitating access to social protection for migrant workers and their families, in accordance with national laws and regulations and international obligations (vi) Promoting scholarship opportunities for students in the region to enhance mobility and the recognition of skills (vii) Expanding humanitarian visa options and the number of people accepted under humanitarian categories, including temporary protection for foreigners caught overseas when disasters occur in home countries (such as the temporary protected status in the United States)

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(viii) Increasing the flexibility of policies and quotas under existing bilateral special relationships that confer privileged rights of entry and stay (such as the Pacific Access Category in New Zealand) (ix) Making allowances for in-country change of immigration status, in particular to allow for the transition from visitor to worker status (x) Providing pathways to residence based on a specified period of lawful presence and stay in the host countries (xi) Reviewing sponsorship requirements for residence in cases where the applicant is from a community highly exposed to climate change impacts (xii) Allowing entry and stay of family members (including parents) of residents from at-risk countries (d) Support skilled workers to remain in countries of origin through social and economic investment and facilitation of regional and bilateral trade and investment. (e) Advocate lower remittance costs and transfers, including through regional and bilateral agreements and partnerships with private sector. (f) Sign and ratify, without exceptions, the following conventions: (i) International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (ii) ILO Migration for Employment Convention (Revised), 1949 (No. 97) (iii) ILO Migrant Workers (Supplementary Provisions) Convention, 1975 (No. 143)

Appendix B

Ten action areas for building climate resilience (WHO AR 2015: 129–132) 1. Governance and policy –– Focal point on climate change and health designated within the Ministry of Health with specific program of action and budget allocated. –– Climate change and health focal points or units work in collaboration with relevant climate-sensitive health programs, e.g., vector-borne diseases, nutrition, infectious diseases, and disaster risk reduction, to build the resilience of the programs. –– NCCHAP and/or H-NAP developed and adopted. –– Agreements, e.g., memorandum of understanding, memorandum of agreement, between the Ministry of Health and main stakeholders at the national level (e.g., Meteorological Services, ministries of environment, food and agriculture, energy, transport, planning) signed, which include concrete roles and responsibilities in relation to protecting health from climate change. –– Health representation ensured in main climate change processes at national, regional, and global levels, e.g., UNFCCC meetings and Conference of the Parties, NAP, and national communications to the UNFCCC. –– Main policies and strategies from health-determining sectors reflect climate change and health considerations both in relation to adaptation, e.g., climate-­ resilient water safety plans, and mitigation, e.g., health co-benefits in transport policies. –– HIAs conducted for new mitigation and adaptation policies and programs in all climate-sensitive sectors, in accordance with Article 4.1.f of the UNFCCC. 2. Capacity development –– Training courses on different topics related to climate change and health conducted targeting health personnel. –– Curricula on climate change and health developed and imparted at secondary and/or tertiary levels. © Springer Nature Switzerland AG 2020 L. A. Palinkas, Global Climate Change, Population Displacement, and Public Health, https://doi.org/10.1007/978-3-030-41890-8

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–– Contingency plans for the deployment of sufficient health personnel in case of outbreaks developed at the respective level, i.e., national, state/provincial, and local. –– Realistic and innovative human resources capacity building plans developed, which address human resource and institutional capacity gaps identified in relevant conducted assessments, e.g., capacity or vulnerability and adaptation assessments. –– Contingencies, adaptation costs, and potential losses and damages from climate change are incorporated by management staff into investment plans. –– An internal and external communication plan developed and implemented, including the development of knowledge products to raise awareness of health and climate change and response options targeting different audiences such as health professionals and decision-makers, communities, the media, and other sectors. –– Health professionals, the media, and community leaders trained in risk communication, including communication of uncertainty. 3. Vulnerability, capacity, and adaptation assessment –– Baseline climate-sensitive health conditions established, which allow the monitoring of changing health status and risk conditions. –– HIAs for key adaptation and mitigation policies and programs of health-­ determining sectors conducted. –– Baselines on existing health infrastructure and capacity established. –– Most vulnerable populations and areas to the health risks of climate change identified. –– Assessment results used to prioritize allocation of resources. –– Plan defined and mechanism established for iterative review of health vulnerability and adaptation options available. 4. Integrated risk monitoring and early warning –– Early detection tools, e.g., rapid diagnostics, syndromic surveillance used to identify changing incidence, and early action triggered. –– Geographical and seasonal distribution of health risks and outcomes, i.e., risk mapping, tracked. –– Early warning systems for relevant extreme weather events and climate-­ sensitive diseases, e.g., malaria early warning systems, zoonotic diseases, and undernutrition, established. –– Indicators on climate change impacts, vulnerability, response capacity, emergency preparedness capacity, and climate and environmental variables included in relevant monitoring systems at national level and reported over time. –– Periodic review for improvements or deterioration of capacity gaps identified in vulnerability and adaptation assessments conducted. –– Health impacts of main environmental determinants of health monitored by health sector.

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–– Effective communication strategydeveloped and implemented on climate risks to health, outlining the scope of information to be included for diverse audiences, e.g., media, public, health personnel, and other sectors, as well as events, who should communicate, and the means of communication. 5. Research –– National research agenda on climate change and health defined through the organization of a stakeholder forum, which involves representatives from the Ministry of Health, research institutions, nongovernmental organizations, and the private sector. –– Databases on climate change and health, and rosters of local experts established. –– Climate change and health knowledge management networks established. –– Training on health impacts of climate change and health vulnerability and adaptation assessment conducted targeting public health research institutions. –– Proposal for funding advanced degree program on climate change and health submitted and funded by relevant research funding organization. –– Research findings used to inform planning, policy, and stakeholder groups. –– Policy and decision-makers included in the conduct of vulnerability assessments. 6. Essential products and technologies –– Health facilities at all levels have access to and use sustainable energy and water supplies. –– Impact of health sector on the environment assessed, and appropriate mechanisms to monitor carbon emissions and environmental impacts developed. –– New technologies such as digitized health records, e-Health, and telemedicine for satellite imagery used to improve health service delivery in remote communities and outer islands. –– Training in pharmaceutical use during extreme heat conditions provided. 7. Management of environmental determinants of health –– Quality standards and regulations on key environmental determinants of health—air quality, water quality, food quality, housing safety, and waste management—revised and enforced so as to reflect broader ranges of expected climate conditions. –– Building regulations and waste management infrastructure promoted, which are both environmentally sustainable and resistant to locally likely extreme events. –– Joint assessment, monitoring, and regulation of climate risks to health promoted, e.g., conduct of HIAs for policies and programs in other sectors, including transport, agriculture, and energy. –– Joint multisectoral risk management approaches to health risks undertaken in relation to disasters, water, waste, food, and air pollution, e.g., food safety,

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diarrheal disease control, integrated vector management, and interagency risk communication. 8. Climate-informed health programs –– Information gathered on seasonal trends used to plan preventive measures for those most at risk, e.g., diarrheal diseases or vector-borne diseases. –– Relevant public health programs and activities taking into consideration short-term influences, i.e., seasonal trends and long-term climate change in their operations, e.g., vector surveillance and control to prevent dengue and chikungunya. 9. Emergency preparedness and management –– Climate-sensitive health risks included under national disaster reduction strategy and plans. –– Evacuation plans defined and implemented in case of need. –– Risk management mainstreamed into development processes. –– Incentive mechanisms promoted for individual actions to reduce exposure. –– Current health-care and public health infrastructure, including water supply and waste disposal and sanitation, are appropriately located and adequately robust to be safe and remain functional under the stress of extreme weather. –– Climate-resilient building codes for health and public health infrastructure developed. –– New health-care and public health infrastructure located, designed, built, and operated with the current and future climate in mind. –– Capacity of local communities to identify risks, prevent exposure to hazards, and take action to save lives in emergencies strengthened. –– Civil society and community groups empowered through participation, dialogue, and information exchange, thus strengthening community-based risk reduction. –– National all-hazards health emergency and disaster risk management programs, capacity assessments, and risk assessments developed and implemented, which account for short- and long-term climate trends. 10. Financing –– Projects and programs on building health system resilience submitted to and funding granted by the main international climate change funds, e.g., Adaptation Fund, SCCF, LDCF, and Green Climate Fund, and bilateral donors. –– Climate variability and change considerations included in proposals on malaria presented to and granted by the Global Fund to Fight AIDS, Tuberculosis and Malaria. –– Health impacts of climate change monitored in programs funded through financial mechanisms specific to health-determining sectors.

Index

A Adaptation, 206 definition of, 206 human adaptability, 206 See also Climigration Afghanistan, 73 Alaska, 128, 129, 134 flooding, 129 Kivalina, 130, 131, 138 Newtok, 127, 128, 131 number of climigrants, 130–132 Alaska Native communities, 130 American Psychological Association and ecoAmerica, 204 Anxiety, 43, 81, 83, 85 anxiety disorder, 24, 83 Generalized anxiety disorder (GAD), 135 Armed Conflict and Location Event Data (ACLED), 75 Asian Development Bank (ADB), 104 Association of Southeast Asian Nations (ASEAN), 152, 159 Australia, 157, 158 drought mental health impacts, 81 wildfires, 60 Black Saturday bushfires, 56, 60 B Bangladesh, 104, 105, 113, 117 climigration, 115 flooding, 101

patterns of displacement displacement-related decisions, 108 numbers of climigrants, 104, 105 rural to urban migration, 114 rural to urban migration, 99, 113 sea level rise (SLR), 101, 102 C California wildfires, 55, 56, 59 Camp Fire, 53, 55–58, 61–63 Carr Fire, 57 Creek Fire, 56 disparities in risk and resilience, 63 drought, 64 economic impacts, 58 evacuees, 63 health impacts, 58 respiratory illness, 59 impacts of displacement communities of origin, 62 host communities, 62 Paradise, 53, 55, 62 rebuilding, 58, 62 Station Fire, 55 Thomas Fire, 54, 56 Tubbs Fire, 54, 57, 62 Woolsey Fire, 56 Canada Fort McMurray Wildfire, 56, 61 Civil conflict, 90–91, 193 Afghanistan, 73 Africa, 75–77, 79 climate change, 79 collective violence, 80

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228 Civil conflict (cont.) historical, 8 Middle East, 79 and population displacement, 76 and social instability, 80 Syria, 72, 73, 79 Climate change as an accelerator, 160 acute weather events, 204 Alaska, 129 Asia, 108 civil conflict, 79, 80 Asia and Pacific, 112 coastal ecosystems, 102 coastal erosion, 129 disparities, 207 economic impacts, 107, 132 agriculture, 107 housing and infrastructure, 107 food insecurity, 77, 79, 108 habitat insecurity, 107 health impacts, 7, 8, 80, 102, 108, 111, 133–135, 207 ciguatera, 108 infectious diseases, 111, 133 injuries, 111 malnutrition, 108 mortality, 111 noncommunicable diseases (NCDs), 111 Pacific island communities, 111 Western Pacific, 109–110 human-induced causes, 203 land insecurity, 106, 107 mental health impacts, 111, 112, 193 “psychoterratic” syndromes, 204 ecoanxiety, 204 solastalgia, 204 natural disasters, 5 ocean acidification, 102 PICTs, 100 sea level rise (SLR), 102 Syria, 73 UNESCAP, 100 water insecurity, 80, 108 Climate-informed health programs, 226 Climate refugees, 8, 100, 103, 113, 161, 203 Climate-related disasters, 5 See also Climate-related events Climate-related displacement, see Climigration Climate-related events acute, 6, 204 long-term, 6, 91, 204

Index Climate resilience capacity development, 153, 223 governance and policy, 223 Climigrants, 77–78, 85, 91 access to services, 86 asylum seekers, 75, 83, 84, 86–88, 91 communicable diseases, 86 definition of, 4, 91 detention camps, 84 legal status, 160 service needs, 171 wildfire evacuees, 63–64 Climigration, 3, 5, 7, 10, 86 as adaptation, 105, 113, 151, 157, 160, 206 Alaska, 129 drivers of, 10, 160, 205 forced, 18, 91, 113, 117, 119, 157, 160, 206 forms of, 5 history of, 2, 3 hot spots Amazon Basin, 7 China, 6 Lake Chad Basin, 6 Middle East, 6 Philippines, 6 illegal, 208 internal, 87, 113, 114, 119 international, 4, 114–116, 118, 119 international destination Australia, 115 China, 115 East Asia, 114 Europe, 114 India, 115 Middle East, 114 Southeast Asia, 114 “new normal”, 203, 204 and populism, 86 public health threat, 207, 208 reasons for, 9, 119, 120, 181, 203 civil conflict, 79–80 food insecurity, 79 UN Economic and Social Council, 115 voluntary, 85, 112, 113, 206 xenophobia, 84 Climigration policies climate-related settlement, 165 costs, 166 development and implementation, 165 development-related displacement, 165 displacement management, 149, 163 facilitation and regulation (see Facilitation and regulation policies)

Index general principles, 150–151 international policies, 160, 161 issues that trigger policy response, 159 mitigation policies, 152–155 national policies, 159, 162 planned relocation, 151, 160 recommendations, 163, 164 requirements, 149 Three-Tier Model, 149, 150 types of policies, 150, 151 Climigration resettlement practice evidence-based services, 190–191 service delivery, 192 Three-Tier Model (see Community impacts; Individual impacts; Socioenvironmental impacts) Coastal erosion Alaska, 128, 129 coastal communities, 139 cohesion vs. dispersion, 141 continuity vs. change, 141, 142 disparities, displacement, 140, 141 displacement impacts on community of origin, 136, 137 impacts on displaced, 136 impacts on host communities, 138–139 displacement-related decisions change in physical environment, 132 health impacts, 133–135 federal agencies, 140 Federal Emergency Management Agency (FEMA), 140 The Stafford Act, 140 Gulf of Mexico, 129, 130 health impacts, 134 impacts of displacement community conflict, 136–138 social ties, 136 Isle de Jean Charles, 127, 129, 131–134, 136, 137, 140, 142 litigation, 137, 138 Native American communities, 129 numbers of climigrants Alaska Native communities, 130 flooding, 132 patterns of displacement displacement-related decisions, 132 numbers of climigrants, 130, 131 sea level rise (SLR) Atlantic coast, 128 US, 128 United States, 134 See also Coastal flooding

229 Coastal flooding Alaska, 129 King tides, 103 patterns of displacement displacement-related decisions, 106–112 sea level rise (SLR), 101–103 (see also Sea level rise (SLR)) See also Coastal erosion Cognitive-Behavioral Intervention for Trauma in Schools (CBITS), 186–188 Common elements treatment approach (CETA), 188 Community conflict Alaska, 137 climigrants, relocated communities, 136 Exxon Valdez oil spill, 138 government agencies, 136 Gulf Coast, 137 loss of cultural identity, 137 social networks, 137 wildfires, 62 Community impacts post-migration social integration, 181 social networks, 181, 182 pre-migration climigration decision-making, 180 community-based disaster preparedness, 179 peer support, 180 risk communication, 179 social networks, 180 social skills and conflict management, 179, 180 social conflicts, 178 Community/lay health workers, 174, 187, 188 Coping with Work and Family Stress, 184 Cyclone Preparedness Program, 180 Cyclones, 90, 101, 102, 105, 106, 111, 113, 118 D Depression, 43, 81, 83, 85 major depressive disorder (MDD), 83 Disaster preparedness, 180, 193 See also Disaster risk reduction Disaster Psychosocial Assessment and Surveillance Toolkit (Disaster-­ PAST), 183 Disaster risk reduction ASEAN Agreement, 152 development planning process, 153

Index

230 Disaster risk reduction (cont.) disaster planning, 153 disaster preparedness, 153 national and international initiatives, 152 operational framework, 153 policies and programs, 152 recommendations, 152 Vanuatu’s planning, 153 VCCDRPP, 153 Disaster Risk Reduction and Management (DRRM), 153 Disparities, 22, 23, 90, 140, 207 climate change, 90–91, 120 responsibility for, 163 displacement, 21, 23, 48, 90, 139 employment opportunities, 23 health impacts, 24 risk and resilience, 207 Displacement, 127 as adaptation, 206, 207 climate change, 203, 205 “climate refugee”, 203 disparities, 21, 90, 141 environmental changes, 204 management, 210, 211 partnerships, 211 mental health impacts, 25, 83 “new normal”, 203, 204 physical health impacts, 85, 86, 208 prevention, 209–210 climate-related environmental changes, 208 consequences, 211 management, 210 partnerships, 211, 212 public health, 207, 208 return migration, 82 Drought, 73–76, 78, 80–82, 107, 112 Bangladesh, 102 Central America, 88, 89 civil conflict, 79 climigrations, 88–90 and disparity, 90 displacement impacts on host communities, 86 economic impacts, 78, 79, 81 food insecurity, 81 mental health impacts, 81 Mozambique, 89 patterns of displacement displacement-related decisions, 80 physical health impacts, 80 respiratory illnesses, 80 Small Island Developing States (SIDS), 102

Somalia, 76, 77 South Sudan, 76 sub-Saharan Africa, 73–77 Sudan, 76 Syria, 6, 73 E East Africa, 76, 77 patterns of displacement numbers of climigrants, 78 Economic and Social Commission for Asia and the Pacific (UNESCAP), 100 Economic impacts, 78, 79, 107 Economic sustainability, 174 El Nino Southern Oscillation (ENSO), 79, 108 Environmental Justice Foundation (EJF), 4 Environmental sustainability, 173 European Network for Traumatic Stress, 185 Evidence-based disaster response, 184, 185 Evidence-based interventions (EBIs), 184, 191, 192 Evidence-based practices (EBPs), 186, 187, 191 Evidence-based treatments (EBTs), 184, 186 Evidence-informed treatments, 185 Extreme weather events (EWEs), 4, 28, 171, 183 See also Climate-related events Exxon Valdez oil spill, 135, 138, 149 Eye Movement Desensitization and Reprocessing (EMDR), 186 F Facilitation and regulation policies community-based approaches, 155 continuum, 156 displacement, 155 forced relocation, 157 guidelines, 156 migration, 155–157 Nansen Initiative, 155 national policies, 156 ‘Safer Islands’ strategy, 156 Families in Transition (FIT) program, 46 Federal Disaster Zone, 36 Federal Emergency Management Agency (FEMA), 19, 35, 37–39, 43, 44, 140, 162 Flooding, 128, 130, 132, 134 Bangladesh, 101, 102 displacement impacts on community of origin, 118 impacts on displaced, 117 impacts on host communities, 119

Index displacement-related decisions habitat security, 107 health impacts, 108, 111 land security, 106, 107 mental health impacts, 111, 112 UNESCAP, 107 North Korea, 103 numbers of climigrants Bangladesh, 104, 105 North Korea, 106 Philippines, 106 Small Island Developing States (SIDS), 105, 106 patterns of displacement displacement-related decisions, 107 international migration, 118 planned relocation (see Planned relocation) Small Island Developing States (SIDS), 102, 103 G Gastrointestinal infection, 86 Government agencies, 136 Great Migration to Europe, 71 Calais Jungle, 87 deaths, 72 displacement impacts on community of origin, 85 impacts on displaced, 82, 83 impacts on host communities, 86, 87 numbers of climigrants, 77 Impacts on Host Communities community conflict, 87 cultural hegemony, 87 legal channels of resettlement, 72 patterns of displacement displacement-related decisions, 77, 79 numbers of climigrants, 77 reasons for, 72 asylum, 72, 77, 78, 82 civil conflict (see Civil conflict) drought, 91 Sub-Saharan Africa, 73 Syria, 73 Gulf of Mexico, 18, 129, 130, 132 sea level rise (SLR), 129, 132 H Health care, 177, 178 Health impacts mitigation access to services, 158, 159 climate-resilient health-care systems, 155

231 focus areas, 154 leadership and governance, 155 migrant-sensitive health systems and programs, 158 migrant workers protection, 159 strategies, 154 Tier III impacts, 158 Healthy migrant effect, 207 Hurricane Katrina, 20, 21, 24, 25, 27–29 characteristics of the displaced, 24 communities, 29 disparities, 29 displacement, 18 access to services, 26 benefits, 27 characteristics of the displaced, 23–25 disparities, 23 displacement locations, 20 impacts on community of origin, 27, 28 impacts on displaced, 25, 29 impacts on host communities, 28 mental health impacts, 25–27 displacement locations Houston, 20 impacts on displaced, 25 mental health impacts, 23–25, 29 patterns of displacement characteristics, 19 destinations, 19, 20 disparities, 20 displacement-related decisions, 20–22 duration, 20 neighborhoods, 22 numbers of climigrants, 19, 20 post-disaster mental health, 26 Hurricane Maria climigration cultural differences, 49 damage, 36, 37 deaths, 37 displacement, 36 disparities, 48 impacts on community of origin, 45 impacts on displaced, 44 impacts on host communities, 46, 47 economic impacts, 42 government assistance, 43 mental health impacts, 42 patterns of displacement, 44 disparities, 45 displacement-related decisions, 39, 40, 42 numbers of climigrants, 38, 48 post-Maria climigration, 1, 47 template for subsequent disasters, 48, 49

Index

232 I Implementation science assessment, 190 Reach, Effectiveness, Adoption, Implementation, and Sustainment Framework (RE-AIM), 190 Stages of Implementation Completion (SIC), 190 evidence-based services, 190 implementation strategy, 190 Community Partnered Participatory Research (CPPR) framework, 191 Getting to Outcomes (GTO), 191 methodological innovation, 190 mixed methods, 190 theories models and frameworks Consolidated Framework for Implementation Research (CFIR), 190 Diffusion of Innovation Theory, 190 Exploration, Preparation, Implementation, and Sustainment (EPIS), 190 Interactive Systems Framework (ISF), 191 Ottawa Model of Research Use (OMRU), 190 Incident Command System (ICS), 179 Individual impacts mental health problems, 182 post-migration accessible and acceptable health care, 186 adaptation and advocacy, 189 community/lay health workers, 187, 188 evidence-based practices, 186, 187 stepped and collaborative care, 188, 189 task shifting, 187, 188 pre-migration building resilience, 184 evidence-based disaster response, 184, 185 first responders training, 184 resource mapping, 183 at-risk population identification, 183 school-based services, 184 traumatic events, 182 Infectious or respiratory diseases, 207 Intergovernmental Panel on Climate Change (IPCC), 4 International migration, 114 International Organization for Migration (IOM), 156, 161 Interpersonal violence, 24

K Kiribati, 102, 108, 115, 120, 157 relocation strategy, 157 L Lake Chad Basin, 6, 71, 75 M Major depressive disorder (MDD), 25 Maldives, 156 Safer Islands’ strategy, 156 Marshall Islands, 102, 108 Migrant workers protection, 159 Mortality disaster-related, 37 Mozambique drought, 89 extreme weather events, 89 migration to South Africa, 90 Ministry of Agriculture and Food Security (MASA), 90 sea level rise (SLR), 89 Multiple Family Group (MFG), 191 N Nansen Initiative, 155 Narrative Exposure Therapy (NET), 186 National disaster management agencies (NDMAs), 153 Native American communities, 142 Natural disasters, 4, 9 Nauru, 108 Network interventions, 182 New Orleans, 17 damage, 22 clinics/public health centers, 23 displacement destinations, 21 evacuation authorities, 28 housing availability, 22 levee system, 18 Lower Ninth Ward, 18 mandatory evacuation, 18 population decline, 27 shelters, 17, 18 temporary evacuation, 19 New Zealand, 157, 158 Nigeria, 75 Boko Haram, 6, 75 North Korea climigrants in China, 106 flooding, 103, 117

Index O Office of Refugee Resettlement (ORR), 177, 181 Organization for Economic Co-operation and Development (OECD), 101 P Pacific Island Countries and Territories (PICTS), 100, 102, 112 Parent Management Training–Oregon (PMTO), 187 Partnerships, 212 Philippines, 6, 106, 152 Typhoon Haiyan, 115, 152 Planned relocation guidelines, 156 Policy recommendations, UNESCAP, 217–221 Posttraumatic stress disorder (PTSD), 24, 25, 43, 59, 60, 83, 135, 182, 186–188 Poverty, 72–74, 80, 85, 87–89, 104 Practical, Robust Implementation and Sustainability Model (PRISM), 191 Problem Management Plus (PM+), 188 Problem-Solving Treatment (PST), 188 Psychological First Aid (PFA), 180, 184, 185 Public health, 212 benefits of services delivery, 208 climate-sensitive, 155 interventions, 154 partnerships, 212 Puerto Rico, 36 circular migration, 47 climigrants, 1, 44 damage, 37 depopulation, 45 economic and social future, 47 mental illness, 42 migration, 42 mortality data, 37 return migration, 38 unemployment, 42 R Randomized controlled trial (RCT), 187 Refugee, 205 definition of, 118 Resource mapping, 183 S Sahel, 74, 75, 78 Sea level rise (SLR), 128, 130, 138 Asia, 101

233 Bangladesh, 102 displacement impacts on community of origin, 118 impacts on displaced, 116–118 impacts on host communities, 119 economic impacts, 133 internal displacement, 113 international migration, 114 patterns of displacement displacement-related decisions, 106 number of climigrants, 103 Solomon Islands, 111 Skills fOr Life Adjustment and Resilience (SOLAR), 184 Small Island Developing States (SIDS), 4 Carteret Islands, 102 climate change as driver of migration, 105 Pacific, 102, 103 patterns of displacement numbers of climigrants, 105 rural to urban migration, 114 Torres Strait Islands, 103 Western Pacific, 105, 106 Social support networks, 181, 182 Social sustainability, 174 Socioenvironmental impacts post-migration employment and financial security, 176, 177 health care, 177, 178 host communities sustainability, 175 housing, 176 pre-migration asset building, 174 preparation, 175 sustainable development, 172–174 Solomon Islands, 111 Somalia, 77 al-Shabaab, 77 civil conflicts, 76 drought, 2, 76, 77 South Sudan drought, 76 Stepped and collaborative care, 188, 189 Strengthening Families Program (SFP), 184 Sub-Saharan Africa agricultural productivity, 73 climigrants, 75 desertification and deforestation, 74 drought, 73–77 East Africa, 73, 76–77 internal migration, 87 West Africa, 73–75 civil conflicts, 75, 76

Index

234 Sudan civil conflicts, 76 climate change, 76 Suicide, 43, 81, 85 Sustainability science, 209 theories models and frameworks Egg of well-being model, 209 Prism model, 209 Three pillars model, 209 Sustainable development, 193, 209 adoption, 172 disasters, 174 economic sustainability, 174 health impacts, 174 infrastructure projects, 173 social sustainability, 174 Sustainable Development Goals (SDGs), 207, 209 Syria, 73 civil conflict, 5, 72, 73, 79 drought, 5, 73 T Task shifting, 187, 188, 192 Teacher Training Implementation Model (TTIM), 191 Team science, 212 Technological disasters, 3 Three-Tier Model, 10, 149, 150, 172 Tokelau, 108 Transdisciplinary science, 212 Translational science, 212 Trauma systems therapy (TST), 189 Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT), 186 Tuvalu, 102, 108 U Uganda, 76, 87, 88 Under-5 years mortality rate (U5MR), 80–88 UN Economic and Social Council, 115 United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP), 217

United Nations Framework Convention on Climate Change (UNFCCC), 150 United States, 130 climigration, 139 coastal erosion, 128–130, 134 wildfires, 54, 55 V Vanuatu, 102, 153, 154 Vanuatu Climate Change and Disaster Risk Reduction Policy (VCCDRPP), 153 W West Africa, 74–76 Wildfires California (see California wildfires) climate change-related, 54 climate models, 54 displacement, 54 impacts on community of origin, 61–62 impacts on displaced, 60–61 impacts on host communities, 62 economic impacts, 57 Fort McMurray Wildfire (see Canada) health impacts Chronic obstructive pulmonary disease (COPD), 59 mental health, 59–61, 63 Particulate matter (PM), 58 respiratory illnesses, 59 patterns of displacement, 56 displacement-related decisions, 57 numbers of climigrants, 56 rebuilding, 57, 62–64 United States, 54, 55 World Bank, 153 World Food Program (WFP), 88, 89 World Health Organization, 164 Framework for Mental Health and Psychological Support after the Tsunami, 185 Inter-Agency Standing Committee, 183