117
8.2 Health and Sanitation
Climate change will affect the health of urban population and adapting to climate change in cities is now an additional concern for local governments and health authorities. The greatest
concern about the impacts of climate change upon human health regards changes in freshwater resources, food supplies, increase in extreme weather events and its indirect
impacts to population such as outbreak of water-borne diseases which are usually associated with contamination due to flooding. Survival of important bacterial pathogens is related to
temperature on one hand and on the other hand extreme rainfall can affect the transport of disease organisms into water supply. In addition it is common to have mosquito-borne
disease such as malaria, dengue as the higher temperatures reduce the development time of pathogens in vectors and increase potential transmissions to humans. Vector species require
specific climatic conditions temperature, humidity to be sufficiently abundant to maintain transmission. The urban heat island effect which is also common in more developed areas of
tropical countries like Thailand is caused by day time heat being retained by the fabric of buildings and by a reduction in cooling effect of vegetation cover result in creation of heat
stresses to urban population. This also has an effect in raising the night time temperature.
Children under the age limit of five are often the victims of sanitation related illnesses and diarrheal disease, primarily because of their less developed immunity and because of their
play behavior can bring them into contact with pathogens. Diarrheal disease also results in higher levels of malnutrition and increased vulnerability to other illness.
Climate related health issues are visible in selected cities for the study with low to high increase variations. The freshwater flooding leads to increased risks of human leptospirosis,
particularly, in affected lands with dwellings and farmland and where the water stagnates for several days. The high ratio highlights the lack of sufficient drainage and water supplies
causing the water to remain for several days and thus enabling the bacteria to develop. Similarly, dengue fever and malaria outbreaks are very common after flood situations.
Songkhla province had to cope in 2007 with a peak of malaria cases. This may be rooted in the combination of flooding events that undermined the medical facilities in the area
quantitatively than qualitatively.
118
Figure 8.13. Ratio of malaria cases per 100,000 of population Source: Department of disease control, Ministry of Public Health
Concerning health issues, Chiang Rai province has to deal regularly with a relatively high ratio of number of leptospirosis cases per 100,000 of population compared with other four
cities. Data shows that Udon Thani province has to face relatively high ratio of number of leptospirosis cases per 100,000 of population, which tends to increase over the period 2003-
2008.
Figure 8.14. Ratio of leptospirosis cases per 100,000 of population Source: Department of disease control, Ministry of Public Health
119 According to the Ministry of Health, the number of dengue hemorrhagic fever cases has
drastically increased in Phuket. The ratio of number of cases per 100,000 of population is four times higher in 2008 than in 2003, as shown in the Figure 8.15.
Related to health issue, Samut Sakhon has to face increasing number of Dengue Hemorrhagic Fever cases. The ratio of number of cases per 100,000 of population has almost double
between 2003 and 2008. Among the cities selected for the study the cities such as Udon Thani, Chiang Rai may have urban heat Island effect higher than coastal cities such as Phuket,
Samut Sakhon and the mean monthly temperature in urban heat islands can create considerable intensity during dray season. Unfortunately this data is not yet available for the
study.
Figure 8.15. Ratio of dengue hemorrhagic fever DHF cases per 100,000 of population Source: Department of disease control, Ministry of Public Health
Table 8.3. Ratio of disease per 100,000 population of Hat Yai municipality Source: Municipality
Population No.
of Cases
ratio per
100,000 Population
No. of
Cases ratio
per 100,000
Population No.
of Cases
ratio per
100,000 Population
No. of
Cases ratio
per 100,000
Malaria 155,585
10 6.42
156,724 7
4.46 157,354
4 2.54
157,382 6
3.18 DHF
155,585 362
232.67 156,724
238 151.85
157,354 722
458.83 157,382
339 215.39
2005 2006
2007 2008
Disease
Table 8.4. Ratio of disease per 100,000 population of Udon Thani municipality Source: Municipality
No. of Cases
ratio per 100,000
DHF 236
59.80 Diarrhea
3,656 925.50
Influenza 298
75.60 Pneomonia
407 102.40
Disease 2009
Jan ‐Oct
120
Table 8.5. Ratio of disease per 100,000 population of Phuket municipality Source: Municipality
No. of
Cases ratio
per 100,000
No. of
Cases ratio
per 100,000
Diarrhea 5,324
2,890.98 9,900
5,262.74 DHF
86 46.70
243 129.18
Influenza 113
61.36 169
89.94 Malaria
44 23.87
54 28.71
Disease 2007
2008
Figure 8.16. Hospitals and health public awareness program Source: Field survey
8.3 Education sector
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