Research Outline for Paula Arcari MA(hons) Edinburgh University
Research Outline for Paula Arcari MA(hons) Edinburgh University.
I am currently working on my masters qualifying thesis which I expect to complete in August 2002. This research will be developed further and form the basis of my masters thesis which will then, hopefully, lead on to a more rigorous, applied study encompassing 3-4 years towards a Ph.D. To date, my work has entailed a thorough literature review of relevant material and the formulation of a proposed methodology. As the exact nature and content of the data I will have access to is still unknown, this methodology may have to be modified over the coming weeks. The following outline provides a basic context for the study, why it is considered necessary, how this will be realised and the potential impact it could have.
Many authors support the applicability of using the El Nino Southern Oscillation (ENSO), to better understand larger scale climatic variations and their implications for many aspects of the human and natural environment. "The ENSO phenomenon, as an annual driver of short-term climate, may provide insights into the impacts of more long-term increases in climate variability which are expected to accompany global warming"( from NOAA's Office of Global Programs). Following these recommendations, this study will examine the impact of ENSO on the distribution of disease in a region which falls directly under the influence of this phenomenon - Indonesia.
Several circumstances make Indonesia as area deserving priority in this type of study. Situated in the equatorial Pacific, it lies firmly in the path of the Walker Circulation, the modification of which, during an ENSO event gives rise to a shift eastwards in the 'normal' ocean/atmosphere interactions. This typically leads to droughts in Australia and Indonesia, typhoons in the central Pacific and heavy rains on the west coast of South America. El Nino effects last between 12-18 months and tend to be following by a reversal in the observed pattern, termed La Nina, bringing rains to formerly drought-stricken areas and vice versa.
The effects of ENSO being climatic, it naturally strikes hardest at those areas of the world whose livelihoods are heavily dependent on the land. These areas are also predominantly the less developed and developing parts of the world which by definition lack the resources necessary to both soften the blow and cope with the consequences. Indonesia, where agriculture constitutes 25% of GDP and employs up to 41% of the labour force, has suffered repeatedly at the hands of ENSO events, most recently in the aftermath of the 97/98 El Nino, the cost of which has been estimated at US$10 billion in reduced agricultural output, forest fires, famine, malnutrition, disease and the resultant setback of the country's economic development goals. It's regions also display another characteristic increasingly associated with ENSO - that of the convergence of certain diseases in affected areas, most notably the vector-borne diseases malaria and dengue fever, all 4 strains of which are present in Indonesia.
In February this year, the Jakarta Post reported a steady increase in malaria since 1998 with disease prevalence in 13 out of the 27 provinces, affecting 15 million Indonesians (according to government statistics). Webster, writing in the Smithsonian, describes a "new pandemic [which] imperils half the world", killing 2.7 million people a year including "at least one child every 30 secs" - a global casualty rate equal to AIDS. More prevalent even than malaria is dengue and dengue hemorrhagic fever (DHF), for which no vaccines exist for the one half of the world's population which is at risk. All of Indonesia's 27 provinces have reported cases of DHF (the most severe form of the virus) and it is reported to be endemic in 12 of these, with periodic outbreaks, as in 1998 when it caused the loss of 430 lives and the hospitalisation of a further 20,000.
The plight of Indonesia has become more notable recently as it now ranks as the first country to report malaria above 2000m, in Irian Jaya, which incidentally also suffered it's first outbreak of DHF in 1993/94. Despite the overwhelming evidence of Indonesia's worsening situation as regards these, and other diseases, as well as the well-documented significant effect which ENSO regularly has on the region (which is predicted to increase), few investigations have undertaken the task of relating these two situations more closely. There is a dearth of studies focussing specifically on climate and disease in South-east Asia, as compared with other parts of the world where this connection has been extensively reported.
The methodology proposed for this study will proceed from an initial temporal and spatial analysis of historical rainfall, temperature and disease data across Indonesia. Subsequently, satellite images of the NDVI (normalised differential vegetation index) will be superimposed to ascertain the 'fit' of this data with the observed patterns (and therefore it's applicability as a future indicator) and analysis of the findings conducted with reference to local environmental and anthropogenic factors. Correlations of SST's (sea-surface temperatures) and the SOI (southern-oscillation index), for the period allowed by the available data, will be made with the figures for disease incidence and these results will provide the basis on which to judge whether accurate prediction of disease outbreaks will be possible. These predictions can then be further refined and represented spatially by applying the insights gained from the first part of the study.
It is my intension that this work will make a relevant contribution to the growing body of knowledge about climate and disease. Through closer analysis of the situation in the context of specific regions, like Indonesia, the wide variety of inter-connections possible and likely causative agents can be effectively unravelled lending greater weight to any prescriptive measures through a 'bottom-up' approach which casts it's net wide, rather than assuming that what is found true in one situation will hold for all. The potential predictive capacity which ENSO lends to this problem raises the possibility of instigating preventative measures, designed to break the chain of disease transmission at the most effective point. The potential exists for the future complete eradication, or at least successful management of these diseases, alleviating the heavy burden which periodic outbreaks place on vulnerable areas.