Extreme weather events disrupt not only Burundi’s economy and agriculture but also people’s health and the country’s health structures. To help health facilities deal with climate change, Cordaid recently piloted an innovative project called Green PBF.
The three-year project supports 33 facilities in the health districts of Gitega and Mutaho (central Burundi) through the performance-based financing approach. Cordaid implements it in close collaboration with the Burundian Ministry of Public Health.
Health impacts of climate change
In the past decade, erratic rainfall patterns have led to more intense droughts, floods, and tornadoes in Burundi. Being a landlocked and densely populated country of hills, valleys, rivers, and lakes the effects are devastating.
“Rising levels of Lake Tanganyika alone have displaced over two hundred thousand people. In upland communities, landslides cause significant damage”, explains Etienne Nkeshimana, who coordinates the Green PBF project.
Climate change has far-reaching health impacts. “In flooded plains, we see an increase of cholera and other epidemics. Stagnant waters are a source of malaria. Floods pollute safe drinking water facilities”, Nkeshimana adds. “Landslides, like floodings, damage roads, isolating communities, making it more difficult for patients to find their way to caregivers or the other way round.”
Drought is an equally undermining health hazard, as water scarcity makes it much harder to uphold hygienic standards. That too can cause the spread of cholera. To make things worse, climate change disrupts seasonal cycles, reduces staple crop productivity, and pushes up food prices. This causes malnutrition rates to go up, particularly among children under five.
‘Healthcare facilities are the first and last resort for disaster victims. They must be able to continue providing basic care to the population.’
“As a result, health facilities in Burundi, already overstretched, now face growing numbers of patients and can hardly meet demands. Often, to face urgent patient demands, they have to draw on modest funds meant to improve the quality of care”, says Nkeshimana.
Last but not least, climate change also hits the infrastructure of health centres. Nkeshimina: “Lack of safe water and energy is a constant concern, only aggravated by extreme weather. And only recently, two health centres we work with had their roofs blown off.”
Long-term commitment and innovation
The Green PBF project, launched on October 30th, is part of a long-term commitment. Cordaid has indeed supported Burundi’s healthcare systems for decades. It is also innovative, using performance-based financing to counter adverse climate change effects on health structures.
For Nkeshimana, the vision behind Green PBF is clear: “Healthcare facilities must continue to function, however extreme the weather events may be. They must also be aware of their effects on the environment. They are the first and last resort for disaster victims and must be able, as far as possible, to continue providing basic care to the population.”
Through Green PBF, Cordaid will strengthen the resilience of health facilities to climate change in four areas: human resources, energy sources, water, sanitation, hygiene, and medical waste management, and lastly infrastructure, technologies, and products.
The project has two phases. Depending on funding, six months of training and preparing the health facilities will be followed by the actual performance-based financing phase of 2,5 years.
Reliable supplies of electricity and safe water
Nkeshimana gives a few concrete examples of what Green PBF wants to accomplish: “Power cuts are a constant concern. The project supports health centres in having and maintaining reliable and green sources of electricity, preferably solar panels. It will train staff to be more economical and ecological in their medical waste management and energy consumption. Like using alternatives for firewood to heat water to sterilize equipment.”
“Quality healthcare is impossible without safe water. That’s why the project supports centres in setting up and maintaining safe water storage systems”, he adds. “It will train staff in mapping and addressing all possible climate change-related risks. These include increased fire hazards in periods of drought and the risks of malfunctioning drainage systems in times of excessive rainfall. Cordaid will support health workers in sensitizing communities about the health impacts of climate change. For instance the hazards of drinking from water sources during or shortly after floods.”
Before, during, and after extreme weather events
Dr. Samuel Ndayiragije from the Ministry of Public Health, who took part in the project launch on October 30th, thinks Green PBF couldn’t have come at a better time: “The effects of climate change are undeniable in Burundi’s healthcare system. The resilience of health infrastructures is a topical and innovative issue that has come at just the right time. The example of certain health facilities that were abandoned when the lake waters rose is telling.”
“We want every health centre to have safe water to drink, wash and sterilize. To have power all year round and everything in place to provide quality health care. Before, after, and during extreme weather events”, says Nkeshimana, summing up the project’s ambitions.
Looking at the future, Dr. Juvénal Ndayishimiye, who represented Cordaid at the project launch, strongly hopes the pilot project of Green PBF will attract more partners: “We hope it will bear fruit in mobilising further funding.”