September 26 is observed as the World Environmental Health Day annually since the day it was initiated back in 2011, by the International Federation of Environmental Health (IFEH). It had started to emphasise the significance of being considerate of the significance of environmental health. World Environmental Health Day is a global awareness day that focuses on promoting and raising awareness about environmental health issues all around the world. This occasion serves as an opportunity to highlight the importance of a clean and safe environment in maintaining and improving human health.
This year, the theme is “Global Environmental Public Health: Standing up to protect everyone’s Health every day”. The specific themes and activities for World Environmental Health Day can vary from year to year, but they typically revolve around issues related to environmental sustainability, pollution prevention, access to clean water and air, food safety, and other aspects of environmental health.
Environmental health is one of the broadest fields within public health because of the myriad of ways external forces can impact on how people eat, live and grow. These forces can be about addressing our natural environment as in the case for clean water or sanitation, but they can also be the consequence of human beings’ actions.
According to the World Health Organisation (WHO) (2022), global environmental issues account for more than 12.6 million deaths each year. Along with the issues mentioned, including soil pollution, ultraviolet radiation, and biodiversity loss. According to data, more than 100 illnesses and injuries can be directly linked to environmental health concerns. Often, these issues have the greatest impact on communities that are poor and already have significant health care vulnerabilities.
A report by Verywell Health (2020) indicates that more than 780 million people lack access to clean drinking water worldwide. As a result, more than 2,200 children die due to diseases caused by poor water quality each day. Harmful microbes, which are more commonly called pathogens or germs, can infect humans and cause illness.
At least 155 countries, including Bangladesh recognise their citizens have the right to live in a healthy environment, either through national legislation or international accords. Despite the protection, the WHO estimates that 23 per cent of all deaths are linked to “environmental risks” like land and air pollution, water contamination and chemical exposure. Exposure to pollutants can also affect the brain, causing developmental delays, behavioral problems, and lower IQ in children. In older people, pollutants are associated with Alzheimer’s and Parkinson’s disease.
The last decade was the hottest in human history while we are already experiencing the impacts of climate change, with wildfires, floods and hurricanes becoming regular events that threaten lives, livelihoods and food security. Climate change also affects the survival of microbes, facilitating the spread of viruses. If no action is taken, pandemics are likely to occur more frequently, spread more rapidly, have greater economic impact and cause more deaths.
In Bangladesh, public health has improved substantially over the past two to three decades. This has led to a reduction in neonatal, infant and child mortality, maternal deaths. The prevalence of stunting, under-weight and wasting have declined while life expectancy at birth increased. According to the World Bank, life expectancy at birth has increased from 59 years in 1990 to 73 years in 2020. Infant mortality has decreased from 95 deaths per 1,000 live births in 1990 to 24 deaths per 1,000 live births in 2020. Maternal mortality has also decreased from 573 deaths per 100,000 live births in 1990 to 173 deaths per 100,000 live births in 2020.
Despite these improvements, Bangladesh, with its burgeoning population and limited resources, faces numerous public health challenges as well. Some of the major concerns include communicable diseases, inadequate healthcare infrastructure, poor sanitation and hygiene practices, malnutrition, poor air quality and high maternal and child mortality rates. Non-communicable diseases (NCDs) are a major health burden in Bangladesh, with an estimated 71% of deaths attributed to NCDs. Cardiovascular diseases; cancers, chronic respiratory diseases, and diabetes are the leading causes of death in the country. The prevalence of risk factors for NCDs, such as tobacco use, physical inactivity, and unhealthy diets, is also high.
In addition, malnutrition remains a significant health challenge in Bangladesh. According to the Bangladesh Demographic and Health Survey (BDHS) 2017-18, 31% of children under five are stunted, 9% are wasted, and 22% are underweight. Stunting is a condition in which a child’s height is significantly below the average for their age, indicating chronic malnutrition. Wasting is a condition in which a child’s weight is significantly below the average for their height, indicating acute malnutrition.
Infectious diseases continue to be a major concern in Bangladesh. Waterborne diseases, such as cholera and various forms of diarrhea, persist due to inadequate access to clean drinking water and sanitation facilities in certain areas. Additionally, vector-borne diseases like malaria and dengue fever remain a significant health threat, prompting ongoing efforts to control mosquito populations and enhance vector control measures.
Malnutrition is another pressing public health issue in Bangladesh. Child malnutrition, characterized by stunting, wasting, and underweight children, remains a widespread problem, particularly in rural and economically disadvantaged regions. The population also grapples with micronutrient deficiencies, including iron-deficiency anemia, which has far-reaching health implications.
Non-communicable diseases (NCDs) have been on the rise in Bangladesh. These include cardiovascular diseases, such as heart disease and stroke, attributed to shifting lifestyles, dietary changes, and an expanding elderly population. Diabetes has become increasingly prevalent, contributing to the nation’s growing NCD burden. Furthermore, the incidence of cancer, especially in urban areas, has been steadily increasing.
Maternal and child health issues persist in Bangladesh, with high maternal mortality rates stemming from complications during pregnancy and childbirth. Despite improvements, child mortality rates, particularly in rural areas, remain a matter of concern, underscoring the need for continued efforts to enhance healthcare access and quality.
Access to healthcare services varies significantly between urban and rural areas, with rural regions often facing limited healthcare infrastructure and workforce shortages. Ensuring the quality of healthcare services and addressing issues such as provider shortages and adequate training for healthcare workers is a critical challenge.
Access to sanitation remains a challenge, with a considerable portion of the population lacking access to improved sanitation facilities, leading to hygiene-related health issues. Mental health issues are often stigmatized and under-addressed, with limited access to mental healthcare services and awareness campaigns.
In addition to these persistent challenges, emerging infectious diseases pose a constant risk, as exemplified by the COVID-19 pandemic. As of March 2023, Bangladesh has reported over 2.6 million confirmed cases of COVID-19 and over 30,000 deaths. The pandemic has placed a significant burden on the healthcare system in Bangladesh, which has struggled to cope with the influx of patients. The pandemic has also disrupted routine healthcare services, such as immunizations, maternal and child health services, and NCD care.
The government of Bangladesh, in collaboration with international organizations and non-governmental groups, has initiated various programs and campaigns to address these public health issues. These initiatives include vaccination campaigns, maternal and child health programs, sanitation efforts, and healthcare system strengthening. However, sustained commitment and resources are essential to make lasting progress in improving public health in Bangladesh. And a primary activity of any public health strategy is information sharing. Public health education will play a vital role in improving the health and well-being of individuals and communities in Bangladesh. By understanding what the risks are, Environmental Health Professionals can better deploy resources to protect everyone’s health every day.
[The writer is Dean, Faculty of Science, and Chairman, Department of Environmental Science, Stamford University Bangladesh. He is also Joint Secretary, Bangladesh Poribesh Andolon (BAPA) & Founder and Chairman, Center for Atmospheric Pollution Studies (CAPS).]