Resilient Livelihoods: Exploring the Intersection of Climate Change and Access to Healthcare Facilities for Women in Sundarbans
29-01-2025
Abstract
Climate change plays a significant role in impacting the lives of marginalised communities who are dependent on natural resources, with gender playing a key role in building resilience. The Sundarbans, an ecologically vulnerable region located at the mouth of the Bay of Bengal, faces severe climate challenges. Its residents, largely reliant on agriculture and fishing, suffer from rising sea temperatures that harm women’s reproductive health. Despite this, women are compelled to fish for survival. This research article explores the hypothesis that climate change in sensitive regions like the Sundarbans has intensified in the past decade, disproportionately affecting women and exacerbating gendered vulnerabilities.
Introduction
The Sundarbans, a unique ecosystem located at the nexus of ecological fragility and human resilience, faces the combined challenges of climate change and anthropogenic factors. Its location in a low-lying coastal zone makes it vulnerable to climatic changes including intense cyclonic activities, rising seawater levels, and increasing salinity of such seawater and drinking water (Dasgupta et al., 2016).
Demographically, the Sundarbans is home to migrants coming in, especially from Bangladesh. The migrants included are those who are poverty-stricken due to their poor economic conditions back home, limited access to education and infrastructure, and medical facilities. Given the systematic gender inequality, restricted access to healthcare, and dependence on natural resources for their survival, women—especially those from vulnerable migrant communities—face disproportionate dangers. This article highlights the challenges faced by the women residents of Sundarbans in the context of climate-induced changes and discusses the urgent requirement for targeted policy interventions to build a climate-resilient society in the region.
Gendered Vulnerabilities in The Face of Climate Change
The compounding challenges of climate change in the Sundarbans have rendered survival particularly precarious for women, placing them in situations of heightened vulnerability. Women face greater exposure to climate risks compared to men due to their significant dependence on natural resources for sustenance and their disproportionate representation among the global poor (UN Women Watch, 2009). Environmental degradation and poverty subject women to unique health adversities such as challenges during menstruation, pregnancy, widowhood, and limited mobility, which are underexplored in academic discourse.
Water Insecurity and Public Health Crisis
The combined challenge of climate-induced changes and environmental degradation has intensified water insecurity in Sundarbans. Despite the deterioration in water quality, many Sundarbans residents continue to consume the contaminated water due to a lack of viable alternatives. For example, in a village in Sundarbans called Chandipur, many residents acknowledge that the water quality has changed (Chourey & Laha, n.d). Furthermore, in many island villages of the region, the absence of treated pipe water compels communities to rely solely on hand pumps for drinking water and nearby pond water for other water-related activities. The groundwater level is also declining as it is stressed due to high demand in agricultural activities.
The lack of sanitation, safe drinking water, and hygiene, along with food insecurity and limited access to healthcare facilities, has triggered a public health crisis in Sundarbans (Chourey & Laha, n.d). Though the entire region is at the forefront of climate-induced changes, the Sundarbans women are more vulnerable than others due to multiple contributing factors.
Lack Of Sanitation Facilities for Women
The Sundarbans women rarely have access to any material suitable for usage throughout their menstrual cycle. In a survey conducted by the South Asian Consortium for Interdisciplinary Water Resources Studies (n.d), it was found that most of the women respondents prefer to use cloth during menstruation due to the lack of limited availability of medical shops and affordable alternatives.
Inadequate access to sanitary facilities exposes individuals to physical risks. They grow sensitive to many chronic diseases. Dr. Pallab Mondal, General Duty Medical Officer at Gosaba Rural Hospital, observed, "There are increasing cases of white discharge, recurring UTIs, irregular bleeding, and cysts among women over 30" (Chourey & Laha, n.d).
Livelihood Activities and Consequent Health Risks for Sundarban Women
The problem of sanitation is also observed in the case of fishing. Due to natural disasters, around 50,000 women in Sundarban coastal villages spend five to six hours every day harvesting tiger prawns in saline rivers like Kalindi, Raimangal, Bidyadhari, and Gosaba. Women spend more time in saline water to earn their livelihood by catching tiger prawns. Women also bathe in the saline water, live in saline water-logged homes and consequently long exposure to saline water interferes with the PH levels in the vagina which destroys the vaginal immune system (Chourey & Laha, n.d). Poor hygiene leads to infection in the vagina and uterus and since the vaginal immune system is weak, infections spread easily. This in medical terms is called Pelvic Inflammatory Disease. Excessive bleeding during menstruation becomes common, and severe pain during sexual intercourse and a burning sensation during urination are usual.
In another study, the researchers drew self-reported health concerns from a list of 67 diseases reported by questioned women. The study found that women who engage in saline-immersive prawn post-larvae catching have significantly greater health concerns than women who engage in similarly comparable low-wage economic activities. Statistical analysis of the poll later revealed a subset of the 67 diseases, including vision issues, irregular menstruation, gastric pain, pain in the legs and hands, knee pain, skin allergies, and itching. This study identified a poverty-environment connection that impairs the health and livelihoods of over 100,000 women in the Sundarbans (Dasgupta et al., 2020).
These stories of women experiencing ailments because of their livelihood activities highlight systemic limitations in addressing workplace safety and health for vulnerable people. Such problems are made worse by the link between poverty and the environment, which fuels a vicious cycle of deteriorating health outcomes and financial reliance on unstable livelihood activities. This emphasizes how crucial it is to break this loop by expanding access to healthcare facilities and diversifying sources of income.
Maternal Health Challenges
Due to climate-induced changes, it has become difficult for a pregnant woman to give birth. A pregnant woman's experience during Cyclone Aila (2009) may provide valuable insights (Karmakar, 2022). Jalema Bibi, 32 years old married woman stated “That day, it was raining heavily. The wind was blowing crazily from the south-eastern side. My husband went fishing. Suddenly, a neighbor told me that the embankment near our locality had broken, and the water had started entering. Everybody started to move to a safer place. He advised me to go to the disaster relief center. I was 8 months pregnant then. It was very difficult for me to walk up to the center. The weather was terrible, rainy and windy. But I started walking. At one point, I felt it was impossible. Yet, I kept walking. Finally, I reached the center and we survived.” The Sundarbans currently has 54 inhabited islands. Communication remains a challenge. Medical facilities are insufficient in various locations. Natural disasters are becoming more common, exacerbating the issue. The predicament of pregnant ladies is easily envisioned (Karmakar, 2022).
The narrative reveals how structural flaws exacerbate the vulnerability of women like Jalema Bibi. Pregnant women incur physical and psychological harm during disasters due to a lack of communication infrastructure, inadequate disaster relief, and inadequate healthcare facilities. Cyclone Aila and other catastrophes highlight the government's lack of preparedness and the urgent requirement for targeted measures to address maternal health issues in climate-stressed environments.
Building Climate Resilience Through Policy snd Community Interventions
There is an immediate need to counteract the impact of climate-induced changes on the women residents of Sundarbans. Dr. Saheed Parvez, the General Duty Medical Officer at Madhabnagar Rural Hospital in Pathar Pratima block, shared, “The majority of patients visiting the hospital suffer from hypertension, hypothyroidism, dermatological issues, diarrhea, and various stomach ailments, along with UTI and reproductive health-related issues. Approximately 60% of patients visiting the hospital experience dermatological problems, and genital and urinary tract infections due to the usage of polluted water with higher salinity. Many women who come to the hospital for delivery are affected by genital infections, increasing the risk of infections for the unborn child” (Chourey & Laha, n.d).
Successful interventions in similar settings on the international stage may act as a model for policy recommendations for the Sundarbans. For example, Bangladesh’s “Climate-Resilient Livelihoods Program” decreased dependence on high-risk jobs by empowering women through alternative revenue-generating enterprises like eco-tourism and crab farming (Nasreen, Mallick, & Neelormi, 2023). Moreover, mobile healthcare units improved maternal and reproductive health in Vietnam's Mekong Delta by delivering critical medical services to isolated locations (Garschagen et al., (2012).
National-level interventions also exist that can be modeled for Sundarbans. To combat water insecurity, for example, the coastal region of Bangladesh has installed solar-powered water desalination plants (Hoque et al., 2019). Similarly, Kerala's Kudumbashree program gave women access to chances for steady income generation (Venugopalan, 2014).
Thus, the climate-induced systemic issues prevalent in Sundarbans can be resolved by implementing such programs into action, establishing climate-resilient healthcare facilities, and providing subsidized access to healthcare. To ensure inclusive development, collaborations with NGOs and community-driven awareness campaigns can further educate locals about health hazards and sustainable livelihoods.
Conclusion
Health issues of coastal women in the Sundarbans have not received appropriate scholarly attention and hence continue to be a huge research gap (Bhattacharya, 2024). Multifaceted policy measures that put an emphasis on alternative livelihoods, community resilience, and equitable healthcare are necessary to address the Sundarbans' compounded problems.
Government policies should prioritize providing equitable healthcare facilities to all residents of Sundarbans, especially women. Invested actors can play a pivotal role in disseminating knowledge to women regarding the detrimental effects of prolonged exposure to saline water on their reproductive health. By combining community-level initiatives with systemic change, the Sundarbans can be used as a model to address climate-induced vulnerabilities around the world.
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