Climate Change and Health

There is an increasing body of evidence in India and across the world regarding the mental health impacts of the extreme weather events, along with other direct and indirect impacts. There is a strong evidence to suggest that these extreme weather events are occurring due to climate change resulting from global warming. The Climate Change debate does not talk much about dealing with the mental health impacts, preoccupied as it is in dealing with physical and economic impacts of climate change. Also, extreme weather events have been occurring in India for a while now. The Indian government has woken up to the fact that these weather events, bringing unprecedented devastation, are indeed “extreme”, only after the recent Kashmir floods. India has been an active participant in the climate change debate and discussions. The purpose of the present chapter is to take an overview of the mental health impacts of the major extreme weather events and emphasize the importance of preparedness in meeting these mental health impacts. The chapter looks into some of the best practices adopted by nations and cities, to deal with the mental health challenges thrown in the wake of such extreme weather events and suggests measures, for governments and communities, to be better prepared to deal with mental health issues arising from future extreme weather events.

This chapter reports exploratory research work on the link between mental well-being and the ‘eco-state’ within the context of countries and regions of the European Union (EU). For the purpose of this chapter, the ‘eco-state’ is defined—paraphrasing Meadowcroft (2005: 3)—as “a state that places [climate change] considerations at the core of its activities”. It is hypothesized that regions with higher levels of mental well-being are located in eco-states with a good ecological performance. For the purpose of this work, ecological performance in the area of climate change is measured using the Climate Change Performance Index 2013, while mental well-being using the WHO-5 scale derived from the third wave of the cross-sectional European Quality of Life Survey for the year 2011. Using exploratory spatial data analysis (ESDA) and regression analysis, regional clusters of mental well-being are identified and classified according to eco-state typologies of EU countries. While it emerges that the better a country performs in ecological terms, the better the levels of regional mental well-being are, the mechanisms of this association remain to be determined. The chapter concludes by suggesting future directions for research on mental well-being and the eco-state.

The effects of the changing climate system have become increasingly important in recent years, leading to a need to better understand, among other things, what impact they have on population health and human thermal comfort.

This research analyzes the variability of thermal (dis)comfort due to heat in summer, in Continental Portugal, between 1981 and 2010, based on an appropriate set of bioclimatic indicators. It also addresses the prevailing synoptic situations during climate paroxysms, namely heat waves, by applying the Heat Wave Duration Index formula. The synoptic classification used is an adaptation proposed by Ramos (1987).

We conclude that the feelings of discomfort due to heat are quite frequent. Since 2000, the cities of Coimbra and Lisbon have revealed a trend for thermal sensations of greater intensity.

The results show evidence of spatial contrasts, with the north-west of the country being thermally more comfortable.

On the basis of the occurrence of paroxysms, the position of the Atlantic anticyclone is connected, at altitude, with situations of meridian circulation and the dominance of wave regime and blocking.

Here, we intend to contribute to the identification of vulnerable areas and predict intense heat situations, preventing risks to public health and human welfare.

In recent years, extreme weather has been recorded on every continent demanding adaptation of health care services to climate change. The aim of this chapter was to conduct a systematic review concerning the effects of temperature variation on the human cardiovascular system in order to access evidence of how heat and cold-waves are affecting health. A systematic search was conducted between December 15th and 25th via health-related databases: PubMed, Medline, LILACS, SciELO and Cochrane Library, using combinations of the DeCS/MeSH terms “ambient temperature”, “health” and “cardiovascular system” and their equivalent in Spanish and Portuguese, published between 2004 and 2014. A total of 47 publications were retrieved, 9 of which met the inclusion criteria. Some studies reported the potential effects of temperature on human health, mostly from high temperatures. The main effect of ambient temperature variation on human systems is abnormalities in blood vessels and homeostatic mechanisms, which trigger a series of responses that may affect the cardiovascular system. Papers from different countries report that changes in ambient temperature alter the profile of hospitalizations, with an increased incidence of cardiovascular disorders, particularly in individuals with predisposing factors or comorbidities, such as being elderly and having Type 2 diabetes. The conclusion is that high ambient temperatures are leading to increased incidence of cardiovascular diseases, mainly heatstroke, and the elderly is the most vulnerable age group.

Air quality and climate change policies are finding new common grounds today as increasing social complexity requires better integration of separate knowledge domains. This chapter addresses the complex relationship between these two policy domains, their scientific background and the related acceptability issue, which varies substantially among countries and social groups and is influenced by social and cultural factors. The first section of this chapter describes the relationship between air quality and climate change policies. Indeed, global CO₂ reduction objectives require complex adaptations of socio-economic behaviours that might not directly appear to be related to pollution reduction or to improvement the exposure of citizens to harmful pollutants. Recent studies, however, have confirmed that air pollution and its impacts are one of the main environmental concerns for citizens, even if relevant differences in public perception between countries still remain. This section also addresses the ambiguities and conflicts that characterise communication between experts and citizens. The second section briefly describes recent scientific evidence that shows the possibility of coupling air quality and climate change mitigation benefits with policies targeted at specific pollutants called short lived climate forcers (SLCF). The third section spells out some preliminary research questions on the acceptability of these policies and their complex relationship with individual interests and cultural contexts. Linking air quality to climate change could be a win-win strategy to increase the social acceptability of specific policies and their implementation if knowledge and communication gaps between citizens and policy makers will be reduced.

São Paulo, Brazil, is a big city that suffers the effects of extreme climatic events like intense rains and droughts. In fact, these circumstances are outcomes of deficits accumulated for years in the production of an urban space that neglected environmental factors in their management, construction and planning. As a coping strategy the municipality of São Paulo promulgated in 2009 the Municipal Policy on Climate Change (MPCC), whose original main objective was to mitigate the emission of greenhouse gases. This chapter aims to analyze São Paulo’s MPCC until 2012 in terms of the Health Sector’s convergence and intersectoral actions, considering a necessary dialectic between global and local towards adaptive measures in the urban scale concerning to climatic variability. The content analysis model as a qualitative approach was applied on documentary data and interviews with public managers. It showed that the primary research hypothesis, which considered that the Health Sector would have its attributions restricted to perform the monitoring of air quality, was refutable. Instead, there was a redirection of health actions, in which a dialectical intersectoral positive relationship was established, with actions that could interact breaking through the traditional model of sectoral policies which are generally reductionist. The MPCC in the perspective of interaction with the Health Sector encountered cooperation among sectors of the government promoting and strengthening adaptive capacities under public health concerns. All of these advances could be possible even with the prevalence of an initial orientation for mitigation in this public policy.

The global food system makes a significant contribution to climate change, affecting greenhouse gas emissions and other major environmental impacts, along the entire food chain. The present study evaluated the determinants and the consequences of food waste at the food service sector, while considering potential solutions. It takes into account the fact that reducing food waste is an important part of the effort to attain environmental goals and to promote public health.

Climate change has direct and indirect impact on human health. The indirect impact includes Malnutrition caused by food insecurity. The population of the Sahel region of Cameroon continuously experiences an increasing level of malnutrition, partly due to the impact of climate change since harsh climatic conditions leading to extreme drought have a negative influence on agriculture. In particular, the extreme drought conditions lead to a reduction in agricultural production an important parameter of food security. This review chapter assesses the impact of climate change on food security which leads to an increase malnutrition in this region. It will help to suggest measures to raise awareness on climate change, food security and malnutrition.

The 2014 Ebola crisis has highlighted public-health vulnerabilities in Liberia, Sierra Leone, and Guinea—countries ravaged by extreme poverty, deforestation and mining-related disruption of livelihoods and ecosystems, and bloody civil wars in the cases of Liberia and Sierra Leone. Ebola’s emergence and impact are grounded in the legacy of colonialism and its creation of enduring inequalities within African nations and globally, via neoliberalism and the Washington Consensus. Recent experiences with new and emerging diseases such as SARS and various strains of HN influenzas have demonstrated the effectiveness of a coordinated local and global public health and education-oriented response to contain epidemics. To what extent is international assistance to fight Ebola strengthening local public health and medical capacity in a sustainable way, so that other emerging disease threats, which are accelerating with climate change, may be met successfully? This chapter considers the wide-ranging socio-political, medical, legal and environmental factors that have contributed to the rapid spread of Ebola, with particular emphasis on the politics of the global and public health response and the role of gender, social inequality, colonialism and racism as they relate to the mobilization and establishment of the public health infrastructure required to combat Ebola and other emerging diseases in times of climate change.

The patterns of general circulation of the atmosphere which determines the characteristics of global and regional climate variations will be different from what it is currently. Current global warming may lead to significant change in global and regional climate related health challenges on humans. The main purpose of this work is to investigate the potential impact of climatic variations in relation to human health with Malaria in perspective. The climatic parameter that was used include the average temperature, rainfall amounts and health indexes of the study area. We investigated the factors responsible for increases or decreases in human’s health in relation to climate variations. Six years climate data and in and out patient malaria records from hospitals in Kosofe, Lagos were used and analyzed with linear regression analyses using the SPSS. The climate variables used in the bivariate correlation analyses include annual and seasonal totals and monthly rainfall in Nigeria. Preliminary result shows that there is a strong relationship between climate variation in rainfall and malaria disease in Nigeria with seasonal cycles.

Ecology, development, behaviour, and survival of mosquitoes as well as the transmission dynamic of pathogens, strongly depend on climatic factors. Models have been developed to predict forthcoming mosquito-borne diseases scenarios based on estimations of future climate patterns. However, the complex interplay of climate variables with the mosquito-host-pathogen systems rend the overall effect of the climate on the local prevalence of mosquito-borne diseases difficult to determine. Therefore, the assumption that warmer global temperatures will produce increase mosquito proliferation and geographic range may not be entirely true. Furthermore, general climatic observations may not reflect the local microclimates experienced by mosquitoes, mainly by the synantrophic species which live in mild human-modified habitats. Human socio-economic context, community’s culture or behavioural habits are also sidestepped factors prone to influence MBD transmission.

This chapter pretends to illustrate the complex scenario where mosquito-borne diseases develop and the myriad of consequences that climate may induce in the incidence of these illness. Different types of models used to predict forthcoming mosquito-borne diseases scenarios are presented as well as the limitations that might preclude their use as tools for the design of surveillance or control strategies.

As an example, it is also presented the history of dengue prevention and re-emergence. The evolution of this well documented disease reveals that besides climate, the increase of human population density, the growth urbanized areas, the upsurge of international mobility, the discontinuity of sustainable source-reduction activities and the emergence of insecticide resistance in mosquitoes are also determinants for dengue prevalence increase.

Dengue fever is a climate-sensitive disease that affects thousands of Brazilians every year and generates substantial losses in private and public markets. This chapter aims to identify the roles of climate, both seasonal and historical, on the risk of dengue epidemics in Brazil while controlling for socioeconomical and political influences on the disease as well as the immune status and spatial contagion of populations. By testing and understanding the climate effects on dengue using a risk function for Brazilian data, this chapter intends to link two relevant agendas: the identification of ways to manage the climate related risks of today and improve the understanding of future risks in the country.

The findings indicate that if climate change occurs as expected, there will be a potential added risk for central-southern areas in Brazil and a risk reduction for northern areas of the country. Short-term deviations from normal rainfall conditions in summer also increase the risk of dengue. Other relevant findings suggest the ineffectiveness of current local expenditures for epidemiological surveillance and the need for integrated actions to control the disease, which include the best use of climate forecast to predict dengue cases.

Climate change and variability is impacting health, across different spatial scales, ecosystems, and water supply and quality. In Bolivia climate change is operating in a framework of poverty and inequality. This chapter focuses on the Bolivian Chaco ecosystems water availability and indigenous health. An ecohealth research was launched to evaluate rural communities and their vulnerability and impacts to current and future climate conditions. The participatory-based approach incorporates community and indigenous organizations, local and national health, and meteorological services. Main observed impacts at Chaco are water stress and warming affecting watersheds, ecosystems and health. Water-borne diseases (WBD) and diarrheal diseases (DD) affected most children evaluated. An average decrease in rainfall of 5–12 %, up to 25 % in winter, especially at the middle and low watershed, is observed. Future increases in temperature (+1–2 °C for 2030–2050), modified rainy patterns and reduced water availability are expected. The both observed and expected warming and less rainfall are correlated with diarrheal vulnerability (VCC_DD) and the number of DD cases at rural and indigenous communities. Thus, increasing trends of WBD and DD are likely for 2030–2050. This experience was useful to design Chaco region climate change policies and indigenous health adaptation strategies focused on WBD/DD. These included: raising awareness about water and health climate vulnerability and impacts, increasing investments for water sources protection, establishing systems to compensate and protect watersheds and water springs, capacity building, WBD/DD prevention actions, and clean technologies for economic activities.

A key component of adapting to climate change and variability is the creation of a new generation of professionals able to understand the role of climate on disease and to quantify its risk in public health. Capacity building in different regions of the globe will help strengthen the decisions made in the health sector and is reflected in the reduction of climate risk.

The International Research Institute for Climate and Society (IRI), the InterAmerican Institute for Global Change Research (IAI), the Ministry of Public Health of Uruguay, the Intergovernmental Commission for Environmental and Occupational Health of (CISAT), and the Pan American Health Organization (PAHO) joined forces to organize the first regional Training Institute on Climate and Health based on the curriculum on climate information for public health developed and implemented worldwide by the IRI.

Participants from member countries of Mercosur region were trained for 2 weeks and regional working teams made up of climate and health professionals were formed and presented research projects to address climate sensitive issues on health in response to the objectives of the Mercosur Action Strategy to Protect Human Health effects of Climate Change. Projects were meant to strengthen and build regional networks of cooperation and participants were able to practically apply the knowledge and tools provided by the course to address relevant topics.

A lot of knowledge remains to be built in climate and public health and the field efficiency of the new approaches implemented is yet to be assessed. It is critical to continue training professionals and to provide spaces for networking and also to create collaborative programs that allow professionals from different institutions, sectors and disciplines to communicate and share their expertise to tackle climate risk.

Landslide disasters are increasing in frequency, magnitude and degraded territory as a result of disorganised land occupation and extreme rainfall events. Consequences such as deaths, injuries, homelessness and social harm are much worse when they occur in vulnerable communities. Socio-environmental disasters occurring in Brazil have highlighted environmental education as key to disaster risk reduction strategy. Based on the idea that the urbanisation process in Brazil contributes to socio-environmental vulnerability and environmental injustice, this chapter discusses the contribution of environmental education projects as an example of strategy for landslide disaster risk reduction since they can motivate inhabitants to participate in disaster risk reduction activities and, hence, to practice participatory risk management, empowering citizenship and strengthening community resilience. The studied project consisted in anon-formal education experience and took place in a landslide risk community in Niterói, a city situated in the metropolitan area of Rio de Janeiro, Brazil. The project involved geotechnicians, researchers of different backgrounds, young residents and members of a local non-government organisation and aimed to analyse this experience as an effort to face climate impacts.

The potential consequences of climate change to our health and wellbeing pose relevant questions and real challenges need to be tackled. These real challenges can be used as strong triggers to initiate action-oriented learning processes.

With the aim of identifying these outcomes, we propose a chapter focused in those educational responses that are being developed to promote a generational transformation which can enhance social knowledge and bonding, having an empowering impact over communities, leading to their transformation and improvement.

This chapter includes interesting initiatives and international trends that are worth disseminating. We have organised them by category and topic. These projects are described in order to identify their structure, function and impacts. Our purpose is to summarize the main socio-environmental education trends that are being developed and the impacts that they are having in different communities and areas, focusing on experiences that involve, not only formal education agents, but also informal education, NGOs and communities, and above all Service Based Learning Methodologies.

In January 2011, an extreme rainfall event took place in the Mountainous Region of the state of Rio de Janeiro causing a catastrophic landslide that resulted in more than 1500 deaths. This event marked a new challenge for disaster reduction in Brazil and introduced several measures for risk management. The dialogue gap between government and the local population could possibly explain the failure of the current risk management model, pointing at the urgent need to integrate actions from the government, the civil society and universities. Nonetheless, a top-down government model still prevails, and communities at risk remain distant from decision makers. This lack of interaction led to local self-organization, like the Córrego Dantas Neighborhood Residents Association (CDNRA), greatly affected by the 2011 disaster. In 2014, CDNRA and the GEOHECO research team started to develop new tools for a better dialogue with the local government. These groups recognized two fundamental needs: (1) to integrate both scientific and popular knowledge in developing a new methodology for risk evaluation and management and, (2) to integrate effective risk management actions with the actions of other disaster-related institutions, including universities, communities, NGOs and the government. Invited institutions attended the 1st Seminar on Landslide Risk Management at the Córrego Dantas Neighborhood. As a result, a multi-institutional network (called Córrego Dantas RIsk MAnagement Network) was founded to provide new tools for the identification of potential landslide disaster areas, as well as to introduce a new design for planning, according to the interests of the community. In this chapter, we describe former procedures and local studies, which have guided the development of CD-RIMAN and the establishment of its main goals.

This chapter addresses socio-environmental challenges, health and traditional communities in the context of climate change. The study regards a protected area, the so-called Mosaico Bocaina, in the municipalities of Angra dos Reis and Paraty, in the state of Rio de Janeiro, and Ubatuba, in the state of São Paulo, where traditional communities from three different ethnic groups live (indigenous, quilombolas and caiçaras). The knowledge of nature and of the physics of climate change (including its causes, consequences and characteristics) isn’t always accompanied by the understanding and science of how climate change affects the well-being and health of populations. The analysis of the public policies and science production for the field concluded that the situation for the region in question is no different from that of other regions in Latin America: (1) public policies have not become effective interventions against climate change in general, and the interest in its implications over the health of populations is recent; (2) the science of climate change is insufficient, especially regarding its effects over the health of populations, whether in this specific region or more encompassing scales; (3) there is no information on how traditional communities perceive climate change, their impacts on health and well-being and tackling strategies. This chapter seeks to contribute to the knowledge of the impacts of climate change on the health and well-being of traditional communities, focusing on the governance tools required to address it. What strategies have traditional communities been using to deal with it? How does the official agenda of efforts reflect the socio-cultural perceptions and mitigation and survival strategies of traditional communities? Qualitative methods of participant observation that combined participation, observation, informal open interviews and analysis of documents were employed. The results generated territorialized knowledge in the social, economic, political and cultural dimensions of climate change and their implications on the health and well-being of traditional communities, as well as allowed the identification of governance mechanisms and socio-cultural strategies that can be used to mitigate, adapt to and help avoiding climate change.

The social practices of traditional communities have low environmental and health impacts. This is important to minimize climate changes and guarantee the health of communitarians. The sustainability of traditional communities has a direct connection with the knowledge about their territories and the constitutive social practices of their territoriality. Building a Spatial Database generates knowledge about their territories and enables carrying out a range of geospatial analyses to support communication and decision making. This paper describes the first step in building a Geodatabase to support the management, planning and communication actions within OTSS, a partnership between FIOCRUZ and the Traditional Communities Forum of the Municipalities of Angra dos Reis, Paraty and Ubatuba in Brazil. Three lines of work were developed: (1) Geodatabase Design—geodata was arranged in different scales, comprising basic and thematic secondary data, as well as primary data relevant for the management and the political action of the communities. The information contained in the system was selected together with representatives from the communities. (2) Geodatabase Analysis and Management—continuous data input from traditional populations and technical teams was made. Analysis of the geodata provided solutions to spatial questions posed by project members and by communities, especially about territorial disputes. (3) Geo-information Availability—preparation of maps, charts, spatial files and other media to support the management of the project, the traditional communities and the implementation of correlated projects.

The occurrence of extreme climate events in Mozambique constitutes a great barrier to swift sustainable economic development due to associated human and material damages. As a result, the population lives in a situation of threat and instability. The most vulnerable societies in Mozambique are those inhabiting settling areas along coastal or river plains, and those whose economies are strictly related to resources highly sensitive to climate changes. The vulnerability factors of two communities in the lower Limpopo River were analysed using a participative tool, the top mecca. The Zongoene and Mahielene communities in the lower Limpopo River basin lack essential adaptation elements that enable responses to climate change and natural disasters. These elements are required nationwide and include a highly diversified economy and access to new production technologies. In addition and in particular, the Zongoene and Mahielene communities rely directly on the services offered by the coastal ecosystems that have been affected by the impacts of floods, droughts, sea level rise and tropical cyclones. Some activities for climate change adaptation were identified and discussed based on the weaknesses and strengths identified.

Climate change is projected to further increase heat waves in number, intensity and duration over most land areas in the twenty-first century. Among the urban population persons with migrant background are particularly considered to be at risk during heat waves due to the intersection of several risk factors: social status (poverty, manual labour), residential area (densely populated, disadvantaged urban areas, heat islands) and health condition. In this chapter we pledge for a differentiated approach in studying heat-related health outcomes and present first descriptive outcomes of two explorative case studies of multi-generation-families in Vienna, comparing a family with Turkish migrant background with a family without migrant background. The data consists of participant observation and in-depth interviews and has been generated in the course of the research project “Vulnerability of and adaption strategies for migrant groups in urban heat environments (EthniCityHeat)” between June and September 2014.

Against the backdrop of Climate Change and the inevitable increase in the negative consequences which arise, there emerges the need to study their economic, socio-demographic and environmental impacts. In this context comes a new threat to human well-being: the “forced environmental migration” of populations due to environmental phenomena resulting from changes in the Earth’s climate. There are regions of the World with greater vulnerability to climate change and its consequences than others; countries with extensive coastal areas are included in these regions. As Portugal is a country with a considerably long coastline, it is extremely important to study the problems that such a shoreline faces, particularly those that arise from the increase in the average sea level. These problems resulting from climate variability associated with abusive and inappropriate use of the coastline increases its degradation and the vulnerability of the resident population. In some situations, the best solution involves implementing the planned withdrawal projects through the displacement of the population to an area more climatically stable, which can be considered “forced environmental migration”. In Portugal, there are several locations in this situation, as we can see through existing initiatives and interviews with local municipal authorities responsible for environmental issues. In the north of the country, withdrawals are planned in seven locations: S. Bartolomeu do Mar, Bonança, Pedrinhas and Cedovém in the municipality of Esposende; Paramos in the municipality of Espinho; Esmoriz and Cortegaça in the municipality of Ovar.

Metropolitan areas require a large flow of environmental services in order to maintain their structures and their population especially considering the challenges associated with climate change. The aim of this chapter is to study inequities among municipalities in the Metropolitan Region of São Paulo—MRSP related to Human Development Index—HDI and the provision and demand for water as an environmental service. Indeed, the growth of metropolitan areas implies pressures for the production of wealth and supply for the population needs resulting in environmental and social pressures as well. This study was conducted by using secondary indicators provided by Brazilian public institutions. In terms of water supply there is a complex and unfair relationship between the municipalities considering their role as providers or receivers of environmental services and so significant inequalities can be observed in the metropolitan area, according to the historic process of urban despoliation characteristic of a developing country. There is a clear distinction between municipalities that have a greater demand for water and those that produce it, since these latter often present worse HDI. In conclusion the diversity of a metropolitan region can be considered necessary in terms of municipalities with different roles. Otherwise, the inequities in the municipalities’ providers of environmental services reveal a context of vulnerability, and such asymmetrical scenario must be considered in order to increase the metropolitan resilience towards uncertain climate change scenarios.

Climate change and ENSO events are increasing hydro-climatic risks and health impacts in Bolivia, Paraguay and Uruguay, as well as social inequalities in Bolivia and Paraguay. Climate scenarios project increase in average temperature in the whole region, a slight decrease in precipitation and modified rainy patterns in the Andean region and Paraguay for 2040. More hydro-climatic extremes are also expected, which will likely worsen health vulnerability without further adaptation measures. A Vulnerability, Impact and Adaptation Network conducted research on excessive rainfall, floods and land-slides from 2007 to 2014 in Bolivia, Paraguay and Uruguay. Herein, a case study of the vulnerability and human impacts of an extreme rainfall and land-slide in Callapa, La Paz, Bolivia in 2011 is presented. As result of early warning system (EWS) and emergency systems human life losses were not recorded. A comparison between two districts (with and without land-slide) was made modifying Urban HEART equity instrument. Its goal was to better inform the adaptation and community resilience measurements design. The health outcomes included dehydration, diarrhea, acute respiratory infections, and mental health issues. Inter-sectoral policies and strategies were developed to improve climate adaptation measures. Despite strong differences in socio-economic and health status the three studied countries are vulnerable to hydro-climatic extremes. EWS and preparedness based on climate and socio-economic assessments and monitoring are crucial to increase resilience to extreme events.

Hydro-climatic anomalies are impacting the well-being of populations and increasing vector-, rodent- and water-borne diseases (H-ID) in Bolivia, Paraguay and Uruguay where extreme ENSO-linked floods have been frequent since 2007. In Paraguay and Uruguay H-ID have increased over the last decade associated with yearly rainfall variability. The extreme floods of Paraguay River in Asuncion (Paraguay) in 2014 were the most devastating ever recorded in terms of affected people due to the increase in exposed population and duration of the event. The extreme flood of 2007 in the Beni region, Bolivian Amazonia, is discussed focusing on the nature of the link with ENSO events. Both well-being and health impacts are discussed as well as the development of adaptation plans after disasters. The evolution of Hepatitis A in Uruguay which was endemic and correlated with droughts where a sewage deficit existed is also discussed because mandatory vaccination strongly reduced the number of cases since 2007. Future climate scenarios show increases in average temperature and modified rainfall patterns, with increases in Uruguay and decreases in Bolivia and Paraguay for 2011–2040. There is high uncertainty with regard to river flow, floods and health impacts, and more hydro-climatic extremes are expected. There is evidence of both an adaptation deficit to cope with current climate and a risk-management learning process, the balance of which remains to be established.

The area comprised of the so-called Mosaico Bocaina is highly environmentally vulnerable due to real estate speculation, large construction projects and conventional tourism, which put forth an unequal, predatory form of development. The current context of climate change and water crisis in Brazil (particularly in the Southeast) amplifies the vulnerability of traditional and coastal communities. Therefore, the development of participatory alternatives to promote equity is fundamental to address territorial needs, thus generating solutions that consider the local context and traditional knowledge and increasing the resilience of affected communities. Based on the fact that sanitation was considered a priority for Praia do Sono—and through an approach that not only combines permaculture, education and sanitary engineering, but also establishes a dialogue between academia, local community and public managers—the Observatory of Sustainable and Healthy Territories, a partnership between the Oswaldo Cruz Foundation (FIOCRUZ), the National Health Foundation (FUNASA) and the Forum of Traditional Communities (FCT) has developed comprehensive social technologies. Raisin awareness in the community aims at the fully incorporating of the proposed solution in a future step. This chapter systemizes the process (from the prioritization to the establishment/implementation of the technological solutions adopted) and analyzes its potential for producing autonomy, equity and sustainability, providing social technologies with the potential to empower communities to provide solutions to mitigate environmental impacts and increase the resilience to climate change.