particularly relevant for small islands, as freshwater here can only be trapped in small and highly
permeable layers (Praveena et al., 2012). The salinity and nutritional intake can affect coastal
populations, especially maternal and child health (Khan et al., 2011). They further mentioned that
exposure to salinity can be a reason for increased diarrheal diseases, hypertension, premature
delivery, skin diseases, and acute respiratory infection in coastal populations. The World Bank
(2013a) also stated that saltwater intrusion can have many health impacts. The Food and Agriculture
Organization (FAO) limits the allowable part of salinity in drinking water to <0.5 parts per thousand
and Khan et al. (2011) stated that, in some regions of Bangladesh, the value was above 15. This
saltwater intrusion puts additional pressure on the per capita availability and quality of fresh water in
some regions.
Saltwater intrusion can be increased by groundwater extraction from coastal wells (World Bank,
2013). This extraction of groundwater could also lead to human-induced subsidence, which could
exacerbate many of the aforementioned stressors (Brecht et al., 2012). We refer here to an
interesting publication related to these issues: Rodolfo and Siringan (2006) strongly argue that SLR is
a problem for coastal areas, but they show that anthropogenic induced subsidence due to excessive
groundwater extraction is much worse but, at the same time, not recognized by the authorities. As
the publication is from 2006, we assume that there have been further activities related to that issue.
Bankoff (2003) raised the point that there have always been EWEs and, while accepting the
relationship between global changes in climate to these events, one has to admit that human
activities (i.e. land use practices, living standards and policy responses) also strongly affect the
frequency and strength of natural hazards such as floods. One human activity that could interfere
with disasters and is discussed in literature is mining. Holden (2012) wrote that mining can interfere
with groundwater resources and therefore aggravate an El Niño induced drought. It deprives the
rural poor of needed water and could, thus cause a disaster when a natural hazard impacts a
vulnerable population (Holden, 2012).
As mentioned earlier, the issue of migration also plays a role in the Philippines. 7 million Filipinos live
as migrants outside the country (ADB, 2012) – mostly due to economic reasons – but even these
could be related to climate change. Others clearly have been forced to migrate due to disasters, e.g.
the 400,000 people that were displaced by the typhoon Sendong (or Washi) that made landfall in
Mindanao in 2011 (IDMC, 2013). The combination of a changing climate and climate-induced
migration can lead to large impacts on people’s health. Mosuela and Margaret (2014) further added
to this topic that a priori migration (discussed for Haiyan) could even be a support in cases of a
disaster, as familial affiliation could be used as a response option.
A detailed overview of the impact of changing climate on health for the Philippines can be found in
Lorenzo et al. (2011) (e.g. time series analysis of several Infectious Diseases).
Interaction with Gender
Peralta (2009) comments that the impacts of climate change are not only unevenly distributed
among countries, but different social groups or parts of the society will be hit in different ways. There
is a demand for research on the link between climate change and gender, not only because women
comprise one of the most vulnerable groups, but also because women play a pivotal role in
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