The young people of today will inherit a world made hazardous by greenhouse gas emissions but those chiefly responsible “will be spared the full brunt of their effects”.
Age has become a clear “fault line” of this phenomenon, write a team of researchers from the Wits Reproductive Health and HIV Institute (Wits RHI) and the SA Medical Research Council (MRC) in a guest editorial in the SA Medical Journal this month.
“While today’s adults will experience some impacts of these emissions, adolescents and future generations will face their full force in time,” note the authors of Climate Change and Adolescents in South Africa: The Role of Youth Activism and the Health Sector in Safeguarding Adolescents’ Health and Education.
“Adolescents have begun to assert their position within the climate crisis. Initiatives like staging a school strike every Friday, forming Extinction Rebellion protests and blocking public sites like the London Tower Bridge have generated considerable momentum,” says Matthew Chersich, associate professor at Wits RHI.
In several countries, adolescents are using litigation to hold their governments and the private sector to account, “a strategy that may have some merit in South Africa”.
But not all adolescents are equally empowered, Chersich writes. “There are major gaps in knowledge among adolescents in many low- and middle-income countries, including SA and climate activism is nascent in these settings.”
South Africa is home to around 10million adolescents aged 10 to 19 who make up about 20% of South Africa’s population. They already face a gamut of challenges, ranging from HIV infection, sexual and physical violence, teenage pregnancy, and substance use to poverty, inequality and gangsterism. Many schools are unsafe, with overcrowded classrooms and high levels of environmental toxins and educational outcomes are poor.
“Overall, the effects of climate change on adolescents and the effects of heat exposure in particular, are underappreciated.”
Many health practitioners have little insight of the impacts of heat on outcomes such as comfort while at school, cognition, education attainment and violence.
Changes in climate affect children and adolescents in unique ways, “given their dynamic biological, psychosocial and cognitive development.
“Compared with boys, the effects on girls may be greater, given that they have higher rates of obesity (which compromises thermoregulation) and of mental health conditions and mortality during extreme weather events,” writes Caradee Wright, senior specialist scientist at the MRC.
“Similarly, sub-groups of adolescents with limited physical or monetary resources to counter the impacts of climate change, such as those living in extreme poverty or with disabilities, may also be at increased risk.”
Children spend more time outdoors than adults, raising their exposure to solar ultraviolet radiation and their risks for exertional heat injuries in sports.
“About 20% of children aged 7 to 17 in SA are engaged in some form of economic activities producing foods for the ‘market’ or their own household. About 17% of these children report working in conditions ‘characterised by extreme temperatures and humidity’, which equates to around 400000 children at considerable risk for dehydration and heatwaves.”
Changes in water quality and availability are principal manifestations of climate change and have implications for adolescent health, notes Wright.
“Droughts may threaten water security in schools where water is often drawn from boreholes or even rivers. Floods, however, can also contaminate water with infectious agents and toxins. Safe water for sanitation and hygiene is especially important in SA, since around 30% of schools use pit latrines or have no toilet at all.
“Most water and food-borne infections are heat sensitive, of particular concern among adolescents given that close contact in the context of their household, school and community.” Social disruptions, such as food insecurity, damage to infrastructure and migration, can have a “major impact” on this age group, explains Chersich.
“Together these direct and indirect impacts pose mental health risks for adolescents, including post-traumatic stress disorder, depression, anxiety, sleep disorders and even suicide.
“Heat exposure can also increase irritability, aggression and violence, a major concern given the rates of physical and sexual violence in schools in SA, both pupil-on-pupil and between teacher and pupil.”
Recent figures from the UN show that globally there is at least one climate change disaster every week. “Even if these disasters trigger mental health conditions in a small fraction of adolescents, that translates into a massive disease burden,” says Chersich.
The mental health and behavioural impacts of climate change are especially pronounced among adolescents who have pre-existing psychological vulnerabilities or “resilience deficits”.
“This is highly relevant in SA, where the burden of mental illness among adolescents is among the highest in the world,” he says. In many schools, classrooms are made out of converted shipping containers or prefabricated sheeting with corrugated iron roofs, “with poor insulation, little natural ventilation and as many as 50 children in a class, who themselves generate a considerable heat load.
“In one study in Johannesburg, which has a relatively mild climate, temperatures reached as high as 47.5ºC in the containers and the large majority of students reported experiencing heat-health symptoms every day, including drowsiness, poor concentration and thirst,” Chersich writes.
These impacts will be even greater in hotter regions, such as the Northern Cape and Limpopo.
Many adolescents live in housing poorly resistant to heat. “In informal settlements and some formal low-cost housing developments (RDP housing), for example, indoor temperatures may be 4-5ºC warmer than outdoors, conditions hardly conducive to completing homework, preparing for examinations and quality sleep.”
There are major equity issues at stake, too, argues Wright. “Adolescents who have attended well-resourced schools with temperatures carefully controlled for optimal concentration will compete for jobs or places at university alongside those who wrote school-leaving examinations in temperatures above 40ºC, and were drowsy and probably poorly hydrated.
“That these examinations are written in the summer months further accentuates these concerns.”
In classes with poor ventilation, levels of carbon or stuffiness rise together with temperature and children experience symptoms characteristic of the “sick building syndrome. “These symptoms affects concentration and student learning and even school attendance and rate of asthma attacks.”
Window opening is a key means of removing heat and carbon. “In towns and cities with high pollution levels, such as Witbank, one of the most polluted towns in the world, doing so would increase exposure to outdoor air pollution.”
Supportive policy frameworks by the departments of Health and Basic Education are required to mainstream climate change adaptation interventions into schools. “Longer term initiatives to make the built environment more heat resistant are critical, especially replacing containers and prefabricated buildings with brick.”
Potential interventions include air-conditioning and mechanical ventilation, providing cold water at regular pre-specified intervals, use of the ancient Egyptian method of applying damp cloths to the body, and improved natural ventilation.
Closed shoes could be substituted for sandals, light-coloured loose clothing could be introduced, school hours adapted during the hottest seasons, trees planted to provide shade and “cooling rooms” used in schools.