How climate change could be causing miscarriages in Bangladesh

INSUBCONTINENT EXCLUSIVE:
Image copyrightSusannah SavageImage caption Young women in the village are anxious about having children and providing
for them In small villages along the eastern coast of Bangladesh, researchers have noticed an unexpectedly high rate of
miscarriage
As they investigated further, scientists reached the conclusion that climate change might be to blame
Journalist Susannah Savage went into these communities to find out more
"Girls are better than boys," says 30-year-old Al-Munnahar
"Boys do not listen
They are arrogant
Girls are polite." Al-Munnahar, who lives in a small village on the east coast of Bangladesh, has three sons but wished for a girl
Once she thought she would have a daughter, but she miscarried the baby
She is among several women who have lost a baby in her village
Image copyrightSusannah SavageImage caption Almost all the food they eat in Al-Munnahar's village now has to be bought
at markets some distance away While miscarriages are not out of the ordinary, scientists who follow the community have
noticed an increase, particularly compared to other areas
The reason for this, they believe, is climate change
The walk to Failla Para, Al-Munnahar's village, is arduous: in the dry season, the narrow track leads into a swamp, and in rainy season,
into the sea
The village itself is not much more than a mound of mud with a few shacks and a chicken pen perched precariously on the slippery surface
"Nothing grows here anymore," says Al-Munnahar
Not many years ago - up until the 1990s - these swamp lands were paddy fields
Image copyrightSusannah SavageImage caption The village, in the district of Chakaria, is built on salty mud, and
families often live in wet, damp conditions when the water gets into their home If rice production back then was not
profitable, it was at least viable
Not anymore
Rising waters and increasing salinity have forced the wealthiest among the villagers to change to shrimp farming or salt harvesting
Today, few paddy fields remain
"This is climate change in action," says Dr Manzoor Hanifi, a scientist from the International Centre for Diarrhoeal Disease Research
Bangladesh (ICDDRB), a research institute
"The effect on the land is visible, but the effect on the body: that we don't see." Brine and briberyICDDRB have been running a health and
demographic surveillance site in and around the district of Chakaria, near Cox's Bazaar, for the last thirty years, enabling them to detect
even small changes in the health of the communities they monitor
bribe forest wardens
husband and two children three years ago
"Because of the water, my kids would always have a fever, especially when our house remained wet after the flood
Everything is easier here." These environmental migrants are faring relatively well, able to grow crops and nearer transport routes to
access jobs and schools
They are also in better health than those they left behind
In particular, women inland are less likely to miscarry
Between 2012 and 2017, the ICDDRB scientists registered 12,867 pregnancies in the area they monitor, which encompasses both the hill area
and the plains
They followed the pregnant women through until the end of the pregnancy and found that women in the coastal plains, living within 20km
(12mi) of the coastline and 7m above sea level were 1.3 times more likely to miscarry than women who live inland
The difference may seem small, but the number of miscarriages on the plains seems to be growing, says Dr Hanifi
Moreover, when comparing the whole Chakaria region to Matlab, another area monitored by ICDDRB, in a part of Bangladesh far removed from the
coast, the scientists also saw a noticeable difference
In Chakaria, 11% of pregnancies end in miscarriage
In Matlab it is 8%
This difference, the scientists believe, is to do with the amount of salt in the water the women drink - the increase of which is caused by
climate change
Families with no choiceSea levels are rising, in part because of the melting of icecaps, but also because the earth's rising temperature
effects atmospheric pressure: even a small change in this causes an inverse effect on the sea level
"With a one millibar decrease in atmosphere pressure," says Dr Hanifi, "the sea level rises by ten millimetres: a series of depressions in
atmospheric pressure can cause a considerable rise in water levels in shallow ocean basins."When sea levels rise, salty sea water flows into
fresh water rivers and streams, and eventually into the soil
Most significantly, it also flows into underground water stores - called aquifers - where it mixes with, and contaminates, the fresh water
It is from this underground water that villages source their water, via tube wells
The water that the village pump in Failla Para spews out is a little red in colour
It is also full of salt
This does not stop villagers drinking from the pump, though - nor from bathing in it and washing and cooking their food in it
The World Health Organization (WHO) recommends that people consume no more than 5g of salt per day
In Chakaria, those living in the coastal zone consume up to 16g per day - over three times what those in the hilly areas do
In countries like the UK, health campaigns have cautioned against excessive salt consumption for years
It causes hypertension, increasing the risk of strokes and heart attacks, and, among pregnant women, miscarriages and preeclampsia
These Bangladeshi families have no idea of the health risk from the water they are drinking, and even if they did, they have little choice
Image copyrightSusannah SavageImage caption Fifty-year old Janatara would never consider leaving "Salt
is bad for crops," says 50-year Janatara, who was born in the village and has never left
When asked if she or her family would leave Failla Para she laughs: "No, of course not! I've been here my whole life, and anyway, where
would we go We are poor." 'Life is so hard here'Her neighbour, 23-year old Sharmin would like to leave
She is uncertain what future there can be for her two sons in Failla Para: "Life is so hard here," she says
Despite this, though, she plans to have another child soon
At the moment, the chance of miscarriage for women like Sharmin and Al-Munnahar is only slightly elevated
But unless something is done, says Dr Hanifi, "this will only get worse, as Bangladesh feels the effects of climate change more and more."
Image copyrightSusannah SavageImage caption Sharmin has two daughters, both of whom were delivered without a midwife
As a low-lying country, full of flood plain land, Bangladesh is particularly vulnerable to changes caused by global warming
But other countries elsewhere, are also likely to experience similar repercussions from rising sea levels
Across the Indian Ocean, the destruction caused by the 2005 tsunami caused saltwater to contaminate agricultural lands and freshwater
drinking sources
In the American state of Florida, rising sea levels has also led to saltwater encroaching on bodies of fresh water
Surprisingly, however, the Chakaria health and demographic surveillance site, which monitors the health-related impact of climate change, is
one of the only sites of its kind."A lot of money is being thrown at climate change interventions," says Dr Hanafi, "but almost none of it
goes into research - not for the public health impact anyway
Everyone is thinking about environmental disasters
No one is thinking about public health."All pictures copyright.