Climate-related displacement, impoverishment and healthcare accessibility in mainland Bangladesh

ABSTRACT

This paper examines the experiences of people displaced internally by climate-related factors in mainland Bangladesh, one of the world's most climate-vulnerable countries. The data derives from a representative survey of 1,200 households drawn equally from displacement-susceptible areas and areas without climate-related displacement. Comparisons are drawn on the basis of four variables: the displaced versus the non-displaced; before displacement versus after displacement; people displaced suddenly versus those displaced gradually; and the frequency of past displacement. The displaced experience multiple disadvantages, including reduced land ownership and reduced access to electricity, sanitary toilets and healthcare services. The disadvantage is greater following sudden displacement and among those who have been displaced multiple times. The impact on the time and cost of accessing healthcare are greater after displacement. The disadvantage of the displaced, thus, is a function of interactions between exposure to natural disaster, impoverishment and lack of access to health services.

KEYWORDS:

• Internal migration
• disadvantage
• climate change
• climate displacement
• healthcare accessibility
• Bangladesh

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Strictly-speaking, unlike for the results for entire households, the results based on data for one respondent per household are not generalizable to the underlying population of people aged 18 and above in the sampled areas. 

2 The ‘suddenly displaced’ households were forced to change their residence at short notice due to a natural disaster, while the ‘gradually displaced’ households resettled in anticipation of a natural disaster. The relocation of a gradually displaced household's materials and possessions often would take a several days to complete.

3 The healthcare facilities and providers considered are; professional doctor, trained healthcare provider, government or private health centre, untrained provider

4 For all outcomes the response categories were ‘decreased’, stayed the same’, and ‘increased’.

5 The health and wellbeing facilities considered are; electricity at home and by solar system, ownership of agricultural land, homestead land, cattle and poultry, and fishing materials, access to drinking water, sanitary toilet, and electronic media, and local availability of doctor, trained provider, untrained provider and non-allopathic provider.

6 Except for age (in years), number of years schooling, the duration of last homelessness and household's monthly healthcare cost all the variables considered involved collection of categorical data. However, for data analytic purposes the continuous and integer-valued variables were grouped into categories.

7 For the remaining 6 per cent the moves were due to events since the last displacement, such as eviction from the immediate post-disaster location or moves to land which had emerged from the river.