healthfeed
Desperation grows in Puerto Rico’s poor communities without water or power.
The health crisis is intensifying two weeks after Hurricane Maria, and government aid is slow. 'We could see significant epidemics,' a health expert warned.
BY PHIL MCKENNA
FOLLOW @MCKENNAPR
Public health conditions are rapidly deteriorating across Puerto Rico as government agencies struggle to restore basic services such as power and clean drinking water and deliver emergency supplies two weeks after Hurricane Maria ravaged the U.S. territory. The situation is dire across much of the island but even more so for its most vulnerable, low-income minority communities.
Only about half the territory's residents had access to potable drinking water, and electricity had been restored to just 5 percent of Puerto Rico as of Tuesday, when President Donald Trump visited the capital, San Juan, according to the Federal Emergency Management Agency.
"The sense of desperation is only growing with every passing day," said Chris Skopec, executive vice president for global health and emergency response with Project HOPE, a Millwood, Virginia-based nonprofit now working in Puerto Rico. "In these kinds of conditions, the ability for an epidemic to spread is really ripe."
In Caño Martín Peña, a densely populated community of mostly wooden homes originally built by impoverished squatters in a flood zone in the heart of San Juan, existing public health issues were exacerbated by the storm.
The community is plagued by untreated sewage that flows into the adjacent Martín Peña Channel. Before Hurricanes Irma and Maria, even moderate rainstorms would cause the debris-clogged channel to overflow, sending raw sewage into basements and causing skin rashes and asthma. Outbreaks of mosquito-borne diseases dengue and Zika are common in the community of 23,000, where 25 percent of adults are unemployed and the median household income is $13,500, according to 2010 U.S. Census data.
"People are drinking whatever comes from the faucet, and it's turbid," said Lyvia Rodríguez del Valle, executive director of the Caño Martín Peña Land Trust Project Corporation, a public-private partnership working with the community. "People lost their roofs. They cannot close their doors, so we are having issues with mosquito bites and other insects, we are having plagues like rats and everything else."
Volunteers from outside aid organizations have helped clear trees and other debris from the streets, but the government response is just starting, Rodríguez del Valle said. Government officials provided an initial delivery of 60 blue tarps on Sunday to the community where 800 families lost their roofs. City garbage trucks began removing debris piles the same day.
"We have barely seen the government here," Rodríguez del Valle said.
More than 12,300 federal staff representing 36 departments and agencies are now on the ground in Puerto Rico and the U.S. Virgin Islands engaged in response and recovery operations, according to FEMA.
'We Could See Significant Epidemics'
Rodríguez del Valle said the mosquito bites that have been reported in Caño Martín Peña in recent days suggest diseases like dengue, Zika or chikungunya, which take several days or longer to surface after the initial bites, are on their way.
Health experts say mosquito- and water-borne diseases present a serious concern for all of Puerto Rico.
"Unless there is massive intervention to implement some type of health infrastructure, we could see significant epidemics in the coming weeks," said Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston.
"I'm concerned about typhoid, paratyphoid and shigella [bacterial diseases that can spread through non-potable water] on the diarrheal side and the vector-borne diseases, especially dengue, because we have dengue in Puerto Rico every year anyway," Hotez said.
Twenty miles east of San Juan in Loiza, a coastal community where 65 percent of residents are black and and nearly half of residents live below the poverty level, there are already reports of diarrheal diseases.
"We are seeing increasing rates of gastrointestinal disease as there are increasing reports of people drinking river water, and otherwise unable to access clean water," Skopec, of Project HOPE, said. "It's a very bad situation and the outlook is that it's going to continue to get worse before it gets better."
Skopec, whose organization is operating a mobile clinic and conducting home visits in the town, said the exact cause of the disease is not known.
On Radio, Hospitals Beg for Fuel for Generators
South of San Juan in Salinas, a low-income community largely of African descent on the Caribbean Coast, community leaders say they have received little outside assistance.
"The hospitals are on the radio asking for diesel and fuel to run their generators," said Ruth Santiago, an environmental lawyer for Comité Diálogo Ambiental, Inc. (Environmental Dialogue) in Salinas. "Elder centers, they are asking families to pick up their relatives."
In an address in Puerto Rico on Tuesday, President Trump praised his administration's response to the storm and compared Hurricane Maria, where the early reported death toll from the hurricane was 16 people, to what he called a "real catastrophe like Katrina" where thousands died.
The governor of Puerto Rico raised the official death count to 34 after Trump left, but that, too, is likely low. Puerto Rico's Center for Investigative Journalism reported that morgues are at capacity, the official system for registering deaths is barely functioning, and the number could rise into the hundreds due to the territory's damaged health care infrastructure.
Leaving Home Behind: 'You Try to Be Strong'
Santiago has driven back and forth to San Juan four times in the past two weeks since Maria made landfall, but she said she is only starting to see military and other supply vehicles on the roads in recent days.
"I don't know why were are not getting the kinds of things that are basic necessities 13 days out from Hurricane Maria," Santiago said. "I know many people who are getting airline tickets and they are just leaving."
Airlines are now offering reduced airfares for those seeking to leave the island, though commercial flights remain limited after Maria severely damaged radar equipment at the main airport, in San Juan.
Cruise ship company Royal Caribbean International offered free passage to thousands of evacuees from Puerto Rico and the U.S. Virgin Islands aboard a ship that arrived in Fort Lauderdale on Tuesday.
For those who evacuate the region and those who remain, many will have to cope with mental health issues related to the storm.
Marcella Chiapperino lost her home and business in Frederiksted, St. Croix, in the U.S. Virgin Islands, to Hurricane Maria after both had been battered by Hurricane Irma two weeks before. Chiapperino said she had her first real night of sleep after boarding the Royal Caribbean ship last Thursday but was still haunted by nightmares. "I was woken up by a dream of this wave coming and wind and pulling me outside the window," she said. "It just sucked me out."
"You try to be strong," she said, "but I think a lot of people will have some kind of post traumatic experience from this."
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Protection for tiny darter contrasts admin moves on grizzlies.
Some tiny Southern fish and the lumbering grizzly bear are dramatizing divergent sides of the debate over adding and removing animals from Endangered Species Act protections.
Some tiny Southern fish and the lumbering grizzly bear are dramatizing divergent sides of the debate over adding and removing animals from Endangered Species Act protections.
Kicking off a series of long-awaited decisions, the Fish and Wildlife Service today proposed listing the trispot darter as threatened under the ESA. Less than 2 inches long, the fish lives in the Coosa River basin spanning parts of Tennessee, Georgia and Alabama.
"The condition of the trispot darter is an indicator that habitat conditions, stream flows and water quality are declining in the Coosa River Basin," Mike Oetker, the service's acting Southeast regional director, said in a statement.
Oetker, a career FWS employee, added that "the good news is that we believe we can reverse those declines and recover the trispot."
Separately, administration officials are proposing that the candy darter found in Virginia and West Virginia also be listed as threatened.
"The candy darter has been called one of our country's most vivid freshwater fish, and all signs suggest its future is threatened," Paul Phifer, FWS Northeast assistant regional director, said in a statement.
The populations of two other species, the holiday darter and the bridled darter, were deemed stable enough to not need ESA protections.
The decisions announced today come as part of what officials termed a "massive settlement agreement" requiring the agency to review the status of more than 400 species. More announcements are imminent.
Grizzly controversy
While the administration is moving to protect tiny fish, in June the Interior Department announced it would remove Yellowstone-area grizzly bears from ESA protections. The move has already prompted litigation, and now it has Congress involved (E&E; News PM, June 22).
Arizona Rep. Raúl Grijalva, the top Democrat on the House Natural Resources Committee, has introduced a bill, H.R. 3894, aimed at enhancing protections for grizzlies and giving American Indian tribes a stronger voice in their management. It would make it against the law for anyone to kill, injure, capture or transport the bears, with some exceptions.
The legislation would not apply to grizzly bears taken in Alaska. And it would permit the killing of grizzlies to save the life of a person in immediate danger, among other exceptions.
The bill would also require officials to consult with affected tribes and the Interagency Grizzly Bear Study Team before taking any action that negatively affects the bear's habitat or results in a higher mortality rate among the species.
"Like a bear snatching salmon from a stream, Trump's Interior Department has snatched defeat from the jaws of victory by delisting Yellowstone grizzlies prematurely and without adequate tribal consultation or safeguards to ensure the bears' long-term survival," Grijalva said in June.
Grijalva is holding a news conference on the bill this afternoon on Capitol Hill with several tribal leaders and the Humane Society. They have accused the administration of ignoring "the objections of scientists and tribal leaders" in the delisting.
It was the Obama administration, though, that in 2016 initiated the delisting process, with the Fish and Wildlife Service announcing at that time it intended to remove the Yellowstone grizzlies from the endangered species list (E&E; News PM, March 3, 2016).
Climate factor
The moves on the darter fish are not without controversy. The public will get its chance to weigh in when Fish and Wildlife tomorrow formally publishes the proposals in the Federal Register and opens a comment period.
As with the grizzly, it continues a debate that's been going on for years. Way back in 1982, FWS identified the trispot darter as a species that might be added to the ESA list.
In 1991, it became a candidate species. In 2010, the Center for Biological Diversity petitioned for it and 403 other aquatic animals to be listed.
Scientists have identified habitat degradation as the largest threat to the future viability of the darters, specifying problems including both the quality and the quantity of water available.
"All of these factors are exacerbated by the effects of climate change," FWS has said.
In particular, the agency notes that "climate models for the southeastern United States project that average annual temperatures will increase, cold days will become less frequent, the freeze-free season will lengthen by up to a month, temperatures exceeding 95 degrees Fahrenheit will increase, heat waves will become longer, and the number of Category 5 hurricanes will increase."
For the candy darter, officials identified the primary threat as hybridization with another fish, the variegated darter. Their studies project a grim future for the candy darter.
"At the end of 25 years, the candy darter will likely occur in four isolated populations and maintain little resilience, redundancy, or representation," the agency said.
FWS did not specify a critical habitat for either the trispot darter or the candy darter.
Twitter: @MichaelDoyle10 Email: mdoyle@eenews.net
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UK College of Agriculture/flickr
Drowning in grain: How Big Ag sowed seeds of a profit-slashing glut.
Abundant supplies have helped lower food prices across the world, but the benefit to consumers and impoverished nations is muted by several factors.
SPECIAL REPORT-Drowning in grain: How Big Ag sowed seeds of a profit-slashing glut
by Reuters
Wednesday, 27 September 2017 11:00 GMT
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Abundant supplies have helped lower food prices across the world, but the benefit to consumers and impoverished nations is muted by several factors
By Rod Nickel
CARMAN, Manitoba, Sept 27 (Reuters) - On Canada's fertile Prairies, dominated by the yellows and golds of canola and wheat, summers are too short to grow corn on a major scale.
But Monsanto Co is working to develop what it hopes will be North America's fastest-maturing corn, allowing farmers to grow more in Western Canada and other inhospitable climates, such as Ukraine.
The seed and chemical giant projects that western Canadian corn plantings could multiply 20 times to 10 million acres by 2025 - adding some 1.1 billion bushels, or nearly 3 percent to current global production.
The question, amid historically high supplies and low grain prices, is whether the world really needs more corn.
A global grains glut is now in its fourth year, with supplies bloated by favorable weather, increasingly high-tech farm practices and tougher plant breeds.
The bin-busting harvests of cheap corn, wheat and soybeans are undermining the business models of the world's largest agriculture firms and the farmers who use their products and services. Some analysts say the firms have effectively innovated their way into a stubbornly oversupplied market.
Never has the world produced so much more food than can be consumed in one season. World ending stocks of total grains - the leftover supplies before a new harvest - have climbed for four straight years and are poised to reach a record 638 million tonnes in 2016/17, according to USDA data.
Farmers and agriculture firms could once count on periodic bouts of crop-destroying weather to tame gluts and drive up prices. But genetically modified crops that repel plant-chewing insects, withstand lethal chemicals and mature faster have made the trend toward oversupply more resistant to traditional boom-and-bust agrarian cycles, experts say.
Another key factor: China - the world's second-biggest corn grower - adopted stockpiling policies a decade ago when crop supplies ran thin, resulting in greater production than the world needs.
"I think the norm is where we are now," said Bryan Agbabian, director of agriculture equities at Allianz Global Investors.
Allianz investors seem to agree: The value of two agriculture equity funds that Agbabian manages fell to $300 million this year from $800 million in 2011 as crop prices slid, he said.
Abundant supplies have helped lower food prices across the world, but the benefit to consumers and impoverished nations is muted by several factors, including problems with corruption and distribution of food in developing regions, said Sylvain Charlebois, professor of food distribution and policy at Canada's Dalhousie University.
The bumper harvests may actually harm poor communities more than they benefit their residents in food savings because lower prices depress farm incomes in the same areas, said John Baffes, a senior economist at the World Bank.
Even as farmers reap bountiful harvests, U.S. net farm incomes this year will total $63.4 billion - about half of their earnings in 2013, according to a U.S. Department of Agriculture forecast.
Lower incomes mean farmers cannot spend as much on seed, fertilizer and machinery, extending their pain to firms across the agriculture sector.
Potash Corp of Saskatchewan, the world's biggest fertilizer company by capacity, closed its newest potash mine last year, eliminating more than 400 jobs, and has seen its U.S.-listed shares fall by nearly half since the beginning of 2015. The drop erased $14 billion in value, and left Potash seeking to merge with rival Agrium Inc.
With profits under pressure, seed and chemical companies are scrambling to consolidate.
Monsanto's annual profit in 2016 was its smallest in six years. It agreed last year to combine with Bayer AG, which would create the world's largest integrated pesticide and seed company if the deal closes next year.
Grain handler Bunge Ltd said this summer it would cut costs, and left the door open to selling itself after posting a 34 percent drop in quarterly earnings.
Bunge CEO Soren Schroder sought to reassure investors in May by saying all that was needed to trim supplies was one bad stretch of weather in the U.S. Midwest.
But the glut pervades many major farming regions, making it unlikely that drought or floods in one region could wipe out the mounting global surplus. Even with dry conditions in North America, Europe and Australia, the U.S. Department of Agriculture forecasts that this year will bring the second-biggest global corn, wheat and soybean harvests ever.
Bunge's Schroder made his comment about bad weather less than three weeks before confirming an informal merger approach from commodities giant Glencore Plc.
"When prices tanked, farmers were no longer willing to pay more" for seed and chemicals, said Jonas Oxgaard, analyst at investment management firm Bernstein. "The mergers are absolutely driven by oversupply because their growth is gone."
Monsanto spokeswoman Trish Jordan said the company believes demand growth still justifies corn expansion, and she disputed the notion that crop science advances are backfiring on agricultural technology firms.
Monsanto rival DowDuPont Inc is making the same bet and currently sells the shortest-season field corn in North America, maturing in 70 days, spokesman Ali Aziz said.
Success in the lab and the field, however, has contributed to oversupply and may continue to sustain it, said Oxgaard, the Bernstein analyst.
"It's somewhat the seed companies' fault - they keep breeding better and better seeds every year," he said.
DARWIN, SEX AND CORN
Charles Darwin helped plant the seeds of the grain glut. The biologist and evolution theorist showed in the late 1800s that cross-fertilization of plants - in which sex cells are fused between crop varieties of the same species - creates a more vigorous breed than those that are self-fertilized.
His work and others' influenced successive generations of crop scientists and led to the development of hybrid corn, said Stephen Moose, a professor specializing in crop genetics at University of Illinois.
U.S. farmers started planting the first significant acres of hybrid corn in the 1930s, and by 1950 it made up nearly all the corn seeded in the United States.
Yields exploded. Farmers who reaped 20.5 bushels of corn per acre in 1930 harvested an average of 38.2 bushels in 1950, according to the U.S. Department of Agriculture.
Further hybrid breeding breakthroughs generated corn with leaves that grow more erect, allowing farmers to sow it more densely without starving plants of sunlight. Yields first topped 100 bushels per acre in 1978.
After conventional breeding breakthroughs became harder to find, corn gained new vigor through the 1990s with genetic modification.
In 1996, U.S. regulators approved corn that was genetically engineered to produce bug-killing proteins, accomplished by inserting a bacterium hostile to the corn borer insect into the plant genome.
Before the end of the 1990s, corn able to resist weed-killing chemical glufosinate or Monsanto's glyphosate hit the market.
Those modified varieties and others that followed proved pivotal in generating the abundant corn crops that have since become commonplace, Moose said.
"In the seed industry, it stimulated a whole other round of investment," Moose said.
In the 20 years since GMO corn reached U.S. farms, yields jumped another 37 percent to a record 174.6 bushels per acre last year.
Some experts believe the expansion of corn yields may soon hit a ceiling. The crop may be nearing the natural limit of its production potential, and crop yields will likely plateau in the next decade, based on how plants convert light to food and their ability to recover from heat, said Ken Cassman, agronomy professor at University of Nebraska-Lincoln.
Technology has also provided better defences against pests.
Syngenta AG's Viptera and Duracade traits, used to control worms and beetles, launched in 2010 and 2013. SmartStax corn seed, introduced by Monsanto and Dow in 2009, brought twin benefits of insect protection and herbicide tolerance, said Paul Bertels, vice-president of production and sustainability at U.S.-based National Corn Growers Association.
The breakthroughs in seed and pesticide technologies have not come without problems. Monsanto is now embroiled in a controversy over dicamba, a big-selling chemical designed to kill weeds that harm Monsanto's genetically modified crops.
Many U.S. farmers say dicamba has drifted from its intended fields, damaging plants that are not resistant to the chemical. Monsanto believes the main causes of drifting are errors by farmers and applicators in deploying the herbicide, company spokeswoman Charla Lord said.
GROWING CORN IN ALASKA
As it grew stronger, corn grew faster. Corn that required 120 days to mature in the U.S. Corn Belt during the 1960s now needs only 105 to 115 days.
Farmers in northern North Dakota plant and harvest corn in 80 days, and have doubled the state's production in five years.
Fast corn is now stirring even the imaginations of researchers in the far north.
University of Alaska Fairbanks horticulture professor Meriam Karlsson grew hundreds of corn plants in the Arctic state in 2015.
The plants, germinated in a greenhouse before they were transplanted outside, grew from a short-season garden corn variety that matured in less than 60 days. Corn rose only four to five feet, allowing plants to spend maximum energy on growing ears, rather than leaves and stalks.
Karlsson had expected few corn plants to survive in Fairbanks - less than 120 miles (190 kilometers) from the Arctic Circle.
"It's much more adaptable than I expected," she said. "Amazing what breeding can do. It was kind of exciting that you could do it."
The lure of technology comes down to money for farmers.
Even with Chicago corn futures down more than 50 percent from their 2012 record high, the high-yielding crop offers one of the strongest returns to Canadian farmers, generating profits per acre four times that of canola, based on average prices and costs, said National Bank analyst Greg Colman.
As corn spreads across the Canadian Prairies, those robust yields are winning farmers over, said Dan Wright, Monsanto Canada's lead for corn and soybeans.
"Once you harvest corn at 140 or 180 bushels, it's something you want to do again," he said.
While corn compares nicely to some crops, it offers U.S. farmers marginal returns at current prices, Bernstein's Oxgaard said. Switching to other crops is not easy in areas like the U.S. Midwest, where farmers traditionally swing between corn and soybeans, and have invested in costly equipment to grow them.
GLUT TRACES ROOTS TO SHORTAGE
The problems of plenty were on nobody's mind less than a decade ago. In 2008, a dramatic food price run-up stirred riots from Haiti to Egypt.
Four years later, the U.S. Midwest, the engine of the global corn and soybean growing machine, suffered its worst drought in decades, opening gaping cracks in the soil and withering crops.
Chicago corn and soybean futures hit record highs as U.S. production fell to multi-year lows.
But high prices proved the cure for high prices.
Farmers in traditionally less productive corn-growing countries such as Russia, Argentina and Brazil expanded corn output to seize bigger profits.
U.S. farming quickly rebounded, reaping record corn harvests in three of the next four years.
New corn varieties have made global production more balanced than ever, with 12 countries producing at least 10 million tonnes of corn annually, up from 10 before the drought.
Even if U.S. or Brazilian corn crops suffered major weather damage, the world would still have the expanding Black Sea corn region to tap, not to mention China's enormous supplies, said Bertels, of the U.S. corn growers association.
China's stockpiling policies, enacted in 2007 when corn supplies were tight, also stimulated oversupply. Aiming for self-sufficiency in grains, Beijing bought virtually the entire domestic crop each year and paid farmers as much as 60 percent more than global prices.
The program stuffed Chinese warehouses with some 250 million tonnes of corn by the time Beijing scrapped it last year. China is now boosting incentives for farmers to switch to soybeans from corn.
"The world's corn is mainly in China," said Li Qiang, chief consultant at Shanghai JC Intelligence Co Ltd.
He said it will take three to four years for stocks to reach a "normal" level of around 40-50 million tonnes.
The Black Sea region, made up of Russia, Ukraine and Kazakhstan, has become a disruptive force with rapidly expanding exports. Moscow aims to drive grain production to 150 million tonnes by 2030 from 117 million in 2016 after increasing storage and export capacity in ports in the last couple of years.
Glut conditions are expected to ease modestly this year, amid dry conditions in China and the United States, but supplies are still so large that prices remain weak.
OVERSUPPLY OF EVERYTHING
In northern North Dakota, an expanding frontier for corn and soybeans, Paul Thomas started dabbling in both crops about a decade ago on his farm near Minot, seeking higher returns than wheat.
Both are now among his biggest crops, including short-season Monsanto corn varieties that have only been available for a couple of years.
Profits may be tougher for Thomas to eke out this year due to dry weather and soft prices, but he shrugs off the struggle.
"We're very capable of producing a large amount of bushels given an economic incentive," he said. "If we end up over-producing, then we shift to one that's more in need. That's just the way agriculture works."
Thomas acknowledged, however, that the traditional dynamic may be changing in this current glut.
"I don't know any single crop that isn't in oversupply," he said.
Seeding equipment is becoming more precise, and increasingly cost-conscious farmers are applying fertilizer and chemicals more intelligently, said Al Mussell, head of research at Canadian think tank Agri-Food Economic Systems.
Monsanto projects that corn will become by the mid-2020s one of the biggest crops produced in Canada, which is an agriculture-exporting powerhouse in canola, wheat, oats and pork.
Soybeans are also spreading across Canada. Farmers seeded a record high 7.3 million acres in 2017, up 75 percent in five years.
On Monsanto's research farm in Carman, Manitoba, the next target is marketing a corn variety that matures in 70 days within the next two years. After that: an even quicker plant to snatch DowDuPont's claim to North America's fastest corn.
It is ambitious but realistic, said Kelly Boddy, manager of Monsanto's research farm.
"Wind the clock back a few years," he said, "and breeders wouldn't have thought it possible."
(Reporting by Rod Nickel in Winnipeg, Manitoba; Additional reporting by Polina Devitt in Moscow; Michael Hirtzer in Chicago and Dominique Patton and Jo Mason in Beijing; Editing by Simon Webb and Brian Thevenot)
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In the Virgin Islands, Hurricane Maria drowned what Irma didn’t destroy.
As islanders wait for doctors, medicine, fuel and manpower to rebuild, the economic toll from the storms is only starting to come to light.
CRUZ BAY, V.I. — Even before two Category 5 hurricanes struck the United States Virgin Islands with punishing fury this month, the notion of paradise here was already about as brittle as a sand dollar.
The local treasury had barely enough cash to keep the government funded for three days. Its debt had grown so large that Wall Street stopped lending it money. The unemployment rate was more than twice the national average.
The one-two punch of Hurricane Irma and Hurricane Maria 14 days later was especially cruel. In many places across the three major islands of this American territory, the second storm drowned what the first couldn’t destroy, ravaging what was once one of the Caribbean’s most idyllic landscapes.
“Maria broke our spirit,” said Ian Samuel of St. John, who lost parts of the upstairs of his house to Irma’s wind and his downstairs to two and a half feet of water from Maria. “I was in a pretty bad car wreck. And it’s like that — when you get out of the car and you’re trying to figure out what’s happening.”
The governor, Kenneth E. Mapp, said he expects that the hospitals on St. Thomas and St. Croix, the most populated islands, will have to be torn down and rebuilt. In St. Thomas, not far from where cruise ships have long unloaded vacationers, tarps and trash cans now collect dripping water from the ceiling of the emergency room, which has to evacuate any critical patients to the mainland.
On St. Croix, one of the few working cell towers went down after someone stole the generator powering it. The authorities had to ease the strict curfew after bodies started piling up at the morgue because people could not stay out long enough to bury those who had passed away of natural causes since the storms.
On St. John, the smallest and most remote of the islands, water and wind reduced beachfront hotel rooms to rubble. A landslide blocked the one road that connects the island from east to west, leaving just enough room for cars to pass but not an ambulance.
So many public school buildings have been compromised on the three islands that students cannot go back to class. And the wind has stripped the trees of all their leaves, leaving the once lush tropical forests looking as if they were set afire with napalm.
The 103,000 people who live in these islands are at the end of a long supply chain of relief that depends heavily on the ports in neighboring Puerto Rico — now crippled by Maria and unable to meet the needs of its own people.
And as Virgin Islanders wait for doctors, medicine, fuel and manpower to rebuild the flattened communications and power grid, the economic toll from the storms is only starting to come to light.
“The economy evaporated pretty much overnight,” said Clint Gaskins, the owner of Longboard, a restaurant on the island of St. John where the only customers these days are the locals who stop by twice a day to pick up meals provided by the Red Cross.
Across the island, the picture is grim: The two largest resorts will not be able to open until next year, if not longer; owners of the restaurants and bars that came away unscathed wonder who will be left for them to serve; and residents who are suddenly without jobs are leaving en masse for the mainland.
“And you’ve got a nearly bankrupt government,” Mr. Gaskins added. “I don’t know how they get out of this.”
The troubles in Puerto Rico are far better known. That island is facing a humanitarian catastrophe following the flooding and destruction from Maria. A debt crisis has left the government so badly strained that it effectively declared bankruptcy in May.
But on a per-capita basis, the often out-of-sight, out-of-mind Virgin Islands carry more debt than Puerto Rico. Wall Street analysts have warned that the territory may be unable to pay back the nearly $2 billion it owes creditors and keep up with billions more in payments it is required to make into a pension system that is projected to be insolvent in less than six years.
“We believe there is a large chance they will default,” said David Hitchcock, an analyst with Standard & Poor’s, which has said it plans to withdraw its ratings of the Virgin Islands — already at a level considered junk by investors — by October because the government has stopped providing it with basic information on its cash flow and financial outlook.
Governor Mapp said in an interview this week that the territory had already made its bond payment due next month and was not in danger of default or bankruptcy, which would have to be authorized by Congress, similar to what happened with Puerto Rico. He said his administration has been working with Wall Street to try to borrow additional funding, but no deals have come together yet.
“I’m not an economist, so I don’t want to sort of say to you it’s going to be all fine. It’s not going to be all fine,” Mr. Mapp said. The government — the territory’s largest employer — had been able to pay its employees since the hurricanes and would do so again this week, he said. But beyond that, he offered no guarantees. His priority, he said, was making sure critically ill patients got out of the two damaged hospitals.
He asked that Washington remember “the forgotten Americans” in the territories. “We are no different than Americans anywhere else,” he said.
Tourism is not only the livelihood for many Virgin Islanders, it provides a third of the local gross domestic product — a revenue stream the local government cannot afford to live without.
A vicious cycle of financial mismanagement, combined with other factors like the loss of one-tenth of the islands’ population since 2008, were hampering the Virgin Islands even as the rest of the country bounced back from the Great Recession.
Basic government functions have suffered neglect for years. The government has shortchanged the hospitals of the funding they are supposed to receive. And that has caused the hospitals to fall behind on payments to entities like the local water and power authority, which has raised rates so high on customers that they pay three times as much as the average in the states. Compounding the financial stress, the federal government caps the amount of money it provides the territories for Medicaid.
“I’m so at a loss right now and really trying to hold it together because we were on the brink before this, in terms of our finances,” Representative Stacey Plaskett, the Virgin Islands delegate to Congress, said in an interview. Ms. Plaskett, like other territorial delegates, cannot vote.
After Irma hit three weeks ago, aid was slow to trickle into St. Thomas and St. John. When military, law enforcement and emergency medical workers finally did begin to settle in, they were forced to pull out as Maria approached, taking the semblance of safety and order they brought with them.
“What it did was send everybody back into shock,” James Smith of St. Thomas, a ferry operator, said of Maria. Many people like him shared a similar reaction now that a week has passed: While the initial shock has worn off, the trauma lingers. “I hear my shutters rattle at night, and I get excited,” Mr. Smith added.
One of the businesses hit badly by the storm was the marine industry. Harbors are littered with ferries that capsized or were washed ashore, leaving fewer vessels to carry supplies back and forth. Masts from sunken sailboats jut out of the water. Charter boats, a big economic driver, lie on beaches, their hulls ripped open.
Reinforcing the sense of despair, St. Croix was hit especially hard by Maria after being spared the worst of Irma’s ferocity. And what had been a staging ground there for relief operations for St. Thomas and St. John was suddenly thrown into a state of emergency.
A week after Maria blew through, the recovery efforts were still lumbering to get off the ground. Power lines sit in tangled piles on the side of the road. Some droop down from broken poles and slap the windshields of cars as they pass by. Houses have been knocked from their foundations and rest precariously on steep hillsides. Piles of garbage grow larger and more fetid by the day, rotting in the tropical sun.
And help from the local and federal government can be hard to come by. When the public clinic on St. John ran out of essential medicines like tetanus shots and did not have doctors and nurses to relieve its overtaxed staff, it was a private individual, Tom Secunda, a co-founder of Bloomberg L.P., who flew them in on a company jet and ferried them to St. John while the federal government kept the ports closed. The company has also donated generators and sent staff to help with recovery logistics.
With no commercial air traffic allowed in or out of the St. Thomas airport, evacuations are being left to wealthy individuals with ties to the islands, including Mr. Secunda and Kenny Chesney, the country singer, who chartered a plane usually used by Nascar to get people and their pets out on Tuesday.
Even as relief begins to flow, residents understand that normalcy will not return for months, if not years.
Kimmeiqua Mahoney sat in what was left of her apartment in a public housing development in the Tutu section of St. Thomas this week, kneading dough for johnny cakes as her fiancé fried them in a pan heated with chunks of broken drywall — his improvisation for charcoal. Ms. Mahoney has two weeks until she is supposed to give birth to her third child, a girl.
She rubbed her belly and looked outside at where there used to be a wall. She said she had no idea where she would live or work after she has her baby. Her job as a warehouse supervisor at a nearby resort is gone. And she has no idea if the housing stipend the government is offering her will cover her expenses. She cannot access her bank account because she has no internet. Neither do the grocery stores, which cannot process her food stamps.
“Already the island was short on jobs,” she said. “Right now we’re just filing for unemployment because it’s the only thing we can do.”
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Lawsuits test local governments' ability to clean up Indonesia's coal mining sector.
So far, 10 coal companies have sued to get their mining permits reinstated. Five have succeeded.
A government commission in 2014 found that thousands of mining permits did not meet Indonesia's legal standards.
Some local governments have moved to shut down violating companies. In one province, South Sumatra, companies are fighting back in court.
So far, 10 companies have sued to get their permits reinstated. Five have succeeded.
A court in Indonesia has once again ruled in favor of coal mining companies whose licenses were revoked by the South Sumatra Provincial Government.
A series of lawsuits by coal companies are currently working their way through the Palembang State Administrative Court — a process activists see as a key test of both the resolve and the ability of local governments to stamp out illegality in the mining sector.
In late August and early September, four companies successfully sued to have their licenses reinstated, bringing the total number of successful cases in South Sumatra up to five.
Problematic licenses
A 2014 review by Indonesia’s anti-graft agency identified problems with roughly 40 percent of the 10,992 mining licenses issued by local officials in 12 provinces, including South Sumatra. Such licenses were deemed not to be “clean and clear,” meaning they had failed to comply with basic laws regarding environmental impact assessments, payment of taxes and royalties, or proper registration of concession boundaries and corporate information.
In response, some local officials took action against violating companies. By April 2017 more than 2,100 permits nationwide were either revoked or allowed to expire without being renewed. In South Sumatra, the provincial government revoked 34 licenses and did not renew an additional 43.
So far, 10 coal mining firms have fought back, suing the South Sumatra government for revoking their licenses. Five of these companies have prevailed in court as of this month.
Most recently, on Sept. 6, the Palembang court ruled in favor of coal miners PT. Trans Power Indonesia and PT. Duta Energi Minerratama.
According to Rabin Ibnu Zainal, director of NGO Pilar Nusantara, the court determined that the companies had already taken steps to resolve the problems with their licenses, and should have been subject to administrative sanctions rather than revocation of their licenses. The gubernatorial decrees withdrawing their licenses were ruled void by the panel of judges overseeing the case, explained Zainal, whose organization monitors coal mining in South Sumatra.
On Aug. 29, the court ruled in favor of PT. Brayan Bintang Tiga Energi and PT. Sriwijaya Bintang Tiga Energi, who successfully argued that the local government did not have the authority to shut down their operations.
“The reasoning of the panel of judges was that both companies are foreign investors, and so the authority to revoke lies with the central government, in this case the Ministry of Energy and Mineral Resources,” explained Zainal.
This followed a June 8 ruling by the same court reinstating the permit of PT Batubara Lahat.
Meanwhile, cases filed by four companies have so far failed. Three of these sued the head of energy and mineral resources for South Sumatra: PT Bintan Mineral Resources, PT Buana Minera Harvest and PT Mitra Bisnis Harvest. Another coal miner, PT Andalas Bara Sejahtera, unsuccessfully sued the provincial governor.
Looking to the future
The government of South Sumatra is appealing the verdicts against it.
In the meantime, environmental activists are concerned that rulings in favor of coal companies will embolden bad actors in the mining sector, and deter officials in South Sumatra and elsewhere from attempting to take action against law-breaking companies.
“This sets a bad precedent,” said Zulfan Setiawan of the South Sumatra branch of the Indigenous Peoples Alliance of the Archipelago (AMAN). Noting that the South Sumatra governor’s actions came in the wake of a nationwide investigation into mining permits, Setiawan said he feared these court cases could have wider implications. “I hope the victory of these companies does not annul or eliminate various matters relating to environmental problems resulting from the activities of coal companies,” he added.
Of particular concern to Setiawan are companies whose activities he said threaten customary land held by indigenous people in South Sumatra.
Across the archipelago, communities living near coal mines have complained of serious negative impacts from mining firms, including water pollution and the dangers of abandoned mine pits, which have claimed the lives of at least 27 people, mostly children.
This story was reported by Mongabay’s Indonesia team and was first published on our Indonesian site on Sept. 18, 2017.
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How diamonds and a bitter feud led to the destruction of an Amazon reserve.
Family rivalry and Brazil’s Catholic church helped miners devastate an indigenous territory that was once a leader in the fight against deforestation.
The Paiter-Suruí are a tribe of roughly 1,400 people, uncontacted until 1969, who live in the Amazon forest on the border between the Brazilian states of Rondônia and Mato Grosso.
In 2013, they became the first indigenous population in the world to sell carbon credits under the UN’s major anti-deforestation scheme. Then, last year, they discovered the earth beneath their forest was rich with diamonds, and all hell broke loose.
The Paiter-Suruí’s 248,000-hectare Seventh of September territory sits on one of the largest unexplored diamond reserves on earth. As the miners moved in, the carbon credit programme collapsed.
But this was not a simple story of industry overpowering conservation. The destruction of this remote part of the Amazon forest reveals the tactics of a campaign by one of Brazil’s most powerful institutions, the Catholic church, that promotes divisions within tribes to bring down carbon credit schemes.
The Seventh of September territory – named after Brazil’s independence day – has long been the subject of the competing visions of two cousins and leaders in the Paiter-Suruí community, Almir and Henrique Suruí.
Almir dreamt of providing a long term, sustainable income for the community through carbon farming under the UN’s Reducing Emissions from Deforestation and Forest Degradation (Redd+) programme.
For a while, it worked. In 2013, the Paiter-Suruí sold 120,000 tonnes of carbon offsets to Brazilian cosmetics giant Natura – the first deal of its kind struck by an indigenous group anywhere on earth. The following year, Fifa bought the same number of credits in order to reduce the footprint of the 2014 football World Cup in Brazil. In 2013, Almir won a UN Forest for People award.
But Henrique, who admitted to this reporter in 2015 he was involved in illegal logging during an interview published in the Brazilian newspaper Folha de Sao Paulo (Portuguese), was not convinced. The proceeds from the carbon were not being divided up evenly he said, and he began to campaign against his cousin, trying to convince villagers to reject the scheme.
It was a struggle of will and local politics. Then, three years ago, Henrique enlisted an ally – the Catholic church.
Brazilian NGO, the Institute for the Conservation and Sustainable Development of the Amazon (Idesam), has been involved in the carbon credit project from its outset. Senior researcher Mariano Cenamo told Climate Home opponents inside the Paiter-Suruí had been heavily influenced by the Indigenous Missionary Council (Cimi), an arm of the Catholic church and the most influential pro-indigenous lobby group in Brazil, even among non-Catholic groups such as the Paiter-Suruí.
Cimi officially opposes carbon credits on the basis that they commodify the indigenous relationship to their land. It is widely rumoured in Brazil that in 2015 Cimi’s then president Bishop Erwin Kräutler, who advised Pope Francis on the writing of his encyclical on climate change Laudato Si, convinced the pontiff to include a passage that condemned carbon credits as “new form of speculation”.
“Cimi promoted the conflict between two different groups inside a territory in order to support an ideological position,” said Cenamo of the Paiter-Suruí. “They strengthened a group that destroyed a world-renowned project. It’s scary.”
Ivaneide Cardozo, the head of local NGO Kanindé, which works closely with the Paiter-Suruí said: “Cimi contributed to increased deforestation in the Seventh of September. It strengthened the party that cuts down the forest.”
In late 2014, Cimi’s newspaper Porantim, one of the major indigenous publications in Brazil, ran a interview with Henrique, in which he accused Almir of misleading the Paiter-Suruí and said: “Life in the community has radically changed. It’s no longer allowed to hunt, to fish, to plant and to produce handicrafts.”
A few weeks later, accompanied by a Cimi lawyer, Henrique had an audience in the national attorney general’s office for indigenous affairs in Brasília. According to official records, Henrique told the government the carbon project was “weakening” the Paiter-Suruí.
In an article about the meeting, Porantim said the carbon project was “loathed” by the Paiter-Suruí and depicted Redd+ initiatives as the “politics of green capitalism and neocolonialism”. As a result of Henrique’s lobbying, the prosecutor’s office in the state of Rondônia began monitoring the carbon project.
Five months after the meeting, in July 2015, this reporter visited the territory and could not verify the claims made by Henrique about the loss of community life. But by that time support for the carbon project was already dwindling: only 10 out of 25 Paiter-Suruí villages were still participating and disagreements over how to redistribute the money divided the Paiter-Suruí.
In 2015, gold was discovered. Then, last year, it was diamonds. Police footage, published on Climate Home for the first time, shows the devastating scars left on this pristine part of the Amazon. Last year, 20 hectares were stripped by mining, according to the last monitoring report of the Suruí Forest Carbon Project.
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Money generated by diamonds fuels the conversion of forest into pasture. Between 2015 and 2016, the territory lost 653 hectares of forest, a deforestation rate 256% higher than the Redd+ project’s allowable limit, leading to the decision to suspend the programme.
“We couldn’t generate more carbon credits because the deforestation rate was larger than predicted,” said Almir, in a telephone interview with Climate Home. “We couldn’t control it.” According to monitoring by NGO Imazon, between August 2016 and July 2017, Seventh of September had the seventh-worst deforestation rate among 419 indigenous lands in the Brazilian Amazon.
Redd+ is the UN climate treaty’s major tool for combating the destruction of forests in developing countries. Florian Eisele, a spokesman for UN-Redd said no faith group was opposed to the programme on a global level and he was “surprised to hear that the Catholic church has been an opponent to Redd+ in Brazil”.
Brazil’s deforestation rate has increased by 24% and 29% respectively in the past two years, after falling for a decade. The inability of an existing and high-profile project to deter mining highlights the difficulty of combating deforestation in an Amazon region increasingly falling prey to legal and illegal industries. Communities are faced with the choice of fast cash or slower, more careful sustainable income. Convincing them to take the long road is tough.
The extent to which the Paiter-Suruí exemplify this was revealed during police raids of the mines in their territory this year. According to a police report, seen by Climate Home, the main indigenous leader behind the diamond mining is Henrique Suruí.
“He only thinks and moves in accordance with mining interests,” said the report. “On the day of the raid, the federal police found heavy machinery in the mining area, which was under supervision and leadership of Indians. It is beyond doubt that they belong to the group led by Henrique Suruí.”
In a phone interview, Henrique told Climate Home the police accusation that he was a linchpin for current mining operations was “a big lie”.
“The guilty one is the federal government. The mining is a disgrace that affects our culture and our land. I blame the white man,” he said. “The carbon project is better than mining, it preserves the environment, but the money it generated should have been distributed for the whole community.”
According to federal police sources, since Climate Home last spoke to Henrique, he and two other Paiter-Suruí admitted involvement with illegal mining and struck a deal in order to collaborate in exchange of minor punishment.
By phone, Cimi executive secretary Cleber Buzatto, told Climate Home the relationship with Henrique was no longer close after the suspicions of his involvement in illegal activities. He said that, during Cimi’s involvement with him, there was nothing linking Henrique to forestry or mining.
“It was quite the opposite, he had always exercised an important leadership in Rondônia state,” said Buzatto. “He was interviewed under these circumstances. He expressed his criticism about carbon credits, which, in our opinion, was well-grounded, especially due to the concentration of the programme in Almir Suruí’s inner circle.”
Almir, however, said that he explained Henrique’s involvement with logging to Cimi as soon as the interview came out, to no avail. “I simply can’t understand why Cimi support the total annihilation of our land instead of a preservation project,” he said.
Buzatto said carbon credit programs tend to undermine collective organisations and change indigenous relationships to nature into mercantile transactions.
Cimi’s attention has now turned to another pioneering carbon credit agreement between a tribe and German development bank KfW, in the neighbouring state of Acre. On 31 July, 57 indigenous leaders and 11 indigenous organisations signed a letter criticising Cimi’s campaign against the Acre scheme. “It comes as a surprise to us that Cimi’s chapter in Acre is making intrigues, acting in bad faith and provoking discord and conflicts among us,” said the letter.
Regarding the controversy in Acre, Buzatto said most of indigenous leaders in the region opposed Redd+. He said that the subscribers of that letter were directly linked to the programme.
Meanwhile in Seventh of September, with the carbon credit scheme in tatters, Henrique’s concentration has shifted to legitimising mining.
“As everybody wants to dig for diamond in our lands, we want it to be without the white man’s involvement,” he told Climate Home.
As the schism among the Paiter-Suruí widens, Almir said that his followers, now a minority inside the ethnic group, are exploring alternatives to carbon. “Some of us went to Europe and struck deals to export coffee and Brazilian nuts. We will try to survive from sustainable agriculture and handicraft. We will find alternatives.”
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Health at a planetary scale.
Why we should think bigger about public health — way bigger.
The human footprint on the earth has grown explosively over the past century or two. Two hundred years ago, there were about 1 billion of us; today, we number more than 7 billion. We have harnessed vast amounts of energy, cleared countless forests, dammed thousands of rivers, reconfigured entire coastlines and built vast cities. We appropriate about half the planet’s accessible fresh water and nearly half the desert-free land surface to feed ourselves.
The results are evident at a planetary scale. The globe is warming. Oceans are becoming more acid. Natural cycles of nitrogen and phosphorus have been greatly altered; runoff fertilizer contributes to hundreds of “dead zones” along coasts. (This year’s Gulf of Mexico dead zone is twice the size of the Chesapeake Bay.) Almost a third of tropical forests and a fifth of coral reefs have been lost, species are disappearing at unprecedented rates, major fisheries are depleted, and persistent organic chemicals have infiltrated even remote ecosystems. Human effects on the planet are so profound that earth scientists have named a new geological epoch: the Anthropocene.
Both of us are physicians, and over the course of our careers we’ve come to realize that these trends are more than just environmental problems: They’re also urgent threats to human health and well-being. While human health is now, by most metrics, better than it’s ever been, ongoing planetary changes threaten to reverse that progress. These threats require a new approach to health research and health policy–a new paradigm that has come to be called “planetary health.”
As a young doctor, Sam spent years working on environmental conservation and human development projects, and realized that ecosystem degradation caused much of the suffering he saw. Howie worked at the U.S. Centers for Disease Control and Prevention, where he led that agency’s environmental health work; while focusing on traditional issues such as chemical contaminants, he realized that large-scale threats, such as climate change, accounted for more and more of the global burden of disease. We both saw the need to link human health directly to the health of the earth’s natural systems on which we depend.
Planetary health asserts that human beings cannot thrive over time while degrading the ecological life support systems that sustain us. Like traditional public health, it defines health broadly, including physical, mental and social well-being; it considers health not just as an individual attribute, but across entire populations; and it pays special attention to those who are most vulnerable. However, it works at large scales, both spatially (from regional to global) and temporally (anticipating the effects of current trends across generations). It regards ecology and the earth sciences as pillars of health science. It rejects the false dichotomy of people vs. nature and holds that to protect people, we must protect natural systems.
This field is growing rapidly. In the past few years, almost 20 universities have introduced programs or courses in planetary health, from the large University of California system to tiny Doane University in Crete, Nebraska. The University of Sydney recently appointed the world’s first professor of Planetary Health. The British medical journal The Lancet and the American Geophysical Union have both launched new academic journals dedicated to this field. Two leading health funders, the Rockefeller Foundation and the Wellcome Trust, are investing in planetary health. (Our work in planetary health has been supported by both funders.) A coordinating body, the Planetary Health Alliance, hosted an inaugural annual meeting in April 2017 at Harvard Medical School that drew over 350 people from 25 countries.
The planetary health framework is now shaping research in domains from river ecology to urban planning, from nutrition to land use. This research takes a systems approach to solving real world challenges, knitting together issues that have traditionally been isolated from each other.
Rivers provide one example. Rivers and lakes in many parts of the world provide habitat for the parasite that causes schistosomiasis. Along one river in Senegal, after a dam was built and altered the ecosystem, this devastating disease spiked. Researchers studied the impact of reintroducing freshwater prawns; the prawns feed on the snails that transmit this devastating disease. The research showed that shrimp farming simultaneously controls schistosomiasis, provides nutrient-rich food to the local population, and helps alleviate poverty.
Cities, where more than half the world’s population now lives, offer another example. Though they offer economic opportunity, cultural vibrancy and potential environmental benefits (due to lower per capita carbon footprints), cities can also pose such hazards as polluted air, noise, substandard housing and nature deprivation. A planetary health approach blends health science with architecture, urban planning, transportation policy, food policy, energy policy, climate science, disaster planning, ecology and more. For example, greenspace and tree canopy reduce the urban heat island and help prevent heat-related deaths. Transportation systems that emphasize walking, cycling and transit promote physical activity and reduce air pollution and CO2 emissions. Green building design reduces energy use, maximizes daylight and optimizes indoor air quality. Such evidence-based solutions help create healthy, sustainable, resilient cities.
Food is yet another example. Agronomists have known for some time that climate change reduces the yield of most major food crops. But climate change has other effects as well: rising carbon dioxide levels erode the nutritional quality of many foods, lowering the levels of critical nutrients including protein, zinc and iron. This research helps anticipate hot spots of potential malnutrition and helps drive the search for more nutritious cultivars.
A final example is land-use changes. In Indonesia, vast tracts of tropical forest have been burned in recent years to create farmland. We found that the resulting smoke exposure across large parts of Singapore, Malaysia and Indonesia caused roughly 100,000 excess deaths in 2015 alone. Such research helps clarify the human costs of these land-use practices. t also drives policy: In Singapore, new legislation allows criminal and civil lawsuits against air polluters, and in Indonesia, a new Peatlands Restoration Agency is modeling the health effects of fires (with our help), part of a strategy to restore peatlands and to prevent the region’s deadliest fires.
As with any new scientific field that crosses boundaries to solve big problems, planetary health faces challenges–in part from the structure of science itself. Research funders, including government agencies and private funders, are too often siloed, with one unit funding health research and another environment research. (In the U.S., the National Institutes of Health funds health research, and the National Science Foundation and EPA environmental research, but they rarely cross over.) As a result, research that integrates the two domains is orphaned. The growth of the field will depend on bolder, more cross-cutting research funding.
Young researchers, too, are often channeled into narrow, hyperspecialized subjects and then remain there as a result of funding and professional reward structures that emphasize disciplinary allegiance over real world problem solving. Universities need to encourage young researchers to tackle big, important questions, train them to do so, and reward them appropriately.
Ultimately, if the insights of planetary health are going to yield their full benefits, it will fall to policymakers to think big–to see the connections among issues such as natural resource management, energy, agriculture and urban development, and to place human health and well-being at the center of their decisions.
“Nothing in biology makes sense except in the light of evolution,” biologist Theodosius Dobzhansky famously wrote in 1973. In the Anthropocene—an era of daunting global challenges—we might make a similar assertion: Nothing in the study of human health and well-being makes sense except in the light of Planetary Health.
Howard Frumkin is a physician and professor of environmental and occupational health sciences at the University of Washington School of Public Health and a member of the steering committee of the Planetary Health Alliance. Samuel Myers is a physician and a senior research scientist at the Harvard T.H. Chan School of Public Health, and director of the Planetary Health Alliance.
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