Haj and climate attributions
Ali Tauqeer Sheikh
CLIMATE change has begun to infringe on the freedom of believers to perform Haj freely and fearlessly. The world was shocked to learn that almost 1,500 individuals died of the heat during the pilgrimage. Heatwaves everywhere in the world, as in Pakistan, have become mercilessly hotter, frequent, and longer. The developments in attributive sciences are able to clearly assign the share of climatic changes to increased temperatures and precipitation. This emerging field of inquiry has begun to guide climate adaptation, risk management, commodity price hedging, insurance, and the landscape of international climate finance.
Detection and attribution of climate change has emerged as an active area of research that uses various methods to link observed changes in climate caused by human activities. This helps determine whether human influence can be distinguished from natural weather cycles, processes and variabilities. Causation, also known as detection and attribution studies, is used to attribute trends, extreme events, impacts, and sensitivity to human-caused climate change. Several attribution techniques are applied for increasingly reliable, timely, and actionable information for climate adaptation and risk management efforts.
Almost 50 studies over the last 10 years or so by the World Weather Attribution (WWA), ClimaMeter and several others have conducted studies to ascertain whether or not climate change is altering the frequency and intensity of extreme weather events (EWEs), helping to determine how climatic changes affect specific trends. These studies can now be undertaken on an almost real-time basis.
Attributional science is now able to provide quantitative assessments of how climate change has affected the odds of similarly extreme weather occurring in the future. Quantifying can now provide scientific evidence on how the likelihood and intensity of specific EWEs has increased. WWA has, for example, found that heatwaves have become 1.2 degrees Celsius hotter than in pre-industrial times. Likewise, a study found that the 2022 heatwave in India and Pakistan was 30 times more likely due to climate change. A recent rapid assessment by ClimaMeter on the heatwave during Haj found that, without the influence of human-caused climate change, temperatures would have been 2.5°C cooler. ClimaMeter and WWAs regularly conduct rapid assessments of the role of climate change in particular EWEs.
Detection and attribution of climate change has emerged as an active area of research.
There are, however, also significant challenges and limitations. An integrated, nuanced approach is required to effectively leverage this emerging field of climate science. A careful consideration of the limitations is needed when applying attribution findings to predict and manage future climate-related risks and damage. The goal of such studies is to provide the best available science-based information to support risk management and climate adaptation. Researchers acknowledge the limitations and uncertainties in their analyses, recognising that ‘we don’t know’ or ‘no significant trend’ are valid findings, as many of the 50 studies by WWA concluded.
Some studies have used ‘source attribution’ to link climate damage to specific emitters, such as fossil fuel companies. This could potentially support liability claims and policies to hold emitters accountable. A Dutch court, for example, has recently ordered Shell to reduce emissions based on this type of attribution. As the world’s second largest oil producer, Saudi Arabia owns Aramco, which is one of the largest corporate emitters of greenhouse gas emissions. According to a report, it is reportedly responsible for more than four per cent of the world’s historical carbon emissions.
Meanwhile, the heat during this year’s Haj is directly linked to global fossil fuel burning and has affected the most vulnerable pilgrims, posing an ethical dilemma for the kingdom that is considered the home and custodian of Islam and its universal values.
Extreme event attribution can potentially be used to inform discussions around loss and damage. Attribution science can inform international policy discussions on L&D mechanisms. While researchers use rigorous methods, some uncertainty remains in precisely quantifying specific EWEs. This could limit the direct application for compensation. There are also concerns that attribution findings could be misrepresented or used for political purposes of assigning blame or liability, rather than informing constructive solutions. L&D encompasses a wide range of slow-onset changes and non-economic losses that are not always fully captured by extreme event attribution. It is argued that the slow-onset needs criteria-based approach using averages and trends, rather than relying solely on detailed singular event studies for L&D policy and finance mechanisms.
Further, uneven data quality and research infrastructure in developing countries poses challenges for applying attribution science to the L&D agenda. Attribution has played a central role in global climate negotiations since the early 1990s, but attribution science has begun to play an important role only in recent years. It is used in financing adaptation and litigation, and will underpin L&D funds. These efforts can influence the global conversation around climate justice and help integrate findings in new approaches to L&D policies and financial mechanisms. For L&D-related financing mechanisms, the methodological refinement will probably provide rapid attribution assessments, and enable a more immediate response and support in the aftermath of extreme events.
Extreme weather events are already having significant economic consequences. They damage property, critical infrastructure, impact human health and productivity, and negatively affect key economic sectors like agriculture, trade, industry, and urban planning. Indirect costs from supply chain disruptions and uncertainty are also substantial. Businesses face growing risks from damage to their facilities, supply chain disruptions and resource scarcity.
These economic impacts do not even account for non-economic losses such as biodiversity loss, or loss of cultural or religious heritage and practices. The floods in Pakistan have caused significant damage to mosques and other religious sites. The Post-Disaster Needs Assessment reported that religious sites in active use, including mosques, shrines, and dargahs were “extensively damaged” by the 2022 floods and that the “deterioration and damage to the sites will negatively affect visitor numbers”. In a similar vein, Haj is a central pillar of Islam and the pilgrimage should not become risky for our elderly parents, women and young children. ClimaMeter study should be a wake-up call, and not a harbinger of what’s to come.
The writer is an Islamabad-based climate change and sustainable development expert.
Published in Dawn, July 4th, 2024
Ali Tauqeer Sheikh
Published July 4, 2024
DAWN
CLIMATE change has begun to infringe on the freedom of believers to perform Haj freely and fearlessly. The world was shocked to learn that almost 1,500 individuals died of the heat during the pilgrimage. Heatwaves everywhere in the world, as in Pakistan, have become mercilessly hotter, frequent, and longer. The developments in attributive sciences are able to clearly assign the share of climatic changes to increased temperatures and precipitation. This emerging field of inquiry has begun to guide climate adaptation, risk management, commodity price hedging, insurance, and the landscape of international climate finance.
Detection and attribution of climate change has emerged as an active area of research that uses various methods to link observed changes in climate caused by human activities. This helps determine whether human influence can be distinguished from natural weather cycles, processes and variabilities. Causation, also known as detection and attribution studies, is used to attribute trends, extreme events, impacts, and sensitivity to human-caused climate change. Several attribution techniques are applied for increasingly reliable, timely, and actionable information for climate adaptation and risk management efforts.
Almost 50 studies over the last 10 years or so by the World Weather Attribution (WWA), ClimaMeter and several others have conducted studies to ascertain whether or not climate change is altering the frequency and intensity of extreme weather events (EWEs), helping to determine how climatic changes affect specific trends. These studies can now be undertaken on an almost real-time basis.
Attributional science is now able to provide quantitative assessments of how climate change has affected the odds of similarly extreme weather occurring in the future. Quantifying can now provide scientific evidence on how the likelihood and intensity of specific EWEs has increased. WWA has, for example, found that heatwaves have become 1.2 degrees Celsius hotter than in pre-industrial times. Likewise, a study found that the 2022 heatwave in India and Pakistan was 30 times more likely due to climate change. A recent rapid assessment by ClimaMeter on the heatwave during Haj found that, without the influence of human-caused climate change, temperatures would have been 2.5°C cooler. ClimaMeter and WWAs regularly conduct rapid assessments of the role of climate change in particular EWEs.
Detection and attribution of climate change has emerged as an active area of research.
There are, however, also significant challenges and limitations. An integrated, nuanced approach is required to effectively leverage this emerging field of climate science. A careful consideration of the limitations is needed when applying attribution findings to predict and manage future climate-related risks and damage. The goal of such studies is to provide the best available science-based information to support risk management and climate adaptation. Researchers acknowledge the limitations and uncertainties in their analyses, recognising that ‘we don’t know’ or ‘no significant trend’ are valid findings, as many of the 50 studies by WWA concluded.
Some studies have used ‘source attribution’ to link climate damage to specific emitters, such as fossil fuel companies. This could potentially support liability claims and policies to hold emitters accountable. A Dutch court, for example, has recently ordered Shell to reduce emissions based on this type of attribution. As the world’s second largest oil producer, Saudi Arabia owns Aramco, which is one of the largest corporate emitters of greenhouse gas emissions. According to a report, it is reportedly responsible for more than four per cent of the world’s historical carbon emissions.
Meanwhile, the heat during this year’s Haj is directly linked to global fossil fuel burning and has affected the most vulnerable pilgrims, posing an ethical dilemma for the kingdom that is considered the home and custodian of Islam and its universal values.
Extreme event attribution can potentially be used to inform discussions around loss and damage. Attribution science can inform international policy discussions on L&D mechanisms. While researchers use rigorous methods, some uncertainty remains in precisely quantifying specific EWEs. This could limit the direct application for compensation. There are also concerns that attribution findings could be misrepresented or used for political purposes of assigning blame or liability, rather than informing constructive solutions. L&D encompasses a wide range of slow-onset changes and non-economic losses that are not always fully captured by extreme event attribution. It is argued that the slow-onset needs criteria-based approach using averages and trends, rather than relying solely on detailed singular event studies for L&D policy and finance mechanisms.
Further, uneven data quality and research infrastructure in developing countries poses challenges for applying attribution science to the L&D agenda. Attribution has played a central role in global climate negotiations since the early 1990s, but attribution science has begun to play an important role only in recent years. It is used in financing adaptation and litigation, and will underpin L&D funds. These efforts can influence the global conversation around climate justice and help integrate findings in new approaches to L&D policies and financial mechanisms. For L&D-related financing mechanisms, the methodological refinement will probably provide rapid attribution assessments, and enable a more immediate response and support in the aftermath of extreme events.
Extreme weather events are already having significant economic consequences. They damage property, critical infrastructure, impact human health and productivity, and negatively affect key economic sectors like agriculture, trade, industry, and urban planning. Indirect costs from supply chain disruptions and uncertainty are also substantial. Businesses face growing risks from damage to their facilities, supply chain disruptions and resource scarcity.
These economic impacts do not even account for non-economic losses such as biodiversity loss, or loss of cultural or religious heritage and practices. The floods in Pakistan have caused significant damage to mosques and other religious sites. The Post-Disaster Needs Assessment reported that religious sites in active use, including mosques, shrines, and dargahs were “extensively damaged” by the 2022 floods and that the “deterioration and damage to the sites will negatively affect visitor numbers”. In a similar vein, Haj is a central pillar of Islam and the pilgrimage should not become risky for our elderly parents, women and young children. ClimaMeter study should be a wake-up call, and not a harbinger of what’s to come.
The writer is an Islamabad-based climate change and sustainable development expert.
Published in Dawn, July 4th, 2024
Hot and dangerous
Aisha Khan
Aisha Khan
Published July 3, 2024
DAWN
THE rise in mercury has a human cost. With each decade getting warmer since 1980, the risk of breaching critical tipping points is getting alarmingly closer. The Intergovernmental Panel on Climate Change assessment reports have repeatedly reiterated the perils of crossing the 1.5 degrees Celsius threshold and issued advisories for urgent reduction in greenhouse gas emissions by 2030 to keep the planet safe. However thus far 1.5ºC has just been used as reference number to make strong political statements with very little to show for any measurable reduction in emissions at scale.
The heat this year is just a preview of what is likely to follow. Extreme events in past years and the health pandemic (Covid-19) are tangible proofs of the enormity of the crisis and its lingering effect on the economy. Other factors like biodiversity loss and climate-induced conflicts may not as yet be visibly relatable to people but are insidiously disrupting the social fabric of society.
Under the current patterns of emissions, it seems more than likely that the world is headed for 2.5 to 2.9ºC temperature increase from pre-industrial levels this century. The beginning of summer in four continents in the northern hemisphere has already scorched cities leaving millions to swelter as temperatures soar to new highs.
For vulnerable countries like Pakistan, this means high-risk scenarios and need for urgent adaptive action. The hidden cost of past emissions trapped in the atmosphere will add to the unfolding crisis. Even if global emissions peak before 2025, their long-term lingering impacts will continue to destabilise the climate, making it extremely difficult to cope with known threats and unknown risks. Fragility and crises will be the new norm as Earth heats up to challenge human actions and its impact on life systems.
The heat this year is just a preview of what is likely to follow.
In South Asia, the rising mercury is also a cryospheric crisis. The water towers that are a source of life to people from Bhutan to Afghanistan are under threat from the scorching heat. According to a report by the International Centre for Integrated Mountain Development, snow levels are a fifth below normal in the Hindu Kush, Karakoram and Himalaya (HKH) region. This can result in excessive flooding initially and end with drought and desertification. Given its geography, the effect of deadly and repeated heatwaves will hit the region in multiple ways from the mountains to the coastline. As extreme heat also traps more moisture in the air, the monsoons this year are predicted to be 33 per cent more intense, amplifying the problem.
The world is on a collision trajectory with nature and time is running out for course correction. The good news is that everyone knows what needs to be done and there is still time to reset the future.
Meanwhile, the rise in atmospheric temperature will also result in a concomitant increase in heated debates over climate justice and moral mandate. Heat stress is not limited to physical effects, nor is it only about a food, water and energy crisis. It has a psychological dimension that manifests itself in behavioural change and altered response mechanism. This chain reaction is often overlooked in planning. Historically, prolonged deprivations, inequality and injustices have resulted in social upheavals and system change. A heat-induced, drought-driven response to thirst, hunger and lack of basic amenities is likely to be even more cataclysmic.
The quantitative difference in resources between the Global North and the Global South and the qualitative difference in absorptive capacities of both will set the stage for conflict and pitched battles if two issues are not addressed quickly. The first underpins the need to address climate justice and the second calls for expediting reform in climate finance. There can be no more delays or debates on these two issues if the global community is serious about keeping its climate promise. Mitigation remains the number one responsibility of high-emitting countries to save the planet and reduce hardships for the already struggling millions around the world.
The scorching heat has an added dimension of peril for Pakistan. The country adds five million people to its population each year. Under this scenario the gap between supply and demand is going to increase beyond the state’s ability to provide food, water and energy to 380m people by 2040. The spectre of shrinking resources and a burgeoning discontented youth population is something that needs to be factored into climate and human security planning.
A hot temper is a dangerous thing to deal with at a wider community scale. It is time to cool down the planet and for responsible countries to reduce emissions rapidly.
The writer is chief executive of the Civil Society Coalition for Climate Change.
aisha@csccc.org.pk
Published in Dawn, July 3rd, 2024
The heat this year is just a preview of what is likely to follow. Extreme events in past years and the health pandemic (Covid-19) are tangible proofs of the enormity of the crisis and its lingering effect on the economy. Other factors like biodiversity loss and climate-induced conflicts may not as yet be visibly relatable to people but are insidiously disrupting the social fabric of society.
Under the current patterns of emissions, it seems more than likely that the world is headed for 2.5 to 2.9ºC temperature increase from pre-industrial levels this century. The beginning of summer in four continents in the northern hemisphere has already scorched cities leaving millions to swelter as temperatures soar to new highs.
For vulnerable countries like Pakistan, this means high-risk scenarios and need for urgent adaptive action. The hidden cost of past emissions trapped in the atmosphere will add to the unfolding crisis. Even if global emissions peak before 2025, their long-term lingering impacts will continue to destabilise the climate, making it extremely difficult to cope with known threats and unknown risks. Fragility and crises will be the new norm as Earth heats up to challenge human actions and its impact on life systems.
The heat this year is just a preview of what is likely to follow.
In South Asia, the rising mercury is also a cryospheric crisis. The water towers that are a source of life to people from Bhutan to Afghanistan are under threat from the scorching heat. According to a report by the International Centre for Integrated Mountain Development, snow levels are a fifth below normal in the Hindu Kush, Karakoram and Himalaya (HKH) region. This can result in excessive flooding initially and end with drought and desertification. Given its geography, the effect of deadly and repeated heatwaves will hit the region in multiple ways from the mountains to the coastline. As extreme heat also traps more moisture in the air, the monsoons this year are predicted to be 33 per cent more intense, amplifying the problem.
The world is on a collision trajectory with nature and time is running out for course correction. The good news is that everyone knows what needs to be done and there is still time to reset the future.
Meanwhile, the rise in atmospheric temperature will also result in a concomitant increase in heated debates over climate justice and moral mandate. Heat stress is not limited to physical effects, nor is it only about a food, water and energy crisis. It has a psychological dimension that manifests itself in behavioural change and altered response mechanism. This chain reaction is often overlooked in planning. Historically, prolonged deprivations, inequality and injustices have resulted in social upheavals and system change. A heat-induced, drought-driven response to thirst, hunger and lack of basic amenities is likely to be even more cataclysmic.
The quantitative difference in resources between the Global North and the Global South and the qualitative difference in absorptive capacities of both will set the stage for conflict and pitched battles if two issues are not addressed quickly. The first underpins the need to address climate justice and the second calls for expediting reform in climate finance. There can be no more delays or debates on these two issues if the global community is serious about keeping its climate promise. Mitigation remains the number one responsibility of high-emitting countries to save the planet and reduce hardships for the already struggling millions around the world.
The scorching heat has an added dimension of peril for Pakistan. The country adds five million people to its population each year. Under this scenario the gap between supply and demand is going to increase beyond the state’s ability to provide food, water and energy to 380m people by 2040. The spectre of shrinking resources and a burgeoning discontented youth population is something that needs to be factored into climate and human security planning.
A hot temper is a dangerous thing to deal with at a wider community scale. It is time to cool down the planet and for responsible countries to reduce emissions rapidly.
The writer is chief executive of the Civil Society Coalition for Climate Change.
aisha@csccc.org.pk
Published in Dawn, July 3rd, 2024
Published July 6, 2024
DAWN
THE last time Karachi’s mortuaries ran out of space was in 2015, and frighteningly enough, for the same reason. Nine years ago, a merciless heatwave swept Karachi’s most vulnerable, and left behind over 2,000 corpses overwhelming the city’s morgues. Today, the same charities that run these morgues are making eerily similar statements as they did then. There is no more space for the dead, in a world that did nothing for them when they were still alive.
And now, the streets of Pakistan’s largest city are turning up dead bodies every day. Temperatures have soared to almost 50 degrees Celsius, with humidity levels that can render the human body’s cooling mechanisms almost entirely useless. On Monday this week, at least 59 heat-related fatalities were reported. Last week, figures as high as 568 bodies were also being bandied about. Most of the dead were homeless people. The youngest victim identified so far was 20 years old.
A probe has been launched by the National Electric Power Regulatory Authority to investigate the deaths. A report is sought from K-Electric to determine if their load-shedding schedule could be linked to some of the deaths. While it may be of some use to see if protracted power cuts are to blame, it can only tell the picture in part.
Heatstrokes are fairly treatable, if not entirely preventable. It requires access to shade, cooling, water, electrolytes, lightweight clothing, and minimising activities during the hottest parts of the day. Instinctive, straightforward instructions. The state tried to let people know. At the beginning of summer, tips and tricks to prevent heat-related illnesses were published far and wide. It’s easy enough to let people know what they need to do. It’s easier still to believe that that’s all it takes to save lives.
There are no safety nets from the heat and there is no one really questioning that absence.
Awareness campaigns are never the end. This government, that relishes publicising the fulfilling of its most menial obligations, seems to forget that often. The most marginalised groups are rarely in a position to follow public health advice, a reality check that the state urgently needs — perhaps almost as much as the victims needed its intervention. If drinking plenty of fluids was advertised, then why is access to clean drinking water a privilege and not a right? If staying in shaded areas is advised, then why are there so many people sleeping on the roads? If medical care for heat-related symptoms is perceived as unaffordable, then is hospital treatment really an option? And if physical labour is not recommended during peak heat hours, then why is the government not making modified timings compulsory for employers?
The truth is that Pakistan’s poor are despised. This disdain is enshrined in our state budgets, our social structures, the prospects for economic mobility and even in the way we advertise our products. We tax the salaried class into oblivion, make basic utilities scarcely available and charge astronomically for when they are. We pay our domestic staff what we spend on one evening out.
We lock people out of economic opportunities because their education quality and English-language proficiency is lacking. We advertise skin whiteness as an aspirational quality because dark people work in the sun, and that’s because they don’t have the choice not to. We sneer at body odour, not realising that access to clean water is a luxury.
There are no safety nets from the heat and there is no one really questioning that absence. Proximity to a life of disease and early, preventable death is determined by real estate. Faisal Edhi, who heads the Edhi Foundation, wryly pointed out that most of the bodies they are collecting come from areas with the highest load-shedding. There would be hell, worse than the Karachi heat, for K-Electric to pay if areas like Clifton and Defence faced the same degree of power cuts.
The Sindh Climate Change Policy acknowledges that “most of the province is located in the intense heat zone, which is expected to see a 4-5°C temperature increase in the 21st century, therefore the burden on human health will be immense due to heatstrokes, diarrhoea, cholera and vector-borne diseases.” It proposes a needs-assessment to support the development of “effective district-wise health, heat and disaster management plans”. There are no given timelines for this lofty goal. It also advocates the “availability of medication and clean drinking water during climatic extremes and emergencies”. There are no measures indicated as to how either will be ensured.
The Karachi Heatwave Management Plan, a reaction to the 2015 Karachi heatwave, contains detailed guidance on surveillance systems and for issuing public alerts when extreme heat is expected. How closely that’s been followed this year is either a scathing indictment of the policy itself, or the district government responsible for implementing it.
Well-designed, thoughtful, and gender-sensitive social protection programmes aimed at protecting the poorest people from extreme heat should rank highly in our lawmakers’ priorities. Considering there is no provision in our rickety public welfare infrastructure for income support for people who are unable to work normal hours or who suffer sickness due to extreme heat, it is unlikely that Karachi has seen the last of its heat-related deaths. And with climate change taking no prisoners, it is especially likely that the same crisis will unfold next summer.
On July 1, Pakistan’s chief meteorologist Dr Sardar Sarfaraz told the press that the “sea breeze has been restored and the heatwave is over”. This is obviously a welcome development for Karachi’s homeless, daily wage earners, and people who must either brave the sweltering afternoon heat or go hungry.
While there is no expectation of the government holding any sway over the weather, to patiently wait for relief from nature is not a policy.
The writer is a human rights and public advocacy expert.
X: @Rimmel_Mohydin
Published in Dawn, July 6th, 2024
Heatwaves and hormones: How climate change is taking a toll on women’s menstruation cycles
Research shows menstruation is either delayed or occurs much earlier than expected in countries most vulnerable to climate change.
Published July 3, 2024
My sister got her first period at the tender age of seven and a half. Not prepared for the pain that comes with menstruation, the mental and physical exhaustion took the best of her. A year later, her period mysteriously stopped and never occurred again until the age of 12.
Menarche, the first menstrual period in a female adolescent, usually occurs between ages 10 and 16, with an average onset of 12.4 years. It often happens unexpectedly and is typically painless. However, the National Institute of Health (NIH) has recently found that menstruation is either delayed or occurs much earlier than expected in countries most vulnerable to climate change.
Pakistan is among the top-ranking countries that are bearing the brunt of this global crisis. Over the past 50 years, the country’s annual mean temperature has risen by about 0.5°C, with the number of heatwaves increasing nearly five-fold.
In May 2022, when temperatures across the country broke a 60-year record, 16-year-old Fariha Atiq — who started menstruating at the age of nine — witnessed possibly the worst period of her life.
“I was completely unequipped to deal with my period. Somehow I coped with it, but as time passed, the seasonal changes worsened my cramps. I remember in the summer of 2022, from April to August I couldn’t move my legs during my menstrual cycle,” she told Dawn.com.
Fariha’s mother, Mrs Atiq, took her to various gynaecologists but all of them described what the teenager was experiencing as ‘normal’, which was far from the pain she endured. Mild to moderate pain before and during menstruation is typical, but severe cramps can stem from various factors.
Mrs Atiq continued her search for a gynaecologist who could ascertain the reason for her daughter’s pain. Eventually, she found Dr Junaid Ansari, an obstetrics expert at Abbasi Shaheed Hospital, Karachi. He explained that the pain was caused by elevated levels of cortisol — a stress hormone influenced by temperature.
Cortisol increases with rising temperatures, contributing to dysmenorrhea, which nearly immobilised the teenager two years back.
Link between hormones and rising temperatures
For most women, menstruation is typically ‘painless’; some, however, experience severe cramps. This is a symptom of dysmenorrhea — pain during the menstrual cycle — and occurs due to the release of cortisol.
Cortisol is a hormone that is released during stressful situations and plays several roles in the female anatomy. It regulates blood sugar levels, metabolism, and blood pressure, and acts as an anti-inflammatory agent. Moreover, the hormone influences the menstrual cycle and prepares the body for pregnancy.
“The primary cause of a prolonged or delayed period can be the release of cortisol, which changes from season to season. For example, in winter, the release is higher, which disrupts the cycle,” Dr Ansari explained to Dawn.com.
The doctor highlighted, however, that he had observed the hormone peak during summers due to intense heat. “Very recently, I came across a 12-year-old girl with a decent body mass index, who wasn’t able to move due to extreme cramps, that too during May and July,” he shared.
“After recommending a cortisol blood test, we discovered that her cortisol level was 30 mcg/dL, significantly above the normal range of 14-20 mcg/dL for someone her age. We opted to monitor the levels and were surprised to find them returning to normal by the end of August following rainfall.
“While I continue my research, I am convinced that severe climate change is causing disruptions in menstrual cycles,” Dr Ansari added.
Extreme stress can disrupt the working of glands that control hormones such as cortisol and are responsible for the release of oestrogen needed for female reproductive characteristics.
Researchers at Poznan University of Medical Sciences in Poland have identified seasonal patterns in cortisol levels among female medical students. The study involved testing students twice in winter and twice in summer, with saliva samples collected every two hours over 24-hour periods to measure cortisol and inflammation markers.
Participants also completed lifestyle questionnaires detailing their sleep habits, diet, and physical activity levels. Unlike previous studies conducted in varied home environments, this research found higher cortisol levels during the summer sessions, while inflammation levels remained consistent across seasons. This further strengthens the argument that rising temperature has an impact on menstrual cycles.
(Un)common conditions
Contrary to popular opinion, dysmenorrhea is not a common condition.
“Most girls who come to me with cases of severe cramps are told by gynaecologists that cramps are normal, which is not true,” Dr Asifa Sofia of the Abbasi Shaheed Hospital told Dawn.com.
“This condition has developed in the last five years, and most patients I attend, the girls go through a painful period through winter,” she said.
Primary dysmenorrhea, the doctor explained, causes pain before and during menstruation. On the other hand, periods that become painful in the later stages could indicate secondary dysmenorrhea, which is often linked to conditions such as endometriosis or uterine fibroids that affect the uterus or pelvic organs.
“This usually occurs due to hormonal changes,” she highlighted, adding that painful periods and disruptions in blood flow were directly connected to erratic weather patterns in the region.
“I work with women from both urban and rural areas. One thing I have observed, which is a common pattern, is that with fluctuating temperatures, the sizes of follicles are affected, which in turn impacts the oestrogen levels,” Dr Sofia said.
The follicle is a small, fluid-filled sac in the ovary that contains one immature egg. Disruptions in size can alter hormones that regulate puberty, menstrual cycle, pregnancy, bone strength and other functions of the female body.
Sabiha, one of Dr Sofia’s patients from Thar, is being treated for an irregular period cycle. In May 2021, she started experiencing severe abdominal pain during menstruation. Like several other women, the 24-year-old initially brushed off the pain until one day, while working around the house, she fainted.
In Thar, May and June mark the hottest months of the year with temperatures reaching up to 122°F (50 °C).
“After that fall, my period has never been normal. I either bleed for 12 days straight or I don’t bleed at all. Irrespective of that, the pain stays the same,” she said. When asked if she had experienced such cramps before she began menstruating, Sabiha replied in the negative.
Sabiha is one such case. Dr Sofia told Dawn.com that she had treated patients after the 2022 floods whose period cycles took a hit from the massive disaster. “Today, even the slightest change in temperatures either alters their follicle size or their oestrogen levels which is alarming,” she pointed out.
Migration and displacement
“My period had always been regular until floods hit my town … suddenly, I started bleeding on random days,” Geetanjali, a resident of Balochistan’s Nasirabad district, recounted.
“I would not get periods for months, and then suddenly I would start bleeding out of nowhere,” said the 25-year-old. “Some days, the bleeding would be so bad and at other times it would just be a drop.”
These disruptions have taken a toll on Geetanjali’s physical health; she has lost 25 kilogrammes in the last three months.
Climate change triggers natural disasters, leading to mass migration which contributes to disturbance in the menstrual cycle. When Pakistan was hit by gigantic floods two years back, women went through brutal menstruation woes, the traces of which can be seen and felt even today.
Alongside poor menstrual hygiene, the affectees were also exposed to pollutants that affected the uterus. As per a systematic review published in the International Journal of Environmental Research and Public Health, pollutants affect the timing of menarche differently depending on the chemicals involved.
Studies have connected exposure to lead, polychlorinated biphenyls (PCBs), and flame retardants with delayed periods. Conversely, some toxicants such as endocrine-disrupting chemicals and the herbicide atrazine have been linked to early menarche.
PCBs were found in floodwaters heavily polluted with human and animal waste, impacting not only the onset of periods but also the shedding of the uterine lining, resulting in irregular menstrual cycles.
According to Geetanjali’s attending doctor Tahira Kashaf, the 25-year-old’s menstrual cycle had a lot to do with her sudden displacement and the stress that came with it.
“Her follicular size was affected by a high cortisol release and low oestrogen levels, leaving her body struggling with the heavy blood flow and cramps,” She said. “I’m concerned she might develop anaemia in a few days.”
The doctor added that a majority of female patients she had treated following the floods, particularly from Sindh and Balochistan, faced a similar problem.
“During a fertility cycle, when a follicle measures between 18 and 22 millimetres in diameter, it indicates rising oestrogen levels and thickening of the uterine lining. However, in the women who I treated post floods, the follicular size ranged between 9-12 millimetres, which indicated that oestrogen levels are extremely low,” Kashaf added.
Erratic patterns
In the past five years, Pakistan has experienced both intense heat and cold. Irregular periods aren’t limited to summer when temperatures rise rapidly, but can also occur in winters.
“I experienced intense cramps last year which made me scream, especially from the end of December to the middle of January,” said Arwa, 22. “I clocked my cycle and consulted a doctor, who asked me to get my melatonin checked.
“When I took the test towards the end of January, it was very low,” she recalled. Surprisingly, Arwa’s pain vanished by February, with regular menstruation cycles until April. But the pain returned in May, much more intense this time.
Aniqa Sajid, a mother of two, narrated going through a similar ordeal on the first and second days of her period.
“This is new to me because it has been happening for the last two years and it only happens during winters. Initially, it was just pain and I was able to move around, but with time … within six months it got so bad that even a couple of painkillers couldn’t help,” she said.
According to the NIH, the absence of natural sunlight during winter can disrupt serotonin and melatonin levels — which also play a part in regulating the menstrual cycle — in the body. This hormonal imbalance can lead to heavy periods. Additionally, when the temperatures decrease, blood vessels compress, leaving a narrower pathway for blood flow and contributing to heavier menstruation.
Dr Tahira Masood, a gynaecologist at the Liaquat National Hospital, also told Dawn.com that menstrual cramps can be intensified during winter.
“Dysmenorrhea is often caused by the secretion of hormone-like substances called prostaglandins. Cold weather can trigger an increase in these substances, leading to more painful cramps.
“The constriction of blood vessels in cold weather can exacerbate menstrual cramps. Many women report more severe cramps during winter, indicating that this is a common experience,” she explained.
Until a few years ago, menstruation was a taboo topic, hardly ever discussed in public. While this has improved over time, especially in urban areas, conversations on period pain and women’s health are still minimal.
As Pakistan scrambles to tackle the climate crisis, it is important to understand that this cannot be done without addressing gender equity, especially the underlying barriers that cause women to be disproportionately affected by natural disasters.
“Most women I come across have no clue that the changes they have been enduring in their menstrual cycles occur because of climate change,” Dr Tahira said, stressing the need for awareness.
She added that women’s health could not be compromised and in the long run, sustainable changes such as temperature-dependent tampons, hormonal medicines and other natural resources that keep the body running need to be normalised.
Aleezeh Fatimah is a pharmacist turned journalist. She tweets at @dalchawalorrone
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