**3. Findings**

depressions, intense precipitation, rising number of warm days and nights, and decreasing number of cold days and nights. AR4 and AR5 IPCC have predicted an increase in frequency and intensity of warm spells or heat waves in the end of twenty-first century, affecting to increase vector-borne diseases, water-borne diseases, reduce cold-related mortality, and diminish food production and labor productivity at different levels over most land areas of the earth [1, 2]. As a matter of fact, there is large number of studies on health effects of heat waves [3, 4]. Some of the studies argue that the contribution of rising in minimum temperatures has decreased in number of deaths associated with cold spells [5, 6]. On the other hand, there are few studies dealing with cold spells and health impacts. For instance, some studies indicated that the effects of extreme cold temperatures are generally more prolonged than heat wave without mortality displacement [3, 7]. However, most of the existing studies on health effects of cold spells are found to be associated with the temperate climate regions in developed countries, while there are very few such studies carried out in tropical or subtropical regions of developing countries [3,

Nepal has experienced global warming and its impacts on forming climate extremities, illhealth of the people, change in agricultural production patterns, etc. over the past recent decades. Cold wave is one of the climate extremities due to global warming in Nepal. The studies of National Agriculture Research Council (NARC) have indicated negative impacts of cold wave on agricultural productivity in Nepal [12]. Other studies have shown the health of the inhabitants being affected due to cold wave in the Tarai region of Nepal in the last two decades [13–16]. The present chapter intends to analyze the climate change patterns and the climate extremities such as cold wave and its impacts on the vulnerable populations in the

The vulnerable population is defined in terms of age group such as children below 5 years of age, pregnant women, and elderly population above 65 years of age [17]. The three subsets of under-five children, such as neonates <1 months, infant <1 year and <5 years, of which

The climate prevailing in Nepal can be divided into four seasons, based on rainfall and temperature conditions. They are rainy summer or Monsoon (June–September with rainy, hot, and humid weather), winter (December–February with coldest and driest weather), pre-monsoon (March–May with hot weather and thunderstorms) and post-monsoon (October–November with cool and pleasant weather). The climate data including monthly minimum and maximum temperatures for all individual years from 1974 to 2014 by the physiographic regions, such as mountain, hill, and Tarai have been acquired from all 67 weather stations from the Department of Hydrology and Meteorology, Kathmandu, and Nepal [19]. These data have been used for describing climate change patterns for all

neonates is the most vulnerable and it is followed by other subsets [18].

8–11].

Tarai region of Nepal.

144 Climate Change and Global Warming

**2. Methodology**

### **3.1. Brief introduction to physiography, climate, and population of Nepal**

#### *3.1.1. Physiography*

Geographically, Nepal can be divided into three broad physiographic regions, namely mountain, hill, and Tarai from north to south (**Figure 1**). The altitudes of these three regions range from 8848 m above sea level (masl) in the north to 60 masl in the south over an average northsouth span of 193 km [24]. Tarai refers to plain topography in Nepal.

The Tarai is the smallest physiographic region, sharing 23% of the country's total area, but it has the largest population with over 50% of the nation's total population of 26.6 million (**Table 1**). Population has increased consistently in this region during the past decades. In 1971, the Tarai's population had shared nearly 38% of the country's total population that increased to over 50% in 2011 [17]. The rapid growth of the Tarai population is considered due to natural cause and other causes including internal migration of population from the hills and international migration from adjoining Indian states [17, 21].

sub-tropical in the Tarai region to the arctic in the high Himalayas. Likewise, the annual precipitation also ranges from over 5000 mm in the Western and Eastern midland mountains to below 150 mm in the northern areas beyond high Himalayas, with an annual mean precipita-

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**Vulnerable groups Total population % of vulnerable population**

Under-five population 1,380,169 10.3 Expected pregnancies 350,497 2.6 Elderly population 534,018 4.0 Total 2,264,684 16.9

**Table 2.** Distribution of population of vulnerable groups in Tarai region, Nepal.

In Nepal, the annual trends of temperature patterns vary remarkably among four different seasons: summer monsoon, post-monsoon, winter and pre-monsoon, and those three physiographic regions (**Table 3**). The annual maximum and minimum temperature trends for the country as a whole are 0.056 and 0.002°C/year, respectively [19]. **Table 3** shows a negative trend of maximum temperature in contrast to the positive trend of minimum temperature

The mean annual maximum temperature for the Tarai region is 30.4 at 95% confidence interval (CI) of 36–30 and mean annual minimum temperature is 18.3 at 95% CI of 16–25. During the winter season, the mean minimum temperature in the Tarai region remains at 9.8°C with 95% CI of 9.5–10.1°C and mean maximum temperature is 23.2 with 95% CI of 22.7–23.7°C. While analysis of temperature trends by year is performed, a conspicuous distinction is found between two slots of years, such as 1974–2014 and 2000–2014 (**Table 4**). During the second slot of years: 2000–2014, negative trends are found in the annual mean minimum temperature, as well as in both mean maximum and minimum temperatures in the winter season in the Tarai region, but found a positive trend in the annual mean maximum temperature in this slot of years. Conversely, positive trends are found in all three temperature conditions during the first slot of years: 1974–2014 except in the winter maximum temperature, which shows negative trend. Thus, the analysis of two slots of periods of years shows a decreasing temperature

Cold waves generally occur in the Tarai region from mid-November to mid-February. On average, the duration of cold waves is found to be 8 days. In 2003, the duration of cold waves remained to be up to 60 days. However, the duration of cold waves prevailing in the Tarai has

Record of hourly average temperature data shows that the peak cold temperature appears to remain from December to January, where minimum temperature goes below 5°C for few

tion of 1858 mm [19, 25].

Source: [17, 21].

during the winter season in the Tarai region [19].

**3.2. Cold wave impacts on Tarai people**

hours during night (**Figure 3**).

risen since 2004, compared to that in 2000 (**Figure 2**).

scenario, particularly during the winter season in the Tarai region.

**Figure 1.** Physiographic regions of Nepal.


**Table 1.** Broad physiographic regions and their features.

**Table 2** exhibits that the combined populations of the vulnerable groups (under-five children, pregnant women, and elderly) account for about 17% of the Tarai's total population. For Nepal, the life expectancy at birth of Nepalese population is 66.51 years, whereas the death rate is 6.75 deaths/1000 population and infant mortality rate is 32 deaths/1000 live births [18].

#### *3.1.2. Climate*

Nepal lies within the subtropical climatic zone over the globe [19]. The climate is largely influenced by the Monsoon system, but there is also an influence of the cyclonic system originating from the Mediterranean Sea during the winter season. Owing to rise of altitude of mountains considerably from the south to the north, Nepal possesses diverse climate types ranging from


**Table 2.** Distribution of population of vulnerable groups in Tarai region, Nepal.

sub-tropical in the Tarai region to the arctic in the high Himalayas. Likewise, the annual precipitation also ranges from over 5000 mm in the Western and Eastern midland mountains to below 150 mm in the northern areas beyond high Himalayas, with an annual mean precipitation of 1858 mm [19, 25].

In Nepal, the annual trends of temperature patterns vary remarkably among four different seasons: summer monsoon, post-monsoon, winter and pre-monsoon, and those three physiographic regions (**Table 3**). The annual maximum and minimum temperature trends for the country as a whole are 0.056 and 0.002°C/year, respectively [19]. **Table 3** shows a negative trend of maximum temperature in contrast to the positive trend of minimum temperature during the winter season in the Tarai region [19].

The mean annual maximum temperature for the Tarai region is 30.4 at 95% confidence interval (CI) of 36–30 and mean annual minimum temperature is 18.3 at 95% CI of 16–25. During the winter season, the mean minimum temperature in the Tarai region remains at 9.8°C with 95% CI of 9.5–10.1°C and mean maximum temperature is 23.2 with 95% CI of 22.7–23.7°C. While analysis of temperature trends by year is performed, a conspicuous distinction is found between two slots of years, such as 1974–2014 and 2000–2014 (**Table 4**). During the second slot of years: 2000–2014, negative trends are found in the annual mean minimum temperature, as well as in both mean maximum and minimum temperatures in the winter season in the Tarai region, but found a positive trend in the annual mean maximum temperature in this slot of years. Conversely, positive trends are found in all three temperature conditions during the first slot of years: 1974–2014 except in the winter maximum temperature, which shows negative trend. Thus, the analysis of two slots of periods of years shows a decreasing temperature scenario, particularly during the winter season in the Tarai region.

#### **3.2. Cold wave impacts on Tarai people**

**Table 2** exhibits that the combined populations of the vulnerable groups (under-five children, pregnant women, and elderly) account for about 17% of the Tarai's total population. For Nepal, the life expectancy at birth of Nepalese population is 66.51 years, whereas the death rate is 6.75 deaths/1000 population and infant mortality rate is 32 deaths/1000 live

Mountain >4870 51,817 35.2 16 1.78 6.7 Hill 300–4870 61,345 41.7 39 11.39 43.0 Tarai <300 34,019 23.1 20 13.32 50.3 Total 147,181 100 75 26.49 100

**districts**

**km2 % In** 

**Population (2011)**

**%**

**million**

Nepal lies within the subtropical climatic zone over the globe [19]. The climate is largely influenced by the Monsoon system, but there is also an influence of the cyclonic system originating from the Mediterranean Sea during the winter season. Owing to rise of altitude of mountains considerably from the south to the north, Nepal possesses diverse climate types ranging from

births [18].

Source: [17].

**Figure 1.** Physiographic regions of Nepal.

146 Climate Change and Global Warming

**Table 1.** Broad physiographic regions and their features.

**Ecological regions Approximate elevation (m) Area Number of** 

*3.1.2. Climate*

Cold waves generally occur in the Tarai region from mid-November to mid-February. On average, the duration of cold waves is found to be 8 days. In 2003, the duration of cold waves remained to be up to 60 days. However, the duration of cold waves prevailing in the Tarai has risen since 2004, compared to that in 2000 (**Figure 2**).

Record of hourly average temperature data shows that the peak cold temperature appears to remain from December to January, where minimum temperature goes below 5°C for few hours during night (**Figure 3**).


**Table 3.** Seasonal temperature trends by physiographic regions, Nepal.


**Table 4.** Trends of maximum and minimum temperature trends in the Tarai region.

There are altogether 30 different types of disaster events being recorded in Nepal [20]. Of these events so far recorded, cold wave is the most crucial one. It is as large and serious as damage of crops due to disaster (**Table 5**). The effect of the cold wave is found across the country (see also **Figure 7**), or primarily in the high mountain region, where there is cold in most of the year, which is, however, not so significant because there exists very thinly scattered population, which mostly have been adapted to the cold climate. But it is crucially very significant in the Tarai region of Nepal, as it possesses largest population size and its poverty level is comparably large [17].

The distribution of average number of deaths due to cold wave by district across the country is found to be varied remarkably. **Figure 5** shows that the number of deaths due to cold wave

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Further, the deaths of people due to cold wave in the Tarai region are found to have taken place in 4 months (**Figure 6**). The distribution of the deaths is that: it has reached peak in January, with 71.5% and followed it by December (22.0%), February (3.8%), and November (2.4%).

**Figure 7** shows 2 years, 2004 and 2013, having the largest number of deaths due to cold wave in the Tarai. Though there is a fluctuation in the number of deaths due to cold wave, gradual rising of number of deaths is found since the year 2000 and more elevated trend of number

in the Tarai region were higher in its central and eastern districts than other parts [20].

**Figure 3.** Distribution of average hourly temperature by winter months, Tarai region.

**Figure 2.** Trend of duration of cold waves in Tarai region, 2000–2013.

of deaths since 2009.

**Figure 4** exhibits yearly trend of deaths of people due to cold wave, which is found to be increased exponentially at 13% per year. It is found that the number of deaths due to cold wave has speedily increased, particularly from the year 2000 onwards.

The magnitude of deaths of people due to cold wave in the Tarai is comparably large in the country, as shown in **Figure 5**. The total deaths from cold wave from 1974 to 2013 were recorded at 822. Of these total deaths, 89% took place in the Tarai region, followed by 9 and 2% in the Hill and the Mountain regions, respectively [20, 22].

**Figure 2.** Trend of duration of cold waves in Tarai region, 2000–2013.

**Figure 3.** Distribution of average hourly temperature by winter months, Tarai region.

There are altogether 30 different types of disaster events being recorded in Nepal [20]. Of these events so far recorded, cold wave is the most crucial one. It is as large and serious as damage of crops due to disaster (**Table 5**). The effect of the cold wave is found across the country (see also **Figure 7**), or primarily in the high mountain region, where there is cold in most of the year, which is, however, not so significant because there exists very thinly scattered population, which mostly have been adapted to the cold climate. But it is crucially very significant in the Tarai region of Nepal, as it possesses largest population size and its poverty

**Temperature conditions (°C/year) 1974–2014 2000–2014** Annual maximum 0.021 0.031 Annual minimum 0.018 −0.040 Winter maximum −0.016 −0.062 Winter minimum 0.024 −0,024

Tarai −0.004 0.018 0.036 0.028 0.021 Hill 0.046 0.049 0.055 0.052 0.052 Mountain 0.101 0.076 0.072 0.085 0.086

Tarai 0.025 0.015 0.015 0.013 0.018 Hill 0.004 0.004 0.014 0.006 0.010 Mountain −0.056 −0.021 0.013 −0.025 −0.015

**Figure 4** exhibits yearly trend of deaths of people due to cold wave, which is found to be increased exponentially at 13% per year. It is found that the number of deaths due to cold

The magnitude of deaths of people due to cold wave in the Tarai is comparably large in the country, as shown in **Figure 5**. The total deaths from cold wave from 1974 to 2013 were recorded at 822. Of these total deaths, 89% took place in the Tarai region, followed by 9 and

wave has speedily increased, particularly from the year 2000 onwards.

**Table 4.** Trends of maximum and minimum temperature trends in the Tarai region.

**Table 3.** Seasonal temperature trends by physiographic regions, Nepal.

**Physiographic regions Temperature trends °C per year (1974–2014)**

**Winter Pre-monsoon Monsoon Post-monsoon Annual**

2% in the Hill and the Mountain regions, respectively [20, 22].

level is comparably large [17].

Source: [19].

Maximum temperature

148 Climate Change and Global Warming

Minimum temperature

The distribution of average number of deaths due to cold wave by district across the country is found to be varied remarkably. **Figure 5** shows that the number of deaths due to cold wave in the Tarai region were higher in its central and eastern districts than other parts [20].

Further, the deaths of people due to cold wave in the Tarai region are found to have taken place in 4 months (**Figure 6**). The distribution of the deaths is that: it has reached peak in January, with 71.5% and followed it by December (22.0%), February (3.8%), and November (2.4%).

**Figure 7** shows 2 years, 2004 and 2013, having the largest number of deaths due to cold wave in the Tarai. Though there is a fluctuation in the number of deaths due to cold wave, gradual rising of number of deaths is found since the year 2000 and more elevated trend of number of deaths since 2009.


**Table 5.** Impacts of cold wave in Tarai region (1974–2014).

**Figure 4.** Death trend due to cold wave during the years 1974–2013.

#### **3.3. Age-specific vulnerable people**

The number of deaths due to cold wave is found varied remarkably among the age groups of vulnerable people. Of the total deaths, about 60% were children below the age of 5 years, while the 35% elderly population occupied 35% and others the rest 5%.

*3.4.2. Adaptation*

ing delivery.

**3.5. Mortality prediction**

Undoubtedly, impact of cold wave is severe among the local communities, whose economic status is poor, and also daily wage laborers are affected the most, as their wage works are hindered due to cold wave. Normally, they use fuelwood to combat the cold wave but that is not adequate to manipulate the room temperature to bring to the normal standard. In response to this, the Government of Nepal is found distributing fire wood to the local inhabitants of certain pocket areas, and warm clothes to the new born baby and mother in the hospital dur-

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**Figure 5.** Spatial distribution of deaths due to cold wave by district in Nepal (1974–2013).

**Figure 6.** Total number of deaths in Tarai region from 1974 to 2013.

The prediction of number of deaths of people due to cold wave has been carried out by using multiple linear regression, based on the data of three variables such as minimum temperature,

#### **3.4. Perception of the people**

#### *3.4.1. Cause of death*

The perception survey indicated that the deaths of the people in the Tarai were mainly due to severe cold, as poor people (children and elderly) with inadequate living conditions (lack of warm cloths and poor house-huts) could not combat with the impacts of severe cold wave. The deaths are found due to diseases like pneumonia, ARI, influenza, COPD, asthma, fever, and hypothermia.

**Figure 5.** Spatial distribution of deaths due to cold wave by district in Nepal (1974–2013).

**Figure 6.** Total number of deaths in Tarai region from 1974 to 2013.

#### *3.4.2. Adaptation*

**3.3. Age-specific vulnerable people**

**Figure 4.** Death trend due to cold wave during the years 1974–2013.

**3.4. Perception of the people**

*3.4.1. Cause of death*

Source: [20].

150 Climate Change and Global Warming

and hypothermia.

The number of deaths due to cold wave is found varied remarkably among the age groups of vulnerable people. Of the total deaths, about 60% were children below the age of 5 years,

**Description Cold wave % of cold wave among the total impacts due to disaster**

Deaths of human beings 822 2.5 Injured due to cold wave 83 0.1 Indirectly affected—morbidity 2405 0.0 Economic losses (US\$) 834,650,000 2.1 Damages of crops (Ha) 26906.5 2.6 Death of cattle 732 0.1

**Table 5.** Impacts of cold wave in Tarai region (1974–2014).

The perception survey indicated that the deaths of the people in the Tarai were mainly due to severe cold, as poor people (children and elderly) with inadequate living conditions (lack of warm cloths and poor house-huts) could not combat with the impacts of severe cold wave. The deaths are found due to diseases like pneumonia, ARI, influenza, COPD, asthma, fever,

while the 35% elderly population occupied 35% and others the rest 5%.

Undoubtedly, impact of cold wave is severe among the local communities, whose economic status is poor, and also daily wage laborers are affected the most, as their wage works are hindered due to cold wave. Normally, they use fuelwood to combat the cold wave but that is not adequate to manipulate the room temperature to bring to the normal standard. In response to this, the Government of Nepal is found distributing fire wood to the local inhabitants of certain pocket areas, and warm clothes to the new born baby and mother in the hospital during delivery.

#### **3.5. Mortality prediction**

The prediction of number of deaths of people due to cold wave has been carried out by using multiple linear regression, based on the data of three variables such as minimum temperature,

1974–2014, the analysis shows negative trends of minimum and maximum temperature conditions in the winter season during 2000–2014 years, indicating increase in the number of cold days in the Tarai. Globally, the annual numbers of warm nights and cold nights have increased and decreased by about 25 and 20 days, respectively, since 1951 [27]. In Nepal, the annual numbers of cool days and cool nights have decreased by about 5 and 9 days, respectively from 1971 to 2006, but however, during the same time period, the warm days have increased by about 16 days and warm nights have increased by only about 7 days [28]. It is interesting to note here that the decreasing trend of cool days and increasing trend of warm

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Death of people due to cold wave is increasing in the Tarai due to increasing duration of cold wave. Tarai region also suffers death of people from heat wave, as it is the hottest region of Nepal. However, the number of deaths due to cold wave is larger than that due to hot wave in the Tarai. The study of MoHA found that the number of deaths in the Tarai due to heat wave from May to August was 45 during the years 1974–2013, which was, however, quite low as compared to the 822 deaths due to cold wave from November to February during the same year duration [20]. The impact of heat wave was mostly on the elderly people, while that of

Death of people in the Tarai is found not only due to cold wave but also because of lack of facilities in living places or public hospitals [19, 26, 29]. For instance, during the severe cold months, the average indoor room temperature was found so low than the normal standard [13, 15]. Even in the hospitals, there was seldom provision of room heating system, resulted into death of neonatal and under-five children due to hypothermia and acute respiratory problem [15]. Further, there has been an increasing trend of mortality and morbidity due to respiratory diseases like ARI, COPD and cardiovascular diseases as a result of decreased temperature or cold wave in the Tarai region of Nepal [16]. The same study has predicted that there will be decrease in number of death of people by 2.68% due to ARI as per 1°C rise in minimum temperature. A study carried out in Sarlahi district of Tarai region found out that about 92% of new born babies born in winter suffered from the hypothermia [30]. Overall, only 10.7% of neonates have received optimum thermal care as per the WHO guidelines [15]. In addition to the deaths of people, there are other adverse impacts of cold wave in the Tarai region. Running schools and daily life and livelihoods of people usually are severely interrupted by the cold waves, especially, the vulnerable people like children, elderly and pregnant with low-income groups, and homeless people and daily waged people are affected the most. It is found that cold wave is a risk factor for diseases like respiratory, cardiovascular, viral influenza and Rotavirus infection [16]. Further, during the onset of cold wave, there would be poor visibility leading to increasing trend of road injuries and interruptions in aviation industry, which ultimately hinder livelihood. Outbreaks of avian influenza have a highly seasonal pattern, with nearly all outbreaks occurring in January and February [31]. In mid-winter, especially, the Tarai region can experience cold waves, which often cause crop

Undoubtedly, impact of cold wave is severe on the community, whose economic status is poor, and daily wage laborers are also affected the most, as their activities are hindered due

days are clearly seen at higher elevations in Nepal [28].

cold wave was on children.

damage that may lead to famine [20, 32].

**Figure 7.** Mortality per month/year due to cold wave in Tarai region.

maximum temperature and rainfall from 1974 to 2014. A significant regression equation was found at [F(3, 38) = 4.258, p < 0.05)], with an R<sup>2</sup> of 0.252. The prediction of the number of deaths by employing the multiple linear regression is found equal to 814.84 + 20.07 (minimum temperature) − 40.70 (maximum temperature) − 0.561 (rainfall), where minimum temperature and maximum temperature are measured with degree centigrade (°C) and rainfall in millimeter (mm). Number of deaths of people is found to be decreased by 20 with an increase of 1° minimum temperature. On the other hand, the number of deaths is calculated at 54 people with a decrease of 1°C of temperature and 0.56 deaths with each millimeter decrease in rainfall.

The multiple regression tool has been used to predict the number of deaths from 2000 to 2013 considering the same three variables and the significant regression equation was found [F[3, 11] = 1.483, p < 0.05)], with an R<sup>2</sup> of 0.29. Prediction of the number of deaths based on the multiple linear regression is equal to 980.45 − 32.442 (minimum temperature) − 25.695 (maximum temperature) − 0.066 (ml), where temperature conditions are measured with degree centigrade (°C) and rainfall is measured in millimeter (mm). The number of deaths is calculated to increase at 32, with a decrease of each degree in minimum temperature. Similarly, 26 people are expected to die with decrease of 1° temperature and 0.066 deaths will occur with a decrease of each millimeter of rainfall.

### **4. Discussions**

As other countries across the world, Nepal has also experienced increasing trend in average annual temperature as well as in minimum and maximum temperature conditions [26]. But however, since the last two decades, Nepal's Tarai region has got a decreasing trend of minimum temperature in winter season, unlike other regions [19]. While attempts have been made to analyze the temperature trend, two slots of year duration such as 1974–2014 and 2000–2014 were found as distinctive. In contrast to the trend of temperature conditions during 1974–2014, the analysis shows negative trends of minimum and maximum temperature conditions in the winter season during 2000–2014 years, indicating increase in the number of cold days in the Tarai. Globally, the annual numbers of warm nights and cold nights have increased and decreased by about 25 and 20 days, respectively, since 1951 [27]. In Nepal, the annual numbers of cool days and cool nights have decreased by about 5 and 9 days, respectively from 1971 to 2006, but however, during the same time period, the warm days have increased by about 16 days and warm nights have increased by only about 7 days [28]. It is interesting to note here that the decreasing trend of cool days and increasing trend of warm days are clearly seen at higher elevations in Nepal [28].

Death of people due to cold wave is increasing in the Tarai due to increasing duration of cold wave. Tarai region also suffers death of people from heat wave, as it is the hottest region of Nepal. However, the number of deaths due to cold wave is larger than that due to hot wave in the Tarai. The study of MoHA found that the number of deaths in the Tarai due to heat wave from May to August was 45 during the years 1974–2013, which was, however, quite low as compared to the 822 deaths due to cold wave from November to February during the same year duration [20]. The impact of heat wave was mostly on the elderly people, while that of cold wave was on children.

maximum temperature and rainfall from 1974 to 2014. A significant regression equation was

deaths by employing the multiple linear regression is found equal to 814.84 + 20.07 (minimum temperature) − 40.70 (maximum temperature) − 0.561 (rainfall), where minimum temperature and maximum temperature are measured with degree centigrade (°C) and rainfall in millimeter (mm). Number of deaths of people is found to be decreased by 20 with an increase of 1° minimum temperature. On the other hand, the number of deaths is calculated at 54 people with a decrease of 1°C of temperature and 0.56 deaths with each millimeter decrease

The multiple regression tool has been used to predict the number of deaths from 2000 to 2013 considering the same three variables and the significant regression equation was found

multiple linear regression is equal to 980.45 − 32.442 (minimum temperature) − 25.695 (maximum temperature) − 0.066 (ml), where temperature conditions are measured with degree centigrade (°C) and rainfall is measured in millimeter (mm). The number of deaths is calculated to increase at 32, with a decrease of each degree in minimum temperature. Similarly, 26 people are expected to die with decrease of 1° temperature and 0.066 deaths will occur with a

As other countries across the world, Nepal has also experienced increasing trend in average annual temperature as well as in minimum and maximum temperature conditions [26]. But however, since the last two decades, Nepal's Tarai region has got a decreasing trend of minimum temperature in winter season, unlike other regions [19]. While attempts have been made to analyze the temperature trend, two slots of year duration such as 1974–2014 and 2000–2014 were found as distinctive. In contrast to the trend of temperature conditions during

of 0.252. The prediction of the number of

of 0.29. Prediction of the number of deaths based on the

found at [F(3, 38) = 4.258, p < 0.05)], with an R<sup>2</sup>

**Figure 7.** Mortality per month/year due to cold wave in Tarai region.

[F[3, 11] = 1.483, p < 0.05)], with an R<sup>2</sup>

decrease of each millimeter of rainfall.

in rainfall.

152 Climate Change and Global Warming

**4. Discussions**

Death of people in the Tarai is found not only due to cold wave but also because of lack of facilities in living places or public hospitals [19, 26, 29]. For instance, during the severe cold months, the average indoor room temperature was found so low than the normal standard [13, 15]. Even in the hospitals, there was seldom provision of room heating system, resulted into death of neonatal and under-five children due to hypothermia and acute respiratory problem [15]. Further, there has been an increasing trend of mortality and morbidity due to respiratory diseases like ARI, COPD and cardiovascular diseases as a result of decreased temperature or cold wave in the Tarai region of Nepal [16]. The same study has predicted that there will be decrease in number of death of people by 2.68% due to ARI as per 1°C rise in minimum temperature. A study carried out in Sarlahi district of Tarai region found out that about 92% of new born babies born in winter suffered from the hypothermia [30]. Overall, only 10.7% of neonates have received optimum thermal care as per the WHO guidelines [15].

In addition to the deaths of people, there are other adverse impacts of cold wave in the Tarai region. Running schools and daily life and livelihoods of people usually are severely interrupted by the cold waves, especially, the vulnerable people like children, elderly and pregnant with low-income groups, and homeless people and daily waged people are affected the most. It is found that cold wave is a risk factor for diseases like respiratory, cardiovascular, viral influenza and Rotavirus infection [16]. Further, during the onset of cold wave, there would be poor visibility leading to increasing trend of road injuries and interruptions in aviation industry, which ultimately hinder livelihood. Outbreaks of avian influenza have a highly seasonal pattern, with nearly all outbreaks occurring in January and February [31]. In mid-winter, especially, the Tarai region can experience cold waves, which often cause crop damage that may lead to famine [20, 32].

Undoubtedly, impact of cold wave is severe on the community, whose economic status is poor, and daily wage laborers are also affected the most, as their activities are hindered due to cold wave. As they are poor, they burn locally available fuelwood or straw, which are also available in small quantity, to combat the cold wave, but this is found not adequate to manipulate the room temperature to bring to the normal standard. Government's effort in this case is very crucial. The government agencies used to distribute fire wood in some pocket areas and warm clothes to the new born baby and delivered mother in the hospitals. Until now, these mere efforts so far undertaken by the government to address the adverse impacts of cold wave seem inadequate. As health is directly and indirectly affected by climate change via various pathways, there should be a priority focus on health in national adaptation sustainable plans for the medium- and long-term needs of all sectors, such as multisectoral preparedness plans [25, 26].

[3] Analitis A, Katsouyanni K, Biggeri A, Baccini M, Forsberg B, Bisanti L, et al. Effects of cold weather on mortality: Results from 15 European cities within the PHEWE project.

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[6] Ebi KL, Mills D. Winter mortality in a warming climate: A reassessment. Wiley Inter-

[7] Kysely J, Pokorna L, Kyncl J, Kriz B. Excess cardiovascular mortality associated with

[8] Cagle A, Hubbard R. Cold-related cardiac mortality in King County, Washington, USA

[9] Healy JD. Excess winter mortality in Europe: A cross country analysis identifying key risk factors. Journal of Epidemiology and Community Health. 2003;**57**(10):784-789 [10] Liu C, Yavar Z, Sun Q. Cardiovascular response to thermoregulatory challenges. The American Journal of Physiology—Heart and Circulatory Physiology. 2015;**309**(11):

[11] Zhou MG, Wang LJ, Liu T, Zhang YH, Lin HL, Luo Y, et al. Health impact of the 2008 cold spell on mortality in subtropical China: The climate and health impact national

[12] Malla G. Climate change and its impact on Nepalese agriculture. Journal of Agriculture

[13] Ellis M, Manandhar N, Shakya U, Manandhar D, Fawdry A, Costello A. Postnatal hypothermia and cold stress among newborn infants in Nepal monitored by continuous ambulatory recording. Archives of Disease in Childhood. Fetal and Neonatal Edition.

[14] Mullany LC, Katz J, Khatry SK, LeClerq SC, Darmstadt GL, Tielsch JM. Risk of mortality associated with neonatal hypothermia in southern Nepal. Archives of Pediatrics &

[15] Khanal V, Gavidia T, Adhikari M, Mishra SR, Karkee R. Poor thermal care practices among home births in Nepal: Further analysis of Nepal demographic and health survey

[16] WHO.Report on Assessment of Health Effects of Cold Waves in Terai Nepal. Kathmandu:

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Health: A Global Access Science Source. 2016;**15**(Suppl):1-33

cold spells in the Czech Republic. BMC Public Health. 2009;**9**(1):19

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H1793-H1812

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Adolescent Medicine. 2010;**164**(7):650-656

2011. PLoS One. 2014;**9**(2):e89950

The Green Move Consultancy; 2017

1996;**75**(1):F42-FF5

## **5. Conclusion and recommendation**

It is evident that the average minimum temperature trend during the winter months is declining in the Tarai region of Nepal. The predictions of minimum and maximum temperature trend with regard to number of deaths have been made with different scenarios, that is, increasing or decreasing of 1°C affecting the change in number of death of people by using the modest model of multiple linear regression. Number of deaths due to cold wave in the Tarai has increased over the past two decades due to increasing duration of cold waves in the winter months. Adverse impacts are seen more on vulnerable groups of population such as under-five children and elderly. These are no doubt, the impacts due to global or regional warming, change in land uses, rapid urbanization, etc. It is urgently essential that the adaptation strategy and plans should be designed and implemented to address the increasing trend of cold wave in the Tarai region and other regions based on the findings and recommendations of the rigorous studies.

### **Author details**

Bandana Pradhan1 \*, Puspa Sharma<sup>2</sup> and Pushkar K. Pradhan<sup>2</sup>


### **References**


[3] Analitis A, Katsouyanni K, Biggeri A, Baccini M, Forsberg B, Bisanti L, et al. Effects of cold weather on mortality: Results from 15 European cities within the PHEWE project. American Journal of Epidemiology. 2008;**168**(12):1397-1408

to cold wave. As they are poor, they burn locally available fuelwood or straw, which are also available in small quantity, to combat the cold wave, but this is found not adequate to manipulate the room temperature to bring to the normal standard. Government's effort in this case is very crucial. The government agencies used to distribute fire wood in some pocket areas and warm clothes to the new born baby and delivered mother in the hospitals. Until now, these mere efforts so far undertaken by the government to address the adverse impacts of cold wave seem inadequate. As health is directly and indirectly affected by climate change via various pathways, there should be a priority focus on health in national adaptation sustainable plans for the medium- and long-term needs of all sectors, such as multisectoral

It is evident that the average minimum temperature trend during the winter months is declining in the Tarai region of Nepal. The predictions of minimum and maximum temperature trend with regard to number of deaths have been made with different scenarios, that is, increasing or decreasing of 1°C affecting the change in number of death of people by using the modest model of multiple linear regression. Number of deaths due to cold wave in the Tarai has increased over the past two decades due to increasing duration of cold waves in the winter months. Adverse impacts are seen more on vulnerable groups of population such as under-five children and elderly. These are no doubt, the impacts due to global or regional warming, change in land uses, rapid urbanization, etc. It is urgently essential that the adaptation strategy and plans should be designed and implemented to address the increasing trend of cold wave in the Tarai region and other regions based on the findings and recommendations of the rigorous studies.

and Pushkar K. Pradhan<sup>2</sup>

[1] Pachauri RK, Allen MR, Barros VR, Broome J, Cramer W, Christ R, et al. Climate change 2014: Synthesis report. In: Contribution of Working Groups I, II and III to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. IPCC; 2014

[2] Pachauri RK, Reisinger A. IPCC Fourth Assessment Report. Geneva: IPCC; 2007

preparedness plans [25, 26].

154 Climate Change and Global Warming

**Author details**

Bandana Pradhan1

**References**

**5. Conclusion and recommendation**

\*, Puspa Sharma<sup>2</sup>

\*Address all correspondence to: bandana@reachpuba.org

1 Institute of Medicine, Tribhuvan University, Kathmandu, Nepal

2 Central Department of Geography, Tribhuvan University, Kirtipur, Nepal


**Chapter 10**

,

**Provisional chapter**

**A Survey of Disaster Risk and Resilience in Small Island**

**A Survey of Disaster Risk and Resilience in Small Island** 

This paper surveys the conceptual framework of disaster risk that relies on its associated components of hazard, vulnerability and exposure. How we measure these risks depends on how we define disaster risk and its components. We focus on the implication and applicability of available conceptual frameworks of disaster risk on small and low-lying islands in the Pacific. We examine some of the available measurements of these disaster risks as they are imperative to the formulation of appropriate disaster risk reduction (DRR) policies for Tuvalu. Though there are diverse views on these definitions in different disciplines, we can capitalise on their commonalities to frame disaster risk models. Here, we intend to use the findings and set a pathway for potential research and to contribute into building resilience, reducing DRR and improving responsiveness to the

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

and reproduction in any medium, provided the original work is properly cited.

<sup>1</sup>According to [2] small countries are more vulnerable to windstorms than other countries which can lead to a decline

Natural disasters such as cyclones, earthquakes, floods, tsunamis, storm surges and heatwaves have distressed the lives of the people around the world. The Asia-Pacific region is the most highly exposed to disasters in the world, with the highest overall disaster-related deaths, representing 75% of global mortality for the years between 1970 and 2011 [1]. Changes in the climate, sea level rise and the intensity of climatic disasters like tropical cyclones1

DOI: 10.5772/intechopen.80266

**States**

**States**

Tauisi Minute Taupo

Tauisi Minute Taupo

**Abstract**

**1. Introduction**

of 3% in GDP per capita.

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

impact of climatic disasters in Pacific Islands.

**Keywords:** disaster risk, hazard, exposure, vulnerability, resilience

http://dx.doi.org/10.5772/intechopen.80266


#### **A Survey of Disaster Risk and Resilience in Small Island States A Survey of Disaster Risk and Resilience in Small Island States**

DOI: 10.5772/intechopen.80266

#### Tauisi Minute Taupo Tauisi Minute Taupo

[17] CBS. Population Monograph of Nepal 2014. Government of Nepal; 2014

Ministry of Health, Nepal; New ERA; and ICF; 2016

of Educational Measurement. 2014;**51**(3):335-337

Population and Environment (MoPE); 2017

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Lancet. 2006;**367**(9514):910-918

Project (IDA-H2680); 2013

Geophysical Research-Atmospheres. 2006;**111**(D5):1-22

and Population; 2015

156 Climate Change and Global Warming

[18] MoH. Nepal Demographic and Health Survey 2016: Key Indicators. Kathmandu, Nepal:

[19] DHM. In: Meteriology DoHa, editor. Observed Climate Trend Analysis in the Districts

[20] MoHA. Nepal Disaster Report 2015. Government of Nepal, Ministry of Home Affairs

[21] DoHS. In: Servises DoH, editor. Annual report 2013/14. Kathmandu: Ministry of Health

[22] UNISDR. Disaster Database Sendai Framework Nepal [Internet]. Available from: http://

[23] Bolin JH, Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach; 2013. New York, NY: The Guilford Press. Journal

[24] MoPE. Climate Change and Glacial Lake Outburst Floods in Nepal, Kathmandu. Kathmandu: ICEM—International Centre Environmental Management with the Nepal

[25] MoPE. Synthesis of Stocktaking Report for National Adaptation Plan (NAP) Formulation Process in Nepal. Kathmandu: Ministry of Population and Environment; 2017

[26] MoPE. Vulnerability and Risk Assessment Framework and Indicators for National Adaptation Plan (NAP) Formulation Process in Nepal. Kathmandu: Ministry of

[27] Alexander L, Zhang X, Peterson T, Caesar J, Gleason B, Tank AK, et al. Global observed changes in daily climate extremes of temperature and precipitation. Journal of

[28] Baidya SK, Shrestha ML, Sheikh MM. Trends in daily climatic extremes of temperature and precipitation in Nepal. Journal of Hydrology and Meteorology. 2008;**5**(1):38-51 [29] Dhimal M, Dhimal ML, Pote-Shrestha RR, Groneberg DA, Kuch U. Health-sector responses to address the impacts of climate change in Nepal. WHO South-East Asia

[30] Mullany LC, Darmstadt GL, Khatry SK, Katz J, LeClerq SC, Shrestha S, et al. Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: A community-based, cluster-randomised trial. The

[31] World-Bank. Project Performance Assessment Report Nepal: Avian Influenza Control

[32] Rohwerder B. Seasonal Vulnerability and Risk Calendar in Nepal. Applied Knowledge

Services. Governance Social Development Humanitarian Conflict; 2016

Ministry of Population and Environment (MoPE) as part of TA–7984 NEP; 2014

and Physiographic Regions of Nepal (1971-2014). Kathmandu: MoPE; 2017

(MoHA) & Disaster Preparedness Network-Nepal (DPNet-Nepal); 2015

www.desinventar.net/DesInventar/profiletab.jsp?countrycode=np

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80266

#### **Abstract**

This paper surveys the conceptual framework of disaster risk that relies on its associated components of hazard, vulnerability and exposure. How we measure these risks depends on how we define disaster risk and its components. We focus on the implication and applicability of available conceptual frameworks of disaster risk on small and low-lying islands in the Pacific. We examine some of the available measurements of these disaster risks as they are imperative to the formulation of appropriate disaster risk reduction (DRR) policies for Tuvalu. Though there are diverse views on these definitions in different disciplines, we can capitalise on their commonalities to frame disaster risk models. Here, we intend to use the findings and set a pathway for potential research and to contribute into building resilience, reducing DRR and improving responsiveness to the impact of climatic disasters in Pacific Islands.

**Keywords:** disaster risk, hazard, exposure, vulnerability, resilience

### **1. Introduction**

Natural disasters such as cyclones, earthquakes, floods, tsunamis, storm surges and heatwaves have distressed the lives of the people around the world. The Asia-Pacific region is the most highly exposed to disasters in the world, with the highest overall disaster-related deaths, representing 75% of global mortality for the years between 1970 and 2011 [1]. Changes in the climate, sea level rise and the intensity of climatic disasters like tropical cyclones1 ,

<sup>1</sup>According to [2] small countries are more vulnerable to windstorms than other countries which can lead to a decline of 3% in GDP per capita.

© 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

droughts and floods have an extremely negative impact on economies, communities, households, people and physical assets [3, 4]. Developing countries are especially vulnerable to these impacts due to their underlying limited natural endowments, economic constraints and limited adaptive capacity [5]. Small Island Developing States (SIDS) are especially vulnerable to large-scale economic and environmental disasters, whereby their geography and size make them highly exposed and vulnerable, with less capacity to respond [6].

**2. Disaster risk**

future time period'.

**2.1. Hazard**

given time and place.

Natural disasters affect people worldwide, causing losses and damages. Climate change and its influence on the frequency and intensity of natural disasters have been part of the emer-

Ref. [10] defined disaster as 'a serious disruption of the functioning of a community or a society involving widespread human, material, economic or environmental losses and impacts, which exceeds the ability of the affected community or society to cope using its own resources'. Here, disasters are being described in relation to exposure, vulnerability and coping mechanisms. The definition of disaster risk reflects on the meaning of disasters; disaster risk is not only the likelihood of a disastrous event but also often associated with mechanisms that inflate the impacts of such events. Particularly, disaster risk is a function of three interlinked components: hazard, exposure and vulnerability [11]. By definition, [10] refers to disaster risk as 'the potential disaster losses, in lives, health, status, livelihoods, assets and services, which could occur to a particular community or a society over some specified

Refs. [12, 13] elaborate on the framework of the 'dual-faced' character of nature that presents a set of possible opportunities and possible hazards, emphasising that disasters are not solely driven by the natural environment but also influenced by human activities, that is, they are the product of political, social and economic environments. They also introduced a conceptual framework that defines and explains the relationship between risks, hazards and vulnerability. This pressure and release (PAR) framework illustrates that the intersection of hazard, vulnerability and coping and recovering capacities correspond to disaster risk. Moreover, [13] advanced the framework of 'progression and vulnerability' comprising of root causes, dynamic

limited access to resources that allow for risk reduction impedes coping and recovery mechanisms for hazards. Nevertheless, disaster risk and its underlying components (hazard, exposure and vulnerability) are changing in relation to the changes in the environment and political,

Hazard is widely recognised as an extreme natural event or process [13], a potential harmful event or process [4], or a hazardous phenomenon [14]. In the past, natural hazards and their

In addition to naturally occurring hazards, the evolution of the way we look at disasters has unfolded new components of disaster risk and extended its scope. [10] refers to hazard as 'a dangerous phenomenon, substance, human activity or condition that may cause loss of life,

6 'Root causes' in this context centres around existing social, economic (e.g. distribution of resources, wealth and power) and political structures. 'Dynamic pressures' concerns with societal deficiencies (relating to economic opportunities) and lack of macro forces. Unsafe conditions are specifically associated with the situation facing vulnerable people in a

This framework reflects the fact that

A Survey of Disaster Risk and Resilience in Small Island States

http://dx.doi.org/10.5772/intechopen.80266

159

gence of the new branch of economic research on the economics of disasters.

pressures and fragile livelihoods and unsafe locations.6

characteristics were the main focus of discourses relating to disasters.

economic and social aspects of society [11].

In the Pacific region, climate-related disaster risk has been increasing in the past decades, most likely because of increased exposure of people and economic assets. Within the Pacific SIDS, the smaller island states<sup>2</sup> like of Tuvalu and Kiribati consist of low-lying3 stretches of atoll islands that are most vulnerable countries to climate change, sea level rise and climatic disasters4 , particularly to destructive cyclones with associated storm surges that can easily flood large parts of the islands. By United Nations (UN) standards, smaller island states are mostly categorised as least developed countries (LDCs). Their vulnerability, exposure and economic status slow their graduation from being LDCs. We focus on Tuvalu and Kiribati as they are low-lying atolls and sovereign states within the Smaller Pacific Island States. In Tuvalu, natural disasters such as cyclones with associated storm surges often flood some islands, inflicting significant damage on the livelihoods and physical assets of the population, while imposing adverse effects on the economy and ecosystems.

The cyclone of 1972 is the worst event ever experienced by Tuvalu.5 However, there have been other noticeable strong storms in the recent past. A more recent event, in 2015, was a distant cyclone (about 1000 km away) called Tropical Cyclone Pam (TC Pam), affecting the islands of Tuvalu with estimated damage and losses of 10% of GDP [9]. The changes in weather patterns and the threat of rising sea levels due to climate change further aggravate these threats.

This inquiry reviews the growing body of the recent literature on disaster risk and associated components influencing it. We aim to understand the concepts of disaster risk in order to recognise its challenges, opportunities and implications for SIDS, particularly low-lying islands like Tuvalu. Through this, we can acquire ideas of what is needed to improve disaster risk management (DRM) and ways to advocate for and strengthen disaster risk reduction (DRR) efforts. Reviewing the literature on disaster risk will also situate this research in its broader context, in order to provide direction for future research in this growing field, with the focus on small island states.

<sup>2</sup> Smaller island states classified under the Pacific Islands Forum comprise Cook Islands, Federated States of Micronesia, Kiribati, Marshall Islands, Nauru, Niue, Palau and Tuvalu.

<sup>3</sup>Ref. [7] stated that the whole land in Tuvalu lies below 5 m.

<sup>4</sup>Vulnerable to natural disasters in per capita terms.

<sup>5</sup> Ref. [8] stated that 'In October 1972, cyclone "Bebe" hit Tuvalu, killing several people destroying millions of dollars worth of property. The capital atoll of Funafuti was engulfed by waves from both the ocean and lagoon side, with a huge 19 km long, 30–40 m wide and 4 m high embankment (called a "storm ridge") being formed as a consequence of the waves moving huge quantities of sediments. The storm damaged houses, infrastructure, boats, coconut trees, the reef flats and caused extensive scouring of the islets in the atoll.' (See http://www.janeresture.com/hurribebe/hurricanebebe2. htm for full details of the impact of cyclone Bebe on Funafuti Island, including documented stories from seven people who experienced the devastation of the event).
