ABSTRACT
Life in the Ganga–Meghna–Brahmaputra (GMB) delta is like the edge of a knife. This an environmentally vulnerable, densely populated and have recently become the ground zero of climate change. During the 19th century the Bengal delta was reclaimed from the sea and resettled by colonial revenue officials to shore up the fiscal coffers of the Bengal Presidency. Such land policy exposed peasants to tropical cyclones. In the 20th century twin political events, the partition of India in 1947 and the 1971 Bangladesh liberation war auxiliary, put pressure on the region’s limited land resource and ecology from East Bengal migrant refugees. Since then, the communities of the delta have been facing tripartite betrayals from a hostile geography, caste politics, and social marginality. In addition, the impact of climate change and global warming has led to worrying concerns among delta community members, policy makers, civil society actors, and environmentalists working on the fragile delta ecosystem. Disaster risk reduction (DRR) policies have strongly emphasized on disaster relief, structural measures such as constructing concrete embankments, and building other physical infrastructures. Policy makers and developmental stakeholders have paid inadequate attention to building long-term socio-economic resilience, leading to poor health outcomes and an increased disease burden on the community. This paper will pay attention to the intersectionality of climate and health vulnerability produced by poverty, indebtedness, sub-optimal public health care provisions, and growing social and economic inequalities in the delta. The livelihood uncertainty is mainly linked to male out-migration from the region that places an unfair physical work, disease, and nutritional burden on the female population in villages. The deprivation and compromise of a marginalized child’s health and wellbeing in villages of the GMB delta begin in the mother’s womb. Malnourished babies in their childhood bear the burden of malnutrition and communicable diseases. In their teens, most boys have to accompany their male household elders as migrant laborers; while the girls are smuggled or married to financially support the family. This precarious cycle continues to sustain a chain reaction of disease burden linked to livelihood emergency and food and nutritional insecurity. The paper will focus on the social determinants of health among Sundarbans residents. This is important because past studies in the delta have focused mainly on the clinical and epidemiological aspects of disease and its impact on vulnerable communities in the delta.
