One of Africa’s starkest illustrations of climate change is found on the dried and desiccated shores of Lake Chad. 

Within the last 60 years, drought and overuse have drained 90 percent of the lake’s water. Cameroon, Chad, Niger, and Nigeria all depend on it for irrigation and clean water. The effects of this ecological disaster in the Sahel region — forced migration and even political violence — are the social effects of climate change, an observation made by Médecins Sans Frontières (MSF) teams in the region. “The Sahel, long affected by conflict and insecurity, is now also increasingly affected by environmental factors that seriously impact the health and nutrition of its populations,” reads a 2018 policy brief written in partnership with The Lancet Countdown. 

MSF is a humanitarian organization that assists the survivors of natural disasters, conflict, epidemics, and people excluded from medical care. These days, the organization’s medical teams are also treating the survivors of catastrophes augmented by climate change. “It’s more that we’re seeing people’s vulnerabilities increasing,” says Carol Devine, lead with Climate-Smart MSF. From the disappearance of Lake Chad to super-typhoons in Bangladesh, MSF is already bearing witness to these devastating effects — and looking inward. 

Greenhouse gas emissions are inherent to international humanitarian efforts today.

Greenhouse gas emissions are inherent to international humanitarian efforts today. Flying to dozens of countries, distributing food with trucks, and powering most field hospitals require fossil fuels. Around 4,000 NGOs working on humanitarian responses have consultative status with the United Nations, a process that gives them access to the vast global body’s resources (although there are likely others who work independently). As a humanitarian organization, MSF adheres to what its website calls “the principles of impartiality, independence and neutrality.” But it also respects another code: medical ethics. “We have an ethical obligation to do no harm,” Devine says. That includes through MSF’s efforts to save human lives and mitigate the unfortunate, but necessary, environmental footprint those efforts entail. The organization’s Climate-Smart plan represents an honest attempt to curtail its environmental impact where necessary and eliminate wherever possible. 

Around 40,000 MSF staff are currently operating in over 70 countries around the world. Their teams are working on Hepatitis B in Cambodia, maternal health in Afghanistan, and mental health in Chechnya. (Devine says MSF’s COVID-19 pandemic response included deploying to the U.S., a first for the organization). In short, MSF is vast, and addressing its climate impacts may seem daunting at first. Step one is calculating the organization’s total GHG emissions. MSF piloted an internal toolkit to measure its GHG impact in five countries — Mexico, Honduras, Kenya, Switzerland, and Canada — in July 2019. Public results show the GHG emissions for MSF projects in Papua New Guinea, Bangladesh, Cambodia and Pakistan totalled 1795 tonnes of CO2. But Devine says, so far, MSF has results for 14 countries.  “What you measure, you mitigate,” she says. “It also means you can set targets and see what your progress is…and the hotspots in your emissions calculations.” 

As MSF expected, its air freight and air travel constituted the largest portion of measured GHG emissions. While the organization can’t necessarily cut out air freight entirely, especially for its food supply programs, Devine says it can reconsider using aircraft for non-emergency deliveries. MSF can also change its travel policies for non-essential trips. “When we measured our footprint and saw what our international travel was — even our Toronto to Montreal travel, because we have an office there — we really switched to train,” she says. “We made options to not go to meetings.” Of course, as the COVID-19 pandemic continues, holding digital meetings is now common practice for large organizations. 

Then there is the process of powering MSF operations, the organization’s second-largest source of pollution. In regions without a functional grid, diesel generators are the norm for field hospitals, refugee camps, and other facilities. “We use a lot of diesel and diesel is dirty,” Devine says. Some operations require diesel to be trucked into the camps themselves, adding a level of pollution before the fuel is even burned. There are several ways MSF is cutting down. One is simply moving away from diesel generators, and MSF is already moving in that direction. “We’ve been using solar in Afghanistan for decades,” Devine says. Switching across the entire organization wouldn’t just improve MSF’s environmental footprint, she says, it would also save money and improve operations in particularly remote areas. 

Ultimately, Devine says, improving MSF’s environmental footprint isn’t just about radical transformation in particular areas. It’s about discovering incremental improvements across MSF’s entire scope of operations. “We want to look at that whole supply chain and find efficiencies all the way,” she says. Reducing paper use in MSF’s U.S. and Canadian offices is one way. Another is looking at the deployment of its vehicle fleet (“In cities, we don’t need Land Cruisers,” she says).  Waste management is a whole other aspect of MSF’s climate plan. Devine was recently reading about a colleague at a hospital in Yemen where garbage was simply incinerated. Why not move to lower-temperature incineration, she asked, or simply reduce waste in the first place? There are also the more obvious ways to cut down on excessive pollution: encouraging office workers in large cities to take public transit rather than driving. “Even if it’s imperfect, think ‘what is short-term, low-hanging fruit,’ and then think about the long-term questions that maybe need executive or board-level input,” Devine says. 

Improving MSF’s environmental footprint isn’t just about radical transformation in particular areas. It’s about discovering incremental improvements across MSF’s entire scope of operations.

Understanding the impact of a humanitarian organization through a climate lens may seem esoteric or terribly niche. For Devine, it isn’t. She stresses that MSF does not study climate change in a scientific capacity, but its medical teams see the real-world impact of climate change and how it affects patients. In Bangladesh’s capital city of Dhaka, for instance, lack of access to sanitation is a huge issue for many residents of the slum of Kamrangirchar. They live and work alongside polluted rivers where they are often forced to draw their water. Polluted conditions in factories also contributes to workplace-related illness. Why are so many people packed into Kamrangirchar in the first place? MSF points to migration from rural areas of Bangladesh due to decreasing crop yields. 

Meanwhile, in the Lake Chad region, droughts threaten the survival of whole populations. According to that 2018 brief with The Lancet Countdown, MSF workers witnessed the results of dry conditions in a region heavily dependent on agriculture. Nearly half of all child deaths in 2016 were related to malnutrition. In Ethopia’s Somali region in 2017, droughts killed off entire herds of cattle necessary for survival, meaning local herders lost their main source of both food and livelihood. They are often forced into refugee camps where potable water is scarce, child mortality skyrockets, and the potential for conflict over scarce resources is high. In the event of heavy rains — as was the case in South Sudan in 2012 — water-borne illnesses such as cholera can be a serious threat. These conditions are not unknown to MSF teams, but climate change can exacerbate their severity and deeply impact the people it serves. 

Understanding MSF’s own environmental footprint is also a boon for the organization itself, although it is nowhere near done its work. On top of trying to improve MSF’s supply chain, it is also trying to upgrade its toolkit’s waste measuring component, improve sustainability initiatives, and delve into alternatives to traditional finance. This includes green bonds and “related case studies on clean energy and sustainable initiatives to scale,” according to MSF’s website. “While we’re still in the exploratory phase, there’s positive interest.” 

MSF teams understand the impact climate change has on disasters, conflicts, and epidemics. Devine says responding to MSF’s footprint is also about improving the organization’s humanitarian mission. “We’re doing it because we understand there are health co-benefits to climate action,” she says. “We understand the potential cost savings. It’s accountability, it’s responsibility, and we want to be responsive.”

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