Regional Conference on “The Environments of the Poor in the Context of Climate Change and

the Green Economy: Making Sustainable Development Inclusive”

24-26 November 2010, New Delhi, India.

Flood induced diseases

among the urban poor
Case of Metro Manila,
Philippines

TRAN VIET NGA, National University of Civil Engineering,

Vietnam
KENSUKE FUKUSHI, IR3S, the University of Tokyo, Japan
The views expressed in this paper/presentation are the views of the author(s) and do not necessarily reflect the views or policies of
the Asian Development Bank (ADB), or its Board of Directors, or the governments they represent. ADB does not guarantee the
source, originality, accuracy, completeness or reliability of any statement, information, data, finding, interpretation, advice, opinion,
or view presented, nor does it make any representation concerning the same. 1
 JICA-WB-ADB Joint Study
Climate Risks and Adaptation in Asian Coastal Mega-Cities

Overall Framework JICA 　–　 ADB 　 –　 World Bank alliance

(Manila) (HoChiMin City) (Bangkok, Kolkata)

Case study of Metro Manila

Methodology JICA – IR3S alliance

E.g. JICA: Metro Manila

Coastal Engineering & Storm surge:
University of Ibaraki
City Case Studies River hydro: CTI International
Transport: ALMEC
Urban poor: Ateneo de Manila University
Firms: National Statistics Office
Health: University of Tokyo

- Urban planners, local governments

Solutions to - Concerted donor efforts
Operations (e.g. World Bank, ADB, bilateral donors)
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Background
• Low level sanitation
• Low education level – lack of
3 knowledge on infection
• Low accessibility to
medication

• Climate change: Increasing extreme event

• Rapid urbanization increases inundation
• Removal of excess water need power
(pump)
• Many Asian cities are developed in low land
at coastal area Infection

Septic
Pathogens tank
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 Urban inundation
4

Direct effects
• Personal property
damage
• Life loss
• Infrastructure damage

Indirect effects
• Infectious diseases
• Tourism

Flood in Hue, Sep. 2009

Photo provided by Quan

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Research Objectives

Characterize and quantify human

health risks associated with exposures
to pathogen in flood water

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 Flood Prone Areas in Metro Manila

KAMANAVA
Pasig-Marikina Basin
Area

West Mangahan Area

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7
Health risk assessment

 How many pathogenic organisms get into the human

body?
 Pathogen concentration of environment (drinking water,
showering water, flood water, water on/in food etc.)
 Level of exposure (time of showering, amount of drinking water
etc.)
 Dose-response relationship

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 Health risk assessment through
8 flood water
Walking
Pathogen
Cooking

Cleaning
Moving
furniture
Infection Washing

…. 8
Exposure assessment
Exposure Scenarios
Level Inundation depth Human behavior

I 0-50 cm most houses will stay dry and it is still possible to walk through the water
II 50-100 cm there will be at least 50 cm of water on the ground floor
III 100-200 cm the ground floor of the houses will be flooded
IV > 200 cm both the first floor and often also the roof will be covered by water.

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Calculation of Risk
POPULATION 6% 11 %

<4 5-14 15-59 > 60 19 %

0-4 year-old
5-14 year-old
year-old year-old year-old year-old 15-59 year-old
over 60 year-old
64 %

Outdoor time  Contact time with flood water

Daily activities and behaviors

of each groups of age were
Intake rate  ingestion volume examined and studied
through literature

Dose

Infection risk

TOTAL RISK 11
Pathogen’s dose-response model

Beta Poison model for E.Coli （ Haas et al., 1999 ）

Single infection risk

−α
 
P (d ) = 1 − 1 +
d 1/α
2 −1  ( )
 N 50 
d: dose
α 　　 = 0.1778
N50 　 = 8.6×107

Annual infection risk

Pannual = 1 − [1 − P (d )]
n

n: number of exposure times per year

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 Map of infectious people

Map of daily risk

Inundation data (scenarios) Inundation map

Population density by banranrays Map of population density

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Metro Manila - Population density map

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Metro Manila - Inundation map
Status-quo Inundation map A1F1 inundation map

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Metro Manila - Inundation map
Bridging between research and practice is challenging

Flood due to Not covered in our

insufficient drainage model due to lack of
lateral profile data

Not covered in
our model as it is
not overflow from
Pasig-Marikina
River

Area not covered

in our analysis

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Estimated daily risk and number of infected people in Metro
Manila

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 Single risk and annual risk associated with pathogen
exposure during flooding period
Group of Age Risk Inundation depth (cm)
< 50 50-100 100-200 >200

0-4 daily risk 0.001491 0.002968 0.005879 0.005879

total risk 0.029407 0.057715 0.111231 0.111231
5 to 14 daily risk 0.000598 0.001194 0.005879 0.011536
total risk 0.011898 0.023615 0.111231 0.207095
15 to 59 daily risk 0.000598 0.001194 0.005879 0.011536
total risk 0.011898 0.023615 0.111231 0.207095
>60 daily risk 0.000150 0.000299 0.001491 0.001491
total risk 0.002992 0.005972 0.029407 0.029407
Total daily risk 0.000674 0.001345 0.005631 0.010328
total risk 0.013398 0.026556 0.106796 0.187491

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Messages
 Risk of the poor contracting gastrointestinal illness due to E.Coli from incidental ingestion of flood
water in Manila over the course of a year varies according to inundation levels and age.
 Contact with flood water poses significant human health risks for residents in the flood-prone
region like Manila, and particularly for poor children and youth.
 To verify the results, evidence of group behaviour during floods, inundation water quality and
natural, social and economic data pertaining to the study area need to be collected.
 Aim of this analysis is to make a contribution to the quantification of climate change-related risks,
and to simulate further discussion and reflection of methodologies for undertaking quantitative
assessments. Quantifying such risks can assist in future health planning and community-based
natural disaster risk management

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Measurable health effects associated with water related-
activities in flood waters (Cabelli, 1982) 20
Thank you very much
for your kind attention

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