As one of the lowest-lying island nation-states in the world, the Republic of the Marshall Islands (RMI) is acutely vulnerable to sea-level rise, flooding, and the associated intrusion of saltwater into crucial freshwater supplies. Persistent, recurrent drought is also affecting agricultural production and access to drinking water.

The East-West Center is collaborating with the Marshall Islands Climate and Migration Project to conduct evidence-based research on climate-sensitive health risks in partnership with the Center’s The East-West Center’s Pacific Regional Integrated Sciences and Assessments (Pacific RISA)  program.

Within the Marshall Islands, substantial migration moves between islands, particularly from outer islands to the capital Majuro and to Ebeye, near the U.S. military base on Kwajalein. In addition, many Marshallese are migrating to the United States, so that nearly one-third of all Marshallese citizens now reside in the United States.

Understanding Migration

The factors triggering human migration are complex, making it difficult to pinpoint and address specific causes. In recent surveys, Marshallese living both in the RMI and the United States cited as motives for emigration better access to healthcare, education, and employment, as well as growing concern about the effects of climate change.

The health-related impacts of climate change are far reaching in Pacific atoll nations. Drought exacerbates existing water shortages and triggers both vector-borne and waterborne diseases, such as dengue fever, zika virus, gastroenteritis, and cholera. Freshwater contamination during storms and flooding exacerbates food- and waterborne illnesses, while salt water intrusion due to sea level rise destroys coastal crops and leads to a greater dependence on imported, often unhealthy foods. With the highest rates of diabetes and tuberculosis in the world, the nations of Micronesia are particularly vulnerable to new shocks to their already stressed healthcare systems.
Flooding in the Marshall Islands. Photo:

Improving the use of climate information can help communities in RMI and Marshallese communities in Hawaiʻi by informing health professionals, policymakers, and community organizations about climate-related health risks. For example, the RMI has been in a state of health emergency since mid-2019 due to an ongoing dengue outbreak. The first national RMI Climate Change and Health Dialog held in Majuro in January, focused on developing a framework for a climate early warning system that could help providers and aid groups better prepare for such outbreaks in the future. Next steps include collaboration with the Majuro National Weather Service Office and the RMI Ministry of Health and Human Services to establish critical thresholds and climate indicators for informed decision-making and development of the appropriate tools for disseminating the relevant information in a timely manner.

Participants at the First RMI National Climate Change and Health Dialog, including His Excellency, RMI President David Kabua (front row, center right) and the Honorable Minister of Health Bruce Bilimon (front row, center left). Photo: RMI Ministry of Health.