♪ mic [loud raindrops] narrator: torrential rain in the dry season. flooding when there's normally drought. desert where there used to be grass. ♪ music

narrator: tens of thousands of deaths in cities across europe from freak heat waves. even more taken to hospital. is this a taste of our future? dr. patrick kinney: climate change is already profoundly affecting public health across the globe. narrator: evidence is mounting that climate change is beginning to have a dramatic impact. so what will it mean for the health of the world's population? half of whom live in densely packed cities. ♪ music jakarta is a sprawling city of 14 million people. mosques and slums stand side-by-side with 21st century skyscrapers. 's an international, financial, and siness hub. ♪ music

motorbikes are still the best way to negotiate the gridlock. in the poorer parts of jakarta things are more basic as people struggle to make a living. but all across the city there is growing concern over a new and potentially lethal health threat. hospitals are dealing with more and more cases of a disease health experts in the city blame on climate change. ♪ music but already the people of jakarta are responding. these women e attempting to tackle the disease head-on. they're hunting for larvae. and if they are found, this is what happens. ♪ music smoking out the enemy. the process is called "fogging." pumping out clouds of insecticide to protect people from the mosquitoes which carry dengue fever.

♪ music the foggers work quickly covering whole areas at speed. the mosquitoes have nowhere to hide. ♪ music people can only stand by and watch. they know these are desperate measures. who knows if they will work. ♪ music around the world patterns of health and disease are changing. but how much of that is directly causedy climate change? >> with change climatic conditions there are vectors that are going to thrive much longer or on a much langer scale. and all of this would lead to a greater chance of disease. ♪ music [prayers chanted]

narrator: friday prayers and jakarta's largest mosque is packed solid. indonesia has the world's largest muslim population. but even prayers can't seem to hold back the relentlesmarch of the disease-carrying mosquitoes. a new case of dengue fever at one of jakarta's public hospitals, its victim completely listless. if she develops the most serious form the disease, she could die within hours from internal bleeding and shock. what is worrying dr. caroline mars is not just this girl's symptoms, but that she is seeing yet another case of dengue at this time of the year. traditionally dengue only strikes in the wet season. but koja hospital in north jakarta has been reporting at

least 10 new cases every day for weeks. and it's june, theoretically the dry season. narrator: the surge in dengue cases is clearly putting a huge strain on the hospital and its staff.

♪ music narrator: for jakarta, increasing outbreaks of diseases like dengue will have profound consequences. more and more people will be unable to work. ♪ music the signs are not good. dengue flourishes in urban environments. and jakarta is as urban as it gets. ♪ music ten-year-old rosalinda manurong has just been diagnosed with the most severe form of dengue: grade three hemorrhagic fever ♪ music she's in terrible pain and is critically ill. there is no

cure for dengue. her parents can only wait and hope she will pull through. narrator: there is no vaccine to prevent dengue. so the disease is sweeping through the district where rosalinda lives, transmitted by infected mosquitoes. her neighbors have already contracted dengue, so has her father. narrator: all the doctors can do for rosalinda is treat her symptoms and put her on a drip. if her condition deteriorates further and she develops internal bleeding, she will need a plasma transfusion. there are four strains of virus which cause dengue fever. most

are transmitted by the mosquito: aedes aegypti. when a person is bitten, they develop a fever which lasts three to seven days. and if things become serious, tiny red spots from internal bleeding. narrator: dengue expert dr. gustan syriam is alarmed by what he's seeing.

♪ music narrator: jakarta is the dengue capitol of indonesia. but it's a relatively new disease to the city. the first outbreak was in 1968. by 2004, there were nearly 21,000 cases and in 2007 more than 35,000. ♪ music buwhat is using th disturbing increase? university professor budi haryanto has a good idea.

♪ music [loud raindrops] narrator: these days dengue outbreaks regularly occur from january to june which includes the start of the dry season. but increasingly, it's not dry anymore. torrential downpours drench the city even in june, and with it comes flooding and pools of clean, warm water. it all adds up to ideal breeding conditions

for the dengue virus and the mosquitoes which carry it. narrator: it is not just health that will be affected by climate change in jakarta, as temperatures increase much of the city will also be vulnerable to sea-level rises.

the city is expanding. poorly controlled development means more is being built in low-lying areas. by 2025, jakarta could be about 60 centimeters lower. and much of this land may be underwater. for the people of jakarta all of this makes for worrying times. and the new weather patterns are not helping either. yaya fadlia's home is close to a river which burst its banks

during the rains. she and her family had to move in with relatives until the water subsided. in the past the area used to flood every five years or so. but now it's becoming an annual event. narrator: regular flooding has triggered a surge in dengue-carrying mosquitoes in yaya's small community. ♪ music last year there were 18 cases of the disease and fear of contracting it looms very large.

narrator: these days yaya is extra cautious, particularly when it comes to her children. she knows it's not the perfect solution but for now that's all she can do. millions of families in cities around the world are facing the same health concerns as dengue extends its grip. latest estimates predict that climate change will leave up to 60 percent of the world at risk, up from the current figure of 35 percent. dr. patrick kinney: well, dengue fever, which affects 50

to a hundred million people across the globe on an average year, is one of the diseases that are newly emerging, resurging, and redistributing on a global scale. narrator: other infectious diseases are also spreading according to climate change experts, especially those carried by insects, otherwise known as vectors. >> vector bond diseases are going to increase because with the change of climatic conditions. there are certain vectors that are going to thrive much longer, on a much larger scale, and all of this would lead to a greater chance of disease in those parts of the worlwhich peaps are immune to these diseases today. ♪ music narrator: five-year-old bulu hari has malaria. for the doctors at this hospital in the ugandan capitol kampala, his symptoms are frighteningly

familiar. narrator: nearly 1 million people, mostly young african children, die every year from the mosquito-borne disease. but the death toll could get even worse. recent studies show that in africa climate change could expose over 100 million more people to the risk of malaria by 2015, and over 170 million by 2035. for the countries affected, it will an an add burden on already stretched hospitals and on many struggling economies. ♪ music the impact can already be seen as malaria starts to spread to new parts of the world.

dr. kinney: we've seen a large outbreak of malaria in the highlands of bolivia. we're seeing mosquitoes at higher altitudes precisely where glaciers are retreating, plant communities are migrating upward, and the temperature of freezing is moving upward in the mountains. narrator: this is just the start of changes to come if climate change is underway. >> climate change will affect health in several ways. you know they're gng to be more freque, more severe, floods, droughts. now those have a direct impact on human health. narrator: sandstorms and droughts are creating new deserts in parts of africa. this in turn is triggering an increase in diseases like meningitis. dr. kinney: bacterial meningitis has reoccurred in the sahel region of africa. and drought may lead to these outbreaks by drying the mucus membranes and allowing

penetration of the bacteria. the malnutrition that results during drought and lack of food may also contribute to the susceptibility of bacterial meningitis. narrator: water-borne diseases like cholera and other causes of diarrhea are also predicted to rise by 8 pcent by 2020, as supplies of safe drinking water are wiped out by floods, droughts and contamination. dr. kinney: we're seeing changes occur more rapidly than even our models project, because of this issue of warming as one moves toward the poles, as well as the warming of winters. narrator: the difficulty for some scientists is how to determine which diseases are caused by normal climate fltuationsnd whichre triggered by a long-term shift in weather patterns. ♪ music until that is settled, the exact impact of climate change on

health will remain unclear making it difficult for governments to prepare. >> the pity of it is that there isn't enough work being done in this area. and some of you got to bring the medical community into partnership with the scientific community that's studying climate change. so that wcan assess what these impacts are ing to be different parts of the world and start taking measus that essentially prevent what's otherwise inevitable. narrator: for cities around the world where more than 50 percent of us currently live, these are criticalimes. while we wait for the scientists to act, is there anything we can do to protect ourselves from the march of nature and its trail of disease? in part two, the fight back begins.

[engine revving] narrator: jakarta is up in smoke. the capitol of indonesia is fighting back against the march of a disease which is becoming more and more deadly. dengue fever used to occur during jakarta's wet season, but the seasons are changing and so is dengue. now it is claiming vehicles all year round. housewife yaya fadlia prides herself on keeping her home clean and disease free. dengue has already claimed victims in her community, but she's determined to stop her children getting it. there's no vaccine to protect them, but she will do whatever it takes to keep her family safe. even this.

meet the jumantics, a neighborhood gang of sorts. yaya is a founder member. the jumantics are a squaof neighbors whose job is to check the community for larvae that could grow into fully fledged dengue mosquitoes. ♪ music every friday the jumantics, whh is sort of for the less catchy mosquito larvae monitoring group, head out to do battle with the insects. ♪ music

narrator: many families in jakarta store their water outside in open containers. the result, contamination with mosquito larvae.

narrator: the jumantics make their way around the entire neighborhood. it is time consuming but for yaya there is no alternative. narrator: 10-year-old rosalinda manurong is stl seriouy ill. she was admitted a week ago with a severe form of the disease: grade three dengue hemorrhagic fever. her mother is on round-the-clock watch, but apart from a drip, there's little that can be done to ease rosalinda's suffering.

narrator: the indonesian government is so worried by the flood of cases like rosalinda's, it's set up an emergency system to try to halt the spread of dengue. every time a new case is admitted, the hospital has to contact the patient's community headquarters within 24 hours. if more than one case is detectedn the district, then the city takes radical action. [engine revving] ♪ music these men are foggers. their mission, to kill the mosquitoes that spread dengue fever. they're out in force in the north of jakarta spraying insecticide. it's like a military operation. ♪ music [engine revving]

no building is left untouched. this is the community's only real hope of fighting off dengue for now. environmental expert budi haryanto is closely monitoring the city's fogging program. narrator: the dengue caring mosquito is a daytime mosquito. on average they can fly up to a hundred meters. by fumigating around them,he foggers hope to trap and kill them.

narrator: residents are supposed to be warned when the foggers are coming, but it >> welcome back to life in paris on france 24. these are your headlines at paris time. three years since the uprising in egypt and the state-oppression is worse than ever. 36 fighter jets and billions of dollars worth of bills. we are getting more on the state visit to india. and, pushed back until friday, the negotiations will go ahead.